Dental pulp stem cells express tendon markers under mechanical loading and are a potential cell source for tissue engineering of tendon-like tissue

Postnatal mesenchymal stem cells have the capacity to differentiate into multiple cell lineages. This study explored the possibility of dental pulp stem cells （DPSCs） for potential application in tendon tissue engineering. The expression of tendon- related markers such as scleraxis, tenascin-C, tenomodulin, eye absent homologue 2, collagens I and VI was detected in dental pulp tissue. Interestingly, under mechanical stimulation, these tendon-related markers were significantly enhanced when DPSCs were seeded in aligned polyglycolic acid （PGA） fibre scaffolds. Furthermore, mature tendon-like tissue was formed after transplantation of DPSC-PGA constructs under mechanical loading conditions in a mouse model. This study demonstrates that DPSCs could be a ootential stem cell source for tissue enEineerin~ of tendon-like tissue.

Dental pulp stem cells and banking of teeth as a lifesaving therapeutic vista

Exfoliated deciduous or an extracted healthy adult tooth can be used to harvest,process,and cryogenically preserve dental pulp stem cells.Future stem cell-based regenerative medicine methods could benefit significantly from these mesenchymal stem cells.Teeth serve as a substantial source of mesenchymal stem cells,otherwise disposed of as medical waste.Care should be taken to store this treasure trove of stem cells.Collective responsibility of patients,dentists,and physicians is necessary to ensure that this valuable resource is not wasted and that every possible dental pulp stem cell is available for use in the future.The dental pulp stem cells(DPSC)inside teeth represent a significant future source of stem cells for regenerative medicine procedures.This review describes the ontogeny,the laboratory processing and collection,and isolation methods of DPSC.This review also discusses currently available stem cell banking facilities and their potential use in regenerative medicine procedures in dental and general medical applications in the future.

Potential of dental pulp stem cells and their products in promoting peripheral nerve regeneration and their future applications

Peripheral nerve injury(PNI)seriously affects people’s quality of life.Stem cell therapy is considered a promising new option for the clinical treatment of PNI.Dental stem cells,particularly dental pulp stem cells(DPSCs),are adult pluripotent stem cells derived from the neuroectoderm.DPSCs have significant potential in the field of neural tissue engineering due to their numerous advantages,such as easy isolation,multidifferentiation potential,low immunogenicity,and low transplant rejection rate.DPSCs are extensively used in tissue engineering and regenerative medicine,including for the treatment of sciatic nerve injury,facial nerve injury,spinal cord injury,and other neurodegenerative diseases.This article reviews research related to DPSCs and their advantages in treating PNI,aiming to summarize the therapeutic potential of DPSCs for PNI and the underlying mechanisms and providing valuable guidance and a foundation for future research.

Mineralized and Osteoid Tissue from Dental Pulp Stem Cells on Micro-arc Oxidation Titanium in vitro

The presence of insufficient bone volume affects the implant healing and success.The aim of this study was to evaluate osteogenic capacity of dental pulp stem cells(DPSCs) on micro-arc oxidation(MAO) titanium surface.DPSCs were challenged at MAO and smooth titanium surface separately for different durations,and the bone marrow mesenchymal stem cells(BMSCs) served as the positive controls.The osteogenic capacity of DPSCs on MAO titanium surface was assessed by using scanning electron microscopy,energy dispersive spectroscopy,biochemical tests and real-time quantitative PCR.Data showed that DPSCs differentiated into osteoblasts and expressed bone morphogenetic genes on MAO titanium surface.The results of this study revealed that DPSCs had good potential to generate mineralized tissue on MAO titanium plates.The differential potential of DPSCs may be regulated by MAO titanium surface.The osteogenesis potential of DPSCs on the MAO titanium was similar with BMSCs.

Clinical trials using dental stem cells:2022 update

For nearly 20 years,dental stem cells(DSCs)have been successfully isolated from mature/immature teeth and surrounding tissue,including dental pulp of permanent teeth and exfoliated deciduous teeth,periodontal ligaments,dental follicles,and gingival and apical papilla.They have several properties(such as self-renewal,multidirectional differentiation,and immunomodulation)and exhibit enormous potential for clinical applications.To date,many clinical articles and clinical trials using DSCs have reported the treatment of pulpitis,periapical lesions,periodontitis,cleft lip and palate,acute ischemic stroke,and so on,and DSC-based therapies obtained satisfactory effects in most clinical trials.In these studies,no adverse events were reported,which suggested the safety of DSC-based therapy.In this review,we outline the characteristics of DSCs and summ-arize clinical trials and their safety as DSC-based therapies.Meanwhile,we also present the current limitations and perspectives of DSC-based therapy(such as harvesting DSCs from inflamed tissue,applying DSC-conditioned medi-um/DSC-derived extracellular vesicles,and expanding-free strategies)to provide a theoretical basis for their clinical applications.

