Tooth regeneration is a stem cell based regenerative medicine procedure in the field of tissue engineering and stem cell biology to replace damaged or lost teeth by regrowing them from autologous stem cells. [1]
As a source of the new bioengineered teeth, somatic stem cells are collected and reprogrammed to induced pluripotent stem cells which can be placed in the dental lamina directly or placed in a reabsorbable biopolymer [2] in the shape of the new tooth. [3]
Young et al first demonstrated in 2002 that teeth could be regenerated from cells. [4]
The first clinical trial on tooth started in 2023 in Japan, for a medicine stimulating tooth regrowth by inhibition of USAG-1. [5] [6] [7]
The majority of stem cell studies have stopped at the stage of animal studies and have not proceeded to clinical trials due to numerous safety and ethical concerns. The potential risks of undesired tissue formation, tumourigenesis, and metastasis has not yet been resolved. [8]
A dental implant is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic is attached to the implant or an abutment is placed which will hold a dental prosthetic or crown.
The pulp is the connective tissue, nerves, blood vessels, and odontoblasts that comprise the innermost layer of a tooth. The pulp's activity and signalling processes regulate its behaviour.
Ameloblasts are cells present only during tooth development that deposit tooth enamel, which is the hard outermost layer of the tooth forming the surface of the crown.
The periodontal ligament, commonly abbreviated as the PDL, are a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which they sit. It inserts into root cementum on one side and onto alveolar bone on the other.
The enamel organ, also known as the dental organ, is a cellular aggregation seen in a developing tooth and it lies above the dental papilla. The enamel organ which is differentiated from the primitive oral epithelium lining the stomodeum. The enamel organ is responsible for the formation of enamel, initiation of dentine formation, establishment of the shape of a tooth's crown, and establishment of the dentoenamel junction.
The dental lamina is a band of epithelial tissue seen in histologic sections of a developing tooth. The dental lamina is first evidence of tooth development and begins at the sixth week in utero or three weeks after the rupture of the buccopharyngeal membrane. It is formed when cells of the oral ectoderm proliferate faster than cells of other areas. Best described as an in-growth of oral ectoderm, the dental lamina is frequently distinguished from the vestibular lamina, which develops concurrently. This dividing tissue is surrounded by and, some would argue, stimulated by ectomesenchymal growth. When it is present, the dental lamina connects the developing tooth bud to the epithelium of the oral cavity. Eventually, the dental lamina disintegrates into small clusters of epithelium and is resorbed. In situations when the clusters are not resorbed, eruption cysts are formed over the developing tooth and delay its eruption into the oral cavity. This invagination of ectodermal tissues is the progenitor to the later ameloblasts and enamel while the ectomesenchyme is responsible for the dental papilla and later odontoblasts.
Regenerative medicine deals with the "process of replacing, engineering or regenerating human or animal cells, tissues or organs to restore or establish normal function". This field holds the promise of engineering damaged tissues and organs by stimulating the body's own repair mechanisms to functionally heal previously irreparable tissues or organs.
The dental follicle, also known as dental sac, is made up of mesenchymal cells and fibres surrounding the enamel organ and dental papilla of a developing tooth. It is a vascular fibrous sac containing the developing tooth and its odontogenic organ. The dental follicle (DF) differentiates into the periodontal ligament. In addition, it may be the precursor of other cells of the periodontium, including osteoblasts, cementoblasts and fibroblasts. They develop into the alveolar bone, the cementum with Sharpey's fibers and the periodontal ligament fibers respectively. Similar to dental papilla, the dental follicle provides nutrition to the enamel organ and dental papilla and also have an extremely rich blood supply.
A polyphyodont is any animal whose teeth are continually replaced. In contrast, diphyodonts are characterized by having only two successive sets of teeth.
Stem-cell therapy uses stem cells to treat or prevent a disease or condition. As of 2024, the only FDA-approved therapy using stem cells is hematopoietic stem cell transplantation. This usually takes the form of a bone marrow or peripheral blood stem cell transplantation, but the cells can also be derived from umbilical cord blood. Research is underway to develop various sources for stem cells as well as to apply stem-cell treatments for neurodegenerative diseases and conditions such as diabetes and heart disease.
