干细胞/祖细胞移植促进牙本质-牙髓再生的进展与挑战:动物研究系统综述(第一部分)。

IF 1.5 Q4 CELL BIOLOGY
American journal of stem cells Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI:10.62347/HENE2422
Saeed Asgary, Mohammad Jafar Eghbal, Sayna Shamszadeh
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引用次数: 0

摘要

通过干细胞/祖细胞移植实现牙本质-牙髓再生是牙髓再生医学的一个前景广阔的前沿领域。这篇系统性综述对动物研究进行了细致评估,以研究干细胞疗法在修复/再生成熟/未成熟动物牙齿的牙本质-牙髓复合体方面的功效。通过对截至2023年10月的PubMed和Scopus数据库进行全面的电子检索,确定/评估了相关的英文研究。评估参数包括牙本质-牙髓复合体形成的放射学和组织学评估。结果测量包括牙髓样和牙本质样组织再生、根尖愈合、牙本质增厚、根尖封闭和牙本质桥形成。偏倚风险评估遵循了实验室动物实验系统审查中心(SYRCLE)的指导方针。在3250篇鉴定文章中,有23篇动物实验被纳入其中,分为成熟牙齿再生程序(11篇)、未成熟牙齿再生程序(4篇)和牙髓治疗(8篇)。尽管潜力巨大,但所纳入的研究偏差很大。值得注意的是,这些研究采用了不同的支架和生长因子,凸显了研究的异质性。牙髓干细胞(DPSCs)和骨髓干细胞,尤其是特定的亚组分,表现出显著的再生潜力:缺氧条件和预处理DPSCs细胞外囊泡增强了再生能力,同时考虑到细胞命运。供体年龄对再生有影响,牙髓切断术和直接牙髓覆盖术仍面临挑战。支架和生长因子的选择会影响结果,因此需要标准化的策略。尽管前景广阔,但临床可行性仍面临重重障碍,需要进一步研究不良反应、优化支架和监管因素。本系统综述阐明了干细胞移植在牙本质-牙髓复合体再生方面的潜力。受研究异质性和偏差的影响,总体证据质量突出表明,需要谨慎解释研究结果。未来的研究应完善方法,并建立可靠的组织学参数,以促进牙本质-牙髓再生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advancements and challenges in stem/progenitor cell transplantation for dentin-pulp regeneration: a systematic review of animal studies (part I).

Dentin-pulp regeneration through stem/progenitor cell transplantation represents a promising frontier in regenerative endodontics. This systematic review meticulously evaluates animal studies to investigate the efficacy of stem cell therapy in repairing/regenerating the dentine-pulp complex in mature/immature animal teeth. Employing a comprehensive electronic search of PubMed and Scopus databases up to October 2023, relevant English studies were identified/assessed. Evaluation parameters encompassed radiographic and histological assessments of dentin-pulp complex formation. Outcome measures included pulp-like and dentin-like tissues regeneration, apical healing, dentin thickening, apical closure, and dentinal bridge formation. The risk-of-bias assessment adhered to the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) guidelines. Out of 3250 identified articles, 23 animal experiments were included, categorized into regenerative procedures in mature teeth (n=11), regenerative procedures in immature teeth (n=4), and vital pulp therapy (n=8). Despite the promising potential, the bias in the included studies was high. Notably, Various scaffolds, and growth factors were employed, highlighting the heterogeneity across the studies. Dental pulp stem cells (DPSCs) and bone marrow stem cells, especially specific subfractions, demonstrated notable regenerative potential: hypoxic conditions and extracellular vesicles from preconditioned DPSCs enhanced regeneration, with considerations of cell fate. Donor age impacted regeneration, and challenges persisted in pulpotomy and direct pulp capping. Scaffold and growth factor choices influenced outcomes, underscoring the need for standardized strategies. Despite the promise, clinical viability faces hurdles, necessitating further investigation into adverse effects, optimized scaffolds, and regulatory considerations. This systematic review illuminates the potential of stem cell transplantation for dentin-pulp complex regeneration. The overall evidence quality, influenced by study heterogeneity and biases, underscores the need for cautious interpretation of findings. Future studies should refine methodologies and establish reliable histological parameters for meaningful advancements in dentin-pulp regeneration.

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