Pulp-dentin regeneration: Current state and future prospects

Y. Cao, M. Song, E. Kim, W. Shon, N. Chugal, G. Bogen, Louis Lin, R. H. Kim, N. H. Park, M. K. Kang

Research output: Contribution to journalArticle

Abstract

The goal of regenerative endodontics is to reinstate normal pulp function in necrotic and infected teeth that would result in reestablishment of protective functions, including innate pulp immunity, pulp repair through mineralization, and pulp sensibility. In the unique microenvironment of the dental pulp, the triad of tissue engineering would require infection control, biomaterials, and stem cells. Although revascularization is successful in resolving apical periodontitis, multiple studies suggest that it alone does not support pulp-dentin regeneration. More recently, cell-based approaches in endodontic regeneration based on pulpal mesenchymal stem cells (MSCs) have demonstrated promising results in terms of pulp-dentin regeneration in vivo through autologous transplantation. Although pulpal regeneration requires the cell-based approach, several challenges in clinical translation must be overcome - including aging-associated phenotypic changes in pulpal MSCs, availability of tissue sources, and safety and regulation involved with expansion of MSCs in laboratories. Allotransplantation of MSCs may alleviate some of these obstacles, although the long-term stability of MSCs and efficacy in pulp-dentin regeneration demand further investigation. For an alternative source of MSCs, our laboratory developed induced MSCs (iMSCs) from primary human keratinocytes through epithelial-mesenchymal transition by modulating the epithelial plasticity genes. Initially, we showed that overexpression of Î"Np63α, a major isoform of the p63 gene, led to epithelial-mesenchymal transition and acquisition of stem characteristics. More recently, iMSCs were generated by transient knockdown of all p63 isoforms through siRNA, further simplifying the protocol and resolving the potential safety issues of viral vectors. These cells may be useful for patients who lack tissue sources for endogenous MSCs. Further research will elucidate the level of potency of these iMSCs and assess their transdifferentiation capacities into functional odontoblasts when transplanted into the root canal microenvironment.

Original languageEnglish (US)
Pages (from-to)1544-1551
Number of pages8
JournalJournal of Dental Research
Volume94
Issue number11
DOIs
StatePublished - Nov 1 2015

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Dentin
Mesenchymal Stromal Cells
Regeneration
Epithelial-Mesenchymal Transition
Endodontics
Protein Isoforms
Periapical Periodontitis
Odontoblasts
Safety
Dental Pulp
Autologous Transplantation
Dental Pulp Cavity
Biocompatible Materials
Tissue Engineering
Infection Control
Keratinocytes
Innate Immunity
Small Interfering RNA
Genes
Tooth

Keywords

  • biocompatible materials
  • cell- and tissue-based therapy
  • dental pulp calcification
  • endodontics
  • epithelial-mesenchymal transition
  • stem cells

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Cao, Y., Song, M., Kim, E., Shon, W., Chugal, N., Bogen, G., ... Kang, M. K. (2015). Pulp-dentin regeneration: Current state and future prospects. Journal of Dental Research, 94(11), 1544-1551. https://doi.org/10.1177/0022034515601658

Pulp-dentin regeneration : Current state and future prospects. / Cao, Y.; Song, M.; Kim, E.; Shon, W.; Chugal, N.; Bogen, G.; Lin, Louis; Kim, R. H.; Park, N. H.; Kang, M. K.

In: Journal of Dental Research, Vol. 94, No. 11, 01.11.2015, p. 1544-1551.

Research output: Contribution to journalArticle

Cao, Y, Song, M, Kim, E, Shon, W, Chugal, N, Bogen, G, Lin, L, Kim, RH, Park, NH & Kang, MK 2015, 'Pulp-dentin regeneration: Current state and future prospects', Journal of Dental Research, vol. 94, no. 11, pp. 1544-1551. https://doi.org/10.1177/0022034515601658
Cao Y, Song M, Kim E, Shon W, Chugal N, Bogen G et al. Pulp-dentin regeneration: Current state and future prospects. Journal of Dental Research. 2015 Nov 1;94(11):1544-1551. https://doi.org/10.1177/0022034515601658
Cao, Y. ; Song, M. ; Kim, E. ; Shon, W. ; Chugal, N. ; Bogen, G. ; Lin, Louis ; Kim, R. H. ; Park, N. H. ; Kang, M. K. / Pulp-dentin regeneration : Current state and future prospects. In: Journal of Dental Research. 2015 ; Vol. 94, No. 11. pp. 1544-1551.
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