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\def\makelabel##1{\upshape ##1}}% } {\end{list}\end{raggedright}} \newenvironment{specHead}[2]% {\vspace{20pt}\hrule\vspace{10pt}% \phantomsection\label{#1}\markright{#2}% \pdfbookmark[2]{#2}{#1}% \hspace{-0.75in}{\bfseries\fontsize{16pt}{18pt}\selectfont#2}% }{} \def\TheFullDate{2018 2018-01-15 (revised: 17 Year 2018 15 January 2018)} \def\TheID{\makeatother } \def\TheDate{2018 2018-01-15} \title{Use of Dental Stem Cells Harvested from a Tooth or Follicle} \author{}\makeatletter \makeatletter \newcommand*{\cleartoleftpage}{% \clearpage \if@twoside \ifodd\c@page \hbox{}\newpage \if@twocolumn \hbox{}\newpage \fi \fi \fi } \makeatother \makeatletter \thispagestyle{empty} \markright{\@title}\markboth{\@title}{\@author} \renewcommand\small{\@setfontsize\small{9pt}{11pt}\abovedisplayskip 8.5\p@ plus3\p@ minus4\p@ \belowdisplayskip \abovedisplayskip \abovedisplayshortskip \z@ plus2\p@ \belowdisplayshortskip 4\p@ plus2\p@ minus2\p@ \def\@listi{\leftmargin\leftmargini \topsep 2\p@ plus1\p@ minus1\p@ \parsep 2\p@ plus\p@ minus\p@ \itemsep 1pt} } \makeatother \fvset{frame=single,numberblanklines=false,xleftmargin=5mm,xrightmargin=5mm} \fancyhf{} \setlength{\headheight}{14pt} \fancyhead[LE]{\bfseries\leftmark} \fancyhead[RO]{\bfseries\rightmark} \fancyfoot[RO]{} \fancyfoot[CO]{\thepage} \fancyfoot[LO]{\TheID} \fancyfoot[LE]{} \fancyfoot[CE]{\thepage} \fancyfoot[RE]{\TheID} \hypersetup{citebordercolor=0.75 0.75 0.75,linkbordercolor=0.75 0.75 0.75,urlbordercolor=0.75 0.75 0.75,bookmarksnumbered=true} \fancypagestyle{plain}{\fancyhead{}\renewcommand{\headrulewidth}{0pt}} \date{} \usepackage{authblk} \providecommand{\keywords}[1] { \footnotesize \textbf{\textit{Index terms---}} #1 } \usepackage{graphicx,xcolor} \definecolor{GJBlue}{HTML}{273B81} \definecolor{GJLightBlue}{HTML}{0A9DD9} \definecolor{GJMediumGrey}{HTML}{6D6E70} \definecolor{GJLightGrey}{HTML}{929497} \renewenvironment{abstract}{% \setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Saleha Shah} \renewcommand\Authands{ and } \date{\small \em Received: 10 December 2017 Accepted: 3 January 2018 Published: 15 January 2018} \maketitle \begin{abstract} Regenerative medicine is gaining popularity and inspires dentists to follow evidence-based literature for educating the parents about collecting, storing, sustainability and utility of dental stem cells about autologous regenerative therapies. Stem cells are present intrinsically in the apical papilla or dental pulp cells for treatment associated to regenerative endodontics. \end{abstract} \keywords{} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \let\tabcellsep& \section[{Introduction}]{Introduction}\par tem cells are pluripotent cells which can divide and increase for a protracted period and differentiate into specialized cell types and tissues of a wide variety. Dental stem cells are a subset of adult mesenchymal stem cells which proliferate rapidly and differentiate into many cell lines. \hyperref[b3]{4} Adult stem cell therapy applies to medical presentations as metabolic disorders, bone marrow transplant for hematopoietic cancers and congenital immunodeficiency syndromes. It is undergoing clinical testing for diabetes, brain trauma/ spinal cord injuries and Parkinson's disease among other conditions. \hyperref[b4]{5,}\hyperref[b5]{6} The oral health applications of stem cells include dental and periodontal tissue regeneration, craniofacial structure repair (cleft lip/palate) and wound healing. \hyperref[b6]{7} They are derived from various sources such as preserved umbilical cord blood, pulp tissue of exfoliating primary teeth, fibroblasts from oral mucosa, 8 periodontal ligaments, surgically removed third molars 9 and gingival fibroblasts. \hyperref[b1]{2,}\hyperref[b8]{9,}\hyperref[b9]{10} They are secured and stored for conserving their proliferation and differentiation potential. \hyperref[b10]{11,}\hyperref[b11]{12} Since these dental stem cells are not very stable and lead to in vivo tumours, 2 more studies are required to assess