It seems that the research community has made some progress in recent years towards methods of rebuilding tooth enamel. This would in principle allow for reconstruction rather than replacement of damaged teeth, and let dental caries be regrown rather than drilled and patched. I noted one possible approach earlier this year, and the work here is the basis for another. These are fairly low-level methodologies, depending on the fine molecular details of mineralization in living organisms. The open access paper makes for interesting reading, albeit rather heavy going for anyone not up to speed on the chemistry involved. It remains to be seen how rapidly this approach can move towards the clinic.
Enamel, located on the outer part of our teeth, is the hardest tissue in the body and enables our teeth to function for a large part of our lifetime despite biting forces, exposure to acidic foods and drinks and extreme temperatures. This remarkable performance results from its highly organised structure. However, unlike other tissues of the body, enamel cannot regenerate once it is lost, which can lead to pain and tooth loss. These problems affect more than 50 per cent of the world's population and so finding ways to recreate enamel has long been a major need in dentistry.
Now a new approach can create materials with remarkable precision and order that look and behave like dental enamel. The materials could be used for a wide variety of dental complications such as the prevention and treatment of tooth decay or tooth sensitivity - also known as dentin hypersensitivity. "This is exciting because the simplicity and versatility of the mineralisation platform opens up opportunities to treat and regenerate dental tissues. For example, we could develop acid resistant bandages that can infiltrate, mineralise, and shield exposed dentinal tubules of human teeth for the treatment of dentin hypersensitivity."
The mechanism that has been developed is based on a specific protein material that is able to trigger and guide the growth of apatite nanocrystals at multiple scales - similarly to how these crystals grow when dental enamel develops in our body. This structural organisation is critical for the outstanding physical properties exhibited by natural dental enamel. Enabling control of the mineralisation process opens the possibility to create materials with properties that mimic different hard tissues beyond enamel such as bone and dentin. As such, the work has the potential to be used in a variety of applications in regenerative medicine.