Buonocore Memorial Lecture

TLDR

Operative dentistry has long employed regenerative strategies such as calcium hydroxide to stimulate reparative dentin, and recent advances in tissue engineering—integrating biology, engineering, and clinical sciences—are expanding the potential to regenerate enamel, dentin, pulp, and even whole teeth. This review aims to synthesize current literature on engineering enamel, dentin, pulp, and whole teeth. The authors conduct a comprehensive literature review of studies on dental tissue engineering, evaluating approaches to scaffold design, cell selection, and morphogenic signaling. The review concludes that evidence supports the future clinical application of engineered dental tissues to replace carious or traumatic losses.

Abstract

Abstract For many years, operative dentistry has been using regenerative approaches to treat dental disease. The use of calcium hydroxide to stimulate reparative or reactionary dentin is clearly an example of such a therapeutic strategy. The advent of tissue engineering is allowing dentistry to move forward in the use of regeneration as an underlying principle for the treatment of dental disease. Tissue engineering is a multi-disciplinary science that brings together biology, engineering and clinical sciences with developing new tissues and organs. It is based on fundamental principles that involve the identification of appropriate cells, the development of conducive scaffolds and an understanding of the morphogenic signals required to induce cells to regenerate the tissues that were lost. This review is focused on the presentation and discussion of existing literature that covers the engineering of enamel, dentin and pulp, as well on the engineering of entire teeth. There are clearly major roadblocks to overcome before such strategies move to the clinic and are used regularly to treat patients. However, existing evidence strongly suggests that the engineering of new dental structures to replace tissues lost during the process of caries or trauma will have a place in the future of operative dentistry.