Regeneration of Pulp/Dentin-Like Tissue in Immature Necrotic Permanent Dog Teeth Using Adipose Tissue-Derived Mesenchymal Stem Cells

Objective: Our aim was to evaluate the potential of adipose tissue-derived mesenchymal stem cells (AD-MSCs) in the regeneration of canal pulp/dentin-like tissue and completion of root maturation of immature necrotic permanent dog teeth with apical periodontitis. Materials and methods: This study is a collaborative work between King Abdulaziz University with, Cairo University, Egypt. A split-mouth design was used in 6 healthy male dogs. Four teeth were selected per dog (total, 24 teeth). The immature upper left second and third permanent incisors were designated as group A (experimental group), and contralateral teeth were designated as group B (control group). Periapical periodontitis was induced in both groups. After disinfection, group A received AD-MSCs and growth factors within a chitosan scaffold, whereas group B received growth factors within a chitosan scaffold. Periradicular healing, root-wall thickening and lengthening, and apical closure were blindly monitored radiographically for 4 months. The animals were euthanized and the teeth examined histologically for healthy pulp/dentin complex-like tissue. Results: Group A showed significantly higher increase in radicular thickening, root lengthening, and apical closure than group B. However, there was no significant difference in apical healing. Histologically, the teeth of group A, but not group B, showed regeneration of pulp/dentin-like tissue. Conclusion: AD-MSCs in conjunction with growth factors incorporated into a chitosan hydrogel scaffold regenerated pulp/dentin-like tissue and facilitated complete root maturation of non-vital immature permanent dog teeth with apical periodontitis.