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Stem Cell Research in Dentistry

Contemporary Issues in Dental Hygiene

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St. Petersburg College

Stem Cell Research in Dentistry

For a woman in Spain with a new windpipe, a whole-organ transplant made from her own tissue testifies to the treatment promises of using stem cell research. This surgery, performed in 2008, was the world’s first tissue-engineered transplant using autologous cells. It took only four days of cell growth to save this woman’s life after tuberculosis destroyed one of her lungs. After only four months, there were no signs of rejection. Also, the woman’s airways developed their own blood supply and were almost indistinguishable from normal airways (Goldie, 2009). Success stories, as seen with this woman, reveal the numerous possibilities the future holds as the potential of stem cell research unfolds. The recent detection of stem cells in dental tissue holds exciting possibilities for dentistry.

Stem cells are unspecialized cells that are able to divide at a rapid pace and differentiate into specialized cell types. Unlike other types of cells, stem cells are capable of renewal through cell division, even after long periods of inactivity. When a stem cell divides, there is the potential for the cell to become another type of a cell with a more specialized function or to remain a stem cell. These cells are used for tissue regeneration and repair, as well as the treatment of many medical conditions. Adult stem cells can be found in bone marrow, brain, liver, lungs, breast, skin, skeletal muscles, hair follicles, and teeth (Huang, Lee, Wang, & Yang, 2010). Recovery of these cells is often difficult because they are buried deep into the tissues, and they account for a very small number of total cells. This makes the process of retrieving them invasive and expensive (Spolarich, 2009).

Dental stem cells are the most accessible adult stem cells. These cells can be isolated from the periodontal ligament, dental pulp, the apex of developing teeth, and from exfoliated deciduous teeth (Huang, 2008). All of the stem cells recovered from these areas are considered to be mesenchymal cells. The most abundant source of undifferentiated mesenchymal cells has been found in the pulp of impacted third molars. Mesenchymal stem cells are multipotent cells that have different capacity levels and are capable of becoming specific tissue forming cells. Multipotent cells can self-renew over the lifetime of an individual. These qualities give dental stem cells the potential for regenerating structures distant from the orofacial region (Mao, 2009). Future medicine may use procedures to repair heart and nervous system tissues from cells retrieved from dental stem cells.

Although no approved dental therapies currently exist, the thought of future implementations into clinical practice provides many possibilities for dental professionals. Regeneration of teeth, pulp, dentin, and periodontal ligaments are just a few benefits of using dental stem cells as treatment options. Many specialists are embracing a new shift towards the advancement of tissue engineering. The American Academy of Pediatric Dentistry’s Council on Clinical Affairs adopted a policy on stem cells, saying it “recognizes the emerging field of regenerative medicine and encourages dentists to follow future evidence-based literature” (Garvin, 2009, para. 18). The American Associations of Endodontists states, “The endodontic community is highly motivated in the promotion of tissue regeneration research and practice” (Huang, 2008, p. 380). Regeneration is a more permanent solution for injury and disease compared to the current temporary fixes of metallics, composites and even implants. In vivo and in vitro studies performed in animals have already showed great promise for such growth. Tooth roots in animals that have been regenerated are comparable to traditional surgical dental implants in terms of strength and function (Spolarich, 2009).

Because of the benefits dental stem cells provide, the current trend is to “bank” these valuable cells. This type of preservation holds no ethical concerns for patients like the controversy of embryonic stem cells. Banking services can be offered to a patient of any age, but are ideally performed when the patient is young and healthy. Younger patients are more likely to be free of chronic disease, and the younger stem cells have gone through fewer cell divisions. Previously, extracted teeth were a waste, but they are now considered an incredible source of mesenchymal stem cells. Stem cells from human exfoliated deciduous teeth, called SHED cells, are found in the dental pulp of deciduous teeth (Huang, 2008). These cells grow and multiply more rapidly than pulp from adult teeth. Recovering extracted teeth or naturally exfoliating teeth are a painless way to preserve cells. The opportune time to bank cells for adolescents is during third molar extractions (Spolarich, 2009).

Many companies exist that provide preservation of deciduous teeth for a patient’s potential use in later life. StemSave and BioEden, Incorporated are examples of these companies; their websites provide information for families and dental professionals regarding services and pricing (Goldie, 2009). Kits from these companies are given to dental offices for the harvested tissue samples. These companies use cryopreservation as the process to preserve dental stem cells. The cells are rapidly cooled to subzero temperatures as low as -196 degrees, which stops all cellular activity. This technique helps prevent ice from causing cell damage or death and allows cells to undergo long-term preservation (Huang et al., 2010).

Banking dental stem cells allows for therapies using a patient’s own cells which will minimize risks. According to Goldie (2009), the danger of donor tissue rejection will not occur when using autologous cells. Autologous cell therapy also avoids the risk of contracting diseases from a donor or from developing an immune response. Stem cell therapies will also include the use of genomic diagnostics and pharmaco-genomic drug therapies, which can tailor the medical treatment for the individual. Dental stem cells are being researched to help treat conditions such as type 1 diabetes, cardiovascular disease, liver disease, strokes, heart attacks, and many more (Spolarich, 2009). Banking stem cells may help meet an individual’s healthcare needs for the rest of their life.

Dental professionals have the opportunity to educate their patients regarding dental stem cells and their potential. By keeping current with the research, the dental team can answer questions regarding the collection and storage of cells. Mao (2009) stated that hygienists can play a helpful role by explaining all the advantages and disadvantages of banking. Tooth banking can be included as a part of the preventive treatment plan for patients. Once patients are given all the information regarding the potential of future regenerative therapies, they are able to make their own informed decisions about their dental stem cells. Banking services should especially be offered to parents for their children because being young is the opportune time for collection (Spolarich, 2009).

Although many stem cell therapies are still waiting for approval, there is a tremendous opportunity to prepare now. Stem cell therapies provide many benefits for treatment and dental cells are clearly the most accessible and least expensive. Harvesting dental stem cells do not raise ethical concerns, which are common when people question the use of embryonic stem cells. The regenerative potentials of dental stem cells could transform the future of dentistry. The current methods of endodontic therapy and restorative procedures may be replaced as new tissues are grown and used for repair. The over-all health of patients can also be impacted from dental stem cells because they can be used to regenerate many different types of tissues aside from the oral cavity. Endless possibilities exist as research continues to open the doors for new treatments and therapies.

References

Garver, J. (2009). Dental stem cell potential explored. ADA News. Retrieved from

http://www.ada.org.

Goldie, M.P. (2009). Stem cell research: Transforming medicine. International Journal of

Dental Hygiene 7(1), 74-75. doi: 10:// 2345.672222

Huang, G. (2008). A paradigm shift in endodontic management of immature teeth:

Conservation of stem cells for regeneration. Journal of Dentistry 36(6), 379-386. doi: 10.1016/j.jdent.2008.03.002.

Huang, Y., Lee, S., Wang, C., & Yang, J. (2010). Dental stem cells and tooth banking for

regenerative medicine. Journal of Experimental & Clinical Medicine 2(3), 111-117.

doi: 10://22469567

Mao, J.J. (2009). Stem cells and dentistry. Journal of Dental Hygiene 83(4), 173-174. Retrieved from http://jdh.adha.org

Spolarich, A. (2009). The cell revolution. Dimensions of Dental Hygiene 7(1),

30-33. Retrieved from http://www.dimensionsofdentalhygiene.com.

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