Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain.
Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain.
Int Endod J. 2021 Nov;54(11):2025-2043. doi: 10.1111/iej.13600. Epub 2021 Aug 20.
Most recently, the biological interactions, that is cytocompatibility, cell differentiation and mineralization potential, between calcium silicate-based biomaterials and periodontal ligament stem cells (PDLSCs) have been studied at an in vitro level, in order to predict their clinical behaviour during endodontic procedures involving direct contact with periodontal tissues, namely root canal treatment, endodontic surgery and regenerative endodontic treatment.
The aim of the present systematic review was to present a qualitative synthesis of available in vitro studies assessing the biological interaction of PDLSCs and calcium silicate-based biomaterials.
The present review followed PRISMA 2020 guidelines. An advanced database search was performed in Medline, Scopus, Embase, Web of Science and SciELO on 1 July 2020 and last updated on 22 April 2021. Studies assessing the biological interactions of PDLSCs with calcium silicate-based sealers (CSSs) and/or cements (CSCs) at an in vitro level were considered for inclusion. The evaluation of the 'biological interaction' was defined as any assay or test on the cytotoxicity, cytocompatibility, cell plasticity or differentiation potential, and bioactive properties of PDLSCs cultured in CSC or CSS-conditioned media. Quality (risk of bias) was assessed using a modified CONSORT checklist for in vitro studies of dental materials.
A total of 20 studies were included for the qualitative synthesis. CSCs and CSSs, as a group of endodontic materials, exhibit adequate cytocompatibility and favour the osteo/cementogenic differentiation and mineralization potential of PDLSCs, as evidenced from the in vitro studies included in the present systematic review.
The influence of the compositional differences, inclusion of additives, sample preparation, and varying conditions and manipulations on the biological properties of calcium silicate-based materials remain a subject for future research.
Within the limitations of the in vitro nature of the included studies, this work supports the potential use of calcium silicate-based endodontic materials in stem cell therapy and biologically based regenerative endodontic procedures.
OSF Registries; https://doi.org/10.17605/OSF.IO/SQ9UY.
最近，在体外水平上研究了硅酸钙基生物材料与牙周膜干细胞（PDLSCs）之间的生物相互作用，即细胞相容性、细胞分化和矿化潜能，以便预测它们在涉及与牙周组织直接接触的根管治疗、牙周手术和再生性根管治疗等牙髓治疗过程中的临床行为。
本系统评价的目的是对评估 PDLSCs 与硅酸钙基生物材料生物相互作用的现有体外研究进行定性综合。
本综述遵循 PRISMA 2020 指南。于 2020 年 7 月 1 日在 Medline、Scopus、Embase、Web of Science 和 SciELO 进行了高级数据库检索，并于 2021 年 4 月 22 日进行了最新检索。纳入了评估 PDLSCs 与硅酸钙基密封剂（CSSs）和/或水泥（CSCs）在体外水平的生物相互作用的研究。“生物相互作用”的评估定义为在 CSC 或 CSS 条件培养基中培养的 PDLSCs 的细胞毒性、细胞相容性、细胞可塑性或分化潜能以及生物活性特性的任何测定或测试。使用改良的牙科材料体外研究 CONSORT 清单评估质量（偏倚风险）。
共纳入 20 项研究进行定性综合。CSCs 和 CSSs 作为一组牙髓材料，表现出足够的细胞相容性，并有利于 PDLSCs 的成骨/成牙骨质分化和矿化潜能，这是本系统评价中纳入的体外研究证明的。
硅酸钙基材料的组成差异、添加剂的加入、样品制备以及对生物性质的不同条件和操作的影响仍然是未来研究的主题。
在纳入研究的体外性质的限制内，本研究支持在干细胞治疗和基于生物学的再生性根管治疗程序中使用硅酸钙基根管材料。
