Dentinogenic potential of the dental pulp: facts and hypotheses
Published Online: 4 Feb 2010DIMITRIOS TZIAFAS
The aim of the present article is to discuss observations and hypotheses from different experimental approaches on the biological mechanisms underlying initiation of tertiary dentin formation and therapeutic control of pulp–dentinal regeneration. The specific dentinogenic potential of dental pulp cells in up-regulating the biosynthetic activity of primary odontoblasts (reactionary dentinogenesis) and differentiation into odontoblast-like cells (reparative dentinogenesis) is described. The role of biologically active matrices and molecules as signaling factors in the expression of the dentinogenic potential of dental pulp cells, in numerous ex vivo and in vivo models, is reviewed. Data are focused on the mechanisms by which the signaling molecules, in the presence of the appropriate pulp microenvironment and specific mechanical support, can induce competent pulpal cells in the acquisition of odontoblast-like cell phenotype and reparative dentin formation. The ability of tissue engineering to stimulate reconstruction of the amputated pulp–dentin complex offers exciting opportunities for the future. Advances in molecular biology and bioengineering research might thus be integrated into the clinical problems of endodontology.
Received 13 February 2009; accepted 2 September 2009.