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Dental Materials : Official Publication... Aug 2023Injectable biomaterials that can completely fill the root canals and provide an appropriate environment will have potential application for pulp regeneration in...
OBJECTIVE
Injectable biomaterials that can completely fill the root canals and provide an appropriate environment will have potential application for pulp regeneration in endodontics. This study aimed to fabricate and characterize a novel injectable human amniotic membrane (HAM) hydrogel scaffold crosslinked with genipin, enabling the proliferation of Dental Pulp Stem Cells (DPSCs) and optimizing pulp regeneration.
METHODS
HAM extracellular matrix (ECM) hydrogels (15, 22.5, and 30 mg/ml) crosslinked with different genipin concentrations (0, 0.1, 0.5, 1, 5, and 10 mM) were evaluated for mechanical properties, tooth discoloration, cell viability, and proliferation of DPSCs. The hydrogels were subcutaneously injected in rats to assess their immunogenicity. The hydrogels were applied in a root canal model and subcutaneously implanted in rats to determine their regenerative potential for eight weeks, and histological and immunostaining analyses were performed.
RESULTS
Hydrogels crosslinked with low genipin concentration demonstrated low tooth discoloration, but 0.1 mM genipin crosslinked hydrogels were excluded due to their unfavourable mechanical properties. The degradation ratio was lower in hydrogels crosslinked with 0.5 mM genipin. The 30 mg/ml-0.5 mM crosslinked hydrogel exhibited a microporous structure, and the modulus of elasticity was 1200 PA. In vitro, cell culture showed maximum viability and proliferation in 30 mg/ml-0.5 mM crosslinked hydrogel. All groups elicited minimum immunological responses, and highly vascularized pulp-like tissue was formed in human tooth roots in both groups with/without DPSCs.
SIGNIFICANCE
Genipin crosslinking improved the biodegradability of injectable HAM hydrogels and conferred higher biocompatibility. Hydrogels encapsulated with DPSCs can support stem cell viability and proliferation. In addition, highly vascularized pulp-like tissue formation by this biomaterial displayed potential for pulp regeneration.
Topics: Humans; Rats; Animals; Dental Pulp; Regeneration; Hydrogels; Amnion; Tooth Discoloration; Biocompatible Materials; Dentin; Cell Differentiation
PubMed: 37393152
DOI: 10.1016/j.dental.2023.06.008 -
International Endodontic Journal Dec 2023To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR). (Observational Study)
Observational Study
AIM
To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR).
METHODOLOGY
This study involved 215 ECR lesions in 194 patients referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK). The clinical and radiographic findings (periapical [PA] and cone beam computed tomography [CBCT]) were readily accessible for evaluation. A checklist was used for data collection. Inferential analysis was carried out to determine if there was any potential association between type and location of tooth in the jaw as well as sex, age of the patient and ECR presentation and radiographic feature.
RESULTS
Eighty-eight patients (94 teeth) were female and 106 patients were male (121 teeth), the mean age (±SD) was 41.5 (±17.7) years. Fifteen patients (7.7%) had more than one ECR lesion. The most affected teeth were maxillary central incisors (21.4% [46 teeth]) and mandibular first molars (10.2% [22 teeth]). ECR was most commonly detected as an incidental radiographic finding in 58.1% [125 teeth] of the cases. ECR presented with symptoms of pulpal/periapical disease in 23.3% [n = 50] and clinical signs (e.g. pink spot, cavitation) in 16.7% [36 teeth] of the cases. Clinical signs such as cavitation (14%), pink spot (5.1%) and discolouration (2.8%) were uncommon, but their incidence increased up to 24.7% when combined with other clinical findings. ECR was detected in the resorptive and reparative phases in 70.2% and 29.8% of the cases respectively.
CONCLUSION
ECR appears to be quiescent in nature, the majority being asymptomatic and diagnosed incidentally from PA or CBCT. When assessed with the Patel classification, most lesions were minimal to moderate in relation to their height (1 or 2) and circumferential spread (A or B). However, the majority of ECRs were in (close) proximity to the pulp. Symptoms and clinical signs were associated with (probable) pulp involvement rather than the height and circumferential spread of the lesion. Clinical signs were more frequently associated when ECR affected multiple surfaces.
