歯髄再生による新しい歯内治療法の臨床研究に向けて

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Loss of pulp due to pulpitis leads to loss of teeth and reduced quality of life. Thus, there is an unmet need for pulp regeneration. Autologous pulp stem/progenitor (CD105^+ or CD31^- side population (SP)) cells were transplanted into a root canal with stromal cell-derived factor (SDF)-l following pulpectomy in mature teeth with complete apical closure. The root canal was filled with regenerated pulp including nerves and vasculature by day 14, followed by new dentin formation in the coronal part and along the dentinal wall by 6 months. The newly regenerated tissue was significantly larger in the transplantation of pulp stem cells compared with those of unfractionated total pulp cells with SDF-1. On the other hand, regenerated tissue was in similar amount 14 days after adipose stem cell transplantation and in significantly less amount after bone marrow stem cell transplantation compared to pulp stem cell transplantation. The matrix formation rate was much higher in adipose stem cell transplantation compared to pulp stem cell transplantation. Qualitative and quantitative protein and mRNA expression patterns of those regenerated tissues were similar to those of normal pulp, demonstrating that the regenerated tissues were indeed pulp tissue. Expression of many angiogenic/neurotrophic factors in the transplanted cells without incorporation into vessels suggested tropic effects. Thus, this novel stem cell therapy is of utility for pulp regeneration. We are now preparing for clinical trial using standard operation procedure (SOP) in good manufacture practice (GMP) facilities, demonstrating safety and efficacy to permit clinical applications in the near future.
2012-08-31

歯髄再生による新しい歯内治療法の臨床研究に向けて

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