El Gezawi Moataz, Wölfle Uta Christine, Haridy Rasha, Fliefel Riham, Kaisarly Dalia
Department of Restorative Dental Sciences, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia.
Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, 80336 Munich, Germany.
ACS Biomater Sci Eng. 2019 Oct 14;5(10):4899-4919. doi: 10.1021/acsbiomaterials.9b00591. Epub 2019 Aug 30.
Currently, the principal strategy for the treatment of carious defects involves cavity preparations followed by the restoration of natural tooth structure with a synthetic material of inferior biomechanical and esthetic qualities and with questionable long-term clinical reliability of the interfacial bonds. Consequently, prevention and minimally invasive dentistry are considered basic approaches for the preservation of sound tooth structure. Moreover, conventional periodontal therapies do not always ensure predictable outcomes or completely restore the integrity of the periodontal ligament complex that has been lost due to periodontitis. Much effort and comprehensive research have been undertaken to mimic the natural development and biomineralization of teeth to regenerate and repair natural hard dental tissues and restore the integrity of the periodontium. Regeneration of the dentin-pulp tissue has faced several challenges, starting with the basic concerns of clinical applicability. Recent technologies and multidisciplinary approaches in tissue engineering and nanotechnology, as well as the use of modern strategies for stem cell recruitment, synthesis of effective biodegradable scaffolds, molecular signaling, gene therapy, and 3D bioprinting, have resulted in impressive outcomes that may revolutionize the practice of restorative dentistry. This Review covers the current approaches and technologies for remineralization, regeneration, and repair of natural tooth structure.
目前，治疗龋损的主要策略包括制备窝洞，然后用生物力学和美学性能较差且界面粘结长期临床可靠性存疑的合成材料修复天然牙体结构。因此，预防和微创牙科被视为保存完好牙体结构的基本方法。此外，传统的牙周治疗并不总能确保可预测的结果，也无法完全恢复因牙周炎而丧失的牙周韧带复合体的完整性。人们付出了很多努力并进行了全面研究，以模拟牙齿的自然发育和生物矿化过程，从而再生和修复天然硬牙组织，并恢复牙周组织的完整性。牙本质 - 牙髓组织的再生面临着诸多挑战，首先是临床适用性的基本问题。组织工程和纳米技术中的最新技术及多学科方法，以及使用现代策略招募干细胞、合成有效的可生物降解支架、分子信号传导、基因治疗和3D生物打印，都取得了令人瞩目的成果，可能会给修复牙科实践带来变革。本综述涵盖了目前用于天然牙体结构再矿化、再生和修复的方法及技术。
