Mechanisms controlling secondary initiation of dentinogenesis: a review

Dentinogenesis can be initiated secondarily as an intrinsic ability of the dental pulp to repair, or after interaction of pulp cells with specific exogenous inductive factors. In the present article the basic developmental aspects, highlighting the mechanism by which dentinogenesis is initiated during tooth development, are discussed. Furthermore, clinical and experimental observations concerning the events taking place during secondary initiation of dentine formation, as part of exposed or non-exposed pulp tissue repair, or as a result of dentine matrix or other chemical-pulp cell interactions, are reviewed. Discussion includes hypotheses relating to the crucial biological steps leading to expression of odontoblastic-like cell phenotype and secondary initiation of dentine histogenesis.