Current and Future Views on Disinfection for Regenerative Strategies

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.