Pulp regeneration with hemostatic matrices as a scaffold in an immature tooth minipig model

Abstract

Control of blood clotting in root canal systems is one of the most critical and difficult concerns for regenerative endodontics therapy (RET). The purpose of this study was to investigate the effects of using gelatin- and fibrin-based hemostatic hydrogels as a scaffold on pulp regeneration in a minipig model . Cell viability of human dental pulp stem cells cultured three-dimensionally in gelatin-based and fibrin-based scaffolds was evaluated by MTT and live/dead assay. RET was performed on 24 immature premolars with an autologous blood clot (PC), gelatin-based and fibrin-based hemostatic matrices (GM and FM), or without the insertion of a scaffold (NC). The follow-up period was 12 weeks. Radiographic and histologic assessments for pulp regeneration were performed. Gelatin-based scaffolds exhibited significantly higher cell viability than fibrin-based scaffolds after 15 days ( P < 0.05). The PC and GM groups showed favorable root development without inflammation and newly mineralized tissue deposited in the root canal system, while FM group presented inflammatory changes with the continuation of root development. The NC group exhibited internal root resorption with periapical lesions. The application of GM in RET led to favorable clinical outcomes of root development without inflammatory changes compared to conventional RET. Our results suggest that GM may serve as a viable regenerative scaffold for pulp regeneration.

Evaluation of a collagen-bioaggregate composite scaffold in the repair of sheep pulp tissue

“…Gelatin is a collagen based biopolymer protein. And they reported that significantly higher cell viability was observed at the gelatin-based scaffolds group when compared with the fibrin-based scaffolds group ( 40 ). We, therefore, used type I collagen as the other component of our sponges.…”

Clinical Potential of Dental Pulp Stem Cells in Pulp Regeneration: Current Endodontic Progress and Future Perspectives

“…Gelfoam was used as a scaffold for applying autologous DPSCs in dogs ( Wang et al, 2013 ), and an injectable nanopeptide hydrogel was also used to apply porcine DPSCs ( Mangione et al, 2017 ). In addition, it was reported that the gelatin-based scaffold was histologically and radiologically more effective than the fibrin-based scaffold when human DPSCs were placed on gelatin- or fibrin-based scaffolds and transplanted into minipigs ( Jang et al, 2020 ). Furthermore, to use the tissue most similar to the original tissue as a scaffold, decellularized swine dental pulp tissue was used as a scaffold and applied to human DPSCs, and the regeneration of pulp-like tissue was confirmed histologically ( Hu et al, 2017 ).…”

Hydrogels and Dentin–Pulp Complex Regeneration: From the Benchtop to Clinical Translation

“…Hydrogels should maintain the desired volume and structural integrity for the required time to perform this function [ 59 ]. For dentin–pulp complex regeneration, hydrogels act as carriers of stem/progenitor cells with odontogenic potential, such as DPSCs [ 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ], odontoblasts-like cells [ 68 , 69 , 70 ], HUVECs [ 64 , 71 ], SCAP [ 72 , 73 ], SHED [ 66 , 74 , 75 , 76 ], BMMSCs [ 66 , 77 , 78 , 79 , 80 ], PDLSCs [ 66 ], endothelial cells [ 78 ] and primary dental pulp cells [ 81 ]. They can also act as carriers for the local delivery of antibiotics, such as clindamycin [ 82 ] and bioactive molecules, aiming to promote tissue regeneration, such as VEGF [ 20 , 61 , 83 ], FGF [ 20 , 83 , 84 , 85 ], BMP [ 65 ], TGF-β1 [ 20 , 86 ], stem cell factor [ 87 ], dentonin sequence [ 88 ] and RGD cell-binding motifs [ 56 , 89 ].…”

“…Additionally, odontoblasts lining the pulp cavity and deposition of reparative dentin along dentinal walls were detectable. DPSCs-laden GelMA showed more promising results as compared to DPSCs-laden fibrin hydrogel, which was associated with periapical radiolucency and internal root resorption [ 67 ].…”