Dental regeneration using stem cells

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Dental regeneration using stem cells

  1. 1. dental regeneration using stem cells The 45th Annual Meeting of the Spanish Society for Periodontics and Osseointegration (SEPA), which will be held May 26-28 in Oviedo, counts on the participation of world-renowned scientific experts in the fields of periodontics, implantology and dentistry. The highlight will be the first-time appearance in Spain of Dr. Paul Sharpe, one of the leading international experts on dental regeneration. The 45th Annual Meeting of SEPA will gather more than 1,500 people in the capital city of Asturias to promote professional progress and gain insight on useful knowledge that will help the industry advance step by step. A Turning Point Several very interesting topics will be discussed in this meeting, including the most controversial and cutting-edge issues pertaining to Dentistry, Periodontics and Implantology, such as dental regeneration using stem cells, the future of periodontology and periimplantology in Spain (with the presentation of the Quo vadis, Periodoncia? study regarding perspectives on periodontology in our country in the upcoming 20 years), achieving clinical excellence (a parallel session will be held on clinical management as a tool of excellence) and innovation in dental aesthetics (not aiming toward1
  2. 2. THE SCIENTIFIC PROGRAM WILL from the University of Sheffield, is Professor ofFOCUS ON HOW TO OBTAIN Molecular Embryology at the University of Manchester, and is currently leading professorCLINICAL EXCELLENCE IN FIELDS at Guy’s Hospital Dental Institute, where heSUCH AS PERIODONTAL PLASTIC established the Department of CraniofacialMICROSURGERY, the treatment of Development.periimplantitis or the placement of implantsand on the main lines of advancement in the As part of his research, he explores geneticaesthetics of bone reconstruction. interactions that control tooth development, as well as the biology and applications ofStem cells: promises and reality dental stem cells for growing new teeth toThe highlight of the 45th SEPA Annual Meeting take the place of those that are missing.will be the appearance of Dr. Paul Sharpe, who Although the technology that he applies is stillwill show the most advanced lines of research in the experimental stages, it is widelyon dental regeneration using stem cells. believed that it’s potential for replacing dentalDr. Paul Sharpe is professor of Craniofacial absences is great, since patients’ new teethBiology at King’s College London, he has will be identical to the original ones. In 2004,published more than 200 research papers and Paul Sharpe unveiled the results of hisis one of the most prestigious researchers in experiments in an animal model in whichthe field of stem cell application in dentistry. scientists implanted stem cells in gums forMany specialists in this field consider Professor subsequent development of a new tooth.Sharpe’s work to be a milestone, as wasBrånemark’s discovery of osseointegration ofdental implants in his era, or Sture Nyman’sregarding periodontal regeneration. PaulSharpe also has his doctorate in Biochemistry Dr. Paul Sharpe Interview for SEPA Noticias Bulletin 1. Dr Sharpe, it’s an honour to have you with us. There near future? are big expectations about your conference among I think the most likely is probably not in dentistry. Dental SEPA Members and the Conference attendees. Is this pulp cells exhibit very similar immune suppressive the first time that you introduce your investigations in a properties to bone marrow mesenchymal stem cells that Spanish congress? are being used in clinical trials as immune suppressants. Yes this is my first time at a SEPA conference and my first If this shows promise, the dental pulp stem cells could visit to Oveido provide a far more accessible autologous cell source. 2. One of your latest publications talks about reparation For dental applications, the most obvious use is in and regeneration of dental structures, and about endodontics to replace pulp tissue. The key here is periodontal ligament and pulpal tissue previously undoubtedly the maintenance of the blood supply. damaged by disease as well. In what state is this 4. If we go a step further, our highest aspiration as research now? dentists would be that we will be able to create new There is a great deal of research being carried out in these teeth. As someone who works in this exciting field, do areas worldwide and progress is being made. My main you really think we will be able to give birth to teeth? interest is trying to gain a better understanding of dental With our current knowledge it is possible, at least stem cells and how they function in vivo to facilitate repair. experimentally using uncultured embryonic cells. 3. With your experience in this field, looking at the However this is a long way from a usable clinical future & thinking of the general dentist that will read this application and there are several very big issues that bulletin…What kind of new treatments based on stem need to be resolved. Large cell numbers are required cells from dental pulp do you think could be used in the that can only realistically be obtained by in vitro 2
