Chapter 21 - Dental tissue engineering

Abstract

Dental tissues are very distinctive in structure, organization, and function, compared to other tissue ensembles in the body. Teeth and supportive structures experience mechanical, thermal, chemical, and microbial challenges. The various dental tissues, such as enamel, dentin, pulp, cementum, periodontal ligament, and alveolar bone anchoring the root, are prone to damage or progressive destruction due to adverse oral conditions as well as microbial infections. Therefore tissue engineering has a great role here. As an opportunity, the dental tissues are inhabited by different progenitor cells helpful in tissue regeneration. This chapter focuses on the research activities occurred to harness the potentials of Tissue Engineering concept for dental tissue regeneration, based on the cell-scaffold-mediator triad. Significant work has been done to understand the role of each component in Dental Tissue engineering. Various cell lines, stem cells, and tooth-derived cells have been used. Cell constructs and without scaffolds have been tried. Scaffold materials include polymers, natural as well as synthetic, hydrogels, bioceramics, and their combinations. Regeneration is attempted with mediators, mainly growth factors and biomimetic molecules. Biofunctionalization also has been tried. Other approaches like cell sheet technology, scaffold-free and cell-free approaches, and growth factor delivery have also been explored. Currently active research is going on in the fabrication of tissue engineering scaffolds using techniques like electrospinning and 3D printing. The state of the art is bioprinting of engineered tissue constructs. The review also covers recent advances in dental tissue engineering, especially the attempts to regenerate dental pulp and periodontium. Most ambitious programs are ongoing in the tissue engineering of whole tooth.