Clinical application prospects and transformation value of dental follicle stem cells in oral and neurological diseases

Since dental pulp stem cells(DPSCs)were first reported,six types of dental SCs(DSCs)have been isolated and identified.DSCs originating from the craniofacial neural crest exhibit dental-like tissue differentiation potential and neuroectodermal features.As a member of DSCs,dental follicle SCs(DFSCs)are the only cell type obtained at the early developing stage of the tooth prior to eruption.Dental follicle tissue has the distinct advantage of large tissue volume compared with other dental tissues,which is a prerequisite for obtaining a sufficient number of cells to meet the needs of clinical applications.Furthermore,DFSCs exhibit a significantly higher cell proliferation rate,higher colony-formation capacity,and more primitive and better anti-inflammatory effects than other DSCs.In this respect,DFSCs have the potential to be of great clinical significance and translational value in oral and neurological diseases,with natural advantages based on their origin.Lastly,cryopreservation preserves the biological properties of DFSCs and enables them to be used as off-shelf products for clinical applications.This review summarizes and comments on the properties,application potential,and clinical transformation value of DFSCs,thereby inspiring novel perspectives in the future treatment of oral and neurological diseases.

Therapeutic and regenerative potential of different sources of mesenchymal stem cells for cardiovascular diseases

Mesenchymalstemcells(MSCs)areidealcandidatesfortreatingmanycardiovasculardiseases.MSCscanmodify the internal cardiac microenvironment to facilitate their immunomodulatory and differentiation abilities,which are essential to restore heart function.MSCs can be easily isolated from different sources,including bone marrow,adipose tissues,umbilical cord,and dental pulp.MSCs from various sources differ in their regenerative and therapeutic abilities for cardiovascular disorders.In this review,we will summarize the therapeutic potential of each MSC source for heart diseases and highlight the possible molecular mechanisms of each source to restore cardiac function.

Application of dental stem cells in three-dimensional tissue regeneration

Dental stem cells can differentiate into different types of cells.Dental pulp stem cells,stem cells from human exfoliated deciduous teeth,periodontal ligament stem cells,stem cells from apical papilla,and dental follicle progenitor cells are five different types of dental stem cells that have been identified during different stages of tooth development.The availability of dental stem cells from discarded or removed teeth makes them promising candidates for tissue engineering.In recent years,three-dimensional(3D)tissue scaffolds have been used to reconstruct and restore different anatomical defects.With rapid advances in 3D tissue engineering,dental stem cells have been used in the regeneration of 3D engineered tissue.This review presents an overview of different types of dental stem cells used in 3D tissue regeneration,which are currently the most common type of stem cells used to treat human tissue conditions.

Therapeutic applications of dental pulp stem cells in regenerating dental,periodontal and oral-related structures

Dental pulp stem cells (DPSCs) have emerged as a promising tool with greatpotential for use in tissue regeneration and engineering. Some of the mainadvantages of these cells are their multifaceted differentiation capacity, along withtheir high proliferation rate, a relative simplicity of extraction and culture thatenables obtaining patient-specific cell lines for their use in autologous celltherapy. PubMed, Scopus and Google Scholar databases were searched forrelevant articles related to the use of DPSCs in regeneration of dentin-pulpcomplex (DPC), periodontal tissues, salivary gland and craniomaxillofacial bonedefects. Few studies were found regarding the use of DPSCs for regeneration ofDPC. Scaffold-based combined with DPSCs isolated from healthy pulps was thestrategy used for DPC regeneration. Studies involved subcutaneous implantationof scaffolds loaded with DPSCs pretreated with odontogenic media, or performedon human tooth root model as a root slice. Most of the studies were related toperiodontal tissue regeneration which mainly utilized DPSCs/secretome. Forperiodontal tissues, DPSCs or their secretome were isolated from healthy orinflamed pulps and they were used either for preclinical or clinical studies.Regarding salivary gland regeneration, the submandibular gland was the onlymodel used for the preclinical studies and DPSCs or their secretome were isolatedonly from healthy pulps and they were used in preclinical studies. Likewise,DPSCs have been studied for craniomaxillofacial bone defects in the form ofmandibular, calvarial and craniofacial bone defects where DPSCs were isolatedonly from healthy pulps for preclinical and clinical studies. From the previousresults, we can conclude that DPSCs is promising candidate for dental and oraltissue regeneration.

