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New research may revolutionize root canal treatment

Replacing diseased pulp in teeth with pre-fabricated blood vessels, instead of synthetic biomaterials, may result in better long-term outcomes for root canal therapy. (Photograph: Kristyna Wentz-Graff/OHSU)
Dental Tribune International

Dental Tribune International

Tue. 20. June 2017

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PORTLAND, Ore., USA: Researchers at the Oregon Health and Science University (OHSU) have developed a revolutionary process by which to engineer new blood vessels in teeth using pre-vascularized dental tissue constructs. With this technique, they anticipate more effective treatment and longer-lasting results for root canal therapy.

According to the American Association of Endodontists, more than 15 million root canal therapies are conducted annually in the U.S. While the treatment is effective in saving a tooth with infected, inflamed or necrotic pulp, the current procedure may cause the tooth to become brittle and susceptible to fracture over time.

“This process eliminates the tooth’s blood and nerve supply, rendering it lifeless and void of any biological response or defense mechanism. Without this functionality, adult teeth may be lost much sooner, which can result in much greater concerns, such as the need for dentures or dental implants,” explained principal investigator and assistant professor Dr. Luiz E. Bertassoni, from the OHSU School of Dentistry.

To address this issue, Bertassoni and his research team used a 3-D printing-inspired process to create blood vessels in the laboratory. The new technique involves placing a fiber mold made of sugar molecules across the root canal and injecting a gel-like material, similar to proteins found in the body, filled with dental pulp cells. The mold is then removed to create a long microchannel in the root canal, and endothelial cells isolated from the interior lining of blood vessels are inserted. In the study, after seven days, dentin-producing cells proliferated near the tooth walls and artificial blood vessels formed inside the tooth.

“This result proves that fabrication of artificial blood vessels can be a highly effective strategy for fully regenerating the function of teeth,” said Bertassoni. “We believe that this finding may change the way that root canal treatments are done in the future.”

The study, titled “A novel strategy to engineer pre-vascularized full-length dental pulp-like tissue constructs,” was published online on June 12 in the Scientific Reports journal. It was funded by the National Institute of Dental and Craniofacial Research of the National Institutes of Health and the OHSU Medical Research Foundation.

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