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Shah P, Aghazadeh M, Rajasingh S, Dixon D, Jain V, Rajasingh J. Stem cells in regenerative dentistry: Current understanding and future directions. J Oral Biosci 2024; 66:288-299. [PMID: 38403241 DOI: 10.1016/j.job.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Regenerative dentistry aims to enhance the structure and function of oral tissues and organs. Modern tissue engineering harnesses cell and gene-based therapies to advance traditional treatment approaches. Studies have demonstrated the potential of mesenchymal stem cells (MSCs) in regenerative dentistry, with some progressing to clinical trials. This review comprehensively examines animal studies that have utilized MSCs for various therapeutic applications. Additionally, it seeks to bridge the gap between related findings and the practical implementation of MSC therapies, offering insights into the challenges and translational aspects involved in transitioning from preclinical research to clinical applications. HIGHLIGHTS To achieve this objective, we have focused on the protocols and achievements related to pulp-dentin, alveolar bone, and periodontal regeneration using dental-derived MSCs in both animal and clinical studies. Various types of MSCs, including dental-derived cells, bone-marrow stem cells, and umbilical cord stem cells, have been employed in root canals, periodontal defects, socket preservation, and sinus lift procedures. Results of such include significant hard tissue reconstruction, functional pulp regeneration, root elongation, periodontal ligament formation, and cementum deposition. However, cell-based treatments for tooth and periodontium regeneration are still in early stages. The increasing demand for stem cell therapies in personalized medicine underscores the need for scientists and responsible organizations to develop standardized treatment protocols that adhere to good manufacturing practices, ensuring high reproducibility, safety, and cost-efficiency. CONCLUSION Cell therapy in regenerative dentistry represents a growing industry with substantial benefits and unique challenges as it strives to establish sustainable, long-term, and effective oral tissue regeneration solutions.
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Affiliation(s)
- Pooja Shah
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Marziyeh Aghazadeh
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheeja Rajasingh
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Douglas Dixon
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Periodontology, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Vinay Jain
- Department of Prosthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Johnson Rajasingh
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Medicine-Cardiology, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA.
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Shanbhag S, Kampleitner C, Sanz-Esporrin J, Lie SA, Gruber R, Mustafa K, Sanz M. Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:467-486. [PMID: 38450852 DOI: 10.1111/clr.14253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? METHODS Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. RESULTS Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). CONCLUSION A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Javier Sanz-Esporrin
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Stein-Atle Lie
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Park JJ, Rochlin DH, Parsaei Y, Shetye PR, Witek L, Leucht P, Rabbani PS, Flores RL. Bone Tissue Engineering Strategies for Alveolar Cleft: Review of Preclinical Results and Guidelines for Future Studies. Cleft Palate Craniofac J 2023; 60:1450-1461. [PMID: 35678607 DOI: 10.1177/10556656221104954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The current standard of care for an alveolar cleft defect is an autogenous bone graft, typically from the iliac crest. Given the limitations of alveolar bone graft surgery, such as limited supply, donor site morbidity, graft failure, and need for secondary surgery, there has been growing interest in regenerative medicine strategies to supplement and replace traditional alveolar bone grafts. Though there have been preliminary clinical studies investigating bone tissue engineering methods in human subjects, lack of consistent results as well as limitations in study design make it difficult to determine the efficacy of these interventions. As the field of bone tissue engineering is rapidly advancing, reconstructive surgeons should be aware of the preclinical studies informing these regenerative strategies. We review preclinical studies investigating bone tissue engineering strategies in large animal maxillary or mandibular defects and provide an overview of scaffolds, stem cells, and osteogenic agents applicable to tissue engineering of the alveolar cleft. An electronic search conducted in the PubMed database up to December 2021 resulted in 35 studies for inclusion in our review. Most studies showed increased bone growth with a tissue engineering construct compared to negative control. However, heterogeneity in the length of follow up, method of bone growth analysis, and inconsistent use of positive control groups make comparisons across studies difficult. Future studies should incorporate a pediatric study model specific to alveolar cleft with long-term follow up to fully characterize volumetric defect filling, cellular ingrowth, bone strength, tooth movement, and implant support.
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Affiliation(s)
- Jenn J Park
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Danielle H Rochlin
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Yassmin Parsaei
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Pradip R Shetye
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Lukasz Witek
- New York University College of Dentistry, New York, NY, USA
| | - Philipp Leucht
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Piul S Rabbani
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
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Bai X, Cao R, Wu D, Zhang H, Yang F, Wang L. Dental Pulp Stem Cells for Bone Tissue Engineering: A Literature Review. Stem Cells Int 2023; 2023:7357179. [PMID: 37868704 PMCID: PMC10586346 DOI: 10.1155/2023/7357179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/03/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Bone tissue engineering (BTE) is a promising approach for repairing and regenerating damaged bone tissue, using stem cells and scaffold structures. Among various stem cell sources, dental pulp stem cells (DPSCs) have emerged as a potential candidate due to their multipotential capabilities, ability to undergo osteogenic differentiation, low immunogenicity, and ease of isolation. This article reviews the biological characteristics of DPSCs, their potential for BTE, and the underlying transcription factors and signaling pathways involved in osteogenic differentiation; it also highlights the application of DPSCs in inducing scaffold tissues for bone regeneration and summarizes animal and clinical studies conducted in this field. This review demonstrates the potential of DPSC-based BTE for effective bone repair and regeneration, with implications for clinical translation.
