Pulp Regenerative Therapy Using Autologous Dental Pulp Stem Cells in a Mature Tooth with Apical Periodontitis: A Case...

Area of Science:

• Dentistry
• Regenerative Medicine
• Stem Cell Therapy

Background:

• Pulp regenerative therapy using autologous dental pulp stem cells (DPSCs) is established for irreversible pulpitis in mature teeth.
• Evidence for DPSC utility in mature teeth with apical periodontitis is lacking.
• This case report investigates the potential of DPSC therapy for apical periodontitis.

Observation:

• A 44-year-old patient with a periapical lesion in a maxillary first premolar underwent pulp regeneration.
• Root canal disinfection utilized nanobubbles with levofloxacin and amphotericin B, alongside conventional irrigation.
• Autologous DPSCs were transplanted after microbial decontamination confirmed by PCR.

Findings:

• The 79-week follow-up showed no adverse events or toxicity.
• The treated tooth responded to electric pulp testing.
• CBCT imaging revealed reduced lesion size, periapical tissue remission, and mineralized tissue formation.
• MRI showed regenerated tissue signal intensity comparable to normal pulp after 24 weeks.

Implications:

• This case demonstrates the potential of DPSCs for pulp regeneration in mature teeth with apical periodontitis.
• Regenerative cell therapy offers a viable alternative for treating apical periodontitis.
• Further research is warranted to validate DPSC efficacy in larger clinical trials.