OBJECTIVE: This extensive and multipart review presents crucial laboratory and practical issues related to pulp-dentin complex regeneration aimed towards advancing clinical translation of regenerative endodontic therapy and enhancing human life quality.
UNASSIGNED: In this multipart review paper, we first present a panorama of emerging potential tissue engineering strategies for pulp-dentin complex regeneration from cell transplantation and cell homing perspectives, emphasizing the critical regenerative components of stem cells, biomaterials, and conducive microenvironments. Then, this review provides details about current clinically practiced pulp regenerative/reparative approaches, including direct pulp capping and root revascularization, with a specific focus on the remaining hurdles and bright prospects in developing such therapies. Next, special attention was devoted to discussing the innovative biomimetic perspectives opened in establishing functional tissues by employing exosomes and cell aggregates, which will benefit the clinical translation of dental pulp engineering protocols. Finally, we summarize careful consideration that should be given to basic research and clinical applications of regenerative endodontics. In particular, this review article highlights significant challenges associated with residual infection and inflammation and identifies future insightful directions in creating antibacterial and immunomodulatory microenvironments so that clinicians and researchers can comprehensively understand crucial clinical aspects of regenerative endodontic procedures.
目的:这篇广泛且多部分的综述提出了与牙髓-牙本质复合物再生相关的关键实验室和实践问题,旨在促进再生牙髓治疗的临床转化和提高人类生活质量。
■在这篇多部分评论论文中,我们首先从细胞移植和细胞归巢的角度介绍了用于牙髓牙本质复合物再生的新兴潜在组织工程策略的全景,强调干细胞的关键再生成分,生物材料,和有益的微环境。然后,这篇综述提供了有关当前临床实践的牙髓再生/修复方法的详细信息,包括直接盖髓和根血运重建,特别关注开发此类疗法的剩余障碍和光明前景。接下来,特别关注致力于讨论通过使用外来体和细胞聚集体来建立功能组织的创新仿生观点,这将有利于牙髓工程协议的临床翻译。最后,我们总结了对再生牙髓药的基础研究和临床应用应给予的认真考虑。特别是,这篇综述文章强调了与残余感染和炎症相关的重大挑战,并确定了未来在创建抗菌和免疫调节微环境方面的有见地的方向,以便临床医生和研究人员能够全面了解再生牙髓治疗的关键临床方面.