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GatorDMD

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Source: The Forsyth Institute


Date Posted: 2004-06-25


Web
Address: http://www.sciencedaily.com/releases/2004/06/040625083022.htm
U.S.- BRAZIL TEAM BIOENGINEERS TOOTH CROWNS IN SECOND MAMMAL SPECIES

Boston, MA -- Researchers at The Forsyth Institute and Massachusetts
General Hospital in Boston and Universidade Federal de Sao Paulo
(UNIFESP) in Brazil have successfully used tissue-engineering
techniques to regenerate rat tooth crowns.

The advance follows Forsyth?s widely-publicized regeneration of pig
tooth crowns in 2002 and adds evidence that it may, one day, be
possible to grow new human teeth from an individual?s own cells.

?We are very excited because mammalian systems tend to operate in
similar ways,? said Pamela Yelick, PhD, Assistant Member of the
Forsyth Staff and the principal investigator. ?Having regenerated
teeth of a second mammalian species allows us to hope for similar
success with human teeth.?

In their newly reported work, the Forsyth team found that it was
possible to maintain individual tooth-forming cells in culture for six
days before implanting them? thus demonstrating that adult dental stem
cells can give rise to tooth crowns containing dentin and enamel and
indicating that it might be possible to expand enough such cells in
culture to grow full-sized teeth.

The advances are reported in the July 2004 Journal of Dental Research,
which also includes a British team?s article on the use of non-dental
stem cells to grow tooth primorida in mice and an editorial describing
?the immense potential? for regenerative and tissue-engineering
applications to dentistry.

In the words of Dominick P. DePaola, DDS, PhD, The Forsyth
Institute?s President and Chief Executive Officer, ?This
groundbreaking science heralds a revolution in dentistry, in which
biological tools will increasingly replace mechanical ones. ?

Paulo Augusto de Lima Pontes, MD, PhD, coordinator of the UNIFESP
Post-Graduation Department of Otorhinolaryngology and Head and Neck
Surgery, said: ? The results shown by the Forsyth-MGH- UNIFESP team
promise new therapeutic options in dental medicine.?

In bioengineering rat teeth, the scientists used techniques similar to
those previously used at Forsyth to form pig teeth. In both sets of
experiments, researchers ?seeded? cells obtained from immature teeth
of animals onto biodegradable polymer scaffolds. The scaffolds were
then implanted in the abdomen of rat hosts. Within three-to-six
months, depending on the particulars of the experiment, small,
recognizable tooth crowns formed.

Previously, Forsyth researchers had grown small teeth from dissociated
pig molar buds, but could not be certain that the new teeth had not
emerged from "clumps" of incompletely dissociated tooth tissue. In the
newly reported work, the scientists grew individual, dissociated tooth
bud cells in culture before implanting them.

In both sets of experiments, the Forsyth scientists used ?adult?
dental stem cells, which give rise only to dental tissue. They did not
use ?embryonic? stem cells, which can be induced to form a variety of
different tissue types.

According to Monica T. Duailibi, DDS, PhD, the paper?s first author,
?Our results show that individual tooth progenitor cells can interact
on scaffolding to form tooth crowns and that it might be possible to
culture enough dental stem cells to grow full-sized teeth.? Dr.
Duailibi conducted the work at Forsyth along with Silvio E. Duailibi,
DDS, PhD, when both were doctoral candidates at UNIFESP. Both are
currently post doctoral researchers in the UNIFESP Department of
Otorhinolaryngology and Head and Neck Surgery.

The scientists? goal is to develop methods for replacing lost or
missing human teeth by growing new teeth, in an individual?s jaw, from
an individual?s own cells.

They are currently working on the possibility of growing new teeth in
a mammalian jaw, and are beginning to work with human tooth tissues.
?Within a year, we expect to determine whether the methods we use to
regrow animals? teeth will be useful in regenerating human teeth,?
Yelick said. ?If the methods prove effective, it will be at least
seven years before they can be tested clinically in humans.?

In the words of collaborator Joseph P. Vacanti, MD, "Dr. Yelick and
the combined team have made enormous progress towards the development
of an engineered living tooth. As more knowledge is gained into the
biologic and genetic mechanisms of tooth development, rational
approaches in building living teeth from stem cells are now
progressing from imagination into reality". Dr. Vacanti is Chief of
the Department of Pediatric Surgery; Surgeon-in-Chief, Hospital for
Children; Director of Pediatric Transplantation, and Director of the
Laboratory for Tissue Engineering and Organ Fabrication, all at
Massachusetts General Hospital.

According to Bruce Donoff, DMD MD, Dean of the Harvard School of
Dental Medicine, ?Having helped fund this important research, we are
proud to be collaborators in this future direction of dentistry. These
advances are moving the field from technique-driven restoration to
those based on biological solutions through regeneration. The possible
impact on dental practice and oral health is far-reaching.?

In addition to Drs. Yelick, Duailibi, and Vacanti, team members
included Conan S. Young, PhD and John D. Bartlett, PhD of the
Department of Cytokine Biology at The Forsyth Institute.

The research was funded by the Harvard School of Dental Medicine and
the Center for Integration of Medicine and Innovative Technology, with
additional support from CAPES (Coordena??o de Aperfei?oamento de
Pessoal de n?vel Superior); UNIFESP; and The Forsyth Institute.

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sorry so long but it is good reading. What part of dentistry do you think will be the most hurt/benefit from this advance in technology?
 
That's a great article! I can't imagine dentistry being hurt by it, and I think it's difficult to ascertain all of the ways it will affect dentistry. I think this quote from the article is informative:

"This groundbreaking science heralds a revolution in dentistry, in which
biological tools will increasingly replace mechanical ones."


I'm excited to see how this research goes. Wouldn't it be cool to regrow/remineralize human teeth. It seems a lot less invasive than current methods, which I think patients will really support.
 
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I see such a development becomming a boon for dentists and the Tooth Fairy. People will tend to become lax in maintaining sound personal oral hygiene habits and will rely on obtaining routine minor restroative services (fillings) if they believe that failed teeth can be easily replaced by implanted tooth buds which will mature and push out the old teeth just like their adult teeth pushed out their baby teeth.

Of course we all know that individual patient issues impacting the prognosis for success of such seeding therapy will remain complex even if the implanting procedure itself becomes routine.
 
If this does become the standard of care, Restorative Dentistry will really take the shaft. Ortho OS and Perio will still do ok. I am not realy sure about endo. The supposed success rate of endodontic treatment (if done appropriately) is around 93% . In the case of an endodonticaly involved tooth, if odontogenic regeneration is a very cheap option then patients might opt to have a non vital tooth extracted, replaced with a temporary space retainer and wait for the new tooth to grow.
However, there is also the big possibility that Odontogenic regeneration will be a part of restorative dentistry.... from a financial stand point, I dont think any dentists are going to be starving.
 
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