Tooth decay is in fact the most prevalent chronic disease says the National Institutes of Health. There is some good news for all those who have experienced tooth pain due to decay at some point in their life. Dual discoveries at USC propose a promising method that can regrow nonliving hard tissue, lessening or even eliminating pain associated with tooth decay.
For the past two decades, Janet Moradian-Oldak, a professor at the Herman Ostrow School of Dentistry of USC, has been researching ways to regrow tooth enamel. The process is not an easy one because tooth enamel is a nonliving tissue and unlike bone, mature enamel cannot rejuvenate. Janet in collaboration with lead author Sauma Prajapati of USC and other colleagues published a study in the Biomaterials journal stating matrix metalloproteinase-20, an enzyme found only in teeth, chops up amelogenin proteins, which in turn facilitate organized enamel crystal formation. MMP-20 clears the way for hard material to take up the vacated space. This is the first time the function of an enzyme for preventing protein occlusion inside a crystal has been described.
Janet who is also the study’s senior author added that MMP-20 is released at a very early stage of enamel formation. MMP-20 chops up proteins during the crystallization of enamel. Together with other enzymes, it gets rid of ‘sludge’ so the enamel making cells in the body can add more mineral and make enamel, the hardest bioceramic in the human body.
The discovery by Janet Moradian-Oldak will be coupled with another study published in the Journal of Biomedical Engineering and Informatics, which concluded an amelogenin-chitosan hydrogel could repair early tooth decay by growing an enamel-like layer that reduces lesions by up to 70 percent.
Qichao Ruan, lead author of the hydrogel study and a postdoctoral research associate in the Center for Craniofacial Molecular Biology at USC remarked that recognizing MMP-20’s function in biomineralization is one of the first steps to learning how dental enamel forms in nature. He added that the findings about MMP-20 are significant as they can not only help to further understand the mechanisms of enamel formation but these findings can also be applied in the design of novel biomaterials for future clinical applications in dental restoration or repair.
Any type of enamel re-growing gel has not been approved by the Food and Drug Administration yet. Even USC is in pre-clinical trials. However, Janet is hopeful that that day is not far when people may be able to use an overnight mouth guard or teeth strips saturated with hydrogel to regrow enamel-like substances and reduce teeth sensitivity.
There are products like toothpaste and mouthwash containing fluoride and casein phosphopeptide-amorphous calcium phosphate that promote remineralization of initial enamel lesions; but the thing is they need to be used regularly to plug up the problem. It is more of a tire patch than a real solution that minimizes the feeling of tooth pain. This gel is different as it fills the cracks and holes with an enamel-like substance making the solution more durable.
Grinding teeth at night, gum recession and the disappearance of enamel over a lifetime due to demineralizing acidic food and drink are all common problems people everywhere face. Statistics reveal that in the United States, about 92 percent of adults between the ages of 20 to 64 have had dental decay in their permanent teeth.
Ruan remarked that when tested in an environment that mimics an oral cavity’s biochemical processes, the hydrogel was able to create a robust attachment, thereby eliminating the threat of secondary cavities in the same spot. It is very likely that the gel could be more effective than traditional crowns that weaken over time. Not just biocompatibility and biodegradability, the gel has unique antimicrobial and adhesion properties that are important for dental applications.
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