  3. 3. The use of stem cells for generating During his conference in the SEPA new teeth has gone from a working Annual Meeting, this expert will hypothesis to being a viable reality point out which new treatments that may reach dental offices in the using dental pulp stem cells could not-so-distant future, especially when be used in the near future. considering the advances in recent According to his research, dental years regarding the utility and pulp stem cells display immune viability of stem cells originating from suppressive properties, similar to periodontal ligament. In the same those of mesenchymal stem cells context, Paul Sharpe has published from bone marrow (which are suggestive studies on the repair and being used in clinical trials as regeneration of dental structures, immune suppressants). If this periodontal ligament and pulp tissue property is confirmed in dental that were previously affected by pulp, stem cells could prove to be disease, offering key elements to help a much more accessible source of better understand dental stem cells autologous cells. and how they work in vivo to promote healing. expansion. Being able to grow cells in conditions that inserted fibromucosa that allows aesthetic retain their tooth-forming abilities is, thus, crucial. One reconstruction. Do you think that in short or medium problem we have found is that teeth made from human term we will have "biological tools" to achieve these cells grow much slower than those made from mouse goals? cells. While this may not be a significant problem in a To be honest I think it is impossible to say. People have clinical context, in the lab it means that experiments to realise that working on cell-based approaches is take longer…and thus progress is slower. much more difficult and more time-consuming than 5. In your investigations you are studying the developing a drug. Drug development can take 20 evolutionary formation of teeth in different species, years to get from discovery to market! especially in heterodont animals such as mammals. 7. Once we consider theoretically that we can be able Do we already know the mechanisms by which an to develop a dental organ using molecular biology incisor or molar are formed? procedures, what you call "natural tooth In very simple terms, yes. However control of crown substitution", the dilemma will be how to control the shape is the least important issue since crowns can be outbreak, the bony insertion and the aesthetic easily changed by established dental techniques.. Far alignment. How do you see this in the future? more important is the formation of the roots. These are trivial problems. If the current ideas work then 6. At present we are able to rebuild the destroyed the tooth that forms will do so along with all its support alveolar ridge in a reasonable manner. However, our tissues, including bone and periodontal ligament. barrier is in the vertical alveolar ridge reconstruction, Alignment of a growing (erupting) tooth is very easy along with regeneration of a high quality keratinized with standard orthodontics.3
  4. 4. Dr. Maurizio Tonetti Interview for www.sepaoviedo2011.comExperts in the field consider that these findings couldlead to clinical applications, among which the most 1. What are your expectations for the Oviedoobvious would be in endondontics for replacing pulp SEPA Meeting ?tissue, where the key issue, without a doubt, would be SEPA has a tradition of excellence anda continuous supply of blood. WITH REGARD TO innovation combined with a specialTHE POSSIBILITY OF GENERATING NEW atmosphere of collegiality and true Mediterranean savoir vivre at all theirTEETH FROM STEM CELLS, THE STUDIES meetings. I expect the Oviedo meeting to be another landmark in terms of science, clinicalCARRIED OUT BY PAUL SHARPE AND HIS translation and enjoyment.COLLEAGUES SUGGEST THAT CURRENT 2. Your lecture is about soft tissue management,KNOWLEDGE MAKES THIS POSSIBLE, at How have we improved the techniques in softleast experimentally, using uncultured embryonic tissue management and where are we going?cells. Nevertheless, a usable clinical application in the Surgery and consequent soft tissuedental practice is very far from being achieved. management has changed radically in the last few years. Thanks to a better understanding of wound healing biology. The impact of riskIn collaboration with SEPA factors and the individuality of the patient, we now start to enjoy unprecedented levels of success: in regeneration, plastic surgery, aesthetics, and conventional periodontal and implant surgery. 3. Do the membranes still have a place in theCon la regenerative techniques?colaboración de: Yes. Membranes have changed a lot; as have the materials that we have available to promote regeneration. What has not changed is the need to support and stabilize soft tissues during healing, and membranes are still a great way to achieve more stable soft tissues. It is also clear that membranes may increase complications, and thus there is a need for advanced training to use them successfully. 4. Is the prevalence of peri-implant lesions responsible for the pendule going back to save more teeth and delay implant placement?8. Finally, from a practical standpoint… Wouldthis kind of treatment of high precision It is a big part of the issue but unfortunatelyrequire a multi-disciplinary approach? not all. Besides the high prevalence of peri-implantitis, we start to realize that: i)Molecular biologists, periodontal surgeons, chewing on implants is not at all like having aorthodontists, restorative dentists skilled in natural tooth; ii) with adequate skills from theaesthetics ... whole team more and more teeth can beOnce a simple, reliable and reproducible saved and preserved over time; iii) patientsapproach is validated it will be treated like a require planning solutions for their dentition for a lifetime.implant and will in fact be a cell implant. Theimplant will be grown in specialised 5. What is your opinion about stem cells inlaboratories, supplied to a dentist who, using regeneration and the research work of Profvery simple surgical techniques, will insert the Sharpe on tooth regeneration?implant into the soft tissue without any bone I am fascinated by the tremendous knowledgedrilling. Growth of the implant will be followed on tooth development that has beenwith standard X-rays and orthodontics applied generated in recent years. I see bothfollowing eruption. The crown will be capped to tremendous potential and great challengescreate the correct visible shape. before a clinical application will become possible. I also foresee that before the times we will be able to “regenerate” teeth, we may be able to use hybrid tissue engineered and prosthetic devices such as metal implants with a functional periodontal ligament. 4

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