Pulp regeneration by transplantation of dental pulp with the synergy of concentrate growth factor: An in vitro and in vivo study

Abstract

Abstract Objectives This study aimed to investigate the mechanism of successful autologous pulp transplantation through semi-in situ pulp regeneration in animal experiments and three case reports of autologous pulp transplantation protocols using concentrated growth factor (CGF)-enriched pulp. Material and methods Wisdom tooth pulp was removed, placed in the anterior molar canal, and implanted in the subcranial space of the cranial apex of SD rats to establish an animal model of hemi-in situ pulp regeneration. Postoperative histological observations were performed. Three patients diagnosed with chronic periapical inflammation in a single canal of the anterior teeth and satisfied with the presence of wisdom teeth were recruited, and the CGF-rich autologous pulp transplantation protocol was selected after obtaining informed consent. Result Animal experiments showed no detachment of all SD rat grafts after surgery, a large amount of neovascularization by HE staining, and positive vascular expression by immunohistochemistry for both human CD31 and murine CD31. The three patients were followed at 3 and 6 months after surgery, and all teeth showed improvement in periapical lesions and positive pulp electrical vitality tests. Conclusion The results of animal experiments indicate that isolated pulp can survive and establish a blood supply with the host, and the addition of CGF facilitates regenerative pulp formation. The clinical results also demonstrated that CGF-rich autologous pulp transplantation protocols are a good regenerative pulp therapy (RET) for the treatment of chronic apical periodontitis in anterior teeth.