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Current and Future Views on Disinfection for Regenerative Strategies

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Abstract

Therapeutics in dentistry commonly aim at the prosthetic restoration of diseased teeth. However, treatments such as vital pulp therapies (VPTs) and regenerative endodontic procedures (REPs) apply principles of wound healing and tissue engineering that provide unique outcomes aimed at restoring damaged tissues of the tooth. Appropriate functioning of stem cells and its microenvironment is therefore critical in accomplishing successful outcomes. Since a microbial aetiology underlies the majority of dental diseases, disinfection of the injured tissue becomes an essential criterion for an optimal regenerative outcome. Existing evidence strongly supports an altered regenerative outcome in the absence of adequate decontamination. Several anti-infective interventions have therefore been proposed that target the microbial flora infecting the dental pulp. However, an ideal disinfectant is one that not only reduces bacterial load but also one that maintains the viability and function of stem cells. This chapter reviews evidence for the role of microorganisms and tissue destruction on stem cell function as well as available strategies to find a balance between disinfection and regeneration.

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References

  • Abe S, Imaizumi M, Mikami Y, Wada Y, Tsuchiya S, Irie S et al (2010) Oral bacterial extracts facilitate early osteogenic/dentinogenic differentiation in human dental pulp-derived cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(1):149–154

    Article  PubMed  Google Scholar 

  • Akcay M, Sari S, Duruturk L, Gunhan O (2015) Effects of sodium hypoclorite as disinfectant material previous to pulpotomies in primary teeth. Clin Oral Investig 19(4):803–811

    Article  PubMed  Google Scholar 

  • Akman M, Akbulut MB, Aydinbelge HA, Belli S (2015) Comparison of different irrigation activation regimens and conventional irrigation techniques for the removal of modified triple antibiotic paste from root canals. J Endod 41(5):720–724

    Article  PubMed  Google Scholar 

  • Albuquerque MTP, Nagata J, Bottino MC (2017) Antimicrobial efficacy of triple antibiotic-eluting polymer nanofibers against multispecies biofilm. J Endod 43(9S):S51–SS6

    Article  PubMed  PubMed Central  Google Scholar 

  • Alghilan MA, Windsor LJ, Palasuk J, Yassen GH (2017) Attachment and proliferation of dental pulp stem cells on dentine treated with different regenerative endodontic protocols. Int Endod J 50(7):667–675

    Article  PubMed  Google Scholar 

  • Alobaid AS, Cortes LM, Lo J, Nguyen TT, Albert J, Abu-Melha AS et al (2014) Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study. J Endod 40(8):1063–1070

    Article  PubMed  PubMed Central  Google Scholar 

  • Althumairy RI, Teixeira FB, Diogenes A (2014) Effect of dentin conditioning with intracanal medicaments on survival of stem cells of apical papilla. J Endod 40(4):521–525

    Article  PubMed  Google Scholar 

  • Basrani BR, Manek S, Sodhi RN, Fillery E, Manzur A (2007) Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod 33(8):966–969

    Article  PubMed  Google Scholar 

  • Baumgartner JC, Xia T (2003) Antibiotic susceptibility of bacteria associated with endodontic abscesses. J Endod 29(1):44–47

    Article  PubMed  Google Scholar 

  • Bimstein E, Rotstein I (2016) Cvek pulpotomy - revisited. Dent Traumatol 32(6):438–442

    Article  PubMed  Google Scholar 

  • Buck RA, Cai J, Eleazer PD, Staat RH, Hurst HE (2001) Detoxification of endotoxin by endodontic irrigants and calcium hydroxide. J Endod 27(5):325–327

    Article  PubMed  Google Scholar 

  • Bui TB, Baumgartner JC, Mitchell JC (2008) Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin. J Endod 34(2):181–185

    Article  PubMed  Google Scholar 

  • Bystrom A, Sundqvist G (1985) The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 18(1):35–40

    Article  PubMed  Google Scholar 

  • Casagrande L, Demarco FF, Zhang Z, Araujo FB, Shi S, Nor JE (2010) Dentin-derived BMP-2 and odontoblast differentiation. J Dent Res 89(6):603–608

