Chew On This: The State of the Art Tooth Regeneration

Wells, Crystal, Angela Sample, Lindsay Luce, and Sachna Pillai

Developments in stem cell research hold the key to the future of dentistry. Dental professionals are on the brink of a new paradigm emerging in providing a mechanism that regulates the fate of a stem cell in producing a natural tooth, relinquishing tooth loss due to trauma, disease, or congenital hypodontia. The purpose of the literature review is to introduce futuristic technology for growing natural teeth by programming adult stem cells derived from wisdom teeth. Dental stem (progenitor) cells, which have the ability to differentiate into dental cell lineages, can be derived from both impacted and erupted human teeth.  These cells are being used to regenerate dental tissues as well. An in-depth search of the literature was accomplished to review research on tooth morphogenesis and differentiation, root development, dentin-pulp, cementum/PDL, bone morphogenic protein usage and enamel regeneration.  Developments in the manipulation of stem cells for the reconstruction of the tooth germ process and the research of in vivo development of artificial tooth germ in the adult oral cavity have been reported. Results from studies have also shown tooth bud cells that have been cultured from adult mice that were seeded onto biodegradable scaffolds and then replaced back into the edentulous area of the adult mouse for 12 weeks has rendered bioengineered tooth crowns, containing enamel, pulp, dentin, and periodontal tissues. From a hygienist’s perspective, because we generally spend most time with the patients, it is our duty to encourage our patients to preserve their teeth; however, it is also important to raise awareness and present available opportunities of regenerative therapies. Tooth regeneration is now a realistic possibility. The literature review supports the use of stem cells to be used as regenerative therapies for the repair and whole tooth replacement using bioengineered tooth germ.