
Toothless No More – Researchers Using Stem Cells To Grow New Teeth - olalonde
http://singularityhub.com/2012/05/10/toothless-no-more-researchers-using-stem-cells-to-grow-new-teeth/
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verisimilitude
Dentist here. You're probably wondering if this is a disruptive threat to the
established business of dentistry -- I have no idea. However, I can say that
throughout the field I consistently run into dentists who will advocate for
the health of the patient over the profit of the business. Consider the
fluoridation of water throughout the world, one of the single greatest public
health advances, when you take into account the benefits versus the cost of
fluoridation.

But the science of it: I'm excited by the tooth growing possibilities, but
it's important to understand that getting these teeth properly integrated into
the body is quite a challenge. I'll give you an example: the periodontal
ligament is like a very precise shock absorber attaching bone to tooth, and
gives some flex to the tooth. (It's also the thing that makes orthodontics
(moving teeth) work in the first place.) Sometimes, (usually in younger folks)
if you knock a whole front tooth out, you can immediately replace it and the
PDL will regenerate. Sometimes, however, the PDL fails to regenerate, and you
end up with a situation where the tooth is ankylosed -- the ligamentous
connection is gone, and the tooth is essentially fused to bone. This is one of
the difficulties that will need to be overcome when regenerating teeth -- if
that PDL fails to develop, you're stuck with a newly regrown tooth fused to
bone. Thus, the tooth is more susceptible to breaking and _really_ difficult
to extract from the mouth if it becomes infected.

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tomkin
Off topic, but I just remembered that when I was a kid there was some snippet
on the news about a new treatment which would allow the gums to be softened
(??) which would give the doctor/ortho time to reform the teeth. This was
supposed to be the quick and fast answer to braces. I never heard of it again
and when I've searched for it I've come up empty. Have you heard of this?

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verisimilitude
You may be thinking of Wilckodontics. From what I could tell, they don't
really go into depth on their website, but what they do is place braces and
then irritate the bone (essentially drill holes ("scar" the bone) in strategic
spots). During the healing from this insult, osteoclastic activity is
increased... accelerating the remodeling of bone. As the bone remodels, it can
respond more quickly to PDL forces than it normally would. I think I first
heard about this in the context of military folks who needed orthodontics, but
needed results quickly.

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yan
Hah. This reminds me of a conversation I had with my dentist.

I was there for yet another appointment to work on a root canal and wondered
out loud why I don't hear more about efforts to regrow actual teeth as opposed
to the gruesome practice of modern dentistry. His take on this was that it
just wasn't worth it: teeth are mostly mechanical. They just exist to bite
through food, and an artificial crown isn't going to develop any more
cavities. His take was that it's much simpler for humanity to just replace
teeth with metal and porcelain than spend research dollars and scientists
trying to grow teeth.

Then again, he makes his living drilling into jaws.

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pseudonym
I would agree with this, although I'm in the unenviable position of needing a
lot of dental work after not having had any for awhile. I'd far rather have
research be done into making longer-lasting and/or cheaper or easier to
implant permanent fake teeth that don't require thousands of dollars of upkeep
throughout your lifetime.

That said, on a conceptual level, the idea that you can regrow teeth with stem
cells is pretty damn cool.

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Silhouette
It cuts both ways. I did have a lot of dental work done when I was younger,
after a couple of unlucky events damaged many of my teeth. Today, I expect to
spend hundreds of pounds on dental work every year or two, mostly repairing
and replacing that earlier work, even though I have excellent oral hygiene and
eat/drink sensibly.

I would spend a great deal of money, or even accept significant pain and
making do without proper teeth for a few weeks, if it meant that I could have
a new set of natural teeth at the end that I could brush and floss normally
and that didn't keep hurting somewhere every few months anyway. Sadly, it
turns out that all the fillings and braces and crowns and bridges in the world
can't keep up with what nature gave me.

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tuxidomasx
The real disrupting tech would be the thing that can kill that 1 strain of
bacteria responsible for eating the sugar on your teeth and pooping acid all
over them in return.

Its this acid discharge that dissolves tooth enamel. So, neutralizing that
acid (like we try to do with baking soda) on a more _permanent_ basis would be
super effective. As would simply targeting the 1 funky bacteria that turns
sugar into acid (as opposed to nuking all the 1000s of beneficial bacteria
too). It would seriously eat into dentists' coffers.

Can't we engineer viruses on a high level to do stuff like this for us yet?
Virus vs Bacteria-- a match for the ages.

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jbermudes
We already did. S. mutans has been genetically modified to excrete water
instead of the acid that normally wears away enamel.

[http://abcnews.go.com/Health/Dental/story?id=98080&page=...](http://abcnews.go.com/Health/Dental/story?id=98080&page=1#.T6whluhYvgA)

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nitrogen
_Recently they tweaked the bacterium again so it would only survive if fed a
particular nutritional supplement. That ensures the bacterium won't spread
from one person to another while kissing or sharing utensils._

AKA vendor lock-in.

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Sanddancer
It's still rather experimental. At this stage, I'd rather have the bacterium
require supplements than risk more widespread problems. Once proven safe, then
hell yeah, open the floodgates.

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apitaru
On a somewhat related note, my dad (a dentist and scientist) recently
discovered that there are stem cells that are almost as easy to manipulate as
embryonic ones .. in our mouthes [1][2]. He always wondered why our gums heal
so quickly, even as we age.