    Article  PubMed  Google Scholar 

  • Chen SM, Ward SI, Olutoye OO, Diegelmann RF, Kelman Cohen I (1997) Ability of chronic wound fluids to degrade peptide growth factors is associated with increased levels of elastase activity and diminished levels of proteinase inhibitors. Wound Repair Regen 5(1):23–32

    Article  PubMed  Google Scholar 

  • Chen L, Zheng L, Jiang J, Gui J, Zhang L, Huang Y et al (2016) Calcium hydroxide-induced proliferation, migration, osteogenic differentiation, and mineralization via the mitogen-activated protein kinase pathway in human dental pulp stem cells. J Endod 42(9):1355–1361

    Article  PubMed  Google Scholar 

  • Chrepa V, Henry MA, Daniel BJ, Diogenes A (2015) Delivery of apical mesenchymal stem cells into root canals of mature teeth. J Dent Res 94(12):1653–1659

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohenca N, Heilborn C, Johnson JD, Flores DS, Ito IY, da Silva LA (2010) Apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing on root canal disinfection in dog teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(1):e42–e46

    Article  PubMed  Google Scholar 

  • van der Sluis LW, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40(6):415–426

    Article  PubMed  Google Scholar 

  • Desai P, Himel V (2009) Comparative safety of various intracanal irrigation systems. J Endod 35(4):545–549

    Article  PubMed  Google Scholar 

  • Diogenes A, Henry MA, Teixeira FB, Hargreaves KM (2013) An update on clinical regenerative endodontics. Endod Topics 28(1):2–23

    Article  Google Scholar 

  • Diogenes AR, Ruparel NB, Teixeira FB, Hargreaves KM (2014) Translational science in disinfection for regenerative endodontics. J Endod 40(4 Suppl):S52–S57

    Article  PubMed  Google Scholar 

  • Fouad AF, Verma P (2014) Healing after regenerative procedures with and without pulpal infection. J Endod 40(4 Suppl):S58–S64

    Article  PubMed  Google Scholar 

  • Frantz C, Stewart KM, Weaver VM (2010) The extracellular matrix at a glance. J Cell Sci 123(Pt 24):4195–4200

    Article  PubMed  PubMed Central  Google Scholar 

  • Galler KM, D’Souza RN, Federlin M, Cavender AC, Hartgerink JD, Hecker S et al (2011) Dentin conditioning codetermines cell fate in regenerative endodontics. J Endod 37(11):1536–1541

    Article  PubMed  Google Scholar 

  • Galler KM, Buchalla W, Hiller KA, Federlin M, Eidt A, Schiefersteiner M et al (2015) Influence of root canal disinfectants on growth factor release from dentin. J Endod 41(3):363–368

    Article  PubMed  Google Scholar 

  • Galler KM, Widbiller M, Buchalla W, Eidt A, Hiller KA, Hoffer PC et al (2016) EDTA conditioning of dentine promotes adhesion, migration and differentiation of dental pulp stem cells. Int Endod J 49(6):581–590

    Article  PubMed  Google Scholar 

  • Garcia-Godoy F, Murray PE (2012) Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol 28(1):33–41

    Article  PubMed  Google Scholar 

  • Gomes BP, Jacinto RC, Pinheiro ET, Sousa EL, Zaia AA, Ferraz CC et al (2006) Molecular analysis of Filifactor alocis, Tannerella forsythia, and treponema denticola associated with primary endodontic infections and failed endodontic treatment. J Endod 32(10):937–940

    Article  PubMed  Google Scholar 

  • Gomes BP, Montagner F, Jacinto RC, Zaia AA, Ferraz CC, Souza-Filho FJ (2007) Polymerase chain reaction of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in primary endodontic infections. J Endod 33(9):1049–1052

    Article  PubMed  Google Scholar 

  • Graham L, Cooper PR, Cassidy N, Nor JE, Sloan AJ, Smith AJ (2006) The effect of calcium hydroxide on solubilisation of bio-active dentine matrix components. Biomaterials 27(14):2865–2873

    Article  PubMed  Google Scholar 

  • Hafez AA, Cox CF, Tarim B, Otsuki M, Akimoto N (2002) An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one- or two-component adhesive system in exposed nonhuman primate pulps. Quintessence Int 33(4):261–272

