| Abstract|| |
Background: Dental stem cell, a type of adult stem cell, exhibits multipotent differentiation capacity and is drawing worldwide attention because of its numerous applications. The advances in applications of dental stem cells seem to be unsurpassed in the near future, for which specialized skills and knowledge in this arena are of prime significance. Hence, there is a need to acquire more knowledge about dental stem cells to obtain maximum benefits from it in the coming years. Dental stem cells in India are still at the budding stage, and there seems to be limited awareness regarding dental stem cells. Aim: This study aimed to assess the awareness of stem cells among the dental professionals. Methodology: The present study was a questionnaire-based study of dental professionals (MDS, BDS, postgraduates, and interns) of three different institutions. Results: Results showed that 95.2% of dental professionals are aware of the terminology dental stem cells and 53.9% of them are aware of various applications of dental stem cells. Chi-square test showed a significant correlation between the sources of information, source of dental stem cells, and clinical applications in relation to the academic qualification of the dental professionals. Conclusion: This study revealed a good level of awareness among the dental professionals, and it also showed the need to spread more knowledge about the advances in applications, storage, banking, and guidelines related to dental stem cells.
Keywords: Cell, dental professionals, dental stem cell, stem cells
|How to cite this article:|
Chitroda PK, Katti G, Attar NM, Shahbaz S, Sreenivasarao G, Patil A. Stem cells in dentistry: A study regarding awareness of stem cells among dental professionals. Indian J Dent Res 2017;28:711-6
|How to cite this URL:|
Chitroda PK, Katti G, Attar NM, Shahbaz S, Sreenivasarao G, Patil A. Stem cells in dentistry: A study regarding awareness of stem cells among dental professionals. Indian J Dent Res [serial online] 2017 [cited 2021 Feb 26];28:711-6. Available from: https://www.ijdr.in/text.asp?2017/28/6/711/221068
| Introduction|| |
Stem cells are defined as clonogenic cells capable of both self-renewal and multilineage differentiation. They are also termed as progenitor cells. It has found various applications in the field of dentistry in the recent years after the discovery of dental stem cells. There are primarily two types of stem cells, namely, embryonic stem cells (ESCs) and adult stem cells (ASCs) or somatic stem cells. Dental stem cell, a type of ASC, exhibits multipotent differentiation capacity and is drawing worldwide attention because of its various applications.,, The advances in applications of dental stem cells seem to be unsurpassed in the near future, for which specialized skills and knowledge in this arena are of prime significance. Hence, there is a need to acquire more knowledge about dental stem cells to obtain maximum benefits from it in the coming years. Dental stem cells in India are still at the budding stage, and there seems to be limited awareness regarding dental stem cells. Therefore, this study aimed to assess the awareness of stem cells among the dental professionals.
| Methodology|| |
The present study is a questionnaire-based study, wherein the questionnaire was circulated among the dental professionals (MDS, BDS, postgraduates (PG), and interns) of three different institutions, namely, Al-Badar Rural Dental College and Hospital, HKE Dental College and Hospital, both from Kalaburgi and Al-Ameen Dental College and Hospital from Vijayapur. The questionnaire ,,, contains 18 questions, which have been developed on the basis of other similar articles related to stem cells and dental stem cells.,,, The questionnaire includes both close-ended and self-administered questions. The data was analyzed using the percentages of the total and Chi-square test.
| Results|| |
The study sample consisted of a total of 189 dental professionals (MDS – 22.2%; PG – 46.6%; BDS – 9%; interns − 22.2%). With 95% confidence level and a margin of error of ±3%, a sample size of 169 participants will allow the study to determine the awareness of stem cells among dental professionals with finite population correction. Final minimum sample size = 169% + 15% anticipated dropout rate. A total number of participants were 194, among which completed questionnaire was given by 189 participants and the dropout was 3%. Using the formula:
Where Z = z statistic at 5% level of significance, d is margin of error, and P is anticipated prevalence rate. About 95.2% of dental professionals are aware of the dental stem cells. The main source of information was internet followed by books, conference/convention/symposium, UG training, and PG training. Almost 18.6% had selected two sources whereas 42.6% had selected more than one source of information. It was observed that 62.96% of dental professionals are aware of different types of dental stem cells whereas 70.9% are also aware of different types of stem cells. Nearly half (42.85% and 43.91%, respectively) of the participants had awareness and knowledge of sources and tooth used for extraction of dental stem cells. Around 53.9% of them are also aware of various applications of dental stem cells. Major percentages, i. e., 64% of respondents are unaware of dental stem cell banks in India. More than half (66.7%) are willing to recommend/advise the patients to store/preserve the dental stem cells. Nearly 40.21% had the knowledge of different applications of dental stem cells in relation to oral health care whereas 39.68% did not have any idea about it. About 61.9% are ready to collect dental stem cells in their clinical practice and 55.02% are not willing to invest for dental stem cell banking.