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Affiliation(s)
- Xiaolei Bai
- Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
| | - Ruijue Cao
- Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
| | - Danni Wu
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
| | - Huicong Zhang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
| | - Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310018, Zhejiang, China
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Namjoynik A, Islam MA, Islam M. Evaluating the efficacy of human dental pulp stem cells and scaffold combination for bone regeneration in animal models: a systematic review and meta-analysis. Stem Cell Res Ther 2023; 14:132. [PMID: 37189187 DOI: 10.1186/s13287-023-03357-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Human adult dental pulp stem cells (hDPSC) and stem cells from human exfoliated deciduous teeth (SHED) hold promise in bone regeneration for their easy accessibility, high proliferation rate, self-renewal and osteogenic differentiation capacity. Various organic and inorganic scaffold materials were pre-seeded with human dental pulp stem cells in animals, with promising outcomes in new bone formation. Nevertheless, the clinical trial for bone regeneration using dental pulp stem cells is still in its infancy. Thus, the aim of this systematic review and meta-analysis is to synthesise the evidence of the efficacy of human dental pulp stem cells and the scaffold combination for bone regeneration in animal bone defect models. METHODOLOGY This study was registered in PROSPERO (CRD2021274976), and PRISMA guideline was followed to include the relevant full-text papers using exclusion and inclusion criteria. Data were extracted for the systematic review. Quality assessment and the risk of bias were also carried out using the CAMARADES tool. Quantitative bone regeneration data of the experimental (scaffold + hDPSC/SHED) and the control (scaffold-only) groups were also extracted for meta-analysis. RESULTS Forty-nine papers were included for systematic review and only 27 of them were qualified for meta-analysis. 90% of the included papers were assessed as medium to low risk. In the meta-analysis, qualified studies were grouped by the unit of bone regeneration measurement. Overall, bone regeneration was significantly higher (p < 0.0001) in experimental group (scaffold + hDPSC/SHED) compared to the control group (scaffold-only) (SMD: 1.863, 95% CI 1.121-2.605). However, the effect is almost entirely driven by the % new bone formation group (SMD: 3.929, 95% CI 2.612-5.246) while % BV/TV (SMD: 2.693, 95% CI - 0.001-5.388) shows a marginal effect. Dogs and hydroxyapatite-containing scaffolds have the highest capacity in % new bone formation in response to human DPSC/SHED. The funnel plot exhibits no apparent asymmetry representing a lack of remarkable publication bias. Sensitivity analysis also indicated that the results generated in this meta-analysis are robust and reliable. CONCLUSION This is the first synthesised evidence showing that human DPSCs/SHED and scaffold combination enhanced bone regeneration highly significantly compared to the cell-free scaffold irrespective of scaffold type and animal species used. So, dental pulp stem cells could be a promising tool for treating various bone diseases, and more clinical trials need to be conducted to evaluate the effectiveness of dental pulp stem cell-based therapies.
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Affiliation(s)
- Amin Namjoynik
- School of Dentistry, University of Dundee, Dundee, DD1 4HR, Scotland, UK
| | - Md Asiful Islam
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Mohammad Islam
- School of Dentistry, University of Dundee, Dundee, DD1 4HR, Scotland, UK.
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Moeenzade N, Naseri M, Osmani F, Emadian Razavi F. Dental pulp stem cells for reconstructing bone defects: A systematic review and meta-analysis. J Dent Res Dent Clin Dent Prospects 2022; 16:204-220. [PMID: 37560493 PMCID: PMC10407871 DOI: 10.34172/joddd.2022.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/02/2022] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Bone reconstruction with appropriate quality and quantity for dental implant replacement in the alveolar ridge is a challenge in dentistry. As dental pulp stem cells (DPSCs) could be a new perspective in bone regeneration in the future, this study investigated the bone regeneration process by DPSCs. METHODS Electronic searches for articles in the PubMed, EMBASE, and Scopus databases were completed until 21 April 2022. The most important inclusion criteria for selecting in vivo studies reporting quantitative data based on new bone volume and new bone area. The quality assessment was performed based on Cochrane's checklist. RESULTS After the title, abstract, and full-text screening of 762 studies, 23 studies were included. A meta-analysis of 70 studies that reported bone regeneration based on new bone area showed a statistically significant favorable influence on bone tissue regeneration compared to the control groups (P<0.00001, standardized mean difference [SMD]=2.40, 95% CI: 1.55‒3.26; I2=83%). Also, the meta-analysis of 14 studies that reported new bone regeneration based on bone volume showed a statistically significant favorable influence on bone tissue regeneration compared to the control groups (P=0.0003, SMD=1.85, 95% CI: 0.85‒2.85; I2=84%). CONCLUSION This systematic review indicated that DPSCs in tissue regeneration therapy significantly affected bone tissue complex regeneration. However, more and less diverse preclinical studies will enable more powerful meta-analyses in the future.
