Abstract
The restoration of dentine lost in deep caries lesions in teeth is a routine and common treatment that involves the use of inorganic cements based on calcium or silicon-based mineral aggregates. Such cements remain in the tooth and fail to degrade and thus normal mineral volume is never completely restored. Here we describe a novel, biological approach to dentine restoration that stimulates the natural formation of reparative dentine via the mobilisation of resident stem cells in the tooth pulp. Biodegradable, clinically-approved collagen sponges are used to deliver low doses of small molecule glycogen synthase kinase (GSK-3) antagonists that promote the natural processes of reparative dentine formation to completely restore dentine. Since the carrier sponge is degraded over time, dentine replaces the degraded sponge leading to a complete, effective natural repair. This simple, rapid natural tooth repair process could thus potentially provide a new approach to clinical tooth restoration.
Highlights
Dentine is a vital tooth mineral that is produced by highly specialised mesenchymal cells called odontoblasts
Treated teeth were removed after 24 h along with controls consisting of untreated teeth, Mineral Trioxide Aggregate (MTA) only and collagen sponge with no inhibitor
Mineral aggregates such as MTA and Biodentine are reported to aid the formation of tertiary dentine, the deposition of this dentine is not at the sites of damage but rather internal in the pulp space[27,28,29]
Summary
Dentine is a vital tooth mineral that is produced by highly specialised mesenchymal cells called odontoblasts. Clinical repair of tooth damage currently involves the use of mineral aggregates that are used to fill the space in dentine created following removal of decay or trauma[1,2,3,4,5]. When the soft inner pulp tissue is exposed, a natural repair process is activated that involves the mobilisation of resident mesenchymal stem cells to differentiate into new odontoblast-like cells that secrete a form of tertiary (reparative) dentine[6,7,8,9]. Having first confirmed that Axin 2 expression and Wnt/β-cat signaling is upregulated following tooth damage we reasoned that addition of Wnt signaling agonists may provide an effective way to stimulate reparative dentine formation and restore lost dentine following caries removal with naturally-generated new dentine (Fig. S1). As a delivery vehicle we used a commercially-available, clinically-approved collagen sponge, Kolspon
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