Tooth Stem Cell Regeneration

For our readers who are not aware, Mequon Smile Design has introduced a new associate dentist to the practice, Dr. Sofia Enea. I am thrilled to expose her to the “new age” of dentistry, reinforce the traditional dental concepts she perfected at Marquette University School of Dentistry and pass along “tricks of the trade” that are only mastered by practicing dentistry over many years. When I think of the amazing profession Dr. Sofia has entered, I reminisce about my initial years as a young, dental professional and I am fascinated by the advancements that have occurred in dentistry; advancements in digital technology, materials utilized, and our communication with patients, just to name a few. The advancement that I find most intriguing currently is the use of stem cells to repair and regenerate teeth.

A human tooth is composed of several different cell types which form the enamel, dentin, pulp, and ligaments of the tooth. The extreme variance in tissue composition of each layer requires different stem cells for formation. The first stem cells were derived from isolated 3rd molar teeth which were typically discarded after they were extracted/removed but were found to be an excellent source of stem cells. Since the onset of research, isolation of several types of stem cells have been identified: periodontal ligament, root apical papillae, and dental follicle stem cells. In 2022, a Harvard University study was conducted to determine if stem cells could help to regenerate pulpal tissue, which is the innervated and vascular part of the tooth that keeps the tooth “alive”. When the tooth pulp is injured by a cavity or tooth fracture, there can be pain and/or infection resulting in the need for a root canal or tooth extraction. This study wanted to find alternative methods to repair the pulp and prevent this destructive cascade of events. The study proved to be a success and the concept of cell-transplant-based regenerative endodontic (root canal) treatment/RET was developed and may become a promising treatment protocol in the future.

Whole tooth regeneration, or stem cell implants, are a treatment concept making even more monumental strides. At the onset, there were challenges identifying the non-embryonic sources, different cell types, and mediums needed to allow for cell growth which are factors that are essential for tooth regeneration. A Japanese research team, led by Dr. Takahashi, a distinguished researcher and head of Oral and Maxillofacial Surgery, have finally identified the genes, cells, and signaling pathways that lead to tooth formation. Excitingly, as you read this article, human clinical trials have begun on a medication that will change dentistry forever.

I am beyond thrilled for Dr. Sofia and her fellow 2024 Marquette University Dental School classmates. Twenty years from now they will be reminiscing about dental school, how they practiced dentistry when they graduated, and astounded by the strides that dentistry has made. Having practiced myself for over twenty years, it is amazing that the dental school graduates of 2024 may not be placing a traditional titanium implants or doing root canals, but instead injecting a drug to induce whole tooth regeneration or stem cells to repair a damaged pulp.