Human dental pulp stem/stromal cells in clinical practice

Abstract

Dental pulp stem/stromal cells (DPSCs) are fibroblast-like, neural crest-derived, and multipotent cells that can differentiate into several lineages. They are relatively easy to isolate from healthy and inflamed pulps, with little ethical concerns and can be successfully cryopreserved and thawed. The therapeutic effects of DPSCs derived from animal or human sources have been extensively studied through in-vitro and in-vivo animal experiments and the findings indicated that DPSCs are effective not only for dental diseases but also for systemic diseases. Understanding that translational research is a critical step through which the fundamental scientific discoveries could be translated into applicable diagnostics and therapeutics that directly benefit humans, several clinical studies were carried out to generate evidence for the efficacy and safety of autogenous or allogeneic human DPSCs (hDPSCs) as a treatment modality for use in cell-based therapy, regenerative medicine/dentistry and tissue engineering. In clinical medicine, hDPSCs were effective for treating acute ischemic stroke and human exfoliated deciduous teeth-conditioned medium (SHED-CM) repaired vascular damage of the corpus cavernous, which is the main cause of erectile dysfunction. Whereas in clinical dentistry, autologous SHED was able to regenerate necrotic dental pulp after implantation into injured teeth, and micrografts enriched with autologous hDPSCs and collagen sponge were considered a treatment option for human intrabony defects. In contrast, hDPSCs did not add a significant regenerative effect when they were used for the treatment of post-extraction sockets. Large-scale clinical studies across diverse populations are still lacking to provide robust evidence on the safety and efficacy of hDPSCs as a new treatment option for various human diseases including dental-related problems.

Keywords: Dental pulp stem/stromal cells, Human clinical studies, Regenerative medicine, Regenerative dentistry, Cell-based therapy

Core Tip: The need for new alternative therapeutic strategies is of paramount importance to improve the cure rate and quality of patients’ lives. Human dental pulp stem/stromal cells and human exfoliated deciduous teeth are promising candidates for regenerative medicine and dentistry as they have been used clinically to treat acute ischemic stroke, erectile dysfunction, traumatized teeth with necrotic pulps, and intrabony defects.