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Affiliation(s)
- Neda Moeenzade
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Naseri
- Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Fereshteh Osmani
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fariba Emadian Razavi
- Clinical Research Development Unit, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
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Sanchez N, Vignoletti F, Sanz-Martin I, Coca A, Nuñez J, Maldonado E, Sanz-Esporrin J, Hernando-Pradíes I, Santamaría S, Herrera D, Garcia-Sanz JA, Sanz M. Cell Therapy Based on Gingiva-Derived Mesenchymal Stem Cells Seeded in a Xenogeneic Collagen Matrix for Root Coverage of RT1 Gingival Lesions: An In Vivo Experimental Study. Int J Mol Sci 2022; 23:ijms23063248. [PMID: 35328670 PMCID: PMC8950013 DOI: 10.3390/ijms23063248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 12/05/2022] Open
Abstract
(1) Background: To investigate the effect of a xenogeneic collagen matrix (CMX) seeded with autologous gingiva-derived mesenchymal cells (GMSCs) when combined with a coronally advanced flap (CAF) in the treatment of localized gingival recession type 1 (RT1). (2) Methods: Dehiscence-type defects were created in seven dogs. GMSCs were isolated, transfected with a vector carrying green fluorescent protein (GFP) and expanded. Once chronified, the defects were randomly treated with (1) CAF plus the combination of CMX and GFP+ GMSCs, (2) CAF plus CMX with autologous fibroblasts, (3) CAF plus CMX and (4) CAF alone. Histological and clinical outcomes at 2- and 6-week healing periods were analyzed and compared among groups. (3) Results: Histologically, the addition of autologous cells to the CMX resulted in reduced inflammation and a variable degree of new cementum/bone formation. CMX plus GMSCs resulted in greater mean recession reduction (1.42; SD = 1.88 mm) and percentage of teeth with recession reduction of ≥2 mm (57%) when compared to the other groups, although these differences were not statistically significant. (4) Conclusions: The histometric and clinical results indicated a positive trend favouring the combination of CMX and GMSCs with the CAF when compared to the groups without cells, although these differences were not statistically significant.
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Affiliation(s)
- Nerea Sanchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Fabio Vignoletti
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Ignacio Sanz-Martin
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Alejandro Coca
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Javier Nuñez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Estela Maldonado
- Department of Anatomy and Embryology, Faculty of Medicine, University Complutense, 28040 Madrid, Spain;
| | - Javier Sanz-Esporrin
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Irene Hernando-Pradíes
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Silvia Santamaría
- Margarita Salas Center for Biological Research (CIB-CSIC), 28040 Madrid, Spain; (S.S.); (J.A.G.-S.)
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
| | - Jose A. Garcia-Sanz
- Margarita Salas Center for Biological Research (CIB-CSIC), 28040 Madrid, Spain; (S.S.); (J.A.G.-S.)
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, 28040 Madrid, Spain; (N.S.); (F.V.); (I.S.-M.); (A.C.); (J.N.); (J.S.-E.); (I.H.-P.); (D.H.)
- Correspondence:
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Mangione F, Salmon B, EzEldeen M, Jacobs R, Chaussain C, Vital S. Characteristics of Large Animal Models for Current Cell-Based Oral Tissue Regeneration. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:489-505. [PMID: 33882717 DOI: 10.1089/ten.teb.2020.0384] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The recent advances in the field of cell-based therapeutics open promising perspectives for oral tissue regeneration. The development of large animal models, which overcome the limits of the rodent models and allow to emulate clinical situations, is crucial for the validation of regenerative strategies to move toward clinical application. Currently, porcine, canine, and ovine models are mainly developed for oral regeneration and their specific characteristics have an impact on the outcomes of the studies. Thus, this systematic review investigates the application of porcine, canine, and ovine models in present cell-based oral regeneration, according to the species characteristics and the targeted tissue to regenerate. A customized search of PubMed, EMBASE, Scopus, and Web of Science databases from January 2015 to March 2020 was conducted. Relevant articles about cell-based oral tissues engineering in porcine, canine, and ovine models were evaluated. Among the evaluated articles, 58 relevant studies about cell-based oral regeneration in porcine, canine, and ovine models matched the eligibility criteria and were selected for full analysis. Porcine models, the most similar species with humans, were mostly used for bone and periodontium regeneration; tooth regeneration was reported only in pig, except for one study in dog. Canine models were the most transversal models, successfully involved for all oral tissue regeneration and notably in implantology. However, differences with humans and ethical concerns affect the use of these models. Ovine models, alternative to porcine and canine ones, were mainly used for bone and, scarcely, periodontium regeneration. The anatomy and physiology of these animals restrain their involvement. If consistency was found in defect specificities and cell trends among different species animal models of bone, dentin-pulp complex, or tooth regeneration, variability appeared in periodontium. Regeneration assessment methods were more elaborate in porcines and canines than in ovines. Risk of bias was low for selection, attrition and reporting, but unclear for performance and detection. Overall, if none of the large animal models can be considered an ideal one, they are of deemed importance for oral cell-based tissue engineering and researchers should consider their relevance to establish favorable conditions for a given preclinical cell-based therapeutics.
