Regenerative Approaches in Dentistry: An Evidence-Based Perspective

Preface
Acknowledgments
Contents
Editors and Contributors
About the Editors
Contributors
The Paradigm of Regenerative Dentistry and Its Future Perspectives
1 Regenerative Approaches for Treatment
2 Therapeutic Targets in the Field of Dentistry
2.1 The Whole Tooth
2.2 Individual Dental Structures
2.2.1 Enamel
2.2.2 The Dentine-Pulp Complex
2.3 Periodontium
2.4 Bone Defects
2.5 Oral Pathology
3 Dental Tissue-Derived Stem Cells
4 Conclusions and Future Direction
References
Dental Tissues Originated Stem Cells for Tissue Regeneration
1 Introduction
2 Stem Cells Obtained from Human Permanent Teeth or Exfoliated Deciduous Teeth
2.1 Isolation and Characterization
2.2 Regenerative Applications
2.2.1 Dentine–Pulp Complex Regeneration
2.2.2 Bone Regeneration
2.2.3 Neural Regeneration
2.2.4 Other Regenerative Applications
3 Stem Cells from the Apical Papilla
3.1 Isolation and Characterization
3.2 Regenerative Applications
3.2.1 Pulp Regeneration and Angiogenesis
3.2.2 Neural Regeneration
3.2.3 Bone Regeneration
3.2.4 Other Regenerative Applications
4 Dental Follicle Stem Cells
4.1 Isolation and Characterization
4.2 Regenerative Applications
4.2.1 Bone Regeneration
4.2.2 Periodontal Regeneration
5 Stem Cells from the Periodontal Ligament
5.1 Isolation and Characterization
5.2 Regenerative Applications
5.2.1 Periodontal Regeneration
5.2.2 Bone Regeneration
5.2.3 Tendon and Cartilage Regeneration
5.2.4 Other Regenerative Applications
6 Banking of DSCs
7 Limitations
8 Conclusions and Future Direction
References
Dentine–Pulp Complex Regeneration
1 Introduction
2 Dentine–Pulp Complex Biology
2.1 Tooth Development
2.2 Dentinogenesis
2.2.1 Odontoblast Life Cycle
2.2.2 Role, Structure, and Composition of Dentine
2.2.3 Types of Dentine
2.2.4 Dentinal Tubules
2.3 Dental Pulp Histology
2.3.1 Structural Organization of the Dental Pulp
2.3.2 Pulp Cells
2.3.3 Extracellular Matrix
2.3.4 Vascularization
2.3.5 Innervation
2.4 Immune Responses in the Dentine–Pulp Complex
2.4.1 Odontoblasts as Immunocompetent Cells
2.4.2 Response of Pulp Immune Cells to Tooth-Invading Pathogens
2.4.3 The Fine Balance and the Interplay between Inflammation and Regeneration in the Dentine–Pulp Complex
3 Stem Cell-Based Dentine–
3.1 Key Players for Dentine–Pulp Complex Regeneration
3.1.1 Pulp Stem/Progenitor Cells
3.1.2 Scaffolds
3.1.3 Growth Factors/Bioactive Molecules
3.1.4 Disinfection
3.2 Complete Dentine–Pulp Complex Regeneration
3.3 Partial Dentine–Pulp Complex Regeneration
4 Acellular Material-Based Dentine–Pulp Complex Formation
4.1 Complete Dentine–Pulp Complex Regeneration
4.2 Partial Dentine–Pulp Complex Regeneration
5 3D Printing for Endodontic Regeneration
5.1 Concept 3D Bioprinting
5.2 Bio-Inks for 3D Bioprinting Applied for Endodontic Regeneration
6 Future Directions
References
Clinical Approach to Regenerative Endodontics
1 Introduction
2 History and Emergence of Regenerative Endodontics
3 Goals of Regenerative Endodontics
4 Why Do We Need a Vital Pulp?
5 Concepts of Regenerative Endodontics
5.1 Cell-Based Approach
5.2 Cell Homing Approach
5.2.1 Problems with Cell Homing
6 Common Challenges in Regenerative Endodontics
6.1 Microbial Control, Growth Factors, and Stem Cell
6.1.1 Instrumentation
6.1.2 Irrigation in Regenerative Endodontics