    PubMed  Google Scholar 

  • Hand RE, Smith ML, Harrison JW (1978) Analysis of the effect of dilution on the necrotic tissue dissolution property of sodium hypochlorite. J Endod 4(2):60–64

    Article  PubMed  Google Scholar 

  • Harrison JW, Hand RE (1981) The effect of dilution and organic matter on the anti-bacterial property of 5.25% sodium hypochlorite. J Endod 7(3):128–132

    Article  PubMed  Google Scholar 

  • Harrison JW, Wagner GW, Henry CA (1990) Comparison of the antimicrobial effectiveness of regular and fresh scent Clorox. J Endod 16(7):328–330

    Article  PubMed  Google Scholar 

  • Hockett JL, Dommisch JK, Johnson JD, Cohenca N (2008) Antimicrobial efficacy of two irrigation techniques in tapered and nontapered canal preparations: an in vitro study. J Endod 34(11):1374–1377

    Article  PubMed  Google Scholar 

  • Hoshino E, Kurihara-Ando N, Sato I, Uematsu H, Sato M, Kota K et al (1996) In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 29(2):125–130

    Article  PubMed  Google Scholar 

  • Huang GT, Garcia-Godoy F (2014) Missing concepts in de novo pulp regeneration. J Dent Res 93(8):717–724

    Article  PubMed  PubMed Central  Google Scholar 

  • Huang GT, Yamaza T, Shea LD, Djouad F, Kuhn NZ, Tuan RS et al (2010) Stem/progenitor cell-mediated de novo regeneration of dental pulp with newly deposited continuous layer of dentin in an in vivo model. Tissue Eng Part A 16(2):605–615

    Article  PubMed  Google Scholar 

  • Iohara K, Imabayashi K, Ishizaka R, Watanabe A, Nabekura J, Ito M et al (2011) Complete pulp regeneration after pulpectomy by transplantation of CD105+ stem cells with stromal cell-derived factor-1. Tissue Eng Part A 17(15-16):1911–1920

    Article  PubMed  Google Scholar 

  • Jacobs JC, Troxel A, Ehrlich Y, Spolnik K, Bringas JS, Gregory RL et al (2017) Antibacterial effects of antimicrobials used in regenerative endodontics against biofilm bacteria obtained from mature and immature teeth with necrotic pulps. J Endod 43(4):575–579

    Article  PubMed  Google Scholar 

  • Ji YM, Jeon SH, Park JY, Chung JH, Choung YH, Choung PH (2010) Dental stem cell therapy with calcium hydroxide in dental pulp capping. Tissue Eng Part A 16(6):1823–1833

    Article  PubMed  Google Scholar 

  • Jungermann GB, Burns K, Nandakumar R, Tolba M, Venezia RA, Fouad AF (2011) Antibiotic resistance in primary and persistent endodontic infections. J Endod 37(10):1337–1344

    Article  PubMed  PubMed Central  Google Scholar 

  • Kakoli P, Nandakumar R, Romberg E, Arola D, Fouad AF (2009) The effect of age on bacterial penetration of radicular dentin. J Endod 35(1):78–81

    Article  PubMed  PubMed Central  Google Scholar 

  • Kato H, Taguchi Y, Tominaga K, Umeda M, Tanaka A (2014) Porphyromonas gingivalis LPS inhibits osteoblastic differentiation and promotes pro-inflammatory cytokine production in human periodontal ligament stem cells. Arch Oral Biol 59(2):167–175

    Article  PubMed  Google Scholar 

  • Kilpadi KL, Sawyer AA, Prince CW, Chang PL, Bellis SL (2004) Primary human marrow stromal cells and Saos-2 osteosarcoma cells use different mechanisms to adhere to hydroxylapatite. J Biomed Mater Res A 68((2):273–285

    Article  Google Scholar 

  • Kitikuson P, Srisuwan T (2016) Attachment ability of human apical papilla cells to root dentin surfaces treated with either 3mix or calcium hydroxide. J Endod 42(1):89–94

    Article  PubMed  Google Scholar 

  • Kodonas K, Gogos C, Papadimitriou S, Kouzi-Koliakou K, Tziafas D (2012) Experimental formation of dentin-like structure in the root canal implant model using cryopreserved swine dental pulp progenitor cells. J Endod 38(7):913–919

