Gutta-Percha Replacement Could Regenerate Dental Pulp

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Many of today’s endodontists use gutta-percha to seal completed root canals. But one researcher at the Texas A&M University Baylor College of Dentistry has a different material in mind that not only seals the canal but also restores the tooth. Plus, the National Institute of Dental and Craniofacial Research has provided a $1.8 million, 5-year research grant to develop it.

Dr. Xiaohua Liu has fabricated a combination of dental pulp stem cells and tubular-shaped scaffolding materials that allow dental pulp to regenerate itself, including correctly structured tissues and blood vessels, to yield a healthy, living tooth.

“The current material used in root canal treatment does not strengthen the root, nor does it provide any defense against bacteria invasion. It simply acts as a space filler,” said Dr. Jianing He, an endodontist and adjunct associate professor consulting on the research.

“The approach proposed in Dr. Liu’s grant will allow the patient to regenerate a pulp-dentin complex that is both anatomically and functionally similar to the original structure,” He said. “This structure will allow continued development of the tooth, and just like the natural tissue, it will have its own defense mechanisms to protect the tooth against future infection.”

“Our strategy is a lot like the root canal, but we actually try to regrow the living tissues inside. In that way, your tooth is still a living tooth,” Liu said. “The challenge with regenerating dental tissue is that we don’t just want to have the cell. We have to make sure it is the right structure.”

Without a well-organized structure, the regenerated tissues won’t be able to perform normal mechanical and biological functions. The first of its kind, the synthetic dentin matrix that Liu and his team designed forms the basis for vascularization tests where a human tooth root injected with the material is implanted under the skin of mouse models. The outcomes of these tests could lead to clinical trials.

Furthermore, there is a difference between regenerating dentin, which has an extremely low ability to repair itself when damage occurs, and bone, which can completely repair itself in a few months without treatment, said Dr. Jerry Feng, professor of biomedical sciences and another consultant on the project.

“Dr. Liu’s work, regeneration of dentin in vitro in a way similar to what’s happening in our body, is a very promising start for patients who have tooth fracture or diseases,” Feng said. “This project is likely to change the future of dentistry if this manmade dentin is applied to human patients.”

“Regenerative endodontics is the frontier of our specialty,” said He. “Our goal is to develop a predictable treatment approach that can be used on a broad patient base and to have endodontists perform these procedures in the future.”

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