PDF(Pubmed)
Abstract：
BACKGROUND: Decellularized extracellular matrix (dECM) from several tissue sources has been proposed as a promising alternative to conventional scaffolds used in regenerative endodontic procedures (REPs). This systematic review aimed to evaluate the histological outcomes of studies utilizing dECM-derived scaffolds for REPs and to analyse the contributing factors that might influence the nature of regenerated tissues.
METHODS: The PRISMA 2020 guidelines were used. A search of articles published until April 2024 was conducted in Google Scholar, Scopus, PubMed and Web of Science databases. Additional records were manually searched in major endodontic journals. Original articles including histological results of dECM in REPs and in-vivo studies were included while reviews, in-vitro studies and clinical trials were excluded. The quality assessment of the included studies was analysed using the ARRIVE guidelines. Risk of Bias assessment was done using the (SYRCLE) risk of bias tool.
RESULTS: Out of the 387 studies obtained, 17 studies were included for analysis. In most studies, when used as scaffolds with or without exogenous cells, dECM showed the potential to enhance angiogenesis, dentinogenesis and to regenerate pulp-like and dentin-like tissues. However, the included studies showed heterogeneity of decellularization methods, animal models, scaffold source, form and delivery, as well as high risk of bias and average quality of evidence.
CONCLUSIONS: Decellularized ECM-derived scaffolds could offer a potential off-the-shelf scaffold for dentin-pulp regeneration in REPs. However, due to the methodological heterogeneity and the average quality of the studies included in this review, the overall effectiveness of decellularized ECM-derived scaffolds is still unclear. More standardized preclinical research is needed as well as well-constructed clinical trials to prove the efficacy of these scaffolds for clinical translation.
UNASSIGNED: The protocol was registered in PROSPERO database #CRD42023433026. This review was funded by the Science, Technology and Innovation Funding Authority (STDF) under grant number (44426).
METHODS: The PRISMA 2020 guidelines were used. A search of articles published until April 2024 was conducted in Google Scholar, Scopus, PubMed and Web of Science databases. Additional records were manually searched in major endodontic journals. Original articles including histological results of dECM in REPs and in-vivo studies were included while reviews, in-vitro studies and clinical trials were excluded. The quality assessment of the included studies was analysed using the ARRIVE guidelines. Risk of Bias assessment was done using the (SYRCLE) risk of bias tool.
RESULTS: Out of the 387 studies obtained, 17 studies were included for analysis. In most studies, when used as scaffolds with or without exogenous cells, dECM showed the potential to enhance angiogenesis, dentinogenesis and to regenerate pulp-like and dentin-like tissues. However, the included studies showed heterogeneity of decellularization methods, animal models, scaffold source, form and delivery, as well as high risk of bias and average quality of evidence.
CONCLUSIONS: Decellularized ECM-derived scaffolds could offer a potential off-the-shelf scaffold for dentin-pulp regeneration in REPs. However, due to the methodological heterogeneity and the average quality of the studies included in this review, the overall effectiveness of decellularized ECM-derived scaffolds is still unclear. More standardized preclinical research is needed as well as well-constructed clinical trials to prove the efficacy of these scaffolds for clinical translation.
UNASSIGNED: The protocol was registered in PROSPERO database #CRD42023433026. This review was funded by the Science, Technology and Innovation Funding Authority (STDF) under grant number (44426).
摘要：
背景：已经提出了来自几种组织来源的脱细胞细胞外基质（dECM）作为再生牙髓手术（REP）中使用的常规支架的有希望的替代品。本系统综述旨在评估利用dECM衍生的支架进行REP的研究的组织学结果，并分析可能影响再生组织性质的因素。
方法：使用PRISMA2020指南。在GoogleScholar中搜索了直到2024年4月发表的文章，Scopus,PubMed和WebofScience数据库。在主要的牙髓期刊中手动搜索其他记录。原始文章包括在REP和体内研究中dECM的组织学结果，体外研究和临床试验被排除.纳入研究的质量评估采用ARRIVE指南进行分析。使用(SYRCLE)偏倚风险工具进行偏倚风险评估。
结果：在获得的387项研究中，包括17项研究进行分析。在大多数研究中,当用作有或没有外源细胞的支架时，dECM显示出增强血管生成的潜力，牙本质发生并再生牙髓样和牙本质样组织。然而,纳入的研究显示去细胞化方法的异质性，动物模型,脚手架源,形式和交付，以及高偏倚风险和平均证据质量。
结论：脱细胞ECM衍生的支架可以为REP中的牙本质牙髓再生提供潜在的现成支架。然而,由于本综述纳入研究的方法学异质性和平均质量，脱细胞ECM来源支架的总体有效性尚不清楚.需要更标准化的临床前研究以及构建良好的临床试验来证明这些支架用于临床翻译的功效。
■该协议已在PROSPERO数据库#CRD42023433026中注册。这篇评论是由科学资助的，技术和创新资助机构(STDF)资助编号(44426)。
方法：使用PRISMA2020指南。在GoogleScholar中搜索了直到2024年4月发表的文章，Scopus,PubMed和WebofScience数据库。在主要的牙髓期刊中手动搜索其他记录。原始文章包括在REP和体内研究中dECM的组织学结果，体外研究和临床试验被排除.纳入研究的质量评估采用ARRIVE指南进行分析。使用(SYRCLE)偏倚风险工具进行偏倚风险评估。
结果：在获得的387项研究中，包括17项研究进行分析。在大多数研究中,当用作有或没有外源细胞的支架时，dECM显示出增强血管生成的潜力，牙本质发生并再生牙髓样和牙本质样组织。然而,纳入的研究显示去细胞化方法的异质性，动物模型,脚手架源,形式和交付，以及高偏倚风险和平均证据质量。
结论：脱细胞ECM衍生的支架可以为REP中的牙本质牙髓再生提供潜在的现成支架。然而,由于本综述纳入研究的方法学异质性和平均质量，脱细胞ECM来源支架的总体有效性尚不清楚.需要更标准化的临床前研究以及构建良好的临床试验来证明这些支架用于临床翻译的功效。
■该协议已在PROSPERO数据库#CRD42023433026中注册。这篇评论是由科学资助的，技术和创新资助机构(STDF)资助编号(44426)。
