Tooth root development involves intricate spatiotemporal cellular dynamics and molecular regulation. The initiation of Hertwig’s epithelial root sheath (HERS) induces odontoblast differentiation and the subsequent radicular dentin deposition. Precisely controlled signaling pathways modulate the behaviors of HERS and the fates of dental mesenchymal stem cells (DMSCs). Disruptions in these pathways lead to defects in root development, such as shortened roots and furcation abnormalities. Advances in dental stem cells, biomaterials, and bioprinting show immense promise for bioengineered tooth root regeneration. However, replicating the developmental intricacies of odontogenesis has not been resolved in clinical treatment and remains a major challenge in this field. Ongoing research focusing on the mechanisms of root development, advanced biomaterials, and manufacturing techniques will enable next-generation biological root regeneration that restores the physiological structure and function of the tooth root. This review summarizes recent discoveries in the underlying mechanisms governing root ontogeny and discusses some recent key findings in developing of new biologically based dental therapies.

牙根发育涉及复杂的时空细胞动力学和分子调节。赫特维希上皮根鞘 (HERS) 的起始诱导成牙本质细胞分化和随后的根性牙本质沉积。精确控制的信号通路可调节 HERS 的行为和牙科间充质干细胞 (DMSC) 的命运。这些途径的破坏会导致根发育缺陷，例如根缩短和分叉异常。牙科干细胞、生物材料和生物打印的进步显示出生物工程牙根再生的巨大前景。然而，复制牙发生的发育复杂性在临床治疗中尚未得到解决，仍然是该领域的主要挑战。正在进行的研究重点是牙根发育机制、先进生物材料和制造技术，这将使下一代生物牙根再生成为可能，从而恢复牙根的生理结构和功能。这篇综述总结了控制牙根个体发育的潜在机制的最新发现，并讨论了开发新的基于生物学的牙科疗法的一些最新关键发现。