When Doctor Ophir Klein looks at the badly deformed teeth in some patient photos, he dreams of someday being able to replace them ? not with artificial dentures, but real teeth created in a lab.
"In the long run?you could, for example, take the precursor organ itself that was not fully developed and implant into the jaw and allow it to develop there," Dr. Klein said.
To make that kind of advance a reality, Klein's team is working to unlock the secrets of how stem cells form into teeth. Using mouse models, they're studying epithelial cells which differentiate to become hardened tooth enamel.
"Of course the long term goal for people in this field is to be able to regenerate the entire tooth structure," Dr. Klein said.
While his team works with the epithelial cells other groups are concentrating on the cells that create the living tissue inside our teeth. For patients, like those at the UCSF Dental School clinic, the technique might offer the promise of regenerating a damaged tooth.
"It would be a very promising thing for people who have extensive dental caries, a way to actually restore their mouth," said Tim Patel, the clinical professor at the UCSF School of Dentistry.
"One potential approach would be to implant cells into the damaged tooth and enable those tissues that have decayed reform," said Dr. Klein. "Another approach would be to regenerate the entire tooth and implant that."
That second strategy recently caught the attention of the California Institute of Regenerative Medicine. They awarded Klein's lab a $3 million grant with the goal of learning how to create teeth with stem cells. Although Dr. Klein believes human applications are still years away, he says teeth offer one of the most realistic scenarios for implanting a bioengineered replacement.
"Because the cavity is readily accessible, failure of transplant of a transplant of a bioengineered organ is less catastrophic than other organs," Dr. Klein said, "which makes it a good choice to try out the therapy."
Dr. Klein's team is also studying patients with dental birth defects with the hopes of identifying the genes that lead to these defects.