Evaluation of Demineralized Dentin Matrix as a Scaffold for Revascularization in Immature Permanent Incisors: A Randomized Controlled Trial and an In -Vitro Study

Necrosis of the immature pulp not only is one of the multiple factors affecting long-term tooth endurance and preservation but also can act as a source of bacterial infection in the periapical area and even the maxillofacial spaces

• The use of regenerative endodontic techniques (RET) have gained popularity in the past decade with several endodontic and pediatric dentistry organization recognizing this technique as a viable technique for immature permanent teeth with necrotic pulps Regenerative endodontics are defined as biologically based techniques planned to physiologically replace impaired tooth structure, including dentin and root constructions, as well as cells of the pulp-dentin complex
• They offer the benefit of root lengthening, thickening, and subsequent apical closure which is not achievable with conventional nonsurgical endodontic treatment (NSET). The success rate of the blood clot (RET) in immature teeth has been reported to be 97.8% .The American Association of Endodontists and the European Society of Endodontology developed evidence-based protocols. To help reduce some of the differences in the RET steps such as EDTA ethylene diamine tetra acetic acid and sodium hypochlorite use, however, variations in terms of intracanal medicament, scaffold, and assessment tools still exist due to the lack of high-quality evidence

A fundamental component of the regenerative endodontic process is the presence of a scaffold for stem cells from the apical papilla to adhere, multiply and differentiate. Based on the results of many studies, the use of blood clot Regenerative procedure is not considered a true scaffold system. But it is an essential part of any appropriately designed tissue engineering regenerative endodontic strategy

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Different treatment options and scaffolds have been tested in regenerative endodontics. Only