Recent Advances in Regenerative Endodontics: Clinical Applications and Challenges

Abstract

This study aims to examine recent advances in regenerative endodontics, focusing on its clinical applications, challenges, and future prospects in modern dental practice. A descriptive narrative review was conducted, analyzing peer-reviewed literature published between 2019 and 2024. Studies were selected from major databases, including PubMed, Scopus, and Web of Science, using keywords related to regenerative endodontics, stem cell therapy, biomaterials, and clinical applications. The review synthesized findings on the biological principles of pulp regeneration, recent technological advancements, and the clinical effectiveness of regenerative endodontic procedures. Emphasis was placed on the role of stem cells, scaffolds, growth factors, and biomaterials in tissue engineering. Additionally, challenges such as biological variability, technical limitations, and ethical considerations were explored to provide a comprehensive perspective on the feasibility of regenerative therapies in standard endodontic practice. The analysis revealed that regenerative endodontics has significantly evolved through innovations in stem cell-based therapies, biomaterial scaffolds, and growth factor delivery systems. Clinical studies demonstrated successful pulp revascularization and continued root development in necrotic immature teeth, offering a biologically superior alternative to conventional apexification. The integration of platelet-rich fibrin, hydrogels, and nanomaterials has improved scaffold functionality, while gene therapy and 3D bioprinting show promise for future applications. However, challenges such as inconsistent treatment outcomes, immune responses, and the lack of standardized protocols remain obstacles to widespread clinical adoption. Economic barriers and ethical concerns regarding stem cell sourcing further complicate the translation of regenerative therapies into routine dental practice. Regenerative endodontics represents a paradigm shift in modern dentistry, providing an alternative to traditional root canal therapy by restoring pulp vitality and promoting natural tooth development. Despite ongoing challenges, advancements in biomaterials, stem cell technology, and molecular signaling offer promising avenues for enhancing treatment predictability and accessibility. Further research, clinical trials, and regulatory frameworks are essential to establish regenerative endodontics as a mainstream treatment modality.