The field of dentistry has seen many changes in terms of advances in technologies. Among the various branches of dentistry is the field of prosthodontics: that deals with the repairing of missing teeth. According to the Journal of Prosthetic Dentistry (2005), it is defined as the diagnosis and treatment of damaged or missing teeth and/or maxillofacial tissues using appropriate substitutes to support the appearance and functions in oral health in patients.
While there are advances in technology such as implant-supported dentures that are manufactured using computer- aided designing and computer- aided manufacturing (CAD/CAM), there are few challenges. These include the correct maintenance of the normal physiological function of the implanted tissues and frequent repairs. According to Clinical Oral Implants Research (2012), the occurrence of peri-implant mucositis is pitched in 80 percent of patients and 50 percent of dental (Mombelli et al., 2012).
This brings in the field of stem cells and regenerative medicine. Dental pulp stem cells (DPSC) and bone marrow-derived mesenchymal stem cells (BMMSC) can differentiate into osteogenic, adipogenic, and chondrogenic lineages. The highest osteogenic potential for tissue-engineered bone has been shown by DPSCs. The stem cells from pulps of human exfoliated deciduous teeth (SHED) show bone marrow MSC-like features. Functional vessel-like structures were formed followed by the formation of dental pulp-like tissue during in vivo transplantation studies that increase the clinical potential of DPSCs to treat a variety of pathologies.
Looking at the field of corneal implantation, a combination of contact lenses and DPSCs has been used for treatment. DPSCs were transplanted using soft contact lenses as carriers to deliver the cells. Not only did the DPSCs shift themselves from the lens but they also expressed cytokeratins 3 and 12 (corneal specific markers) showing the suitability of dental mesenchymal stem cells for corneal disease treatment (Marei and Backly, 2018).
Given the promise of transplanting insulin-producing islet cells from a donor pancreas to treat diabetes, there have been attempts to differentiate stem cells into beta cells of the pancreas. DPSCs become promising as their collection poses minimal risk or discomfort for the patient. The administration of DPSCs in mice with diabetic neuropathy resulted in relief from pain (more than what was achieved with clinically used analgesics) with the probable involvement of secreted angiogenic and anti-inflammatory factors (Guimarães et al, 2013).
DPSCs isolated from the administration of dental pulp of third molars extracted from young patients into mouse models of muscular dystrophy caused re-epithelialization and new blood vessel formation to also promote myogenic precursor cells within the transplanted muscles (Martínez-Sarrà and team, 2017).
These studies and many others open up the potential of dental mesenchymal stem cells to treat dental issues and other non-dental diseases. The transplantation of DPSCs and their secretions exerting paracrine effects can translate into a clinical scenario for treating a host of diseases.
The glossary of prosthodontic terms. J Prosthet Dent. 2005 Jul; 94(1):10-92.
Mombelli A, Müller N, Cionca N. The epidemiology of peri-implantitis. Clinical Oral Implants Research. 2012 Oct; 23 Suppl 6():67-76.
Marei, M. K., & El Backly, R. M. (2018). Dental Mesenchymal Stem Cell-Based Translational Regenerative Dentistry: From Artificial to Biological Replacement. Frontiers in bioengineering and biotechnology, 6, 49.
Guimarães ET, Cruz Gda S, Almeida TF et al. Transplantation of stem cells obtained from murine dental pulp improves pancreatic damage, renal function, and painful diabetic neuropathy in diabetic type 1 mouse model. Cell Transplant. 2013; 22(12):2345-54.
Martínez-Sarrà E, Montori S, Gil-Recio C ,et al. Human dental pulp pluripotent-like stem cells promote wound healing and muscle regeneration. Stem Cell Research & Therapy 2017 Jul 27; 8(1):175.