Development of a Treatment Concept for Dental Pulp Tissue Engineering

• Applicant: Professorin Dr. Kerstin Galler, Ph.D.
• Subject Area: Dentistry, Oral Surgery ; Biomaterials
• Term: from 2015 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 270069690

Conventional root canal treatment involves the complete removal of inflamed or necrotic pulp tissue from the root canal system, enlargement, disinfection and obturation of the void with a synthetic material. However, the dental pulp, which fulfils several important functions, and thus tooth vitality are lost after such a procedure. Recent advances in stem cell biology and dental pulp tissue engineering as well as clinical reports of regenerative procedures to sustain tooth vitality might be the prelude of a paradigm shift in endodontics and lead to the establishment of treatment strategies enabling us to regenerate dental pulp in the future. Whereas implantation of autologous stem cells is a promising strategy, it is hampered by issues of cell harvest and expansion as well as high cost. Alternatively, cell-free approaches could be considered, which involve the recruitment, migration, proliferation and differentiation of resident stem cells. The conditions for such a regenerative procedure might be optimized by the use of a bioactive scaffold material, which is placed into the root canal, and furthermore by taking advantage of growth factors entrapped in the dentin matrix. Modified protocols for root canal preparation, irrigation and filling will be required in order to provide an environment that is conducive for stem cell recruitment and new tissue formation. In the proposed project, we intend to establish a protocol for a biology-based approach to endodontic treatment. The overall goal of this application is to establish a procedure for dental pulp regeneration, which follows the cell-homing concept. After partial or complete removal of pulp tissue in case of irreversibly inflamed or necrotic tissue, a regenerative procedure will include 1) disinfection of the root canal, 2) release of growth factors by EDTA-conditioning of root canal dentin, 3) collection of irrigation solution with growth factors from the root canal, 4) mixture with a biomaterial capable of growth factor-binding, 5) re-insertion of growth-factor-laden material into the root canal and 6) coverage of the scaffold with a bioactive cement followed by tight sealing of the canal system. This work could contribute to the development of a treatment strategy to engineer dental pulp which does not require the application of exogenous stem cells or growth factors and which might thus be well applicable in regenerative endodontics.

• DFG Programme: Research Grants