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Affiliation(s)
- Francesca Mangione
- URP 2496 Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), UFR Odontology, Université de Paris, Montrouge, France.,Henri Mondor Hospital, AP-HP, Créteil, France
| | - Benjamin Salmon
- URP 2496 Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), UFR Odontology, Université de Paris, Montrouge, France.,Bretonneau Hospital, AP-HP, Paris, France.,Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, AP-HP, Paris, France
| | - Mostafa EzEldeen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Maxillofacial Surgery Department, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Maxillofacial Surgery Department, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Catherine Chaussain
- URP 2496 Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), UFR Odontology, Université de Paris, Montrouge, France.,Bretonneau Hospital, AP-HP, Paris, France.,Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, AP-HP, Paris, France
| | - Sibylle Vital
- URP 2496 Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), UFR Odontology, Université de Paris, Montrouge, France.,AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Colombes, France
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Berbéri A, Fayyad-Kazan M, Ayoub S, Bou Assaf R, Sabbagh J, Ghassibe-Sabbagh M, Badran B. Osteogenic potential of dental and oral derived stem cells in bone tissue engineering among animal models: An update. Tissue Cell 2021; 71:101515. [PMID: 33657504 DOI: 10.1016/j.tice.2021.101515] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 12/20/2022]
Abstract
Small bone defects can heal spontaneously through the bone modeling process due to their physiological environmental conditions. The bone modeling cycle preserves the reliability of the skeleton through the well-adjusted activities of its fundamental cell. Stem cells are a source of pluripotent cells with a capacity to differentiate into any tissue in the existence of a suitable medium. The concept of bone engineering is based on stem cells that can differentiate into bone cells. Mesenchymal stromal cells have been evaluated in bone tissue engineering due to their capacity to differentiate in osteoblasts. They can be isolated from bone marrow and from several adults oral and dental tissues such as permanent or deciduous teeth dental pulp, periodontal ligament, apical dental papilla, dental follicle precursor cells usually isolated from the follicle surrounding the third molar, gingival tissue, periosteum-derived cells, dental alveolar socket, and maxillary sinus Schneiderian membrane-derived cells. Therefore, a suitable animal model is a crucial step, as preclinical trials, to study the outcomes of mesenchymal cells on the healing of bone defects. We will discuss, through this paper, the use of mesenchymal stem cells obtained from several oral tissues mixed with different types of scaffolds tested in different animal models for bone tissue engineering. We will explore and link the comparisons between human and animal models and emphasized the factors that we need to take into consideration when choosing animals. The pig is considered as the animal of choice when testing large size and multiple defects for bone tissue engineering.
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Affiliation(s)
- Antoine Berbéri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon.
| | - Mohammad Fayyad-Kazan
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon; Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon.
| | - Sara Ayoub
- Department of Prosthodontics, Faculty of Dentistry, Lebanese University, Beirut, Lebanon.
| | - Rita Bou Assaf
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon.
| | - Joseph Sabbagh
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.
| | - Michella Ghassibe-Sabbagh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Bassam Badran
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon.
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10
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IL-1 Receptor Antagonist Protects the Osteogenesis Capability of Gingival-Derived Stem/Progenitor Cells under Inflammatory Microenvironment Induced by Porphyromonas gingivalis Lipopolysaccharides. Stem Cells Int 2021; 2021:6638575. [PMID: 33531908 PMCID: PMC7834827 DOI: 10.1155/2021/6638575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/20/2020] [Accepted: 01/05/2021] [Indexed: 12/28/2022] Open
Abstract
Mesenchymal stem cells (MSCs) have been considered to be a future treatment option for periodontitis due to their excellent regenerative capability. However, it is still a challenge to protect MSCs' biological properties from multiple bacterial toxins in local inflammatory environment. The present study is aimed at investigating the treatment effect of interleukin-1 receptor antagonist (IL-1ra) on cell proliferation, migration, and osteogenic differentiation of gingival-derived mesenchymal stem cells (GMSCs) under an inflammatory microenvironment induced by Porphyromonas gingivalis lipopolysaccharides (P. gingivalis-LPS). GMSCs derived from Sprague-Dawley (SD) rats' free gingival tissues were treated with P. gingivalis-LPS (10 μg/mL) to create in vitro inflammatory environment. Different concentrations of IL-1ra (0.01-1 μg/mL) were used to antagonize the negative effect of LPS. Cell behaviors including proliferation, cloning formation unit (CFU), cell migration, osteogenic differentiation, mineral deposition, and cytokine production were assessed to investigate the protection effect of IL-1ra on GMSCs under inflammation. The toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) pathway activated by LPS was evaluated by real-time quantitative polymerase chain reaction (RT-PCR) and western blot. In response to P. gingivalis-LPS treatment, cell numbers, cloning formation rate, cell migration rate, proinflammatory cytokine production, and osteogenic differentiation-associated protein/mRNA expressions as well as mineralized nodules were suppressed in a time-dependent manner. These negative effects were effectively attenuated by IL-1ra administration in a time- and dose-dependent manner. In addition, mRNA expressions of TLR4 and IkBα decreased dramatically when IL-1ra was added into LPS-induced medium. IL-1ra also reversed the LPS-induced TLR4/NF-κB activation as indicated by western blot. The present study revealed that IL-1ra decreased inflammatory cytokine production in a supernatant, so as to protect GMSCs' osteogenesis capacity and other biological properties under P. gingivalis-LPS-induced inflammatory environment. This might be explained by IL-1ra downregulating TLR4-mediated NF-κB signaling pathway activation.
