WHY DENTAL REGENERATION VERSUS REPAIR?
Tooth loss is a well-recognized global health problem impacting society and the economy . It affects one’s individual capacity for eating, smiling, speaking, and psychosocial wellbeing [2, 3].
The challenge of tooth-loss is closely related to the capacity of the clinician to provide patients with esthetic and functional dental solutions efficiently. The options are either to replace the tooth with an artificial solution (“repair”) such as an implant system or preserve the tooth using reparative or by nature foreseen regenerative methods.
At REGEDENT AG, we focus on smart regenerative protocols that can be used in periodontal and peri-implant situations to deliver optimal biomechanical properties, esthetic results while offering long-term reliability. The spectrum of our solutions focuses on soft- as well as hard-tissue regeneration.
HOW DO YOU REGENERATE DENTAL TISSUES?
A significant clinical challenge is to achieve functional integration of different soft and hard tissue components, such as bone, ligaments, or cementum with one another and with the host environment to provide a predictable long-term survival of the tooth or the artificial substitute .
When treating patients with a lack of soft and/or hard tissue, the fundamental concept is to combine a scaffold with biologically active molecules that form a “tissue-engineering construct.” In the presence of adequate blood supply, this construct promotes the regeneration of tissues . The regenerative process leverages biology-based procedures to replace artificially placed material with autologous material during the different phases of the wound healing process . As such, the scaffold is expected to perform various functions, including the support of cell colonization, migration, growth, and differentiation.
A critical consideration is the requirement to facilitate timely revascularization of the tissue-engineered construct following implantation in vivo. The design of the scaffold also needs to consider physicochemical properties, morphology, and degradation kinetics .
In periodontology, the regenerative procedure focuses on functional biomimicry, especially in terms of addressing the key interface between the periodontal ligament and the tooth root, whereby the formation of cementum with the insertion of functional periodontal ligament fibers is essential. Additional requirements are the provision of space for bone regeneration and the prevention of epithelial downgrowth along the root surface . To accelerate the healing process the scaffold material can be combined with bioactive molecules, such as surgical-grade hyaluronic acid.
Scientific literature & clinical studies
- Righolt AJ, Jevdjevic M, MarcenesW, Listl S. Global-, regional-, and country-level economic impacts of dental diseases in 2015. J Dent Res. 2018;97(5):501–7. https://doi.org/10.1177/0022034517750572.
- Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93(7):20–8. https://doi. org/10.1177/0022034514537828.
- Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–7. https://doi.org/10.1177/0022034517693566.
- Ivanovski S, Vaquette C, Gronthos S, Hutmacher DW, Bartold PM. Multiphasic scaffolds for periodontal tissue engineering. Journal of Dental Research. 2014 Dec;93(12):1212-1221. DOI: 10.1177/0022034514544301.
- Bartold PM, Xiao Y, Lyngstaadas SP, Paine ML, Snead ML. (2006). Principles and applications of cell delivery systems for periodontal regeneration. Periodontol 2000 41: 123-135
- Hargreaves, Kenneth M; Cohen, Stephen, eds. (2011). Pathways of the Pulp 10th Edition. St. Louis, Missouri, US: Mosby Elsevier. p. 602. ISBN 978-0-323-06489-7.