370 - Scaffolds Used in Regenerative Endodontics: an Analysis of In-Vivo Studies

Background: Regenerative endodontics is a treatment which provides several benefits including its ability to restore pulpal components and functions including continued root development and apical closure for necrotic immature permanent teeth. Recent advancements in tissue engineering have identified three critical components - stem cells, growth factors, and scaffolds - and their spatial and temporal assembly as the foundation of pulpal tissue regeneration. Dental providers at Boston Children’s Hospital have encountered some difficulty in achieving the formation of a blood clot as a scaffold. In addition to this challenge, blood clots also lack certain properties of an ideal scaffold such as the incorporation of growth factors and appropriate mechanical properties.

Methods: A literature review was conducted on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRIMSA-ScR) Checklist. A total of 341 articles were reviewed; of these, 12 met our inclusive criteria.

Conclusions: Current literature demonstrates that platelet rich (PRP, PRF) biological scaffolds have numerous in-vivo studies that demonstrate adequate comparable success rates to the traditional blood clot (BC) scaffold. Current literature lacks well designed in-vivo studies involving scaffolds that are synthetic or derived from other biological sources. Additional research is necessary in order to identify novel scaffolds and to further improve overall success rates for regenerative treatment for the necrotic immature permanent tooth.