外泌体是由大多数细胞分泌的细胞外信号囊泡的最小子集,其具有与其他组织和细胞类型长距离通信的能力。由于它们能够用作各种疾病的治疗选择,因此它们在再生医学中的使用最近获得了巨大的动力。目前每年有超过5000种出版物关于这个主题,其中许多在牙科空间。这篇广泛的评论文章是旨在总结外泌体在再生牙科中的所有治疗用途的第一篇范围审查。总共944篇文献被鉴定为在牙科领域使用外泌体,因为它们的再生/治疗潜力或用于源自口腔的诊断目的。总的来说,根据其再生潜力选择了113篇研究文章(102篇体外研究,60在体内,50项研究包括两项)。治疗性外泌体最常见的来源是牙髓,牙周膜细胞,牙龈成纤维细胞,脱落的乳牙干细胞,和根尖乳头都被证明可以促进包括骨骼在内的许多组织的再生潜力,牙骨质,牙周膜,神经,帮助正畸牙齿移动,缓解颞下颌关节紊乱,在其他人中。结果表明,在100%的研究中,外泌体的使用导致了积极的结果。在骨骼领域,发现外泌体的表现与rhBMP2相同或更好,同时显著减轻炎症.用外泌体的简单牙龈注射治疗牙周炎动物模型,并且当静脉内施用外泌体时甚至观察到益处。外泌体比生长因子稳定得多,并且显示出对牙周炎环境中常规发现的牙周病原体降解的抵抗力更强。牙周再生领域的比较研究发现,即使与它们的天然亲本干细胞相比,外泌体的结果也更好。总共47项诊断研究揭示了唾液/沟液外泌体在诊断出生缺陷方面的作用。心血管疾病,糖尿病,牙龈衰退检测,牙龈炎,肠易激综合征,神经退行性疾病,口腔扁平苔藓,口腔鳞状细胞癌,口咽癌检测,正畸牙根吸收,胰腺癌,牙周炎,种植体周围炎,干燥综合征,和各种系统性疾病。因此,我们将外泌体描述为具有“非凡的”潜力,作为具有显著优势的临床医生的宝贵工具。
Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with the ability to communicate with other tissues and cell types over long distances. Their use in regenerative medicine has gained tremendous momentum recently due to their ability to be utilized as therapeutic options for a wide array of various diseases. Over 5000 publications are currently being published on this topic yearly, many of which in the dental space. This extensive review article is the first scoping review aimed at summarizing all therapeutic uses of exosomes in regenerative dentistry. A total of 944 articles were identified as using exosomes in the dental field for either their regenerative/therapeutic potential or for diagnostic purposes derived from the oral cavity. In total, 113 research articles were selected for their regenerative potential (102 in vitro, 60 in vivo, 50 studies included both). Therapeutic exosomes were most commonly derived from dental pulps, periodontal ligament cells, gingival fibroblasts, stem cells from exfoliated deciduous teeth, and the apical papilla which have all been shown to facilitate the regenerative potential of a number of tissues including bone, cementum, the periodontal ligament, nerves, aid in orthodontic tooth movement, and relieve temporomandibular joint disorders, among others. Results demonstrate that the use of exosomes led to positive outcomes in 100% of studies. In the bone field, exosomes were found to perform equally as well or better than rhBMP2 while significantly reducing inflammation. Periodontitis animal models were treated with simple gingival injections of exosomes and benefits were even observed when the exosomes were administered intravenously. Exosomes are much more stable than growth factors and were shown to be far more resistant against degradation by periodontal pathogens found routinely in a periodontitis environment. Comparative studies in the field of periodontal regeneration found better outcomes for exosomes even when compared to their native parent stem cells. In total 47 diagnostic studies revealed a role for salivary/crevicular fluid exosomes for the diagnosis of birth defects, cardiovascular disease, diabetes, gingival recession detection, gingivitis, irritable bowel syndrome, neurodegenerative disease, oral lichen planus, oral squamous cell carcinoma, oropharyngeal cancer detection, orthodontic root resorption, pancreatic cancer, periodontitis, peri-implantitis, Sjögren syndrome, and various systemic diseases. Hence, we characterize the exosomes as possessing \"remarkable\" potential, serving as a valuable tool for clinicians with significant advantages.