12th January 2017

New tooth repair method could revolutionise dental treatments

Researchers at Kings College London report a way of using an Alzheimer's drug to stimulate the renewal of living stem cells in tooth pulp.

Following trauma or an infection, the soft inner pulp of a tooth can become exposed and infected. To protect the tooth from infection, a thin band of dentine is naturally produced and this seals the tooth pulp, but is insufficient to effectively repair large cavities. Currently, dentists use human-made cements or fillings – such as calcium and silicon-based products – to treat these larger cavities and fill holes in teeth. This cement remains in the tooth and fails to disintegrate, meaning that the normal mineral level of the tooth is never completely restored.

However, in a study published this week by Scientific Reports, scientists from the Dental Institute at King's College London have proven a way to activate the stem cells contained in the pulp of the tooth and generate new dentine – the mineralised material that protects the tooth – in large cavities, potentially reducing the need for fillings or cements.

This novel, biological approach could allow teeth to use their natural ability to fully repair large cavities, rather than using cements or fillings, which are prone to infections and often need replacing a number of times. Indeed, when fillings fail or infection occurs, dentists have to remove and fill an area that is larger than what is affected, and after multiple treatments the tooth may eventually need to be extracted.

Significantly, one of the small molecules used by the team to stimulate the renewal of stem cells included Tideglusib, previously used in clinical trials to treat neurological disorders including Alzheimer's disease. This presents a real opportunity to fast-track the treatment into practice.

Using biodegradable collagen sponges, the team applied low doses of small molecule glycogen synthase kinase (GSK-3) to the tooth. They found that the sponge degraded over time and that new dentine replaced it, leading to complete and natural repair. Collagen sponges are commercially-available and clinically approved, again adding to the potential of the treatment's swift pick-up and use in dental clinics.

"The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities – by providing both pulp protection and restoring dentine," says lead author of the study, Professor Paul Sharpe from King's College London. "In addition, using a drug that has already been tested in clinical trials for Alzheimer's disease provides a real opportunity to get this dental treatment quickly into clinics."

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