From Stem to Roots: Tissue engineering in Endodontics

Abstract

The vitality of dentin-pulp complex is fundamental to the life of tooth and is a priority for targeting clinical management strategies. Loss of the tooth, jawbone or both, due to periodontal disease, dental caries, trauma or some genetic disorders, affects not only basic mouth functions but aesthetic appearance and quality of life. One novel approach to restore tooth structure is based on biology: regenerative endodontic procedure by application of tissue engineering. Regenerative endodontics is an exciting new concept that seeks to apply the advances in tissue engineering to the regeneration of the pulp-dentin complex. The basic logic behind this approach is that patient-specific tissue-derived cell populations can be used to functionally replace integral tooth tissues. The development of such ‘test tube teeth’ requires precise regulation of the regenerative events in order to achieve proper tooth size and shape, as well as the development of new technologies to facilitate these processes. This article provides an extensive review of literature on the concept of tissue engineering and its application in endodontics, providing an insight into the new developmental approaches on the horizon. Key words:Regenerative, tissue engineering, stem cells, scaffold.

Dental Stem Cells Characterization and Bone Regenerative Potential in Oral Medicine

“…Sometimes DPSCs are referred to as odontoblastoid cells, because they appear to synthesize and secrete dentin matrix like the odontoblast that they replace [14]. When transplanted in vivo (using immunocompromised mice as hosts), the cells derived from dental pulp generated functional dental tissue in the form of complexes like dentine/pulp.…”

“…It is thought that SCAPs may be responsible for the formation of primary odontoblasts that account for the formation of root dentin, whereas DPSCs seem to be the source of replacement odontoblasts that produce reparative dentine [9,12,13]. To conclude, SCAPs are derived from a developing tissue that may represent a population of early stem/progenitor cells, which may be a superior cell source for tissue regeneration [13], since they also showed other favourable characteristics, such as higher proliferative rate, telomerase activity and improved migration capacity [14][15][16].…”

“…These cells were first isolated from the follicle of human impacted third molars [14]. In vitro, following adequate induction, DFPCs have been demonstrating osteogenic, odontogenic and cementogenic differentiation capacity [9].…”

“…SHED cells represent a population of multipotent stem cells that are more immature than the DPSCs and, in vivo, they seem to be able to induce bone or dentin formation [13,14].…”

Role of Dental Stem Cells in Regenerative Medicine

“…DPSC'S were the first type of dental stem cells to be isolated from the human permanent third molars by Gronthos et al in 2000 6 . They exhibited high proliferation rate and high frequency of colony formation that produced calcific nodules.…”