Headlines in the news and on social media platforms proclaiming that soon we will be growing new teeth are effective at grabbing your attention. However, while many regenerative therapies are showing promising results in preclinical studies and clinical trials, it’s crucial to understand that some applications are still in the beginning stages of development. This includes whole tooth regeneration. When informing the public about advances in regenerative oral healthcare, it is imperative to provide accurate information with realistic time expectations.
Many of the recent advances in regenerative dentistry have come about because of stem cell research. Why stem cells? Stem cells are a special type of cells that have two important properties. The first is that they are able to self-renew or make more cell like themselves. Second, they are able to become other cells that do different things in a process known as differentiation. Over the years, stem cell research has given us a better understanding of how diseases occur, how to use some types of stem cells to evaluate drugs for safety and quality, and techniques to guide stem cells into becoming specific cells to regenerate and repair tissues that have been damaged or affected by disease. Doctors have performed stem cell transplants, also known as bone marrow transplants, for many decades. Stem cells replace cells damaged by chemotherapy or disease or assist the immune system to fight some types of cancer and blood-related diseases. Leukemia, lymphoma, neuroblastoma, and multiple myeloma are often treated this way.
Because of their unique regenerative abilities and wide range of applications, stem cells became a key focus area in biotechnology. In dentistry, researchers focus primarily on the pulp of wisdom teeth, which contain a rich source of mesenchymal stem cells (MSCs) that have the potential to regenerate various tissues, including bone, dental tissue, and nerve tissue. They also harvest periodontal ligament stem cells, a type of MSC in the perivascular space of the periodontal ligament. These play a crucial role in the regeneration and maintenance of periodontal tissues, alveolar bone, and cementum. As reported in previous columns, knowledge gained in regenerative research has already been incorporated into modern oral healthcare. This includes bioactive restorative materials, platelet-rich plasma, platelet-rich fibrin, guided bone regeneration, guided tissue regeneration, and endodontic revascularization.
Besides whole tooth regeneration, clinical studies are focusing on repairing or regenerating nerve tissues in the oral cavity, restoring function to damaged salivary glands, regenerating bone tissue in the jaw, and transplanting dental pulp stem cells into disinfected necrotic teeth to restore tooth vitality and vertical and horizontal root growth in immature teeth with incomplete root formation and medications to halt degenerative changes in the TMJ and other joints. Many of these studies are being assisted and accelerated by the advances in data collection and international research sharing practices developed during the human genome project. Advances in regenerative healthcare rely on the collaboration of experts from veterinary, oral and general medicine with physicists and bioengineers.
This also requires time, lots of time. From concept to research to machine modeling to clinical trials to human trials…because patient care and safety is not negotiable.
Dr. Stephen Petras
An Illinois Licensed General Dentist