Vital Pulp Therapy—Current Progress of Dental Pulp Regeneration and Revascularization

Pulp vitality is extremely important for the tooth viability, since it provides nutrition and acts as biosensor to detect pathogenic stimuli. In the dental clinic, most dental pulp infections are irreversible due to its anatomical position and organization. It is difficult for the body to eliminate the infection, which subsequently persists and worsens. The widely used strategy currently in the clinic is to partly or fully remove the contaminated pulp tissue, and fill and seal the void space with synthetic material. Over time, the pulpless tooth, now lacking proper blood supply and nervous system, becomes more vulnerable to injury. Recently, potential for successful pulp regeneration and revascularization therapies is increasing due to accumulated knowledge of stem cells, especially dental pulp stem cells. This paper will review current progress and feasible strategies for dental pulp regeneration and revascularization.

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Characterization of Stable Hypoxia-Preconditioned Dental Pulp Stem Cells: Implication for Pulp Regeneration

10.21203/rs.3.rs-102950/v1 ◽

2020 ◽

Author(s):

Mohammed Zayed ◽

Koichiro Iohara ◽

Hideto Watanabe ◽

Mami Ishikawa ◽

Michiyo Tominaga ◽

...

Keyword(s):

Stem Cells ◽

Stem Cell ◽

Dental Pulp ◽

Clinical Utility ◽

Dental Pulp Stem Cells ◽

Proliferation Rate ◽

Stem Cell Marker ◽

Stem Cell Markers ◽

Pulp Tissue ◽

Pulp Regeneration

Abstract Background: Dental pulp stem cells (DPSCs) have been developed as a potential source of mesenchymal stem cells (MSCs) for regeneration of dental pulp and other tissues. However, further strategies to isolate highly functional DPSCs beyond the colony-forming methods are required. Our clinical study has demonstrated safety and efficacy of DPSCs isolated by G-CSF-induced mobilization and cultured under normoxia (mobilized DPSCs, MDPSCs) for pulp regeneration. It is well known that the oxygen concentration is closely linked to the maintenance of stemness. Thus, in this investigation, hypoxia-preconditioned DPSCs (hpDPSCs) was characterized to develop and improve the clinical utility for regeneration of dental pulp in endodontics.Methods: Colony-forming DPSCs were isolated and preconditioned with hypoxia in a stable closed cultured system and compared with MDPSCs isolated from the individual dog teeth. We examined the proliferation rate, migration potential, anti-apoptotic activity and gene expression of the stem cell markers and angiogenic/neurotrophic factors. Trophic effects of the conditioned medium (CM) were also evaluated. In addition, the expression of immunomodulatory molecules upon stimulation with IFN-γ were investigated. The pulp regenerative potential and transplantation safety of hpDPSCs were further assessed in pulpectomized teeth in dogs by histological and immunohistochemical analyses and by chemistry of blood and urine. tests Results: hpDPSCs demonstrated higher proliferation rate and expression of a major regulator of oxygen homeostasis, HIF-1α, and a stem cell marker, CXCR-4. The direct migratory activity of hpDPSCs in response to G-CSF was significantly higher than MDPSCs. The CM of hpDPSCs stimulated neurite extension. However, there were no changes in angiogenic, migration and anti-apoptotic activities compared with the CM of MDPSCs. The expression of immunomodulatory gene, PTGE was significantly up-regulated by IFN gamma in hpDPSCs compared with MDPSCs. However, no difference in nitric oxide was observed. The regenerated pulp tissue was quantitatively and qualitatively similar in hpDPSC transplants compared with MDPSC transplants in dog teeth. There was no evidence of toxicity or adverse events of the hpDPSC transplantation Conclusions: These results demonstrated that hpDPSCs improved stem cell properties compared to MDPSCs, suggesting their potential clinical utility for pulp regeneration.