According to 49.6% of dental professionals, the main obstacles to seek treatment with the aid of dental stem cells are high cost, lack of awareness, ethical issues, and insufficient knowledge about stem cells among dental practitioners as well as people whereas only 3.72% said that there is no hindrance to obtain treatment using stem cells. Less than one-third (16.4%) of dental professionals had attended workshop/conference/seminar/continuing dental education (CDE) program on application of dental stem cells, and hence, 89.42% are enthusiastic to attend such programs or conferences in the near future. A greater number of respondents, i.e., 84.13% are unaware of the guidelines related to dental stem cells given by the Indian Council of Medical Research. Nearly 75.13% of dental professionals agreed that dental professional associations should regulate the use of stem cell and regenerative dentistry whereas 19.05% were not sure of it.
| Discussion|| |
Stem cells are the cells that have the ability to differentiate into different types of cell by undergoing numerous cell divisions along with maintaining the property to differentiate and proliferate into mature cell types., Stem cells are also called as the precursor cells or the progenitor cells because of the ability of self-renewal and transdifferentiation.,,, The term “stem cell” was coined by Wilson. A histologist from Russia by name Alexander Maksimov postulated the existence of hematopoietic stem cells in the year 1908.,, Based on the origin and their potential of differentiation, stem cells are broadly classified as ESCs and ASCs.,,, ASCs are multipotent cells that have the ability to differentiate into more than one type of cell but not all the type of cells. ASCs are also known as postnatal stem cells or somatic stem cells  which can be obtained from bone marrow, umbilical cord, pancreas, adipose tissue, and dental pulp., Dental stem cell is a type of adult mesenchymal cell which has ease of access and is feasible source of stem cells., There are various sources of dental stem cells in the orofacial region such as dental pulp stem cells, dental follicle stem cells, stem cells of apical papilla, periodontal ligament stem cells, tooth germ progenitor cells, and immature dental pulp stem cells. There are numerous applications of this progenitor cell such as continued root formation, regeneration of an immature tooth with extensive pulp damage, periodontal regeneration, biological tooth, and stem cell-based therapies, which are gaining worldwide attention because of its copious benefits. This questionnaire study was conducted to assess the awareness of dental stem cells among the dental professionals.
In the present study, Chi-square test showed a significant correlation between the source of information, source of dental stem cells, and clinical applications in relation to the academic qualification of the dental professionals which may be due to more knowledge acquired by highly qualified dental residents. On contrary, Sede et al. showed nonsignificant association between attitudes toward the use of stem cell with qualification.
Even significant correlation was also found regarding awareness of dental stem cell banks, investment and willingness to collect dental stem cells with respect to academic levels of the respondents.
Almost 95.2% of dental professionals are aware of the dental stem cells [Graph 1]. This study revealed 53.9% awareness of the application of dental stem cells [Graph 2]. Sede et al. found 81% of awareness about the use of stem cell in dentistry. According to our study, the major source of information was internet followed by books which may be due ease of access to this source. In contrary to this, a study conducted by Sede et al. showed that the undergraduate training and conference/symposium/seminar were the primary source of information. This could be due to increased spurt of conversation regarding the topic within the public through a variety of forums like increased publication of scientific articles and also because it is one of the most novel topics ruling the world of medicine and dentistry.,,
In this study, a thumping majority, i.e., 89.42% [Graph 3] showed interest to attend CDE programs or conferences in near future which could be due to increasing research, applications in this field, and also may be due to lack of sufficient in-depth knowledge about dental stem cells. This necessitates the organization of training/CDE program-related dental stem cells. Goyal reported that 73% of the participants were enthusiastic to attend such conference/workshop/CDE programs because they had never attended the same.
About 49.6% of dental professionals believed that the main obstacles to seek treatment with the aid of dental stem cells are high cost, lack of awareness, ethical issues, and insufficient knowledge about stem cells among dental practitioners, and comparable results were found in a survey done by Goyal where 63.50% agreed that the high cost, lack of awareness, and lack of sufficient knowledge were hindering people to obtain treatment using dental stem cells. These factors that refrain the people from obtaining treatment using dental stem cells could be minimized by reasonable charging the fees similar to other standardized management procedures  and by also spreading awareness at the public level by conducting seminars/lectures at public level which in return will decrease the misconceptions related to stem cells.
Nearly 75.13% of dental professionals agreed that dental professional associations should regulate the use of stem cell and regenerative dentistry as this may be due to the fact that dental pulp stem cells have equivalent potential to differentiate when compared with the stem cells obtained from bone marrow [Graph 4]. Analogous results (85.3%) were noticed in a study done by Utneja et al.
