Ulternative Therapy

Dental Pulp Stem Cells,

a New Era in Tissue Engineering

Stem cells are primitive cells that can differentiate and regenerate deteriorating cells in different parts of the body such as heart, bones, muscles and nervous system. For years scientists all over the world have been working on possibilities of using these stem cells to regenerate human cells which are damaged due to illness, developmental defects and accidents. This article is to give an overall idea about stem cells in general, history and future, and where does dentistry stand in that field.

Key words: Stem cell, Embryonic stem cells, Adult stem cells, SHED, Chondrocytes, Osteoblasts, Adipocytes, Mesenchymal stem cells. Introduction

Dr. Ghada A. Karien BDS, JDB (Paed) • Paediatric dentist Jordanian Dental Board in paediatric dentistry • MOH/Al-Basheer hospital ghadakarien@gmail.com

The term stem cell was proposed for scientific use by Russian histologist Alexander Maksimov in 1908. While research on stem cells grew out of findings by Canadian scientists in the 1960s.1, 2 In general there are two broad types of stem cells which are: Embryonic stem cells, and Adult stem cells. Embryonic stem cells were harvested from embryos, they are cells derived from the inner cell mass of the blastocyst (early stage embryo, 4-5 days old, consist of 50-150 cells) of earlier morula stage embryo.3 In other words these are the cells that form the three germ layers, and are capable of developing more than 200 cell types. In 1998 the first human embryonic stem cell line was derived at university of Wisconsin-Madison.4 Embryonic stem cells have both moral and technical problems, because these cells will later develop into a human being, taking these cells will require destruction of an embryo. Technically these cells are difficult to control and grow and they might as well form tumors after their injection. Differentiating embryonic stem cells into usable cells while avoiding transplant rejection are just a few of the hurdles that embryonic stem cell researchers still face.5 And after ten years of research6, there are no approved treatments or human trials using embryonic stem cells; but because of the combined abilities of unlimited expansion and pluripotency, embryonic stem cells remain a theoretically potential source of regenerative medicine and tissue replacement after injury or disease.


Smile Dental Journal Volume 4, Issue 2 - 2009

8 Smile Dental Journal Volume 4. Stem cell therapy which was once a science fiction is now becoming more towards reality. and it might make the dream of many people come true.17 Specifically talking about the dental field. Issue 2 . liver disease.Placing the stem cell into a mold of tooth crown which is made of Enamel-like substance with a scaffold material. the tooth fairy might be able one day to save their life. Parkinson’s.13 2. these factors play an important role in the multiplication and differentiation of stem cells into the specifically needed type of cells. and then they will start to loop blood vessels through this scaffold.Scaffold of extra cellular matrix. 3. blindness. after that this will be implanted elsewhere in the body and wait until it is mature. One of the major advantages one gets from harvesting stem cells from his own body and then using them later in his tissue regeneration if he has an illness is that there will be no refusal of these cells as they are already body parts. 3. diabetes.18 Discovery that human mature pulp tissue contains a population of multi-potent mesenchymal dental pulp stem cells with high proliferative potential for self renewal and the ability to differentiate into functional odontoblast has revolutionized dental research and opened new avenues in particular for reparative and reconstructive dentistry and tissue engineering in general. and most strikingly regenerating entire teeth structures is the horizon. In the future. Alzhimer. there are three approaches which were investigated by different labs to implant stem cells from teeth in humans and these are: 1. BMPs (bone morphogenic proteins) and cytokines play a major role in organogenesis.If there are no teeth present in the oral cavity from which stem cells can be harvested. years from now dental stem cells will hopefully be able to correct cleft palate sparing children from multiple surgeries. So parents taking the decision to bank their children’s milk teeth might be the best gift they could ever give to their child. 2.Responding stem cells which are originally harvested from the patient and preserved under good conditions to maintain their special ability to differentiate into a wide range of cells. then these teeth will be extracted and implanted in the oral cavity. medical researchers anticipate being able to use technologies derived from stem cell research to treat a wider variety of diseases including cancer.Tissue engineering and regenerative medicine seek to replace lost or damaged tissues due to any reason. we can take stem cell from unerupted wisdom tooth. multiple sclerosis.16. this is like planting a seed and waiting for it to grow. Milk teeth which were kept by children under their pillows to be collected by the tooth fairy might have a greater meaning.2009 . which provide these cells with the environment and mold to grow into what we want them to become and function. and in the dental aspect specifically GDf-11 (growth/differentiation factor 11) which is a novel member of BMP/TGF B family is expressed in differentiating odontoblasts and plays a major role in differentiation of dental pulp stem cells into odontoblasts which is the corner stone in teeth tissue engineering. Many people will ask themselves. in other words the patient will not need to go through the process of immunosuppressant and that will spare him lots of suffering and time. spinal cord injuries.15.14. for example in cases of car accidents or falling down. and this needs three major ingredients which are: 1.Morphogenic signals such as growth factors and differentiation factors.Harvesting a wisdom tooth of a person and releasing stem cells from their pulp tissue. organize them into three dimensional structures and give proper cues to them before putting them back into the socket. how can the scientists be able to use dental stem cells in regenerating dental tissues? Well. and these implanted stem cells will help to regenerate the pulp of the injured teeth sparing them root canal treatments. muscle damage and many other diseases. stem cells will also have the potential to save injured teeth and jaw bones. correct periodontal defects. heart diseases. the stem cells are then implanted in a severely injured tooth.

