Encapsulated Acellular System From Mesenchymal Stem Cells for Dental Pulp Regeneration

Inclusion Criteria: Systemically healthy patients (ASA I). Patient presenting with a maxillary or mandibular incisor/canine and mandibular premolar with mature apex, pulpal necrosis, and apical radiographic evidence of apical periodontitis (PAI ≥2 and CBCTPAI ≥1). Patient presents with a tooth that does not respond to electrical and thermal pulp testing. Patients with restorable teeth (considering the definition of class A or B, according to Samet and Jotkowitz classification) without the need for a single fine prosthesis (crown) or major restoration. Exclusion Criteria: Patients not available for the follow-up period (27 weeks). Patients who will undergo orthodontic treatment in the next six months. Patients with reports of allergies to any material or medication used in the study. Pregnant patients. Heavy smokers (more than 10 cigarettes per day). Patients with a history of systemic diseases that impair immune function, such as diabetes mellitus, immunodeficiency, leukemia, Addison's and Cushing's disease. Patients who have used immunosuppressive drugs or chemotherapy, 3 months before the study. Or that they will be irradiated or undergo chemotherapy. Patients who have endodontically treated teeth. Patients who have teeth with signs of severe root resorption. Patients who have teeth with mobility class III or Dens invaginatus. Patients who have teeth with a history of avulsion-type dentoalveolar trauma. Patients who have teeth with clinical and/or radiographic evidence of root fracture. Patients who have teeth that cannot be completely isolated with rubber dam. Patients who have teeth with more than one root or root canal.