Endodontal regeneration by mimicking local stem cell niches

Dental trauma is health concern that affects all ages. Traditionally, dentistry has focused on repair of dental tissue, but in recent years a trend has been initiated to regenerate functional teeth. This has proven to be a challenging task due to the multiple and complex tissues that form a tooth.

In this dissertation, we first describe new techniques involving custom additive manufacturing (3D printing) that have been used to regenerate craniofacial tissues and their potential for future uses in the treatment of craniomaxillofacial injuries, including bone, periodontal ligament and teeth. We then describe the techniques that we developed to further investigate the regeneration of two dental tissues (dentin and dental pulp).

In general, we use a combination of 3D printing, stem cell treatment and biophysical stimulation to regenerate the two dental tissues above mentioned. For dentin, we used custom ß-Tricalcium Phosphate bioinks for the manufacturing of 3D scaffolds in combination with stem cells from exfoliated deciduous teeth (SHEDs) by means of hydrostatic pressure stimulation. For the dental pulp we look into regenerating pulp vitality by means of angiogenesis by using co-cultures of dental pulp stem cells (DPSCs) with microvascular fragments (MVFs) in custom 3D printed anatomically correct tooth biochambers. For both of the tissues explored in this dissertation we conclude that the physical stimulus rather than a chemical one can be used to cue the differentiation of stem cells in the desired tissue. This was quantified by various odontogenic, osteogenic and angiogenic gene markers.