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Science hopes to cure bad teeth with regenerative biomaterials

August 1, 2016

Many of us are reluctant to go to the dentist even as grownups – as irrational as it might seem, the fear of the dental surgeon still lurks on the back of our minds.

Although dental treatment has progressed in time and managed to integrate revolutionary techniques once they were commercially available, there are some unpleasant procedures that patients nowadays share with those from generations preceding them.

Getting a root canal basically maintained its structure, procedural steps and triggers: once there are no other less-intrusive solutions that can be applied to the damaged tooth, the dentist has to remove the infected tissue, clean the tooth and put in the fillings. It is a meticulous job for the dentist and a stressful one for the patient, even when the pain is taken out of the entire process.

Recently a joint team of researchers from the University of Nottingham and the Wyss Institute at Harvard University presented their work on regenerative tooth filling via a specially developed biomaterial – and won the Royal Society of Chemistry’s Emerging Technologies Competition 2016’s second prize, consisting of “tailored business support from multinational partner companies, business training, media support, and a cash prize of £3,000”

This subject has been approached before, but this time the future of dentistry feels closer, since these synthetic biomaterials allow an “effective and practical approach” towards tooth tissue regeneration.

The race for regenerative biomaterials in dentistry

As we mentioned above, there are more than a few attempts to obtain the perfect bioengineering product that would turn invasive dentistry interventions into less intrusive, less toxic procedures that would build on the healthy tissue and help reconstructing it in the place of old, affected parts.

Nanoparticles could act as re-generators, preventing root canals and fillings, in a more sustainable process than the current one. Antibacterial nanoparticles target infections and prevent their spreading or re-appearance, while reconstructive nanoparticles should determine the re-growth of the healthy tooth. This approach belongs to the researchers in bioengineering from the University of Illinois at Chicago.

The above-mentioned regrowth solution coming from the University of Nottingham and the Wyss Institute at Harvard University involves stem cells incorporated into an innovative biomaterial, so that the damaged teeth get stimulated to rebuild themselves at a micro level.

The subdomain dealing with these possible approaches is called regenerative dentistry, as opposed to restorative dentistry. Columbia University is another research center that features its own Tissue Engineering and Regenerative Medicine Laboratory – you can see here an interview with Dr. Jeremy Mao on the role of stem cells, the regenerative dentistry awareness and the potential dentist role shape-shifting towards doctors becoming gateways to “wide variety of regenerative therapies.

There are a lot of professionals and patients who put their hopes into seeing these breakthroughs materialized. Of course, on the other hand, many professionals (and even patients) are reluctant when contemplating the idea of such methods taking the place of the usual procedures – some because they cannot wrap their mind around futuristic technologies, others because they feel threatened by an eventual fall into obsolescence once the new techniques would gain ground. The different cost distribution scheme involved in tooth regrowth and the potentially reduced number of sessions for this type of procedure would require a different schedule and a different type of dentist-patient interaction.

On the other hand, the regeneration appointments could in fact resemble the current dental appointments in terms of number and frequency, or the costs might be easily spread over a large number of sessions – making the new treatment methods as accessible as the traditional ones, or at least allowing tailored insurance coverage programs.

Dental stem cells

The DPSCs or dental pulp stem cells are different from the previously mentioned bioengineered materials that contain stem cells by the fact they are actually harvested from healthy teeth, and preserved for future healthcare use. Dental stem cells can be used in treating non-dental issues; they are deemed as easier to harvest, bank and preserve than natural stem cells coming from other sources. Theoretically, nothing impedes such healthy teeth stem cells from being further used in bioengineered materials that would determine damaged teeth regeneration, so there is a link to our main topic. However, the notions are distinct: regenerative dentistry stem cells are not necessarily the same as DPSCs.

Dental stem cells harvesting is currently a major concern also for various researcher teams across the world, from China to India, but there are a few facts worth noticing, such as the fact that in order for the viable stem cells to be harvested the healthy, blood irrigated tooth must be first extracted – as it results from this overview of regenerative dentistry here. The listed applications in dentistry are “regeneration of damaged dentin, pulp, resorbed root, periodontal regeneration and repair perforations”, while broader applications count heart therapies, regenerating brain tissue, muscular dystrophy therapies or bone regeneration.

Since cell stem research received investments and encouragements from the Obama administration, and also got an important place among the U.S. Army’s research programs via the Armed Forces Institute for Regenerative Medicine and its regenerative dentistry projects, it is possible for this generation of active dentists to witness an accelerated rhythm of research, as well as revolutionary breakthroughs.