Ducret M, Costantini A, Gobert S, Farges J-C, Bekhouche M
Institut de biologie et Chimie des Protéines, 7 Passage du Vercors, 69007 Lyon,
Eur Cell Mater. 2021 Jan 2;41:1-14. doi: 10.22203/eCM.v041a01.
Tissue engineering-based endodontic therapies, designed to regenerate the dental pulp (DP) in the devitalised endodontic space, have been proposed to improve tooth longevity compared to conventional root-filling therapies. Their aim is to restore tooth vitality and major DP functions necessary to maintain tooth health such as immunosurveillance, sensitivity and healing/repair/regenerative capacities. Several formulations based on the use of fibrin, the main component of the blood clot matrix, recently gave valuable results in the regeneration of the human DP. This review describes recent fibrin-based scaffolds designed for that purpose. After having presented the various strategies for DP regeneration, the main fibrin-based scaffolds reported so far for clinical use in endodontics were reviewed. Particular emphasis was given to hydrogel devices that may be improved by incorporation of bioactive molecules that stimulate vascularisation and tissue neoformation or provide antibacterial properties. Data indicate that fibrin-based scaffolds constitute a highly favourable environment for mesenchymal stem cells, which is maintained upon functionalisation. Additional knowledge is needed to understand how fibrin and functionalising agents affect adhesion, survival, proliferation, migration and differentiation of cells incorporated in the scaffold or which will colonise it from neighbouring host tissues. This knowledge is needed to adapt the hydrogel formulation for various clinical conditions.
基于组织工程的牙髓治疗旨在使失活牙髓腔内的牙髓再生，与传统的根管充填治疗相比，该疗法被认为可以延长牙齿寿命。其目的是恢复牙齿活力以及维持牙齿健康所需的主要牙髓功能，如免疫监视、感觉功能以及愈合/修复/再生能力。最近，几种基于血凝块基质主要成分纤维蛋白的配方在人类牙髓再生方面取得了有价值的成果。本综述描述了近期为此目的设计的基于纤维蛋白的支架。在介绍了牙髓再生的各种策略后，对迄今为止报道的主要用于牙髓病临床治疗的基于纤维蛋白的支架进行了综述。特别强调了水凝胶装置，通过加入刺激血管生成和组织新形成或具有抗菌特性的生物活性分子，水凝胶装置可能会得到改进。数据表明，基于纤维蛋白的支架为间充质干细胞提供了一个非常有利的环境，这种环境在功能化后得以维持。需要更多的知识来了解纤维蛋白和功能化剂如何影响支架内或从邻近宿主组织定植于支架的细胞的粘附、存活、增殖、迁移和分化。为适应各种临床情况调整水凝胶配方，需要这些知识。
