Regenerative Dentistry and Dental Tissue Engineering: Contemporary Strategies, Biomaterials, and Clinical Applications

Abstract

Regenerative dentistry represents a paradigm shift in oral healthcare, moving beyond palliative repair towards biologically driven restoration of native dental tissues. Drawing upon principles from developmental biology, materials science, and cell biology, dental tissue engineering seeks to recreate structurally and functionally competent analogues of enamel, dentine, pulp, cementum, and the periodontium. Over the past two decades, remarkable advances in scaffold fabrication, stem cell biology, growth factor delivery, and bioreactor technology have collectively accelerated progress from bench to early clinical translation. Despite this momentum, formidable challenges remain: the intrinsic complexity of tooth architecture, immune-mediated rejection of exogenous cells, poor vascularisation of engineered constructs, and the absence of standardised regulatory pathways. This review critically evaluates contemporary strategies in dental tissue engineering, with particular attention to biomaterial design, cell sourcing, signalling molecule delivery, and clinical feasibility. Scaffold-based and scaffold-free approaches are assessed alongside gene therapy, bioprinting, and cell homing strategies. The translational limitations of current models — including the gap between in vitro findings and in vivo performance — are examined in detail. Key areas of emerging consensus are identified, as are those requiring further experimental scrutiny. Regenerative endodontics, periodontal regeneration, and whole-tooth bioengineering are discussed as distinct yet interconnected domains. This review is intended to serve clinicians, bioengineers, and researchers seeking a rigorous, current synthesis of the field, and to highlight priority directions for future investigation.