Intraoperative bioprinting of human adipose-derived stem cells and extra-cellular matrix induces hair follicle-like downgrowths and adipose tissue formation during full-thickness craniomaxillofacial skin reconstruction

Craniomaxillofacial(CMF)reconstruction is a challenging clinical dilemma.It often necessitates skin replacement in the form of autologous graft or flap surgery,which differ from one another based on hypodermal/dermal content.Unfortunately,both approaches are plagued by scarring,poor cosmesis,inadequate restoration of native anatomy and hair,alopecia,donor site morbidity,and potential for failure.Therefore,new reconstructive approaches are warranted,and tissue engineered skin represents an exciting alternative.In this study,we demonstrated the reconstruction of CMF full-thickness skin defects using intraoperative bioprinting(IOB),which enabled the repair of defects via direct bioprinting of multiple layers of skin on immunodeficient rats in a surgical setting.Using a newly formulated patient-sourced allogenic bioink consisting of both human adipose-derived extracellular matrix(adECM)and stem cells(ADSCs),skin loss was reconstructed by precise deposition of the hypodermal and dermal components under three different sets of animal studies.adECM,even at a very low concentration such as 2%or less,has shown to be bioprintable via droplet-based bioprinting and exhibited de novo adipogenic capabilities both in vitro and in vivo.Our findings demonstrate that the combinatorial delivery of adECM and ADSCs facilitated the reconstruction of three full-thickness skin defects,accomplishing near-complete wound closure within two weeks.More importantly,both hypodermal adipogenesis and downgrowth of hair follicle-like structures were achieved in this two-week time frame.Our approach illustrates the translational potential of using human-derived materials and IOB technologies for full-thickness skin loss.

Mesenchymal Stem Cells and Tooth Engineering

Tooth loss compromises human oral health. Although several prosthetic methods, such as artificial denture and dental implants, are clinical therapies to tooth loss problems, they are thought to have safety and usage time issues. Recently, tooth tissue engineering has attracted more and more attention. Stem cell based tissue engineering is thought to be a promising way to replace the missing tooth. Mesenchymal stem cells （MSCs） are multipotent stem cells which can differentiate into a variety of cell types. The potential MSCs for tooth regeneration mainly include stem cells from human exfoliated deciduous teeth （SHEDs）, adult dental pulp stem cells （DPSCs）, stem cells from the apical part of the papilla （SCAPs）, stem cells from the dental follicle （DFSCs）, periodontal ligament stem cells （PDLSCs） and bone marrow derived mesenchymal stem cells （BMSCs）. This review outlines the recent progress in the mesenchymal stem cells used in tooth regeneration.

Polymeric vs hydroxyapatite-based scaffolds on dental pulp stem cell proliferation and differentiation

AIM: To evaluate adhesion, proliferation and differentiation of human dental pulp stem cells(h DPSCs) on four commercially available scaffold biomaterials. METHODS: hD PSCs were isolated from human dental pulp tissues of extracted wisdom teeth and established in stem cell growth medium. h DPSCs at passage 3-5 were seeded on four commercially available scaffold biomaterials, SureO ss(Allograft), Cerabone(Xenograft), PLLA(Synthetic), and OSTEON Ⅱ Collagen(Composite), for 7 and 14 d in osteogenic medium. Cell adhesion and morphology to the scaffolds were evaluated by scanning electron microscopy(SEM). Cell proliferation and differentiation into osteogenic lineage were evaluated using DNA counting and alkaline phosphatase(ALP) activity assay, respectively. RESULTS: All scaffold biomaterials except Sure Oss(Allograft) supported h DPSC adhesion, proliferation and differentiation. hD PSCs seeded on PLLA(Synthetic) scaffold showed the highest cell proliferation and attachment as indicated with both SEM and DNA counting assay. Evaluating the osteogenic differentiation capability of hD PSCs on different scaffold biomaterials with ALP activity assay showed high level of ALP activity on cells cultured on PLLA(Synthetic) and OSTEON ⅡCollagen(Composite) scaffolds. SEM micrographs also showed that in the presence of Cerabone(Xenograft) and OSTEON Ⅱ Collagen(Composite) scaffolds, the h DPSCs demonstrated the fibroblastic phenotype with several cytoplasmic extension, while the cells on PLLA scaffold showed the osteoblastic-like morphology, round-like shape. CONCLUSION: PLLA scaffold supports adhesion, proliferation and osteogenic differentiation of hD PSCs. Hence, it may be useful in combination with hD PSCs for cell-based reconstructive therapy.

