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Neuroimmunomodulation 2021This study investigated the clinical values of miR-27a-3p for pulpitis patients, and its association with TLR4.
INTRODUCTION
This study investigated the clinical values of miR-27a-3p for pulpitis patients, and its association with TLR4.
METHODS
Sixty-six patients with pulpitis and 34 cases without pulpitis were recruited; the pulp tissue and serum samples were collected from each participant. Real-time polymerase chain reaction was used for measurement of gene expression levels. The diagnosis values were assessed by the receiver operating characteristic curve. The target gene of miR-27a-3p was confirmed by the luciferase reporter assay.
RESULTS
MiR-27a-3p was downregulated in both serum and pulp tissue of pulpitis patients. MiR-27a-3p could distinguish pulpitis patients from healthy controls and might be a predictor for the development of irreversible pulpitis. A high level of TLR4 was also detected in both peripheral blood monocytes and pulp tissues from pulpitis patients and showed a negative association with the miR-27a-3p level. TLR4 was a direct target gene of miR-27a-3p.
DISCUSSION/CONCLUSION
MiR-27a-3p might be a promising biomarker for the diagnosis of pulpitis and predict the development of irreversible pulpitis. MiR-27a-3p might be involved in the pathogenesis of pulpitis via targeting TLR4.
Topics: Gene Expression; Humans; MicroRNAs; Pulpitis
PubMed: 34237753
DOI: 10.1159/000516136 -
The Veterinary Clinics of North... Jan 2022Endodontic therapy is intended to preserve the function of mature teeth with irreversible pulpitis or pulp necrosis or to maintain the vitality of endodontically... (Review)
Review
Endodontic therapy is intended to preserve the function of mature teeth with irreversible pulpitis or pulp necrosis or to maintain the vitality of endodontically compromised immature teeth. Standard root canal therapy and vital pulp therapy are 2 mainstays of endodontic treatment. Recent knowledge has improved the outcomes of endodontic treatment with newer materials, such as mineral trioxide aggregate. Composite or prosthodontic crown restoration is also a critical key to success.
Topics: Animals; Prosthodontics; Pulpitis; Root Canal Therapy
PubMed: 34838250
DOI: 10.1016/j.cvsm.2021.09.003 -
Journal of the American Dental... Jan 2023Local anesthesia is essential for pain control in dentistry. The authors assessed the comparative effect of local anesthetics on acute dental pain after tooth extraction... (Review)
Review
BACKGROUND
Local anesthesia is essential for pain control in dentistry. The authors assessed the comparative effect of local anesthetics on acute dental pain after tooth extraction and in patients with symptomatic irreversible pulpitis.
TYPES OF STUDIES REVIEWED
The authors searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and the US Clinical Trials registry through November 21, 2020. The authors included randomized controlled trials (RCTs) comparing long- vs short-acting injectable anesthetics to reduce pain after tooth extraction (systematic review 1) and evaluated the effect of topical anesthetics in patients with symptomatic pulpitis (systematic review 2). Pairs of reviewers screened articles, abstracted data, and assessed risk of bias using a modified version of the Cochrane risk of bias 2.0 tool. The authors assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Fourteen RCTs comparing long- vs short-acting local anesthetics suggest that bupivacaine may decrease the use of rescue analgesia and may not result in additional adverse effects (low certainty evidence). Bupivacaine probably reduces the amount of analgesic consumption compared with lidocaine with epinephrine (mean difference, -1.91 doses; 95% CI, -3.35 to -0.46; moderate certainty) and mepivacaine (mean difference, -1.58 doses; 95% CI, -2.21 to -0.95; moderate certainty). Five RCTs suggest that both benzocaine 10% and 20% may increase the number of people experiencing pain reduction compared with placebo when managing acute irreversible pulpitis (low certainty).
PRACTICAL IMPLICATIONS
Bupivacaine may be superior to lidocaine with epinephrine and mepivacaine with regard to time to and amount of analgesic consumption. Benzocaine may be superior to placebo in reducing pain for 20 through 30 minutes after application.
