Is it possible to regrow teeth? Promising research in regenerative dentistry

The fillings, crowns, and implants used today in the treatment of tooth loss and decay offer significant solutions for millions of people. However, these methods often focus on repairing damage rather than fully restoring the biological function of the tooth. For this reason, scientists at various research centers around the world are working on methods that could enable dental tissue to regenerate itself or make the development of new teeth possible in the laboratory.

Regenerative medicine is at the heart of this research. The goal is to encourage the regeneration of tissue lost due to decay, ensure the repair of the tooth's fundamental structures such as enamel and dentin, and, in the longer term, enable the biological replacement of missing teeth. According to experts, this goal has not yet translated into clinical practice; however, laboratory findings are being closely monitored for the future of dentistry.

Biochemist Hannele Ruohola-Baker from the Institute for Stem Cell and Regenerative Medicine at the University of Washington in the US states that she frequently receives messages from people who want to participate in experiments that could help them regrow their teeth. According to Ruohola-Baker, this interest shows how high the expectation is for more permanent and biological solutions in dentistry.

A GOAL BEYOND FILLINGS

Dental health is not seen as limited only to aesthetics or chewing function. Gum diseases and bacteria in the mouth are associated with heart disease, respiratory infections, and certain neurological conditions. Tooth loss, meanwhile, can lower overall quality of life by affecting nutrition, speech, smiling, and social life.

Although current treatments alleviate these problems, they have limitations. The lifespan of fillings varies depending on the material used and the patient's oral hygiene; some fillings may need to be replaced over the years. While implants are a strong option for missing teeth, they do not fully mimic the nerve and tissue structure of a natural tooth. For this reason, researchers are turning to approaches that do not just fill the gap but attempt to rebuild the tooth's own tissue.

Research by Prof. Anne George from the University of Illinois Chicago campus focuses on the self-repair capacity of the layer of the tooth called dentin. Dentin is the layer located under the tooth enamel, which is more sensitive to decay than enamel. George and her team are studying the proteins that play a role in the growth, mineralization, and repair of damage to dentin. This information could form the basis for future treatments that could allow cavities caused by decay to close through the production of new dentin.

Ruohola-Baker's team is working on another goal that could be described as "living fillings." In research conducted on donated wisdom teeth, it has been observed that ameloblast cells, which form enamel, disappear after a human tooth erupts. The team created tooth organoids that secrete enamel proteins in the laboratory by converting stem cells into ameloblast-like cells and dentin-producing odontoblasts using chemical signals.

The first practical goal of this approach is to be able to use enamel-like proteins in cracked or damaged teeth. A more distant goal is to place engineered cells that can initiate tooth development into the patient's mouth, allowing the process to proceed in a manner similar to natural development.

THE LONG ROAD FROM LABORATORY TO CLINIC

Studies aimed at the complete biological replacement of missing teeth are also progressing from different directions. Ana Angelova Volponi from King's College London in the UK assesses that teeth developed in the laboratory could be a more durable and biological alternative to implants. Volponi's team succeeded in producing hybrid, tooth-like structures with living roots by combining cells taken from adult human gum tissue with tooth-forming cells taken from mice.

Research by Prof. Pamela Yelick from the Tufts University School of Dental Medicine has focused on the creation of tooth-like structures through the combination of human and pig dental cells. In experiments conducted on Yucatán miniature pigs, tooth-like structures emerged on bioengineered scaffolds that mimic the environment of a developing tooth. Yelick considers these results a "proof of principle" that the method could work.

Despite this, experts do not expect the regrowth of teeth to become a routine treatment in the near term. More laboratory work, animal experiments, safety assessments, and clinical trials are required before they can be applied to humans. Ruohola-Baker emphasizes that studies to be conducted on non-human primates will also be one of the important steps in this process.

Regenerative dentistry research is important not only for dental treatments but also for understanding how hard and soft tissues develop together. According to scientists, reaching safe, sustainable, and accessible treatments will take time; however, solutions that repair decay with its own tissue or produce biological equivalents for missing teeth are no longer just the subject of science fiction.