Progress in Bioengineered Whole Tooth Research: from Bench to Dental Patient Chair
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Tooth loss is a significant health issue that affects the physiological and social aspects of everyday life. Missing teeth impair simple tasks of chewing and speaking and can also contribute to reduced self-confidence. An emerging and exciting area of regenerative medicine-based dental research focuses on the formation of bioengineered whole tooth replacement therapies that can provide both the function and sensory responsiveness of natural teeth. This area of research aims to enhance the quality of dental and oral health for those suffering from tooth loss. Current approaches use a combination of dental progenitor cells, scaffolds and growth factors to create biologically based replacement teeth to serve as improved alternatives to currently used artificial dental prosthetics.
This article is an overview of current progress, challenges, and future clinical applications of bioengineered whole teeth.
Recent accomplishments suggest that whole tooth bioengineering for human tooth replacement is indeed possible and, in fact, is the future of dentistry.
KeywordsOdontogenesis Tooth loss Cell differentiation Odontoblasts Ameloblast Dentin
Compliance with Ethical Standards
Conflict of Interest
Elizabeth E. Smith declares that she has no conflict of interest.
Pamela C. Yelick reports that she has two patents pending, one relevant to the field of study, and one that is not.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 12.Jussila M, Thesleff I. Signaling networks regulating tooth organogenesis and regeneration, and the specification of dental mesenchymal and epithelial cell lineages. Cold Spring Harb Perspect Biol. 2012;4.Google Scholar
- 18.Young CS, Abukawa H, Asrican R, Ravens M, Troulis MJ, Kaban LB, Vacanti JP, Yelick PC. Tissue-engineered hybrid tooth and bone. Tissue Eng. 2005;11.Google Scholar
- 20.Gao ZH, Hu L, Liu GL, Wei FL, Liu Y, Liu ZH, Fan ZP, Zhang CM, Wang JS, Wang SL. Bio-Root and implant-based restoration as a tooth replacement alternative. J Dent Res. 2016.Google Scholar
- 21.••Yang K-C, Kitamura Y, Wu C-C, Chang H-H, Ling T-Y, Kuo T-F. Tooth germ-like construct transplantation for whole-tooth regeneration: an in vivo study in the miniature pig. Artif Organs. 2016;40:E39–50. This recent study is of major importance because it showed the successful generation of erupted bioengineered teeth in a porcine tooth loss model. Implanted tooth buds were composed of gelatin-chrodroitin-hyaluronan scaffolds seeded with differentiated odontoblast and osteoblasts and gingival epithelial cells. This investigation supports the proposal for using adult autologous cells for whole tooth bioengineering in future clinical applications.CrossRefPubMedGoogle Scholar
- 34.Angelova Volponi A, Kawasaki M, Sharpe PT. Adult human gingival epithelial cells as a source for whole-tooth bioengineering. J Dent Res. 2013.Google Scholar
- 43.••Kuchler-Bopp S, Bécavin T, Kökten T, Weickert JL, Keller L, Lesot H, et al. Three-dimensional micro-culture system for tooth tissue engineering. J Dent Res. 2016;95:657–64. This recent study is of major importance because it demonstrates that that tooth organogenesis can be achieved by incorporating scaffold free single cell suspensions with the hanging drop method. Since a considerably low amount of cells were used, as compared to traditional hanging drop methods, this approach can be used for high-throughput screening of dental cell sources from normal and even pathologic tissue for tooth development and regenerative medicine studies.CrossRefPubMedGoogle Scholar
- 44.••Zhang W, Vázquez B, Yelick PC. Bioengineered post-natal recombinant tooth bud models. J Tissue Eng Regen Med. 2014; n/a-n/a. This study is of major importance because it demonstrated that postnatal tissues from porcine wisdom teeth can be recombined to form bioengineered tooth tissues suggesting that the odontogenic potential was maintained after extraction. These results coincide with earlier work that showed the conserved odontogenic potential of dental postnatal single cell suspensions. In addition, this work supports the possibility of using human dental tissues from unerupted wisdom teeth to generate functional whole replacement teeth.Google Scholar
- 48.Monteiro N, Yelick PC. Advances and perspectives in tooth tissue engineering. J Tissue Eng Regen Med. 2016;n/a-n/a.Google Scholar
- 52.Prescott RS, Alsanea R, Fayad MI, Johnson BR, Wenckus CS, Hao J, et al. In vivo generation of dental pulp-like tissue by using dental pulp stem cells, a collagen scaffold, and dentin matrix protein 1 after subcutaneous transplantation in mice. J Endod. 2008;34:421–6.CrossRefPubMedPubMedCentralGoogle Scholar
- 56.Ventola CL. Medical applications for 3D printing: current and projected uses. Pharm Ther. 2014;39:704–11.Google Scholar
- 59.Fuellhase C, Soler R, Andersson KE, Atala A, Yoo JJ. 264 Generation of organized bladder tisue constructs using a novel hybrid printing system. Eur Urol Suppl. 8:186.Google Scholar
- 63.Thesleff I, Mikkola M. The role of growth factors in tooth development. In Int Rev Cytol Vol. 2002;Volume 217. (Academic Press), pp. 93–135.Google Scholar
- 82.•Oshima M, Inoue K, Nakajima K, Tachikawa T, Yamazaki H, Isobe T, et al. Functional tooth restoration by next-generation bio-hybrid implant as a bio-hybrid artificial organ replacement therapy. Sci Rep. 2014;4:6044. This investigation is of importance because it demonstrates that a bio-hybrid design can be used as a possible alternative to whole tooth bioengineering. This bio-hybrid tooth root approach resulted in an implant that was supported by regenerated periodontal tissues formation and function.CrossRefPubMedPubMedCentralGoogle Scholar