Abstract
Regenerative dentistry has paved the way for a new era for the replacement of damaged dental tissues. Whether the causative factor is dental caries, trauma, or chemical insult, the loss of the pulp vitality constitutes one of the major health problems worldwide. Two regenerative therapies were introduced for a fully functional pulp-dentin complex regeneration, namely, cell-based (cell transplantation) and cell homing (through revascularization or homing by injection of stem cells in situ or intravenously) therapies, with each demonstrating advantages as well as drawbacks, especially in clinical application. The present review is aimed at elaborating on these two techniques in the treatment of irreversibly inflamed or necrotic pulp, which is aimed at regenerating a fully functional pulp-dentin complex.
Highlights
Dental tissue regeneration requires the presence of specialized cells capable of the production of a tissue-specific extracellular matrix (ECM) [1, 2]
Regenerative dentistry is no longer a dream, thanks to the current efforts to imply stem/progenitor cell-based techniques to enhance the regeneration of the pulp-dentin complex and to replace conventional endodontic pulp therapy
Efforts started to target cell homing for pulp-dentin complex regeneration as a simpler, safer, and reasonably priced approach compared to the cell-based transplantation therapy
Summary
Dental tissue regeneration requires the presence of specialized cells capable of the production of a tissue-specific extracellular matrix (ECM) [1, 2]. The potential of stem/progenitor cells, whether endogenous or exogenous, to adapt to various environmental niche could be exploited in regenerative endodontics and pulp-dentin tissue regeneration [4,5,6]. A suggested approach to address problems related to pulp-dentin tissue regeneration relied principally on the use of various sources of stem/progenitor cells, combined with multiple scaffold systems and growth factors [9]. Trials and continuous animal studies were directed to investigate the effectiveness of cell-based transplantation on pulp healing and dentin regeneration [7, 13, 14]. Autologous transplanted constructs of dental pulp stem/progenitor cells (DPSCs) in combination with platelet-rich fibrin (PRF) proved to promote the regeneration of pulp-dentin-like tissue inside dogs’ root canals [15]. A further animal study employing human DPSCs and platelet-derived growth factor
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