Dental enamel: the human pearl
Dental enamel, the hardest tissue in our body, is made up of highly organised calcium phosphate crystals assembled together via a process known as 'biomineralisation'.
This process strictly regulates the secretion and the structure of organic framework in a way to be capable to control the growth of enamel's crystals in organised fashion. Thanks to this magnificent structure, tooth enamel can function for many decades – see a recent paper I wrote with Professor Alvaro Mata on Hierarchical Biomineralisation
As we all know, the oral cavity is a very challenging environment where our teeth have to withstand masticatory forces, acids, sugars, and sometimes extreme temperatures.
No enamel? More problems
Clinical problems that lead to enamel loss are many including; dental caries, trauma, erosion, and mechanical tooth-wear.
About 45 per cent of the population suffer from such problems, which can lead to pain, further tissue loss and eventually tooth loss.
Unfortunately, once enamel is damaged, there is no way for it be self-healed or regenerated with the current filling restorative materials that are available in the market such as dental amalgam, composite or glass ionomer cements.
Unfortunately, these materials lack the anisotropic nature and structural integrity compared to those found in dental enamel, which lead to surface mismatch, fractures, rocking of restorations, marginal damage and leakage, and further loss of dental tissues.
Therefore, a major goal in modern dentistry is to develop materials that can look and behave to some extent like the native dental enamel. That's what we are trying to do and achieve with our research to help our patients.
Is it possible to mimic enamel?
Inspired by enamel development known as 'biomineralisation', we have developed a synthetic organic material based on proteins that is not only capable to nucleate enamel-like crystals but also able to guide the growth of these crystals in a hierarchical manner that mimic dental enamel to a level that has not been reported previously – see a summary of my latest research paper with colleagues.
To repair tooth enamel, we have attached this matrix on top of human dentine in the lab, immersed it in a solution rich of calcium and phosphate that mimic our saliva, where the synthetic crystals start to grow in a similar fashion to that of dental enamel – see the full research article online.
Future research steps
We are currently conducting few animal studies to optimise our processes and validate our results. We envisage that this research can be applied clinically in about 3-4 years.
We are tackling early tooth decay and tooth erosion, however in the future we are hoping that we can apply these materials to replace bigger dental defects.
As well, we anticipate that this technology would find applications in implant dentistry and periodontology including implant coatings as well as guided tissue/bone regeneration (GTR/GBR).
We believe that the versatility and simplicity of our technique could open up multiple routes towards tissue regeneration, in a way that could revolutionise both the biomedical and dental fields.
If you have any questions on comments on our work, please do get in touch.
Please share our video below on your social channels to help communicate our work more widely – thank you!
Dr Sherif Elsharkawy, BDS (Hons), MSc, MFGDP RCSEng, PhD
Clinical Teacher in Restorative Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London
Postdoctoral Research Assistant, Institute of Bioengineering, Queen Mary University of London
