Current Development Of The Application.

Dental root has two types of applications that can replace a root which is dental
implant and root canal. This application had been used since 21st century is a technique that
needs a patient to make several visits to clinics to undergo several surgeries. The applications
can make the implant teeth or root canal functions and looks like natural teeth. At present,
this application had been common techniques with an organized process, very little
discomfort, and has a very high success rate in the hands of experts. However, there must be
more research and investigation to meet the requirements and its biocompatibility. Some
dental research has currently developed new applications that still need a clinical trial before
it can be used.

Pulp/Dentin Regeneration and BioRoot Engineering

In 2008, George et al. have discovered a new application which a new population of
mesenchymal stem cells (MSCs) that present in the apical papilla of permanent immature
teeth which is called stem cells from the apical papilla (SCAP). This is where the source of
odontoblasts, part of the outer surface of the dental pulp that responsible of formation of root
dentin. These stem cells allow the continuous growth of root teeth of incompletely developed
teeth to become matured teeth. The regeneration of pulp inside a damage tooth is a basic
application of the stem cells therapy in the field of dentistry.

1. The Potential Role of SCAP in Continued Root Formation

In the clinical case of a human immature incisor injured and the fractured of crown
with exposure of pulp has been proved that the role of apical papilla in formation root. The
apical papilla was maintained while the pulp was removing. There is continuously root-tip
formation even after root canal treatment. However, to verify whether the radiographic
evidence of continued apical development is because of dentin formation from the apical
papilla the further investigation is needed. Using mini-pigs as a subject, a pilot experiment
was released. The apical papilla is remove surgically at an early stage of the root
development halted the root development even though the pulp tissue being intact. In
contrast, other roots of the tooth containing apical papilla showed normal growth and
development
 2. SCAP for Pulp/Dentin Tissue Engineering and Regeneration

Mooneys groups it the first tested the dental pulp tissue engineering. Bohl et al.
reported high cell density tissue similar to the native pulp is observed when culturing pulp
cells grown on polyglycolic acid (PGA) in vitro. Buurma et al. also found that pulp cells
seeded in PGA and implanted into the subcutaneous space of immunocompromised mice
produced extracellular matrix. Further investigation is needed to verify whether SCAP are a
more suitable stem-cell source for pulp generation than dental pulp stem cells (DPSCs) and
stem cells from human exfoliated deciduous teeth (SHED) because of their natural role as a
source for primary odontoblasts than the replacement odontoblasts.

3. SCAP for Bioroot Engineering

The researcher had been used larger animals such as dogs and swine to be test
regarding the regeneration at orthotopic sites. However, its failed to show root formation in
dogs while success rate of root formation in the swine. Another step to form bioroot is by
using SCAP and PDLSCs. Autologous SCAP and PDLSCs is seeded into HA and gelfoam
scaffold in a minipig model and implanted into sockets of the lower jaw. A space is left for
post insertion which is post channel was recreated. The bioroot is formed after three months
and a crown was inserted. It has been prove that was a rapid way of creating a root onto
which an artificial crown can be installed. Therefore, the root structure of bioroot developed
by SCAP in a random manner is different from a natural root. However, a natural relationship
with the surrounding bone can be observed because of the bioroot is envelop with periodontal
ligament tissue.

Dental implant and root canal have been a main option to replace missing teeth. Although its
have a great improvement, it is still lack of natural relationships with bone compared to
bioroot. Tooth regeneration is the effective way to replace a painful tooth implants. In fact, it
is less invasive and maybe less expensive process. Tooth regeneration also as an approach for
patients who are not suitable candidates for dental implant and cannot afford it. However,
several things need to be analysed such as the mechanical strength of the bioroot that need to
be improved as a natural tooth. Harmful effects also must be avoid by carefully analysed the
differentiated of stem cells to the according cell types before they can be used clinically.