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A new approach to root formation.
Mehdi Vatanpour1, Mina Zarei, Maryam Javidi
1Department of Endodontics, Dental School, Islamic Azad University , Tehran, Iran.
Iranian Endodontic Journal
|October 31, 2013
Summary
Promoting Hertwig
Area of Science:
- Endodontics
- Regenerative dentistry
Background:
- Treatment of open apex teeth with necrotic pulp presents a significant clinical challenge in endodontics.
- Root formation in immature teeth with open apices is often incomplete, complicating standard endodontic procedures.
Purpose of the Study:
- To investigate the potential for root formation in open apex teeth with necrotic pulp.
- To explore the role of Hertwig's epithelial root sheath remnants and epithelial rests of Malassez in root development.
Main Methods:
- Review of endodontic treatment principles for immature teeth.
- Discussion of the biological mechanisms involving epithelial remnants in root development.
- Emphasis on the importance of thorough root canal irrigation.
Main Results:
- The presence and promotion of Hertwig's epithelial root sheath remnants appear crucial for root formation.
- Epithelial rests of Malassez may also contribute to the regenerative process.
- Effective root canal irrigation is a key factor in facilitating these regenerative events.
Conclusions:
- Root formation in open apex teeth with necrotic pulp is achievable.
- Stimulating Hertwig's epithelial root sheath remnants and epithelial rests of Malassez, coupled with meticulous irrigation, can promote root development.

