Bilirubin induces discoloration and hypodontia on tooth

Background: Systematic and local factors give various effects to teeth during odontogenesis or after eruption. Discoloration of teeth is also caused by systematic and local factors and sometimes leads to esthetic and biological problems. Bilirubin is the product of heme metabolism and causes greenish discoloration and hypodontia with its high concentration in blood. Objective: This review aimed to indicate effects of bilirubin on odontogenesis with in vitro model established by stem cells of human exfoliated deciduous teeth (SHED). Results: Recent studies showed that bilirubin suppressed cell proliferation and promoted cell death in SHED with alteration of their involved-signaling pathways. In addition, it was indicated that pamidronate recovered bilirubin-altered signaling pathways and bilirubin-impaired dentinogenic function of SHED. Conclusion: SHED could be tool to established human in vitro model to elucidate human pathogenesis and for screening to pick up the candidates of medicines.