The current state of dentistry is on the edge of a future where treatments will be conducted faster, cause less damage to surrounding tissue, and rebuild esthetically precise replicas of the treated area. Let’s face it, we’re already there, but it’s only the beginning. Tools such as 3D imaging technology, in-office milling machines, and laser cutting are only the beginning.
The current dental treatments for missing or damaged teeth include dentures and implants crowned with prosthetic caps. Although some functionality is eventually restored in the tooth, a mimic copy of the biological tooth is never retained. That’s why odontogenesis treatments with oral stem cells are being researched and developed throughout the world.
Regenerative endodontic procedures (REPs) are an alternative treatment to traditional root canal treatment for immature teeth. It involves the transfer of apically positioned stem cells of the apical papilla (SCAP), into the root canal system. Clinical success has been reported. But the predictability of expected outcomes and the formation of new tissues are affected by the lack of an available scaffold that mimics the complexity of the dental pulp extracellular matrix (ECM).
In the study, three methods were evaluated that could be used as a potential autograph scaffold for the decellularization of human dental pulp. The goal was to isolate the extracellular matrix (ECM) of the tissue from its inhabiting cells. This leaves an ECM scaffold of the exact, original, tissue. Tissue engineering occurs when post-natal stem cells are cultivated on a bio-engineered, three-dimensional scaffold. The study used tooth slices of extracted third molars that were decellularized by such methods.
One of the three methods demonstrated the maximum observed decellularization with minimal impact on the ECM composition and organization. Additionally, recellularization of the scaffold supported the proliferation and differentiation of the SCAP. Ultimately, the study demonstrated that human dental pulp from healthy extracted teeth can be successfully decellularized, and the resulting scaffold supports the proliferation and differentiation of SCAP. This autograft form in REPs can provide a much needed, suitable scaffold for the endodontics that could improve clinical outcomes and promote the survival of teeth with poor prognosis.