The role of stem cell therapy in regeneration of dentine-pulp complex: a systematic review.
The role of stem cell therapy in regeneration of dentine-pulp complex: a systematic review.
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DOI：
10.1007/s40204-018-0100-7
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发表时间：
2018-12
影响因子：
4.9
通讯作者：
Dummer PMH
中科院分区：
文献类型：
--
作者：
Bakhtiar H;Mazidi S A;Mohammadi Asl S;Ellini MR;Moshiri A;Nekoofar MH;Dummer PMH
牙髓感染会导致炎症，最终导致组织坏死，传统的治疗方法是牙髓切除和根管治疗。再生医学和组织工程学的进步，以及新干细胞来源的引入，使牙髓组织再生成为可能。这篇系统的综述分析了自2010年以来发表的动物研究，以确定干细胞疗法再生牙本质-牙髓复合体(DPC)的能力和临床方案的成功。不包括体外和人类临床研究，只包括动物模型的实验研究。牙髓干细胞是最常用的细胞类型。大多数干细胞被结合到各种类型的支架中，并植入根管中。一些研究将生长因子与干细胞相结合，试图改善结果。利用小动物模型研究异位移植是一种简单且非系统的评价技术。到目前为止，干细胞浓度还没有报道；因此，这种动物研究的翻译价值仍然值得怀疑。尽管所有类型的干细胞似乎都能再生牙本质-牙髓复合体，但在选择细胞类型时仍有几个因素被考虑。联合管理因子对于诱导干细胞的系统性迁移、其血管化和分化为成牙本质细胞样细胞是必不可少的。支架提供了一种可生物降解的结构，能够控制生长因子的释放。为了发现问题和降低成本，新的策略应该首先在皮下或肾包膜植入中进行测试，然后再进行根管模型以确认结果。
Infection of the dental pulp will result in inflammation and eventually tissue necrosis which is treated conventionally by pulpectomy and root canal treatment. Advances in regenerative medicine and tissue engineering along with the introduction of new sources of stem cells have led to the possibility of pulp tissue regeneration. This systematic review analyzes animal studies published since 2010 to determine the ability of stem cell therapy to regenerate the dentine-pulp complex (DPC) and the success of clinical protocols. In vitro and human clinical studies are excluded and only the experimental studies on animal models were included. Dental pulp stem cells constitute the most commonly used cell type. The majority of stem cells are incorporated into various types of scaffold and implanted into root canals. Some of the studies combine growth factors with stem cells in an attempt to improve the outcome. Studies of ectopic transplantation using small animal models are simple and non-systematic evaluation techniques. Stem cell concentrations have not been so far reported; therefore, the translational value of such animal studies remains questionable. Though all types of stem cells appear capable of regenerating a dentine-pulp complex, still several factors have been considered in selecting the cell type. Co-administrative factors are essential for inducing the systemic migration of stem cells, and their vascularization and differentiation into odontoblast-like cells. Scaffolds provide a biodegradable structure able to control the release of growth factors. To identify problems and reduce costs, novel strategies should be initially tested in subcutaneous or renal capsule implantation followed by root canal models to confirm results.