More than 15 million root canals are performed yearly by disinfection and placement of a root filling. An alternative approach would regenerate the pulp-dentin complex using autologous post-natal mesenchymal stem cells (MSCs) with a resorbable scaffold.
View submitted ideas on what it will take to reach this goal.
Tooth can be used as bioscaffold by decellularizing and demineralizing the permanent human tooth by controlled way of chemical use. The Extracellular matrix of the pulp and dentin acts as niche for the mesenchymal stem cell to grow and differentiate into odontoblasts and can recalcify the tooth again.Using autologous stem cell to reseed these scaffolds and then implanting them in the socket after immidiate extration... more »
Using glycopolymers to mimic the natural barrier function of mucins and the glycocalyx to improve protection for natural healing and support the environment for cell growth rather than apoptosis or necrosis.
A better understanding of the mechanisms that bacteria use to modulate oral mucosal responses to maintain health could provide new opportunities to develop preventive strategies based on auto-therapies. Thinking about host-microbes interactions in health as a dynamic (but not static) process will support this goal.
Dental caries and periodontal disease are biofilm-related infections. An imbalance in biofilms composition can lead to disbyosis and onset of the disease. The final aim of preventive therapies should be to restore healthy mutual relationships between oral biofilms and human body rather than achieving biofilm eradication, microbial killing or antifouling surfaces. In this sense, a biofilm can act as a reservoir for the... more »
In a dry mouth, how do we ensure caries restoration lasts a long time? Can we develop non-invasive ways to remineralize and repair teeth?
A comprehensive definition of hard and soft oral and craniofacial tissue health needs to be defined with deviations that are considered "healthy". Once criteria exists, it will be easier to determine disease state in these tissues.
The primary reason that composite restorations fail is recurrent decay. Recurrent decay is a pernicious problem for patients ― the defective restoration will be replaced with a larger restoration that will fail, this will lead to replacement with an even larger restoration, possible root canal and eventually tooth loss. Engineered peptides coupled to novel material chemistries can break this vicious cycle by inhibiting... more »
The immune system broadly can regulate development, regeneration, and disease, but it is not yet well understood how to harness the immune system to treat autoimmune or chronic inflammatory disease or to promote regeneration. Multi-disciplinary research, which deepens our knowledge of immunology as well as develops engineering approaches to tune cell behavior, may enable future advancements in immunotherapies in oral... more »
Dental composites are nowadays widely used and are made of an acrylic resin matrix reinforced with glass filler microparticles. Unfortunately, due to the formation of microcracks approximately 25% of the replacements are caused by fracture of the restoration. The development of novel self-healing and fatigue-resistant composite restorations with the capacity to repair cracks in situ for extended periods of time would... more »
Controlled expression of chemokines could be used to direct select immune cells to the microenvironment of diseased or injured tissues. Since different chemokines will recruit particular immune cells based on the chemokine receptors those cells express, it may be possible to add or induce the expression of specific chemokines at local sites of disease or injury to recruit “good” or desired immune cells to that location,... more »
Cellular & microbial interactions with the extracellular matrix in oral cavity calcified & non-calcified tissues are major determinants of structural & functional oral health. Proposed: multi-disciplinary approaches to increase understanding of multi-faceted roles of extracellular matrix (ECM) in craniofacial dev., inflammation & tissue repair, innate & adaptive immunity, microbial-host tissue interactions, and in... more »
The idea is to trigger the endogenous regenerative program after an injury by manipulating target gene expression level. Need to identify the genetic targets for increasing endogenous tissue renewal to aid in endogenous repairing.
Develop approaches for generation of functional dental, oral and craniofacial (DOC) cell types by in situ reprogramming from other cell types available at a given tissue site. Examples of this kind of reprogramming are available in the literature: pancreatic endocrine beta-cells from pancreatic exocrine cells; cardiomyocytes and neurons from fibroblasts, among others. Although potentially very useful for regeneration... more »
The local tissue microenvironment can determine the success or failure of regenerative approaches, but much more needs to be discovered about how local extracellular matrix and bound signaling components can influence regenerative approaches. Applying future insights from embryonic development to modify local microenvironments and niches could facilitate successful regeneration.