Scaffolds bioativos: avaliação do efeito antimicrobiano e ou/ anti-inflamatório sobre hDPSCs

Abstract

The objective of this scoping review was to gather and map the available evidence on the use of antimicrobial and/or anti-inflammatory scaffolds on pulp stem cells for pulp regeneration purposes. Two independent reviewers performed a comprehensive search of four electronic databases as of April 10, 2021: MEDLINE, Embase, Scopus, and Web of Science. The selection criteria were: 1) studies that evaluated the biological properties (eg antimicrobial, antibacterial and anti-inflammatory) of scaffolds/hydrogels loaded or not with drugs/bioactive molecules; 2) studies that verified the effects of scaffolds on human dental pulp stem cells; and 3) studies that tested scaffolds targeting regenerative endodontics. Initially, 1,804 potentially relevant articles were identified and, after excluding 364 duplicates, 1,399 were considered ineligible based on the inclusion criteria. After screening, 41 articles remained and were pre-selected for full-text analysis by the reviewers. Finally, only 13 articles were selected for this review. Overall, the studies consisted primarily of drug-laden hybrid scaffolding. Six studies tested the effects of drugs such as metronidazole and ciprofloxacin, and only one study verified the anti-inflammatory property of the scaffold. Most studies have verified the antimicrobial properties against the bacterium Enterococus faecalis. In general, the studies verified the cytotoxicity of scaffolds in human pulp stem cells, with positive results for cell viability. Scaffolds that did not use drugs in their composition may also have antimicrobial properties, creating a favorable environment for stem cells. The scaffolds with drugs resulted in antimicrobial properties derived from their composition. In conclusion, the use of drugs and molecules with antimicrobial properties can reduce bacterial growth according to the effect of the dosage. However, to preserve cell viability results, minimal doses of these drugs are indicated. Natural structures such as fibrin and collagen without the use of drugs can result in antimicrobial effects, so these compounds are important candidates for reducing pulp inflammation events in the future.