Vidyya Medical News Service
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Volume 6 Issue 176 Published - 14:00 UTC 08:00 EST 24-Jun-2004 Next Update - 14:00 UTC 08:00 EST 25-Jun-2004
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Growing replacement teeth and dental tissues

The restoration of lost tooth tissue, whether from disease or trauma, represents a significant proportion of the daily routine for many practicing clinicians. The challenge and resource burden of restoring lost tooth tissue will be with us for many years to come.

Two reports in the July issue of the Journal of Dental Research highlight exciting advances in moving toward the tissue engineering of teeth. At The Forsyth Institute (Boston, MA), Pamela Yelick and colleagues have seeded cultured tooth germ cells on biodegradable scaffolds which were then implanted to bioengineer tooth tissues, while in London (UK), Paul Sharpe's group has been able to generate tooth structures from non-dental mesenchymal cells placed in contact with embryonic oral epithelium and transplanted to an ectopic site.

The latter report is pivotal in that it demonstrates that uncommitted mesenchymal stem cells, in association with oral epithelium, can be instructed to mimic developmental events leading to growth of a tooth structure comprised of enamel, dentin, and pulp, with a morphology resembling that of a natural tooth. These observations offer very exciting opportunities for replacement of natural teeth damaged through disease or trauma and for those missing in hypodontia. There are obvious practical obstacles still to be overcome before this might be available as a routine clinical treatment, but it provides an elegant example of the translation of basic science research to the clinical arena.

There are also significant opportunities in the shorter term to exploit this knowledge for the development of novel regenerative therapies which seek to restore partial tooth tissue loss. Such approaches provide potential for restoration of the structural integrity of the dental tissues where the new tissues become an integral part of the tooth, thus minimizing some of the problems of restoration failure with traditional dental materials through interface failure and bacterial microleakage, etc.

Clearly, the future for regenerative and tissue-engineering applications to dentistry is one with immense potential, capable of bringing quantum advances in treatment for our patients. The need for high-quality research in the basic sciences is paramount to ensuring that the development of novel clinical treatment modalities is underpinned by robust mechanistic data, and that such approaches are effective. This translational model epitomizes how dentistry should evolve and highlights the need for close partnerships between basic and clinical scientists.

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