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2016 ; 7
(ä): 58
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Pulp Regeneration: Current Approaches and Future Challenges
#MMPMID27014076
Yang J
; Yuan G
; Chen Z
Front Physiol
2016[]; 7
(ä): 58
PMID27014076
show ga
Regenerative endodontics aims to replace inflamed/necrotic pulp tissues with
regenerated pulp-like tissues to revitalize teeth and improve life quality. Pulp
revascularization case reports, which showed successful clinical and radiographic
outcomes, indicated the possible clinical application of pulp regeneration via
cell homing strategy. From a clinical point of view, functional pulp-like tissues
should be regenerated with the characterization of vascularization,
re-innervation, and dentin deposition with a regulated rate similar to that of
normal pulp. Efficient root canal disinfection and proper size of the apical
foramen are the two requisite preconditions for pulp regeneration. Progress has
been made on pulp regeneration via cell homing strategies. This review focused on
the requisite preconditions and cell homing strategies for pulp regeneration. In
addition to the traditionally used mechanical preparation and irrigation,
antibiotics, irrigation assisted with EndoVac apical negative-pressure system,
and ultrasonic and laser irradiation are now being used in root canal
disinfection. In addition, pulp-like tissues could be formed with the apical
foramen less than 1 mm, although more studies are needed to determine the
appropriate size. Moreover, signaling molecules including stromal cell derived
factor (SDF-1?), basic Fibroblast Growth Factor (bFGF), Platelet Derived Growth
Factor (PDGF), stem cell factor (SCF), and Granulocyte Colony-Stimulating Factor
(G-CSF) were used to achieve pulp-like tissue formation via a cell homing
strategy. Studies on the cell sources of pulp regeneration might give some
indications on the signaling molecular selection. The active recruitment of
endogenous cells into root canals to regenerate pulp-like tissues is a novel
concept that may offer an unprecedented opportunity for the near-term clinical
translation of current biology-based therapies for dental pulp regeneration.