Stem Cells: Sources, Therapies and the Dental Practioner

Recent exciting discoveries place dentists at the forefront of engaging their patients in potentially life-saving therapies derived from a patient’s own stem cells located in deciduous and permanent teeth. Adult stem cells, including dental stem cells, have the potential, like bone marrow-derived stem cells and adipose-derived stem cells, to cure a number of diseases. In medicine, stem cell-based treatments are being used and investigated for conditions as diverse as Parkinson’s disease, neural degeneration following brain injury, cardiovascular disease and autoimmune diseases. Stem cells will be used in dentistry for the regeneration of dentin and/or dental pulp, biologically viable scaffolds will be used for the replacement of orofacial bone and cartilage, and defective salivary glands will be partially or completely regenerated. Dental stem cells can be obtained from the pulp of the primary and permanent teeth, from the periodontal ligament, and from associated healthy tissues. Exfoliating/extracted deciduous teeth and permanent teeth extracted for orthodontic treatment, trauma or dental implant indications are all readily available sources of dental stem cells. The harvest of these dental stem cells results in minimal trauma. Dental professionals have the opportunity to make their patients aware of these new sources of stem cells that can be stored for future use as new therapies are developed for a range of diseases and injuries. Introduction/Overview Recent exciting discoveries place dentists at the forefront of engaging their patients in potentially life-saving therapies derived from a patient’s own stem cells located in deciduous and permanent teeth. In 2000, the National Institutes of Health (NIH) released two studies of research on human teeth detailing the discovery of adult stem cells in impacted third molars and even more resilient stem cells in deciduous teeth. Dentistry and medicine are evolving into new forms, in which care is being delivered with increasing frequency through biologically based approaches. The first wave of this paradigm shift in health care is likely more imminent than anyone is willing to predict at present, and its impact will eventually be felt in every medical and dental office and setting. In medicine, stem cell-based treatments are being used and investigated for conditions as diverse as Parkinson’s disease, diabetes, liver disease, neural degeneration following brain injury, cardiovascular disease and autoimmune diseases. Biomolecules will be used in dentistry for periodontal regeneration, stem cells will be used in the regeneration of dentin and/or dental pulp, biologically viable scaffolds will be used for the replacement of orofacial bone and cartilage, and defective salivary glands will be partially or completely regenerated.1 No longer will it be necessary to rely on the chance of finding a cellular match from a donor, and devastating and formerly incurable diseases could potentially be treated. This is no longer science fiction. Some stem cell therapies have already been approved or are being reviewed by the U.S. Food and Drug Administration (FDA), while others are at various stages of development. Starting in the 1970s, it was discovered that cells taken from bone marrow postnatally had the ability to differentiate into bone, cartilage and marrow fat cells when they were transplanted.2,3 Stem cell research has increased dramatically in recent years as the potential for use of stem cells has become better understood. Degenerative diseases increase in incidence with age, and as the baby boomer population ages it can be anticipated that the need for viable and improved treatment options for these diseases will increase. Patients are being treated using stem cells for cardiovascular, orthopedic, dental, oncological and other conditions. Table 1: Baby boomers in the U.S. population (in millions) 0 10,000 20,000 30,000 40,000 50,000 Men 45–64 Women 45–64 Men over 65 Women over 65 2000