Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan.
J Dent Res. 2021 Nov;100(12):1351-1358. doi: 10.1177/00220345211007427. Epub 2021 Apr 29.
Dental pulp regeneration is a promising approach to restore the vitality of necrotic teeth. We have previously reported the fabrication of scaffold-free cell constructs containing only dental pulp stem cells (DPSCs) and their ability to form pulp-like tissue in the pulpless tooth. However, the DPSC construct could not build pulp-like tissue with a full root length because it is difficult to induce blood vessels from a small root canal foramen. Therefore, we hypothesized that vascular structure could be preformed in the DPSC construct by employing endothelial differentiation capability of DPSCs, and vascularized constructs might facilitate dental pulp regeneration in the pulpless tooth. In this study, vascularized DPSC constructs were fabricated by inducing endothelial differentiation, and then we investigated the behavior of differentiated DPSCs, the internal structure of cell constructs, and their pulp regenerative ability in vivo. We observed that DPSCs positive for CD31 and von Willebrand factor were localized at the outer layer of constructs and formed a reticulated lumen structure. The cells constituting the outer layer of the construct expressed endothelial differentiation markers at higher levels than cells in the inner part. These results indicated that DPSCs in the outer layer differentiated into endothelial cells and formed vascular-like structures in the cell construct. Next, a vascularized DPSC construct was transplanted into the human pulpless tooth that was implanted into immunodeficient mice in the subcutaneous space. After 6 wk of implantation, the vascularized construct formed pulp-like tissues with higher density of human CD31-positive blood vessels when compared with specimens implanted with a DPSC construct without prevascularization. These results suggest that the vascular structure formed in the DPSC construct facilitated the blood supply and enhanced pulp regeneration. This study demonstrates that a vascularized DPSC construct is a prospective biomaterial as an implant for novel dental pulp regeneration.
牙髓再生是一种有前途的方法,可以恢复坏死牙齿的活力。我们之前曾报道过仅含有牙髓干细胞(DPSCs)的无支架细胞构建体的制造及其在无髓牙中形成牙髓样组织的能力。然而,由于从较小的根管口难以诱导血管,因此 DPSC 构建体无法形成具有完整根长的牙髓样组织。因此,我们假设通过利用 DPSCs 的内皮细胞分化能力,可以在 DPSC 构建体中预先形成血管结构,并且血管化的构建体可能有助于无髓牙中的牙髓再生。在这项研究中,通过诱导内皮细胞分化来制造血管化的 DPSC 构建体,然后我们研究了分化的 DPSCs 的行为、细胞构建体的内部结构及其在体内的牙髓再生能力。我们观察到,CD31 和血管性血友病因子阳性的 DPSCs 定位于构建体的外层,并形成网状腔结构。构成构建体外层的细胞表达内皮细胞分化标志物的水平高于内部细胞。这些结果表明,构建体外层的 DPSCs 分化为内皮细胞,并在细胞构建体中形成类似血管的结构。接下来,将血管化的 DPSC 构建体移植到植入免疫缺陷小鼠皮下空间的人无髓牙中。植入 6 周后,与未预先血管化的 DPSC 构建体植入的标本相比,血管化的构建体形成了具有更高密度的人 CD31 阳性血管的牙髓样组织。这些结果表明,在 DPSC 构建体中形成的血管结构促进了血液供应并增强了牙髓再生。这项研究表明,血管化的 DPSC 构建体是一种有前途的生物材料,可作为新型牙髓再生的植入物。
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