Topics: Humans; Acute Pain; Anesthesia, Local; Anesthetics, Local; Benzocaine; Bupivacaine; Epinephrine; Lidocaine; Mepivacaine; Pulpitis
PubMed: 36608963
DOI: 10.1016/j.adaj.2022.10.014 -
Archives of Oral Biology Sep 2022In this study, it was aimed to examine the catalase activity in clinically healthy and caries-related inflamed symptomatic human dental pulps of young and old...
OBJECTIVES
In this study, it was aimed to examine the catalase activity in clinically healthy and caries-related inflamed symptomatic human dental pulps of young and old individuals.
DESIGN
Sixty pulp samples from young and old healthy donors, were collected depending on pulpal status. 48 samples were used for spectrophotometric analysis and 12 samples for immunohistochemistry. Healthy pulps were maintained from non-carries, extracted third molars. Reversible and irreversible pulpitis samples were obtained by pulp extirpation during endodontic treatment. Following homogenization catalase enzyme activity was determined by spectrophotometry. Additionally, two pulp tissue samples from each group were fixed and evaluated for catalase immunoreactivity.
RESULTS
Catalase enzyme activity in old healthy pulp samples were significantly higher than healthy young samples (p ≤ 0.05). Reversible and irreversible pulpitis samples indicated significantly decreased activity compared to healthy samples in elderly group (p ≤ 0.05). Young reversible pulpitis samples showed significantly increased catalase activity when compared to irreversible pulpitis and the reversible pulpitis samples in elderly group (p ≤ 0.05). Immunohistochemical evaluation indicated that there was intense catalase immunoreactivity in young patients with reversible pulpitis compared with reversible pulpitis in elderly group. However, weak immunoreactivity was observed in young irreversible pulpitis and elderly reversible pulpitis samples.
CONCLUSIONS
The pulp tissues presented different levels of catalase activities against pulpitis and aging.
Topics: Aged; Aging; Catalase; Dental Pulp; Humans; Inflammation; Pulpitis
PubMed: 35728513
DOI: 10.1016/j.archoralbio.2022.105482 -
Journal of Endodontics Nov 2023During pulpitis, as bacteria penetrate deeper into the dentin and pulp tissue, a pulpal innate immune response is initiated. However, the kinetics of the immune...
INTRODUCTION
During pulpitis, as bacteria penetrate deeper into the dentin and pulp tissue, a pulpal innate immune response is initiated. However, the kinetics of the immune response, how this relates to bacterial infiltration during pulpitis and an understanding of the types of immune cells in the pulp is limited.
METHODS
Dental pulp exposure in the molars of mice was used as an animal model of pulpitis. To investigate the kinetics of immune response, pulp tissue was collected from permanent molars at different time points after injury (baseline, day 1, and day 7). Flow cytometry analysis of CD45+ leukocytes, including macrophages, neutrophils monocytes, and T cells, was performed. 16S in situ hybridization captured bacterial invasion of the pulp, and immunohistochemistry for F4/80 investigated spatial and morphological changes of macrophages during pulpitis. Data were analyzed using two-way ANOVA with Tukey's multiple comparisons.
RESULTS
Bacteria mostly remained close to the injury site, with some expansion towards noninjured pulp horns. We found that F4/80 macrophages were the primary immune cell population in the healthy pulp. Upon injury, CD11b Ly6G neutrophils and CD11b Ly6GLy6C monocytes constituted 70-90% of all immune populations up to 7 days after injury. Even though there was a slight increase in T cells at day 7, myeloid cells remained the main drivers of the immune response during the seven-day time period.
CONCLUSIONS
As bacteria proliferate within the pulp chamber, innate immune cells, including macrophages, neutrophils, and monocytes, predominate as the major immune populations, with some signs of transitioning to an adaptive immune response.
Topics: Animals; Immunity, Innate; Disease Models, Animal; Mice; Pulpitis; Dental Pulp; Macrophages; Neutrophils; Monocytes; Flow Cytometry
PubMed: 37678750
DOI: 10.1016/j.joen.2023.08.019 -
Computational and Mathematical Methods... 2021Inflammatory reaction of pulp tissue plays a role in the pathogen elimination and tissue repair. The evaluation of severity of pulpitis can serve an instructive function...
