Stem Cell Transplantation for Pulpal Regeneration: A Systematic Review

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Dental Research

Background:

• Conventional root canal treatment addresses pulpal pathological conditions.
• Stem/progenitor cell transplantation is being explored as an alternative regenerative approach.
• Previous animal studies suggest benefits for pulp-dentin complex regeneration.

Purpose of the Study:

• To systematically review animal studies on stem/progenitor cell-mediated pulp-dentin complex regeneration.
• To quantitatively analyze outcomes of cell transplantation versus control in intraoral animal models.
• To assess the impact of stem/progenitor cells on pulp, neural, vascular, and dentinal regeneration.

Main Methods:

• Systematic review and meta-analysis of in vivo animal studies.
• Screening of PubMed and EMBASE databases up to July 2014, with cross-referencing and hand searching.
• Quantitative analysis of regenerated pulp area, capillaries, regenerated dentin area, and nerves.
• Risk of bias assessment using SYRCLE's tool.

Main Results:

• Five studies involving 64 animals were included; all had high risk of bias.
• Stem/progenitor cell transplantation significantly increased regenerated pulp area (SMD: 2.28 [0.35-4.21]).
• Regenerated dentin area was significantly greater with cell transplantation (SMD: 6.91 [5.39-8.43]).
• One study reported significant increases in capillaries and nerves post-transplantation.

Conclusions:

• Stem/progenitor cell transplantation appears to enhance pulp-dentin complex regeneration in animal models.
• Limited data quantity and quality currently prevent definitive conclusions.
• Further high-quality research is needed to validate these findings.