Tissue Engineering and Regenerative Endodontics

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procedure steps:

The procedure is applied in two visits as follows:

In visit 1, following anesthesia and isolation, the necrotic pulp space is accessed and debrided with
minimal instrumentation

and copious irrigation with lower concentration of 1.5% sodium hypochlorite. A medicament of
calcium hydroxide paste or an antibiotic mixture is placed and the tooth is temporarily

sealed for 1 to 4 weeks. Minocycline is not recommended

for anterior teeth because of tooth discoloration.

In visit 2, anesthesia is performed using 3% mepivacaine without vasoconstrictor to promote a blood

clot formation. Following isolation, the medicament is removed using copious irrigation with 17%
EDTA followed by drying. An endodontic instrument is then introduced 1 to 2 mm past the
radiographic apex to induce a blood clot formation to a level that allows 3 to 4 mm of restorative
material. A thin, resorbable collagen matrix is placed followed by white MTA or calcium hydroxide

as capping material. MTA may also discolor the crown of anterior teeth. The tooth is then restored
with a permanent restorative material