Tooth Repair and Regeneration

Abstract

Purpose of ReviewCurrent dental treatments are based on conservative approaches, using inorganic materials and appliances.This report explores and discusses the newest achievements in the field of “regenerative dentistry,” based on the concept of biological repair as an alternative to the current conservative approach.Recent FindingsThe review covers and critically analyzes three main approaches of tooth repair: the re-mineralization of the enamel, the biological repair of dentin, and whole tooth engineering.SummaryThe development of a concept of biological repair based on the role of the Wnt signaling pathway in reparative dentin formation offers a new translational approach into development of future clinical dental treatments.In the field of bio-tooth engineering, the current focus of the researchers remains the establishment of odontogenic cell-sources that would be viable and easily accessible for future bio-tooth engineering.

Redox Control of IL-6-Mediated Dental Pulp Stem-Cell Differentiation on Alginate/Hydroxyapatite Biocomposites for Bone Ingrowth

“…Conservative therapies based on filling materials, fixed dental bridges, or removable dentures and dental implants are used to replace tooth structure or missing teeth [20]. Biomechanical overload, osseointegration failure, infections, and inflammation are common complications of surgical procedures [21], as well as failed cell adhesion on the material surface due to bacterial interference or ineffective coating [22].…”

Scaffold-based developmental tissue engineering strategies for ectodermal organ regeneration

“…Classical TE approaches for teeth mainly aim to repair/regenerate single tooth components, such as enamel, dentin-pulp complex and different tissues of the periodontium [ [71] , [72] , [73] , [74] , [75] ]. Enamel repair has been principally investigated by targeting the remineralization of the defective enamel, particularly challenging given the acellular structure, inorganic composition, and high mechanical properties.…”

“…In the first case, cells (e.g. dental pulp stem cells, stem cells from apical papilla, stem cells from exfoliated deciduous teeth, stem cells of non-dental origin, and iPSCs [ [73] , [74] , [75] , 83 , 84 ]), morphogenetic factors ​and scaffolds [ [85] , [86] , [87] , [88] , [89] ] are combined in vitro and then implanted in vivo at targeted site. In the latter case, biodegradable, porous, acellular scaffolds [ 82 ], possibly coupled with signalling molecules such as cytokines, are implanted in vivo to promote cell colonization and recruitment from surrounding tissues (‘cell homing’ strategy), as well as proper vascularization and innervation [ [90] , [91] , [92] , [93] ].…”

Tooth Formation: Are the Hardest Tissues of Human Body Hard to Regenerate?

“…In the following years, efforts in creating a whole tooth from only cells and tissues ("bio-tooth") will be very likely in the focus. However, despite all efforts and achieved results in basic and translational research, this approach is still challenging [48,58,69,193,194].…”

“…This phenomenon can be explained by the fact that mesenchymal stem cells lose their dense packaging formed by cellular condensation and thus their linked cell contacts, which is a prerequisite for an inductive capacity in vivo. Ongoing research focuses therefore also on how an odontogenic potential can be maintained in vitro [194]. 3D micro-culture systems such as the hanging drop method in liquid media may allow the preservation of such signals.…”