Periodontal ligament stem cells are stem cells found near the periodontal ligament of the teeth. These cells have shown potential in the regeneration of not only the periodontal complex but also other dental and non-dental tissues. They are involved in adult regeneration of the periodontal ligament, alveolar bone, and cementum. The cells are known to express STRO-1 and CD146 proteins.
The Nova Southeastern University College of Dental Medicine is the dental school of Nova Southeastern University. It is located in Fort Lauderdale, Florida, United States. When it opened in 1997, it was the first new dental school to open in the United States in 24 years. It is the largest dental school in Florida. The school is accredited by the American Dental Association.
Sclerostin domain-containing protein 1 is a protein that in humans is encoded by the SOSTDC1 gene.
Dental pulp stem cells (DPSCs) are stem cells present in the dental pulp, which is the soft living tissue within teeth. DPSCs can be collected from dental pulp by means of a non-invasive practice. It can be performed with an adult after simple extraction or to the young after surgical extraction of wisdom teeth. They are pluripotent, as they can form embryoid body-like structures (EBs) in vitro and teratoma-like structures that contained tissues derived from all three embryonic germ layers when injected in nude mice. DPSCs can differentiate in vitro into tissues that have similar characteristics to mesoderm, endoderm and ectoderm layers. They can differentiate into many cell types, such as odontoblasts, neural progenitors, osteoblasts, chondrocytes, and adipocytes. DPSCs were found to be able to differentiate into adipocytes and neural-like cells. DPSC differentiation into osteogenic lines is enhanced in 3D condition and hypoxia. These cells can be obtained from postnatal teeth, wisdom teeth, and deciduous teeth, providing researchers with a non-invasive method of extracting stem cells. The different cell populations, however, differ in certain aspects of their growth rate in culture, marker gene expression and cell differentiation, although the extent to which these differences can be attributed to tissue of origin, function or culture conditions remains unclear. As a result, DPSCs have been thought of as an extremely promising source of cells used in endogenous tissue engineering.
Regenerative endodontic procedures is defined as biologically based procedures designed to replace damaged structures such as dentin, root structures, and cells of the pulp-dentin complex. This new treatment modality aims to promote normal function of the pulp. It has become an alternative to heal apical periodontitis. Regenerative endodontics is the extension of root canal therapy. Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the pulp due to dental caries, congenital deformity or trauma. Regenerative endodontics instead seeks to replace live tissue in the pulp chamber. The ultimate goal of regenerative endodontic procedures is to regenerate the tissues and the normal function of the dentin-pulp complex.
Platelet-rich fibrin (PRF) or leukocyte- and platelet-rich fibrin (L-PRF) is a derivative of PRP where autologous platelets and leukocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and is used as a tissue-engineering scaffold in oral and maxillofacial surgeries. PRF falls under FDA Product Code KST, labeling it as a blood draw/Hematology product classifying it as 510(k) exempt.
Regeneration in humans is the regrowth of lost tissues or organs in response to injury. This is in contrast to wound healing, or partial regeneration, which involves closing up the injury site with some gradation of scar tissue. Some tissues such as skin, the vas deferens, and large organs including the liver can regrow quite readily, while others have been thought to have little or no capacity for regeneration following an injury.
Craniofacial regeneration refers to the biological process by which the skull and face regrow to heal an injury. This page covers birth defects and injuries related to the craniofacial region, the mechanisms behind the regeneration, the medical application of these processes, and the scientific research conducted on this specific regeneration. This regeneration is not to be confused with tooth regeneration. Craniofacial regrowth is broadly related to the mechanisms of general bone healing.
In periodontology, gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of surgical procedures in which the gingiva is grafted. The aim may be to cover exposed root surfaces or merely to augment the band of keratinized tissue.
Professor Alastair J Sloan is an applied bioscientist and expert in the broad field of mineralised connective tissues, and since January 2020 current head of the Melbourne Dental School, University of Melbourne.
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