Applications of stem cells and bioprinting for potential treatment of diabetes

Currently, there does not exist a strategy that can reduce diabetes and scientists are working towards a cure and innovative approaches by employing stem cellbased therapies. On the other hand, bioprinting technology is a novel therapeutic approach that aims to replace the diseased or lost β-cells, insulin-secreting cells in the pancreas, which can potentially regenerate damaged organs such as the pancreas. Stem cells have the ability to differentiate into various cell lines including insulinproducing cells. However, there are still barriers that hamper the successful differentiation of stem cells into β-cells. In this review, we focus on the potential applications of stem cell research and bioprinting that may be targeted towards replacing the β-cells in the pancreas and may offer approaches towards treatment of diabetes. This review emphasizes on the applicability of employing both stem cells and other cells in 3 D bioprinting to generate substitutes for diseased β-cells and recover lost pancreatic functions. The article then proceeds to discuss the overall research done in the field of stem cell-based bioprinting and provides future directions for improving the same for potential applications in diabetic research.

New insight into dental epithelial stem cells:Identification,regulation,and function in tooth homeostasis and repair

Tooth enamel,a highly mineralized tissue covering the outermost area of teeth,is always damaged by dental caries or trauma.Tooth enamel rarely repairs or renews itself,due to the loss of ameloblasts and dental epithelial stem cells(DESCs)once the tooth erupts.Unlike human teeth,mouse incisors grow continuously due to the presence of DESCs that generate enamel-producing ameloblasts and other supporting dental epithelial lineages.The ready accessibility of mouse DESCs and wide availability of related transgenic mouse lines make mouse incisors an excellent model to examine the identity and heterogeneity of dental epithelial stem/progenitor cells;explore the regulatory mechanisms underlying enamel formation;and help answer the open question regarding the therapeutic development of enamel engineering.In the present review,we update the current understanding about the identification of DESCs in mouse incisors and summarize the regulatory mechanisms of enamel formation driven by DESCs.The roles of DESCs during homeostasis and repair are also discussed,which should improve our knowledge regarding enamel tissue engineering.

Dental stem cell-conditioned medium for tissue regeneration: Optimization of production and storage

BACKGROUND Mesenchymal stem cells(MSC)effects on tissue regeneration are mainly mediated by their secreted substances(secretome),inducing their paracrine activity.This Conditioned medium(CM),including soluble factors(proteins,nucleic acids,lipids)and extracellular vesicles is emerging as a potential alternative to cell therapy.However,the manufacturing of CM suffers from variable procedures and protocols leading to varying results between studies.Besides,there is no welldefined optimized procedure targeting specific applications in regenerative medicine.AIM To focus on conditioned medium produced from dental MSC(DMSC-CM),we reviewed the current parameters and manufacturing protocols,in order to propose a standardization and optimization of these manufacturing procedures.METHODS We have selected all publications investigating the effects of dental MSC secretome in in vitro and in vivo models of tissue regeneration,in accordance with the PRISMA guidelines.RESULTS A total of 351 results were identified.And based on the inclusion criteria described above,118 unique articles were included in the systematic review.DMSC-CM production was considered at three stages:before CM recovery(cell sources for CM),during CM production(culture conditions)and after production(CM treatment).CONCLUSION No clear consensus could be recovered as evidence-based methods,but we were able to describe the most commonly used protocols:donors under 30 years of age,dental pulp stem cells and exfoliated deciduous tooth stem cells with cell passage between 1 and 5,at a confluence of 70%to 80%.CM were often collected during 48 h,and stored at-80°C.It is important to point out that the preconditioning environment had a significant impact on DMSCCM content and efficiency.

