处理后牙本质基质在活髓保存领域中的研究进展  

Research progress of treated dentin matrix in vital pulp therapy

作　　者：戴雨果 郭维华[1,2,3] DAI Yuguo;GUO Weihua(Department of Pediatric Dentistry,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;Frontier Innovation Center for Dental Medicine Plus,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;Yunnan Key Laboratory of Stomatology,The Affiliated Hospital of Stomatology,School of Stomatology,Kunming Medical University,Kunming 650500,China)

机构地区：[1]四川大学华西口腔医院儿童口腔科,四川成都610041 [2]四川大学华西口腔医院口腔医学+前沿创新中心,四川成都610041 [3]昆明医科大学附属口腔医院,云南省口腔医学重点实验室,云南昆明650500

出　　处：《口腔疾病防治》2025年第4期320-327,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金资助项目(82270958);四川省创新人才项目(2022JDRC0043);云南省重大科技项目(202302AA310038)。

摘　　要：近年来,处理后牙本质基质(treated dentin matrix,TDM)在活髓保存治疗(vital pulp therapy,VPT)领域的研究和开发应用不断增多。TDM含有转化生长因子-β(transforming growth factor-β,TGF-β)、骨形态发生蛋白2(bone morphogenetic protein 2,BMP2)等成牙/成骨相关蛋白和因子;对牙源性干细胞具有良好的成牙本质向分化促进作用和良好的生物相容性;在VPT领域的设计开发中,相关材料从粉末、糊剂到可注射复合凝胶、凝胶支架等,其成牙本质能力得到越来越多的关注和认可。TDM在动物实验、临床试验中较传统盖髓材料可形成排列良好的成牙本质细胞层、均匀的牙本质小管结构,是其作为VPT材料最大的优势所在。未来TDM在VPT领域应用的挑战主要集中在力学性能的提升与异种材料应用时潜在的免疫排斥问题,应进一步明确TDM的成牙本质通路机制、探索其免疫调控能力;同时,利用TDM构建用于VPT的组织工程支架是具有广阔前景的策略。本文对TDM及相关材料在VPT领域中的研究进展作一综述。There has been an increase in research interest and application of treated dentin matrix(TDM)in vital pulp therapy(VPT)in recent years.TDM has excellent biocompatibility and contains transforming growth factor⁃β,bone morphogenetic protein 2,and other odontogenesis/osteogenesis⁃related proteins and factors that promote odontogenic dif⁃ferentiation of dental stem cells.TDM⁃based products,ranging from powders and pastes to injectable composite gels and gel scaffolds,have gained increasing consensus for their ability to induce dentin⁃like tissue regeneration.Animal and clinical studies found that TDM has significant advantages over traditional pulp capping materials,as it can form well⁃organized layers of odontoblast⁃like cells and uniform dentinal tubule structures.Future challenges of TDM in VPT ap⁃plication are primarily focused on improving mechanical properties and addressing potential immune rejection issues with heterologous material use.Additionally,further studies should be conducted on the odontogenetic pathway mecha⁃nism of TDM and the immune regulatory capabilities of xenogeneic dentin matrix materials.Utilizing TDM to construct tissue engineering scaffolds for VPT presents a promising strategy.This article reviews the structure and biological properties of TDM and related materials,thoroughly examines their progresses in the field of VPT,and discusses their cur-rent challenges as well as future research directions.

关 键 词：活髓保存治疗 生物材料 处理后牙本质基质 脱矿牙本质基质 转化生长因子-β 骨形态发生蛋白2 牙本质再生 牙髓-牙本质复合体 直接盖髓 牙源性干细胞 

分 类 号：R78[医药卫生—口腔医学]