Almost 84% are unaware of the guidelines related to dental stem cells given by the Indian Council of Medical Research [Graph 5]. Hence, there is a need to spread awareness regarding these guidelines as the opinion of the dental residents may help to reframe them which in turn might facilitate to enhance the safety of procedures/treatment done using dental stem cells.
| Conclusion|| |
This questionnaire study revealed a good level of awareness among the dental professionals. When divided into groups, MDS staff was completely aware of the terminology followed by PG students, BDS staff, and interns. This study also showed a significant correlation between the academic qualification and the level of knowledge and awareness among the dental professionals. This urges a need to spread more knowledge about the advances in applications, storage, banking, and guidelines related to dental stem cells at UG level which can be done by conducting seminars and also by organizing seminars and conferences. Similar surveys and research must be conducted at different levels to spread the awareness globally so that everyone can gain the benefits in the near future.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bansal R, Jain A. Current overview on dental stem cells applications in regenerative dentistry. J Nat Sci Biol Med 2015;6:29-34.
Bhatt R, Bhatt A, Gurjar D, Dave L. Evaluating awareness on dental pulp stem cells and its applications amongst graduating dental students of Ahmedabad and Gandhinagar district: A cross-sectional survey. Adv Hum Biol 2014;4:54-9. [Full text]
Goomer P, Sidhu AK, Tuli P, Kansal S, Bansal K, Thakre GR. Awareness of stem cells and health implications of SHED found in pediatric dentition among Indian population. J Int Oral Health 2014;6:44-7.
Rai S, Kaur M, Kaur S. Applications of stem cells in interdisciplinary dentistry and beyond: An overview. Ann Med Health Sci Res 2013;3:245-54.
] [Full text]
Sede MA, Audu O, Azodo CC. Stem cells in dentistry: Knowledge and attitude of Nigerian dentists. BMC Oral Health 2013;13:27.
Goyal A. Knowledge, awareness and attitude regarding stem cells among dental practitioners in Udaipur city, Rajasthan. Int J Adv Res 2015;3:677-84.
Utneja S, Nawal RR, Ansari MI, Talwar S, Verma M. A survey of attitude and opinions of endodontic residents towards regenerative endodontics. J Conserv Dent 2013;16:314-8.
] [Full text]
Sloan AJ, Waddington RJ. Dental pulp stem cells: What, where, how? Int J Paediatr Dent 2009;19:61-70.
Deepika N, Devadiga S, Moidin T, Mittal S, Koshal N. Stem cells: A boon in dentistry. J Dent Res Rev 2015;2:47-51. [Full text]
Estrela C, Alencar AH, Kitten GT, Vencio EF, Gava E. Mesenchymal stem cells in the dental tissues: Perspectives for tissue regeneration. Braz Dent J 2011;22:91-8.
Bhateja S. Stem cells: Role in medical and dental therapies. J Orofac Sci 2012;4:114. [Full text]
Egusa H, Sonoyama W, Nishimura M, Atsuta I, Akiyama K. Stem cells in dentistry – Part I: Stem cell sources. J Prosthodont Res 2012;56:151-65.
Pera MF, Reubinoff B, Trounson A. Human embryonic stem cells. J Cell Sci 2000;113:5-10.
Nadig RR. Stem cell therapy – Hype or hope? A review. J Conserv Dent 2009;12:131-8.
] [Full text]
Fortier LA. Stem cells: Classifications, controversies, and clinical applications. Vet Surg 2005;34:415-23.
Xiao L, Nasu M. From regenerative dentistry to regenerative medicine: Progress, challenges, and potential applications of oral stem cells. Stem Cells Cloning 2014;7:89-99.
Pushpalatha C, Nimbal A, Jain S, Tammannavar P. Dental pulp stem cells scope in dentistry. IOSR J Dent Med Sci 2013;8:38-41.
Sharma R, Bhargava D, Yadav M, Rastogi P, Chandavarkar V, Siddhartha M, et al
. Dental stem cells: Harnessing newer possibilities. J Indian Acad Forensic Med 2013;35:378-82.
Vyas S, Vyas K, Madathanapalli S, Shende V, Srivastav R. Stem cells – The future of dentistry: A review. J Indian Acad Oral Med Radiol 2011;23:S370-2.
Nakashima M, Akamine A. The application of tissue engineering to regeneration of pulp and dentin in endodontics. J Endod 2005;31:711-8.
Huang GT, Gronthos S, Shi S. Mesenchymal stem cells derived from dental tissues vs. those from other sources: Their biology and role in regenerative medicine. J Dent Res 2009;88:792-806.
Dr. Nikhat M Attar
C/o. M.R. Attar Advocate, Sahara Marriage Hall Road, Hameed Nagar Noubag-II, Vijayapur - 586 101, Karnataka
Source of Support: None, Conflict of Interest: None