Inflammatory reaction of pulp tissue plays a role in the pathogen elimination and tissue repair. The evaluation of severity of pulpitis can serve an instructive function in therapeutic scheme. However, there are many limitations in the traditional evaluation methods for the severity of pulpitis. Based on the Gene Expression Omnibus (GEO) database, our study discovered 843 differentially expressed genes (DEGs) related to pulpitis. Afterwards, we constructed a protein-protein interaction (PPI) network of DEGs and used MCODE plugin to determine the key functional subset. Meanwhile, genes in the key functional subset were subjected to GO and KEGG enrichment analyses. The result showed that genes were mainly enriched in inflammatory reaction-related functions. Next, we screened out intersections of PPI network nodes and pulpitis-related genes. Then, 20 genes were obtained as seed genes. In the PPI network, 50 genes that had the highest correlation with seed genes were screened out using random walk with restart (RWR). Furthermore, 4 pulpitis-related hub genes were obtained from the intersection of the top 50 genes and genes in the key functional subset. Finally, GeneMANIA was utilized to predict genes coexpressed with hub genes, and expression levels of the 4 hub genes in normal and pulpitis groups were analyzed based on GEO data. The result demonstrated that the 4 hub genes were mainly coexpressed with chemokine-related genes and were remarkably upregulated in the pulpitis group. In short, we eventually determined 4 potential biomarkers of pulpitis.
Topics: Algorithms; Biomarkers; Case-Control Studies; Chemotaxis, Leukocyte; Computational Biology; Cytokines; Databases, Genetic; Gene Expression Profiling; Gene Expression Regulation; Gene Ontology; Gene Regulatory Networks; Genetic Markers; Humans; Protein Interaction Maps; Pulpitis
PubMed: 34630628
DOI: 10.1155/2021/1808361 -
Archives of Oral Biology Oct 2017To review the available literature in regard to the inflammatory process and pulpitis. Setting forth to evaluate if differences in the levels of various cytokines... (Review)
Review
OBJECTIVE
To review the available literature in regard to the inflammatory process and pulpitis. Setting forth to evaluate if differences in the levels of various cytokines (TNF-α, IL-1β, IL-2, IL-6 and IL-8) can be observed in clinically diagnosed normal and irreversibly inflamed pulps that could serve as possible markers and/or diagnostic tools to predict and differentiate between certain states of inflammation. Methods used to measure and assess levels of cytokines have been limited to two protein quantification methods ELISA and/or Multiplex Array.
DESIGN
The databases PubMed, EMBASE/Ovid, The Cochrane Central Register of Controlled Trials, Cochrane Reviews and Scopus were consulted for the electronic literature search. Screening of titles and abstracts followed the PRISMA guidelines while data extraction and the assessment of the full texts were carried out in accordance to the GRADES assessment.
RESULTS
The review showed that significant increases in levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α in irreversible pulpitis samples exist, in comparison to normal pulp samples which serve as a good basis for potential markers. Due to larger discrepancies in available literature, IL-2 seems rather unsuitable at the moment, while IL-6 and TNF alpha seem to be more promising.
CONCLUSION
It may be concluded that even by combining two protein quantification methods inconsistencies between studies exist. At the moment it is difficult to select just one specific cytokine suitable for testing, rather it supports the rationale that further high-quality clinical studies are needed.
Topics: Biomarkers; Cytokines; Dental Pulp; Humans; Pulpitis
PubMed: 28600966
DOI: 10.1016/j.archoralbio.2017.05.008 -
BMC Oral Health May 2021Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is... (Review)
Review
Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is a highly dynamic tissue equipped with a network of resident immunocompetent cells that play major roles in the defense against pathogens and during tissue injury. However, the efficiency of these mechanisms during dental pulp inflammation (pulpitis) varies due to anatomical and physiological restrictions. Uncontrolled, excessive, or unresolved inflammation can lead to pulp tissue necrosis and subsequent bone infections called apical periodontitis. In most cases, pulpitis treatment consists of total pulp removal. Although this strategy has a good success rate, this treatment has some drawbacks (lack of defense mechanisms, loss of healing capacities, incomplete formation of the root in young patients). In a sizeable number of clinical situations, the decision to perform pulp extirpation and endodontic treatment is justifiable by the lack of therapeutic tools that could otherwise limit the immune/inflammatory process. In the past few decades, many studies have demonstrated that the resolution of acute inflammation is necessary to avoid the development of chronic inflammation and to promote repair or regeneration. This active process is orchestrated by Specialized Pro-resolving lipid Mediators (SPMs), including lipoxins, resolvins, protectins and maresins. Interestingly, SPMs do not have direct anti-inflammatory effects by inhibiting or directly blocking this process but can actively reduce neutrophil infiltration into inflamed tissues, enhance efferocytosis and bacterial phagocytosis by monocytes and macrophages and simultaneously inhibit inflammatory cytokine production. Experimental clinical application of SPMs has shown promising result in a wide range of inflammatory diseases, such as renal fibrosis, cerebral ischemia, marginal periodontitis, and cancer; the potential of SPMs in endodontic therapy has recently been explored. In this review, our objective was to analyze the involvement and potential use of SPMs in endodontic therapies with an emphasis on SPM delivery systems to effectively administer SPMs into the dental pulp space.
