New Drill for Tomorrow’s Dentists

The dental world of the future will be one where patients grow their own new teeth, much like a 6-year-old.

Dentists will implant cells from a young tooth, then apply proteins to make it grow. Roots will grow into the jaw, dentin and enamel will form, and a new tooth will grow where there was once just a gum. The best part is it won’t hurt.

By Kristen Philipkoski

http://wired.com/news/medtech/0,1286,63510,00.html?tw=wn_tophead_2

That’s just one of the dental techniques people will be able to take advantage of within a decade, if all goes well. Lasers, let alone archaic drills, will be a distant memory.

"That’s sort of the ultimate, down-the-road futuristic stuff," said Erick Rabins, president and CEO of Dentigenix, a company that helps researchers get their cutting-edge technologies to market. "I’m not pessimistic, but there’s some mind-blowing molecular biology (that) has to go on before that’s going to happen."

While we wait for scientists to crack tooth biology, many dental treatments will soon be painless, even pleasant. Dentists are already turning their offices into spas, replete with massages, videos and extensive music selections, along with laughing gas to order.

One new technology promises to eliminate the need not only for drilling but also for filling in the United States as early as next year. The HealOzone is already kicking drills and lasers to the ditch in Canada, Europe and Australia.

The machine generates ozone, which occurs naturally in the environment when ultraviolet radiation forces oxygen in the atmosphere to recombine temporarily into groups of three oxygen atoms (O3). Lightning can also cause ozone to form, resulting in that characteristic rainstorm smell.

Ozone also happens to be an efficient killer of cavity-causing bacteria. The device and follow-up treatment not only kill cavities, but also reverse decay in all but the deepest cavities.

The machine channels air through "dryer beads" that suck moisture out of the ambient air to create ozone. A disposable silicone tip that hermetically seals the tooth delivers bursts of ozone. The dentist uses a handheld instrument to squirt a solution on the treated area, turning any remaining ozone back into oxygen, since ozone can be harmful if inhaled in large enough amounts (researchers in the United Kingdom recently learned that ozone killed more people than previously expected in the 2003 heat wave).

Later, patients use an oral rinse and spray for about two to three weeks; the treatments contain fluoride, calcium, zinc, phosphate and xylitol, which help strengthen and re-mineralize the tooth.

The machine can also sterilize dental instruments, kill bacteria during a root canal and treat gingivitis and bad breath. Researchers in the United Kingdom are studying its ability to whiten teeth as well.

KaVo, the company that makes the HealOzone as well as the popular Diagnodent laser cavity detector, has sold more than 200 HealOzone units in the United Kingdom, and just recently began sales in Australia and Canada. The company hopes the unit will be available in the United States by 2006, according to Angelika Goeppel, marketing manager at KaVo.

Other technologies will emerge on the road to the Holy Grail of home-grown teeth. Pam Yelick and her colleagues at the Forsyth Institute provided a glimpse into the future when they generated tooth crowns made of dentin and enamel from young pig "tooth buds."

They’re working now to perfect the process by identifying the specific stem cells that engender the growth of dentin and enamel. Once they pinpoint the cells, they’ll likely be able to bioengineer teeth that don’t need replacement, just repair.

"A lot of this will lead to spinoff technologies," Yelick said. "It would be to regenerate reparative dentin and enamel."

Meanwhile, researchers at the Paffenbarger Research Center have already developed "smart fillings." Unlike dumb amalgam or composite fillings that just fill a hole, smart fillings release calcium and phosphate ions when they come in contact with acids from tooth bacteria. The ions prevent and — if animal studies translate to humans — also repair cavities.

"If damage has already been done by the acid, the release of calcium and phosphate ions can repair this damage," said Dr. Fred Eichmiller, director of the Paffenbarger center. He noted that human clinical studies to prove the re-mineralization effect are not yet complete.

The first smart filling on the market is Aegis from the Harry J. Bosworth Company, which costs about the same as regular fillings. Bosworth has also recently released a "smart" material for braces to prevent cavities from forming underneath difficult-to-clean hardware.

Another line of research could eliminate the need for most of this dental technology. Forsyth researchers hope to begin human clinical trials of a cavity vaccine soon. The vaccine worked in animals — it stimulated the immune system to prevent the development of cavities. In humans it would be squirted into the nose rather than injected or swallowed. The researchers anticipate a one-time treatment at 12 to 24 months of age would provide a lifetime free of cavities.