their safety and efficacy prior to initiating clinical trials in humans. \hyperref[b10]{11,}\hyperref[b11]{12} Modern regenerative endodontics is augmented by newer techniques including tissue engineering and regenerative medicine. \hyperref[b12]{13} Stem cell transplantation and cell homing strategies are applicable to pulp regeneration. Stem cells are isolated, expanded, seeded and transplanted into the scaffold. Cell homing achieve tissue repair/regeneration by replacing the necrotic, inflamed or injured pulpal tissue with a regenerated pulp-like tissue by recruiting endogenous cells via signaling molecules. Compared with stem cell transplantation, cell homing strategies do not need to isolate and manipulate stem cells in vitro. \hyperref[b13]{14,}\hyperref[b14]{15,}\hyperref[b15]{16} \section[{S}]{S}\par Author: e-mail: saleha.shah@aku.edu An example of cell homing strategy is pulp revascularization of immature teeth. Histologically most of the tissues formed in suc cases are unlike pulp like tissue and comprise of cementum, periodontal, and bone-like tissues. \hyperref[b16]{17} Additional studies are required to increase the success rate of pulp revascularization in immature teeth, facilitate the formation of pulp-like tissues and applying cell homing in mature teeth.\par The first prerequisite for promoting pulpal regeneration include disinfection of the pulp space and dentinal walls via different root canal disinfectants including intracanal medication with antibiotics, ultrasonic-assisted irrigation, EndoVac apical negativepressure system of irrigation and laser irradiation. \hyperref[b17]{18} Another precondition for pulp regeneration is the proper size of the apical foramen, especially in mature teeth with closed apex in adults. An apical foramen too small in size will affect both the migration of endogenous cells as well as neovascularization and reinnervation during regeneration. A minimum of 1.1 mm apical foramen is necessary to obtain revascularization. \hyperref[b18]{19} Morphologically the regenerated tissues should encompass connective tissues for new dentin formation at a controlled rate similar to healthy pulp, display cell density, and architecture as the natural tissue, and have innervation and vascularization. \hyperref[b20]{20} Vascularization and innervation are vital pulpal characteristics hence the new regenerated blood vessels must connect with the periapical or bone marrow tissues around the teeth to receive a regular blood flow from circulation, nutrient supply and sense hot/cold stimulation and pain during infection. \hyperref[b21]{21} An area of concern for homing cell strategy is the source of stem. They are derived from dental pulp stem cells (DPSCs), apical papilla (SCAP), bone marrow stem cells (BMSCs), periodontal ligament cells migrating to the root canal by chemokines and others. \hyperref[b22]{22} To conclude; even though some experimental and clinical studies yield pulp-like vascularized tissue; the information about the function of this tissue is insufficient. Hence further studies are required to succeed in functional pulp regeneration. \backmatter \begin{bibitemlist}{1} \bibitem[Endod]{b19}\label{b19} \textit{}, Endod . doi: 10.1111/j. 1600-9657.1986.tb00132.x. \textit{Dent. Traumatol} 2 p. . \bibitem[Yang et al. ()]{b14}\label{b14} ‘Autophagy in SDF-1?-mediated DPSC migration and pulp regeneration’. J W Yang , Y F Zhang , C Y Wan , Z Y Sun , S Nie , S J Jian . doi: 10.1016/j. biomaterials.2014.12.006. \textit{Biomaterials} 2015a. 44 p. . \bibitem[Perry et al. 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()]{b7}\label{b7} ‘Generation of human induced pluripotent stem cells from oral mucosa’. K Miyoshi , D Tsuji , K Kudoh . \textit{J Biosci Bioeng} 2010. 110 (3) p. . \bibitem[Kökten et al. ()]{b21}\label{b21} ‘Immunomodulation stimulates the innervation of engineered tooth organ’. T Kökten , T Bécavin , L Keller , J L Weickert , S Kuchler-Bopp , H Lesot . \xref{http://dx.doi.org/10.1371/journal.pone.0086011}{10.1371/journal.pone.0086011}. \textit{PLoS ONE} 2014. 