Although DPSC scaffolds provide direct tissue reconstruction, secretome-enhanced scaffolds are clinically applicable as a cell-free, scalable and potentially safer method and a better understanding of the advantages and disadvantages of DPSC secretome-modified scaffolds will assist in the development of future and emerging translational opportunities for personalized, minimally invasive regenerative endodontic therapies.
Abstract
Regeneration of dental pulp has surfaced as an exciting area of exploration in regenerative endodontics, as a result of progress in stem cell biology and their applications, along with biomaterials. Of the different cell populations studied, dental pulp stem cells (DPSCs) are recognized as possessing significant regenerative potential considering their multipotency, immunomodulatory properties and capacity to differentiate into odontoblast-like cells. Interest has also increased in alternative approaches, such as the DPSC-derived secretome, which serves as a bioactive consulting of molecules like cytokines, growth factors and extracellular vesicles, to initiate regenerative processes through paracrine signalling without the limitations of cell-based treatments. This review highlights the relative therapeutic potential of DPSCs secretome when integrated with three-dimensional scaffolds for the regeneration of the pulp-dentin complex. We discuss the biological mechanisms by which DPSCs secretome helps in regeneration assess the compatibility of scaffolds, and review advantages and limitations regarding their use based on efficacy, immunogenicity, storage and clinical use. Although DPSC scaffolds provide direct tissue reconstruction, secretome-enhanced scaffolds are clinically applicable as a cell-free, scalable and potentially safer method. A better understanding of the advantages and disadvantages of DPSC secretome-modified scaffolds will assist in the development of future and emerging translational opportunities for personalized, minimally invasive regenerative endodontic therapies.
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