Pulp Stem Cell–Mediated Functional Pulp Regeneration

Abstract

The preservation of vital dental pulp with vasculature and nerve components remains one of the most significant challenges in modern dentistry. Due to the immense potential for neurovascularization, mesenchymal stem cell (MSC) transplantation has shown emerging promise in regenerative medicine and dental translational practice. Actually, pulp mesenchymal stem cells, including postnatal dental pulp stem cells (from permanent teeth) and stem cells from human exfoliated deciduous teeth, possess unique properties based on their origins from neural crest or glial cells. Furthermore, they reside in a neurovascular niche and have the potential for neurogenesis, angiogenesis, and neurovascular inductive activity. According to current pulp regeneration strategies, pulp stem cell–mediated approaches to regeneration have demonstrated convincing evidence that they can rebuild the complex histologic structure of native pulp in situ with highly organized physiologic patterns or even achieve de novo regeneration of complete dental pulp tissues. More importantly, recent clinical studies emphasized in situ neurovascularization outcomes in successful regeneration of vitalized pulp via pulp stem cell transplantation. In this review, we summarize recent breakthroughs in pulp stem cell–mediated pulp regeneration, emphasizing the crucial achievement of neurovascularization. This functional pulp regeneration represents an innovative and promising approach for future regenerative endodontics.

Pulp stem cells derived from human permanent and deciduous teeth: Biological characteristics and therapeutic applications

“…Regarding the favorable extraoral applications of PSCs, although adverse impacts of PSC transplantation have not been reported, biosecurity concerns with stem cell transplantation are still prevalent, including pathogen transmission and tumorigenesis which impede their more extensive therapeutic applicability. In this scenario, first, there is an emerging desire to provide optimized PSCs‐associated infrastructure, including the launch of multicenter combined clinical trials, PSC industrialization based on potential genotypic matches and favorable culture and cryopreservation properties, as well as establishment of good manufacturing practice‐grade PSC banking . Then, the long‐term reliability should be carefully evaluated.…”

Pulp-Derived Exosomes in a Fibrin-Based Regenerative Root Filling Material

“…Dental pulp is a unique epithelium-free soft tissue in a hard tissue shell. It is characterized by a variety of cell types including immune cells, odontoblasts, fibroblasts, and dental pulp stem cells [34]. A recent study showed that odontoblasts secrete exosomes protecting cells from apoptosis, which is particularly important in an inflamed state [35].…”

Exosomes Derived From Stem Cells From Apical Papilla Promote Craniofacial Soft Tissue Regeneration Through Enhancing Cdc42-Mediated Vascularization

“…Meanwhile, the neural crest-derived MSCs carry neurovascular factors such as vascular endothelial growth factor, platelet derived growth factor, and brain-derived neurotrophic factor, which mediate the angiogenic process to improve tissue regeneration and treat ischemic diseases [24][25][26]. Exosomes have similar cellular properties to the parent cell [27].…”