ABSTRACT
The proper size, shape, color, and alignment of teeth influences the nature of our smile and determines our uniqueness as individual humans. In addition to their esthetic value, teeth are important for the mastication of food and for proper speech. Despite these critical functions, the importance and uniqueness of teeth are frequently overlooked by health professionals. The loss of dentition to common diseases like caries, periodontal disease and to trauma imposes significant emotional and financial burdens on patients and their families. Despite the overall success of osseo-integrated titanium implants, tooth forms that are bioengineered from natural tissues/cells represent the next wave of dental regenerative medicine. The calcified tooth matrices of enamel, dentin, and cementum each possesses unique biomechanical, structural and biochemical properties. When consideration is given to the bioengineering of whole tooth forms, several challenges exist that relate to the restoration of specific shapes and sizes as well as the (re)generation of these highly specialized mineralized matrices. In order to provide an appreciation for the complexity of the tooth as a whole, this chapter first discusses the components of a mature tooth and its surrounding structures. Next, the basic principles of tooth development that lend the molecular and genetic bases for modern bioengineering strategies is presented. Important contributions from mouse and human genetic studies is also briefly overviewed. Finally, recent data from successful tooth engineering initiatives involving somatic and stem cell approaches along with whole tooth organ strategies is discussed. In projecting future research directions, this chapter concludes with a brief discussion of the challenges and opportunities that exist for bioengineering one of the most complex of all vertebrate organ systems.
