Tissue-engineering strategies, prosthodontic potential and clinical-translation challenges of regenerative teeth

Although traditional oral prosthetic approaches such as dental implants and fixed bridges have been widely applied, they are limited by the absence of proprioception and periodontal ligament–mediated buffering. With advances in regenerative medicine, particularly stem-cell technology and tissue engineering, replacing artificial teeth with "bio-teeth" has become a research hotspot in the field of oral rehabilitation. Based on the three core elements of tissue engineering—seed cells, scaffold materials and growth factors—this review summarizes research progress in three major technical routes: pulp-dentin complex regeneration, bio-root regeneration and whole-tooth regeneration, and analyzes the application potential and existing limitations of each route. On this basis, the core challenges facing the clinical translation of regenerative-tooth technology are discussed, including the bottleneck of vascularization, difficulties in morphological control and the complexity of the oral immune microenvironment. A comparative analysis with current mainstream prosthetic schemes is also conducted to explore potential combined-application strategies in the future. In the short term, regenerative teeth cannot completely replace conventional prosthetic treatments and may instead complement existing approaches such as implant restoration and fixed bridges. Current animal studies and limited early-stage clinical trials indicate that regenerative-tooth technology is expected to drive the transformation of oral rehabilitation from the "artificial substitution" mode to "biological reconstruction". Nevertheless, its mature clinical application still requires sustained interdisciplinary collaborative research.