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11
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Synthetic Scaffold/Dental Pulp Stem Cell (DPSC) Tissue Engineering Constructs for Bone Defect Treatment: An Animal Studies Literature Review. Int J Mol Sci 2020; 21:ijms21249765. [PMID: 33371390 PMCID: PMC7767470 DOI: 10.3390/ijms21249765] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Recently a greater interest in tissue engineering for the treatment of large bone defect has been reported. The aim of the present systematic review and meta-analysis was to investigate the effectiveness of dental pulp stem cells and synthetic block complexes for bone defect treatment in preclinical in vivo articles. Methods: The electronic database and manual search was conducted on Pubmed, Scopus, and EMBASE. The papers identified were submitted for risk-of-bias assessment and classified according to new bone formation, bone graft characteristics, dental pulp stem cells (DPSCs) culture passages and amount of experimental data. The meta-analysis assessment was conducted to assess new bone formation in test sites with DPSCs/synthetic blocks vs. synthetic block alone. Results: The database search identified a total of 348 papers. After the initial screening, 30 studies were included, according to the different animal models: 19 papers on rats, 3 articles on rabbits, 2 manuscripts on sheep and 4 papers on swine. The meta-analysis evaluation showed a significantly increase in new bone formation in favor of DPSCs/synthetic scaffold complexes, if compared to the control at 4 weeks (Mean Diff: 17.09%, 95% CI: 15.16–18.91%, p < 0.01) and at 8 weeks (Mean Diff: 14.86%, 95% CI: 1.82–27.91%, p < 0.01) in rats calvaria bone defects. Conclusion: The synthetic scaffolds in association of DPSCs used for the treatment of bone defects showed encouraging results of early new bone formation in preclinical animal studies and could represent a useful resource for regenerative bone augmentation procedures
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12
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Ercal P, Pekozer GG. A Current Overview of Scaffold-Based Bone Regeneration Strategies with Dental Stem Cells. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1288:61-85. [PMID: 32185698 DOI: 10.1007/5584_2020_505] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Bone defects due to trauma or diseases still pose a clinical challenge to be resolved in the current tissue engineering approaches. As an alternative to traditional methods to restore bone defects, such as autografts, bone tissue engineering aims to achieve new bone formation via novel biomaterials used in combination with multipotent stem cells and bioactive molecules. Mesenchymal stem cells (MSCs) can be successfully isolated from various dental tissues at different stages of development including dental pulp, apical papilla, dental follicle, tooth germ, deciduous teeth, periodontal ligament and gingiva. A wide range of biomaterials including polymers, ceramics and composites have been investigated for their potential as an ideal bone scaffold material. This article reviews the properties and the manufacturing methods of biomaterials used in bone tissue engineering, and provides an overview of bone tissue regeneration approaches of scaffold and dental stem cell combinations as well as their limitations.
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Affiliation(s)
- Pınar Ercal
- Faculty of Dentistry, Department of Oral Surgery, Altinbas University, Istanbul, Turkey.
| | - Gorke Gurel Pekozer
- Faculty of Electrical and Electronics Engineering, Department of Biomedical Engineering, Yıldız Technical University, Istanbul, Turkey
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13
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Granz CL, Gorji A. Dental stem cells: The role of biomaterials and scaffolds in developing novel therapeutic strategies. World J Stem Cells 2020; 12:897-921. [PMID: 33033554 PMCID: PMC7524692 DOI: 10.4252/wjsc.v12.i9.897] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/05/2020] [Accepted: 08/16/2020] [Indexed: 02/06/2023] Open
Abstract
Dental stem cells (DSCs) are self-renewable cells that can be obtained easily from dental tissues, and are a desirable source of autologous stem cells. The use of DSCs for stem cell transplantation therapeutic approaches is attractive due to their simple isolation, high plasticity, immunomodulatory properties, and multipotential abilities. Using appropriate scaffolds loaded with favorable biomolecules, such as growth factors, and cytokines, can improve the proliferation, differentiation, migration, and functional capacity of DSCs and can optimize the cellular morphology to build tissue constructs for specific purposes. An enormous variety of scaffolds have been used for tissue engineering with DSCs. Of these, the scaffolds that particularly mimic tissue-specific micromilieu and loaded with biomolecules favorably regulate angiogenesis, cell-matrix interactions, degradation of extracellular matrix, organized matrix formation, and the mineralization abilities of DSCs in both in vitro and in vivo conditions. DSCs represent a promising cell source for tissue engineering, especially for tooth, bone, and neural tissue restoration. The purpose of the present review is to summarize the current developments in the major scaffolding approaches as crucial guidelines for tissue engineering using DSCs and compare their effects in tissue and organ regeneration.
