Dental pulp regeneration via cell homing

Endodontic Topics, 2013

Journal of Materials Science: Materials in Medicine

Based on the concept of tissue engineering (Cells—Scaffold—Bioactive molecules), regenerative endodontics appeared as a new notion for dental endodontic treatment. Its approaches aim to preserve dental pulp vitality (pulp capping) or to regenerate a vascularized pulp-like tissue inside necrotic root canals by cell homing. To improve the methods of tissue engineering for pulp regeneration, numerous studies using in vitro, ex vivo, and in vivo models have been performed. This review explores the evolution of laboratory models used in such studies and classifies them according to different criteria. It starts from the initial two–dimensional in vitro models that allowed characterization of stem cell behavior, through 3D culture matrices combined with dental tissue and finally arrives at the more challenging ex vivo and in vivo models. The travel which follows the elaboration of such models reveals the difficulty in establishing reproducible laboratory models for dental pulp regeneratio...

Texila International Journal of Academic Research, 2023

Stem cells, also known as progenitor/precursor cells, have the unique trait of self-renewal and multi-lineage differentiation. Dental stem cells (DSCs) are holding a pivotal role during recent times as they thrive as the cornerstone for the development of cell transplantation therapies that correct periodontal disorders and damaged dentin. DSCs are used therapeutically for different organ systems and numerous diseases, including neurological disorders, diabetes, liver disease, bone tissue engineering, and dentistry. In dentistry, the focus is on predominantly regenerating the pulp and damaged dentin, repairing perforations, and periodontal regenerations. Above all, whole tooth regeneration has been constantly under research. The next decade could be a crucial junction where huge leaps in stem cell-based regenerative therapies could become a reality with successful tissue engineering therapies this could be a biological alternative to synthetic materials that are in use currently. But dental stem cells have their share of challenges for which the research must happen effectively adhering to social responsibilities at all levels. Keywords: Stem cells, Regeneration, Regenerative therapy, SHED.

Journal of biomedical materials research. Part B, Applied biomaterials, 2015

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and ...

Nigerian journal of surgery : official publication of the Nigerian Surgical Research Society, 2014

Stem cells are primitive cells that can differentiate and regenerate organs in different parts of the body such as heart, bones, muscles and nervous system. This has been a field of great clinical interest with immense possibilities of using the stem cells in regeneration of human organ those are damaged due to disease, developmental defects and accident. The knowledge of stem cell technology is increasing quickly in all medical specialties and in dental field too. Stem cells of dental origin appears to hold the key to various cell-based therapies in regenerative medicine, but most avenues are in experimental stages and many procedures are undergoing standardization and validation. Long-term preservation of SHED cells or DPSC is becoming a popular consideration, similar to the banking of umbilical cord blood. Dental pulp stem cells (DPSCs) are the adult multipotent cells that reside in the cell rich zone of the dental pulp. The multipotent nature of these DPSCs may be utilized in bo...

Stem Cells International, 2016

Recent advances in biomaterial science and tissue engineering technology have greatly spurred the development of regenerative endodontics. This has led to a paradigm shift in endodontic treatment from simply filling the root canal systems with biologically inert materials to restoring the infected dental pulp with functional replacement tissues. Currently, cell transplantation has gained increasing attention as a scientifically valid method for dentin-pulp complex regeneration. This multidisciplinary approach which involves the interplay of three key elements of tissue engineering—stem cells, scaffolds, and signaling molecules—has produced an impressive number of favorable outcomes in preclinical animal studies. Nevertheless, many practical hurdles need to be overcome prior to its application in clinical settings. Apart from the potential health risks of immunological rejection and pathogenic transmission, the lack of a well-established banking system for the isolation and storage o...

Iranian Endodontic Journal, 2014

Regenerative endodontic procedure is introduced as a biologically based treatment for immature teeth with pulp necrosis. Successful clinical and radiographic outcomes following regenerative procedures have been reported in landmark case reports. Retrospective studies have shown that this conservative treatment allows for continued root development and increases success and survival rate of the treated teeth compared to other treatment options. Although the goal of treatment is regeneration of a functional pulp tissue, histological analyses show a different outcome. Developing predictable protocols would require the use of key elements for tissue engineering: stem cells, bioactive scaffolds, and growth factors. In this study we will review the evidence based steps and outcomes of regenerative endodontics.