6.1.3 Intracanal Medicaments
6.2 Scaffolds
7 AAE Guideline on Irrigation and Intracanal Medicament Protocol
8 Can RET Be Performed in All Immature Permanent Teeth with a Necrotic Pulp?
9 Treatment Outcome
10 Levels of Evidence for Regenerative Endodontics
11 Impact of Apical Foramen Size on Treatment Outcome
12 Side Effects of RET
13 Follow-Up
14 Future of Regenerative Endodontics: What Can We Improve?
14.1 Microbial Control
14.1.1 Irrigation Activation
15 Conclusion
References
Tooth Bioengineering and Whole Tooth Regeneration
1 Introduction
2 Stem Cell-Based Strategies for Tooth Regeneration
2.1 Dental Stem Cells
2.1.1 Dental Pulp Stem Cells
2.1.2 Stem Cells from Human Exfoliated Deciduous Tooth
2.1.3 Periodontal Ligament Stem Cells
2.1.4 Root Apical Papilla Stem Cells
2.1.5 Dental Follicle Stem Cells
2.2 Induced Pluripotent Stem Cells
2.3 Stem Cell-Based Strategy for Dental Pulp Regeneration
2.4 Stem Cell-Based Strategy for Enamel Regeneration
2.5 Stem Cell-Based Strategy for Periodontal Tissue Regeneration
2.6 Stem Cell-Based Strategy for Whole Tooth Regeneration
3 Biomaterials-Based Approaches for Tooth Engineering
3.1 Biomaterials for Enamel Regeneration
3.2 Biomaterials for Dentine-Pulp Complex Regeneration
3.3 Biomaterials Applied for Periodontal Regeneration
3.4 Biomaterials for Whole Tooth Regeneration
4 Bioengineered Tooth Germ-Based Methods for Functional Tooth Replacement
5 Conclusion and Future Perspectives
References
Regenerative Approaches in Periodontics
1 Introduction
2 Periodontium
3 Nature of Periodontal Healing and Regeneration
4 Regenerative Capacity of Periodontal Ligament Cells
5 Types of Periodontal Defects
6 Current Surgical Treatment Protocols in Regenerative Periodontology
7 Team of the Periodontist and the General Dental Practitioner
7.1 Indications for Surgical Periodontal Therapies
7.2 Contraindications for Surgical Periodontal Therapies
8 Periodontal Flaps
9 Classification of Periodontal Surgical Procedures
9.1 Resective Periodontal Surgical Procedures
9.2 Regenerative Periodontal Surgerical Procedures
10 Regeneration of Bone and Bone Grafts
11 Classification of Bone Grafts
11.1 Autografts
11.2 Allografts
11.3 Xenografts
11.4 Alloplasts
12 Guided Tissue Regeneration
12.1 Barrier Membranes
13 Periodontal Plastic Surgery
14 Concept of Periodontal Tissue Engineering
14.1 Stem Cells and Cell Sheet Technology
14.2 Biomaterials for Periodontal Tissue Engineering
14.3 Scaffolds
14.4 Growth Factors
15 Soft Tissue Engineering
16 Challenges in Periodontal Regenerative Therapies
16.1 Variables Influencing Periodontal Regeneration
16.2 Patient-Related Factors
16.3 Surgical Technique
16.4 Local Factors
17 Future of Regenerative Periodontics: What Is Next?
18 Conclusion
References
Regeneration for Implant Dentistry
1 Guided Bone Regeneration
1.1 Membranes
1.2 Bone Graft Substitutes
1.3 Bioactive Molecules
1.3.1 Bone Morphogenetic Proteins
1.3.2 Growth Differentiation Factor 5 (GDF-5)
1.3.3 Teriparatide (Human Recombinant Parathyroid Hormone)
1.3.4 Hemoderivates: Platelet-Fibrin (PRF), Platelet-Rich Plasma (PRP), and Leukocyte-Platelet-Rich Fibrin
2 Posterior Mandible Bone Regeneration
2.1 Bone Block Grafting
2.2 Distraction Osteogenesis (DO)
2.3 Guided Bone Regeneration
3 Sinus Floor Elevation for Bone Regeneration