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LECZENIE BIOLOGICZNE MIAZGI ZĘBÓW STAŁYCH

Pomeranian Journal of Life Sciences ◽

10.21164/pomjlifesci.38 ◽

2016 ◽

Vol 60 (2) ◽

Author(s):

Piotr Makowiecki ◽

Matylda Trusewicz ◽

Łukasz Tyszler ◽

Jadwiga Buczkowska-Radlińska

Keyword(s):

Treatment Option ◽

Dental Pulp ◽

Permanent Teeth ◽

Accurate Assessment ◽

Tissue Destruction ◽

Pulp Tissue ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Tooth Survival ◽

Tooth Tissue

The vitality of dental pulp is essential for long‍‑term tooth survival. The aim of vital pulp therapy is to preserve vital, healthy pulp tissue. This therapy’s foundation is the elimination of bacteria from the dentin‍‑pulp complex. The treatment option depends on the cause and extent of mineralised tooth tissue destruction. The outcome of such treatment is determined by accurate assessment of the pulp’s status and the dentist’s ability to predict the success of the therapy. The aim of this review is to facilitate the dentist in making a proper decision referring to vital pulp therapy in permanent teeth, and to provide an overview of new approaches in such treatment.

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Comparative biological properties and mineralization potential of three endodontic materials for vital pulp therapy: Theracal PT, Theracal LC, and Biodentine on human dental pulp stem cells (hDPSCs).

Journal of Endodontics ◽

10.1016/j.joen.2021.08.001 ◽

2021 ◽

Author(s):

José L. Sanz ◽

Anna Soler-Doria ◽

Sergio López-García ◽

David García-Bernal ◽

Francisco J. Rodríguez-Lozano ◽

...

Keyword(s):

Stem Cells ◽

Dental Pulp ◽

Biological Properties ◽

Dental Pulp Stem Cells ◽

Pulp Therapy ◽

Mineralization Potential ◽

Vital Pulp Therapy ◽

Human Dental Pulp

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Stem Cells Derived from Human Exfoliated Deciduous teeth [shed] in Neuronal Disorders: A Review

Current Stem Cell Research & Therapy ◽

10.2174/1574888x16666201221151512 ◽

2020 ◽

Vol 16 ◽

Author(s):

Minu Anoop ◽

Indrani Datta

Keyword(s):

Stem Cells ◽

Neurodegenerative Diseases ◽

Dental Pulp ◽

Therapeutic Potential ◽

Permanent Teeth ◽

Deciduous Teeth ◽

Proliferative Potential ◽

Pulp Tissue ◽

Human Exfoliated Deciduous Teeth

: Most conventional treatments for neurodegenerative diseases fail due to their focus on neuroprotection rather than neurorestoration. Stem cell‐based therapies are becoming a potential treatment option for neurodegenerative diseases as they can home in, engraft, differentiate and produce factors for CNS recovery. Stem cells derived from human dental pulp tissue differ from other sources of mesenchymal stem cells due to their embryonic neural crest origin and neurotrophic property. These include both dental pulp stem cells [DPSCs] from dental pulp tissues of human permanent teeth and stem cells from human exfoliated deciduous teeth [SHED]. SHED offer many advantages over other types of MSCs such as good proliferative potential, minimal invasive procurement, neuronal differentiation and neurotrophic capacity, and negligible ethical concerns. The therapeutic potential of SHED is attributed to the paracrine action of extracellularly released secreted factors, specifically the secretome, of which exosomes is a key component. SHED and its conditioned media can be effective in neurodegeneration through multiple mechanisms, including cell replacement, paracrine effects, angiogenesis, synaptogenesis, immunomodulation, and apoptosis inhibition, and SHED exosomes offer an ideal refined bed-to-bench formulation in neurodegenerative disorders. However, in spite of these advantages, there are still some limitations of SHED exosome therapy, such as the effectiveness of long-term storage of SHED and their exosomes, the development of a robust GMP-grade manufacturing protocol, optimization of the route of administration, and evaluation of the efficacy and safety in humans. In this review, we have addressed the isolation, collection and properties of SHED along with its therapeutic potential on in vitro and in vivo neuronal disorder models as evident from the published literature.

