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Biomimetic Approaches for the Design and Development of Multifunctional Bioresorbable Layered Scaffolds for Dental Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Campodoni Elisabetta, Dozio Samuele Maria, Mulazzi Manuela, Montanari Margherita, Montesi Monica, Panseri Silvia, Sprio Simone, Tampieri Anna, Sandri Monica
The tooth is a small yet complex organ, composed by hard calcified tissues which constitute the dentin, enamel and cementum, and a connective tissue represented by the periodontal ligaments and dental pulp. Its peculiar structure and cell organization define it as one of the resilient tissues in the human body (Chai et al. 2009). Unfortunately, it comes with a drawback: the tooth has no self-regeneration capacity, excluding enamel reconstruction helped by a conscientious diet and oral care, and the slightest fracture or cavity reaching the dentin will become permanent. Moreover, tooth diseases tend to be also irreversible and are generally widespread. For instance, periodontitis is listed second among the most common chronic diseases, with an incidence rate like that of diabetes and cardiovascular diseases (Williams et al. 2008; Haumschild and Haumschild 2009). Therefore it is no surprise that tooth regeneration, especially when compared to the current conservative approaches and resective surgeries, is considered to be a challenging but appealing scientific goal (Du et al. 2006; Duraccio et al. 2015). To achieve this goal, many issues must be overcome. One of the most relevant is how to drive the correct development of the new dental tissues (Sloan and Lynch 2012).
Cell homing strategy as a promising approach to the vitality of pulp-dentin complexes in endodontic therapy: focus on potential biomaterials
Published in Expert Opinion on Biological Therapy, 2022
Elaheh Dalir Abdolahinia, Zahra Safari, Sayed Soroush Sadat Kachouei, Ramin Zabeti Jahromi, Nastaran Atashkar, Amirreza Karbalaeihasanesfahani, Mahdieh Alipour, Nastaran Hashemzadeh, Simin Sharifi, Solmaz Maleki Dizaj
One of the essential aspects of tissue engineering is the use of biodegradable scaffolds [18]. For tissue engineering, a variety of synthetic or natural polymers and calcium phosphate-based materials have been used. Polyglycolic acid (PGA) was employed as a scaffold in the first work on dental tissue engineering [19]. In addition, collagen sponge scaffolds and collagen gels have recently been found to be effective for tooth regeneration [16,20]. Thus, scaffolds promote cell recruitment, proliferation, and differentiation and serve as a vehicle for bioactive or targeted cells [6,21,22]. These functions may contribute to their capacity to stimulate the revitalization of tooth regeneration. However, there are various alternative scaffold materials available, and knowledge of their effects on tooth regeneration is currently limited [23].
Dental stem cells in tooth regeneration and repair in the future
Published in Expert Opinion on Biological Therapy, 2018
Christian Morsczeck, Torsten E. Reichert
In contrast to whole tooth regeneration, dental implantology is faced with major changes. The production of a biological tooth root has been successfully tested in big animal models and it is very likely that the same strategy can be applied soon to humans. So it is possible that dental implantology in the near future becomes a discipline without metal-based dental implants. Biological tooth root engineering could be implemented in the near future. For this approach, autologous dental stem cells can be isolated and used directly or stored in a tooth bank before use. Sophisticated engineered biomaterials, for example, will direct the differentiation of dental stem cells such as DFCs into cells of the tooth attachment apparatus. These biomaterials can be printed in a 3D printer according to the requirements of the regenerated tissue. For the directed differentiation of stem cells, growth factors so on will be combined with 3D printed scaffolds. All technologies are available today. Moreover, treatments in periodontics and endodontics with dental stem cells have been already tested, and they will improve our opportunities for tooth repair remarkably. These progressive stem-cell-based therapies will improve tooth longevity and therefore the quality of life in aging societies.
Dental stem cells for tooth regeneration: how far have we come and where next?
Published in Expert Opinion on Biological Therapy, 2023
In contrast to whole tooth regeneration, stem cell research in dental implantology is progressing in a straight line. The creation of a biological tooth root has been successfully tested in a primate animal model and may soon be tested in humans. Interestingly, some authors discussed a combination of metal-based dental implants and a biological tooth root that could be a bridging-technology before replacing metal-based implants with biological tooth roots. A first use of stem cells with dental implants in the patient is only a matter of time, which has already been shown in the regeneration of the tooth pulp and the periodontium. Further advances can also be expected in the coming years with dental stem cells in endodontics, and periodontology, which, however, do not necessarily have to be related to the use of whole stem cells. I think a future scenario could be that only parts of dental stem cells such as exosomes in combination with biomaterials can be 3D printed according to the requirements of the regenerated tissue. Pre-clinical studies with EVs have been very promising and such stem cell fragments are much easier for clinicians to handle than stem cell cultures, although there are already a number of dental stem cell banks, so GMP with dental stem cells is already established. However, we do not know always the exact composition of EVs and their most effective components are not known either, so that quality control is difficult. We still understand far too little about the important mechanisms in the stem cells that would enable regeneration. Basic research is an important area of research here and an indispensable prerequisite for the safe use of stem cells or their components in regenerative dentistry. The targeted manipulation of endogenous dental stem cells by, for example, specific growth or by transcription factors after genetic manipulation is probably better for dental therapies than the generation of EVs, which contains components with unknown function. So, basic research with dental stem cells is still very important to develop new strategies in regenerative dentistry. Based on basic research a strategy was already developed to close a tooth cavity by the induction of repairing dentin after the activation of the WNT pathway in dental pulp cells. This strategy has made some progress over the last 5 years and should soon be ready for the next step. In conclusion, dental stem cells have opened new options, which, in combination with findings from basic research with dental stem cells, will lead to new treatment options in the future. I think that products for the activation of endogenous stem cells for tissue repair will find the way into the clinic before larger cultured tissues can be used in dentistry. My final thoughts therefore are on tissue engineering for dentistry to grow larger tissues under in vitro conditions and the stem cell research for meat production (growth of muscle tissue), both areas of tissue engineering inter alia have to solve the problem that functional cells inside larger tissues need to be supplied with oxygen. Perhaps because of the larger plans for in vitro meat production, this problem is being solved here before it finds its way into dentistry. It would be very desirable for dental research if there was a great openness for cooperations in the future.