Scientific poster presented at the 1st annual IADSR conference in Lahore, 2011.

1. Tissue Engineering: A New Era in Dentistry
Asim W., Fatima A. A., Sara I., M.A. Fareed
FMH C M&D
Tissue Engineering is the application of the principles and methods of engineering and the life sciences toward the
fundamental understanding of structure / function relationships in normal and pathological mammalian tissues and the
development of biological substitutes to restore, maintain, or improve functions.[1] Stem cells capable of self-renewal are
isolated via ultrafiltration or centrifugation of the source tissue, seeded on to a scaffold, and combined in a bioreactor along
with growth factors. The cell culture is grown till the tissue or organ required has been formed; the successfully regenerated
structure is then implanted into the body.[2]
Scaffold
Dental stem cells
A scaffold is an artificial
structure capable of supporting
3-D Tissue Formation.
1. Natural or Synthetic Polymers,
commonly Polyglycolic Acid or
Polylactic Acid.[4]
2. Allow cell movement, growth
factor delivery, nutrient
diffusion.
3. Often biodegradable.
Stem cells are undifferentiated
totipotent, pluripotent or
multipotent cells.[3]
1) Dental mesenchymal cells:
a) Dental pulp SCs
b) Periodontal ligament SCs
c) Dental follicle SCs
d) Human exfoliated deciduous
teeth SCs
2) Dental epithelial SCs
Growth Factors
Bioreactor
Growth Factors are regulatory
substances that stimulate cell
growth, proliferation and
differentiation. Current growth
factor release technologies[5]:
1. Fibrin Glue
2. Emdogain®
3. Gem21S®
4.INFUSE® Bone Graft
5.OP-1® Implant
A bioreactor is an engineered
or manufactured device that
supports a biologically active
environment.
Discussion
Although prosthetic implants already exist to replace lost dental structures, it is expected the implant failure rate will increase
dramatically with an increase in high-risk operations and the entry of improperly trained surgeons into the field.[6] Additionally,
the success rate of using dental materials to repair teeth in which the pulp has been exposed is very low, limiting the clinician
to either pulpotomy or extraction as the only viable treatment options.[7]
Ethical issues arise concerning the source of cells (patient’s own vs. donated cells) and the type (adult-donor vs. fetal cells). In
addition, on what basis will it be decided who receives these new tissue therapies?[8]
Future Prospects
Tissue engineering is applied to nearly all types of tissues related to the oral cavity, including bone, cartilage, skin and oral
mucosa, dentin and dental pulp, and salivary glands. According to many researchers, test-tube teeth may become completely
engineered organs![6]
[1]. Tahoe
[2]. Biomaterials, Artificial Organs and Tissue Engineering” by A.E. Bishop and L.D.K Buttery
[3] Y.H. Huang at al, “Dental Stem Cells & Tooth Banking for Regenerative Medicine”, 2010.
[4]. Liu et al, “Design & Development of Three Dimensional Scaffolds”, 2007.
[5]. F-M Chen et al, “New Insights into & Novel Applications of Release Technology for Periodontal Reconstructive Therapies ”, 2010
[6]. Earthman et al, “Reconstructive Materials & Bone Tissue Engineering in Implant Dentistry”, 2006.
[7]. “Regenerative Medicine of Skin, Hair, Dental Tissues and Cornea”
[8]. Kaigler et al, “Tissue Engineering’s Impact on Dentistry”, 2001