Baylor College of Dentistry
Revolutionizing
the Root Canal
Dental pulp regeneration is the end goal of this
$1.8 million NIH grant awarded to TAMBCD researchers
by Jennifer Eure Fuentes
It’s a developing therapy that could stand
to revolutionize root canal treatment as we
know it, potentially impacting endodontists like Dr. Jianing He, adjunct associate
professor and a consultant on the project.
“The current material used in root canal
treatment does not strengthen the root nor
does it provide any defense against bacteria
invasion; it simply acts as a space filler,” He
says. “The approach proposed in Dr. Liu’s
grant will allow the patient to regenerate a
pulp-dentin complex that is both anatomically and functionally similar to the original structure. This structure will allow
continued development of the tooth, and
just like the natural tissue, it will have its
own defense mechanisms to protect the
tooth against future infection.”
It’s a project several years in the making
already. Liu explains one of the hurdles his
team has had to address since starting the
study in 2011.
“Our strategy is a lot like the root canal, but
we actually try to regrow the living tissues
inside. In that way, your tooth is still a living tooth. The challenge with regenerating
dental tissue is that we don’t just want to
have the cell; we have to make sure it is in
the right structure,” Liu says. The reason:
Without a well-organized structure, the
regenerated tissues cannot perform normal
mechanical and biological functions.
And the structure of dentin, that dense,
bony tissue under enamel that houses the
pulp, is very, very distinctive. It’s long and
tuberous — picture your garden variety
rhubarb, but 2 to 4 micrometers in diameter. The synthetic dentin matrix designed
by Liu and his team is the first of its kind
and forms the basis for vascularization
tests, in which a human tooth root injected
with the material is implanted under the
skin of mouse models. The outcome could
lay the groundwork for additional preclinical testing and, eventually, clinical trials.
Dr. Jerry Feng, professor and vice chair of
biomedical sciences and a consultant on
the project, shares another consideration
when dealing with regeneration of dentin
found in teeth as compared to regeneration
of bone found elsewhere in the body.
“The major difference between bone and
tooth dentin is that the dentin has an
extremely low capability to repair itself when
damage occurs,” says Feng. “In contrast,
bone can completely repair itself in a few
months without treatment, in most cases.
“Dr. Liu’s work, regeneration of dentin in
vitro in a way similar to what’s happening
in our body, is a very promising start for
patients who have tooth fracture or diseases. This project is likely to change the
future of dentistry if this man-made dentin
is applied to human patients.”
Endodontists welcome the advancement’s
groundbreaking potential.
“Regenerative endodontics is the frontier
of our specialty,” says He. “The American
Association of Endodontists recognizes its
importance and has developed special
committees and grants to support the
research and development in this field;
however, there has not been a lot of NIH
funding for this type of research. Therefore
it is especially exciting to see Dr. Liu’s grant
get funded.
“Our goal is to develop a predictable treatment approach that can be used on a broad
patient base, and to have endodontists perform these procedures in the future.”
Founded in 1905 as State Dental College, Texas
A&M University College of Dentistry in Dallas is a
nationally recognized center for oral health sciences education, research, specialized patient
care and continuing dental education.
Jennifer Eure Fuentes is a communications
specialist at Texas A&M Health Science Center
Baylor College of Dentistry. A 2006 graduate of
Texas Christian Unive