Future dentistry: cell therapy meets tooth and periodontal repair and regeneration

Abstract

Cell-based tissue repair of the tooth and – tooth-supporting – periodontal ligament (PDL) is a new attractive approach that complements traditional restorative or surgical techniques for replacement of injured or pathologically damaged tissues. In such therapeutic approaches, stem cells and/or progenitor cells are manipulated in vitro and administered to patients as living and dynamic biological agents. In this review, we discuss the clonogenic potential of human dental and periodontal tissues such as the dental pulp and the PDL and their potential for tooth and periodontal repair and/or regeneration. We propose novel therapeutic approaches using stem cells or progenitor cells, which are targeted to regenerate the lost dental or periodontal tissue.

Stem cell-based approaches in dentistry

“…The theoretical basis for dental tissue repair is the activation of stem and progenitor cells that will enhance the regenerative process (Bluteau et al, 2008;Caton et al, 2011). Mesenchymal stem cells (MSCs) were originally isolated from bone marrow (Friedenstein et al, 1970).…”

Multipotent Dental Stem Cells: An Alternative Adult Derived Stem Cell Source for Regenerative Medicine

“…When a patient's dental pulp cavity becomes infected or diseased, often the entire pulp is removed and replaced with a filling. Due to the ability of DPSCs to form the dentine-pulp-like complex in vivo, it has been suggested that this may soon be an option for regenerative therapy of teeth (Caton et al, 2010). SHEDs also have shown potential for regenerating the dental-pulp-like tissue in vivo when transplanted into immunocompromised mice (Cordeiro et al, 2008) and therefore may be useful for future regenerative endodontic procedures.…”

“…An important development in tissue engineering is the use of hydroxyapatite/ tricalcium phosphate (HA/TCP) particles and other carrier particles that allow dental stem cells cultured in vitro and delivered in vivo (Caton et al, 2010;Sharma et al, 2010). Also important to for dental tissue engineering is developing appropriate biodegradable scaffolds that can be seeded with stem cells for use in transplants and that provide the correct 3D space for differentiation (Caton et al, 2010;Dannan, 2009;Huang, 2009;Sharma et al, 2010;Yen and Sharpe, 2008). Scaffolds are made from both synthetic polymers like polylactic acid (PLA), polyglycolic acid (PGA), polylacticco-glycolic acid (PLGA), and polycaprolactone (PCL)) or natural polymers like collagen, fibrin, polysaccharides and alginates (Sharma et al, 2010).…”

Insulin-Like Growth Factor 1 Receptor and p38 Mitogen-Activated Protein Kinase Signals Inversely Regulate Signal Transducer and Activator of Transcription 3 Activity to Control Human Dental Pulp Stem Cell Quiescence, Propagation, and Differentiation

“…The factors that control this balance are currently being identified in hematopoietic, nervous, and epithelial tissues, but the factors that control the quiescence and activation of DPSCs still await discovery. It has been shown, however, that tumor necrosis factor alpha (TNFa) and other inflammatory factors can activate odontoblastic precursors and stimulate their proliferation and differentiation in response to bacterial infection [16,26,27]. Other studies have shown that the downstream targets of TNFa, the p38 mitogen-activated protein kinase (p38 MAPK) [27][28][29] and the insulin-like growth factor 1 receptor (IGF-1R) [30][31][32], also control odontoblast differentiation [33][34][35] and development [36,37].…”