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Bionic dental pulp: Its potential value following root canal therapy

M.M. Ren Zheng, B.M.E. Gongping Li, M.M. Hao He, M.D. Yinghe Lin *

Department of Prosthetics, West China College of Stomatology, No. 14, 3rd Section, South Renmin Road, Chengdu, Sichuan 610041, China

a r t i c l e i n f o

Article history:

Received 30 August 2008

Accepted 12 September 2008

s u m m a r y

Dental pulp can provide nutrition for teeth. The teeth after root canal therapy without pulp will turn frai-

ler because of dehydration, and it may be easily broken. Bionic dental pulp possesses similar components

of the healthy dental pulp. So we put forward a hypothesis that bionic dental pulp can be filled into root

canals to provide nutrition for teeth like healthy pulp. Then the life-span of teeth after root canal therapy

could increase.

Crown Copyright 2008 Published by Elsevier Ltd. All rights reserved.

Introduction

Pulpitis and Periapical Disease that are a type of chronic, bacte-rial and infective disease are often found in oral cavity. The diseaseincidence can be higher than 70 percent [1]. At present, the root

canal therapy is the most effective and thorough treatment forPulposis and Periapical Disease. Obviously, teeth after root canaltherapy cannot last a long time under service [2]. Currentlynano-technology, tissue engineering and regeneration medicine

are hot spots for study. So the author proposes that bionic dentalpulp be established with nano-technology and the methods oftissue engineering and regeneration medicine, and put into theteeth after root canal therapy.

The components of bionic dental pulp

The normal teeth pulp includes nerve, blood vessel, lymph and

connective tissue.Tissue engineering and regeneration medicine need stem cells,

growth factors and frame of extracellular matrix combinedperfectly [3]. So bionic dental can be divided into three parts:

1. Stem cells: make the mesenchymal stem cells (MSCs) as seed

cells [4]. MSCs were proved to be biologically safe and idealseed cells for researches on human tissue engineering andregeneration medicine. They are mainly localized in the bonemarrow and also are resided in the umbilical blood, peripheralblood, fatty tissue, skin, and so on. BMSCS which can be gained

conveniently from patients ilium and cultured easily divide andproliferate quickly, and in vivo and vitro it can differentiatemulti-directionally [5] such as neural stem cells (NSCs) [6],vessel endothelial cells (VECs)[7]and so on. MSCs may secrete

a few nerve nutrition factors to make NSCs transform into nervecell [8]. VECs can maintain regular form and physiology func-

tion of blood vessel as the frames and linings; meanwhile they

can regulate and control the proliferation and contraction ofvascular smooth muscle cells. In some conditions, MSCs finallycan be induced to differentiate and grow into vessel and nervewhich are the basic compositions of bionic dental pulp. So MSCs

play an important role in bionic dental pulp.2. Growth factors:growth factor refers to a naturally occurring pro-

tein capable of stimulating cellular proliferation and cellulardifferentiation. Growth factors that have no any drug toxicity

and will not cause any immunological reaction are importantfor regulating a variety of cellular processes. Platelet-rich plasmain vitro [9] that includes platelet above 70 percent containsmany growth factors. Nanotechnology becomes one of the main

technology as well as the information technology and biotech-nology. Nanoparticle vector has been used broadly in clinic.Nanocapsule[10]which is composed of outer covering and coreis a kind of nanoparticles which are used as carriers. So in bionic

dentalpulp, Platelet-richplasma in vitro can be made as thecoreand some biotic-absorbable material can be used to wrap thecore with nano-technology. Then growth factors can be releasedslowly by the corrosion of outer coverings. So Platelet-rich

plasma in vitro is another important part of bionic dental pulp.3. The frameof extracellularmatrix:collagen [11] isthemainproteinof

connective tissue in animals and the most abundant protein inmammals, it can serve many functions, such as providing supportand anchorage for cells, segregating tissues from one another, andregulating intercellular communication. Meanwhile it has manymerits, such as high tensile strength, biotic-absorbable nature,

low antigen-activity, and low cell toxicity and so on. Therefore,collagen is important component of bionic dental pulp, too.

The theory of bionic dental pulp

Bionic dental pulp requires imperative condition for existence.For example, every root canal is sterile, apical foramen isunobstructed; root tip has no inflammation, etc. MSCs and

0306-9877/$ - see front matter Crown Copyright 2008 Published by Elsevier Ltd. All rights reserved.doi:10.1016/j.mehy.2008.09.029

* Corresponding author. Tel.: +86 13980050654; fax: +86 28 85502407.

E-mail address:yinghe99@163.com(M.D. Yinghe Lin).

Medical Hypotheses 72 (2009) 129130

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nano- Platelet-rich plasma in vitro permeate into root tip by apicalforamen and induce new vessel and nerve there to grow into root

canals along the frame of extracellular matrix. Then bionic dentalpulp is shaped.

It can provide nutrition which is taken in by dentinal tubules forteeth like normal dental pulp.

The defects of bionic dental pulp

1. The feeling of teeth: bionic dental pulp has not the same feelingas the healthy dental pulp. The absorption of nutrition for teeth:There are no odontoblasts in bionic dental pulp. Whether the

nutrition can be absorbed completely is unknown.2. The possibility of inducing immunological reaction: MSCs and

Platelet-rich plasma in vitro come from individual body, but

the frame of Extracellular matrix is artificial. Whether immuno-logical reaction can be induced is a question.

There are many differences between healthy dental pulp and

bionic dental pulp. The bionic dental pulp is just a hypothesis. Aqualitative leap is needed from hypothesis to accomplishment.

References

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