By Emma Yasinski
Recent advances in regenerative dentistry have engendered a great deal of excitement among clinicians and academics when it comes to the prospects of re-growing living replacement dental tissues and whole teeth.
But as the Journal of Dentistry recently noted in an article as part of a yearlong commemorative series on dental advances, the roots of today’s regenerative dentistry advances are planted in the distant past and the established field of translational dentistry.
“This exciting era in regenerative dentistry, particularly for whole-tooth tissue engineering, builds on many key successes over the past one hundred years that have contributed to our current knowledge and understanding of signaling pathways directing natural tooth and dental tissue development,” write authors Pamela C. Yelick, PhD. and Paul T. Sharpe, PhD. These past successes, they add, are “the foundation for current strategies” and the future of dental treatments.
Dr. Yelick is a professor in the department of orthodontics at Tufts School of Dental Medicine and is an internationally recognized leader in dental tissue engineering and craniofacial development, with more than 80 peer-reviewed basic research publications, more than a dozen reviews, and over 200 abstracts since the year 2000.
Dr. Sharpe is the head of the Centre for Craniofacial & Regenerative Biology at King’s College of London and has published over 300 research papers, including articles in Nature, Science, PNAS and Cell press.
"We anticipate that continued advances in the fields of dental tissue engineering and regenerative dental medicine will facilitate the development of improved dental repair therapies, including whole tooth tissue engineering," Drs. Yelick and Sharpe noted in a news release.
While describing how the process of regenerative dentistry has evolved, Drs. Yelick and Sharpe write that researchers in the lab are bringing us tantalizingly close to reliable technologies to regenerate teeth so that we could replace damaged teeth with real, living teeth made up of dentin, nerves, and blood vessels, rather than metal or plastic replacements.
Scientists have made significant breakthroughs in understanding the molecular signaling between cells that tell them to grow into the types of cells found in teeth. They’ve been able to replicate this signaling in Petri dishes, but have not yet been able to make it continue for more than two days. To build full teeth, researchers will need to keep the signaling active longer. (Some groups have had success using cells from adult teeth implanted on scaffolds in the mouths of mini pigs.)
Researchers also need to figure out how to make regenerated teeth take the shape and size that match the rest of an individual’s teeth. One popular idea is harnessing the power of 3D printing, which would allow scientists to use a computer-aided design (CAD) program to help produce the exact required tooth.
For those working on 3D printing as well as other strategies, other challenges remain. They’ll need to find ways to get blood flow through the teeth, as vasculature is extremely difficult to create. They’ll need to create ideal scaffolds that precisely mimic the natural scaffolding of their patients’ tissues. One of the biggest challenges will be ensuring the new teeth are properly integrated into their patients’ mouths.
Dr. Sharpe is optimistic, noting in the press release, “At the present time, the overall concept of tooth bioengineering has been proven in principle. Combinations of adult and embryonic cells from mice and humans have been shown to form tooth primordia in vitro. Surgical transplantation of these constructs into the mouth was shown to provide a suitable environment for their development into fully functional, erupted teeth."
Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.