[1] Sorry for the PR-ish link (I'll ask him for the actual paper) -
[http://singularityhub.com/2012/05/10/toothless-no-more-
resea...](http://singularityhub.com/2012/05/10/toothless-no-more-researchers-
using-stem-cells-to-grow-new-teeth/)

[Edit 2] Here's the original publication (free) from Stem Cells Journal
<http://onlinelibrary.wiley.com/doi/10.1002/stem.425/abstract>

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pbharrin
They only got a grant for $1.5M to work on this? These dentists are in the
wrong business! They should make an iPhone app to share pictures with your
friends then they will really cash in!

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MichaelApproved
Maybe they could create an app that was a virtual mouth. You'd have to brush
and floss regularly. Every clean checkup would get you 100 points . When you
get a cavity, you lose 200 points. Make it for kids.

If you make this app, I want 5% ;)

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tocomment
Does anyone know why these kind of things always seem to need a scaffold? When
our original teeth grew there was no scaffold needed. Why can't we trigger
that kind of growth?

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infinite8s
Your growing jaw provided the scaffold.

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enfilade
A quote from the article: "So far, teeth have been regenerated in mice and
monkeys, and clinical trials with humans are underway, but whether the
technology can generate teeth that are nourished by the blood and have full
sensations remains to be seen."

I understand the vital importance of pain as a signal that damage has occurred
or is occurring. One of the real design flaws in the body, however, is the
inability for humans to consciously shut off pain (at least temporarily) after
they are aware of it.

The pain from a severe toothache is one of the worst sensations possible, and
doesn't seem to accomplish much. If dental regeneration can become commonplace
and relatively cheap, I think I would prefer new teeth without nerve endings
and "full sensations."

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geophile
Oh man, I would love this. For some reason, every so often, a tooth of mine
starts hollowing out from the inside and I need a root canal. Then a few years
after that, the hollowing out resumes and the tooth eventually distintgrates,
and then I need an implant. This has happened four times already, and it looks
like #5 is beginning.

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pavel_lishin
This is still pretty experimental, although it's worked for mice and monkeys,
and apparently they're working on human testing.

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afarrell
Is there any reason the fashion industry couldn't use this to produce, say, a
coat with teeth for buttons? I would totally wear that, especially to my D&D
game.

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bitwize
And maybe, if the Nerve Ending Fairy leaves them enough $100 bills, Americans
can afford one of these new teeth!

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12uu45dd
Toothless stem cell researchers. Getting crafty.

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nerdfiles
I have nothing "scientific" or explanatory or "insightful" to offer. I've
always found dentistry to be barbaric. And I've lived in terror of dentists.
As a youngster, I, without guidance, stumbled onto using electric toothbrushes
through my own devising. I did not brush properly, on the assumption that the
technology I was using, and using it in a way I thought best of it, was the
way to properly brush teeth, as opposed to the dentist's recommended methods.

My mistake, whups. But within a year's time (age 10-11), I developed 13
cavities. I was devastated. For years I have lived with a slip-up in my
formative years, and am still living with that mistake, stupidity, etc.

But THIS excites me extremely. Daily I live with empty, squishy graves where
two upper canines on each side used to LIVE. The "grave" analogy is not mine.
I sought sympathy from a friend one day, as I confessed to him my difficult
decision to have the teeth removed.

But I agreed with his words. And I felt a kind of bereavement. Daily I feel
it, and it affects my work. I feel declawed. Detuned. Constantly I question my
competence based on my linguistic performance, as the procedure has re-
introduced my lisp. (I wouldn't dare give presentations on HTML5 and advancing
technologies to corporateheads in this state now.) I'm sure millions of others
would be liberated if they could regain those portions of their minds that
their teeth or lack thereof distract them from.

I will follow this science, and try to understand it.

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indiecore
This is pretty cool because I recently learned that you can also HARVEST stem
cells from wisdom teeth and get it put away. From teeth they came and to teeth
they may go.

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aiscott
"To date, the NSU researchers have received about $1.7 million in grants for
their dental stem cell research."

They should have done a kickstarter.

How much did facebook pay for instagram again?

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pinchyfingers
__Quack Alert __

I'm just relaying what I've heard, so take it with a grain of salt, but on an
episode of No Agenda, Adam Curry says that he had dinner with a guy who worked
in stem cell research in Germany (I'm fairly certain it was Germany) the guy
said with confidence that the technology exists to regrow fingers. The guy
expressed frustration that such technology will never be released.

I know that most people will be highly skeptical, but it doesn't sound all
that unreasonable to me.

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carbocation
Stem cell biology and synthetic organogenesis (not sure what the term for this
will eventually be) are not my fields. However, we are getting excited about
regrowing myocardium from stem cells when sitting on top of a pre-existing
scaffolding. That's one _tissue-type_.

A finger requires afferent and efferent nerves, bone, cartilage, synovium,
tendons, ligaments, vasculature, interstitium, muscle, dermis, and epidermis.
It seems highly unlikely that we can regrow a _finger_ given current
technology. Each individual piece? Maybe. Each of those pieces in their proper
place coalescing into a functional whole? I don't buy it.

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berntb
You argue against building the tissue. I buy your argument.

Small children can regrow fingertips, yes? Couldn't it be possible to use that
mechanism for fingers?

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carbocation
My understanding is that there is research in what you suggested. I'm just
saying that I don't believe we yet have the technology to grow a finger.
Someday, almost surely we will. Just, not for some time. Or so I think.

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Mz
They can already regrow a fingertip in an adult, though I think that is (as
you said) still in research stages and not available to the general public.
Having regrown lung tissue of my own using info available online and no fancy
gizmos to speak of, presumably we aren't terribly far off from bigger
accomplishments.

