Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo USP, Bauru School of Dentistry, Bauru, SP, 17012-901, Brazil.
Department of Physiology and Pathology, Universidade Estadual Paulista UNESP, Araraquara School of Dentistry, Araraquara, SP, 14801-903, Brazil.
Clin Oral Investig. 2021 Aug;25(8):4749-4779. doi: 10.1007/s00784-021-04013-4. Epub 2021 Jun 28.
The aim of this review is to highlight recent progress in the field of biomaterials-mediated dental pulp tissue engineering. Specifically, we aim to underscore the critical design criteria of biomaterial platforms that are advantageous for pulp tissue engineering, discuss models for preclinical evaluation, and present new and innovative multifunctional strategies that hold promise for clinical translation.
The current article is a comprehensive overview of recent progress over the last 5 years. In detail, we surveyed the literature in regenerative pulp biology, including novel biologic and biomaterials approaches, and those that combined multiple strategies, towards more clinically relevant models. PubMed searches were performed using the keywords: "regenerative dentistry," "dental pulp regeneration," "regenerative endodontics," and "dental pulp therapy."
Significant contributions to the field of regenerative dentistry have been made in the last 5 years, as evidenced by a significant body of publications. We chose exemplary studies that we believe are progressive towards clinically translatable solutions. We close this review with an outlook towards the future of pulp regeneration strategies and their clinical translation.
Current clinical treatments lack functional and predictable pulp regeneration and are more focused on the treatment of the consequences of pulp exposure, rather than the restoration of healthy dental pulp.
Clinically, there is great demand for bioinspired biomaterial strategies that are safe, efficacious, and easy to use, and clinicians are eager for their clinical translation. In particular, we place emphasis on strategies that combine favorable angiogenesis, mineralization, and functional tissue formation, while limiting immune reaction, risk of microbial infection, and pulp necrosis.
本综述旨在强调生物材料介导的牙髓组织工程领域的最新进展。具体而言，我们旨在强调有利于牙髓组织工程的生物材料平台的关键设计标准，讨论临床前评估模型，并提出具有临床转化前景的新的创新多功能策略。
本文是对过去 5 年最新进展的全面综述。详细地说，我们调查了再生牙髓生物学领域的文献，包括新的生物和生物材料方法，以及那些结合了多种策略的方法，以实现更具临床相关性的模型。在 PubMed 上使用以下关键词进行搜索：“再生牙科”、“牙髓再生”、“再生牙髓学”和“牙髓治疗”。
在过去的 5 年中，再生牙科领域取得了重大进展，这一点可以从大量的出版物中得到证明。我们选择了我们认为朝着可临床转化解决方案前进的具有代表性的研究。我们在这篇综述的结尾展望了牙髓再生策略的未来及其临床转化。
目前的临床治疗方法缺乏功能性和可预测性的牙髓再生，更多地侧重于牙髓暴露后果的治疗，而不是健康牙髓的恢复。
临床上，人们对安全、有效、易于使用的仿生生物材料策略有很大的需求，临床医生渴望将其应用于临床。特别是，我们强调那些结合了有利的血管生成、矿化和功能性组织形成的策略，同时限制免疫反应、微生物感染和牙髓坏死的风险。