Journal of endodontics, 2007

Millions of teeth are saved each year by root canal therapy. Although current treatment modalities offer high levels of success for many conditions, an ideal form of therapy might consist of regenerative approaches in which diseased or necrotic pulp tissues are removed and replaced with healthy pulp tissue to revitalize teeth. Researchers are working toward this objective. Regenerative endodontics is the creation and delivery of tissues to replace diseased, missing, and traumatized pulp. This review provides an overview of regenerative endodontics and its goals, and describes possible techniques that will allow regenerative endodontics to become a reality. These potential approaches include root-canal revascularization, postnatal (adult) stem cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. These regenerative endodontic techniques will possibly involve some combination of disinfection or debridement of infected ro...

Tissue Engineering Part B: Reviews, 2018

Following the basis of tissue engineering (Cells-Scaffold-Bioactive molecules), regenerative endodontic has emerged as a new concept of dental treatment. Clinical procedures have been proposed by endodontic practitioners willing to promote regenerative therapy. Preserving pulp vitality was a first approach. Later procedures aimed to regenerate a vascularized pulp in necrotic root canals. However, there is still no protocol allowing an effective regeneration of necrotic pulp tissue either in immature or mature teeth. This review explores in vitro and preclinical concepts developed during the last decade, especially the potential use of stem cells, bioactive molecules, and scaffolds, and makes a comparison with the goals achieved so far in clinical practice. Regeneration of pulp-like tissue has been shown in various experimental conditions. However, the appropriate techniques are currently in a developmental stage. The ideal combination of scaffolds and growth factors to obtain a complete regeneration of the pulp-dentin complex is still unknown. The use of stem cells, especially from pulp origin, sounds promising for pulp regeneration therapy, but it has not been applied so far for clinical endodontics, in case of necrotic teeth. The gap observed between the hope raised from in vitro experiments and the reality of endodontic treatments suggests that clinical success may be achieved without external stem cell application. Therefore, procedures using the concept of cell homing, through evoked bleeding that permit to recreate a living tissue that mimics the original pulp has been proposed. Perspectives for pulp tissue engineering in the near future include a better control of clinical parameters and pragmatic approach of the experimental results (autologous stem cells from cell homing, controlled release of growth factors). In the coming years, this therapeutic strategy will probably become a clinical reality, even for mature necrotic teeth.

Journal of Babol University of Medical Sciences, 2022

Background and Objective: Tooth decay is the main cause of pulp and periapical diseases, and when the pulp involves the tooth, there is no other choice but to drain the pulp to save the tooth. The emergence of new methods of regenerative treatments has made it possible to restore dental pulp and dentin. Since regenerative treatments have been limited to immature teeth, this study was conducted to regenerate mature pulp tissue by dental pulp stem cell transplantation along with Platelet Rich Plasma (PRP) Matrix in rabbits. Methods: This experimental pilot study was conducted on a maxillary central incisor in a 1-year-old 2kg adult male albino rabbit. After completely cleaning the pulp tissue from the root and crown and washing the root canal, File #30 was passed through the apex to cause bleeding. Then dental pulp stem cells along with PRP were injected into the canal and the crown was sealed with glass ionomer cement. After 14 days, a radiograph was taken from the tooth, the extracted tooth was stained by hematoxylin-eosin and examined by light microscope. Findings: In the histological examination, in the inner wall of the root canal of odontoblasts, small thickness was observed in tubular dentin (about 1 mm) and pseudovascular structures. Furthermore, the entire space of the root canal was filled with a small and scattered number of inflammatory cells and pulp-like living tissue. Conclusion: Based on the results of this study, the observation of pseudovascular structures indicates the regenerative potential of dental pulp stem cells and opens a window for studies with more samples to effectively regenerate the dental pulp.