It's something of a historical accident that dentists stand in a somewhat separate cultural enclave of medicine; the forward edge of regenerative medicine for teeth is little different from that for other tissue these days.To pick one example, stem cells are a big deal in dental research:
research has demonstrated that mixed populations of cultured post-natal tooth bud cells can be used to generate bioengineered dental tissues.
Current research efforts focus on the identification and characterization of dental cell populations, scaffold materials, and design that can be most effectively used for tooth tissue engineering applications. Hoechst dye profiling and immuno-sorting methods were used to generate enriched clonal dental stem cell (DSC) lines. Expanded DSC and non-DSC lines are currently being examined, by both in vitro and in vivo methods, to define their potential to differentiate. Molecular and differentiation profiles will provide important characterizations of tooth bud cells, eventually to facilitate ongoing tooth tissue engineering efforts.
Efforts to tissue engineer replacement teeth, or repair damaged tooth tissue in situ, appear to be proceeding at much the same rate as other stem cell medicine. The next decade should prove to be very interesting indeed, as many threads of regenerative research come to fruition and commercially available therapies.
Meanwhile, intermediary technologies for regeneration are moving forward:
Using low-intensity pulsed ultrasound (LIPUS), Dr. Tarak El-Bialy from the Faculty of Medicine and Dentistry and Dr. Jie Chen and Dr. Ying Tsui from the Faculty of Engineering have created a miniaturized system-on-a-chip that offers a non-invasive and novel way to stimulate jaw growth and dental tissue healing.
"If the root is broken, it can now be fixed," said El-Bialy. "And because we can regrow the teeth root, a patient could have his own tooth rather than foreign objects in his mouth."
Dr. El-Bialy first discovered new dental tissue was being formed after using ultrasound on rabbits. In one study, published in the American Journal of Orthodontics and Dentofacial Orthopedics, El Bialy used ultrasound on one rabbit incisor and left the other incisor alone. After seeing the surprising positive results, he moved onto humans and found similar results.
There's no reason that effective stimulation of healing has to be achieved by the direct use of chemicals or biological cues, although that does seem to be the wave of the future. If mechanical or other forms of stimulation can be cost effective for the benefit they supply, then more power to those who are striving to understand the mechanisms and bring therapies to market.