Topics: Humans; Male; Female; Young Adult; Adult; Middle Aged; Tooth Cervix; Cone-Beam Computed Tomography; Dental Pulp; Incisor; Molar; Dental Pulp Diseases; Root Resorption
PubMed: 37801348
DOI: 10.1111/iej.13968 -
International Journal of Biological... Mar 2024In the last ten years, remarkable characteristics and a variety of functionalities have been created in biopolymeric materials for clinical dental applications. This... (Review)
Review
In the last ten years, remarkable characteristics and a variety of functionalities have been created in biopolymeric materials for clinical dental applications. This review gives an overview of current knowledge of natural biopolymers (biological macromolecules) in terms of structural, functional, and property interactions. Natural biopolymers such as polysaccharides (chitosan, bacterial cellulose, hyaluronic acid, and alginate) and polypeptides (collagen and silk fibroin) have been discussed for dental uses. These biopolymers exhibit excellent properties alone and when employed with other composite molecules making them ideal for treatment of periodontitis, endodontics, dental pulp regeneration and oral wound healing. These biopolymers together with the composite materials exhibit better biocompatibility, inertness, elasticity and flexibility which makes them a leading candidate to be used for other dental applications like caries management, oral appliances, dentures, dental implants and oral surgeries.
Topics: Dental Pulp; Regeneration; Polysaccharides; Biopolymers; Collagen; Dentistry; Biocompatible Materials
PubMed: 38185301
DOI: 10.1016/j.ijbiomac.2024.129215 -
Journal of Endodontics Jan 2024This study aimed to assess pulp survival in a randomized trial on pulp lavage in adult nonpainful posterior teeth with carious pulp exposure. The treatment included... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
This study aimed to assess pulp survival in a randomized trial on pulp lavage in adult nonpainful posterior teeth with carious pulp exposure. The treatment included complete caries excavation, direct pulp capping with mineral trioxide aggregate, and immediate restoration with composite resin.
METHODS
Fluid was collected from the pulp wound to assess matrix metalloproteinase-9 (MMP-9) and total protein values. Before pulp capping, cavities were randomly (block randomization, n = 48) washed with a physiological saline or a sodium hypochlorite solution (2.5% NaOCl). Treatment outcome was assessed clinically (cold test) and radiographically after at least 1 year and again after at least 3 years. Painful failures were differentiated from nonpainful failures. Pulp survival was estimated using the Kaplan-Meier method including 95% confidence intervals (CIs) up to 1500 days.
RESULTS
From the 96 patients originally enrolled, 73 individuals could be followed continuously. The clinical observations indicated a beneficial and sustained effect of pulp lavage with 2.5% NaOCl over a control treatment with physiological saline solution on estimated pulp survival 1500 days postintervention, with 7% (95% CI, 1%-40%) in the saline group versus 55% (95% CI, 30%-100%) in the NaOCl group. High MMP-9/total protein values in pulpal fluid collected from the exposed site indicated early and painful treatment failures yet were not associated with failures that occurred more than 250 days after intervention.
CONCLUSIONS
The low 4-year success rates reported here challenge the concept of direct pulp capping in the cases that were included. NaOCl lavage did not only increase the survival of affected pulps substantially but also particularly diminished painful failures (33% in the NaOCl group vs 62% in the saline group). The lack of the predictive value of MMP-9 assessments beyond early treatment failures points to inflammatory states of the pulp tissue under deep caries, which are not related to neutrophil infiltration.
