Tissue engineering: from research to dental clinics

Abstract

Tissue engineering is an interdisciplinary field that combines the principles of engineering, material and biological sciences toward the development of therapeutic strategies and biological substitutes that restore, maintain, replace or improve biological functions. The association of biomaterials, stem cells, growth and differentiation factors has yielded the development of new treatment opportunities in most of the biomedical areas, including Dentistry. The objective of this paper is to present the principles underlying tissue engineering and the current scenario, the challenges and the perspectives of this area in Dentistry.

Significance: The growth of tissue engineering as a research field has provided a novel set of therapeutic strategies for biomedical applications. Indeed, tissue engineering may lead to new strategies for the clinical management of patients with dental and craniofacial needs in the future.

Fig. 1. The principles of Tissue Engineering using dental stem cells may allow the regeneration of osseous, neural and tooth-related tissues

Fig. 2

Flow of events leading to protein synthesis. A) Binding of ligand to its specific cell membrane receptor triggers intracellular signaling and activation of gene expression. B) Synthesis of new RNA template from transcription of the original strand of DNA. C) Assembling of the ribosome complex at the initiation codon of the mRNA molecule. D) Decoding of mRNA in sets of nucleotides forming a polypeptide chain. E) Folding in the Golgi apparatus to complete protein synthesis. This can be followed by protein secretion to the extracellular environment or “sequestration” within the cell itself.

Fig. 3

Dental pulp tissue engineered for 35 days inside root canal using SHED cells (A) and natural dental pulp from a young premolar (B). It is possible to observe the formation of a healthy tissue without inflammatory signs and a densification of odontoblast-like cell along dentin walls in the SHED originated tissue similar to the control. The engineered tissue occupies the whole apical portion (C) and immunohistochemistry with PCNA (proliferating cell nuclear activity) and Factor VIII show a proliferative tissue with well estabilished and mature blood network (D and E).