Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Department of Biologic and Materials Science, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Dent Mater. 2023 Apr;39(4):333-349. doi: 10.1016/j.dental.2023.03.013. Epub 2023 Mar 7.
The current standard for treating irreversibly damaged dental pulp is root canal therapy, which involves complete removal and debridement of the pulp space and filling with an inert biomaterial. A regenerative approach to treating diseased dental pulp may allow for complete healing of the native tooth structure and enhance the long-term outcome of once-necrotic teeth. The aim of this paper is, therefore, to highlight the current state of dental pulp tissue engineering and immunomodulatory biomaterials properties, identifying exciting opportunities for their synergy in developing next-generation biomaterials-driven technologies.
An overview of the inflammatory process focusing on immune responses of the dental pulp, followed by periapical and periodontal tissue inflammation are elaborated. Then, the most recent advances in treating infection-induced inflammatory oral diseases, focusing on biocompatible materials with immunomodulatory properties are discussed. Of note, we highlight some of the most used modifications in biomaterials' surface, or content/drug incorporation focused on immunomodulation based on an extensive literature search over the last decade.
We provide the readers with a critical summary of recent advances in immunomodulation related to pulpal, periapical, and periodontal diseases while bringing light to tissue engineering strategies focusing on healing and regenerating multiple tissue types.
Significant advances have been made in developing biomaterials that take advantage of the host's immune system to guide a specific regenerative outcome. Biomaterials that efficiently and predictably modulate cells in the dental pulp complex hold significant clinical promise for improving standards of care compared to endodontic root canal therapy.
目前治疗不可逆转牙髓损伤的标准方法是根管治疗，该方法涉及牙髓空间的完全清除和清创，并填充惰性生物材料。采用再生方法治疗病变牙髓可能允许天然牙结构的完全愈合，并增强曾经坏死牙齿的长期预后。因此，本文的目的是强调牙髓组织工程和免疫调节生物材料特性的现状，确定它们在开发下一代基于生物材料的技术方面协同作用的令人兴奋的机会。
概述了炎症过程，重点介绍了牙髓的免疫反应，以及随后的根尖周和牙周组织炎症。然后，讨论了最近在治疗感染引起的炎症性口腔疾病方面的进展，重点是具有免疫调节特性的生物相容性材料。值得注意的是，我们根据过去十年的大量文献搜索，强调了生物材料表面或内容/药物掺入方面的一些最常用的修饰，这些修饰侧重于基于免疫调节的方法。
我们为读者提供了有关牙髓、根尖周和牙周疾病相关免疫调节的最新进展的批判性总结，同时还介绍了侧重于愈合和再生多种组织类型的组织工程策略。
在开发利用宿主免疫系统来引导特定再生结果的生物材料方面已经取得了重大进展。与根管治疗相比，能够高效且可预测地调节牙髓复合体中细胞的生物材料为改善护理标准提供了重要的临床前景。
