Endodontics in the era of hydraulic calcium silicate cements: special focus on tooth discolouration following regenerative endodontic treatment

Regenerative endodontic treatment is a biologically based approach for the treatment of immature teeth with pulp necrosis. In this approach, a sequence of procedural steps, such as disinfection of the root canal space, introduction of a scaffold into the root canal, sealing of the scaffold with an intracanal coronal barrier and restoration of crowns, is followed. Most commonly, hydraulic calcium silicate cements such as mineral trioxide aggregate have been used as the coronal barrier in regenerative endodontic treatment. Although there is still much to be known regarding the details of each step, the procedures performed before and after establishment of the coronal barrier may interact with hydraulic calcium silicate cements and play a role in some of the outcomes of regenerative endodontic treatment. Tooth discolouration has been reported as a common unwanted patient-orientated outcome. This review provides an overview of the probable impact of each procedural step on hydraulic calcium silicate cements in regenerative endodontic treatment, with special attention paid to tooth discolouration. Keywords: hydraulic calcium silicate cement, immature teeth, regenerative endodontic treatment, tooth discolouration