Regrowing dental tissue with stem cells from baby teeth

September 11, 2018 by Katherine Unger Baillie, University of Pennsylvania
Stem cells extracted from baby teeth were able to regenerate dental pulp (shown, with fluorescent labeling) in young patients who had injured one of their adult teeth. Credit: University of Pennsylvania

Sometimes kids trip and fall, and their teeth take the hit. Nearly half of children suffer some injury to a tooth during childhood. When that trauma affects an immature permanent tooth, it can hinder blood supply and root development, resulting in what is essentially a "dead" tooth.

Until now, the standard of care has entailed a procedure called apexification that encourages further , but it does not replace the lost tissue from the injury and, even in a best-case scenario, causes root development to proceed abnormally.

New results of a clinical trial, jointly led by Songtao Shi of the University of Pennsylvania and Yan Jin, Kun Xuan, and Bei Li of the Fourth Military Medicine University in Xi'an, China, suggest that there is a more promising path for children with these types of injuries: Using extracted from the patient's baby teeth. The work was published in the journal Science Translational Medicine.

"This treatment gives patients sensation back in their teeth. If you give them a warm or cold stimulation, they can feel it; they have living teeth again," says Shi, professor and chair in the Department of Anatomy and Cell Biology in Penn's School of Dental Medicine. "So far we have follow-up data for two, two and a half, even three years and have shown it's a safe and effective therapy."

Shi has been working for a decade to test the possibilities of after discovering them in his daughter's baby tooth. He and colleagues have learned more about how these dental stem , officially called human deciduous pulp stem cells (hDPSC), work and how they could be safely employed to regrow dental tissue, known as pulp.

The Phase I trial, conducted in China, which has a research track for clinical trials, enrolled 40 children who had each injured one of their permanent incisors and still had baby teeth. Thirty were assigned to hDPSC treatment and 10 to the control treatment, apexification.

Those that received hDPSC treatment had tissue extracted from a healthy baby tooth. The stem cells from this pulp were allowed to reproduce in a laboratory culture, and the resulting cells were implanted into the injured tooth.

Upon follow-up, the researchers found that patients who received hDPSCs had more signs than the control group of healthy root development and thicker dentin, the hard part of a tooth beneath the enamel. Blood flow increased as well.

At the time the patients were initially seen, all had little sensation in the tissue of their injured . A year following the procedure, only those who received hDPSCs had regained some sensation. Examining a variety of immune-system components, the team found no evidence of safety concerns.

As further support of the treatment's efficacy, the researchers had the opportunity to directly examine the tissue of a treated when the patient reinjured it and had to have it extracted. They found that the implanted stem cells regenerated different components of dental pulp, including the cells that produce dentin, connective tissue, and blood vessels.

"For me the results are very exciting," Shi says. "To see something we discovered take a step forward to potentially become a routine therapy in the clinic is gratifying."

It is, however, just a first step. While using a patient's own stem cells reduces the chances of immune rejection, it's not possible in adult patients who have lost all of their . Shi and colleagues are beginning to test the use of allogenic stem cells, or cells donated from another person, to regenerate dental tissue in adults. They are also hoping to secure FDA approval to conduct clinical trials using hDPSCs in the United States.

Eventually, they see even broader applications of hDPSCs for treating systemic disease, such as lupus, which Shi has worked on before.

"We're really eager to see what we can do in the dental field," Shi says, "and then building on that to open up channels for systemic disease therapy."

Explore further: Researcher uses stem cells to attack bacteria and regenerate dental pulp

More information: Kun Xuan et al, Deciduous autologous tooth stem cells regenerate dental pulp after implantation into injured teeth, Science Translational Medicine (2018). DOI: 10.1126/scitranslmed.aaf3227

Related Stories

Researcher uses stem cells to attack bacteria and regenerate dental pulp

February 7, 2018
Emi Shimizu's research could someday transform a procedure dental patients dread: the root canal.

Bioengineered tooth replacement opens doors to new therapies

August 20, 2018
Tooth loss is a significant health issue currently affecting millions of people worldwide. While artificial dental implants are the existing standard tooth replacement therapy, they do not exhibit many properties of natural ...

New stem cell delivery approach regenerates dental pulp-like tissue in a rodent model

December 19, 2016
When a tooth is damaged, either by severe decay or trauma, the living tissues that comprise the sensitive inner dental pulp become exposed and vulnerable to harmful bacteria. Once infection takes hold, few treatment options—primarily ...

Recommended for you

Regrowing dental tissue with stem cells from baby teeth

September 11, 2018
Sometimes kids trip and fall, and their teeth take the hit. Nearly half of children suffer some injury to a tooth during childhood. When that trauma affects an immature permanent tooth, it can hinder blood supply and root ...

The starch risk to teeth

August 7, 2018
An examination of research on oral health, commissioned by the World Health Organisation, has indicated that for oral health we should stick to whole grain carbohydrates and avoid processed ones, especially if sweet.

Experts question benefits of fluoride-free toothpaste

August 7, 2018
Dental health experts worry that more people are using toothpaste that skips the most important ingredient—fluoride—and leaves them at a greater risk of cavities.

Researchers discover cellular messengers communicate with bacteria in the mouth

May 8, 2018
A new UCLA-led study provides clear evidence that cellular messengers in saliva may be able to regulate the growth of oral bacteria responsible for diseases, such as periodontitis and meningitis.

Drug-filled, 3-D printed dentures could fight off infections

April 25, 2018
Nearly two-thirds of the U.S. denture-wearing population suffer frequent fungal infections that cause inflammation, redness and swelling in the mouth.

Bacteria boost antifungal drug resistance in severe childhood tooth decay

April 25, 2018
Early childhood caries, a form of severe tooth decay affecting toddlers and preschoolers, can set children up for a lifetime of dental and health problems. The problem can be significant enough that surgery is the only effective ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.