RESUMO
The paradigm shift in the endodontic field from replacement toward regenerative therapies has witnessed the ever-growing research in tissue engineering and regenerative medicine targeting pulp-dentin complex in the past few years. Abundant literature on the subject that has been produced, however, is scattered over diverse areas of knowledge. Moreover, the terminology and concepts are not always consensual, reflecting the range of research fields addressing this subject, from endodontics to biology, genetics, and engineering, among others. This fact triggered some misinterpretations, mainly when the denominations of different approaches were used as synonyms. The evaluation of results is not precise, leading to biased conjectures. Therefore, this literature review aims to conceptualize the commonly used terminology, summarize the main research areas on pulp regeneration, identify future trends, and ultimately clarify whether we are really on the edge of a paradigm shift in contemporary endodontics toward pulp regeneration.
RESUMO
Dental pulp tissue engineering (TE) endeavors to regenerate dentin/pulp complex by combining a suitable supporting matrix, stem cells, and biochemical stimuli. Such procedures foresee a matrix that can be easily introduced into the root canal system (RCS) and tightly adhere to dentin walls to assure the dentin surface's proper colonization with progenitor cells capable of restoring the dentin/pulp complex. Herein was investigated an injectable self-setting hyaluronic acid-based (HA) hydrogel system, formed by aldehyde-modified (a-HA) with hydrazide-modified (ADH), enriched with platelet lysate (PL), for endodontic regeneration. The hydrogels' working (wT) and setting (sT) times, the adhesion to the dentine walls, the hydrogel's microstructure, and the delivery of human dental pulp cells (DPCs) were studied in vitro. Hydrogels incorporating PL showed a suitable wT and sT and a porous microstructure. The tensile tests showed that the breaking point occurs after 4.3106 ± 1.8677 mm deformation, while in the indentation test after 1.4056 ± 0.3065 mm deformation. Both breaking points occur in the hydrogel extension. The HA/PL hydrogels exhibited supportive properties and promoted cell migration toward dentin surfaces in vitro. Overall, these results support using PL-laden HA injectable hydrogels (HA/PL) as a biomaterial for DPCs encapsulation, thereby displaying great clinical potential towards endodontic regenerative therapies.
RESUMO
El objetivo del presente artículo es la revisión de la literatura desde enero 2013 hasta diciembre 2017 con el fi n de encontrar el enfoque actual de la ingeniería de tejidos para regenerar la pulpa dental. Se realizó una revisión bibliográfi ca en diciembre de 2017 en el motor de búsqueda PubMed utilizando los descriptores: dental regeneration, pulp regeneration y dental pulp regeneration. La tendencia de estos últimos cinco años está dirigida mayormente al estudio de las células madre y pocos de estos estudios se han enfocado en las moléculas de señalización. Se concluyó que las DPSC fueron las más utilizadas, los escasos estudios de andamios utilizaron colágeno, a coágulo sanguíneo, plasma rico en plaquetas y una diversidad de moléculas de señalización donde prevalece el uso de fragmentos de dentina en sus diferentes formas; se utilizó un número similar de estudios in vivo e in vitro (AU)
The aim of this paper is the literature review since January 2013 until December 2017 in order to fi nd the current approach of tissue engineering to regenerate dental pulp. A bibliographic review was made on December 2017 in the PubMed search engine using the descriptors: dental regeneration, pulp regeneration and dental pulp regeneration. The trend of the last fi ve years is mainly directed to the study of stem cells and few of these studies have focused on signaling molecules. It was concluded that the DPSC were the most used, scant scaff olding studies used collagen, a blood clot, platelet-rich plasma, and a variety of signaling molecules where the use of dentine fragments in their diff erent forms prevails; a similar number of in vivo and in vitro studies were used (AU)
Assuntos
Humanos , Animais , Regeneração , Engenharia Tecidual , Polpa Dentária , Células-Tronco , Materiais Biocompatíveis , Técnicas In Vitro , Alicerces TeciduaisRESUMO
Antecedentes: El estándar dorado para diagnosticar segundos molarescon conducto radicular en C antes del inicio de un tratamiento endodóntico restaurador es la tomografía cone beam. La difi cultad para accedera los servicios tomográfi cos y su baja distribución en los consultorios odontológicos nos han llevado a diseñar una técnica alternativa enradiografías panorámicas nombrada «evidencia del ángulo obtenido¼(EAO). Objetivo: El objetivo de este trabajo fue crear un punto de cortey estimar la precisión diagnóstica del mismo mediante un estudio pilotocuyo resultado será utilizado en una futura investigación de validación de pruebas diagnósticas...
Background: The gold standard to diagnose second molars withC-shaped root canals prior to beginning an endodontic and restorative treatment is cone-beam tomography. Tomographic services are hard to access and have a low distribution in dental clinics this has led usto design an alternative technique in panoramic radiographs named«evidence of the obtained angle¼ (EAO). Objective: The aim of thisstudy was to create a breakpoint and estimate its diagnostic accuracy through a pilot study; its results will be used in a future investigation of validation of diagnostic tests...
