Technological Advances In Medicine and Dentistry Part 2
On Managed Tissue Engineering
-Sounds like a lot of science to me… Could you maybe give a few examples?
-Of course. Very often we encounter cases where patients suffer from long-term tooth loss. In many instances this results in some drastic changes in the tissues that used to support teeth. Namely, the bone and the gums that once surrounded teeth undergo the process of resorbtion (reduction in volume, density and mass) and it happens in various ways. For example, in the upper jaw naturally occurring cavities filled with air that are also referred to as sinuses, start growing in size following the teeth loss at the expense of the bone that used to hold those teeth. To conduct ideal and most favorable rehabilitative treatment one would need placement of dental implants in areas of tooth loss. However, with enlarged sinuses and insufficient amount of bone the implant treatment may not be feasible unless local tissue controlled engineering has been carried out prior to placement of dental implants. In such cases we would change the enlarged sinuses to regain lost bone volume by the means of introducing bioactive grafts into the area. This can be biologically compatible forms of calcium combined with growth factors such as cellular platelet rich plasma derived from a patient’s own blood and / or bone inducing synthetic proteins that are currently FDA approved and available for practical use. Once a successful healing and regeneration has taken place placement of the implants would be just a plain sailing!! Another example may be when a patient suffers gum recession and gingival graft (gum tissue re-planting) is indicated. This can be achieved with far greater predictability and degree of success should tissue growth factors are used in the process. This is especially important when we deal with patients that suffer from other problems such as diabetes, or any other condition that would validate extra measures to support regeneration, or even in smokers for we surely know healing is significantly impaired by cigarette smoking.
–What about stem cells? Seems there are not really being used in current applications.
-Well, by introducing all those factors we just spoke about we are INDEED using patients’ own stem cells for we now know that stem cells are present in virtually every tissue of human body. We just “wake them up” and make them work. As far as engineering tissue from stem cells in a lab dish is concerned, that is still the area of research, but no longer a science fiction. The future of stem cell medicine is widely acknowledged and there are even some trendy developments already taking place. Many of our readers must have heard about collecting umbilical blood when a baby is born. This is done for harvesting and preserving stem cells for potential future use. But probably very few know that tooth pulp is also an excellent source of stem cells. And the same tissue banks that offer storage of umbilical stem cells offer the same procedure for stem cells extracted from intact wisdom or baby teeth. We offer this to our patients that are future savvy so to speak. Though usage of those cells for practical medical application is not cleared by FDA, I am absolutely certain that in a few years the technology will be available for their safe and effective use, but for now it may be wise to store them. Just recently there was a report that group of scientist successfully introduced tooth derived stem cells as a part of experimental spine injury surgery in lab mice. So we’re almost there!
To be continued…