Dental tissue repair: future biologically based opportunities

The development of future dental and regenerative endodontic therapies requires a fundamental understanding of both the biology of the tooth and the key clinical questions that need to be addressed. Therefore, productive partnerships between clinicians and basic scientists are essential to drive the field forward and to enable improved treatment outcomes for patients. The aim of this review is to provide a scientific background to dentine-pulp biology, including how developmental processes relate to the innate ability of the dentine-pulp to repair itself and regenerate, as well as to analyse the interaction between tooth repair and the inflammatory response. Furthermore, the way in which calcium hydroxide and calcium silicate-based restorative materials interact with the tooth to facilitate dental tissue repair processes is described, and finally, several emerging scientific areas with the potential for exploitation and clinical translation are highlighted. The exciting development of 'smart' dental materials, which work in synchrony with the body's repair response are also discussed, as well as how these therapeutic adjuncts may supplement current dental treatments. The potential of other 'regenerative treatments', including growth factor-, stem cell- or physical sciences-based therapies involving low-level light and ultrasound are discussed. The final section highlights recent experimental data on the current state of the relatively novel area of epigenetics and how developing an understanding of related processes within the dentine-pulp complex can be exploited for patient benefit. Schlagwörter: mesenchymal stem cells, regenerative endodontics, tissue engineering, vital pulp therapy