Direct Dental Pulp Tissue Grafting – a Novel Approach to Regenerative Endodontics

The translation of dental pulp stem cells (DPSC) transplantation into clinic practice is hindered by the Good Manufacturing Practice (GMP) approval for in vitro autologous DPSC expansion. In order to circumvent the laboratory procedure, we proposed an unprecedented approach for regenerative endodontics – direct dental pulp tissue grafting. This study has demonstrated that cells directly migrating out from dental pulp tissue explantation (DPTE), functioning as the putative cell source in our approach for tissue regeneration, exhibits stem cell properties such as elongated lifespan as well as multi-potent differentiation in vitro as equivalent to DPSC. Additionally, our data from ex vivo tissue engineering with either porous biodegradable scaffold (poly-L-Lactic acid) or injectable self-assembly scaffold (PuraMatrix Hydrogel) suggests that dental pulp tissue fragments are survivable and proliferative in three-dimensional culture, generating stem cell population with odontogenic differentiation potential as well as mineralization capacity. Consequently, this preliminary investigation has established the fundamental rationale for the utilization of direct pulp tissue grafting in pulp-dentin complex engineering, charting out a blueprint for subsequent studies of a brand-new technique for regenerative endodontics