Will dentists soon be able to regenerate teeth?

Earning a dental assistant degree is a great way to help keep people smiling for the long haul. After all, dentistry is partially the art of preservation, a way of maintaining our teeth from the daily perils of food and drink, as well as unforeseen blows to the mouth. When an adult loses a tooth, dentists have a variety of options to minimize pain, preserve functionality and keep the patient’s smile looking its very best. This has traditionally been done with veneers, dental implants or full on dentures, but new research is finding it might be possible to regenerate a lost tooth, or at the very least, integrate implants with increased permanency.

The case of alligators

Humans lose their baby teeth, or milk teeth, at a young age, which are then replaced with adult teeth. But after permanent teeth are in place adults lose the ability for tooth renewal.Alligators, on the other hand, despite having similarly structured teeth to humans, have the lifelong ability to regenerate lost teeth. Regenerative biology in alligators, along with other animals, including an array of reptiles, fish and mammals, provided the grounds for a study conducted by the Department of Pathology at the University of Southern California, Los Angeles.

The goal of the study was to “identify stem cells that can be used as a resource for episodic tooth renewal.”Considering the wear and tear our teeth take throughout a lifetime, discovering a means of regenerating new teeth periodically would be an enormous advancement in the field of dentistry. Understanding what signals an alligator to generate a new tooth might be the key to finding a similar signal in humans. Adult teeth that have decayed over years of food consumption and environmental impact could potentially be replaced, giving adults healthier teeth into old age. For future workers in the dental profession, this could eventually mean developing new procedures for generating new teeth in humans who have lost permanent teeth. It could also mean developing new ways of surgically rooting dental implants. However, the process of generating new teeth relies on finding a method of keeping stem cells cyclically active.3

Regenerating teeth in humans

Another study conducted by a collaboration of labs in China found tooth-like structures can be generated by stem cells found in human urine, called induced pluripotent stem cells.4 Potentially,  dental tissues could be regenerated with specific stem cells provided by an individual patient. Although adult stem cells have been effectively used in tissue engineering, researchers are still working out the kinks to make generating patient-specific teeth a clinical reality.5 This particular study concluded that stem cells from human urine possess enamel and properties found in human teeth that could be used as a tool in the future of regenerative therapy.6

One of the ongoing challenges for dental surgery and regenerative therapy is providing long-term structural integrity. Surgical adjustments can be chronic and costly, and learning more about regenerative biology could possibly not only lead to generating new teeth, but making existing dental implants stronger. Conditions such as aseptic loosening cause joint replacements and dental implants to need additional treatment multiple times, a burden on both the patient and the doctor.7 Generating dental tissue can make implants more permanent fixtures that coalesce naturally with the human mouth. Therefore, tissue engineering can assist in integrating tooth implants with natural tissue.8

The future of dentistry benefits from these studies because it helps encourage the longevity of human teeth. Dental hygienists and assistants could eventually be seeing new teeth in adults of all ages.

1“Specialized stem cell niche enables repetitive renewal of alligator teeth” Ping Wua, Xiaoshan Wua,b, Ting-Xin Jianga, Ruth M. Elseyc, Bradley L. Templed, Stephen J. Diverse, Travis C. Glennd, Kuo Yuanf, Min-Huey Cheng,h, Randall B. Widelitza, and Cheng-Ming Chuong. Proceedings of the National Academy of the Sciences of the United States of America. July 31, 2012.  http://www.pnas.org/content/early/2013/05/08/1213202110.full.pdf+html

2“Specialized stem cell niche enables repetitive renewal of alligator teeth” Ping Wua, Xiaoshan Wua,b, Ting-Xin Jianga, Ruth M. Elseyc, Bradley L. Templed, Stephen J. Diverse, Travis C. Glennd, Kuo Yuanf, Min-Huey Cheng,h, Randall B. Widelitza, and Cheng-Ming Chuong. Proceedings of the National Academy of the Sciences of the United States of America. July 31, 2012. http://www.pnas.org/content/early/2013/05/08/1213202110.full.pdf+html

3“Specialized stem cell niche enables repetitive renewal of alligator teeth” Ping Wua, Xiaoshan Wua,b, Ting-Xin Jianga, Ruth M. Elseyc, Bradley L. Templed, Stephen J. Diverse, Travis C. Glennd, Kuo Yuanf, Min-Huey Cheng,h, Randall B. Widelitza, and Cheng-Ming Chuong. Proceedings of the National Academy of the Sciences of the United States of America. July 31, 2012. http://www.pnas.org/content/early/2013/05/08/1213202110.full.pdf+html

4“Generation of tooth-like structures from integration-free human urine induced pluripotent stem cells” Jinglei Cai1, Yanmei Zhang1, Pengfei Liu12, Shubin Chen1, Xuan Wu12, Yuhua Sun3, Ang Li4, Ke Huang1, Rongping Luo1, Lihui Wang1, Ying Liu15, Ting Zhou1, Shicheng Wei36, Guangjin Pan1 and Duanqing Pei. Cell Regeneration Journal. July 30, 2013. http://www.cellregenerationjournal.com/content/2/1/6

5“Generation of tooth-like structures from integration-free human urine induced pluripotent stem cells” Jinglei Cai1, Yanmei Zhang1, Pengfei Liu12, Shubin Chen1, Xuan Wu12, Yuhua Sun3, Ang Li4, Ke Huang1, Rongping Luo1, Lihui Wang1, Ying Liu15, Ting Zhou1, Shicheng Wei36, Guangjin Pan1 and Duanqing Pei. Cell Regeneration Journal. July 30, 2013.  http://www.cellregenerationjournal.com/content/2/1/6

6“Generation of tooth-like structures from integration-free human urine induced pluripotent stem cells” Jinglei Cai1, Yanmei Zhang1, Pengfei Liu12, Shubin Chen1, Xuan Wu12, Yuhua Sun3, Ang Li4, Ke Huang1, Rongping Luo1, Lihui Wang1, Ying Liu15, Ting Zhou1, Shicheng Wei36, Guangjin Pan1 and Duanqing Pei. Cell Regeneration Journal. July 30, 2013. http://www.cellregenerationjournal.com/content/2/1/6

7“Surface-mediated bone tissue morphogenesis from tunable nanolayered implant coatings” Nisarg J. Shah,1,2 Md. Nasim Hyder,1,2 Joshua S. Moskowitz,1 Mohiuddin A. Quadir,1,2 Stephen W. Morton,1,2 Howard J. Seeherman,3 Robert F. Padera,4,5 Myron Spector,4,6,7 and Paula T. Hammond. Science Translation Med. April 28, 2014.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001255/

8“Surface-mediated bone tissue morphogenesis from tunable nanolayered implant coatings” Nisarg J. Shah,1,2 Md. Nasim Hyder,1,2 Joshua S. Moskowitz,1 Mohiuddin A. Quadir,1,2 Stephen W. Morton,1,2 Howard J. Seeherman,3 Robert F. Padera,4,5 Myron Spector,4,6,7 and Paula T. Hammond. Science Translation Med. April 28, 2014.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001255/

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