    Article  PubMed  Google Scholar 

  • Kontakiotis EG, Filippatos CG, Tzanetakis GN, Agrafioti A (2015) Regenerative endodontic therapy: a data analysis of clinical protocols. J Endod 41(2):146–154

    Article  PubMed  Google Scholar 

  • Latham J, Fong H, Jewett A, Johnson JD, Paranjpe A (2016) Disinfection efficacy of current regenerative endodontic protocols in simulated necrotic immature permanent teeth. J Endod 42(8):1218–1225

    Article  PubMed  Google Scholar 

  • Lei L, Chen Y, Zhou R, Huang X, Cai Z (2015) Histologic and immunohistochemical findings of a human immature permanent tooth with apical periodontitis after regenerative endodontic treatment. J Endod 41(7):1172–1179

    Article  PubMed  Google Scholar 

  • Lessa FC, Aranha AM, Nogueira I, Giro EM, Hebling J, Costa CA (2010) Toxicity of chlorhexidine on odontoblast-like cells. J Appl Oral Sci 18(1):50–58

    Article  PubMed  PubMed Central  Google Scholar 

  • Lin LM, Shimizu E, Gibbs JL, Loghin S, Ricucci D (2014) Histologic and histobacteriologic observations of failed revascularization/revitalization therapy: a case report. J Endod 40(2):291–295

    Article  PubMed  Google Scholar 

  • Lovelace TW, Henry MA, Hargreaves KM, Diogenes A (2011) Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. J Endod 37(2):133–138

    Article  PubMed  Google Scholar 

  • Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L (2013) Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. J Endod 39(11):1456–1460

    Article  PubMed  Google Scholar 

  • Manochehrifar H, Parirokh M, Kakooei S, Oloomi MM, Asgary S, Eghbal MJ et al (2016) The effect of mineral trioxide aggregate mixed with chlorhexidine as direct pulp capping agent in dogs teeth: a histologic study. Iranian Endod J 11(4):320–324

    Google Scholar 

  • Mansbridge J (2008) Skin tissue engineering. J Biomater Sci Polym Ed 19(8):955–968

    Article  PubMed  Google Scholar 

  • Martin DE, Henry MA, Almeida JFA, Teixeira FB, Hargreaves KM, Diogenes AR (2012) Effect of sodium hypochlorite on the odontoblastic phenotype differentiation of SCAP in cultured organotype human roots. J Endod 38(3):e26

    Google Scholar 

  • Martin G, Ricucci D, Gibbs JL, Lin LM (2013) Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma. J Endod 39(1):138–144

    Article  PubMed  Google Scholar 

  • Martinho FC, Gomes BP (2008) Quantification of endotoxins and cultivable bacteria in root canal infection before and after chemomechanical preparation with 2.5% sodium hypochlorite. J Endod 34(3):268–272

    Article  PubMed  Google Scholar 

  • Meschi N, Hilkens P, Lambrichts I, Van den Eynde K, Mavridou A, Strijbos O et al (2016) Regenerative endodontic procedure of an infected immature permanent human tooth: an immunohistological study. Clin Oral Investig 20(4):807–814

    Article  PubMed  Google Scholar 

  • Morsczeck CO, Drees J, Gosau M (2012) Lipopolysaccharide from Escherichia coli but not from Porphyromonas gingivalis induce pro-inflammatory cytokines and alkaline phosphatase in dental follicle cells. Arch Oral Biol 57(12):1595–1601

    Article  PubMed  Google Scholar 

  • Nagata JY, Soares AJ, Souza-Filho FJ, Zaia AA, Ferraz CC, Almeida JF et al (2014) Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2% chlorhexidine gel in pulp revascularization. J Endod 40(6):778–783

    Article  PubMed  Google Scholar 

  • Nair PN, Henry S, Cano V, Vera J (2005) Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99(2):231–252

    Article  PubMed  Google Scholar 

  • Nowzari H, Matian F, Slots J (1995) Periodontal pathogens on polytetrafluoroethylene membrane for guided tissue regeneration inhibit healing. J Clin Periodontol 22(6):469–474

