The Future of Restorative Dentistry

***UPDATED: December 21, 2016*** Scientists working with dental stem cells at Tufts University have recently had an incredible breakthrough. Researchers at Tufts University School of Dental Medicine (TUSDM) have shown that using collagen-based biomaterial to deliver stem cells inside damaged teeth can regenerate tissues that are similar to dental pulp. The team examined the use of gelatin methacrylate (GelMA), a low-cost hydrogel that comes from naturally occurring collagen, as the scaffold to support the growth of new dental pulp tissue. Using dental pulp stem cells from extracted wisdom teeth and encapsulated in GelMA, researchers successful delivered the cells to isolated, previously damaged human tooth roots that had been extracted from patients during unrelated clinical treatment. The roots were then implanted in a rodent animal and allowed to grow for up to eight-weeks. After just two weeks, the scientists observed pulp-like tissue inside the once empty tooth roots, according to a news release from Tufts. After four weeks, cell growth increased and the formation of blood vessels occurred. And at eight-weeks, pulp-like tissue filled the entire dental pulp space, including highly organized blood vessels populated with red blood cells.

“Endodontic treatment, such as a root canal, essentially kills a once living tooth. It dries out over time, becomes brittle and can crack, and eventually might have to be replaced with a prosthesis,” said senior study author and professor at TUSDM, Pamela Yelick. “OUr findings validate the potential of an alternative approach to endodontic treatment, with the goal of regenerating a damaged tooth so that it remains living and functions like any other normal too.”

Original story:

Tooth loss as an adult can be both painful and embarrassing, and for many, filling the gap can’t happen fast enough. Traditionally, the best replacement options have included man made dentures or implants, but as modern medicine continues to push conventional boundaries, alternative solutions are becoming more possible. For example, a researcher at Tufts School of Dental Medicine has been working with dental stem cells to grow new teeth and jawbone, and the implications are very exciting.

According to a recent article from Tufts Dental Medicine, a team of researchers, led by professor of orthodontics and director of the division of craniofacial and molecular genetics, Pam Yelick, is developing a way to turn dental stem cells into healthy new teeth and bone. The work involves a process where stem cells are harvested from healthy adult tooth pulp. Scientists then isolate the cells in the lab before “coaxing them” to form new tooth buds, which are very small clusters of soft tissue that will grow into a mature tooth. Their work is truly revolutionary, and the potential use in restorative dentistry is astronomical.

Working with tooth buds is extremely complex, said Yelick, because they only form in embryonic conditions, when bone, tooth, soft palate and gums are beginning to form. But the use of stem cells offers a much better solution to tooth replacement than dentures or implants, which Yelick says “create a totally artificial situation.” Some patients find dentures uncomfortable, and dental implants, while the best available option at this time,  can cause gradual bone loss.

“If you could instead implant living, vascularized tooth in the jaw, that could be a much better option,” Yelick claimed.

While the future for dental stem cells is bright, developing the best method to grow tooth bud tissue has been problematic. The exact combination of nutrients and growth hormones are necessary at precisely the right time, making the process extremely challenging. Yelick’s team is currently working on creating a “scaffold,” or biological environment similar to that which form in an embryo, and while their work looks promising, there’s still much to be done. In order for the cells to grow, the scaffold has to have the exact same shape and elasticity of real embryonic tissue. The scientists are testing a variety of materials, including polyester and silk, to find the best configuration, but the work is time consuming. In the last several years, Yelick and her team have found success in developing tooth buds and implanting them in pig jaws, with early-stage adult teeth developing in about five months. While this is certainly encouraging, Yelick was quick to point out that the use of dental stem cells in humans is still years away.

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