Descelularização e recelularização de polpas dentárias para desenvolvimento de scaffolds naturais - revisão sistemática

Abstract

Advances in tissue engineering creates innovative therapeutic possibilities in dentistry, combined with oral rehabilitation of the patient. Within endodontics, this field is quite new and promising, since it can revolutionize current treatments used for dental pulp diseases and provide a possibility of pulp regeneration. Scaffolds are threedimensional structures similar to the original tissue, in texture macro and micro geometry, which favors cell adhesion and its consequent expression. The best scaffold for tissue engineering would be the decellularized extracellular matrix of the target tissue, since decellularization allows researchers to obtain natural, cell-free matrices, characterized by adequate 3D organization and adequate molecular composition. This study proposed a systematic review on the best methods for decellularization and recelularization of dental pulp for making natural scaffolds for use in pulp revitalization. A total of 300 references were retrieved from the electronic databases searched until May 2020, with the first search occurring in July 2019. After removing duplicates, 174 titles / abstracts were evaluated by two independent reviewers, calibrated according to the proposed eligibility criteria. The result of the calibration process demonstrated a substantial level of agreement between the reviewers (κ = 0.75) and a total of 6 articles were included in the qualitative synthesis of results. In vitro and in vivo studies of the recovered studies demonstrated some level of positive results in relation to biological tests, even in light of the different levels of complexity of the tests ocurred in different studies. Promising results have been observed in the development of decellularized biological scaffolds derived from dental pulp with the perseverance of extracellular structural components necessary for tissue regeneration. However, the current data is too heterogeneous to compare and identify the advantages of any specific method used in the retrieved studies.