Revitalization Treatment in Endodontics: A State-Of-The-Art Review

Ten years after the European Society of Endodontology (ESE) issued its inaugural Position Statement in 2016, revitalization (BrE: revitalisation) treatment has progressed from an experimental approach to a cornerstone of contemporary endodontic practice. This state-of-the-art review provides a comprehensive synthesis of the biological and clinical advances that have redefined the treatment options for permanent teeth with incomplete root formation after loss of pulp vitality, as well as broader applications beyond these cases. The review refines case selection by integrating biological potential with clinical aetiology and extended applications for revitalization, while evaluating the role of modern diagnostic and operative aids in enhancing procedural precision. It details technical protocols ranging from evidence-based irrigation to the precise placement of barriers and definitive restorations, ensuring a seamless transition from disinfection to long-term structural stability. Beyond methodological refinements, there is growing awareness of prognosis in relation to specific case constellations, accompanied by clearer articulation of realistic treatment aims. These aims prioritize the absence of signs and symptoms of infection and long-term tooth survival, while increasingly emphasizing patient-centred outcomes. Furthermore, the review explores the practical intersection of revitalization and orthodontic management and presents a proactive framework for early recognition and management of complications and procedural failures. By delineating these clinical boundaries, it offers a contemporary basis for clinical decision-making and supports the upcoming update of the ESE Position Statement.