Mesenchymal stem cells (MSCs), characterized by their undifferentiated and multipotent nature, can be derived from various sources, including bone marrow, adipose, and dental tissues. Among these, dental MSCs (DSCs) exhibit universal MSC characteristics and are attracting considerable attention for regenerating oral and craniofacial tissues. This review provides a contemporary overview of recently published clinical studies using DSCs for various orodental and maxillofacial regenerative applications, including bone, periodontal, and endodontic regeneration. It also explores the utilization of DSCs in treating systemic conditions, exemplified by their application in managing conditions such as COVID-19 and osteoarthritis. The available evidence underscores the potential of DSCs and their secretome as efficacious tools in regenerative medicine for both dental and nondental clinical applications, supporting the continued promise of stem cell–based therapies. It is nevertheless evident that there are a number of important challenges that restrict the widespread utilization of DSCs, namely, difficulty in standardizing autologous preparations, insufficient cell surface marker characterization, high production costs, and regulatory compliance requirements. Further, the unique requirements of dental applications, especially complex structures such as the periodontium, where temporospatial control over the healing process is required, necessitate the combination of stem cells with appropriate scaffolds according to the principles of tissue engineering. There is currently insufficient evidence to support the clinical translation of DSCs into clinical practice, and phase 3 clinical trials with standardized protocols for cell sourcing, propagation, dosing, and delivery are required to move the field forward. In summary, this review provides a contemporary overview of the evolving landscape of stem cell therapy, offering insights into the latest developments and trends as well as the challenges that need to be addressed for the widespread application of DSC-based cell therapies.

中文翻译：

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牙科间充质干细胞在人体临床试验中的治疗用途


间充质干细胞 （MSC） 以其未分化和多能性质为特征，可来自各种来源，包括骨髓、脂肪和牙齿组织。其中，牙科 MSC （DSC） 表现出普遍的 MSC 特性，在口腔和颅面组织的再生方面引起了相当大的关注。本综述对最近发表的使用 DSCs 用于各种口腔颌面再生应用的临床研究进行了当代概述，包括骨骼、牙周和牙髓再生。它还探讨了 DSC 在治疗全身性疾病中的应用，例如它们在管理 COVID-19 和骨关节炎等疾病中的应用。现有证据强调了 DSC 及其分泌组作为牙科和非牙科临床应用的再生医学有效工具的潜力，支持基于干细胞的疗法的持续前景。然而，很明显，存在许多限制 DSC 广泛使用的重要挑战，即自体制备标准化困难、细胞表面标志物表征不足、生产成本高以及法规遵从性要求。此外，牙科应用的独特要求，尤其是牙周组织等复杂结构，需要对愈合过程进行时间空间控制，因此需要根据组织工程原理将干细胞与适当的支架相结合。 目前没有足够的证据支持将 DSC 临床转化为临床实践，需要具有细胞来源、增殖、给药和递送标准化方案的 3 期临床试验来推动该领域的发展。总之，本综述对干细胞疗法不断发展的前景进行了当代概述，提供了对最新发展和趋势的见解，以及基于 DSC 的细胞疗法的广泛应用需要解决的挑战。