Pulpal and periapical diseases account for a large proportion of dental visits, the current treatments for which are root canal therapy (RCT) and pulp revascularisation. Despite the clinical signs of full recovery and histological reconstruction, true regeneration of pulp tissues is still far from being achieved. The goal of regenerative endodontics is to promote normal pulp function recovery in inflamed or necrotic teeth that would result in true regeneration of the pulpodentinal complex. Recently, rapid progress has been made related to tissue engineering-mediated pulp regeneration, which combines stem cells, biomaterials, and growth factors. Since the successful isolation and characterisation of dental pulp stem cells (DPSCs) and other applicable dental mesenchymal stem cells, basic research and preclinical exploration of stem cell-mediated functional pulp regeneration via cell transplantation and cell homing have received considerably more attention. Some of this effort has translated into clinical therapeutic applications, bringing a ground-breaking revolution and a new perspective to the endodontic field. In this article, we retrospectively examined the current treatment status and clinical goals of pulpal and periapical diseases and scrutinized biological studies of functional pulp regeneration with a focus on DPSCs, biomaterials, and growth factors. Then, we reviewed preclinical experiments based on various animal models and research strategies. Finally, we summarised the current challenges encountered in preclinical or clinical regenerative applications and suggested promising solutions to address these challenges to guide tissue engineering-mediated clinical translation in the future.

Although mesenchymal stem cell-derived exosomes (MSC-exos) have been shown to have therapeutic effects in experimental periodontitis, their drawbacks, such as low yield and limited efficacy, have hampered their clinical application. These drawbacks can be largely reduced by replacing the traditional 2D culture system with a 3D system. However, the potential function of MSC-exos produced by 3D culture (3D-exos) in periodontitis remains elusive. This study showed that compared with MSC-exos generated via 2D culture (2D-exos), 3D-exos showed enhanced anti-inflammatory effects in a ligature-induced model of periodontitis by restoring the reactive T helper 17 (Th17) cell/Treg balance in inflamed periodontal tissues. Mechanistically, 3D-exos exhibited greater enrichment of miR-1246, which can suppress the expression of Nfat5, a key factor that mediates Th17 cell polarization in a sequence-dependent manner. Furthermore, we found that recovery of the Th17 cell/Treg balance in the inflamed periodontium by the local injection of 3D-exos attenuated experimental colitis. Our study not only showed that by restoring the Th17 cell/Treg balance through the miR-1246/Nfat5 axis, the 3D culture system improved the function of MSC-exos in the treatment of periodontitis, but also it provided a basis for treating inflammatory bowel disease (IBD) by restoring immune responses in the inflamed periodontium.

Background: The National Dental Undergraduate Clinical Skills Competition known as the Guanghua Cup was held in Guangzhou, China, for three consecutive years from 2017 to 2019 to promote the clinical teaching of undergraduate dental education and to enhance communication among different universities. The present study aimed to introduce the organization, procedures, and consequences of the competition, in addition to analyzing the influences of competition on the reform of undergraduate dental education. Methods: By analyzing the descriptive statistics of the Guanghua Cup, the competitions’ organization, the participating students’ performances, and the outcomes of competitions were analyzed. After distributing questionnaires to all participants of the 2nd and 3rd Cups, their attitudes towards the competition and their evaluation of the role of the competitions in promoting undergraduate dental education were analyzed. Results: A total of 24 schools participated in the 3 competition years. The contents of the competitions covered cariology, endodontics, periodontology, prosthodontics, oral and maxillofacial surgery, dental anatomy, and first aid (e.g., operative skills and theoretical knowledge). Compared with those of the 2nd Cup, the mean scores of the operative skills significantly improved in the stations related to periodontology, prosthodontics, and dental anatomy (p < 0.05) in the 3rd Cup. In addition, 338 valid questionnaires were collected, for a response rate of 87.79 %. Overall, the participants spoke highly of the Guanghua Cup. Based on their self-perception and self-evaluation, the majority of interviewees agreed that the competition helped develop collegiality and teamwork among the participating students, improved the students’ clinical skills and promoted the improvement of teaching resources (e.g., purchasing and updating equipment, models or experimental materials). Conclusions: The competition enjoyed the widest coverage since it involved dental schools from all of the different geographical regions of China. Dental students could exhibit their clinical skills in a competitive environment and develop collegiality and teamwork. Future competitions should be optimized through their organization and contents. The education quality of the participating schools affected by such competition should be investigated in a more objective and comparable way.

Artificial intelligence (AI) has been developing rapidly recently, with large language models such as Chat Generative Pre-trained Transformer (ChatGPT) gar