Root canal? Next-gen treatment could involve stem cells, not surgery

BUFFALO, N.Y. — Camila Sabatini, DDS, PhD, associate professor of restorative dentistry in the School of Dental Medicine at the University at Buffalo, has received the Harold Amos Medical Faculty Development Program (AMFDP) award from the Robert Wood Johnson Foundation to study novel therapies to repair damaged teeth.

The selective four-year $420,000 grant will allow Sabatini to investigate strategies for the regeneration of tooth defects. She will work in collaboration with Techung Lee, PhD, associate professor of biochemistry in the Jacobs School of Medicine and Biomedical Sciences. Frank Scannapieco, PhD, SUNY Distinguished Professor of Oral Biology, will serve as advisor in this fellowship.

The award, traditionally reserved for promising physician-scientists to help them advance toward achieving a senior rank in academic medicine, expanded in scope to include dentistry in 2012 and nursing in 2015.

“As the only dentist in a cohort of 16 scholars selected this year, this award reflects her outstanding contributions to the field” Scannapieco said.

Sabatini’s research, investigating novel biologically based avenues for tooth repair, may reduce the need for root canals and could potentially have major implications in the way dental care is rendered.

“Root canals happen when an infection has advanced to the nerve of the tooth,” Sabatini said. “The nerve is removed, and the canals are sealed with a synthetic material. The loss of vitality weakens the tooth, making it prone to fracture.”

In this proposal, Sabatini explained, the team will investigate ways to use stem cells of dental origin to promote the repair of damaged teeth potentially avoiding the need for a root canal.

 “Over the past two decades, scientists have come to rely on stem cells for tissue regeneration. We haven’t tapped into that nearly enough in dental medicine,” Sabatini noted. “The standard of care in dentistry today — fillings and implants — is still quite outdated as it is based on the use of synthetic materials only. We are looking to increase our understanding of the biology of the host, so we can identify potential avenues for tissue repair.”

Cancer therapy drugs and gene therapy

The four-year grant will allow the team to investigate a drug repurposing approach with an immunostimulant drug used in cancer therapy and a gene therapy strategy.

“The appeal of drug repurposing is the potential for immediate clinical translation since phase I trials can be bypassed, moving directly to phase II trials,” Sabatini said. “Gene therapy could provide a cost-effective avenue for the healing of tooth defects.” 

The therapies will be investigated using dental pulp stem cells obtained from extracted human molars and animal trials in mice where artificially induced tooth defects will receive the various therapies. The animal studies proposed under this award could take the investigators a step closer to the next phase in the process of regulatory approvals of therapies and devices by the Federal Drug Administration (FDA).

“The possible impact of this research is profound,” Scannapieco said. “These innovative technologies have the potential to be widely applicable and cost-effective, ushering in a significant paradigm shift in dental care.”

Advancing team science and research-driven dental education

Sabatini joined the dental school in 2007 as a clinical assistant professor and was promoted to associate professor in 2015. She also currently serves as an adjunct professor in oral biology and in chemical and biological engineering.

A previous recipient of a National Institutes of Health (NIH) research award – in collaboration with Chong Cheng, PhD, professor, and Mark Swihart, PhD, SUNY Distinguished Professor and chair, both of the Department of Chemical and Biological Engineering – Sabatini has worked toward advancing a vision of team science and research-driven dental education.

“Embracing science at the core of dental education is the only path forward,” she said. “We, in academic centers, have a monumental task to evolve in our understanding of the profession and the factors that will influence the future workforce supply and demand.

“Understanding changes happening in dental practice will guide academic centers in meeting these demands. Several therapies will make their way into the profession over the next decade. Regenerative dentistry, while still in the early stages, will make its way into the mainstream as a non-invasive treatment option.”

Sabatini’s AMFDP award followed a competitive peer-reviewed process, involving distinguished members of a National Advisory Committee affiliated with agencies such as the American Heart Association, the National Institute of Diabetes and Digestive and Kidney Diseases, among others.

“I am thrilled about this opportunity,” Sabatini said. “I look forward to continuing to build my research program, expanding into the field of regenerative medicine and contributing to the NIH-funded pool of dentist/scientists for the advancement of this work.”