Biomedical Engineering Reference
In-Depth Information
Chapter 3
Pulp Regeneration by Harnessing
Dental Pulp Stem Cells
Misako Nakashima and Koichiro Iohara
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/58905
1. Introduction
Teeth possess multiple functions. Besides mastication, they are important for taste, tactile
sense, speech and esthetics. The longevity of teeth is critical for the maintenance and enhance‐
ment of quality of life. Over fifty percent of extracted teeth are caused by caries and root
fracture. Deep caries and pulp exposure have been treated by pulp capping or partial pulp
amputation to preserve pulp tissue, with limited success. In case of irreversible pulpitis,the
entire pulp has to be removed and the root canal space has to be completely filled with artificial
materials after disinfection. However, incomplete disinfection and coronal leakage cause
periapical disease. The endodontic success rate is less than 50-70% for retreatment of those
endodontically failed teeth with periapical lesions and/or some clinical symptoms. Enlarge‐
ment and debridement of infected root canals render teeth brittle. The post-operative proce‐
dures with post preparation also increase the possibility of root fracture. Therefore, loss of
pulp vitality is highly associated with root fracture and tooth loss. There has been no superior
synthetic material to replace natural pulp and dentin. Thus, regenerating pulp-dentin tissues
seems to be an ideal approach to restore tooth functions compromised by pulp injury and/or
inflammation (Nakashima and Akamine, 2005; Nakashima, et al., 2009). Under natural
conditions, pulp and dentin have limited capacity to regenerate and repair when damaged.
This chapter describes recent advances and promising approaches for pulp regeneration,
including isolation and characteristics of pulp stem/progenitor cells and partial and complete
regeneration of pulp. The complete pulp regeneration with other tissue stem cells is also
addressed.
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