Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Biomolecules. 2024 Mar 11;14(3):330. doi: 10.3390/biom14030330.
Pulpitis is a common and frequent disease in dental clinics. Although vital pulp therapy and root canal treatment can stop the progression of inflammation, they do not allow for genuine structural regeneration and functional reconstruction of the pulp-dentin complex. In recent years, with the development of tissue engineering and regenerative medicine, research on stem cell-based regenerative endodontic therapy (RET) has achieved satisfactory preliminary results, significantly enhancing its clinical translational prospects. As one of the crucial paracrine effectors, the roles and functions of exosomes in pulp-dentin complex regeneration have gained considerable attention. Due to their advantages of cost-effectiveness, extensive sources, favorable biocompatibility, and high safety, exosomes are considered promising therapeutic tools to promote dental pulp regeneration. Accordingly, in this article, we first focus on the biological properties of exosomes, including their biogenesis, uptake, isolation, and characterization. Then, from the perspectives of cell proliferation, migration, odontogenesis, angiogenesis, and neurogenesis, we aim to reveal the roles and mechanisms of exosomes involved in regenerative endodontics. Lastly, immense efforts are made to illustrate the clinical strategies and influencing factors of exosomes applied in dental pulp regeneration, such as types of parental cells, culture conditions of parent cells, exosome concentrations, and scaffold materials, in an attempt to lay a solid foundation for exploring and facilitating the therapeutic strategy of exosome-based regenerative endodontic procedures.
牙髓病是口腔临床的常见病和多发病。尽管活髓治疗和根管治疗可以阻止炎症的进展，但它们不能实现牙髓牙本质复合体的真正结构再生和功能重建。近年来，随着组织工程和再生医学的发展，基于干细胞的再生性根管治疗（RET）的研究取得了令人满意的初步结果，显著提高了其临床转化前景。作为重要的旁分泌效应物之一，外泌体在牙髓牙本质复合体再生中的作用和功能引起了广泛关注。由于其具有成本效益高、来源广泛、良好的生物相容性和高安全性等优点，外泌体被认为是促进牙髓再生的有前途的治疗工具。因此，在本文中，我们首先重点介绍外泌体的生物学特性，包括其发生、摄取、分离和鉴定。然后，从细胞增殖、迁移、牙源性分化、血管生成和神经生成的角度，揭示外泌体在再生性根管治疗中涉及的作用和机制。最后，我们还努力阐明外泌体在牙髓再生中的临床策略和影响因素，如亲本细胞类型、亲本细胞的培养条件、外泌体浓度和支架材料等，旨在为探索和促进基于外泌体的再生性根管治疗策略奠定基础。
