Most artificial implants in medicine are purely mechanical. They do not harness the natural biology, merely co-exist alongside it. This is no different in dentistry where false teeth tend not to interact with the biology of the mouth. Inoue and his team are developing bio-hybrid dental implants that are capable integrating themselves into the jawbone. The new implant will be more stable and long-lasting as well as being able to replicate the function and feel of natural teeth. They also have the crucial ability of being able to adapt to the restructuring in the jawbone that occurs as children age. Children’s adult teeth must be able to move as the jawbone grows and adapt to new positions. Inoue summarises the issues surrounding dental implants: ‘At present, dental implants are connected directly to the alveolar bone, with no mediation by periodontal tissues. It must be remembered, however, that these tissues play an important role not only in tooth support, but also in maintaining various physiological functions, including sensation and the tooth movement that usually accompanies bone remodelling.’ The implant designed by Inoue and his team is based on a standard titanium core, but is enhanced in several different ways. The implant is coated in hydroxyapatite (HA), a mineral found in high concentrations in dentin and that is known to help stimulate bone growth. This basic implant is transplanted with a mixture of periodontal tissue extracted from another tooth. Together, HA and the periodontal tissue work together to promote true ossointegraton and the creation of a bio-hybrid implant. In experiments with young mice, the implant has been shown to integrate fully in the jaw and move as and when necessary during development, just like a normal tooth. In addition to these benefits, the novel hybrid actually maintains the ability of the tooth to sense noxious stimuli – something no current implant can do.