It develops within the jawbone and after the eruption its root(s) are firmly anchored in the alveolar bone proper. Tooth is a complex organ consisting of highly organized structures with various but specific shapes. Recent advances in tissue engineering have drawn scientists to test the possibility of regeneration a whole tooth or part of the tooth structure ( 1– 4). Dentin is produced by odontoblasts derived from ectomesenchyme and these cells continue to exist in the pulp throughout life span. Enamel is made by ameloblasts derived from ectoderm and these cells are no longer present after the hard tissue formation is complete. Tooth is built by cells originated from both ectoderm and mesoderm. Due to the small volume of the pulp tissue encased in dentin with blood supply, only from one opening end at the root apex, when pulp tissue is infected, it is difficult for the immune system to eradicate the infection without collateral blood supply. Additionally, it possesses highly responsive sensory nervous system that generates unbearable pain when tooth is inflicted by mechanical trauma, chemical irritation or microbial invasion. Before any microbial invasion is taken place, the root canal is occupied by dental pulp tissue whose main function is to produce dentin and maintain the biological and physiological vitality of the dentin. Root canal infection develops if the caries is extensive and the infection often spreads into the jawbone. When invasion occurs and manifests as a dental caries, the caries may become a gateway into the host internal tissues. Although the mucosal system is heavily protected by a strong immune defense mechanism, tooth is vulnerable to microbial invasion. Tooth is the only organ that penetrates from the host internal tissue through the “oral integumentary layer” into the external environment – the oral cavity, which is a completely wet environment. Tooth enamel is incapable of self-repairing whereas dentin and cememtum have limited capacity to regenerate.
The prospective outcome of the current advancement and challenge in this line of research will be discussed. This article will review the recent endeavor on pulp and dentin tissue engineering and regeneration.
With the advent of modern tissue engineering concept and the discovery of dental stem cells, regeneration of pulp and dentin has been tested. Regeneration of dentin relies on having vital pulps however, regeneration of pulp tissue has been difficult as the tissue is encased in dentin without collateral blood supply except from the root apical end. Entire pulp amputation followed by the pulp space disinfection and filled with an artificial rubber-like material is employed to treat the infection -commonly known as root canal or endodontic therapy. Extensive forms of caries destroy enamel and dentin and can lead to dental pulp infection. Enamel and dentin are commonly under the attack by caries. Tooth enamel is incapable of self-repairing whereas dentin and cememtum can regenerate with limited capacity. Hard tissue is difficult to repair especially dental structures.
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