Regenerative Approaches in Dentistry: An Evidence-Based Perspective

Description

This book provides evidence-based information in the field of regenerative dentistry discussing the most recent advances, current clinical applications, limitations and future directions. The coverage encompasses the regeneration of alveolar bone, the dentine-pulp complex, enamel, the periodontium and other tissues associated with the oral cavity. A full description is provided of regenerative approaches in dentistry including regenerative endodontics and tooth repair, regenerative periodontics, regenerative assisted orthodontics, regenerative approaches in oral medicine, and dental tissue derived stem cells and their potential applications. The book is written by an international team of leading experts. It will be beneficial for students, practitioners and researchers in the fields of endodontics, periodontics and implantology. 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