Pulp stem cells derived from human permanent and deciduous teeth: Biological characteristics and therapeutic applications

Abstract

Abstract Human pulp stem cells (PSCs) include dental pulp stem cells (DPSCs) isolated from dental pulp tissues of human extracted permanent teeth and stem cells from human exfoliated deciduous teeth (SHED). Depending on their multipotency and sensitivity to local paracrine activity, DPSCs and SHED exert therapeutic applications at multiple levels beyond the scope of the stomatognathic system. This review is specifically concentrated on PSC-updated biological characteristics and their promising therapeutic applications in (pre)clinical practice. Biologically, distinguished from conventional mesenchymal stem cell markers in vitro, NG2, Gli1, and Celsr1 have been evidenced as PSC markers in vivo. Both perivascular cells and glial cells account for PSC origin. Therapeutically, endodontic regeneration is where PSCs hold the most promises, attributable of PSCs’ robust angiogenic, neurogenic, and odontogenic capabilities. More recently, the interplay between cell homing and liberated growth factors from dentin matrix has endowed a novel approach for pulp-dentin complex regeneration. In addition, PSC transplantation for extraoral tissue repair and regeneration has achieved immense progress, following their multipotential differentiation and paracrine mechanism. Accordingly, PSC banking is undergoing extensively with the intent of advancing tissue engineering, disease remodeling, and (pre)clinical treatments. Significance statement Pulp stem cells can be readily harvested from dental pulp tissue of extracted permanent teeth and exfoliated deciduous teeth, respectively. However, a systematic and comprehensive review about pulp stem cells in terms of biological attributes and therapeutic applications is lacking. Accordingly, this review is concentrated on pulp stem cells to emphasize their updated biological characteristics such as cell markers, multipotency and origin, and promising therapeutic applications, including endodontic regeneration and extraoral tissue repair and regeneration, as well as rising cell bank with the intent of enhancing the understanding of dental mesenchymal stem cells and advancing associated tissue engineering and disease treatment.