Dental pulp regeneration via cell homing

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Endodontics

Background:

• Root canal treatment is standard for necrotic pulp, but regenerative endodontics offers an alternative.
• Regenerative strategies include cell transplantation and cell homing, with cell homing being more clinically translatable.
• Cell homing utilizes endogenous host cells for tissue repair and regeneration, avoiding complex procedures and high costs associated with cell transplantation.

Purpose of the Study:

• To systematically review cell homing strategies for dental pulp regeneration.
• To evaluate in vitro, in vivo ectopic, and in situ pulp revascularization studies on cell homing.
• To assess the potential of cell homing in achieving pulp-like tissue regeneration.

Main Methods:

• Systematic review of MEDLINE/PubMed and Scopus databases without date limitations.
• Inclusion of studies on in vitro experiments, in vivo ectopic transplantation models, and in situ pulp revascularization.
• Independent screening and selection of articles by two reviewers based on predefined criteria.

Main Results:

• In vitro studies demonstrated that cytokines induce dental pulp stem/progenitor cell migration, proliferation, and differentiation.
• In vivo studies showed regeneration of connective pulp-like tissues with neovascularization, and in some cases, new innervation and dentine deposition.
• In situ pulp revascularization regenerated intracanal pulp-like tissues exhibiting neovascularization, innervation, and dentine formation.

Conclusions:

• Cell homing strategies show significant potential for dental pulp regeneration, evidenced by tissue neovascularization, innervation, and dentine formation.
• While further research is needed to optimize cell homing for reliability and effectiveness, it is currently the most clinically viable pathway.
• This approach offers a promising alternative to conventional root canal therapy for treating inflamed or necrotic pulp tissue.