Tissue Engineering for Immature Teeth with Apical Periodontitis

Dedication To my parents, to whom I dedicate my thesis. You have guided me throughout my life and professional career in a positive direction. Your continual love and support for your children has taught me the most important lessons in life. I am the luckiest son in the world. Thanks for all the love and support. I am the luckiest brother and uncle in the world. Family is everything. To my grandparents: Thank you for being such wonderful influences in my life. To Grandma, who is a role model to me and inspires me to be the best endodontist I can be. To my wife, Erica: You are my best friend and soul mate. Your endless love and support inspires me every day. There are no words to describe how blessed I am to have you in my life. I am the luckiest husband in the world. To my thesis committee and wonderful endodontics department at UNC. Thank you for all of your help and support throughout my residency. Abstract Nozomu Yamauchi: Tissue Engineering for Immature Teeth with Apical Periodontitis (Under the direction of Dr. The purpose of this study was to explore novel strategies to engineer a vital support structure within a root canal space by induced blood clot, exposure of dentin matrix and a cross-linked collagen scaffold. Radiographically, there was significant difference in periradicular healing and root wall thickening for scaffold groups. Two mineralized tissues were formed. A dentin associated mineralized tissue (DAMT) and bony islands (BI). Histomorphometric analysis showed more mineralized tissue formation in the scaffold groups. Exposure of the dentin matrix appeared to increase the adherence of DAMT to dentin. Histochemical and immunohistochemical characterization show DAMT is distinct from dentin or bone. Although DAMT resembled cementum, it showed a more immature and woven collagen matrix. BI resembled a bone matrix. The use of cross-linked collagen scaffold and exposure of dentin matrix combined with blood clot may provide an efficient approach for the treatment of immature teeth with apical periodontitis.