he was luckily able to isolate. In general Mesenchymal Stem Cells MSC are non-haematopoietic stromal cells capable of differentiating into a range of cells.g. Smile Dental Journal Volume 4. Adipocytes: Another type of stem cells that have the ability to repair damaged cardiac tissues following a heart attack. Osteoblasts: They are stem cells that have the ability to regenerate bone. Pluripotent stem cells can be found in cord blood but are small in Number. blood and bone marrow. Issue 2 .. Mesenchymal Stem Cells: Those are the most potent among all tissue stem cells and have the ability to differentiate into various types of reparative cells. and even some of these banks do not only freeze cord stem cells but also dental stem cells of baby teeth.. the tooth is extracted by the dentist and preserved in a special kit provided from the stem cell bank company who then in their turn transfer the tooth to their special labs to harvest the dental stem cells and store them in their bank for each child confidentially until they are needed later for the child himself or a member of his family.2009 7 .8 These adult stem cells have been successfully used for many years to treat leukemia and related bone/blood cancers through bone marrow transplants. which are cells found in a developed organism and they have two properties: first the ability to divide and create another cell like itself.11 After the scientists studied the dental pulp looking for stem cells they found that the dental pulp was rich in different stem cell types such as: Chondrocytes: which are stem cells that have the ability to regenerate cartilage and these cells play an important role in the treatment of arthritis and joint diseases.12 Most adult stem cells are lineage restricted and are generally referred by their tissue of origin e. endothelial stem cells.etc.9. adipose derived stem cells. grow and preserve these stem cells’ regenerative ability. The first one marrow transplant between two siblings was done successfully in 1968.Ulternative Therapy That opened the window wide for the so called adult stem cells. those cells were first discovered in bone marrow and they were noticed to have the ability to double into many populations without loss of function.10 Stem Cells in Dentistry In the year 2003 Dr. They can be found in both children and adult. Mesenchymal stem cells Recently stem cell banks are present. Songtao Shi who is a paediatric dentist discovered baby tooth stem cells by using the deciduous teeth of his six year old daughter. This can be done easily when a child’s anterior milk tooth is shedding. and he named them as SHED (Stem cells from Human Exfoliated Deciduous teeth). mesenchymal stem cells. they also have the so called homing property which means that when they are delivered systemically they migrate to the site of injury.7 Adult stem cells can in general be found in umbilical cord blood. So it is to say that MSC are more promising for therapeutic applications than other types of stem cells. Second they divide to create a more differentiated cell than itself.

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