Medical Hypotheses 72 (2009) 129–130

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Medical Hypotheses
journal homepage: www.elsevier.com/locate/mehy

Bionic dental pulp: Its potential value following root canal therapy
M.M. Ren Zheng, B.M.E. Gongping Li, M.M. Hao He, M.D. Yinghe Lin *
Department of Prosthetics, West China College of Stomatology, No. 14, 3rd Section, South Renmin Road, Chengdu, Sichuan 610041, China

a r t i c l e i n f o s u m m a r y

Article history: Dental pulp can provide nutrition for teeth. The teeth after root canal therapy without pulp will turn frai-
Received 30 August 2008 ler because of dehydration, and it may be easily broken. Bionic dental pulp possesses similar components
Accepted 12 September 2008 of the healthy dental pulp. So we put forward a hypothesis that bionic dental pulp can be filled into root
canals to provide nutrition for teeth like healthy pulp. Then the life-span of teeth after root canal therapy
could increase.
Crown Copyright Ó 2008 Published by Elsevier Ltd. All rights reserved.

Introduction
Pulpitis and Periapical Disease that are a type of chronic, bacte-
rial and infective disease are often found in oral cavity. The disease
incidence can be higher than 70 percent [1]. At present, the root
canal therapy is the most effective and thorough treatment for
Pulposis and Periapical Disease. Obviously, teeth after root canal
therapy cannot last a long time under service [2]. Currently
nano-technology, tissue engineering and regeneration medicine
are hot spots for study. So the author proposes that bionic dental
pulp be established with nano-technology and the methods of
tissue engineering and regeneration medicine, and put into the
teeth after root canal therapy.
The components of bionic dental pulp
The normal teeth pulp includes nerve, blood vessel, lymph and
connective tissue.
Tissue engineering and regeneration medicine need stem cells,
growth factors and frame of extracellular matrix combined
perfectly [3]. So bionic dental can be divided into three parts:
1. Stem cells: make the mesenchymal stem cells (MSCs) as seed
cells [4]. MSCs were proved to be biologically safe and ideal
seed cells for researches on human tissue engineering and
regeneration medicine. They are mainly localized in the bone
marrow and also are resided in the umbilical blood, peripheral
blood, fatty tissue, skin, and so on. BMSCS which can be gained
conveniently from patient’s ilium and cultured easily divide and
proliferate quickly, and in vivo and vitro it can differentiate
multi-directionally [5] such as neural stem cells (NSCs) [6],
vessel endothelial cells (VECs) [7] and so on. MSCs may secrete
a few nerve nutrition factors to make NSCs transform into nerve
cell [8]. VECs can maintain regular form and physiology func-
* Corresponding author. Tel.: +86 13980050654; fax: +86 28 85502407.
E-mail address: yinghe99@163.com (M.D. Yinghe Lin).
tion of blood vessel as the frames and linings; meanwhile they
can regulate and control the proliferation and contraction of
vascular smooth muscle cells. In some conditions, MSCs finally
can be induced to differentiate and grow into vessel and nerve
which are the basic compositions of bionic dental pulp. So MSCs
play an important role in bionic dental pulp.
2. Growth factors: growth factor refers to a naturally occurring pro-
tein capable of stimulating cellular proliferation and cellular
differentiation. Growth factors that have no any drug toxicity
and will not cause any immunological reaction are important
for regulating a variety of cellular processes. Platelet-rich plasma
in vitro [9] that includes platelet above 70 percent contains
many growth factors. Nanotechnology becomes one of the main
technology as well as the information technology and biotech-
nology. Nanoparticle vector has been used broadly in clinic.
Nanocapsule [10] which is composed of outer covering and core
is a kind of nanoparticles which are used as carriers. So in bionic
dental pulp, Platelet-rich plasma in vitro can be made as the core
and some biotic-absorbable material can be used to wrap the
core with nano-technology. Then growth factors can be released
slowly by the corrosion of outer coverings. So Platelet-rich
plasma in vitro is another important part of bionic dental pulp.
3. The frame of extracellularmatrix: collagen [11] is the main protein of
connective tissue in animals and the most abundant protein in
mammals, it can serve many functions, such as providing support
and anchorage for cells, segregating tissues from one another, and
regulating intercellular communication. Meanwhile it has many
merits, such as high tensile strength, biotic-absorbable nature,
low antigen-activity, and low cell toxicity and so on. Therefore,
collagen is important component of bionic dental pulp, too.
The theory of bionic dental pulp
Bionic dental pulp requires imperative condition for existence.
For example, every root canal is sterile, apical foramen is
unobstructed; root tip has no inflammation, etc. MSCs and

0306-9877/$ - see front matter Crown Copyright Ó 2008 Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.mehy.2008.09.029
130 M.M. Ren Zheng et al. / Medical Hypotheses 72 (2009) 129–130
nano- Platelet-rich plasma in vitro permeate into root tip by apical
foramen and induce new vessel and nerve there to grow into root
canals along the frame of extracellular matrix. Then bionic dental
pulp is shaped.
It can provide nutrition which is taken in by dentinal tubules for
teeth like normal dental pulp.
The defects of bionic dental pulp
1. The feeling of teeth: bionic dental pulp has not the same feeling
as the healthy dental pulp. The absorption of nutrition for teeth:
There are no odontoblasts in bionic dental pulp. Whether the
nutrition can be absorbed completely is unknown.
2. The possibility of inducing immunological reaction: MSCs and
Platelet-rich plasma in vitro come from individual body, but
the frame of Extracellular matrix is artificial. Whether immuno-
logical reaction can be induced is a question.
There are many differences between healthy dental pulp and
bionic dental pulp. The bionic dental pulp is just a hypothesis. A
qualitative leap is needed from hypothesis to accomplishment.
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