Tooth loss is a major public health issue affecting more than 158 million people worldwide. The current standard of care is to replace missing teeth with synthetic dental implants, and/or fixed or removable prosthetics. While successful in some cases, these treatment options are inferior to natural teeth with many associated complications.  Therefore, research has been focusing on the formation of bioengineered whole tooth replacement therapies with the ability to provide both the function and sensory responsiveness of natural teeth.  Now, two preclinical studies develop innervated, bioengineered tooth bud constructs whose features resemble natural tooth buds implanted subcutaneously into rats without the use of immunosuppressors.  The teams state this is the first report to describe the use of postnatal dental cells to create bioengineered tooth buds exhibiting the features of natural tooth development.  The studies were published in the Journal of Dental Research, they can be found here and here.

Previous studies show stem cell-based tissue engineering is a promising approach to replace or repair lost or damaged tissues or even organs in humans. Two major types of stem cells currently used in tissue engineering research are embryonic stem cells and postnatal stem cells. However, ethical concerns remain in using embryonic stem cells, with difficulties in isolation, expansion, and differentiation of postnatal stem cells cited as factors limiting their clinical application.  The current studies implant bioengineered teeth without using an immunosuppressant, and supplies nerves to them.

The first study develops cellularized bioengineered tooth bud constructs from postnatal dental cells capable of developing the hallmark features of natural tooth buds such as the dental epithelial stem cell niche, enamel knot signaling centers, transient amplifying cells, as well as mineralized dental tissue formation.  Results show these constructs were encapsulated within a hydrogel material successfully implanted subcutaneously into immunocompromised rats.

The second study utilizes autologous mesenchymal cells mined from bone marrow to supply nerves to bioengineered teeth without using an immunosuppressor. The lab states the innervation of teeth is essential for functionality and protection with this new method providing innervation while avoiding multiple side effects associated with immunosuppressors.

The teams surmise they successfully used postnatal dental cells to develop bioengineered tooth buds exhibiting features of natural tooth development, and used autologous mesenchymal cells to innervate the bioengineered teeth without treatment with an immunosuppressor.  For the future, the researchers propose future innervated, bioengineered tooth buds as a promising and clinically relevant tooth replacement therapy.

Source: International Association for Dental Research

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