中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (10): 1620-1625.doi: 10.12307/2024.311

• 生物材料综述 biomaterial review • 上一篇    下一篇

基于炎症微环境调控组织工程再生性牙髓治疗

饶  瑾,姜  水,石海山   

  1. 暨南大学口腔医学院,广东省广州市  510632
  • 收稿日期:2023-04-08 接受日期:2023-05-13 出版日期:2024-04-08 发布日期:2023-08-21
  • 通讯作者: 石海山,博士,副教授,硕士生导师,暨南大学口腔医学院交叉学科教研室主任,暨南大学口腔医学院,广东省广州市 510632
  • 作者简介:饶瑾,女,2000年生,广东省人,汉族,主要从事口腔生物材料学研究。
  • 基金资助:
    广州市科技计划项目基础与应用基础研究项目(202102021127),项目负责人:石海山

Regenerative endodontic therapy based on tissue engineering mediating by inflammatory microenvironment

Rao Jin, Jiang Shui, Shi Haishan   

  1. School of Stomatology, Jinan University, Guangzhou 510632, Guangdong Province, China
  • Received:2023-04-08 Accepted:2023-05-13 Online:2024-04-08 Published:2023-08-21
  • Contact: Shi Haishan, PhD, Associate professor, Master’s supervisor, School of Stomatology, Jinan University, Guangzhou 510632, Guangdong Province, China
  • About author:Rao Jin, School of Stomatology, Jinan University, Guangzhou 510632, Guangdong Province, China
  • Supported by:
    Basic and Applied Basic Research Project of Guangzhou Science and Technology Plan Program, No. 202102021127 (to SHS)

摘要:


文题释义:

炎症微环境:微环境是稳定维持正常细胞增殖、分化、代谢和功能活动的重要因素,其变化直接影响细胞功能和组织稳态。细菌感染及外源性刺激会直接导致微环境失衡:机体细胞通过受体识别激活防御机制应对外界刺激,释放炎症递质,形成炎症微环境。
组织工程再生性牙髓治疗:是针对牙髓-牙本质复合体及牙根结构受到损伤、牙本质停止生长的患牙,通过干细胞、生长因子及支架材料的协同作用,实现牙髓‑牙本质复合体功能性再生,促使牙髓坏死年轻恒牙的牙根继续发育的一种治疗手段。


背景:近年来,再生性牙髓治疗概念随着组织工程的发展逐渐形成,炎症微环境在调控牙髓再生方面起着关键作用。

目的:文章从炎症牙髓微环境变化出发,着眼于炎症与再生平衡,重点介绍炎症微环境中组织工程再生性牙髓治疗的研究进展,为未来再生性牙髓治疗的研究提供参考。
方法:在PubMed和中国知网数据库中进行检索,中文检索词为“牙髓再生,炎症,再生性牙髓治疗,组织工程”;英文检索词为“pulp regeneration,inflammation,regenerative endodontic therapy,tissue engineering”,分别检索2013-2023年发表的相关文献,最终纳入61篇文献进行综述分析。

结果与结论:①牙髓炎症微环境的变化涉及一系列细胞与分子反应,随炎症进展,微环境对组织修复的作用弊大于利。②炎症通过干细胞募集及激活补体系统等方式促进牙髓再生,也能通过免疫抑制、纤维化破坏再生过程。③组织工程三要素(干细胞、生长因子及支架材料)协同介导炎症反应以恢复炎症-再生平衡,如利用白细胞介素6调节牙髓干细胞功能介导炎症微环境以促进牙髓再生。④当前研究缺乏对感染、炎症问题的关注,牙髓炎症微环境的变化机制尚不清晰,通过有机结合组织工程再生性牙髓治疗的三要素调控炎症微环境,构建再生微环境,精准地调控炎症-再生平衡或是提高临床适用性的突破口之一,但该部分研究仍存在较大空缺,期望未来的研究就如何实现炎症环境下的牙髓再生展开更多的探索,也还需更多动物实验、随机临床试验为组织工程再生性牙髓治疗的临床实践奠定基础。

https://orcid.org/0009-0006-7562-0388(饶瑾);https://orcid.org/0000-0003-3831-6898(石海山)

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料口腔生物材料纳米材料缓释材料材料相容性组织工程

关键词: 组织工程, 再生性牙髓治疗, 牙髓再生, 炎症, 炎症微环境, 干细胞, 生长因子, 支架

Abstract: BACKGROUND: Recently, regenerative endodontic therapy is a promising alternative to the maturation of tissue engineering. Inflammatory microenvironment plays a key role in regulating pulp regeneration.
OBJECTIVE: To focus on the change in the inflammatory pulp microenvironment, the balance between inflammation and regeneration, and the research advances in tissue-engineered regenerative endodontic therapy within the context of the inflammatory microenvironment to provide a reference for future investigations into regenerative endodontic therapy.
METHODS: We conducted a literature search on PubMed and CNKI using search terms “pulp regeneration, inflammation, regenerative endodontic therapy, tissue engineering” in Chinese and English for articles published between 2013 and 2023. The review finally included 61 relevant articles.
RESULTS AND CONCLUSION: (1) The changes in the microenvironment of pulpitis involve a complex interplay of cellular and molecular reactions, which, as inflammation progresses, ultimately the microenvironment hinders tissue repair more than facilitates it. (2) Inflammation can promote dental pulp regeneration through stem cell recruitment and activate the complement system, but it can also hinder the regenerative process through immunosuppression and fibrosis. (3) Tissue engineering’s three components (stem cells, growth factors, scaffold materials) collaborate to balance inflammation and regeneration, for example, by using interleukin-6 to regulate dental pulp stem cells and foster a regenerative environment. (4) Current research has been largely silent on infection and inflammation issues. The mechanisms underlying changes in the microenvironment of pulpitis are still not fully understood. One promising avenue for improving the clinical applicability of regenerative dental pulp therapy is to achieve precise regulation of the inflammatory-regeneration balance and create a regenerative microenvironment by synergistically leveraging the three elements of tissue engineering. However, this field of investigation still exhibits significant gaps in understanding, necessitating further exploration into innovative strategies for facilitating dental pulp regeneration under inflammation. As such, additional animal experimentation and randomized clinical trials are required to establish a robust foundation for the clinical practice of tissue engineering-based regenerative dental pulp therapy.

Key words: tissue engineering, regenerative endodontic therapy, pulp regeneration, inflammation, inflammatory microenvironment, stem cell, growth factor, scaffold

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