Gong Ting, Heng Boon Chin, Lo Edward Chin Man, Zhang Chengfei
Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong.
Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong.
Stem Cells Int. 2016;2016:9204574. doi: 10.1155/2016/9204574. Epub 2016 Mar 16.
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 of dental-derived stem cells is the most pressing issue that awaits resolution and the properties of supportive scaffold materials vary across different studies and remain inconsistent. This review critically examines the classic triad of tissue engineering utilized in current regenerative endodontics and summarizes the possible techniques developed for dentin/pulp regeneration.
生物材料科学和组织工程技术的最新进展极大地推动了再生牙髓病学的发展。这导致了牙髓治疗的范式转变,从简单地用生物惰性材料填充根管系统,转变为用功能性替代组织修复受感染的牙髓。目前,细胞移植作为一种科学有效的牙本质-牙髓复合体再生方法,越来越受到关注。这种多学科方法涉及组织工程三个关键要素——干细胞、支架和信号分子——的相互作用,在临床前动物研究中产生了大量令人瞩目的良好结果。然而,在将其应用于临床之前,还需要克服许多实际障碍。除了免疫排斥和病原体传播的潜在健康风险外,缺乏完善的用于分离和储存牙源性干细胞的库系统是最亟待解决的问题,而且支持性支架材料的特性在不同研究中各不相同且仍不一致。本文综述批判性地审视了当前再生牙髓病学中使用的经典组织工程三元组,并总结了为牙本质/牙髓再生开发的可能技术。