Fan Z P
Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction of Oral, Capital Medical University School of Stomatology, Beijing 100050, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Oct 9;52(10):605-609. doi: 10.3760/cma.j.issn.1002-0098.2017.10.005.
The morbidity of tooth missing is the highest one among all the human organ diseases. The present restorations used in clinic, including fixed bridges, removable dentures and implant prosthetics, all exhibit their own defects, and hardly to restore the whole tooth structure and function. With the development of stem cells and tissue engineering, as an alternative, tooth regeneration, aiming at the generation of a structure like nature tooth, will be the therapeutic orientation to restore the lost tooth. The dental root, which supports the crown and occlusal force, is the fundamental part for tooth function. Based on the theory of tissue engineering, bio-roots were successfully generated by using mesenchymal stem cells (MSC) in miniature pigs. But the success rate of bio-root is not too high, is urgent to be improved for future clinic application. MSC mediated bio-root regeneration is depended on the dentinogenic differentiation regulation of MSC. Up to now, many factors affect the directed differentiation of MSC and further for the success rate of bio-root, including seeding cells, scaffold, growth factors and microenvironmental niche, etc. Microenvironmental niche is the key factor for affecting the MSC characteristics and special tissue regeneration. Basically, the bio-root is regenerated in jaw, while the jaw microenvironmental niche is prone to induce MSC for osteogenic differentiation, instead of dentinogenic differentiation. How to improve the dentinogenic differentiation of MSC in jaw microenvironmental niche is the key issue for increasing the success rate of bio-root.
牙齿缺失的发病率是所有人体器官疾病中最高的。目前临床上使用的修复体,包括固定桥、可摘义齿和种植修复体,都有各自的缺陷,很难恢复整个牙齿的结构和功能。随着干细胞和组织工程的发展,作为一种替代方法,旨在生成类似天然牙齿结构的牙齿再生将成为修复缺失牙齿的治疗方向。支撑牙冠和咬合力量的牙根是牙齿功能的基本组成部分。基于组织工程理论,在小型猪中利用间充质干细胞(MSC)成功生成了生物牙根。但生物牙根的成功率不高,亟待改进以用于未来的临床应用。MSC介导的生物牙根再生依赖于MSC的牙本质生成分化调控。到目前为止,许多因素影响MSC的定向分化以及生物牙根的成功率,包括种子细胞、支架、生长因子和微环境龛等。微环境龛是影响MSC特性和特定组织再生的关键因素。基本上,生物牙根在颌骨中再生,而颌骨微环境龛容易诱导MSC向成骨分化,而非牙本质生成分化。如何在颌骨微环境龛中提高MSC的牙本质生成分化是提高生物牙根成功率的关键问题。