Rejeneratif Endodontik Tedavinin Temel Bileşenleri: Kök Hücreler, Büyüme Faktörleri Ve İskeleler
Özet
Rejeneratif endodontik tedavi (RET), geleneksel kök kanal tedavilerine alternatif olarak geliştirilen ve pulpa–dentin kompleksinin biyolojik olarak yeniden oluşturulmasını amaçlayan yenilikçi bir yaklaşımdır. Diş pulpası; beslenme, duyu iletimi ve savunma gibi fonksiyonlarıyla dişin canlılığında kritik rol oynamaktadır. Pulpa dokusunun enfekte veya nekrotik hale gelmesi durumunda uygulanan klasik yöntemler enfeksiyonu ortadan kaldırsa da, doğal fonksiyonları geri kazandırmamaktadır. RET ise doku mühendisliği prensiplerine dayanarak kök hücreler, büyüme faktörleri ve biyolojik iskele materyallerinin bir araya getirilmesiyle yeni, fonksiyonel bir doku oluşumunu hedefler. Özellikle kök gelişimi tamamlanmamış genç dişlerde uygulandığında, kök gelişiminin devam etmesini sağlayarak prognozu iyileştirmektedir. Günümüzde en yaygın kullanılan yöntem revaskülarizasyon olup, kan pıhtısı, PRP veya PRF kullanılarak kök hücrelerin kanal içine göçü sağlanmaktadır. Bununla birlikte, kök hücre nakli ve hücre çağırma stratejileri de geliştirilmiştir. İdeal bir RET, yalnızca pulpa dokusunu değil, aynı zamanda damarlaşma ve sinirlenmeyi de yeniden sağlayarak doğal pulpa fonksiyonlarını geri kazandırmalıdır. Bu yönüyle RET, diş hekimliğinde geleceğin standart tedavi protokollerini değiştirme potansiyeline sahiptir.
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