Are Root Canals Headed for Obscurity? Stem Cell Study Indicates Maybe So

Scientists report in the current issue of STEM CELLS Translational Medicine that they are close to developing a new and effective way to treat tooth decay that fully restores the tooth rather than requires it to be filled, capped or extracted. The method, which uses stem cells, could prove especially useful in treating the kinds of cavities leading to that most dreaded and painful procedure — the root canal.

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Durham, NC (PRWEB) June 12, 2013

Scientists report in the current issue of STEM CELLS Translational Medicine that they are close to developing a new and effective way to treat tooth decay that fully restores the tooth rather than requires it to be filled, capped or extracted. The method, which uses stem cells, could prove especially useful in treating the kinds of cavities leading to that most dreaded and painful procedure — the root canal.

“Dental cavities and inflammation of the surrounding pulp is a challenging public health issue, as tooth decay not only can cause a patient great pain but it also can lead to other serious health issues including heart disease,” explained Misako Nakashima, DDS, Ph.D., of the National Center for Geriatrics and Gerontology in Obu, Japan. “Generally we treat deep cavities by capping the tooth and removing any inflamed pulp surrounding it. But this has limited success and the problem frequently progresses until the tooth must be removed.”

In this newest study, conducted by Dr. Nakashima and several of her NCGG colleagues along with scientists from Shin Nippon Biomedical Laboratories in Kagoshima and from the School of Dentistry at Aichi-gakuin University in Nagoya, the goal was to test a stem cell-based therapy that would regenerate the dentin-pulp complex and, consequently, totally restore the tooth’s structure and function. At the same time, they wanted to assess the safety of pulp stem cell transplantation in humans as a prelude to upcoming clinical trials.

They began by performing root canals on a group of 18 dogs, collecting the pulp stem cells and then treating them in the lab with a growth factor called granulocyte-colony stimulating factor (G-CSF). They then transplanted the treated cells back in the dogs, with each animal receiving its own cells to reduce the chance of rejection.

“Other studies demonstrated the therapeutic effects and safety of mesenchymal stem cells (MSCs) for various diseases. There have been no preclinical reports, however, to support the use of pulp stem cells as a potential treatment for pulpitis in clinical trials,” Dr. Nakashima said. “We also knew that previous studies involving the spinal cord show that combining G-CSF with stem cells derived from other types of tissues, bone marrow stromal cells, neuronal stem cells and amniotic fluid stem cells had several benefits. So we reasoned that G-CSF might positively impact the pulp stem cells, too.”

When they examined the results, which included comparing the G-CSF treated cells to a control group of non-treated cells, they found the cells did indeed regenerate the pulp tissue and completely filled in the dogs’ root canals.

“We also noted that the pulp stem cells treated with G-CSF yielded a significantly larger amount of regenerated dentin-pulp complex than those without it,” Dr. Nakashima observed. “Also noteworthy was the reduced number of inflammatory cells, the decrease in cell death and the significant increase in neurite outgrowth (the projections that transfer a cell’s impulses compared to those without G-CSF). Furthermore, there was no evidence of toxicity or adverse events.”

Based on these preclinical results of efficacy and safety, a clinical trial of pulp regeneration has already been initiated with the permission of the Japanese Ministry of Health, Labor and Welfare, she added.

“This first preclinical demonstration of the efficacy and safety after transplantation of clinical-grade pulp stem cells together with G-CSF for dentin-pulp regeneration is very encouraging,” said Anthony Atala, M.D., Editor of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine.

The full article, “A novel combinatorial therapy with pulp stem cells and G-CSF for total pulp regeneration,” can be accessed at http://www.stemcellstm.com.

About STEM CELLS Translational Medicine: STEM CELLS TRANSLATIONAL MEDICINE (SCTM), published by AlphaMed Press, is a monthly peer-reviewed publication dedicated to significantly advancing the clinical utilization of stem cell molecular and cellular biology. By bridging stem cell research and clinical trials, SCTM will help move applications of these critical investigations closer to accepted best practices.

About AlphaMed Press: Established in 1983, AlphaMed Press with offices in Durham, NC, San Francisco, CA, and Belfast, Northern Ireland, publishes two other internationally renowned peer-reviewed journals: STEM CELLS® (http://www.StemCells.com), celebrating its 31th anniversary in 2013, is the world's first journal devoted to this fast paced field of research. The Oncologist® (http://www.TheOncologist.com), also a monthly peer-reviewed publication, entering its 18th year, is devoted to community and hospital-based oncologists and physicians entrusted with cancer patient care. All three journals are premier periodicals with globally recognized editorial boards dedicated to advancing knowledge and education in their focused disciplines.