Researchers at Temple University’s Kornberg School of Dentistry and College of Engineering are reporting progress in their collaborative efforts in using stem cells to regrow the pulp tissue and dentin tissue that make up the center of a tooth. According to the researchers, their work may even make undergoing a root canal a more pleasant experience.
“These two tissues come from a similar region and have a close relationship to each other. They make up the pulp-dentin complex. If dentin decay is not that severe, the pulp can generate new dentin to repair it. All this happens naturally,” said Maobin Yang, DDS, MDS, PhD, associate professor of endodontology and director of the Regenerative Health Research Laboratory.
“But when we see patients, most have the pulp infected, so the nerve has to be taken out,” said Yang. “The root canal is then empty, so we currently fill up the root canal with inert treatment.”
Yang wanted to find a better treatment, so he began to research the use of stem cells in with a small scaffold to simultaneously regenerate pulp and dentin tissue. However, there is one problem in generating the tissue by using stem cells.
“When you put the components into the canal, they don’t have spatial control, so they don’t know where to grow the pulp and the dentin—the dentin outside and the pulp inside. So we need structure,” Yang said.
Laura H. Carnell Professor Peter Lelkes, PhD, chair of the Department of Bioengineering at the College of Engineering, then worked with Yang to develop a bioengineered two-sided scaffolding to guide the tissue growth. They have been collaborating for the past three years.
“The beauty of the system is that we have shown in vitro that we can engineer a two-sided scaffold and can guide the stem cells to differentiate into both pulp cells and dentin, producing odontoblasts that will eventually repair the root canal. We, our smart scaffold, can do this differentially with great efficacy,” said Lelkes.
The partnership began when Yang arrived at Temple six years ago and began working out of a lab in Lelkes’ lab, where he found a friend and mentor in Lelkes. So when Yang needed bioengineering assistance in his research, he turned to Lelkes.
“This is one of the great cases when he says, ‘Here, I have a clinical problem. Let’s try to find an engineering solution to this problem,” Lelkes said.
Growing full teeth is still a distant goal, Yang said, because the various materials that make up teeth are complex and differ in their components. He said that most similar research focuses on regenerating parts of the tooth and that regenerating the nerve and dentin as they are would be particularly valuable since root canal treatment is so common. The next step would be testing the tissue growth technique in animal models.
“I believe in the next 10 years, or sooner, when patients come to the endodontist for a root canal treatment, we will be able to provide an alternative, equivalent, or even better treatment modality, which is to regrow the nerves and the blood vessels and to grow new pulp back into your tooth instead of using inert material,” Yang said. “With investments and lots of research, I believe that we will get there soon.”