Stem Cells: Present Understanding and Prospects for Regenerative Dentistry

Abstract

Regenerative medicine in dentistry focuses on repairing damaged oral tissues using advanced tools like stem cells, biomaterials, and tissue engineering (TE). Mesenchymal stem cells (MSCs) from dental sources, such as dental pulp and periodontal ligament, show significant potential for tissue regeneration due to their proliferative and differentiative abilities. This systematic review, following PRISMA guidelines, evaluated fifteen studies and identified effective strategies for improving dental, periodontal, and bone tissue regeneration through scaffolds, secretomes, and bioengineering methods. Key advancements include the use of dental pulp stem cells (DPSCs) and periodontal ligament stem cells (PDLSCs) to boost cell viability and manage inflammation. Additionally, pharmacological agents like matrine and surface modifications on biomaterials improve stem cell adhesion and promote osteogenic differentiation. By integrating these approaches, regenerative medicine and TE can optimize dental therapies and enhance patient outcomes. This review highlights the potential and challenges in this field, providing a critical assessment of current research and future directions.

Keywords: oral tissue regeneration; regenerative dentistry; stem cells.

Figure 1

Dental pulp stem cells have the capacity to regenerate in various ways. Diagram illustrating the dental pulp stem cells’ capacity for multi-differentiation in the regeneration of periodontal and dentin–pulp complex tissues.

Figure 2

PRISMA flowchart following guidelines.

Figure 3

(A): Bias assessment; (B): legend (Xiaomeng Li et al., 2021 [81], Miao Yu et al., 2021 [82], Eleonora Cianci et al., 2015 [68], Wenyan Kang et al., 2019 [54], Junqing Liu et al., 2019 [83], Fa-Ming Chen et al., 2016 [84], Bin Ge et al., 2019 [85], Linglu Jia et al., 2019 [86], Hong Wang et al., 2019 [87], C-Y Lin et al., 2018 [88], Shuchen Li et al., 2018 [89], Jing Li et al., 2020 [90], Hynmin Choi et al., 2017 [74], Tara Gross et al., 2023 [91], Samer Hanna et al., 2023 [92]).

Figure 3

(A): Bias assessment; (B): legend (Xiaomeng Li et al., 2021 [81], Miao Yu et al., 2021 [82], Eleonora Cianci et al., 2015 [68], Wenyan Kang et al., 2019 [54], Junqing Liu et al., 2019 [83], Fa-Ming Chen et al., 2016 [84], Bin Ge et al., 2019 [85], Linglu Jia et al., 2019 [86], Hong Wang et al., 2019 [87], C-Y Lin et al., 2018 [88], Shuchen Li et al., 2018 [89], Jing Li et al., 2020 [90], Hynmin Choi et al., 2017 [74], Tara Gross et al., 2023 [91], Samer Hanna et al., 2023 [92]).

Figure 4

Three key components are the focus of TE: biocompatible scaffolds, stem cells, and bioactive compounds such as drug or growth hormone delivery systems creating materials with strong regenerative potential for the purpose of repairing or regenerating damaged oral tissues in regenerative dentistry.

Figure 5

Principles of TE: Various cells extracted from the oral cavity, e.g., pulp tissue, apical papilla, gingival tissue, and periodontal ligament tissue, are seeded on growth factor-soaked scaffolds. The required tissues are obtained after appropriate in vitro culture and finally implanted in vivo.

Figure 6

Control of the differentiation of stem cells derived from oral tissues mediated by circRNA.