A comparative evaluation of regenerative endodontic therapy, vital pulp therapy and combination of regenerative endodontic and vital pulp therapy in permanent mature mandibular molar teeth with periapical lesions.

The foundation of restorative dentistry rest on principles that the maintenance of a healthy and functional pulp dentin complex would result in successful healing of exposed pulp. Like other connective tissue, pulp tissue has potential to heal. Root canal treatment is indicated in permanent mature teeth with pulpal and peri radicular diseases which involves complete removal of pulp tissue from the root canals, disinfection and restoring them with bioinert materials. Root canal treatment is non-conservative, non-biological and also expensive, time consuming and tooth becomes non-vital. The current scenario of endodontology has been shifted towards more biological treatment. The pulp dentin complex has the potential to regenerates even if the tooth has symptoms indicative of irreversible pulpitis. Pulpitis caused by caries is the main reason for root canal treatment. Instead of complete pulp tissue removal by pulpectomy, combined regenerative endodontic and vital pulp therapy is a conservative therapy as regenerative endodontic procedure is a biological based procedure that regenerate and repairs lost tooth structure and vital pulp therapy focuses on preserving and promoting the health of the remaining vital pulp tissue.