Abstract
Introduction: Tooth loss is a significant health issue. Currently, this situation is often treated
with the use of synthetic materials such as implants and prostheses. However, these treatment modalities
do not fully meet patients' biological and mechanical needs and have limited longevity. Regenerative
medicine focuses on the restoration of patients' natural tissues via tissue engineering techniques instead of
rehabilitating with artificial appliances. Therefore, a tissue-engineered tooth regeneration strategy seems
like a promising option to treat tooth loss.
Objective: This review aims to demonstrate recent advances in tooth regeneration strategies and discoveries
about underlying mechanisms and pathways of tooth formation.
Results and Discussion: Whole tooth regeneration, tooth root formation, and dentin-pulp organoid generation
have been achieved by using different seed cells and various materials for scaffold production. Bioactive
agents are critical elements for the induction of cells into odontoblast or ameloblast lineage. Some
substantial pathways enrolled in tooth development have been figured out, helping researchers design
their experiments more effectively and aligned with the natural process of tooth formation.
Conclusion: According to current knowledge, tooth regeneration is possible in case of proper selection of
stem cells, appropriate design and manufacturing of a biocompatible scaffold, and meticulous application
of bioactive agents for odontogenic induction. Understanding innate odontogenesis pathways play a crucial
role in accurately planning regenerative therapeutic interventions in order to reproduce teeth.
Keywords:
Tooth regeneration, stem cell, scaffold, tissue engineering, regenerative therapy, odontogenesis.
Graphical Abstract
[9]
Hu B, Liu Y, Wang S. Tooth tissue engineering: From cells to organ, an odyssey far from finished. Shanghai Journal of Stomatology 2005; 14(2): 99-102.
[63]
Huang X, Xu X, Bringas PJ, Hung YP, Chai Y. Smad4-Shh-Nfic signaling cascade-mediated epithelial-mesenchymal interaction is crucial in regulating tooth root development. J bone Miner Res Off J Am Soc Bone Miner Res 2010; 25(5): 1167-78.
[73]
Saraswathi P, Saravanakumar S. A simple method of tooth regeneration by bone marrow mesenchymal stem cells in albino rats. Eur J Anat 2010; 14(3): 121-6. [Available from] https://www.scopus.com/inward/record.uri?eid=2-s2.0-84856066166partnerID=40md5=365b2987d7eee294719e6ec1cc839e9e]
[108]
Albrektsson T, Johansson C. Osteoinduction, osteoconduction and osseointegration Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 2001; 10(2): 96-101.
[113]
Li X, Yuan Y, Liu L, Leung Y-S, Chen Y, Guo Y. 3D printing of hydroxyapatite/tricalcium phosphate scaffold with hierarchical porous structure for bone regeneration. Biodes Manuf 2020; 3(1): 15-29. [Available from]. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85077594727&doi=10.1007%2Fs42242-019-00056-5&partnerID=40&md5=732dba386f1aea504b593cfd639af790]
[127]
Yang F, Cui W, Xiong Z, Liu L, Bei J, Wang S. Poly(l,l-lactide-co-glycolide)/tricalcium phosphate composite scaffold and its various changes during degradation in vitro. Polym Degrad Stabil 2006; 91(12): 3065-73. [Available from]. https://www.sciencedirect.com/science/article/pii/S0141391006002503
[190]
Cremers S, Garnero P, Seibel MJ. Biochemical Markers of Bone Metabolism. Martin TJBT-P of BB San Diego: Academic Press. 2008; pp. 1857-81. Available from:
[https://www.sciencedirect.com/science/article/pii/B9780123738844000203