    Article  PubMed  Google Scholar 

  • Okino LA, Siqueira EL, Santos M, Bombana AC, Figueiredo JA (2004) Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel. Int Endod J 37(1):38–41

    Article  PubMed  Google Scholar 

  • Oliveira LD, Carvalho CA, Carvalho AS, Alves Jde S, Valera MC, Jorge AO (2012) Efficacy of endodontic treatment for endotoxin reduction in primarily infected root canals and evaluation of cytotoxic effects. J Endod 38(8):1053–1057

    Article  PubMed  Google Scholar 

  • Pankajakshan D, Albuquerque MT, Evans JD, Kamocka MM, Gregory RL, Bottino MC (2016) Triple antibiotic polymer nanofibers for intracanal drug delivery: effects on dual species biofilm and cell function. J Endod 42(10):1490–1495

    Article  PubMed  PubMed Central  Google Scholar 

  • Payne WG, Wright TE, Ko F, Wang X, Robson MC (2002) Bacterial degradation of growth factor. J Appl Res Clin Exp Therap 3(1)

    Google Scholar 

  • Peng C, Zhao Y, Wang W, Yang Y, Qin M, Ge L (2017) Histologic findings of a human immature revascularized/regenerated tooth with symptomatic irreversible pulpitis. J Endod 43(6):905–909

    Article  PubMed  Google Scholar 

  • Pinto N, Harnish A, Cabrera C, Andrade C, Druttman T, Brizuela C (2017) An innovative regenerative endodontic procedure using leukocyte and platelet-rich fibrin associated with apical surgery: a case report. J Endod 43(11):1828–1834

    Article  PubMed  Google Scholar 

  • Ring KC, Murray PE, Namerow KN, Kuttler S, Garcia-Godoy F (2008) The comparison of the effect of endodontic irrigation on cell adherence to root canal dentin. J Endod 34(12):1474–1479

    Article  PubMed  Google Scholar 

  • Roberts-Clark DJ, Smith AJ (2000) Angiogenic growth factors in human dentine matrix. Arch Oral Biol 45(11):1013–1016

    Article  PubMed  Google Scholar 

  • Robson MC (1997) Wound infection. A failure of wound healing caused by an imbalance of bacteria. Surg Clin North Am 77(3):637–650

    Article  PubMed  Google Scholar 

  • Rosenfeld EF, James GA, Burch BS (1978) Vital pulp tissue response to sodium hypochlorite. J Endod 4(5):140–146

    Article  PubMed  Google Scholar 

  • Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A (2012) Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod 38(10):1372–1375

    Article  PubMed  Google Scholar 

  • Sabrah AH, Yassen GH, Spolnik KJ, Hara AT, Platt JA, Gregory RL (2015) Evaluation of residual antibacterial effect of human radicular dentin treated with triple and double antibiotic pastes. J Endod 41(7):1081–1084

    Article  PubMed  Google Scholar 

  • Sander L, Karring T (1995) New attachment and bone formation in periodontal defects following treatment of submerged roots with guided tissue regeneration. J Clin Periodontol 22(4):295–299

    Article  PubMed  Google Scholar 

  • Saoud TM, Zaazou A, Nabil A, Moussa S, Lin LM, Gibbs JL (2014) Clinical and radiographic outcomes of traumatized immature permanent necrotic teeth after revascularization/revitalization therapy. J Endod 40(12):1946–1952

    Article  PubMed  PubMed Central  Google Scholar 

  • Sato T, Hoshino E, Uematsu H, Kota K, Iwaku M, Noda T (1992) Bactericidal efficacy of a mixture of ciprofloxacin, metronidazole, minocycline and rifampicin against bacteria of carious and endodontic lesions of human deciduous teeth in vitro. Microbial Ecol Health Dis 5(4):171–177

    Article  Google Scholar 

  • Sato T, Hoshino E, Uematsu H, Noda T (1993) In vitro antimicrobial susceptibility to combinations of drugs of bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol 8(3):172–176

    Article  PubMed  Google Scholar 

  • Sato I, Ando-Kurihara N, Kota K, Iwaku M, Hoshino E (1996) Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J 29(2):118–124

