For the first time ever, a dead or “non-vital” tooth can “return to life” through the implantation of stem cells, a process carried out by Venezuelan scientists.
Dr. José Cardier, head of the Cellular Therapy Unit of the Venezuelan Institute for Scientific Research (IVIC), the only one in the South American country and one of the few in Latin America, talked to RT about this unique experience, during which he has both been treated as a patient and worked as a researcher.
Cardier, a professor at the Faculty of Medicine of the Central University of Venezuela (UCV) with more than 50 publications in international journals, explained the process for returning sensitivity to a tooth that had undergone root canal treatment.
So far, this cell regeneration process is in the experimental phase and is carried out in Venezuela for free. It is expected that when a certain number of patients has been reached, the process can become more widespread in hospitals and dental offices.
RT: Is this the first case in the world of dental regeneration from bone marrow stem cells?
Dr. José Cardier: Yes, it is the first case reported in the world of dental pulp regeneration by implanting mesenchymal stromal cells in the teeth of patients.
It has such an impact that it was published in the Journal of Endodontics—one of the most important [publications] in the field of endodontics and dentistry—as a single case, which is called a “case report” in international journals due to its impact.
How do you get stem cells from bone marrow?
The cells we use come from bone marrow and are not from the patient; they are from healthy individuals who are not related to them. Those mesenchymal stromal cells are not rejected, so we can use them in other people. They are not only used in endodontics, but also for cases of periodontal disease and to regenerate skin in burned patients.
We obtain these cells by puncturing the the upper part of the hip bone, which is called the iliac crest. We insert a needle and aspirate bone marrow, which is like blood, and take it to the IVIC cell therapy unit, which is the only one in Venezuela and one of very few in Latin America.
The unit is twelve years old and is unique in doing many types of regeneration procedures. It is dedicated to basic stem cell research and technological developments to treat patients who need to regenerate organs and tissue. In addition, it is a pioneer in Latin America in the regeneration of bones in fractures that do not heal, in the treatment of people with cartilage damage in the knee, and the treatment of people with burns.
A stem cell implant was recently performed for corneal regeneration.
What are the necessary conditions to carry out the process?
We make cell cultures, and the mesenchymal stromal cells multiply by millions. We keep them in tubes, frozen in liquid nitrogen, and every time we need them, we thaw them to use in patients. That is the source, but those cells can be in other places like adipose tissue and skin. We have them everywhere in our body.
How does it happen?
Once we plan to treat patients who have undergone root canal treatment, the patients are evaluated in the IVIC dental center, which has microscopes adapted for the specialty of endodontics.
A group of specialists under the direction of the endodontist reopens the tooth, cleans it, disinfects it, places the cells, and closes the canal. From this, the cells are allowed to begin to evolve. X-rays and tests are then done with cold, heat, electricity points, and taps on the tooth.
For these types of procedures, human resources are essential and are made up of people with a very high level of training, experience, and knowledge in the area of stem cells and tissue regeneration. We have all this in the IVIC cell therapy unit.
You should also have specialists in endodontics, periodontics, and other areas. Carrying out basic research and developments to bring them to the patient is multidisciplinary work.
To carry out this type of procedure, resources such as equipment, materials, and reagents must be available.
What does it mean that after the process, patients will have “living teeth?”
When doing a root canal, the dental pulp is removed, which contains the nerves, the nutrition of the cells, and the blood vessels. This pulp is only formed in the embryo and, when it is removed, there is no chance of it regenerating, so we lose sensitivity.
When someone has a root canal done, it is popularly said that they “pulled out the nerve.” The tooth remains like a honeycomb: totally empty, and, although it serves as a support, it is dead.
The fundamental thing [with stem cell therapy] is that the tooth recovers sensitivity so that it is “alive,” and thus, a crown can be implanted that is not on a “dead tooth.”
I am one of those patients who had a root canal: I felt nothing, my tooth was dead with a crown. Mesenchymal stromal cells were placed in the canal and the pulp was regenerated. Today I have a living tooth, with sensitivity.
Is it possible to mass produce this process in the short or medium term?
Yes. These are experimental procedures for which the patient pays nothing. All costs are financed by the state through the Ministry of Science and Technology, which provides everything necessary to carry out research and development.
Once we complete a number of cases, we will request authorization so that these cells, which act as medicine, have the approval of the Ministry of Health. With that we can proceed to send them to the dental offices.
In the IVIC dental center, we treat ten to twelve patients in one morning. There was one afternoon where we saw more than 20 cases in the periodontal and pulp regeneration areas. In other words, the process can be extended to public and private hospitals and dental offices.
The great commitment of the state, the Ministry of Science and Technology, the current minister, Gabriela Jiménez, and the IVIC authorities allow Venezuela to be at the forefront of organ and tissue regeneration in both Latin America and the world.
Translation: Orinoco Tribune
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