干细胞和支架与牙髓再生及其血运重建

Regenerative endodontics is defined as biologically based procedures designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp–dentin complex. The methods of acquiring stem cells include stem-cell transplantation, cell homing, and induced bleeding. Stem-cell transplantation can yield ectopic dental pulp-like tissues, with the advantages of easily controlling the number of cells transplanted and selecting the optimal subpopulation of stem/progenitor cells. Meanwhile, cell homing is defined as the migration of endogenous host stem cells to the root canal of the offending teeth using signaling molecules. The process is also characterized by the subsequent proliferation and differentiation of the endogenous host stem cells into pulp–dentin-like tissues. Inducing pulp bleeding into the root canals of immature permanent teeth is an important step in regenerative endodontics. Scaffold refers to the structural support for the cells that synthesize tissues. This component promotes cell attachment and provides a specific environment conducive to pulp or dentin regeneration. Pulp regeneration cannot take place without revascularization or angiogenesis. Procedures such as infection control, pretreatment of root canals, and coronal sealing, provide a favorable environment for pulp regeneration, including pulp revascularization. The application and development of tissue engineering technology in endodontics bring new hope for dental pulp regeneration, despite the occurrence of numerous problems.