Background: Symptomatic cartilage lesions and early osteoarthritis produce significant clinical and economic burdens. Cartilage repair can improve the symptoms and delay arthroplasty. The complete healing of damaged cartilage with the consistent reproduction of normal hyaline cartilage has not yet been achieved. The choice of harvesting site might influence the cells' abilities to modulate immunologic and inflammatory responses. Recently, dental pulp has been shown to contain a stem cell niche consisting of dental pulp stem cells (DPSCs) that maintain their self-renewal capacity due to the active environment in the dental pulp of deciduous teeth. Objective: The aim of this study was to critically review the current literature on the potential and limitations of the use of dental pulp-derived mesenchymal stem cells in cell-based therapies for cartilage regeneration. Methods: An electronic, customized search of scientific articles was conducted using the PubMed/MEDLINE and EMBASE databases from their inception to December 2018. The inclusion criteria were applied, and the articles that described the use of DPSC in cartilage treatment were selected for complete evaluation. The articles were classified according to the scaffold used, experimental model, chondrogenic differentiation features, defect location, cartilage evaluation, and results. After the application of the eligibility criteria, a total of nine studies were selected and fully analyzed. Results: A variety of animal models were used, including mice, rats, rabbits, and miniature pigs, to evaluate the quality and safety of human DPSCs in the repair of cartilage defects. Among the articles, two studies focused on preclinical models of cartilage tissue engineering. Five studies implanted DPSCs in other animal sites. Conclusion: The use of DPSCs is a potential new stem cell therapy for articular cartilage repair. The preclinical evidence discussed in this article provides a solid foundation for future clinical trials. Impact statement Osteoarthritis presents an ever-increasing clinical and socioeconomic burden. While cartilage repair has the potential to improve symptoms and delay joint replacement, complete regeneration of hyaline cartilage has been an elusive goal. Dental pulp has been shown to contain a niche that protects dental pulp stem cells (DPSCs) from the cumulative effects of genetic and environmental factors and maintains their self-renewal capacity due to the active environment. Transplantation and preclinical trials have demonstrated the strong potential of regenerative tissue-engineering protocols using DPSCs.

中文翻译：

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人类牙髓干细胞用于软骨再生的系统评价。

背景：有症状的软骨病变和早期骨关节炎会给临床和经济造成沉重负担。软骨修复可以改善症状并延迟关节置换术。尚未实现受损软骨的完全愈合以及正常透明软骨的一致繁殖。收获部位的选择可能会影响细胞调节免疫和炎症反应的能力。近来，已显示出牙髓含有由牙髓干细胞（DPSC）组成的干细胞小生境，由于牙髓中的牙髓的活跃环境，其可维持其自我更新能力。目的：这项研究的目的是批判性地审查有关牙髓来源的间充质干细胞在基于细胞的软骨再生治疗中的潜力和局限性的最新文献。方法：从PubMed / MEDLINE和EMBASE数据库创建到2018年12月，进行电子，个性化的科学文献搜索。采用纳入标准，选择描述DPSC在软骨治疗中用途的文章进行全面评估。 。根据使用的支架，实验模型，软骨分化特征，缺损部位，软骨评估和结果对文章进行分类。应用资格标准后，总共选择了九项研究并进行了全面分析。结果：使用了多种动物模型，包括小鼠，大鼠，兔子和小型猪），以评估人类DPSC在软骨缺损修复中的质量和安全性。在这些文章中，两项研究集中于软骨组织工程的临床前模型。五项研究将DPSC植入其他动物部位。结论：DPSC的使用是关节软骨修复的潜在新干细胞疗法。本文讨论的临床前证据为将来的临床试验奠定了坚实的基础。影响陈述骨关节炎的临床和社会经济负担日益增加。尽管软骨修复具有改善症状和延迟关节置换的潜力，但是透明软骨的完全再生一直是个遥不可及的目标。牙髓已被证明具有生态位，可保护牙髓干细胞（DPSC）免受遗传和环境因素的累积影响，并由于活跃的环境而保持其自我更新的能力。移植和临床前试验证明了使用DPSC进行再生组织工程的强大潜力。