Multidifferentiation potential of dental-derived stem cells

Tooth-related diseases and tooth loss are widespread and are a major public health issue.The loss of teeth can affect chewing,speech,appearance and even psychology.Therefore,the science of tooth regeneration has emerged,and attention has focused on tooth regeneration based on the principles of tooth development and stem cells combined with tissue engineering technology.As undifferentiated stem cells in normal tooth tissues,dental mesenchymal stem cells(DMSCs),which are a desirable source of autologous stem cells,play a significant role in tooth regeneration.Researchers hope to reconstruct the complete tooth tissues with normal functions and vascularization by utilizing the odontogenic differentiation potential of DMSCs.Moreover,DMSCs also have the ability to differentiate towards cells of other tissue types due to their multipotency.This review focuses on the multipotential capacity of DMSCs to differentiate into various tissues,such as bone,cartilage,tendon,vessels,neural tissues,muscle-like tissues,hepatic-like tissues,eye tissues and glands and the influence of various regulatory factors,such as non-coding RNAs,signaling pathways,inflammation,aging and exosomes,on the odontogenic/osteogenic differentiation of DMSCs in tooth regeneration.The application of DMSCs in regenerative medicine and tissue engineering will be improved if the differentiation characteristics of DMSCs can be fully utilized,and the factors that regulate their differentiation can be well controlled.

甲基丙烯酸酐改性明胶/经处理牙本质基质生物活性支架的制备及性能

背景:牙髓-牙本质再生一直是近几年研究的热点及难点,构建复合生物支架材料为牙髓-牙本质再生提供了新的思路与方法。目的:观察甲基丙烯酸酐改性明胶/经处理牙本质基质支架对人牙髓干细胞增殖、迁移与成骨分化的影响。方法:将不同质量的经处理牙本质基质分散至甲基丙烯酸酐改性明胶溶液中,使甲基丙烯酸酐改性明胶与经处理牙本质基质的质量比分别为2∶1、1∶1、1∶2,采用冷冻干燥法制备甲基丙烯酸酐改性明胶/经处理牙本质基质支架,检测支架的微观形貌、吸水率及机械性能。采用不同质量比的支架浸提液、DMEM培养基(对照组)分别培养人牙髓干细胞,检测细胞增殖与迁移情况。采用不同质量比的支架浸提液+成骨诱导液、DMEM培养基+成骨诱导液(对照组)分别培养人牙髓干细胞,碱性磷酸酶染色分析成骨能力。结果与结论:①扫描电镜下可见3组支架均具有多孔结构,随着支架中经处理牙本质基质质量的增加,支架的孔隙率升高,组间两两比较差异有显著性意义(P<0.05);随着支架中经处理牙本质基质质量的增加,支架的吸水率升高,组间两两比较差异有显著性意义(P<0.05);随着支架中经处理牙本质基质质量的增加,支架的抗压强度、剪切强度增大。②CCK-8检测显示培养3,5,7 d,2∶1、1∶1、1∶2支架组细胞增殖吸光度值均高于对照组(P<0.05),并且随着支架中经处理牙本质基质质量的增加,细胞增殖吸光度值升高(P<0.05);细胞划痕实验显示2∶1、1∶1、1∶2支架组细胞迁移率均大于对照组(P<0.05),并且随着支架中经处理牙本质基质质量的增加,细胞迁移率增大(P<0.05)。③碱性磷酸酶染色显示,2∶1、1∶1、1∶2支架组细胞成骨分化能力均强于对照组,并且随着支架中经处理牙本质基质质量的增加,细胞成骨能力增强。④结果表明,甲基丙烯酸酐改性明胶与经处理牙本质基质质量比为1∶2的支架最适合牙髓干细胞的增殖与分化。

