Dental pulp tissue engineering

Abstract

Dental pulp is a highly specialized mesenchymal tissue that has a limited regeneration capacity due to anatomical arrangement and postmitotic nature of odontoblastic cells. Entire pulp amputation followed by pulp space disinfection and filling with an artificial material cause loss of a significant amount of dentin leaving as life-lasting sequelae a non-vital and weakened tooth. However, regenerative endodontics is an emerging field of modern tissue engineering that has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. Thereby, this article reviews the most recent endeavors to regenerate pulp tissue based on tissue engineering principles and provides insightful information to readers about the different aspects involved in tissue engineering. Here, we speculate that the search for the ideal combination of cells, scaffolds, and morphogenic factors for dental pulp tissue engineering may be extended over future years and result in significant advances in other areas of dental and craniofacial research. The findings collected in this literature review show that we are now at a stage in which engineering a complex tissue, such as the dental pulp, is no longer an unachievable goal and the next decade will certainly be an exciting time for dental and craniofacial research.

What is the clinical applicability of regenerative therapies in dentistry?

“…Tissue engineering is a multidisciplinary field that combines principles of physics and chemistry with biological sciences, aiming towards the regeneration of tissues and organs 1 . It is based on a triad composed of stem cells, which are undifferentiated cells with the capacity to originate several cell lines, the scaffolds, which simulate the extracellular matrix and act as a skeleton providing the support for these cells, and growth factors, which are bioactive molecules, mediators of cellular activity, thus regulating their behavior 1 .…”

“…It is based on a triad composed of stem cells, which are undifferentiated cells with the capacity to originate several cell lines, the scaffolds, which simulate the extracellular matrix and act as a skeleton providing the support for these cells, and growth factors, which are bioactive molecules, mediators of cellular activity, thus regulating their behavior 1 .…”

“…Embryonic stem cells were t he first to be studied presenting pluripotency, i.e. they have the ability to differentiate into all cell types of the adult organism 1 . However, the use of these cells still arouses heated ethical discussion around the world, which has caused researchers to look for alternative sources of adult stem cells, also has recently been used to reprogram stem cells genetically by inserting specific genes of interest into the cellular genome.…”

“…These materials are able to repair the function of the stomatognathic system, but do not reestablish the biological activity and consequently interactions with the other oral structures 1 . Calcium hydroxide (Ca(OH) 2 ) and Mineral Trioxide Aggregate (MTA) are materials widely used by dentists to protect pulp tissue 11 .…”

“…These, in turn, can be isolated from bone marrow (BMSC), adipose tissue (ASC) and from various regions of the oral cavity. Somatic stem cells are a more favorable source for application in tissue engineering because they do not present ethical impediments 1 . Gronthos et al 3 performed the first isolation of stem cells from dental pulp (DPSCs) and demonstrated, for the first time, that they were able to form a tissue similar to dentin.…”