Duncan Henry F, Kobayashi Yoshifumi, Shimizu Emi
Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Lincoln Place, Dublin, Ireland.
Oral Biology Department, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, USA.
Curr Oral Health Rep. 2018 Dec;5(4):276-285. doi: 10.1007/s40496-018-0194-y. Epub 2018 Sep 17.
To summarize current views on the role and therapeutic potential of growth factors (GFs) within endodontic cell homing.
Cell homing/revitalization techniques aim to regenerate dentin and pulp using endogenous cells. Clinically, revitalization has successfully created new vital tissue in necrotic permanent teeth with an open apex; however, there is no evidence of new odontoblasts, pulp tissue, or predictable extension in root length. Although the response is reparative rather than regenerative, exciting opportunities to improve these biologically-based strategies remain by (1) efficiently sequestering dentin-matrix-components (DMCs) using irrigants and dental materials (2) designing next-generation GF-releasing scaffold materials and (3) utilizing other sources of GF such as cells and plasma-rich plasma and plasma-rich fibrin.
GFs can promote reparative-dentinogenesis and pulp-like tissue formation. The future development and clinical approval of GF-functionalized-scaffolds is a priority; however, current focus should be to harness DMCs and target the interaction of stem cells and GFs.
总结目前关于生长因子(GFs)在牙髓细胞归巢中的作用及治疗潜力的观点。
细胞归巢/再生技术旨在利用内源性细胞再生牙本质和牙髓。临床上,再生技术已成功地在根尖开放的坏死恒牙中创造出新的活组织;然而,尚无新的成牙本质细胞、牙髓组织或牙根长度可预测性延长的证据。尽管这种反应是修复性而非再生性的,但通过以下方式仍有令人兴奋的机会来改进这些基于生物学的策略:(1)使用冲洗剂和牙科材料有效螯合牙本质基质成分(DMCs);(2)设计下一代释放GF的支架材料;(3)利用其他GF来源,如细胞、富血小板血浆和富纤维蛋白血浆。
GFs可促进修复性牙本质形成和牙髓样组织形成。GF功能化支架的未来开发和临床批准是当务之急;然而,目前的重点应是利用DMCs并靶向干细胞与GFs的相互作用。