Lajla Hasić Branković

Lajla Hasić Branković

Dejan Marković

Regenerative Endodontic Procedure in Young Permanent Teeth: Current Perspectives

The term "Regenerative Endodontic Procedure" (REP) is reserved for a series of endodontic interventions aimed at "regenerating" the pulp-dentin complex, prolonging the lifespan of the tooth, and maintaining its function.
REP has traditionally been associated with biologically based therapeutic modalities primarily conducted in young permanent teeth diagnosed with pulp necrosis. Methods such as apexification and apexogenesis have historically achieved significant successes, as confirmed by numerous case reports, cohort studies, and randomized trials, thereby creating conditions for the expansion of indication fields.
However, considering that REP procedures are largely empirical, questions arise regarding the uniformity of protocols related to case selection, as well as therapeutic procedures, medications, and techniques aimed at "regenerating" the pulp-dentin complex. The heterogeneity of protocols can indeed create uncertainties for practitioners.
This lecture aims to initiate a discussion towards the establishment of a professional consensus based on biological principles, as well as existing clinical REP protocols, with attention to medications and techniques. It will also address expected outcomes, complications during and after the REP procedure, with the aim of enhancing and improving clinical protocols.
As part of the presentation, a case of regenerative endodontic procedure (REP) on young permanent teeth with pulp necrosis and apical root resorption of traumatic etiology will be showcased. As we know, opinions on whether REP is a therapeutic modality for teeth with trauma are divided. The literature lacks clear guidelines on whether trauma-related cases exhibiting external root resorption are indicated for REP.
This report describes the course of REP treatment performed on the upper central and one lateral incisor of a 16-year-old boy following dental trauma. The REP treatment involved minimal mechanical canal preparation, extensive irrigation, and an antibiotic dressing lasting for two weeks. During the second appointment, efforts were made to provoke bleeding from the apex to allow a blood clot to fill the canal and serve as a scaffold for the regeneration or repair of the pulp-dentin complex. As the bleeding was unsatisfactory, it was decided to utilize platelet-rich plasma (PRP) as an alternative scaffold instead of a blood clot. After applying PRP into the canals, they were sealed with MTA (mineral trioxide aggregate), and the teeth were subsequently restored using adhesive restorative procedures. The clinical outcome will be presented after a one-year follow-up.
The presentation will provide a detailed description of the complete clinical protocol for REP, offering pediatric dentists valuable guidance for everyday clinical practice.

Personal Informations:
Name: Lajla Hasić Branković
Date of Birth: November 5, 1973
Address:Hasana Sušića 7, Sarajevo
Email: lajlabrankovic@gmail.com
Phone: + 387 61 259 520

Education:
*2001: Doctor of Dental Medicine, Faculty of Dentistry, University of Sarajevo.
*2009: Master’s Degree, Master’s Thesis: "Comparison of Potentiometric Parameter Values in Dental Plaque and Saliva After Topical Application of Low-Concentration Fluoride Solutions"
*2009: Completed Specialist Training in Dental Pathology and Endodontics
*2012: PhD, Doctoral Thesis: "Examination of the Physical Properties of Remineralized Enamel After the Combined Use of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and Fluoride Preparations"
Professional Experience:
*2002 - Present: Member of the teaching academic staff, continuous development through all collaborative and teaching ranks, Faculty of Dentistry, University of Sarajevo
- Engage in teaching various courses, including Dental Pathology (both pre-clinic and clinical), Restorative Dentistry, and Endodontics, across all academic levels.
- Concurrently provide clinical services as a specialist dentist.
- Mentor and co-mentor for dental residents' education, contributing to the training and development of future dental professionals.
- Certified trainer for selected rotary endodontic systems.
- Author and co-author of over 70 research papers presented at international congresses and published in scientific and professional journals, as well as three university textbooks.
*2023 - Present: President, Endodontic Chamber of Bosnia and Herzegovina
- Oversee the activities and strategic direction of the chamber, promoting advancements in the field of endodontics and ensuring high standards of practice among members.
*Current Position: Tenured Professor, Cathedra of Dental Pathology and Endodontics, Faculty of Dentistry, University of Sarajevo
- Responsibilities include teaching twelve undergraduate courses within the specialized field and three postgraduate courses.