3.1 Techniques of Sinus Augmentation (Sinus Lift)
3.2 Sinus Lift Outcomes
4 Bone Tissue Engineering (BTE)
4.1 Biomaterials
4.1.1 Osteoinductive Materials
4.1.2 Polymers
4.1.3 Collagen-Based Composite Scaffolds
4.2 Cells
4.3 Protein Corona on Biomaterial Surfaces
5 Peri-Implantitis
6 Conclusions and Future Direction
References
Regenerative Approaches in Orthodontic and Orthopedic Treatment
1 Bone Remodeling and Regeneration Through Tissue Engineering
2 Cell Sources for Bone Regeneration
3 Biomaterials for Bone Regeneration
3.1 Growth Factors for Bone Regeneration
4 Regenerative Approaches for Jaw Discrepancies
4.1 Orthodontic Treatment Tissue Engineering Approaches for Jaw Discrepancies
4.1.1 Osteoclastic Activity Accelerates Orthodontic Tooth Movement Rate
4.1.2 Osseointegration Enables Definite Anchorage in Orthodontic Treatment
4.1.3 Intramembranous Osteogenesis Corrects Jaw Discrepancy
4.1.4 Factors Regulating Orthodontic Tooth Movement
4.2 Orthodontic/Orthopedic Treatment Tissue Engineering Approaches for Jaw Discrepancies
4.2.1 DO in the Maxilla
4.2.2 DO in the Mandible
4.3 Bone Tissue Engineering for the Maxillofacial Region
4.3.1 Vascularization in Bone Regeneration
4.3.2 Research Models
5 Regenerative Aspects in Orthodontic Treatments for Periodontal Diseases
5.1 Orthodontics Improves Periodontal Esthetics: Gingival Recession/Black Triangle
5.2 Orthodontics in Prosthesis
5.3 Orthodontics Helps Reconstruct Periodontium
5.4 Orthodontic Application in Periodontal Treatment
6 Regenerative Approaches for Temporomandibular Joint Disorders (TMD)
6.1 Tissue Engineering of the TMJ
6.2 Future Treatment for the TMD Treatment
7 Conclusions and Future Perspectives
References
Regenerative Approaches in Oral and Maxillofacial Surgery
1 Introduction
2 Current Treatment and Clinical Evidence for Treatment of Defects Caused by Malignancy and Trauma
3 Current Treatment and Clinical Evidence for Congenital Defects
3.1 Principles and Advantages of Stem Cell-Based Therapies
3.2 Hard Tissue Repair
3.3 Soft Tissue Repair
4 Current Clinical Evidence for Stem Cell-Based Therapies
5 Future Prospects
6 Conclusion
References
Regenerative Approaches in Oral Medicine
1 Introduction and Concepts
1.1 Stem Cells
1.2 Growth Factors
1.3 Matrices
1.4 Scaffolds and Grafts
1.5 Bioprinting
2 Current Applications of Stem Cells for Treating or Preventing Oral Conditions
2.1 Oral Mucosal Lesions
2.1.1 Oral Lichen Planus
2.1.2 Oral Leukoplakia and Epithelial Dysplasia
2.2 Oral Malignancies
2.2.1 Head and Neck Squamous Cell Carcinoma
2.3 Salivary Gland Disorders
2.3.1 Local Obstructive, Inflammatory, or Reactive Disorders
2.3.2 Salivary Gland Tumours
2.3.3 Immune-Mediated Salivary Disorders
2.3.4 Radiation-Induced Xerostomia
2.3.5 Radioiodine-Induced Xerostomia
2.3.6 Post-chemotherapy Xerostomia
2.4 Craniofacial Bone Pathology
2.4.1 Ameloblastoma
2.4.2 Odontogenic Keratocyst
2.4.3 Osteosarcoma
2.4.4 Cemento-Osseous Dysplasia
2.4.5 Ossifying Fibroma
2.4.6 Fibrous Dysplasia
2.4.7 Osteogenesis Imperfecta
2.4.8 Idiopathic Osteosclerosis
2.4.9 Paget’s Disease
2.4.10 Osteonecrosis
2.4.11 Post-trauma
2.4.12 Maxillofacial Infections
2.5 Temporomandibular Joint Disorders
2.6 Orofacial Pain
2.6.1 Inflammatory Orofacial Pain
2.6.2 Neuropathic Orofacial Pain
2.6.3 Masticatory Myalgia
3 Conclusion and Future Directions
References
Index