19. Whole Tooth Engineering

There are several challenges in using common removable artificial dental implants, including high risk of bone loss and implant failure. Therefore, bioengineering of physiologically functional whole teeth using regenerative approaches seems essential. To a bioengineer a whole tooth, autologous stem cell-seeded scaffolds, and stem cell reassociations can be implanted at the site of the tooth loss, where they may develop and erupt similarly to a natural tooth. Successful bioengineering of a whole tooth requires appropriate cell source(s), scaffolds, and the induction of the cascade expression of special genes involved in tooth development. To achieve such tooth therapy, we need to fully understand the structure and interaction procedure of epithelial/mesenchymal stem cells during embryonic development of teeth. In this chapter, we first focus on different cell sources and cell signaling pathways through which different parts of a tooth form during tooth development. Then, we describe the recent methods employed for bioengineering a whole tooth, including the organ germ method, sheet engineering, and scaffold-based tissue engineering. Ultimately, the functionality of an engineered whole tooth and future prospects of whole tooth engineering are discussed.