Su Wanting, Liao Chufang, Liu Xiangning
School of Stomatology, Jinan University, Guangzhou, China.
Clinical Research Platform for Interdiscipline of Stomatology, Jinan University, Guangzhou, China.
Int Endod J. 2025 Mar;58(3):391-410. doi: 10.1111/iej.14180. Epub 2024 Dec 11.
Dental pulp tissue engineering is expected to become an ideal treatment for irreversible pulpitis and apical periodontitis. However, angiogenesis and neurogenesis for functional pulp regeneration have not yet met the standard for large-scale clinical application, and need further research.
This review focused on the potential mechanisms of angiogenesis and neurogenesis in pulp regeneration, including stem cell types, upstream and downstream regulatory molecules and cascade signalling pathways, thereby providing a theoretical basis and inspiring new ideas to improve the effectiveness of dental pulp tissue engineering.
An electronic literature search was carried out using the keywords of 'pulp regeneration', 'stem cell transplantation', 'dental pulp stem cells', 'angiogenesis' and 'neurogenesis'. The resulting literature was screened and reviewed.
Stem cells used in dental pulp tissue engineering can be classified as dental-derived and non-dental-derived stem cells, amongst which dental pulp stem cells (DPSC) have achieved promising results in animal experiments and clinical trials. Multiple molecules and signalling pathways are involved in the process of DPSC-mediated angiogenic and neurogenetic regeneration. In order to promote angiogenesis and neurogenesis in pulp regeneration, feasible measures include the addition of growth factors, the modulation of transcription factors and signalling pathways, the use of extracellular vesicles and the modification of bioscaffold materials.
Dental pulp tissue engineering has had breakthroughs in preclinical and clinical studies in vivo. Overcoming difficulties in pulpal angiogenesis and neurogenesis, and achieving functional pulp regeneration will lead to a significant impact in endodontics.
牙髓组织工程有望成为不可逆性牙髓炎和根尖周炎的理想治疗方法。然而，用于功能性牙髓再生的血管生成和神经发生尚未达到大规模临床应用的标准，需要进一步研究。
本综述聚焦于牙髓再生中血管生成和神经发生的潜在机制，包括干细胞类型、上下游调节分子和级联信号通路，从而为提高牙髓组织工程的有效性提供理论依据并启发新思路。
使用“牙髓再生”“干细胞移植”“牙髓干细胞”“血管生成”和“神经发生”等关键词进行电子文献检索。对检索到的文献进行筛选和综述。
牙髓组织工程中使用的干细胞可分为牙源性和非牙源性干细胞，其中牙髓干细胞（DPSC）在动物实验和临床试验中已取得了有前景的结果。多种分子和信号通路参与了DPSC介导的血管生成和神经发生再生过程。为促进牙髓再生中的血管生成和神经发生，可行的措施包括添加生长因子、调节转录因子和信号通路、使用细胞外囊泡以及修饰生物支架材料。
牙髓组织工程在体内的临床前和临床研究中已取得突破。克服牙髓血管生成和神经发生方面的困难，并实现功能性牙髓再生将对牙髓病学产生重大影响。
