Since there are multiple breakthrough news (mostly containing phrases like No more dental fillings!) all over the web we have decided to put together single page with all current and upcoming state-of-the-art treatments that will revolutionize dentistry. This page is designed to be reliable and up-to-date, but please check "last updated" date to be sure if we kept our promise!
First of all, it is important to separate enamel remineralization and enamel regeneration. In this article, we are discussing only the latter one, which means growing new layers of enamel, which your body is unable to do on its own.
Most promising work regarding regrowing enamel
Repair of tooth enamel by a biomimetic mineralization frontier ensuring epitaxial growth
When will this treatment be available?
Main problem with this treatment is really slow regrowth rate – 2.7µm for 48 hours treatment which equals approximately 17777 hours needed to regrow one millimeter of enamel. So to be clinically applicable this technology would have to be improves. As of now it does not look as a viable treatment for dental caries but it may be helpful in the future in treating enamel erosion. We expect this treatment to be commercially available within 15-20 years’ time and only to treat enamel erosion, not dental caries.
Other work regarding regrowing enamel
A Synthetic Enamel for Rapid Tooth Repair
This work, by dr Kazue Yamagishi and her team is a novel idea of restoring teeth with early decay. Instead of drilling and filling teeth with resins she suggests using special toothpaste with HAP crystals (called Synthetic Enamel). After etching tooth with early decay, her toothpaste is applied and creates perfect seal unlike resins that are unable to do so. Although the treatment is called a toothpaste it actually is a form of a professional treatment performed on a dental chair that takes about 15 minutes to complete. If you ask us, it’s somewhat similar to clinically available DMG Icon technology, only more biocompatible. Initial information on this treatment was published in 2005, and toothpaste was announced for 2016 (Japanese market) but as of 2020 it’s still not available and it does not look like it’s going to be in the near future or ever.
Dentin is a tissue that is usually covered by enamel (or some kind of dental fillings) and surrounds the entire pulp. This is the second layer that gets affected if you develop dental caries. In contrast to enamel, your body can grow new layers of dentin (called secondary and tertiary dentin) but it does not happen in the way you may think it does.
Most promising work regarding regrowing dentin and its regeneration
Promotion of natural tooth repair by small molecule GSK3 antagonists
When will this treatment be available?
At this point there are no clinical trials available yet, but the treatment was confirmed do be viable in humans regarding low toxicity and ability to regrow larger layers of dentin. We expect this treatment to be available within 10 years’ time.
Pulp is the inner part of each tooth and it’s made of living connective tissue and cells called odontoblasts. It is sealed and protected by dentin but in case of deep caries or trauma can be exposed and infected. So far the only way of treating such conditions was an endodontic treatment which is a form of a therapy that involves the removal of the dental pulp.
Dental pulp regeneration – most promising treatment alternative to root canals
SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration
Novel form of regenerative treatment to replace classic endodontic treatment is SealBio developed in India in 2012. It is a new kind of endodontic treatment protocol that’s non-surgical and developed to manage pulp and periapically involved teeth. It has been found to cure and regenerate an infected root canal through stem cell activation. Sounds good right? Sadly the stem cell activation and sealing are done at apical foramen, and the pulp in the chamber is still removed, so that’s not exactly what you may have thought.
Low Level Laser Therapy for dental pulp regeneration
Since there is no real alternative to root canal therapy, the only way to help regenerate your pulp (successful to a limited extent) is LLLT, which stands for Low-Level Laser Therapy (red soft laser). It has been studied that under certain conditions pulp in dogs’ teeth responded better when subjected to LLLT before direct pulp capping.1 But they have also shown that the use of MTA material instead of gold foil gave better results than the LLLT which suggests that the treatment is not as effective, as we’d like it to be.
Growing teeth – whole tooth regrowth
There are two possible approaches to growing new teeth – implanting whole living teeth or growing teeth directly in the mouth of a patient. Sadly there are no upcoming treatments at this point. However, there were some discoveries and advancements and we will describe them all here soon.
Vaccine for dental caries
There are multiple approaches regarding vaccination for dental caries, some of them have clinical trials in progress.
Since growing and implanting whole teeth is not coming anytime soon we have decided to focus also on dental implants research and innovation since last years there were some impressive advancements in this field as well.
Modern dental implants are a technology that is about 40 years old since their milestones in osseointegration were termed in 1981. The standard screw-type implant has not changed much since that time, but there were some novel approaches listed below. Implants debuted as a metal (titanium) screw
Zirconium as a dental implant material
Bioimplant (RAI – Root Analogue Implant)
This is first CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) implant development system based in Vienna, Austria, Europe (and as of now, available only there). Each procedure consists of three steps:
- pre op CT/DVT scan
- tooth extraction in certain manner
- immediate (same or next day) implant placement with protective splint
- crown fitting after 8-12 weeks healing period is complete
Main advantages of this approach compared to classic dental implants are the following:
- there is no need for a sinus lift or bone grafting
- there is also no need for a classic implant surgery – the whole procedure is simplified and easier, meaning there is no drilling into bones
- the implant is designed to fit your bone socket, rather than drilled into bone that later fits the implant
- implant is made fully from zirconium (it’s 100% titanium free)
However it is also important to address limitations of this system:
- you need to have your tooth still in place
- success rate is marginally lower than classic implants
- it is being offered in only one place – in Vienna (Austria, Europe)
- it is slightly more expensive than classic zirconium implants
This system is based a concept similar to the Bioimplant, but uses titanium instead of zirconium as a base material (titanium base is fused seamlessly to the zirconium crown for aesthetic purposes). While it may sound inferior, the main advantage of this company is that the implants are not produced on-site and thanks to that it is being offered in more places than just one. Yet the FDA approval is not cleared, so currently you cannot get any kind of anatomic implants in the United States.
Please note that as of 2020 Replicate Tooth went bankrupt and their technology will no longer be in commercial use.
1 The Effect of Low Level Laser Therapy on Direct Pulp Capping in Dogs – J Lasers Med Sci. 2016 Summer; 7(3): 177–183.
This article is still work in progress and was last updated on July 10, 2020.