Regenerative Endodontic Procedures: A Perspective from Stem Cell Niche Biology

Area of Science:

• Biomaterials Science
• Stem Cell Biology
• Endodontic Research

Background:

• Cell therapy is crucial for treating pulpal and periapical diseases in endodontics.
• Reconstructing natural microenvironments is key for regulating dental stem cell activity.

Purpose of the Study:

• To review factors influencing histologic outcomes in preclinical regenerative endodontic procedures.
• To explore stem cell characteristics, scaffold properties, and lesion factors impacting pulp regeneration.

Main Methods:

• Systematic literature search of PubMed using keywords for regenerative endodontics and dental stem cell biology.
• Review of 268 articles focusing on factors affecting histologic results after pulpectomy and regenerative endodontic procedures.

Main Results:

• Stem cell origin, scaffold biomimicry, and lesion size significantly influence the histologic appearance of the regenerated pulp-dentin complex.
• Accumulating evidence highlights the role of transcription factors in pulp-dentin complex formation and survival/trophic factors in niche recovery.

Conclusions:

• Stem cells are not interchangeable; dentin-entrapped molecules and positional markers are vital for assessing pulp regeneration and stem cell survival.
• Future preclinical experiments require ex vivo amplification of dental stem cells, scaffolds mimicking dentin's molecular content, and positional transcription factors for histologic assessment.