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Affiliation(s)
- Cornelia Larissa Granz
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, Münster 48149, Germany
| | - Ali Gorji
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, Münster 48149, Germany
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14
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Bone Healing and Regeneration Potential in Rabbit Cortical Defects Using an Innovative Bioceramic Bone Graft Substitute. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to elucidate the local effect and micro-computed tomographic (μ-CT) assessment following bone implantation of an innovative bioceramic (α-calcium sulfate hemihydrate; α-CSH) on femur lateral condyle cortical bone of rabbit models. The innovative α-CSH bioceramic was synthesized through a green processing technology (microwave irradiation treatment). The bilateral implantation model was performed among 24 New Zealand White rabbits which were divided into three groups based on the type of filling materials: α-CSH, control, and blank. Treatments were performed in defects with 6 mm diameter and 7 mm depth and observed after 2, 4, 8, and 12 weeks. Material reaction and bone formation after implantation were evaluated radiographically and histopathologically. The μ-CT analysis results showed that the degradation of α-CSH and control material was similar at 4 and 8 weeks. The bone volume in the defects indicated the α-CSH increased most in 8 weeks. In histopathological evaluation, the α-CSH group was repaired with lamellar bone and well-grown bone marrow infiltration similar to the control material. Moreover, the α-CSH revealed a faster degradation rate and better healing progress than the control material under the same conditions. Therefore, the α-CSH was confirmed to be useful in promoting osteoconduction and in controlling the resorption rate in bone defects. Further, the innovative α-CSH could be considered as a promising bone substitute for utilization in bone reconstructive therapy in dental and orthopedic fields.
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15
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Assessment of the Release of Vascular Endothelial Growth Factor from 3D-Printed Poly-ε-Caprolactone/Hydroxyapatite/Calcium Sulfate Scaffold with Enhanced Osteogenic Capacity. Polymers (Basel) 2020; 12:polym12071455. [PMID: 32610580 PMCID: PMC7408109 DOI: 10.3390/polym12071455] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) is one of the most crucial growth factors and an assistant for the adjustment of bone regeneration. In this study, a 3D scaffold is fabricated using the method of fused deposition modeling. Such a fabricated method allows us to fabricate scaffolds with consistent pore sizes, which could promote cellular ingrowth into scaffolds. Therefore, we drafted a plan to accelerate bone regeneration via VEGF released from the hydroxyapatite/calcium sulfate (HACS) scaffold. Herein, HACS will gradually degrade and provide a suitable environment for cell growth and differentiation. In addition, HACS scaffolds have higher mechanical properties and drug release compared with HA scaffolds. The drug release profile of the VEGF-loaded scaffolds showed that VEGF could be loaded and released in a stable manner. Furthermore, initial results showed that VEGF-loaded scaffolds could significantly enhance the proliferation of human mesenchymal stem cells (hMSCs) and human umbilical vein endothelial cells (HUVEC). In addition, angiogenic- and osteogenic-related proteins were substantially increased in the HACS/VEGF group. Moreover, in vivo results revealed that HACS/VEGF improved the regeneration of the rabbit’s femur bone defect, and VEGF loading improved bone tissue regeneration and remineralization after implantation for 8 weeks. All these results strongly imply that the strategy of VEGF loading onto scaffolds could be a potential candidate for future bone tissue engineering.
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16
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Cristaldi M, Mauceri R, Tomasello L, Pizzo G, Pizzolanti G, Giordano C, Campisi G. Dental pulp stem cells for bone tissue engineering: a review of the current literature and a look to the future. Regen Med 2018; 13:207-218. [PMID: 29553875 DOI: 10.2217/rme-2017-0112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The aim of this narrative review is to investigate the implication of mesenchymal stem cells harvested from human dental pulp in in vivo bone tissue regeneration. We focused on studies related to roles of human dental pulp stem cells in in vivo bone regeneration. A total of 1021 studies were identified; after the assessment of eligibility, only 39 studies were included in the review. The evaluated information of the studies regards the experimental strategies (e.g., the isolation method, the scaffold, the in vivo animal models). The overall main evidences highlighted from the analysis are that dental pulp stem cells and human-exfoliated deciduous teeth stem cells supported by a suitable scaffold should be considered a valuable source for bone tissue regeneration.
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Affiliation(s)
- Marta Cristaldi
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Rodolfo Mauceri
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Laura Tomasello
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Giuseppe Pizzo
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Giuseppe Pizzolanti
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Carla Giordano
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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17
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Cristaldi M, Mauceri R, Tomasello L, Pizzo G, Pizzolanti G, Giordano C, Campisi G. Dental pulp stem cells for bone tissue engineering: a review of the current literature and a look to the future. Regen Med 2018. [DOI: 10.2217/rme-2017-0112 10.2217/rme-2017-0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of this narrative review is to investigate the implication of mesenchymal stem cells harvested from human dental pulp in in vivo bone tissue regeneration. We focused on studies related to roles of human dental pulp stem cells in in vivo bone regeneration. A total of 1021 studies were identified; after the assessment of eligibility, only 39 studies were included in the review. The evaluated information of the studies regards the experimental strategies (e.g., the isolation method, the scaffold, the in vivo animal models). The overall main evidences highlighted from the analysis are that dental pulp stem cells and human-exfoliated deciduous teeth stem cells supported by a suitable scaffold should be considered a valuable source for bone tissue regeneration.