Topics: Endodontics; Humans; Inflammation; Inflammation Mediators; Lipids; Periapical Periodontitis; Pulpitis
PubMed: 34030680
DOI: 10.1186/s12903-021-01619-8 -
Cytokine Feb 2020Pulpitis is known as a typical inflammation of dental pulp tissue, and microorganisms of the oral microbiome are involved in this opportunistic infection. Studies... (Review)
Review
Pulpitis is known as a typical inflammation of dental pulp tissue, and microorganisms of the oral microbiome are involved in this opportunistic infection. Studies indicated that several factors related to host response have a crucial role in pulpitis. Among these factors, inflammatory mediators of the immune system such as cytokines and chemokines contribute to pulpal defense mechanisms. A wide range of cytokines have been observed in dental pulp and these small molecules are able to trigger inflammation and participate in immune cell trafficking, cell proliferation, inflammation, and tissue damage in pulp space. Therefore, the aim of this review was to describe the role of cytokines in the pathogenesis of pulpitis.
Topics: Animals; Bacteria; Cell Proliferation; Cytokines; Dental Pulp; Humans; Inflammation; Inflammation Mediators; Pulpitis
PubMed: 31670007
DOI: 10.1016/j.cyto.2019.154896 -
International Endodontic Journal Mar 2022Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as... (Review)
Review
Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as reversible or irreversible, a classification for therapeutic purposes that determines the capability of the pulp to heal. Recently, new knowledge about dental pulp physiopathology led to orientate therapeutics towards more frequent preservation of pulp vitality. However, full adoption of these vital pulp therapies by dental practitioners will be achieved only following better understanding of cell and tissue mechanisms involved in pulpitis. The current narrative review aimed to discuss the contribution of the most significant experimental models developed to study pulpitis. Traditionally, in vitro two (2D)- or three (3D)-dimensional cell cultures or in vivo animal models were used to analyse the pulp response to pulpitis inducers at cell, tissue or organ level. In vitro, 2D cell cultures were mainly used to decipher the specific roles of key actors of pulp inflammation such as bacterial by-products, pro-inflammatory cytokines, odontoblasts or pulp stem cells. However, these simple models did not reproduce the 3D organisation of the pulp tissue and, with rare exceptions, did not consider interactions between resident cell types. In vitro, tissue/organ-based models were developed to better reflect the complexity of the pulp structure. Their major disadvantage is that they did not allow the analysis of blood supply and innervation participation. On the contrary, in vivo models have allowed researchers to identify key immune, vascular and nervous actors of pulpitis and to understand their function and interplay in the inflamed pulp. However, inflammation was mainly induced by iatrogenic dentine drilling associated with simple pulp exposure to the oral environment or stimulation by individual bacterial by-products for short periods. Clearly, these models did not reflect the long and progressive development of dental caries. Lastly, the substantial diversity of the existing models makes experimental data extrapolation to the clinical situation complicated. Therefore, improvement in the design and standardisation of future models, for example by using novel molecular biomarkers, databased models and artificial intelligence, will be an essential step in building an incremental knowledge of pulpitis in the future.
Topics: Animals; Artificial Intelligence; Dental Caries; Dental Pulp; Dentists; Humans; Models, Theoretical; Professional Role; Pulpitis
PubMed: 35034368
DOI: 10.1111/iej.13683