Costa Luis A, Eiro Noemi, Vaca Andrea, Vizoso Francisco J
Research Unit, Fundación Hospital de Jove, 161, 33920 Gijón, Spain.
Bioengineering (Basel). 2022 Dec 20;10(1):4. doi: 10.3390/bioengineering10010004.
The teeth, made up of hard and soft tissues, represent complex functioning structures of the oral cavity, which are frequently affected by processes that cause structural damage that can lead to their loss. Currently, replacement therapy such as endodontics or implants, restore structural defects but do not perform any biological function, such as restoring blood and nerve supplies. In the search for alternatives to regenerate the dental pulp, two alternative regenerative endodontic procedures (REP) have been proposed: (I) cell-free REP (based in revascularization and homing induction to remaining dental pulp stem cells (DPSC) and even stem cells from apical papilla (SCAP) and (II) cell-based REP (with exogenous cell transplantation). Regarding the last topic, we show several limitations with these procedures and therefore, we propose a novel regenerative approach in order to revitalize the pulp and thus restore homeostatic functions to the dentin-pulp complex. Due to their multifactorial biological effects, the use of mesenchymal stem cells (MSC)-derived secretome from non-dental sources could be considered as inducers of DPSC and SCAP to completely regenerate the dental pulp. In partial pulp damage, appropriate stimulate DPSC by MSC-derived secretome could contribute to formation and also to restore the vasculature and nerves of the dental pulp.
牙齿由硬组织和软组织构成，是口腔中复杂的功能结构，常受导致结构损伤并可能致使牙齿脱落的病变影响。目前，诸如牙髓治疗或植入等替代疗法可修复结构缺陷，但无法发挥任何生物学功能，比如恢复血液和神经供应。在探寻使牙髓再生的替代方法过程中，已提出两种替代性再生牙髓治疗程序（REP）：（I）无细胞REP（基于血管再生以及对残留牙髓干细胞（DPSC）乃至根尖乳头干细胞（SCAP）的归巢诱导）和（II）基于细胞的REP（进行外源性细胞移植）。关于最后这个主题，我们指出了这些程序存在的若干局限性，因此，我们提出一种新颖的再生方法，以重振牙髓，从而恢复牙本质 - 牙髓复合体的稳态功能。鉴于其多因素生物学效应，使用源自非牙科来源的间充质干细胞（MSC）分泌组可被视为诱导DPSC和SCAP完全再生牙髓的诱导剂。在部分牙髓损伤中，通过MSC分泌组适当刺激DPSC有助于牙髓的形成，还能恢复牙髓的血管和神经。
