-
Stem Cell Reviews and Reports Nov 2023Maintenance of the visual function is the desired outcome of ophthalmologic therapies. The shortcomings of the current treatment options, like partial recovery,... (Review)
Review
Maintenance of the visual function is the desired outcome of ophthalmologic therapies. The shortcomings of the current treatment options, like partial recovery, post-operation failure, rigorous post-operative care, complications, etc., which are usually encountered with the conventional treatment options has warranted newer treatment options that may eliminate the root cause of diseases and minimize the side effects. Cell therapies, a class of regenerative medicines, have emerged as cutting-edge treatment option. The corneal and retinal dystrophies during the ocular disorders are the major cause of blindness, worldwide. Corneal disorders are mainly categorized mainly into corneal epithelial, stromal, and endothelial disorders. On the other hand, glaucoma, retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, Stargardt Disease, choroideremia, Leber congenital amaurosis are then major retinal degenerative disorders. In this manuscript, we have presented a detailed overview of the development of cell-based therapies, using embryonic stem cells, bone marrow stem cells, mesenchymal stem cells, dental pulp stem cells, induced pluripotent stem cells, limbal stem cells, corneal epithelial, stromal and endothelial, embryonic stem cell-derived differentiated cells (like retinal pigment epithelium or RPE), neural progenitor cells, photoreceptor precursors, and bone marrow-derived hematopoietic stem/progenitor cells etc. The manuscript highlights their efficiency, drawbacks and the strategies that have been explored to regain visual function in the preclinical and clinical state associated with them which can be considered for their potential application in the development of treatment.
Topics: Humans; Cornea; Cell- and Tissue-Based Therapy; Retinal Degeneration; Retina; Corneal Diseases
PubMed: 37704835
DOI: 10.1007/s12015-023-10623-0 -
Frontiers in Bioscience (Landmark... Oct 2023Dental pulp stem cells (DPSCs) are a type of mesenchymal stem cells derived from dental pulp that serves as an important model for investigating biological regeneration.... (Review)
Review
Dental pulp stem cells (DPSCs) are a type of mesenchymal stem cells derived from dental pulp that serves as an important model for investigating biological regeneration. DPSCs have a multipotent differentiation capacity and can promote different biological processes, including osteogenesis, odontogenesis, chondrogenesis, and angiogenesis. These biological processes are regulated by an extensive range of intra- and extra-cellular factors. Further, biomechanical cues, such as substrate stiffness, physical stress, and cell spreading, have been highlighted as particularly important modulators of DPSC function. This review sought to discuss various related signaling components involved in biomechanical cues and their respective roles in cellular and tissue responses in DPSCs, summarize current findings, and provide an outlook on the potential applications of biomechanics in regenerative medicine and tissue engineering.
Topics: Stem Cells; Dental Pulp; Cell Differentiation; Osteogenesis; Mesenchymal Stem Cells; Cells, Cultured; Cell Proliferation
PubMed: 37919075
DOI: 10.31083/j.fbl2810274 -
Cureus Oct 2023The pathophysiology of calcified dental pulp is considered to be comparable to that of calcified atheroma in the artery. These calcified masses are small nodular which... (Review)
Review
The pathophysiology of calcified dental pulp is considered to be comparable to that of calcified atheroma in the artery. These calcified masses are small nodular which is seen more often in the coronal pulp region than in the radicular pulp. This is generally more common in the elderly population and usually corresponds to increasing age. Calcifications are also found in the brain, breast, arteries, and kidneys. There is a link between pulp calcification and cardiovascular problems. It is commonly assumed that individuals suffering from cardiovascular diseases have a higher risk of calcification in the pulp. The use of radiography as a quick means of detecting cardiovascular disease is possible. The pulp calcification process is usually triggered by the osteoblastic process. The process is identified by the presence of an osteoid matrix, which is built down by odontoblast cells in the pulp's peripheral portions, culminating in the production of tissue that is comparable to dentine. This review will look at pulp calcifications from all angles, including their mechanism, clinical considerations, radiographic features, and management, and also to determine if there is a link between pulp calcification and cardiovascular problems.
PubMed: 38021616
DOI: 10.7759/cureus.47258 -
International Journal of Oral Science Mar 2024Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and... (Review)
Review
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
Topics: Humans; Consensus; Root Canal Therapy; Gutta-Percha; Dental Pulp Necrosis; Retreatment; Dental Pulp Cavity; Root Canal Filling Materials; Root Canal Preparation
PubMed: 38429281
DOI: 10.1038/s41368-024-00285-0 -
Frontiers in Immunology 2023Dental pulp stem cells (DPSCs) have received a lot of attention as a regenerative medicine tool with strong immunomodulatory capabilities. The excessive inflammatory... (Review)
Review
Dental pulp stem cells (DPSCs) have received a lot of attention as a regenerative medicine tool with strong immunomodulatory capabilities. The excessive inflammatory response involves a variety of immune cells, cytokines, and has a considerable impact on tissue regeneration. The use of DPSCs for controlling inflammation for the purpose of treating inflammation-related diseases and autoimmune disorders such as supraspinal nerve inflammation, inflammation of the pulmonary airways, systemic lupus erythematosus, and diabetes mellitus is likely to be safer and more regenerative than traditional medicines. The mechanism of the anti-inflammatory and immunomodulatory effects of DPSCs is relatively complex, and it may be that they themselves or some of the substances they secrete regulate a variety of immune cells through inflammatory immune-related signaling pathways. Most of the current studies are still at the laboratory cellular level and animal model level, and it is believed that through the efforts of more researchers, DPSCs/SHED are expected to be transformed into excellent drugs for the clinical treatment of related diseases.
