Cavities are a real nightmare for many because of the pain they cause and also because of the mandatory visit to the dentist, which for some resembles hell itself. And it is no less a problem, since untreated tooth decay is one of the most common problems in the world, affecting some 2,000 million patients worldwide, as pointed out by the Global Burden of Disease 2019.
A serious problem. A cavity requires quick dental treatment, since it is impossible for them to cure on their own or with a simple pill. This is because mature tooth enamel, what we see of the tooth, is a hard tissue, without cells and, therefore, cannot regenerate itself once it is damaged by bacteria.
In this way, if left untreated, the cavity progresses, destroys the tooth and takes us directly to the dentist’s chair for a filling. This is where the dentist must remove all of the damaged enamel and replace it with a type of putty that hardens to look like enamel, even though it really isn’t.
The objective. For years, science has been searching for the “holy grail” of dentistry: a method to regenerate enamel biologically. However, getting the enamel compound to grow in an aligned and orderly manner, as biology does, is a nearly impossible thing.
The now. A team of researchers from King’s College London has achieved something radically new: using keratin, the protein found in our hair or even in the wool of sheep.
With this project, the researchers, instead of betting on a “patch” as now, keratin self-assembles into a fibrous network and forms structures as if it were the perfect scaffold.
This is where the magic happens. This keratin scaffold guides the ordered growth of the molecules that make up the tooth. The study discovered that the keratin structure itself is flexible and reorganizes itself during mineralization (changing from β-sheets to α-helices), actively orchestrating the formation of the new mineral layer.
It has already been tested. To test if this new material worked, they took human teeth and artificially caused “white spot lesions,” which are the first visible stage of a cavity. With this base, the keratin film was applied and incubated in a mineralization solution, resulting in a comprehensive repair of the tooth with an adequate structure.
The future. The most important thing is that this regeneration is not just aesthetic; It is functional. The study measured the mechanical properties of the repaired enamel and the results surpassed one of the current standard treatments: resin infiltration.
Both in the hardness and mechanical properties tests, it was seen that the result was really positive when it came to being able to use the tooth as if it were the integral version. In this way, this study establishes a preclinical framework for using a platform based on keratin, a cheap, abundant and biocompatible material. The manufacturing process is simple and does not use solvents.
This could represent a “paradigm shift” in the clinical management of early caries. Instead of just having to drill and fill them, the possibility of curing and regenerating them is offered to restore both aesthetics and mechanical properties.
Images | Villen Pierre Ozan Guer
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