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再生牙髓治疗的生物材料与支架设计策略

Biomaterials and Scaffold Design Strategies for Regenerative Endodontic Therapy.

作者信息

Raddall Gavin, Mello Isabel, Leung Brendan M

机构信息

Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada.

Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada.

出版信息

Front Bioeng Biotechnol. 2019 Nov 15;7:317. doi: 10.3389/fbioe.2019.00317. eCollection 2019.

Abstract

Challenges with traditional endodontic treatment for immature permanent teeth exhibiting pulp necrosis have prompted interest in tissue engineering approaches to regenerate the pulp-dentin complex and allow root development to continue. These procedures are known as regenerative endodontic therapies. A fundamental component of the regenerative endodontic process is the presence of a scaffold for stem cells from the apical papilla to adhere to, multiply and differentiate. The aim of this review is to provide an overview of the biomaterial scaffolds that have been investigated to support stem cells from the apical papilla in regenerative endodontic therapy and to identify potential biomaterials for future research. An electronic search was conducted using Pubmed and Novanet databases for published studies on biomaterial scaffolds for regenerative endodontic therapies, as well as promising biomaterial candidates for future research. Using keywords "regenerative endodontics," "scaffold," "stem cells" and "apical papilla," 203 articles were identified after duplicate articles were removed. A second search using "dental pulp stem cells" instead of "apical papilla" yielded 244 articles. Inclusion criteria included the use of stem cells from the apical papilla or dental pulp stem cells in combination with a biomaterial scaffold; articles using other dental stem cells or no scaffolds were excluded. The investigated scaffolds were organized in host-derived, naturally-derived and synthetic material categories. It was found that the biomaterial scaffolds investigated to date possess both desirable characteristics and issues that limit their clinical applications. Future research investigating the scaffolds presented in this article may, ultimately, point to a protocol for a consistent, clinically-successful regenerative endodontic therapy.

摘要

对于表现出牙髓坏死的年轻恒牙,传统牙髓治疗面临的挑战促使人们对组织工程方法产生兴趣,以再生牙髓 - 牙本质复合体并使牙根发育得以继续。这些程序被称为再生牙髓治疗。再生牙髓过程的一个基本组成部分是存在一个支架,供来自根尖乳头的干细胞附着、增殖和分化。本综述的目的是概述已被研究用于支持根尖乳头干细胞进行再生牙髓治疗的生物材料支架,并确定未来研究的潜在生物材料。使用PubMed和Novanet数据库进行了电子检索,以查找关于再生牙髓治疗生物材料支架的已发表研究以及未来研究有前景的生物材料候选物。使用关键词“再生牙髓病学”、“支架”、“干细胞”和“根尖乳头”,在去除重复文章后确定了203篇文章。使用“牙髓干细胞”代替“根尖乳头”进行的第二次检索产生了244篇文章。纳入标准包括使用来自根尖乳头的干细胞或牙髓干细胞与生物材料支架相结合;排除使用其他牙干细胞或无支架的文章。所研究的支架分为宿主来源、天然来源和合成材料类别。结果发现,迄今为止所研究的生物材料支架既有理想的特性,也存在限制其临床应用的问题。对本文中介绍的支架进行的未来研究最终可能会指向一种一致的、临床成功的再生牙髓治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/070c/6874017/42679534b252/fbioe-07-00317-g0001.jpg

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