Vitality of the dentin-pulp complex in health and disease: growth factors as key mediators.

The vitality of the dentin-pulp complex, both during tissue homeostasis and after injury, is dependent on pulp cell activity and the signalling processes, which regulate the behavior of these cells. Research, particularly over the last ten to fifteen years, has led to a better understanding of the molecular control of cellular behavior. Growth factors play a pivotal role in signalling the events of tissue formation and repair in the dentin-pulp complex. Sequestration of growth factors in the dentin matrix during tissue formation provides a pool of these molecules, which may be released during injury and contribute to signalling of reparative events. Therapeutic intervention with recombinant growth factors also provides possibilities for control of cell activity during repair. Harnessing both endogenous and exogenous sources of growth factors can provide exciting opportunities for novel biological approaches to dental tissue repair and the blueprint for tissue engineering of the tooth. These approaches offer significant potential for improved clinical management of dental disease and maintenance of tooth vitality.