Meeting the challenges and clinical requirements for dental regeneration; the New Zealand experience

Disease and trauma leading to tooth loss and destruction of supporting bone is a significant oral handicap, which may be addressed through surgical therapies that aim to regenerate the lost tissue. Whilst complete regeneration of teeth is still aspirational, regeneration of supporting structures (dental pulp, cementum, periodontal ligament, bone) is becoming commonplace, both for teeth and for titanium dental implants that are used to replace teeth. Most grafting materials are essentially passive, however the next generation of oral regenerative devices will combine non-antibiotic antimicrobials and/or osteogenic or inductive factors and/or appropriate multipotential stem cells. The review gives an overview of the approaches taken, including fabrication of novel scaffolds, incorporation of growth factors and cell-based therapies, and discusses the preclinical animal models we employ in the development pathway. [Display omitted] •Regenerative therapies commonly used for oral disease and trauma•Most regenerative approaches employ grafting with passive scaffolds•Development needs expertise in biomaterials, cell culture and pre-clinical models•Active scaffolds combine novel non-antibiotic anti-microbials and bioactives•3-D printing of active scaffolds is challenging but holds promise•Various oral stem-cell reservoirs may be utilised