Present and future of tissue engineering scaffolds for dentin-pulp complex regeneration

Dina G. Moussa, Conrado Aparicio

Research output: Contribution to journalReview articlepeer-review

57 Scopus citations

Abstract

More than two thirds of the global population suffers from tooth decay, which results in cavities with various levels of lesion severity. Clinical interventions to treat tooth decay range from simple coronal fillings to invasive root canal treatment. Pulp capping is the only available clinical option to maintain the pulp vitality in deep lesions, but irreversible pulp inflammation and reinfection are frequent outcomes for this treatment. When affected pulp involvement is beyond repair, the dentist has to perform endodontic therapy leaving the tooth non-vital and brittle. On-going research strategies have failed to overcome the limitations of existing pulp capping materials so that healthy and progressive regeneration of the injured tissues is attained. Preserving pulp vitality is crucial for tooth homeostasis and durability, and thus, there is a critical need for clinical interventions that enable regeneration of the dentin-pulp complex to rescue millions of teeth annually. The identification and development of appropriate biomaterials for dentin-pulp scaffolds are necessary to optimize clinical approaches to regenerate these hybrid dental tissues. Likewise, a deep understanding of the interactions between the micro-environment, growth factors, and progenitor cells will provide design basis for the most fitting scaffolds for this purpose. In this review, we first introduce the long-lasting clinical dental problem of rescuing diseased tooth vitality, the limitations of current clinical therapies and interventions to restore the damaged tissues, and the need for new strategies to fully revitalize the tooth. Then, we comprehensively report on the characteristics of the main materials of naturally-derived and synthetically-engineered polymers, ceramics, and composite scaffolds as well as their use in dentin-pulp complex regeneration strategies. Finally, we present a series of innovative smart polymeric biomaterials with potential to overcome dentin-pulp complex regeneration challenges.

Original languageEnglish (US)
Pages (from-to)58-75
Number of pages18
JournalJournal of Tissue Engineering and Regenerative Medicine
Volume13
Issue number1
DOIs
StatePublished - Jan 2019

Bibliographical note

Funding Information:
This research was supported by the National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH) under the award number R01‐DE026117 to Conrado Aparicio and the post‐doctoral fellowship R90‐DE023058‐06, MinnCResT Program, to Dina Moussa. The authors would like to thank Dr. Chun Wang from the Department of Biomedical Engineering at the University of Minnesota for the constructive feedback on the contents of this review article.

Funding Information:
This research was supported by the National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH) under the award number R01-DE026117 to Conrado Aparicio and the post-doctoral fellowship R90-DE023058-06, MinnCResT Program, to Dina Moussa. The authors would like to thank Dr. Chun Wang from the Department of Biomedical Engineering at the University of Minnesota for the constructive feedback on the contents of this review article.

Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.

Keywords

  • dentin-pulp complex
  • endondontics
  • multifunctional scaffolds
  • natural scaffolds
  • synthetic scaffolds
  • tissue engineering

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