The end of dentures: Science is about to help you regrow your own teeth
Millions of adults will lose at least one permanent tooth, and many will lose several more as the years go by. In the United States alone, an estimated 178 million people are missing at least one tooth, which explains why dentures and titanium implants replacements are so common.
Dentistry is now aiming for something better, a living replacement that feels and functions like the original. The idea is not science fiction anymore, and it is moving from animal studies toward carefully designed human trials.
Pamela C. Yelick of Tufts University School of Dental Medicine leads one of the teams moving this vision toward the clinic. A recent study from her and colleague Weibo Zhang have pushed the conversation onto the main stage.
Dentures as tooth replacements
Tooth loss is not rare, and the burden rises with age worldwide. About 7 percent of people 20 or older have complete tooth loss, and that figure reaches 23 percent for those 60 or older.
Modern implants are anchored directly to the jaw through osseointegration, a concept that traces back to Per Ingvar Brånemark’s mid twentieth century work with titanium and bone.
The history matters because it explains why implants are stable, and also why they do not feel like natural teeth.
Natural teeth are suspended in the socket by the periodontal ligament, which provides sensation and micro movement control that implants lack. That difference shows up as reduced tactile sensitivity with implants compared with natural teeth.
Load also travels differently through an implant than through a tooth root cushioned by ligament fibers. Over time, that can contribute to bone loss around the fixture and biological complications that sometimes lead to failure.
Two routes to living teeth
One route grows a replacement as a tissue, using a scaffold that guides cells to assemble into a tooth.
In a recent large animal study, researchers used decellularized tooth bud scaffolds seeded with human dental pulp cells, porcine dental epithelial cells, and endothelial cells.
They then implanted these constructs into adult minipig jaws where they formed tooth like tissues including periodontal ligament.
The other route tries to spark tooth development in place by presenting the right developmental signals to adult cells.
Teams mapping the choreography of early human tooth formation are building a playbook that identifies the epithelial and mesenchymal cues needed to kick off organized growth.
Tooth roots and ligaments
The scaffold approach matters because the emerging structures were not inert.
They developed tooth supporting ligament and mineralized tissues in the socket and progressed over a period of months, which brings the approach closer to human scale.
“Even creating a tooth root that you could put an artificial crown on, with living dental pulp in the middle, secured by periodontal ligaments instead of being screwed into the jaw, could be a huge improvement to a person’s oral health and in turn, systemic health,” said Yelick.
Protein helps tooth replacement
A separate line of work targets a specific protein, USAG-1, that suppresses tooth formation. Blocking USAG-1 in mice rescued missing teeth caused by different genetic problems, and the same strategy produced new incisors in ferrets, which share a human-like replacement pattern.
“Moreover, a single administration was enough to generate a whole tooth,” stated Katsu Takahashi, whose group reported the antibody treatment while at Kyoto University.
A humanized anti USAG-1 antibody has been advanced by industry collaborators, with investigators reporting that a phase 1 protocol has been finalized and preparations for future studies are underway.
That marks the shift from animal proof of concept to testing for safety, dosing, and early signals of activity in people.
Financing updates from partners indicate plans to run the first in human study and to prepare for subsequent pediatric trials if early results support it.
The initial clinical focus is congenital tooth agenesis in young children, where a therapy that triggers tooth development could change lifelong care.
What would count as success
A living tooth would restore ligament mediated sensation, which helps people modulate bite force and detect grit or high spots. It would also reconnect to bone through tissues that are built to bear chewing loads.
Those features could reduce pain and bone loss around a replacement compared with a rigid post.
They could also lengthen functional life compared with today’s devices, which often need repair or replacement after years of wear.
What about cost and complexity
Cell based therapies will only reach clinics if they can be produced reliably and priced within reach of today’s prosthetic options.
Sourcing compatible epithelial cells at the right developmental stage is a known challenge, and that is why teams built their scaffolds around young pig tooth buds while they refine ways to recruit a patient’s own cells.
Work with induced pluripotent stem cells (iPSCs) is also moving forward, including efforts to make enamel forming cells and repair enamel defects.
As methods improve, the main questions will be safety, quality control, and whether costs can compete with implant dentistry.
Tooth replacement and future tech
An atlas of human fetal tooth development now details epithelial subpopulations and their signaling to mesenchyme.
That resource gives researchers the specific factors and timing likely needed to nudge adult cells toward making a new tooth unit.
If those cues can be delivered precisely, either by a staged therapy in the jaw or by organoid-like constructs that finish maturing in the socket, dentists could one day replace a lost tooth with a living one that integrates, remodels, and feels like it belongs.
The study is published in Stem Cells Translational Medicine.
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