Review Article

Tissue Regeneration on Rise: Dental Hard Tissue Regeneration and Challenges—A Narrative Review

Table 1

Research articles included the review.

Prior workStudy tittleTeeth involveConclusion

Olaru et al. [1]Hard dental tissue regeneration—approaches and challengesThe whole tooth or only one of its component structuresThe regeneration of the hard dental tissues and the entire tooth was entirely facilitated by stem cells regardless of the technique used—scaffold based or scaffold free
The significant amount of differentiation and interconnectedness required for enamel restoration has somewhat hampered the effectiveness of stem cell-based enamel regeneration thus far

Baranova et al. [22]Tooth formation: are the hardest tissues of the human body hard to regenerate?Dental tissue regeneration and/or whole-tooth regenerationScientific investigation at several levels, including the identification of suitable cell sources with tooth-inductive signals, will be necessary to further the regeneration of entire teeth
Given that enamel is an acellular tissue that cannot be replicated in vitro using a purely cell-based method, functionalized biomaterials are likely to be crucial to other dental tissues, and hard dental tissues such as dentin and cementum are growing again. In addition, methods to improve 3D organogenesis, 3D printing uses, and the right way to use stimulating chemicals and drugs should all be carefully looked into on a translational level

Ahmed et al. [23]Tissue engineering approaches for enamel, dentin, and pulp regeneration: an updateEnamel, dental pulpal tissues, and the dentinPromising methods for preserving the health and repairing the integrity of dental tissues include bioprinting and tissue engineering based on stem and progenitor cells
Creating culture media without serum or animal products to help cells grow and a clear set of globally recognized markers to separate and identify stem and progenitor cells are two more major issues that must be resolved prior to stem and progenitor cell-based transplantation treatments routinely applied in medical facilities

Kim et al. [24]Tooth-supporting hard tissue regeneration using biopolymeric material fabrication strategiesAlveolar bone to PDL or PDL to cementumWith their biological immobilization, chemical modification-assisted degradation controls, and manufacturing methods for 3D architectures, biopolymer fabrication techniques can make it easier to create mineralized tissue by controlling where and when tissue grows into periodontal defects
With synthetic Sharpey’s fibres serving as the framework for the teeth, neogenic regulation and fibrous tissue calcification in that area are important for improving biomechanical integration for the hard-to-soft tissue complex and making it easier to restore the regenerated periodontal compound

Tompkins et al. [25]Molecular mechanisms of cytodifferentiation in mammalian tooth developmentBud, cap, bell, and terminal differentiationPhenotypic proteins, such as amelogenin and dentin matrix protein 2 of both odontoblasts and ameloblasts, may serve as the best approach during cytodifferentiation

Thesleff [26]From understanding tooth development to the bioengineering of teethThe whole toothA child’s tooth production process can take up too many years when it occurs in vivo. Growth-stimulatory signaling molecules could resolve this issue. Controlling the size, shape, and colour of the dental crown is one of the other issues that still have to be resolved, but these can be resolved using current clinical dentistry techniques. Lastly, there is a significant chance that cells cultured outside of the human body could develop into cancerous cells. The majority of stem cell treatments have this risk, and research is currently being conducted in order to mitigate the chance of cancer

Olley et al. [27]Expression analysis of candidate genes regulating successional tooth formation in the human embryoThe whole toothThese results validate the expression of SPROUTY2, GAS1, and RUNX2 throughout the early stages of human tooth formation. While only GAS1 transcripts were discernible in the successional lamina during these early stages of development, the domains of RUNX2 and GAS1 are consistent with a role-influencing function of the primary dental lamina

Huang et al. [28]Tooth regeneration: insights from tooth development and spatial-temporal control of bioactive drug releaseThe whole toothThe intricate spatial-temporal regulatory network of tooth development makes it difficult to identify the critical and necessary components for tooth regeneration. If this research is successful, however, it will liberate restricted parameters that will enable tooth regeneration. Furthermore, before these technologies are clinically translated, additional proof of their in vivo safety is required

Hu et al. [29]Stem cell-based tooth and periodontal regenerationTooth and periodontalResearchers studied various approaches, such as cell injection, bioroot regeneration, cell-based periodontal regeneration, cell-homing techniques, and epithelial-mesenchymal-based whole tooth regeneration, for tooth and periodontal regeneration. Nonetheless, further research is required to determine the posttransplantation fates and roles of stem cells

Takeo and Tsuji [30]Organ regeneration based on developmental biology: past and futureThe whole toothThe idea that functional organ regeneration in vivo as a future-oriented regenerative therapy for organ replacement can be accomplished by orthotopically transplanting both an operational organ and a bioengineered organ germ is supported by research

Yu and Klein [31]Molecular and cellular mechanisms of tooth development, homeostasis, and repairThe whole toothOrganogenesis, the complex process of tooth formation, involves utilizing multiple pathways that can produce diverse effects in various dental tissue compartments. By using multidisciplinary approaches, we should be able to gain a better understanding of stem cell and dental developmental biology, which will help lay a stronger foundation for future regenerative medicine techniques

Calamari et al. [32]Tissue mechanical forces and evolutionary developmental changes act through space and time to shape tooth morphology and functionThe whole toothIt is critical to comprehend the processes controlling the acquisition of appropriate tooth morphologies and compositions, as well as the control of progenitor and stem cells throughout tooth growth or regeneration, in order to create stem-cell-based treatments that promote tooth regeneration

Yuan and Chai [33]Regulatory mechanisms of jawbone and tooth developmentJaw bones and teethShared regulatory systems and other variables tightly connect the development of the jaws and teeth due to their similar cranial neural crest cell origins. In several transgenic mouse models, there is evidence of a close link between the teeth and jaws, where abnormalities are present in both

Hyun et al. [34]Effect of FGF-2, TGF-β-1, and BMPs on teno/ligamentogenesis and osteo/cementogenesis of human periodontal ligament stem cellsPeriodontal ligamentAccording to the findings, fibroblast growth factor-2 mostly causes the stem cells from the human periodontal ligament to differentiate into teno/ligatogenesis and inhibits BMP-2- and BMP-4-induced hard tissue differentiation