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Platform technologies for regenerative endodontics from multifunctional biomaterials to tooth-on-a-chip strategies

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Abstract

Objectives

The aim of this review is to highlight recent progress in the field of biomaterials-mediated dental pulp tissue engineering. Specifically, we aim to underscore the critical design criteria of biomaterial platforms that are advantageous for pulp tissue engineering, discuss models for preclinical evaluation, and present new and innovative multifunctional strategies that hold promise for clinical translation.

Materials and methods

The current article is a comprehensive overview of recent progress over the last 5 years. In detail, we surveyed the literature in regenerative pulp biology, including novel biologic and biomaterials approaches, and those that combined multiple strategies, towards more clinically relevant models. PubMed searches were performed using the keywords: “regenerative dentistry,” “dental pulp regeneration,” “regenerative endodontics,” and “dental pulp therapy.”

Results

Significant contributions to the field of regenerative dentistry have been made in the last 5 years, as evidenced by a significant body of publications. We chose exemplary studies that we believe are progressive towards clinically translatable solutions. We close this review with an outlook towards the future of pulp regeneration strategies and their clinical translation.

Conclusions

Current clinical treatments lack functional and predictable pulp regeneration and are more focused on the treatment of the consequences of pulp exposure, rather than the restoration of healthy dental pulp.

Clinical relevance

Clinically, there is great demand for bioinspired biomaterial strategies that are safe, efficacious, and easy to use, and clinicians are eager for their clinical translation. In particular, we place emphasis on strategies that combine favorable angiogenesis, mineralization, and functional tissue formation, while limiting immune reaction, risk of microbial infection, and pulp necrosis.

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Acknowledgement

Figures (Figs. 1 and 2) in this manuscript were partially created with Bio Render.

Funding

The work was supported by the National Institutes of Health/National Institute for Dental and Craniofacial Research (NIH/NIDCR, grants F30-DE029359 to WBS and R01DE026578 to MCB), the São Paulo Research Foundation – FAPESP (grant 2016/15674-5), and by the Coordination for the Improvement of Higher Education Personnel – CAPES (Finance Code 001). The content of this review is solely the responsibility of the authors and does not necessarily represent the official view of the funding sources. We apologize to colleagues whose work we could not discuss due to space limitations.

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Authors and Affiliations

  1. Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo USP, Bauru School of Dentistry, Bauru, SP, 17012-901, Brazil

    Diana G. Soares

  2. Department of Physiology and Pathology, Universidade Estadual Paulista UNESP, Araraquara School of Dentistry, Araraquara, SP, 14801-903, Brazil

    Ester A. F. Bordini & Carlos A. de Souza Costa

  3. Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA

    Ester A. F. Bordini & Marco C. Bottino

  4. Department of Biologic and Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA

    W. Benton Swanson

  5. Department of Biomedical Engineering, College of Engineering, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA

    Marco C. Bottino

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  1. Diana G. Soares
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  2. Ester A. F. Bordini
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  3. W. Benton Swanson
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  4. Carlos A. de Souza Costa
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  5. Marco C. Bottino
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Correspondence to Marco C. Bottino.

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Soares, D.G., Bordini, E.A.F., Swanson, W.B. et al. Platform technologies for regenerative endodontics from multifunctional biomaterials to tooth-on-a-chip strategies. Clin Oral Invest 25, 4749–4779 (2021). https://doi.org/10.1007/s00784-021-04013-4

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