Biomolecule-Mediated Therapeutics of the Dentin–Pulp Complex: A Systematic Review

Abstract

The aim of this systematic review was to evaluate the application of potential therapeutic signaling molecules on complete dentin-pulp complex and pulp tissue regeneration in orthotopic and ectopic animal studies. A search strategy was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in the MEDLINE/PubMed database. Animal studies evaluating the application of signaling molecules to pulpectomized teeth for pulp tissue or dentin-pulp complex regeneration were included. From 2530 identified records, 18 fulfilled the eligibility criteria and were subjected to detailed qualitative analysis. Among the applied molecules, basic fibroblast growth factor, vascular endothelial growth factor, bone morphogenetic factor-7, nerve growth factor, and platelet-derived growth factor were the most frequently studied. The clinical, radiographical and histological outcome measures included healing of periapical lesions, root development, and apical closure, cellular recolonization of the pulp space, ingrowth of pulp-like connective tissue (vascularization and innervation), mineralized dentin-like tissue formation along the internal dentin walls, and odontoblast-like cells in contact with the internal dentin walls. The results indicate that signaling molecules play an important role in dentin/pulp regeneration. However, further studies are needed to determine a more specific subset combination of molecules to achieve greater efficiency towards the desired tissue engineering applications.

Kappa-Carrageenan/Chitosan/Gelatin Scaffolds Provide a Biomimetic Microenvironment for Dentin-Pulp Regeneration

“…Dentin and pulp tissue engineering would significantly benefit dental clinical practice, and therefore recent studies have focused on the discovery of new bioactive materials to facilitate this purpose. Indirect and direct pulp capping materials have been utilized throughout the years to accommodate induced odontogenesis at the site of pulp exposure or proximity [ 2 ].…”

“…Progress in dental tissue engineering and regenerative dentistry has been tremendous over the past decades, with recent milestones on translational research having led to the development of innovative concepts in tissue engineering of hard and soft dental tissues, among which is the dentin-pulp complex [ 1 ]. Since the discovery of dental pulp stem cells (DPSCs), many biomaterials and signaling molecules have been investigated for their odontogenic response [ 2 ]. For example, in cases of direct and indirect pulp capping, various biocompatible platforms containing calcium and silicate-based materials have been utilized, aiming to reconstitute the exposed area and induce the odontogenic differentiation of the cells and the formation of a biomimetic mineralized barrier (tertiary dentinogenesis) [ 3 ].…”

“…They reside in the pulp of permanent teeth and their main role is the production of odontoblasts and dentin. Moreover, the accessibility and the relatively easy process of isolation compared to other stem cell types, as well as their excellent behavior under in vitro conditions, make them a very promising cell type for experimentation in the regenerative medicine area [ 2 , 4 , 8 ]. For these reasons, DPSCs have been used in dental tissue engineering to evaluate their potential for dental reconstruction [ 9 , 10 ].…”

Synthetic Proteins in Dental Applications

“…One of the current challenges in dentistry is the development of biomaterials that present adequate adhesion to collagen fibers and in turn promote the proliferation and differentiation of the cells of the dentin-pulp complex [56]. Collagen is a fibrous protein that constitutes a major part of the extracellular matrix of dentinogenesis providing strength, stability, and protection to this highly structured complex [57,58]. Collagen is a protein found in various tissues of the human body, including skin, bones, tendons, and teeth.…”

The prognostic marker elastin correlates with epithelial–mesenchymal transition and vimentin‐positive fibroblasts in gastric cancer

“…Communication between tumor cells and CAFs has been extensively studied. Fibroblasts can activate a misguided wound‐healing response while recruiting immune cells and affecting vascular permeability [ 13 , 14 ]. Moreover, CAFs can secrete a large amount of oncogenic elastin (ELN) to promote tumor proliferation and metastasis [ 15 , 16 ].…”