Gene-enhanced tissue engineering for dental hard tissue regeneration: (2) dentin-pulp and periodontal regeneration

Part 1 reviewed the principals of gene-enhanced tissue engineering and the techniques of introducing DNA into cells. This manuscript will review recent advances in gene-based therapies for dental hard tissue regeneration, specifically as it pertains to dentin regeneration/pulp capping and periodontal regeneration.The goal of gene-enhanced tissue engineering is to regenerate lost tissue by the local delivery of cells that have been genetically-enhanced to deliver physiologic levels of specific growth factors. The basis for this approach lies in the presence of a population of progenitor cells that can be induced, under the influence of these growth factors, to differentiate into the specific cells required for tissue regeneration, with guidance from local cues in the wound environment [1].From a tissue engineering approach, the oral cavity has significant advantages compared to other sites in the body, including easy access and observability. Potential applications for gene-based tissue engineering therapies in the oral and maxillofacial complex include the delivery of growth factors for periodontal regeneration, pulp capping/dentin regeneration, treatment of malignant neoplasms of the head and neck [2], regeneration for bone grafting of large osseous defects in dental and craniofacial reconstruction (e.g. bone augmentation prior to prosthetic reconstruction, fracture repair, and repair of facial bone defects secondary to trauma, tumor resection, or congenital deformities), and articular cartilage repair [3,4].This manuscript will review recent advances in gene-based therapies for dental hard tissue regeneration, specifically as it pertains to dentin regeneration/pulp capping and periodontal regeneration.The goal of modern restorative dentistry is to functionally and cosmetically restore lost tooth structure. Destroyed coronal tooth structure, most commonly resulting from dental caries, is currently restored using metal or polymer-based materials; primarily silver am