Tissue engineering of teeth using adult stem cells.

Tooth development, a process which occurs in the developing embryo, involves the reciprocal and sequential signalling between epithelial and mesenchymal tissue of the developing first branchial arch. The oral epithelium produces the first inductive signals for odontogenesis at around E10.0, which trigger off a cascade of events that result in the formation of a tooth. We have engineered a tooth in vitro by harnessing the basic principles of odontogenesis and the inductive capability of the oral epithelium of the developing embryo. We replaced the mesenchymal portion of the developing mandibular primordium with aggregates of stem cells from embryos as well as stem cells taken from adult mice. The cell aggregates were covered with embryonic epithelium from E10.0 mouse embryos to form recombinant explants. In vitro culture of these recombinant explants resulted in the induction of early tooth marker genes in the cell aggregates, indicating that the cells were able to respond to the odontogenic signals produced by the oral epithelium. In vivo culture of explants resulted in the induction of Dspp within the cell aggregates indicating that tooth tissue was present. Three recombinant explants, where the cell aggregates consisted of adult bone marrow cells, produced teeth. To determine whether the oral cavity would be able to sustain the growth of an implanted tooth germ, E14.5 molar rudiments were implanted into the diastema region of the maxilla of adult mice. The resulting teeth appeared to be normal in size and were connected to the underlying bone. These experiments are an indication that it is possible to induce odontogenesis and engineer a tooth using adult cells of non-dental origin. They also indicate that developing tooth germs could be successfully implanted into the gingiva of patients.