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The Role of Stem Cell Therapy in Regeneration of Dentine-Pulp Complex: A Systematic Review Publisher



Bakhtiar H1, 2 ; Mazidi S A3 ; Mohammadi Asl S3 ; Ellini MR1, 3 ; Moshiri A4 ; Nekoofar MH5 ; Dummer PMH6
Authors
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Authors Affiliations
  1. 1. Endodontic Department, Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
  2. 2. Stem Cell Research Center, Central Tehran Branch, Islamic Azad University, No. 4, 10th Neyestan St., Pasdaran Ave, Tehran, Iran
  3. 3. Student Research Committee, Islamic Azad University, Tehran branch, No. 4, 10th Neyestan St., Pasdaran Ave, Tehran, Iran
  4. 4. Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, West Fatemi St, Etemadzadeh St, Tehran, Iran
  5. 5. Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, North Karegar St, P.O. Box: 14395-433, Tehran, 14399-55991, Iran
  6. 6. Endodontology Research Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom

Source: Progress in Biomaterials Published:2018


Abstract

Infection of the dental pulp will result in inflammation and eventually tissue necrosis which is treated conventionally by pulpectomy and root canal treatment. Advances in regenerative medicine and tissue engineering along with the introduction of new sources of stem cells have led to the possibility of pulp tissue regeneration. This systematic review analyzes animal studies published since 2010 to determine the ability of stem cell therapy to regenerate the dentine-pulp complex (DPC) and the success of clinical protocols. In vitro and human clinical studies are excluded and only the experimental studies on animal models were included. Dental pulp stem cells constitute the most commonly used cell type. The majority of stem cells are incorporated into various types of scaffold and implanted into root canals. Some of the studies combine growth factors with stem cells in an attempt to improve the outcome. Studies of ectopic transplantation using small animal models are simple and non-systematic evaluation techniques. Stem cell concentrations have not been so far reported; therefore, the translational value of such animal studies remains questionable. Though all types of stem cells appear capable of regenerating a dentine-pulp complex, still several factors have been considered in selecting the cell type. Co-administrative factors are essential for inducing the systemic migration of stem cells, and their vascularization and differentiation into odontoblast-like cells. Scaffolds provide a biodegradable structure able to control the release of growth factors. To identify problems and reduce costs, novel strategies should be initially tested in subcutaneous or renal capsule implantation followed by root canal models to confirm results. © 2018, The Author(s).