负载骨形态发生蛋白2水凝胶诱导牙髓干细胞的成骨分化

背景:前期研究证明,甲基丙烯酸酐改性明胶/经处理牙本质基质复合水凝胶支架可促进人牙髓干细胞的增殖及分化。水凝胶负载骨形态发生蛋白2被认为是骨修复中有前景的材料。目的:观察负载不同质量浓度骨形态发生蛋白2的甲基丙烯酸酐改性明胶/经处理牙本质基质复合水凝胶对人牙髓干细胞成骨向分化的诱导作用。方法:制备含0,50,100,200μg/mL骨形态发生蛋白2的甲基丙烯酸酐改性明胶/经处理牙本质基质复合水凝胶,分别记为GelMA/TDM、BMP-2(50 ng/mL)GelMA/TDM、BMP-2(100 ng/mL)GelMA/TDM、BMP-2(200 ng/mL)GelMA/TDM,检测复合水凝胶对骨形态发生蛋白2的体外缓释性能。采用改良组织块酶消化法提取人牙髓干细胞,分别接种于4种水凝胶表面,采用CCK-8法检测细胞增殖,DAPI染色检测细胞黏附;对各组水凝胶表面的人牙髓干细胞进行成骨诱导,进行碱性磷酸酶染色、碱性磷酸酶活性检测与茜素红染色,采用RT-PCR法检测相关成骨基因(Runx2、骨形态发生蛋白2、骨桥蛋白、骨钙素、Ⅰ型胶原)表达。结果与结论:①甲基丙烯酸酐改性明胶/经处理牙本质基质复合水凝胶可持续释放骨形态发生蛋白2长达21 d,在第3-6天释放较快,第6天之后释放趋于平稳;②4种水凝胶均可促进人牙髓干细胞的增殖,其中以BMP-2(100 ng/mL)-GelMA/TDM复合水凝胶的作用最明显;相较于GelMA/TDM复合水凝胶,BMP-2-GelMA/TDM复合水凝胶可促进人牙髓干细胞的黏附,其中以BMP-2(200 ng/mL)-GelMA/TDM复合水凝胶的作用最明显;③相较于GelMA/TDM复合水凝胶,BMP-2-GelMA/TDM复合水凝胶可提升碱性磷酸酶活性、钙结节含量与相关成骨基因表达,综合分析显示BMP-2(100 ng/mL)-GelMA/TDM复合水凝胶的作用更明显;④结果表明,BMP-2(100 ng/mL)-GelMA/TDM复合水凝胶促进牙髓干细胞成骨向分化的能力更明显。

影响牙髓干细胞成骨及成牙本质分化的相关物理因素及作用机制

背景:牙髓干细胞是口腔颌面部组织工程中极具应用潜力的干细胞之一,较骨髓间充质干细胞具有采集方便、伦理问题少以及增殖分化潜能高等优势。目前,除了生物化学等因素外,物理刺激对于牙髓干细胞的成骨/成牙本质分化也起着关键性的作用。目的:综述影响牙髓干细胞成骨/成牙本质分化的相关物理因素以及可能涉及的信号传导通路作用机制,寻找影响其分化的最佳诱导条件。方法:检索PubMed和中国知网数据库,以“牙髓干细胞,成骨分化,成牙本质分化,低氧,机械力,激光,磁场,微重力”为中文检索词,以“dental pulp stem cells(DPSCs),osteogenesis differentiation,odontoblastic differentiation,hypoxia,mechanical force,laser therapy,magnetic fields,microgravity”为英文检索词,选取与影响牙髓干细胞成骨/成牙本质分化相关物理因素有关的79篇文献进行综述。结果与结论:(1)微环境中直接或间接的物理信号在调控牙髓干细胞定向分化方面展现出了广阔的应用前景。低氧、力学刺激(动静水压力、机械牵张力及剪切力等)、激光、微重力和磁场等相关物理因素对牙髓干细胞的影响以促进成骨/成牙本质分化为主,因口颌系统拥有复杂的力学环境,力学刺激是细胞环境改变的关键物理因素,同时也是组织工程的一个前沿领域,深入探讨牙髓干细胞对力学环境的响应为口腔疾病的诊断及治疗提供新思路。(2)因该领域比较“年轻”,相关因素涉及的设备参数尚未统一,相关结果存在不一致性,未能达成共识,之后应进一步探索及优化相关物理因素的最佳诱导参数及作用条件。(3)支架材料作为组织工程的三要素之一,在牙髓干细胞成骨/成牙本质分化方面也起到了促进作用,同时也推动了材料学的发展及临床技术的进步。(4)其中涉及到的信号通路有Notch,Wnt,MAPK等,关于物理刺激如何调控牙髓干细胞行为的相关生物学基础尚未明确,未来将进一步探究其具体作用机制,为物理因素影响下的牙髓再生及骨组织工程提供新思路。