Scientists at the Columbia University’s Dental School have perfected a “cell-homing-based tooth regeneration” procedure that allows the use of autologous stem cells to grow teeth, including molars. In this blog-article, i will first examine the procedure (Section A) and then dig a little deeper in this technique’s modus operandi (Section B).
How the Stem Cell Dental Procedure Works
Tooth regeneration is a stem cell based regenerative medicine procedure. It is tissue engineering via stem cell biology. Its purpose is to replace damaged or lost teeth by regrowing them from autologous stem cells. (1)
The dental bio-engineering is done via somatic stem cells that are collected and reprogrammed to induced pluripotent stem cells which can then be placed in the dental lamina directly or placed in a reabsorbable biopolymer in the shape of the new tooth. (2)
Within 2 months, the stem cells grow into a new tooth, an exact match of the precedent tooth. As a bonus, the stem cells also produce the bone that connects the tooth to the jaw, eliminating the need for bone grafting, a procedure that can delay dental implant surgery 6 to 9 months. With regenerated teeth, there is also no risk of the implanted tooth falling out. (3)
While the dental company Odontics’ scientists have made significant advancements in stem cell tooth regeneration, the technique does not yet appear to be available in most dental clinics, let alone the official new standard of care. However, Dr. Jeremy Mao, the Edward V. Zegarelli Professor of Dental Medicine at Columbia University Medical Center, has recently made significant progress using a growth factor-covered, three-dimensional scaffold.
In this perspective, Dr. Mao has developed a way to guide stem cells to the scaffold, where a tooth then grows and attaches to the surrounding tissue in as little as 9 weeks. This was one of the last obstacles in this dental bioengineering scheme (4)
This technology, referred to as cell-homing-based tooth regeneration, alleviates the need to prepare stem cells in an external environment, such as a Petri dish. Columbia University is in the process of or already has patented this technology. (5)
Human molar scaffolding from the lab of Dr. Jeremy Mao.
Credit: Image courtesy of Columbia University Medical Center
Mechanisms of Action: From Genes to stem Cell Differentiation
Young et al. first demonstrated in 2002 that teeth could be regenerated from cells. (6) Thereafter, scientists at the Dental Institute of King’s College London successfully used stem cells to grow new teeth in mice. A little later on, the UK based dental company Odontis developed the patented product, BioTooth¨, in 2004 and is awaiting additional clinical trials before putting this procedure on the market.
The researchers’ main difficulty was controlling the size and shape of the newly formed tooth. After 3 years of research, scientists at Odontis learned which genes were responsible for tooth type and size. This was a major breakthrough that brought them several steps closer to applying the technology to humans. Since, the scientists at Columbia have considerably perfected the technique of stem cell teeth regeneration.
“…a new technique pioneered in the Tissue Engineering and Regenerative Medicine Laboratory of Dr. Jeremy Mao, Edward V. Zegarelli Professor of Dental Medicine, and a professor of biomedical engineering at Columbia University, can orchestrate the body’s stem cells to migrate to three-dimensional scaffold that is infused with growth factor. This can yield an anatomically correct tooth in as soon as nine weeks once implanted in the mouth.“These findings represent the first report of regeneration of anatomically shaped tooth-like structures in vivo, and by cell homing without cell delivery,” Dr. Mao and his colleagues said in the paper.“The potency of cell homing is substantiated not only by cell recruitment into scaffold microchannels, but also by regeneration of a putative periodontal ligaments newly formed alveolar bone.” (7)
Stem cell tooth implantation should be the new dental standard of care in the near future, notwithstanding the Dental Industry’s stubborn “vested interests” (ie, the dogmas and financial interests relative to mercury fillings, industrial fluoride toothpaste and root canals). (8)
Dental implants is the most rapidly increasing area of dentistry, growing 15-20% every year. But just as with other dental procedures, there are major inconveniences and risks with this surgical dental procedure. It is executed in stages and entails several procedures, many of which can be painful. Artificial implants carry many risks, from infection, to nerve damage, sinus and circulatory issues as well as the risks of general anesthesia. Furthermore, the healing process can take up to 18 months and the implants can refuse to align with the jawbone and end up falling out.
A stem cell implant would require only require a local anesthetic only. Stem cell tooth implants are also a healthier and more comfortable alternative to dentures. Unlike dentures, the newly developed teeth move with the mouth, conserving the health of the gums.
To grow a new tooth “orthotopically,” or in the socket where the tooth will integrate with surrounding tissue in ways that are impossible with hard metals or other materials is indeed quite a medical revolution in the art of dentistry and avoids the mouth to experience metal galvanic effects and other inconveniences from metal implants.
These findings represent the first report of regeneration of anatomically shaped tooth-like structures in vivo, and by cell homing without cell delivery. The potency of cell homing has been substantiated not only by cell recruitment into scaffold microchannels, but also by the regeneration of periodontal ligaments and newly formed alveolar bone.
These stem cell implants are expected to cost around $2500-3500. (9), thus they are not that much more expensive than the conventional implants and would require only post-op care as tooth extractions.
We are still awaiting written response from Columbian dental school to get informed on the latest in terms of human clinical trials and clinical practice. We will keep you posted upon reception of updating news regarding this teeth implant consideration.
Christian Joubert CSO and HMI director