From pulpal stem cells to tooth repair: an emerging field for dental tissue engineering

Abstract

In current dental practices, traditional restorative approaches may have relatively limited long-term survival and may be associated to diverse complications, such as allergy, pulpitis, or periodontal pathologies. To overcome these shortcomings, novel innovative strategies have been envisioned for tooth repair. During the two last decades, the extensive advances in our understanding of tooth development as well as stem cell research provide the foundation for exciting opportunities in dental tissue engineering. The replacement of lost teeth by engineered dental tissue appears as a fascinating goal. However, the feasibility remains an intriguing question. Is the challenge to create a new tooth acting as a substitute for lost tooth or to regenerate only part of this organ that is enamel, dentin, or dental pulp? Is it possible to exploit stem cells for transplantation purposes to promote matrix formation and mineralization in the framework of endodontic treatment? Finally, investigating the functional properties of pulpal stem cells is however mandatory to envision novel therapeutic dental strategies. In this review, we summarize the current knowledge of stem cells used for dental tissue engineering and discuss the ensuing challenges for regenerative dentistry.