Topics: Adult; Humans; Dental Pulp Capping; Matrix Metalloproteinase 9; Calcium Compounds; Silicates; Dental Pulp; Root Canal Therapy; Treatment Outcome; Dental Caries; Oxides; Drug Combinations; Pulp Capping and Pulpectomy Agents
PubMed: 37890614
DOI: 10.1016/j.joen.2023.10.008 -
Frontiers in Medicine 2024Bone defects resulting from severe trauma, tumors, inflammation, and other factors are increasingly prevalent. Stem cell-based therapies have emerged as a promising... (Review)
Review
Bone defects resulting from severe trauma, tumors, inflammation, and other factors are increasingly prevalent. Stem cell-based therapies have emerged as a promising alternative. Dental pulp stem cells (DPSCs), sourced from dental pulp, have garnered significant attention owing to their ready accessibility and minimal collection-associated risks. Ongoing investigations into DPSCs have revealed their potential to undergo osteogenic differentiation and their capacity to secrete a diverse array of ontogenetic components, such as extracellular vesicles and cell lysates. This comprehensive review article aims to provide an in-depth analysis of DPSCs and their secretory components, emphasizing extraction techniques and utilization while elucidating the intricate mechanisms governing bone regeneration. Furthermore, we explore the merits and demerits of cell and cell-free therapeutic modalities, as well as discuss the potential prospects, opportunities, and inherent challenges associated with DPSC therapy and cell-free therapies in the context of bone regeneration.
PubMed: 38487022
DOI: 10.3389/fmed.2024.1339573 -
Clinical and Experimental Dental... Dec 2023This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning... (Review)
Review
OBJECTIVES
This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning scientific publications based on root and root canal morphology using the CBCT.
MATERIAL AND METHODS
For this bibliometric analysis, an extensive search was carried out on September 25, 2023 using the Scopus database. Pertinent articles in the field were scrutinized after applying inclusion and exclusion criteria. Data were evaluated using Vosviewer and Microsoft Excel.
RESULTS
A literature search revealed the initiation of scientific publication in 2008. Significant contributions made by Saudi Arabia, India, and China concerning the number of publications were seen. Similarly, Jazan University from SA was recognized as the leading institute. The Journal of Endodontics was the leading journal, while authors JNR Martins and G Gambarini produced the highest number of papers.
CONCLUSIONS
This bibliometric analysis demonstrated that scientific publications have increased tremendously since 2008. Significant contributions have been made by developing and developed nations. The Journal of Endodontics and Jazan University have been identified as the leading journal and institute.
Topics: Humans; Dental Pulp Cavity; Endodontics; Bibliometrics; Cone-Beam Computed Tomography; Databases, Factual
PubMed: 37877522
DOI: 10.1002/cre2.801 -
Frontiers in Bioengineering and... 2023
PubMed: 37496850
DOI: 10.3389/fbioe.2023.1249969 -
Anatomical Record (Hoboken, N.J. : 2007) May 2024PIEZO1 and PIEZO2 are essential components of mechanogated ion channels, which are required for mechanotransduction and biological processes associated with mechanical...
PIEZO1 and PIEZO2 are essential components of mechanogated ion channels, which are required for mechanotransduction and biological processes associated with mechanical stimuli. There is evidence for the presence of PIEZO1 and PIEZO2 in teeth and periodontal ligaments, especially in cell lines and mice, but human studies are almost nonexistent. Decalcified permanent human teeth and mouse molars were processed for immunohistochemical detection of PIEZO1 and PIEZO2. Confocal laser microscopy was used to examine the co-localization of PIEZO 1 and PIEZO2 with vimentin (a marker of differentiated odontoblasts) in human teeth. In the outer layer of the human dental pulp, abundant PIEZO1- and PIEZO2-positive cells were found that had no odontoblast morphology and were vimentin-negative. Based on their morphology, location, and the absence of vimentin positivity, they were identified as dental pulp stem cells or pre-odontoblasts. However, in mice, PIEZO1 and PIEZO2 were ubiquitously detected and colocalized in odontoblasts. Intense immunoreactivity of PIEZO1 and PIEZO2 has been observed in human and murine periodontal ligaments. Our findings suggest that PIEZO1 and PIEZO2 may be mechanosensors/mechanotransducers in murine odontoblasts, as well as in the transmission of forces by the periodontal ligament in humans and mice.