    Article  PubMed  Google Scholar 

  • Sawyer AA, Hennessy KM, Bellis SL (2005) Regulation of mesenchymal stem cell attachment and spreading on hydroxyapatite by RGD peptides and adsorbed serum proteins. Biomaterials 26(13):1467–1475

    Article  PubMed  Google Scholar 

  • Shimizu E, Jong G, Partridge N, Rosenberg PA, Lin LM (2012) Histologic observation of a human immature permanent tooth with irreversible pulpitis after revascularization/regeneration procedure. J Endod 38(9):1293–1297

    Article  PubMed  Google Scholar 

  • Shimizu E, Ricucci D, Albert J, Alobaid AS, Gibbs JL, Huang GT et al (2013) Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment. J Endod 39(8):1078–1083

    Article  PubMed  Google Scholar 

  • Shrestha A, Cordova M, Kishen A (2015) Photoactivated polycationic bioactive chitosan nanoparticles inactivate bacterial endotoxins. J Endod 41(5):686–691

    Article  PubMed  Google Scholar 

  • da Silva LA, Nelson-Filho P, da Silva RA, Flores DS, Heilborn C, Johnson JD et al (2010) Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs’ teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(5):779–787

    Article  PubMed  Google Scholar 

  • Siqueira JF Jr, Rocas IN (2008) Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 34(11):1291–301.e3

    Article  PubMed  Google Scholar 

  • Slomiany BL, Piotrowski L, Slomiany A (1996) Susceptibility of growth factors to degradation by Helicobacter pylori protease: effect of ebrotidine and eucralfate. Biochem Mol Biol Int 40(1):209–215

    PubMed  Google Scholar 

  • Smith MacDonald E, Nowzari H, Contreras A, Flynn J, Morrison J, Slots J (1998) Clinical and microbiological evaluation of a bioabsorbable and a nonresorbable barrier membrane in the treatment of periodontal intraosseous lesions. J Periodontol 69(4):445–453

    Article  PubMed  Google Scholar 

  • Smith AJ, Smith JG, Shelton RM, Cooper PR (2012) Harnessing the natural regenerative potential of the dental pulp. Dent Clin N Am 56(3):589–601

    Article  PubMed  Google Scholar 

  • Smith AJ, Duncan HF, Diogenes A, Simon S, Cooper PR (2016) Exploiting the bioactive properties of the dentin-pulp complex in regenerative endodontics. J Endod 42(1):47–56

    Article  PubMed  Google Scholar 

  • de Souza LB, de Aquino SG, de Souza PP, Hebling J, Costa CA (2007) Cytotoxic effects of different concentrations of chlorhexidine. Am J Dent 20(6):400–404

    PubMed  Google Scholar 

  • Stadelmann WK, Digenis AG, Tobin GR (1998) Impediments to wound healing. Am J Surg 176(2A Suppl):39S–47S

    Article  PubMed  Google Scholar 

  • Thomas MV, Puleo DA (2011) Infection, inflammation, and bone regeneration: a paradoxical relationship. J Dent Res 90(9):1052–1061

    Article  PubMed  PubMed Central  Google Scholar 

  • Torabinejad M, Milan M, Shabahang S, Wright KR, Faras H (2015) Histologic examination of teeth with necrotic pulps and periapical lesions treated with 2 scaffolds: an animal investigation. J Endod 41(6):846–852

    Article  PubMed  Google Scholar 

  • Torabinejad M, Nosrat A, Verma P, Udochukwu O (2017) Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod 43(11):1806–1820

    Article  PubMed  Google Scholar 

  • Trevino EG, Patwardhan AN, Henry MA, Perry G, Dybdal-Hargreaves N, Hargreaves KM et al (2011) Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips. J Endod 37(8):1109–1115

    Article  PubMed  Google Scholar 

  • Trombelli L, Schincaglia GP, Scapoli C, Calura G (1995) Healing response of human buccal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report. J Periodontol 66(1):14–22

    Article  PubMed  Google Scholar 

  • Tuzuner T, Alacam A, Altunbas DA, Gokdogan FG, Gundogdu E (2012) Clinical and radiographic outcomes of direct pulp capping therapy in primary molar teeth following haemostasis with various antiseptics: a randomised controlled trial. Eur J Paediatr Dent 13(4):289–292

