Title Osteogenic Stem Cell Regenerative Therapy Shows Potential to Regenerate Dental Tissues for Whole Tooth Replacement
Clinical Question Is stem cell tooth regenerative therapy an effective intervention for a whole tooth replacement?
Clinical Bottom Line Osteogenic stem cells have shown a potential to regenerate dental tissues when an ideal environment has been created. The reviews describe in vitro and animal in vivo experiments that successfully used mesenchymal stem cells for tooth regeneration. However, better-designed in vivo research is required to confirm the most effective way to bioengineer a tooth.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
26106427Ramamoorthi/2015137 articlesSystematic review of non-randomized trials
Key resultsThis article is a systematic review on current stem cell research using dental mesenchymal stem cells (MSCs) for tooth and bone regeneration. The selected studies included at least one type of dental stem cell tissue, studied the potential for bone regeneration, and evaluated at least one outcome from either in vitro or in vivo experiments. The quality was assessed using ARRIVE guidelines for in vivo and modified ARRIVE and CONSORT guidelines for in vitro experiments. Due to the heterogeneity of sources, 137 full articles were used in a qualitative review, rather than a quantitative review with a statistical meta-analysis. Various stem cells and osteogenic factors from different species of animals were studied in vitro and in vivo. Most studies showed osteogenic potentials of the stem cells; however, during the quality analysis, inadequate sample sizes and omission of sample-selecting data were flaws in these studies. Dental stem cell research needs an improvement in designing animal randomized controlled experiments that can provide a high level of evidence to eventually lead to human clinical trials.
25052182Oshima/2014Narrative Review
Key resultsThis article reviews recent studies that show promising evidence for whole tooth replacement using tooth regeneration. It discusses the factors and their mechanisms during tooth organogenesis, as well as which osteogenic stem cells are involved in tissue regeneration and engineering. Aggregation of the stem cells and the presence of osteogenic factors lead to reconstruction of an organ germ, which replicates “epithelial-mesenchymal interactions.” These three-dimensional organs are found to be functional and lead to a formation of bioengineered teeth with restored proprioceptive potential for noxious stimuli.
Evidence Search (("tooth"[MeSH Terms] OR "tooth"[All Fields]) AND ("regeneration"[MeSH Terms] OR "regeneration"[All Fields]) AND ("stem cells"[MeSH Terms] OR ("stem"[All Fields] AND "cells"[All Fields]) OR "stem cells"[All Fields])) AND ("review"[Publication Type] OR "review literature as topic"[MeSH Terms] OR "systematic review"[All Fields]) AND ("2006/10/24"[PDat] : "2016/10/20"[PDat])
Comments on
The Evidence
Validity: Bone marrow-derived mesenchymal stem cells (BMMSCs) have been proven to be the “gold standard,” but it is very difficult to harvest these cells; therefore, dental tissue-derived mesenchymal stem cells (MSCs) are widely used instead. MSCs from different locations are involved in tissue engineering and have shown validity in primary studies for tooth regenerative experiments. Well-designed randomized controlled trials and clinical studies will increase the validity of this research since the available studies are predominately primary studies with histology and critical or umbrella reviews.
Applicability In addition to implant placement and/or bone grafting, tooth regeneration therapy would play a significant role in treating patients with edentulism. Having an additional option to replace teeth would increase patients’ confidence level in dentists, and also having regenerated tissue with a functioning cell network would increase the prognoses of hard/soft tissues and existing restorations. Limited applicability may include: high cost; possible side effects from transplanted cells and unexpected physiologic responses; the health status of the patient; controlling tooth morphology and difficult maintenance of the transplanted site.
Specialty (General Dentistry) (Periodontics)
Keywords Tooth regeneration stem cells, bioengineering tooth
ID# 3108
Date of submission 11/10/2016
E-mail kimh8@livemail.uthscsa.edu
Author Hee Sun Kim, DDS
Co-author(s) e-mail
Faculty mentor H. Ralph Rawls, PhD
Faculty mentor e-mail RAWLS@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available