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Affiliation(s)
- Marta Cristaldi
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Rodolfo Mauceri
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Laura Tomasello
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Giuseppe Pizzo
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Giuseppe Pizzolanti
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Carla Giordano
- Biomedical Department of Internal & Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology & Metabolism, University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological & Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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18
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Leyendecker Junior A, Gomes Pinheiro CC, Lazzaretti Fernandes T, Franco Bueno D. The use of human dental pulp stem cells for in vivo bone tissue engineering: A systematic review. J Tissue Eng 2018; 9:2041731417752766. [PMID: 29375756 PMCID: PMC5777558 DOI: 10.1177/2041731417752766] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/13/2017] [Indexed: 12/20/2022] Open
Abstract
Dental pulp represents a promising and easily accessible source of mesenchymal stem cells for clinical applications. Many studies have investigated the use of human dental pulp stem cells and stem cells isolated from the dental pulp of human exfoliated deciduous teeth for bone tissue engineering in vivo. However, the type of scaffold used to support the proliferation and differentiation of dental stem cells, the animal model, the type of bone defect created, and the methods for evaluation of results were extremely heterogeneous among these studies conducted. With this issue in mind, the main objective of this study is to present and summarize, through a systematic review of the literature, in vivo studies in which the efficacy of human dental pulp stem cells and stem cells from human exfoliated deciduous teeth (SHED) for bone regeneration was evaluated. The article search was conducted in PubMed/MEDLINE and Web of Science databases. Original research articles assessing potential of human dental pulp stem cells and SHED for in vivo bone tissue engineering, published from 1984 to November 2017, were selected and evaluated in this review according to the following eligibility criteria: published in English, assessing dental stem cells of human origin and evaluating in vivo bone tissue formation in animal models or in humans. From the initial 1576 potentially relevant articles identified, 128 were excluded due to the fact that they were duplicates and 1392 were considered ineligible as they did not meet the inclusion criteria. As a result, 56 articles remained and were fully analyzed in this systematic review. The results obtained in this systematic review open new avenues to perform bone tissue engineering for patients with bone defects and emphasize the importance of using human dental pulp stem cells and SHED to repair actual bone defects in an appropriate animal model.
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19
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Shanbhag S, Pandis N, Mustafa K, Nyengaard JR, Stavropoulos A. Alveolar bone tissue engineering in critical-size defects of experimental animal models: a systematic review and meta-analysis. J Tissue Eng Regen Med 2017; 11:2935-2949. [PMID: 27524517 DOI: 10.1002/term.2198] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/07/2016] [Accepted: 03/14/2016] [Indexed: 01/17/2023]
Abstract
Regeneration of large, 'critical-size' bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as a promising alternative to autogenous, allogeneic and biomaterial-based bone grafting. The objective of this systematic review was to answer the focused question: in animal models, do cell-based BTE strategies enhance regeneration in alveolar bone critical-size defects (CSDs), compared with grafting with only biomaterial scaffolds or autogenous bone? Following PRISMA guidelines, electronic databases were searched for controlled animal studies reporting maxillary or mandibular CSD and implantation of mesenchymal stem cells (MSCs) or osteoblasts (OBs) seeded on biomaterial scaffolds. A random effects meta-analysis was performed for the outcome histomorphometric new bone formation (%NBF). Thirty-six studies were included that reported on large- (monkeys, dogs, sheep, minipigs) and small-animal (rabbits, rats) models. On average, studies presented with an unclear-to-high risk of bias and short observation times. In most studies, MSCs or OBs were used in combination with alloplastic mineral-phase scaffolds. In five studies, cells were modified by ex vivo gene transfer of bone morphogenetic proteins (BMPs). The meta-analysis indicated statistically significant benefits in favour of: (1) cell-loaded vs. cell-free scaffolds [weighted mean difference (WMD) 15.59-49.15% and 8.60-13.85% NBF in large- and small-animal models, respectively]; and (2) BMP-gene-modified vs. unmodified cells (WMD 10.06-20.83% NBF in small-animal models). Results of cell-loaded scaffolds vs. autogenous bone were inconclusive. Overall, heterogeneity in the meta-analysis was high (I2 > 90%). In summary, alveolar bone regeneration is enhanced by addition of osteogenic cells to biomaterial scaffolds. The direction and estimates of treatment effect are useful to predict therapeutic efficacy and guide future clinical trials of BTE. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Bergen, Norway
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
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20
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Yu TT, Cui FZ, Meng QY, Wang J, Wu DC, Zhang J, Kou XX, Yang RL, Liu Y, Zhang YS, Yang F, Zhou YH. Influence of Surface Chemistry on Adhesion and Osteo/Odontogenic Differentiation of Dental Pulp Stem Cells. ACS Biomater Sci Eng 2017; 3:1119-1128. [PMID: 33429586 DOI: 10.1021/acsbiomaterials.7b00274] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ting-Ting Yu
- Center
for Craniofacial Stem Cell Research and Regeneration, Department of
Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Fu-Zhai Cui
- School
of Materials Science and Engineering, Tsinghua University, Beijing 100084, P. R. China
| | - Qing-Yuan Meng
- School
of Materials Science and Engineering, Tsinghua University, Beijing 100084, P. R. China
| | - Juan Wang
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics & Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - De-Cheng Wu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics & Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Jin Zhang
- Division
of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, Massachusetts 02139, United States
