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Published on: October 27, 2023
Regenerative Endodontics in Teeth With Irreversible Pulpitis: A Scoping Review
Mahmoud Torabinejad1, Neda Najafimakhsoos2, George Bogen3
1Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA.
International Endodontic Journal
|May 25, 2026
Summary
Regenerative endodontic procedures (REPs) show limited evidence for pulp regeneration in irreversible pulpitis (IP). While biologically plausible, vital pulp therapy (VPT) remains the preferred method for pulp preservation in these cases.
Area of Science:
- Endodontics
- Regenerative Dentistry
- Dental Materials Science
Background:
- Regenerative endodontic procedures (REPs) are increasingly utilized for pulpal pathologies, especially in immature teeth.
- Bioactive calcium silicate materials have advanced vital pulp therapy (VPT) and REPs.
- Current diagnostic criteria for irreversible pulpitis (IP) may overestimate pulp damage, as some pulps retain regenerative capacity.
Purpose of the Study:
- To conduct a scoping review evaluating evidence for using REPs to preserve and regenerate vital pulp tissue in teeth diagnosed with IP.
Main Methods:
- A comprehensive literature search was performed across multiple databases (MEDLINE, Web of Science, Cochrane Library, Scopus, Google Scholar).
- Manual citation searching was also conducted to ensure thorough literature coverage.
- Studies were selected based on predefined inclusion and exclusion criteria.
Main Results:
- Four case reports showed moderately successful pulp regeneration with REPs in immature permanent teeth with IP.
- Two case series and two case reports indicated comparable outcomes using REPs in mature permanent teeth with IP.
Conclusions:
- Clinical evidence supporting REPs for pulp regeneration in teeth with IP is currently limited.
- The biological basis for REPs in IP is conceptually strong, warranting future research.
- Vital pulp therapy (VPT) is currently the recommended approach for pulp preservation in teeth diagnosed with IP.
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