Dental Pulp Tissue Engineering in Full-length Human Root Canals

Abstract

The clinical translation of stem-cell-based dental pulp regeneration will require the use of injectable scaffolds. Here, we tested the hypothesis that stem cells from exfoliated deciduous teeth (SHED) can generate a functional dental pulp when injected into full-length root canals. SHED survived and began to express putative markers of odontoblastic differentiation after 7 days when mixed with Puramatrix™ (peptide hydrogel), or after 14 days when mixed with recombinant human Collagen (rhCollagen) type I, and injected into the root canals of human premolars in vitro. Roots of human premolars injected with scaffolds (Puramatrix™ or rhCollagen) containing SHED were implanted subcutaneously into immunodeficient mice (CB-17 SCID). We observed pulp-like tissues with odontoblasts capable of generating new tubular dentin throughout the root canals. Notably, the pulp tissue engineered with SHED injected with either Puramatrix™ or rhCollagen type I presented similar cellularity and vascularization when compared with control human dental pulps. Analysis of these data, collectively, demonstrates that SHED injected into full-length human root canals differentiate into functional odontoblasts, and suggests that such a strategy might facilitate the completion of root formation in necrotic immature permanent teeth.

Stem Cell Transplantation for Pulpal Regeneration: A Systematic Review

“…3,23 The efficacy of pulpal tissue regeneration has been predominantly assessed using qualitative histological approaches, with only few studies applying quantitative evaluations (defining and quantifying the amount of the experimentally regenerated tissues). A challenge to the quantitative assessment of a successful pulpdentin complex regeneration remains-the definition of the primary regenerative outcomes; whether neural, vascular, soft, or hard tissue/dentinal regeneration.…”

“…2 Recent advances in tissue engineering have paved the way for biologically reparative/regenerative pulpal therapy. 3 Stem/progenitor cell transplantation for tissue regeneration has been applied with promising results in various medical fields, including the treatment of cardiovascular diseases 4 and for periodontal regeneration. 5 Generally, such treatments aim at modulating the local microenvironment to be more inductive for endogenous cells, 6,7 to enhance the migration, proliferation, and commitment of endogenous and/or exogenous stem/progenitor cells to suitably committed cells, and to favor the biosynthesis of extracellular matrix components for tissue regeneration.…”

Graphene and graphene oxide as nanomaterials for medicine and biology application

“…Polymeric substances have wide use in dentistry and biomedical field [128]. However, some of the polymer-based materials used in regenerative and reconstructive dentistry are poorly suited for areas that bear the load and may induce inflammatory responses.…”

Is There a Role for Neural Crest Stem Cells in Periodontal Regeneration?

“…When subcutaneously transplanted into immunocompromised mice, SHED showed the capacity to produce bone-like structures on the surface of ceramic bovine bone scaffolds [39]. SHED also exhibited the potential to differentiate into odontoblasts and endothelial cells and, consequently, promoted the formation of dentin and microvessels; SHED cultured in tooth root complexes that were composed of the roots of human premolars within nanofiber hydrogel or collagen scaffolds upregulated the expression of dentin-related genes in vitro [45]. After implantation of these complexes into the dorsum of immunocompromised mice, SHED-derived connective tissues occupied the full extension of the root canal.…”