Therapeutic potential of dental pulp stem cells and their derivatives: Insights from basic research toward clinical applications

Abstract

For more than 20 years, researchers have isolated and identified postnatal dental pulp stem cells (DPSCs) from different teeth, including natal teeth, exfoliated deciduous teeth, healthy teeth, and diseased teeth. Their mesenchymal stem cell (MSC)-like immunophenotypic characteristics, high proliferation rate, potential for multidirectional differentiation and biological features were demonstrated to be superior to those of bone marrow MSCs. In addition, several main application forms of DPSCs and their derivatives have been investigated, including stem cell injections, modified stem cells, stem cell sheets and stem cell spheroids. In vitro and in vivo administration of DPSCs and their derivatives exhibited beneficial effects in various disease models of different tissues and organs. Therefore, DPSCs and their derivatives are regarded as excellent candidates for stem cell-based tissue regeneration. In this review, we aim to provide an overview of the potential application of DPSCs and their derivatives in the field of regenerative medicine. We describe the similarities and differences of DPSCs isolated from donors of different ages and health conditions. The methodologies for therapeutic administration of DPSCs and their derivatives are introduced, including single injections and the transplantation of the cells with a support, as cell sheets, or as cell spheroids. We also summarize the underlying mechanisms of the regenerative potential of DPSCs.

Keywords: Cell injections; Cell sheets; Cell spheroids; Dental pulp stem cells; Modified cells; Regeneration.

Figure 1

Overview of the main sources of dental pulp stem cells and their derivatives and examples of their applications in regenerative medicine. Dental pulp stem cells (DPSCs) can be isolated from dental pulp tissue of different ages and health statuses, such as the healthy dental pulp tissue of adult impacted teeth, the pulp of children's exfoliated deciduous teeth, and the inflamed dental pulp tissue of patients with caries or periodontitis. Using cell sorting technologies, dental pulp stem cells can be isolated into multiple cell subsets with specific phenotypes, such as CD271+ DPSCs, CD24a+ DPSCs, and CD146+ DPSCs. Several main derivatives of DPSCs derived from long-term applications, including cell injections, genetically modified cells, cell sheets and cell spheroids, which can be used in the treatment of various diseases such as dental pulp diseases, periodontal diseases, and bone defects. DPSC: Dental pulp stem cell.