9 p. e86011. \bibitem[Eslaminejad et al.]{b9}\label{b9} ‘In vitro growth and characterization of stem cells from human dental pulp of deciduous versus permanent teeth’. M B Eslaminejad , S Vahabi , M Shariati , H Nazarian . \textit{J Dent (Tehran)} 7 (4) p. . \bibitem[Nourbakhsh et al. ()]{b4}\label{b4} ‘Induced in vitro differentiation of neural-like cells from human exfoliated deciduous teeth-derived stem cells’. N Nourbakhsh , M Soleimani , Z Taghipour . \textit{Int J Dev Biol} 2011. 55 (2) p. . \bibitem[Wada et al. ()]{b8}\label{b8} ‘Induced pluripotent stem cell lines derived from human gingival fibroblasts and periodontal ligament fibroblasts’. N Wada , B Wang , N H Lin , A L Laslett . \textit{J Periodontal Res} 2011. 46 (4) p. . \bibitem[Hynes et al. ()]{b2}\label{b2} ‘Induced pluripotent stem cells: A new frontier for stem cells in dentistry’. K Hynes , D Menichanin , R Bright . \textit{J Dent Res} 2015. 94 (11) p. . \bibitem[Sun et al. ()]{b13}\label{b13} ‘Investigation of dental pulp stem cells isolated from discarded human teeth extracted due to aggressive periodontitis’. H H Sun , B Chen , Q L Zhu , H Kong , Q H Li , L N Gao . doi: 10.1016/j. biomaterials.2014.08.003. \textit{Biomaterials} 2014. 35 p. . \bibitem[Yang et al. ()]{b1}\label{b1} ‘Pulp regeneration: Current approaches and future challenges’. J Yang , G Yuan , Z Chen . \textit{Front Physiol} 2016. 7 p. 58. \bibitem[Thibodeau and Trope ()]{b16}\label{b16} ‘Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature’. B Thibodeau , M Trope . \textit{Pediatr. Dent} 2007. 29 p. . \bibitem[Kling et al. ()]{b18}\label{b18} \textit{Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors}, M Kling , M Cvek , I Mejare . 1986. \bibitem[Nakashima and Iohara ()]{b12}\label{b12} ‘Regeneration of dental pulp by stem cells’. M Nakashima , K Iohara . \xref{http://dx.doi.org/10.1177/0022034511405323}{10.1177/0022034511405323}. \textit{Adv. Dent. Res} 2011. 23 p. . \bibitem[Zhou et al. ()]{b22}\label{b22} ‘Role of bone marrow-derived progenitor cells in the maintenance and regeneration of dental mesenchymal tissues’. J Zhou , S Shi , Y Shi , H Xie , L Chen , Y He . \xref{http://dx.doi.org/10.1002/jcp.22538}{10.1002/jcp.22538}. \textit{J. Cell. Physiol} 2011. 226 p. . \bibitem[Conde et al. ()]{b0}\label{b0} ‘Stem cell based pulp tissue engineering: Variables enrolled in translation from the bench to the bedside, a systematic review of literature’. M C Conde , L A Chisini , F F Demarco . \textit{Int Endod J} 2016. 49 (6) p. . \bibitem[El-Sayed et al. ()]{b20}\label{b20} ‘Stem Cell transplantaion for pulpal regeneration: a systematic review’. Fawzy El-Sayed , K M Jakusz , K Jochens , A Dörfer , C Schwendicke , F . \xref{http://dx.doi.org/10.1089/ten.teb.2014.0675}{10.1089/ten.teb.2014.0675}. \textit{Tissue Eng. Part B Rev} 2015. 21 p. . \bibitem[Nishino et al. ()]{b6}\label{b6} ‘Stem cells from human exfoliated deciduous teeth (SHED) enhance wound healing and the possibility of novel cell therapy’. Y Nishino , Y Yamada , K Ebisawa . \textit{Cytotherapy} 2011. 13 (5) p. . \bibitem[Yildirim et al. (2016)]{b11}\label{b11} ‘The comparison of the immunologic properties of stem cells isolated from human exfoliated deciduous teeth, dental pulp, and dental follicles’. S Yildirim , N Zibandeh , D Genc , E M Ozcan , K Goker , T Akkoc . \url{http://www.webcitation.org/6tkJoR5zd} \textit{Stem Cells Int} 2016. 2016. June 9, 2017. p. 4682875. (Archived by WebCite® at) \bibitem[Shi et al. ()]{b23}\label{b23} ‘The efficacy of mesenchymal stem cells to regenerate and repair dental structures’. S Shi , P M Bartold , M Miura , B M Seo , P G Robey , Gronthos , S . \xref{http://dx.doi.org/10.1111/j.1601-6343.2005.00331.x}{10.1111/j.1601-6343.2005.00331.x}. \textit{Orthod. Craniofac. Res} 2005. 8 p. . \bibitem[Fouad ()]{b17}\label{b17} ‘The microbial challenge to pulp regeneration’. A F Fouad . \xref{http://dx.doi.org/10.1177/0022034511405388}{10.1177/0022034511405388}. \textit{Adv. Dent. Res} 2011. 23 p. . \end{bibitemlist} \end{document}