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Odontoblast-Like Cells Differentiated from Dental Pulp Stem Cells Retain Their Phenotype after Subcultivation

International Journal of Cell Biology ◽

10.1155/2018/6853189 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 12

Author(s):

Paula A. Baldión ◽

Myriam L. Velandia-Romero ◽

Jaime E. Castellanos

Keyword(s):

Stem Cells ◽

Dental Pulp ◽

Matrix Protein ◽

Dental Materials ◽

Dental Pulp Stem Cells ◽

Cell Physiology ◽

Pulp Tissue ◽

Alizarin Red ◽

Dentin Matrix Protein ◽

Mineral Deposition

Odontoblasts, the main cell type in teeth pulp tissue, are not cultivable and they are responsible for the first line of response after dental restauration. Studies on dental materials cytotoxicity and odontoblast cells physiology require large quantity of homogenous cells retaining most of the phenotype characteristics. Odontoblast-like cells (OLC) were differentiated from human dental pulp stem cells using differentiation medium (containing TGF-β1), and OLC expanded after trypsinization (EXP-21) were evaluated and compared. Despite a slower cell growth curve, EXP-21 cells express similarly the odontoblast markers dentinal sialophosphoprotein and dentin matrix protein-1 concomitantly with RUNX2 transcripts and low alkaline phosphatase activity as expected. Both OLC and EXP-21 cells showed similar mineral deposition activity evidenced by alizarin red and von Kossa staining. These results pointed out minor changes in phenotype of subcultured EXP-21 regarding the primarily differentiated OLC, making the subcultivation of these cells a useful strategy to obtain odontoblasts for biocompatibility or cell physiology studies in dentistry.

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Cell-derived micro-environment helps dental pulp stem cells promote dental pulp regeneration

Cell Proliferation ◽

10.1111/cpr.12361 ◽

2017 ◽

Vol 50 (5) ◽

pp. e12361 ◽

Cited By ~ 7

Author(s):

Xuexin Zhang ◽

Hui Li ◽

Jingjing Sun ◽

Xiangyou Luo ◽

Hefeng Yang ◽

...

Keyword(s):

Stem Cells ◽

Dental Pulp ◽

Dental Pulp Stem Cells ◽

Pulp Regeneration

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Dental Pulp Tissue Regeneration Using Dental Pulp Stem Cells Isolated and Expanded in Human Serum

Journal of Endodontics ◽

10.1016/j.joen.2016.11.018 ◽

2017 ◽

Vol 43 (4) ◽

pp. 568-574 ◽

Cited By ~ 16

Author(s):

Evandro Piva ◽

Susan A. Tarlé ◽

Jacques E. Nör ◽

Duohong Zou ◽

Elizabeth Hatfield ◽

...

Keyword(s):

Stem Cells ◽

Human Serum ◽

Tissue Regeneration ◽

Dental Pulp ◽

Dental Pulp Stem Cells ◽

Pulp Tissue ◽

Dental Pulp Tissue ◽

Pulp Tissue Regeneration

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A Cell-Based Approach to Dental Pulp Regeneration Using Mesenchymal Stem Cells: A Scoping Review

International Journal of Molecular Sciences ◽

10.3390/ijms22094357 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4357

Author(s):

Sahng G. Kim

Keyword(s):

Stem Cells ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Scoping Review ◽

Clinical Studies ◽

Dental Pulp ◽

Animal Studies ◽

Risk Of Bias ◽

Pulp Regeneration

Despite the recent explosion of investigations on dental pulp regeneration using various tissue engineering strategies, the translation of the findings from such studies into therapeutic applications has not been properly achieved. The purpose of this scoping review was to systematically review the efficacy of mesenchymal stem cell transplantation for dental pulp regeneration. A literature search was conducted using five electronic databases from their inception to January 2021 and supplemented by hand searches. A total of 17 studies, including two clinical trials and 15 animal studies using orthotopic pulp regeneration models, were included for the review. The risk of bias for the individual studies was assessed. This scoping review demonstrated that the regeneration of vascularized pulp-like tissue was achieved using the stem cell transplantation strategy in animal models. Autologous cell transplantation in two clinical studies also successfully regenerated vascularized vital tissue. Dental pulp stem cell subpopulations, such as mobilized dental pulp stem cells, injectable scaffolds such as atelocollagen, and a granulocyte-colony forming factor, were the most commonly used for pulp regeneration. The overall risk of bias was unclear for animal studies and was moderate or judged to raise some concerns for clinical studies. More high-quality clinical studies are needed to further determine the safety and efficacy of the stem cell transplantation strategy for dental pulp regeneration.

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