Topics: Humans; Mice; Animals; Periodontal Ligament; Vimentin; Mechanotransduction, Cellular; Dental Pulp; Ion Channels
PubMed: 37975162
DOI: 10.1002/ar.25351 -
Cells May 2024Fibrosis is a pathological condition consisting of a delayed deposition and remodeling of the extracellular matrix (ECM) by fibroblasts. This deregulation is mostly...
Fibrosis is a pathological condition consisting of a delayed deposition and remodeling of the extracellular matrix (ECM) by fibroblasts. This deregulation is mostly triggered by a chronic stimulus mediated by pro-inflammatory cytokines, such as TNF-α and IL-1, which activate fibroblasts. Due to their anti-inflammatory and immunosuppressive potential, dental pulp stem cells (DPSCs) could affect fibrotic processes. This study aims to clarify if DPSCs can affect fibroblast activation and modulate collagen deposition. We set up a transwell co-culture system, where DPSCs were seeded above the monolayer of fibroblasts and stimulated with LPS or a combination of TNF-α and IL-1β and quantified a set of genes involved in inflammasome activation or ECM deposition. Cytokines-stimulated co-cultured fibroblasts, compared to unstimulated ones, showed a significant increase in the expression of IL-1β, IL-6, NAIP, AIM2, CASP1, FN1, and TGF-β genes. At the protein level, IL-1β and IL-6 release as well as FN1 were increased in stimulated, co-cultured fibroblasts. Moreover, we found a significant increase of MMP-9 production, suggesting a role of DPSCs in ECM remodeling. Our data seem to suggest a crosstalk between cultured fibroblasts and DPSCs, which seems to modulate genes involved in inflammasome activation, ECM deposition, wound healing, and fibrosis.
Topics: Dental Pulp; Fibroblasts; Humans; Inflammasomes; Stem Cells; Collagen; Coculture Techniques; Extracellular Matrix; Cells, Cultured; Cytokines; Dermis; Interleukin-1beta
PubMed: 38786058
DOI: 10.3390/cells13100836 -
Journal of Dental Sciences Apr 2024Dental pulp stem cells (DPSCs) exhibit versatile differentiation capabilities, including neural differentiation, prompting the hypothesis that they may be implicated in...
BACKGROUND/PURPOSE
Dental pulp stem cells (DPSCs) exhibit versatile differentiation capabilities, including neural differentiation, prompting the hypothesis that they may be implicated in the neurodevelopment of teeth. This study aimed to explore the temporospatial dynamics between DPSCs and tooth innervation, employing immunofluorescence staining and fluorescent dye injections to investigate the distribution of DPSCs, neural stem cells (NSCs), nerve growth cones, and sensory nerves in developing mouse tooth germs at various stages.
MATERIALS AND METHODS
Immunofluorescence staining targeting CD146, Nestin, and GAP-43, along with the injection of AM1-43 fluorescent dye, were utilized to observe the distribution of DPSCs, NSCs, nerve growth cones, and sensory nerves in mouse tooth germs at different developmental stages.
RESULTS
Positive CD146 immunostaining was observed in microvascular endothelial cells and pericytes within and around the tooth germ. The percentage of CD146-positive cells remained consistent between 4-day-old and 8-day-old second molar tooth germs. Conversely, Nestin expression in odontoblasts and their processes decreased in 8-day-old tooth germs compared to 4-day-old ones. Positive immunostaining for GAP-43 and AM1-43 fluorescence revealed the entry of nerve growth cones and sensory nerves into the pulp in 8-day-old tooth germs, while these elements were confined to the dental follicle in 4-day-old germs. No co-localization of CD146-positive DPSCs with nerve growth cones and sensory nerves was observed.
CONCLUSION
DPSCs and NSCs were present in dental pulp tissue before nerves penetrated the pulp. The decline in NSCs after nerve entry suggests a potential role for DPSCs and NSCs in attracting neural growth and/or differentiation within the pulp.
PubMed: 38618089
DOI: 10.1016/j.jds.2024.02.007