| | - Xiao-Xing Kou
- Center
for Craniofacial Stem Cell Research and Regeneration, Department of
Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Rui-Li Yang
- Center
for Craniofacial Stem Cell Research and Regeneration, Department of
Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Yan Liu
- Center
for Craniofacial Stem Cell Research and Regeneration, Department of
Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Yu Shrike Zhang
- Division
of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, Massachusetts 02139, United States
| | - Fei Yang
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics & Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Yan-Heng Zhou
- Center
for Craniofacial Stem Cell Research and Regeneration, Department of
Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
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21
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Taking the endochondral route to craniomaxillofacial bone regeneration: A logical approach? J Craniomaxillofac Surg 2017; 45:1099-1106. [PMID: 28479032 DOI: 10.1016/j.jcms.2017.03.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 01/09/2023] Open
Abstract
The current golden standard for treatment of craniomaxillofacial critical size bone defects, autologous bone grafting, is associated with several disadvantages which have prompted an increased demand for alternatives. New solutions are emerging in the form of bone tissue engineering. This involves harvesting of multipotent mesenchymal stromal cells (MSCs), after which they can be differentiated towards the osteogenic lineage mimicking intramembranous bone formation. However, translating this approach from laboratory to clinic has met with limited success. Consequently, attention has shifted towards investigation of the alternative endochondral route of bone regeneration. At a first glance, this approach may not appear logical for maxillofacial bone regeneration as most bones in the face originate from intramembranous mechanisms. Therefore, the goal of this review is to discuss the sense and non-sense of exploring endochondral bone regeneration as a novel reconstructive option for craniomaxillofacial bone defects. The embryological origin of craniomaxillofacial bone structures and their repair mechanisms are introduced. Also, the potential of MSC-like cells, the neural crest-derived stem cells from craniomaxillofacial sources, are discussed with a focus on regeneration of bone defects. Further, the current status of endochondral bone regeneration from MSCs is highlighted. Together, these aspects contribute in answering whether endochondral bone regeneration can be a logical approach to restore craniomaxillofacial bone defects.
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22
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de Misquita MRDOF, Bentini R, Goncalves F. The performance of bone tissue engineering scaffolds in in vivo animal models: A systematic review. J Biomater Appl 2016; 31:625-636. [DOI: 10.1177/0885328216656476] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Bone tissue engineering is an excellent alternative for the regeneration of large bone defects caused by trauma or bone pathologies. Scaffolds, stem cells, and bioactive molecules are the three key components of bone regeneration. Although a wide range of biomaterials of various compositions and structures has been proposed in the literature, these materials are rarely used in clinical applications. Therefore, more standardized studies are required to design scaffolds that enable better bone regeneration and are suitable for clinical use. The aim of this systematic review was to compare the performance of scaffolds used in preclinical animal studies to determine which class of materials has achieved a higher rate of bone neoformation (osteoinduction and osteoconduction). The selected studies were divided into three groups according to the following experimental models: studies that used subcutaneous models, bone defects in calvaria, and bone defects in long bones. Despite the large number of parameters in the included studies, we generally concluded that biomaterials containing calcium phosphates had important osteoinductive effects and were essential for better performance of the materials. Furthermore, natural polymers generally had better performance than synthetic polymers did, especially when the materials were associated with stem cells. The combination of materials from different classes was the most promising strategy for bone tissue regeneration.
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Affiliation(s)
| | | | - Flavia Goncalves
- Universidade Ibirapuera – Unidade Chacara Flora, Sao Paulo, Brazil
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23
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Multipotent Differentiation of Human Dental Pulp Stem Cells: a Literature Review. Stem Cell Rev Rep 2016; 12:511-523. [DOI: 10.1007/s12015-016-9661-9] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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24
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Aquino-Martínez R, Rodríguez-Carballo E, Gámez B, Artigas N, Carvalho-Lobato P, Manzanares-Céspedes MC, Rosa JL, Ventura F. Mesenchymal Stem Cells Within Gelatin/CaSO4 Scaffolds Treated Ex Vivo with Low Doses of BMP-2 and Wnt3a Increase Bone Regeneration. Tissue Eng Part A 2016; 22:41-52. [DOI: 10.1089/ten.tea.2015.0181] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rubén Aquino-Martínez
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Edgardo Rodríguez-Carballo
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Beatriz Gámez
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Natalia Artigas
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Patricia Carvalho-Lobato
- Unitat d'Anatomia i Embriologia Humana, Departament de Patologia i Terapèutica Experimental, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Maria Cristina Manzanares-Céspedes
- Unitat d'Anatomia i Embriologia Humana, Departament de Patologia i Terapèutica Experimental, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jose Luis Rosa
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Francesc Ventura
- Departament de Ciències Fisiològiques II, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Spain
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The effects of dental pulp stem cells on bone regeneration in rat calvarial defect model: Micro-computed tomography and histomorphometric analysis. Arch Oral Biol 2015; 60:1729-35. [DOI: 10.1016/j.archoralbio.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/31/2015] [Accepted: 09/03/2015] [Indexed: 01/09/2023]
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