“We’ll just grow you a new one.” That’s the sentence your dentist will say instead of the one you’re bracing for. No “you’ll need a dental implant.” No lecture on procedures. Just like that, a new, authentic tooth.
No dentist says this today, but that end goal is closer than it sounds.
Regenerative medicine already replaces damaged tissue using a patient’s own cells. MACI, an FDA-approved therapy, repairs torn knee cartilage this way: Pull healthy cells from the patient, grow more of them in a lab, put them back, let biology handle the rest. Researchers now want to know if the same idea works on an entire tooth.
Fillings, crowns, root canals, implants. These options restore a patient’s functional abilities well.
However, a dental implant with a bone graft does not fully reestablish sensations of a real tooth. Dental implants do not heal, remodel, or respond to the forces around it because there are nerves, ligaments, and living relationships with the bone holding it in place.
If we were to regenerate the tooth instead of replacing it, that changes everything in the field of dentistry.
MACI, a Potential Regenerative Platform for Dentistry
MACI comes from Vericel, a biotech company that’s spent over a decade focused specifically on cell-based tissue repair. It treats damaged knee cartilage using the patient’s own chondrocytes, the cells that maintain cartilage. Surgeons harvest healthy chondrocytes, expand them in a lab, and seed them onto a collagen scaffold. That scaffold goes into the damaged tissue site, and the chondrocytes mature and rebuild the tissue from there (3, 4).
(4) Figure 1
Figure 2 (6)
The most exciting part is that this workflow translates.
Same Workflow, Different Organ
| Cartilage regeneration | Tooth regeneration |
|---|---|
| Healthy cartilage biopsy | Dental pulp stem cells |
| Chondrocytes | DPSCs / SCAP / SHED |
| Collagen membrane | Tooth-shaped scaffold |
| Implant site | Extraction socket |
| Cartilage repair | Living tooth |
Researchers are already working on nearly every row on the right. One review sums it up plainly: “Tooth regeneration becomes possible with the right stem cells, the right scaffold, and the right bioactive signaling to push those cells toward becoming a tooth and nothing else” (1).
Building a Living Tooth
If we were to apply the MACI blueprint to tooth regeneration here’s a rough idea of how it could happen.
Harvest stem cells first. Dental pulp stem cells, or DPSCs, live in the soft tissue at the center of a tooth. They’re renewable, and unlike embryonic stem cells, they don’t come loaded with ethical baggage.
Expand them next. A handful of cells can’t build a tooth any more than three contractors can build a house. You need enough workers on site before anything gets built.
Design a custom scaffold. A CBCT scan maps the exact shape of the missing tooth. AI-assisted design and 3D printing could eventually turn that scan into a scaffold built for the patient’s own mouth. That part still lives more in the future than the present.
Figure 3 (5)
Teach the cells what to become. Stem cells have no idea they’re supposed to build a tooth. Signaling molecules like BMP, FGF, and Shh tell them what to do and where. Not like “growth factors.” Think GPS instructions: enamel here, dentin there, nerve tissue somewhere else.
Grow blood vessels. No blood supply, no oxygen. No oxygen, no tooth. Vascularization has to happen inside the scaffold, or the tissue dies before it gets the chance to mature.
Implant it. The scaffold disappears once it’s done its job. What stays behind isn’t a prosthetic. It’s living tissue built from the patient’s own cells.
Two Different Kinds of Hard
Cartilage barely has a blood supply. That’s why it doesn’t heal well on its own, and why MACI exists in the first place. Doctors step in because the tissue can’t really fix itself.
Teeth have plenty of blood supply. The problem here is the complex structure of the tooth Enamel, dentin, pulp, blood vessels, nerves, periodontal ligament, root, cementum, and a bone connection that has to survive the force of a bite. Nine different tissues, nine different embryonic origins, all of them needing to grow together in the right order.
So it’s not that one is harder than the other. Cartilage regeneration is a battle due to a lack of resources. On the other hand, tooth regeneration is a fight due to a lack of coordination amongst all the tissue types
Where the Research Actually Stands
Some of this is real. Some of it is still aspiration.
Already demonstrated: Isolating and culturing dental stem cells, partial pulp regeneration, periodontal regeneration, tooth bud engineering in animal models, biodegradable scaffolds suited to oral tissue, growth-factor delivery systems that guide how cells differentiate (1, 2).
Not yet possible: Routine whole-tooth regeneration in humans, enamel regeneration after a tooth has erupted, predictable control over the size and shape of a regenerated tooth, a fully vascularized and innervated replacement tooth that functions like the original.
That second list is where the field spends most of its time right now.
Looking into the future…
Picture the appointment. A patient gets a CBCT scan. A clinician pulls a small sample of dental pulp stem cells, same visit, no separate surgery. Software designs a scaffold matched to the exact geometry of the missing tooth. A bioprinter builds it layer by layer, loaded with the growth factors that tell the cells what to become. The scaffold goes into the socket.
Months pass. Regeneration is slow, biological, and mostly invisible.
Then there’s a tooth where the gap used to be. Rooted. Alive. Part of the patient again.
Dentistry has always been about replacing what disease destroys. Regenerative dentistry asks a different question: Instead of replacing a missing tooth, help the body grow another one.
Now more than ever, science isn’t asking if we can regrow a tooth. It’s asking how.
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References
- Hazrati P, Mirtaleb MH, Boroojeni HSH, Koma AAY, Nokhbatolfoghahaei H. Current Trends, Advances, and Challenges of Tissue Engineering-Based Approaches of Tooth Regeneration: A Review of the Literature. Curr Stem Cell Res Ther. 2024;19(4):473-496. doi: 10.2174/1574888X17666220818103228. PMID: 35984017.
- Zhang W, Yelick PC. Tooth Repair and Regeneration: Potential of Dental Stem Cells. Trends Mol Med. 2021 May;27(5):501-511. doi: 10.1016/j.molmed.2021.02.005. Epub 2021 Mar 26. PMID: 33781688; PMCID: PMC9907435.
- MACI Implant. The science behind MACI: unlocking the potential of your patient’s own cells. YouTube. Published October 18, 2019. Accessed July 10, 2026. https://www.youtube.com/watch?v=4saIEjRwFbE.
- Jacobi M, Villa V, Magnussen RA, Neyret P. MACI – a new era? Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology. 2011;3(1):10. doi:10.1186/1758-2555-3-10.
- DataM Intelligence 4 Market Research LLP. (2026). United States tooth regeneration market to reach USD 1,978.05 million by 2033, driven by stem cell therapy and tissue engineering innovations. OpenPR.
- Smith, B. D., & Grande, D. A. (2015). The current state of scaffolds for musculoskeletal regenerative applications. Nature Reviews Rheumatology, 11, 213–222. https://doi.org/10.1038/nrrheum.2015.27
- xAI. (2026). AI-generated illustration of tooth regeneration comparing a natural tooth and dental implant within the jaw [AI-generated image]. Grok.
