Title : Cementum regeneration: How far have we come?
Abstract:
Gingivitis is a prevalent disease which is characterized by swollen and bleeding gums [5]. If left untreated, it can lead to the destruction of the supporting framework of the tooth called the bone-periodontal ligament-cementum complex or periodontal complex [6]. Inflammation of this complex is called periodontitis which if not halted results in lose or lost teeth [6]. Regeneration of periodontium lost as a result of periodontitis is essential to prevent tooth loss. The complexity of the PDL apparatus makes its complete and functional regeneration challenging to achieve [3]. The transplantation of periodontal ligament stem cells into the periodontal defect has been shown to form periodontal ligament fibers similar to the natural periodontal ligament fibers without any adverse effects [100-102]. Alveolar bone regeneration has been successfully stimulated using different bone grafts and biomaterials [104,105]. Cementum is the least understood of all the structures in the periodontal complex [6]. Its regeneration, therefore, is a challenge. This review aims at analyzing how far have we been able to understand cementum or cementogenesis to be able to regenerate or engineer it. For the successful regeneration of cementum, the important factors which are prerequisites to understanding its multifactorial nature should be taken into account. Cementoblastic progenitor selection and the possibility of involvement of specific integrins and signalling events in their recruitment have since created an enigma about the mechanism of cementogenesis [16,18,19]. Here we are going to explore how far we have come in understanding these enigmatic factors in the light of recent research in the field. This review also explores the role of stem cells and scaffolds in cementum tissue engineering.