Topics: Animals; Cell Differentiation; Dental Pulp; Stem Cells; Inflammation; Anti-Inflammatory Agents
PubMed: 38077342
DOI: 10.3389/fimmu.2023.1284868 -
International Journal of Oral Science Dec 2023Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for... (Review)
Review
Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
Topics: Humans; Consensus; Endodontics; Tooth; Printing, Three-Dimensional; Dental Care; Cone-Beam Computed Tomography; Root Canal Therapy
PubMed: 38052782
DOI: 10.1038/s41368-023-00261-0 -
Clinical Oral Investigations Aug 2023Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria that enter the bloodstream and establish infections in the inner linings or valves of...
INTRODUCTION
Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria that enter the bloodstream and establish infections in the inner linings or valves of the heart, including blood vessels. Despite the availability of modern antimicrobial and surgical treatments, IE continues to cause substantial morbidity and mortality. Oral microbiota is considered one of the most significant risk factors for IE. The objective of this study was to evaluate the microbiota present in root canal (RC) and periodontal pocket (PP) clinical samples in cases with combined endo-periodontal lesions (EPL) to detect species related to IE using NGS.
METHODS
Microbial samples were collected from 15 RCs and their associated PPs, also from 05 RCs with vital pulp tissues (negative control, NC). Genomic studies associated with bioinformatics, combined with structuring of a database (genetic sequences of bacteria reported for infective endocarditis), allowed for the assessment of the microbial community at both sites. Functional prediction was conducted using PICRUSt2.
RESULTS
Parvimonas, Streptococcus, and Enterococcus were the major genera detected in the RCs and PPs. A total of 79, 96, and 11 species were identified in the RCs, PPs, and NCs, respectively. From them, a total of 34 species from RCs, 53 from PPs, and 2 from NCs were related to IE. Functional inference demonstrated that CR and PP microbiological profiles may not be the only risk factors for IE but may also be associated with systemic diseases, including myocarditis, human cytomegalovirus infection, bacterial invasion of epithelial cells, Huntington's disease, amyotrophic lateral sclerosis, and hypertrophic cardiomyopathy. Additionally, it was possible to predict antimicrobial resistance variants for broad-spectrum drugs, including ampicillin, tetracycline, and macrolides.
CONCLUSION
Microorganisms present in the combined EPL may not be the only risk factor for IE but also for systemic diseases. Antimicrobial resistance variants for broad-spectrum drugs were inferred based on PICRUSt-2. State-of-the-art sequencing combined with bioinformatics has proven to be a powerful tool for conducting studies on microbial communities and could considerably assist in the diagnosis of serious infections.
CLINICAL RELEVANCE
Few studies have investigated the microbiota in teeth compromised by combined endo-periodontal lesions (EPL), but none have correlated the microbiological findings to any systemic condition, particularly IE, using NGS techniques. In such cases, the presence of apical periodontitis and periodontal disease can increase IE risk in susceptible patients.
Topics: Humans; Periodontal Diseases; Endocarditis; Bacteria; Periodontal Pocket; Microbiota
PubMed: 37401984
DOI: 10.1007/s00784-023-05104-0 -
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 -
International Journal of Oral Science Aug 2023Carious lesions are bacteria-caused destructions of the mineralised dental tissues, marked by the simultaneous activation of immune responses and regenerative events...
Carious lesions are bacteria-caused destructions of the mineralised dental tissues, marked by the simultaneous activation of immune responses and regenerative events within the soft dental pulp tissue. While major molecular players in tooth decay have been uncovered during the past years, a detailed map of the molecular and cellular landscape of the diseased pulp is still missing. In this study we used single-cell RNA sequencing analysis, supplemented with immunostaining, to generate a comprehensive single-cell atlas of the pulp of carious human teeth. Our data demonstrated modifications in the various cell clusters within the pulp of carious teeth, such as immune cells, mesenchymal stem cells (MSC) and fibroblasts, when compared to the pulp of healthy human teeth. Active immune response in the carious pulp tissue is accompanied by specific changes in the fibroblast and MSC clusters. These changes include the upregulation of genes encoding extracellular matrix (ECM) components, including COL1A1 and Fibronectin (FN1), and the enrichment of the fibroblast cluster with myofibroblasts. The incremental changes in the ECM composition of carious pulp tissues were further confirmed by immunostaining analyses. Assessment of the Fibronectin fibres under mechanical strain conditions showed a significant tension reduction in carious pulp tissues, compared to the healthy ones. The present data demonstrate molecular, cellular and biomechanical alterations in the pulp of human carious teeth, indicative of extensive ECM remodelling, reminiscent of fibrosis observed in other organs. This comprehensive atlas of carious human teeth can facilitate future studies of dental pathologies and enable comparative analyses across diseased organs.
Topics: Humans; Dental Pulp; Fibronectins; Extracellular Matrix; Dental Caries; Sequence Analysis, RNA
PubMed: 37532703
DOI: 10.1038/s41368-023-00238-z -
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