A Cell-Based Approach to Dental Pulp Regeneration Using Mesenchymal Stem Cells: A Scoping Review.

Sahng G Kim

doi:10.3390/ijms22094357

Abstract

Despite the recent explosion of investigations on dental pulp regeneration using various tissue engineering strategies, the translation of the findings from such studies into therapeutic applications has not been properly achieved. The purpose of this scoping review was to systematically review the efficacy of mesenchymal stem cell transplantation for dental pulp regeneration. A literature search was conducted using five electronic databases from their inception to January 2021 and supplemented by hand searches. A total of 17 studies, including two clinical trials and 15 animal studies using orthotopic pulp regeneration models, were included for the review. The risk of bias for the individual studies was assessed. This scoping review demonstrated that the regeneration of vascularized pulp-like tissue was achieved using the stem cell transplantation strategy in animal models. Autologous cell transplantation in two clinical studies also successfully regenerated vascularized vital tissue. Dental pulp stem cell subpopulations, such as mobilized dental pulp stem cells, injectable scaffolds such as atelocollagen, and a granulocyte-colony forming factor, were the most commonly used for pulp regeneration. The overall risk of bias was unclear for animal studies and was moderate or judged to raise some concerns for clinical studies. More high-quality clinical studies are needed to further determine the safety and efficacy of the stem cell transplantation strategy for dental pulp regeneration.

Highlights

Dental pulp regeneration requires an integrated use of three key elements, including cells, biomaterial scaffolds, and signaling molecules, which enables the recapitulation of biological processes for normal tissue development [1,2,3,4,5,6]
Electronic searches for relevant studies were performed in the PubMed, Scopus, Web of Science, Embase, and Medline databases from their inception until January 2021 using the combinations of the following keywords: “pulp regeneration”, “pulp revascularization”, “pulp revitalization”, “regenerative endodontics’, “animal”, “human”, “clinical”, “stem cells”, “mesenchymal stem cells”, “pulpectomy”, “cell transplantation”
Stem cell transplantation is a major in vivo pulp regeneration approach

Summary

Introduction

Dental pulp regeneration requires an integrated use of three key elements, including cells, biomaterial scaffolds, and signaling molecules, which enables the recapitulation of biological processes for normal tissue development [1,2,3,4,5,6]. Various combinations of this triad have been used to regenerate the pulp–dentin complex [3,4,5]. The stem cells release a multitude of biological trophic factors [14], which can modulate the immune function and promote regenerative cellular events, such as mobilization, proliferation, and differentiation of resident cells, in addition to enhancing angiogenesis and neurogenesis [15,16]

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