Study On Animal Experiment And Clinical Application Of Xenogenic/Autologous Pulp Regeneration And Transplantation

Objective(s):(1)To establish an animal experimental model of ectopic dental pulp regeneration in SD rats and explore the biological mechanism of dental pulp transplantation and regeneration.(2)Clinical evaluation of chronic apical periodontitis(CAP)treated by autogenous dental pulp transplantation.(3)Evaluation on the effect of concentrated growth factors(CGF)on animal experiments and clinical randomized controlled studies of dental pulp transplantation.Methods:Animal experiment: The pulp of the fresh third molar was extracted and placed into a pre-collected and prepared anterior molar canal,which was implanted into the subcranial space of SD rats to establish an animal model of ectopic pulp regeneration.The experiment was divided into 3 groups: blank control group,pulp group,and pulp + CGF group,and histological observation of pulp regeneration was performed after surgery.Clinical trial: 20 patients diagnosed with single root canal CAP in anterior teeth and also meeting the presence of third molar were clinically recruited,and after informed consent,the autologous pulp transplantation protocol was selected and divided into experimental and control groups according to whether CGF was added or not,with postoperative follow-up for clinical and imaging evaluation.Results:(1)All SD rats survived well after animal experiments,and no immune rejection or graft shedding was observed.(2)Hematoxylin-Eosin staining(HE)showed large number of neovasculi formation in most samples in the experimental group,and no obvious neovasculi formation in the control group.Immunohistochemistry showed that CD31 in human and mouse blood vessels were positively expressed in most samples of the experimental group,while CD31 in the control group was negatively expressed.(3)Two of the 20 patients were lost to follow-up after surgery,and the remaining patients had good compliance.During the follow-up at 3 and 6 months after surgery,some patients in the control group and the experimental group showed positive Electric pulp test(EPT)after surgery.Conclusion(s):(1)The results of animal experiments showed that the isolated dental pulp could survive xenograft and establish blood supply with the graft host,and the addition of CGF was conducive to the formation of regenerated dental pulp tissue.(2)The clinical results also proved that the CGF enriched autogenous pulp transplantation program can achieve the preservation of the living pulp of the affected tooth,reduce the frequency of postoperative visit and reduce postoperative complications.(3)The effect of autogenous pulp transplantation in the treatment of CAP single root canal anterior teeth is ideal,worthy of further promotion and application in clinic.