    PubMed  Google Scholar 

  • Verma P, Nosrat A, Kim JR, Price JB, Wang P, Bair E et al (2017) Effect of residual bacteria on the outcome of pulp regeneration in vivo. J Dent Res 96(1):100–106

    Article  PubMed  Google Scholar 

  • Vianna ME, Horz HP, Gomes BP, Conrads G (2006) In vivo evaluation of microbial reduction after chemo-mechanical preparation of human root canals containing necrotic pulp tissue. Int Endod J 39(6):484–492

    Article  PubMed  Google Scholar 

  • Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S (2018) Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 51:605

    Article  PubMed  Google Scholar 

  • Vishwanat L, Duong R, Takimoto K, Phillips L, Espitia CO, Diogenes A et al (2017) Effect of bacterial biofilm on the osteogenic differentiation of stem cells of apical papilla. J Endod 43(6):916–922

    Article  PubMed  Google Scholar 

  • Ward CL, Sanchez CJ Jr, Pollot BE, Romano DR, Hardy SK, Becerra SC et al (2015) Soluble factors from biofilms of wound pathogens modulate human bone marrow-derived stromal cell differentiation, migration, angiogenesis, and cytokine secretion. BMC Microbiol 15:75

    Article  PubMed  PubMed Central  Google Scholar 

  • Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M (2005) Disinfection of immature teeth with a triple antibiotic paste. J Endod 31(6):439–443

    Article  PubMed  Google Scholar 

  • Yang SF, Rivera EM, Baumgardner KR, Walton RE, Stanford C (1995) Anaerobic tissue-dissolving abilities of calcium hydroxide and sodium hypochlorite. J Endod 21(12):613–616

    Article  PubMed  Google Scholar 

  • Yassen GH, Eckert GJ, Platt JA (2015) Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restor Dent Endod 40(2):104–112

    Article  PubMed  Google Scholar 

  • Yilmaz S, Dumani A, Yoldas O (2016) The effect of antibiotic pastes on microhardness of dentin. Dent Traumatol 32(1):27–31

    Article  PubMed  Google Scholar 

  • Yoshinari N, Tohya T, Mori A, Koide M, Kawase H, Takada T et al (1998) Inflammatory cell population and bacterial contamination of membranes used for guided tissue regenerative procedures. J Periodontol 69(4):460–469

    Article  PubMed  Google Scholar 

  • Yoshinari N, Tohya T, Kawase H, Matsuoka M, Nakane M, Kawachi M et al (2001) Effect of repeated local minocycline administration on periodontal healing following guided tissue regeneration. J Periodontol 72(3):284–295

    Article  PubMed  Google Scholar 

  • Zhang D-D, Chen X, Bao Z-F, Chen M, Ding Z-J, Zhong M (2014) Histologic comparison between platelet-rich plasma and blood clot in regenerative endodontic treatment: an animal study. J Endod 40(9):1388–1393

    Article  PubMed  Google Scholar 

  • Zhu X, Zhang C, Huang GT, Cheung GS, Dissanayaka WL, Zhu W (2012) Transplantation of dental pulp stem cells and platelet-rich plasma for pulp regeneration. J Endod 38(12):1604–1609

    Article  PubMed  Google Scholar 

  • Zhu W, Zhu X, Huang GT, Cheung GS, Dissanayaka WL, Zhang C (2013) Regeneration of dental pulp tissue in immature teeth with apical periodontitis using platelet-rich plasma and dental pulp cells. Int Endod J 46(10):962–970

    Article  PubMed  Google Scholar 

  • Zucchelli G, Sforza NM, Clauser C, Cesari C, De Sanctis M (1999) Topical and systemic antimicrobial therapy in guided tissue regeneration. J Periodontol 70(3):239–247

    Article  PubMed  Google Scholar 

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Ruparel, N.B., Austah, O.N., Diogenes, A. (2019). Current and Future Views on Disinfection for Regenerative Strategies. In: Duncan, H., Cooper, P. (eds) Clinical Approaches in Endodontic Regeneration. Springer, Cham. https://doi.org/10.1007/978-3-319-96848-3_7

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