Research,  Science

Teeth regeneration and regrowth: current research and future treatments 2020

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!

Enamel regeneration

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


Dentin regeneration

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


Pulp regeneration

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 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

There are two possible approaches to growing new teeth – implanting whole living teeth or growing teeth directly in the mouth of a patient.


Implants advancements

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

Replicate Tooth

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.

References

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 January 15, 2020.

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