Researchers at the University of Washington have developed a therapy that uses peptides to promote the regrowth of tooth enamel in order to treat dental cavities.
An end to tooth decay?
There are multiple regenerative medicine approaches being developed to combat tooth decay; for example, earlier this year, we discussed a method that uses gsk3 antagonists to spur the regeneration of teeth. This is a similar approach that is showing promising results.
The study published in the journal ACS Biomaterials Science and Engineering shows a technique that may allow teeth to be rebuilt and may mean the end of dental cavities and the problems they bring .
The technique was inspired by the body’s own natural proteins that help teeth to form and enamel to regrow. The researchers first isolated the essence of amelogenin, a key protein responsible for the formation of enamel on teeth; they then developed peptides based on the amelogenin protein to enhance tooth repair.
The peptides are shown to bind to the surface of teeth and recruit calcium and phosphate ions. This means that teeth can replace lost enamel at a faster rate than would naturally occur, which could potentially remineralize teeth damaged by decay.
The researchers report that just one treatment is enough to create between 10-50 micrometers of new enamel on a tooth. Once the system is fully developed, it could be easily deployed in toothpaste, gel solutions, and dental composites as an alternative to current dental methods. Such a system could be bought over the counter and a part of daily dental care in the near future.
White spot lesions (WSL) and incipient caries on enamel surfaces are the earliest clinical outcomes for demineralization and caries. If left untreated, the caries can progress and may cause complex restorative procedures or even tooth extraction which destroys soft and hard tissue architecture as a consequence of connective tissue and bone loss. Current clinical practices are insufficient in treating dental caries.
A long-standing practical challenge associated with demineralization related to dental diseases is incorporating a functional mineral microlayer which is fully integrated into the molecular structure of the tooth in repairing damaged enamel. This study demonstrates that small peptide domains derived from native protein amelogenin can be utilized to construct a mineral layer on damaged human enamel in vitro. Six groups were prepared to carry out remineralization on artificially created lesions on enamel: (1) no treatment, (2) Ca2+ and PO43- only, (3) 1100 ppm fluoride (F), (4) 20 000 ppm F, (5) 1100 ppm F and peptide, and (6) peptide alone. While the 1100 ppm F sample (indicative of common F content of toothpaste for homecare) did not deliver F to the thinly deposited mineral layer, high F test sample (indicative of clinical varnish treatment) formed mainly CaF2 nanoparticles on the surface.
Fluoride, however, was deposited in the presence of the peptide, which also formed a thin mineral layer which was partially crystallized as fluorapatite. Among the test groups, only the peptide-alone sample resulted in remineralization of fairly thick (10 μm) dense mineralized layer containing HAp mineral, resembling the structure of the healthy enamel. The newly formed mineralized layer exhibited integration with the underlying enamel as evident by cross-sectional imaging. The peptide-guided remineralization approach sets the foundation for future development of biomimetic products and treatments for dental health care.
Dental cavities bring a host of problems, including allowing bacteria to infiltrate deeper into the body, thus adding to the overall microbial burden; this, in turn, ties up the immune system and may contribute to aging in the long term.
There are multiple research teams working on a solution to dental cavities, and while it may seem like we are always hearing about these things but they never arrive, there is a fair chance that we should see something soon, given recent progress.
In broader terms, this is a great demonstration of regenerative medicine and how we might use our natural repair systems to rebuild damaged tissues in the future.
 Dogan, S., Fong, H. K., Yucesoy, D. T., Cousin, T., Gresswell, C. G., Dag, S., … & Sarikaya, M. (2018). Biomimetic Tooth Repair: Amelogenin-derived peptide enables in vitro remineralization of human enamel. ACS Biomaterials Science & Engineering.