Cell homing strategy: A new method of regenerative endodontic treatment

Pulpectomy or root canal therapy in pulp disease, makes the teeth fragile and disposed to loss. Therefore, rebuilding dental-pulp complex proceed longevity and health for teeth. In Cell homing-based regeneration, the tooth undergoes transplanting cell-free scaffolds followed by recruit of the endogenous stem cells at bioactive molecules commands. This model results in revitalization and regeneration of the dental-pulp complex. The appropriate biomaterials for scaffolds and growth factors are under investigation. A review over evidence obtained on the aforementioned issue, was performed for English-language literature published in the past 5 years on PubMed and ScienceDirect. Recently, a scaffold containing calcium phosphate, carbonate apatite and bovine collagen type 1, has led to revitalization and remineralization of root canal walls in necrotic immature teeth. It seems that such this scaffold, must be applied in combination with blood clot scaffolds in the apical segment and appropriate growth factors to reach to dental-pulp regeneration in necrotic immature teeth. Some research recommends that mixture of hydrogels with robust porous scaffolds could possibly mimic ECM. Results indicated that granulocyte-colony stimulating factor with the capability of inducing cell proliferation, dentinogenesis, angiogenesis and neurogenesis could be an acceptable growth factor. Studies indicated that compounds with composition of tricalcium silicate, tantalum oxide, and zirconium oxide in immature teeth with necrotic pulp, potentially cause stem cells of apical papilla to survive and differentiate. Furthermore, conditioning root dentin walls with Ethylenediaminetetraacetic acid (EDTA), releases growth factors such as Transforming growth factor beta-1 (TGF-?1), basic fibroblast growth factor (bFGF) and Vascular endothelial growth factor (VEGF) from demineralized dentin. This agent promotes migration and attachment of pulp stem cells along with dentinogenesis and can be effective before scaffolds replacement. In the end, the evidence suggest that cell homing strategy could be an effective complementary or substitute to conventional pulp therapy and cell transplantation.