One of the most prevalent dental issues in the world is periodontal disease. Statistically, more than 30% of adults suffer from it. What generally starts with the inflamed and bleeding gums of gingivitis, if left untreated, progresses to not only damage supporting gum tissue that loosen teeth, it also disintegrates the jawbone.
It’s a defect that presents considerable challenges for dental rejuvenation,
Dental implants are often required for nutritional, and not just cosmetic reasons. If upper and lower molars have been lost, particularly on both sides, being able to properly chew anything becomes impossible. Naturally, nutrition suffers.
To ensure better ongoing health after tooth loss, implants are only suitable if bone density is viable. Otherwise the implants will fail; which is not the desired outcome for either patient, or practitioner.
Lack of jawbone is also a challenge in terms of regenerative medicine. This is advancing branch of dental technology works toward developing methods to repair decay, wear and tear, and oral trauma that also includes the use of stem cells.
Amelogenin is a major protein in tooth enamel development. As well as having a positive effect on the immune response, it shows promising abilities in the regeneration of periodontal tissue.
This is sometimes the issue with implants. As with an organ transplant, a patient’s physiology can reject the titanium posts, and without the necessary bone osseointegration occurring, there is no foundation for prosthetic stability and it’s deemed a failed procedure.
The modifying properties that amelogenin has on the immune system gives enormous potential as a biocompatible therapy in jawbone generation. What limits its clinical application, and compromises efficacy is its rapid release.
The discovery is that calcium alginate hydrogel – recognised for its superior biocompatibility and used extensively in wound repair – is as a solid candidate in developing a bioengineered drug delivery system.
The release of injected amelogenin is slowed with the addition of the hydrogel.
Study indications are that this synthesised composite gel has the practical properties of injectability, biocompatibility and biodegradability. It has the ability to regulate the microenvironment of bone healing, while directly stimulating osteogenesis.
It’s groundbreaking technology that offers corrective bone regeneration to patients with large areas of defective jaw. Small defects, like fractures, heal themselves because the body can bridge and restore the missing bone tissue.
Substantial bone damage from physical trauma, tumour removal, tooth extraction, gum disease or dental implant inflammation renders the bone unable to renew itself because the physical expanse has no structural support.
In this current study, a collaboration of Tel Aviv University and the University of Michigan, the developed hydrogel mimics the natural substances in the extracellular matrix of bones: that which surrounds cells and gives them form.
Unsurprisingly, every type of tissue in the human body has specific extracellular matrix properties. For bones, it’s a rigid, fibrillary structure enabling cells to differentiate.
At a nanometric level, the patient’s cell attaches to the gel, which gives it the structural frame. From this point it is able to receive the relevant biosignals from the fibres and growth begins.
To test the properties, researches grew cells in a 3D model of the hydrogel.
Using model animals that were given extensive bone defects outside the normal parameters of spontaneous healing, various monitoring and examination methods over two months proved that the defects were fully regenerated with original density and new blood vessels.
This successfully stimulated bone growth also exhibited accelerated healing, because the hydrogel had reactivated the immune system.
It’s an innovation with applications for orthopaedics as well as dental medicine.
When teeth are lost due to force trauma or bacterial infection, dental implants are a standard treatment. Without sufficient bone for anchoring the implant, the only options have been complex bone grafts from the patient, or a xenograft: the sterilised mineral of bovine bone. Both carry complications, long-term risks and side effects.
Most notably, the xenograph is not biodegradable. The graft material can displace, and foreign body reactions like cysts and chronic inflammation can result.
The organic, injectable material discovered and tested by the researchers is Polyetheretherketone (PEEK). Although other studies had demonstrated the impressive characteristics of PEEK-based materials, this is the first one that evaluated PEEK-containing injectable hydrogels for bone regeneration.
It gives an incredibly promising future in oral health to both patient and practitioner.
Soon, all that will be needed to repair severely degenerated or missing jawbone is an injection. That it carries no autoimmune effects or long-term risks, with rapid and complete healing, will improve the quality of life for many in a way that was never thought possible.
Note: All content and media on the Bacchus Marsh Dental House website and social media channels are created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.
