Department of Oral and Maxillofacial Pathology, Division of Craniofacial and Molecular Genetics, Tufts University, Boston, Mass., USA.
Gerontology. 2011;57(1):85-94. doi: 10.1159/000314530. Epub 2010 May 6.
BACKGROUND: with today's 21st century technological advancements, it is expected that individuals will either retain their natural teeth or obtain functional tooth replacements throughout their entire life. Modern dental therapies for the replacement of missing teeth largely utilize partial or complete dentures and titanium implants capped with prosthetic crowns. Although these prostheses serve a purpose, they are not equivalent, neither in function nor aesthetics, to natural teeth. Recent progress in dental tissue engineering has lent significant credibility to the concept that biological replacement teeth therapies may soon be available to replace missing teeth. OBJECTIVE: in this review, we summarize the emerging concepts of whole-tooth replacement strategies, using postnatal dental stem cells (DSCs) and dental tissue engineering approaches. METHODS: we provide a thorough and extensive review of the literature. RESULTS: current approaches to achieve clinically relevant biological replacement tooth therapies rely on the cultivation of DSCs capable of relaying odontogenic induction signals, through dental epithelial-mesenchymal cell interactions. DSC expansion and differentiation can be achieved by programming progenitor stem cells to adopt dental lineages, using instructive, bioengineered scaffold materials. Periodontal ligament regeneration in particular has demonstrated significant progress recently, despite the somewhat unpredictable clinical outcomes, with regard to its capacity to augment conventional metallic dental implants and as an important component for whole-tooth tissue engineering. Following recent advances made in DSC and tissue engineering research, various research groups are in the midst of performing 'proof of principle' experiments for whole-tooth regeneration, with associated functional periodontal tissues. This mini-review focuses on recent and promising developments in the fields of pulp and periodontal tissue DSCs that are of particular relevance for dental tissue and whole-tooth regeneration. CONCLUSION: continued advances in the derivation of useable DSC populations and optimally designed scaffold materials unequivocally support the feasibility of dental tissue and whole-tooth tissue engineering.
背景:随着 21 世纪科技的进步,人们有望在一生中保留天然牙齿或获得功能性牙替代物。目前用于替换缺失牙齿的现代牙科疗法主要使用局部或全口义齿以及用假牙冠覆盖的钛植入物。虽然这些假体有一定的作用,但在功能和美观上都无法与天然牙齿相媲美。最近在牙科组织工程方面的进展使得人们相信,用生物方法来替换牙齿的治疗方法可能很快就可以用来替换缺失的牙齿。
目的:在这篇综述中,我们总结了使用产后牙源性干细胞(DSC)和牙科组织工程方法的全牙替换策略的新兴概念。
方法:我们对文献进行了全面和广泛的回顾。
结果:目前实现临床相关生物替代牙治疗的方法依赖于培养能够传递成牙诱导信号的 DSC,通过牙上皮-间充质细胞的相互作用。可以通过编程祖细胞干细胞采用牙系,使用指导、生物工程支架材料来实现 DSC 的扩增和分化。最近牙周韧带再生取得了显著进展,尽管其增强传统金属牙种植体的能力及其作为全牙组织工程的重要组成部分的临床结果有些不可预测,但仍取得了进展。在 DSC 和组织工程研究取得的最新进展之后,许多研究小组正在进行“原理验证”实验,以实现具有相关功能牙周组织的全牙再生。本综述主要关注牙髓和牙周组织 DSC 领域最近和有前途的进展,这些进展对牙科组织和全牙再生具有特殊意义。
结论:在可利用的 DSC 群体的衍生和最佳设计的支架材料方面的持续进展,明确支持了牙科组织和全牙组织工程的可行性。
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