Or: can we grow complete teeth in the lab?
Genetic treatment methods are among the frontiers of modern medicine, with many attempts and successes in hereditary or malignant diseases. Tissue engineering—growing tissues under laboratory conditions—has also advanced significantly.
In dentistry, genetic technologies are developing toward clinical applications. The most common today is diagnostics (via a simple saliva test; you can read an example here).
What are stem cells?
Stem cells are undifferentiated cells that can develop into several different tissues. This helps explain their potential to support healing of damaged or missing tissues.
Today, when tooth tissue, gums, or supporting bone around a tooth is damaged, we usually treat with artificial materials meant to “fill the gap” and restore enough structure for function and aesthetics. But is there a way to renew tissues—not only replace them? Will genetic engineering one day allow us to create a complete tooth that can replace a missing tooth instead of an implant?
An impossible dream?
At present we do not have a realistic ability to create a complete tooth in the laboratory, despite occasional breakthrough headlines—and it is unclear whether that will be possible in the future. Researchers are, however, optimistic about using stem cells to restore parts of the tooth: repairing damaged nerve tissue in the tooth (which may help avoid root canal treatment), regenerating bone and gum tissue that has receded (today often treated surgically only), and even restoring tooth roots (the portion within the gum that supports the crown).
Stem cells are often taken from baby teeth or wisdom teeth, but they do not currently allow creation of a complete tooth for two main reasons: tooth germ development in humans is slow, and accelerating it may risk uncontrolled differentiation and tumor formation; and the stem cells we can currently harvest have already undergone some early differentiation, so they are not early enough to form every tooth cell type. Still, the ability to develop root tissue and supporting tissues may be enough for a biological implant based on hard tissue as an alternative to today’s metal implants. Experiments using 3D printing to create a tooth scaffold of the desired shape, together with growth factors that guide cells into the intended tissue, have already shown strong success in large animals, and human application appears closer than ever.
In summary, laboratory technology to repair tooth tissues and create implant alternatives (but not complete teeth) already exists; the next stage is clinical application. We hope that in the not-too-distant future, regenerating vital tooth parts (such as the nerve and gum tissue) will become part of what dentistry can offer.