Department of Operative Dentistry & Periodontology, University of Regensburg, Regensburg, Germany.
Regen Med. 2011 Jan;6(1):111-24. doi: 10.2217/rme.10.86.
Although teeth can withstand enormous abrasive forces, they are susceptible to damage due to trauma, acids and bacterial attack. Conventional treatment relies on synthetic materials to fill defects and replace whole teeth, but these remain substitutes and cannot restore the tissues' physiological architecture and function. With the isolation of postnatal stem cells from various sources in the oral cavity and the development of smart materials for cell and growth factor delivery, possibilities for alternative, biology-based treatments arise. Interdisciplinary approaches are needed to move from replacement to regeneration, involving clinicians as well as biologists, stem cell researchers and material scientists. First, in order to provide an appreciation for the complexity of the tooth as a whole, its components and surrounding structures will be described. Next, the basic principles of tooth development will be presented, which can be applied to recreate signaling events and utilize them to build whole teeth. For the regeneration of individual tooth structures, the classical tissue engineering triad can be utilized, using dental stem cells, scaffold materials and relevant growth and differentiation factors. Recent successful engineering initiatives on whole teeth as well as on specific tissues such as enamel, the dentin-pulp complex or periodontal ligament will be discussed. In projecting future research directions, we conclude with a brief discussion of key components necessary to develop effective strategies for dental tissue engineering, which might enable us to implement novel regenerative strategies in clinical practice in the near future.
尽管牙齿能承受巨大的磨损力，但由于外伤、酸和细菌的侵袭，它们仍容易受损。传统的治疗方法依赖于合成材料来填补缺陷和替代整个牙齿，但这些仍然是替代品，无法恢复组织的生理结构和功能。随着从口腔各种来源分离出的成体干细胞以及用于细胞和生长因子传递的智能材料的发展，出现了替代的、基于生物学的治疗方法的可能性。需要采取跨学科的方法从替代治疗转向再生治疗，涉及临床医生以及生物学家、干细胞研究人员和材料科学家。首先，为了全面了解牙齿的复杂性及其组成部分和周围结构，将对其进行描述。其次，将介绍牙齿发育的基本原理，这些原理可应用于重现信号事件并利用这些信号事件来构建整个牙齿。对于单个牙齿结构的再生，可以利用牙齿干细胞、支架材料和相关的生长和分化因子来利用经典的组织工程三联体。将讨论最近在整个牙齿以及特定组织（如牙釉质、牙本质牙髓复合体或牙周韧带）方面的成功工程设计。在预测未来的研究方向时，我们将简要讨论开发有效的牙科组织工程策略所需的关键组成部分，这可能使我们能够在不久的将来在临床实践中实施新的再生策略。
