Role of angiogenesis in endodontics: contributions of stem cells and proangiogenic and antiangiogenic factors to dental pulp regeneration

Abstract

Introduction: Dental pulp regeneration is a part of regenerative endodontics, which includes isolation, propagation, and re-transplantation of stem cells inside the prepared root canal space. The formation of new blood vessels through angiogenesis is mandatory to increase the survival rate of re-transplanted tissues. Angiogenesis is defined as the formation of new blood vessels from preexisting capillaries, which has great importance in pulp regeneration and homeostasis. Here the contribution of human dental pulp stem cells and proangiogenic and antiangiogenic factors to angiogenesis process and regeneration of dental pulp is reviewed.

Methods: A search was performed on the role of angiogenesis in dental pulp regeneration from January 2005 through April 2014. The recent aspects of the relationship between angiogenesis, human dental pulp stem cells, and proangiogenic and antiangiogenic factors in regeneration of dental pulp were assessed.

Results: Many studies have indicated an intimate relationship between angiogenesis and dental pulp regeneration. The contribution of stem cells and mechanical and chemical factors to dental pulp regeneration has been previously discussed.

Conclusions: Angiogenesis is an indispensable process during dental pulp regeneration. The survival of inflamed vital pulp and engineered transplanted pulp tissue are closely linked to the process of angiogenesis at sites of application. However, the detailed regulatory mechanisms involved in initiation and progression of angiogenesis in pulp tissue require investigation.

Keywords: Angiogenesis; proangiogenic and antiangiogenic factors; pulp regeneration; pulp stem cells.

Conflict of interest statement

The authors deny any conflicts of interest related to this study.

Published by Elsevier Inc.

Figures

Figure 1

Schematic presentation of angiogenesis process in regenerative endodontic procedures: (A) the dentin-pulp complex regenerative process including the contributions of DPSCs and growth factors contribution in the angiogenesis process occurring through this regenerative process; (B) the dental pulp regeneration procedure performed inside a prepared root canal by transplanting a tissue-engineered scaffold including stem cells, which secret the necessary growth factors for sprouting angiogenesis.