[ Ссылка ]
[ Ссылка ]
Use link to read entire article
Can enamel grow back?
In August 2023, a research team succeeded in creating stem-cell based organoids that secrete the proteins which form dental enamel. Led by scientists from the University of Washington School of Dentistry, the researchers consider this breakthrough to be ‘critical first step’ in developing stem-cell-based treatments to repair damaged teeth.
The team said it hoped to use this research to create an enamel that is as durable as that found in natural teeth. The enamel could be created in laboratories and used to fill cavities or applied as a ‘living filling’ to grow into the cavity.
‘This may finally be the “century of living fillings” and human regenerative dentistry in general.’
Hannele Ruohola-Baker
Hannele Ruohola-Baker, a professor of biochemistry, headed the project. She said: ‘Many of the organs we would like to be able to replace, like human pancreas, kidney, and brain, are large and complex. Regenerating them safely from stem cells will take time.
‘Teeth on the other hand are much smaller and less complex. They’re perhaps the low-hanging fruit. It may take a while before we can regenerate them, but we can now see the steps we need to get there.
‘This may finally be the “century of living fillings” and human regenerative dentistry in general.’
Ethics of stem cell regeneration
While these trials have seemed promising, the potential for tooth regeneration through stem cells does raise some ethical concerns.
David Obree, Archie Duncan fellow in medical ethics at the University of Edinburgh, spoke to Dentistry.co.uk about the potential implications of tooth regrowrth. He described stem cell regeneration as ‘an exciting development which is likely to revolutionise dentistry and medicine in general’. However, he also named the source of stem cells used and their cost as potential ethical issues.
‘Will this be an expensive treatment only available to the rich, or will the technology be cheap and available to everyone?’
David Obree
‘It may be that cells taken from extracted deciduous or wisdom teeth will be the pluripotent stem cells of choice, both for teeth and other organ renewal, and thus an interesting side-line for dentists harvesting the cellular material’
It is currently unclear how expensive stem cell treatments would be when available to the public and if offering them on the NHS would be possible.
Mineral enamel repair
An alternative approach to tooth regrowth is mineral regeneration to repair damaged enamel.
In 2019, a gel was developed by mixing calcium and phosphate ions in an alcoholic solution with the organic compound trimethylamine. This solution successfully produced clusters of calcium phosphate, the main component of dental enamel.
When applied to damaged tooth samples, the gel was found to create a three-micrometre-thick layer of new enamel in 48 hours. According to the researchers, this repair ‘would be permanent’.
Zhaoming Liu co-authored the study with colleagues from the Zhejiang University School of Medicine. He said: ‘Our newly regenerated enamel has the same structure and similar mechanical properties as native enamel.
‘We hope to realise tooth enamel regrowth without using fillings which contain totally different materials.’
The materials used within the trial are cheap and can be prepared on a large scale.
Dr Liu continued: ‘After intensive discussion with dentists, we believe that this new method can be widely used in future.’
Will we ever be able to regrow teeth?
Results from studies have been positive about the potential for regenerating damaged teeth. Despite this, there are still significant barriers to whole tooth regrowth.
For example, the use of RNA to induce tooth regrowth has so far only been successful in patients who are born with missing teeth. While these patients are likely to be able to access the new medicine by 2030, this will not assist those who lose teeth later in life.
On the other hand, researchers said they were hopeful that further investigation could broaden the application of the medication to those who have lost teeth due to gum disease or injury.
Stem cell regeneration also raises some concerns including the ethics of using embryonic stem cells and the potential for immunological rejection.
However, transplant rejection was found to be uncommon across several studies when adult stem cells taken from organs such as tooth pulp or umbilical cords were used. The 2023 review concluded that oral and facial treatment was possible with adult stem cells from many different organs.
Overall while studies have shown positive results for potential methods of tooth regeneration, there is no clear timeline for if and when it will be possible to regrow whole teeth.
Follow Dentistry.co.uk
