Challenges of stem cell-based pulp and dentin regeneration: a clinical perspective

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Dental Research

Background:

• Tissue regeneration strategies include cell-based and cell-free approaches.
• Significant progress has been made in stem cell-based pulp and dentin regeneration.
• Cell-free approaches have yielded less convincing results for pulp regeneration.

Purpose of the Study:

• To review advancements in stem cell-based pulp and dentin regeneration.
• To highlight the critical concept of critical size defects in pulp regeneration.
• To discuss challenges hindering clinical translation of pulp regeneration therapies.

Main Methods:

• Review of animal studies demonstrating pulp/dentin-like tissue regeneration using various stem cells (dental pulp stem cells, SCAP, BMMSCs, ADMSCs).
• Analysis of limitations in current cell-free regeneration approaches.
• Discussion of the importance of defining critical size defects for predicting regeneration outcomes.

Main Results:

• Stem cell-based approaches have shown partial to complete regeneration of pulp/dentin-like tissues in animal models.
• Cell-free approaches lack convincing evidence for pulp regeneration, especially in critical size defects.
• The concept of critical size defects remains undefined, impacting the predictability of regeneration.

Conclusions:

• Stem cell-based pulp and dentin regeneration holds significant promise but faces hurdles for clinical application.
• Defining critical size defects is essential for advancing cell-free and cell-based regeneration strategies.
• Overcoming current challenges is necessary for the successful clinical implementation of regenerative dentistry therapies.