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Journal of Dental Research, Dental... 2021Dental hypersensitivity is due to the exposure of the dentin layer after wear of enamel or cementum, exposing the dentinal tubules and the nerve endings of odontoblasts...
Dental hypersensitivity is due to the exposure of the dentin layer after wear of enamel or cementum, exposing the dentinal tubules and the nerve endings of odontoblasts within these tubules. The present study aimed to assess the factors related to dental hypersensitivity in individuals with cleft lip and palate and the most common therapy received. The medical records of 536 patients with cleft lip and/or palate (281 males, 255 females) with a mean age of 18 were analyzed in a single center. The inclusion criterion was patients reporting dental hypersensitivity from May 2015 to October 2019. The origin of dental hypersensitivity was evaluated considering orthodontic movement, periodontal diseases, and reversible and irreversible pulpitis. The therapy indicated by the dental professionals for dental hypersensitivity were recorded. Descriptive statistics were performed. Of 61 teeth with dental hypersensitivity, 10 were attributed to orthodontic movement, 21 to periodontal problems, 27 to reversible pulpitis, and three to irreversible pulpitis. The most used therapies were the application of fluoride varnish and prophylaxis, dentifrice indication for dental sensitivity, free gingival grafts, pulpectomy, desensitizing agent application, conservative endodontic treatment (direct pulp protection), and restoration of non-carious cervical lesions. Reversible pulpitis was the most prevalent etiologic factor of dental hypersensitivity in individuals with cleft lip and palate. Dentifrices for dental sensitivity and fluoride varnish application were frequently recommended.
PubMed: 33927840
DOI: 10.34172/joddd.2021.008 -
Cytokine May 2022This research aims to quantify pro-inflammatory cytokines from the exudates of dental pulp tissues are helpful in the diagnosis of pulpitis, thus, laying down the...
BACKGROUND
This research aims to quantify pro-inflammatory cytokines from the exudates of dental pulp tissues are helpful in the diagnosis of pulpitis, thus, laying down the foundation for further vital pulp therapy on irreversible pulpitis.
METHODS
The authors selected patients admitted to Beijing Stomatological Hospital from October 2016 to March 2018. Exudates were collected from pulp exposure and were divided into four groups, which encompass normal pulps (Group 1), early stage of chronic pulpitis (Group 2), late stage of chronic pulpitis (Group 3) and acute attack of chronic pulpitis (Group 4).
RESULTS
The cytokines IL-1β, IL-6, IL-8 and TNF from the exudates of dental pulp tissues were quantified by cytometric bead array using enhanced sensitivity flex sets. All statistical analyses were performed using SPSS 22.0 and the 2-sided significance level was set at p < 0.05. The Kruskal-Wallis test, Mann-Whitney U test and Spearman correlation analysis were employed to process data.
CONCLUSION
There were 32, 37, 14, 29 samples in Groups 1, 2, 3 and 4, respectively. Only small amount of IL-1β, IL-8 was expressed in normal pulps and almost no TNF, IL-6 could be detected in Group 1. No difference was observed in the concentration of TNF between Group 2, 3, 4.
Topics: Cytokines; Dental Pulp; Exudates and Transudates; Humans; Interleukin-6; Interleukin-8; Pulpitis
PubMed: 35255379
DOI: 10.1016/j.cyto.2022.155846 -
Cell Biochemistry and Function Jul 2020Invasion of dentinal tubules and pulp tissue by pathogenic bacteria may cause infection leading to pulpitis. Sirtuin 6 (SIRT6) is a NAD-dependent protein deacetylase...
Invasion of dentinal tubules and pulp tissue by pathogenic bacteria may cause infection leading to pulpitis. Sirtuin 6 (SIRT6) is a NAD-dependent protein deacetylase encoded by the SIRT6 gene. The effect of SIRT6 on lipopolysaccharide (LPS)-induced pulpitis and its mechanism of action were discussed in this study. Dental pulp cells (DPCs) were extracted from human teeth and injected with LPS to induce inflammation. The cells injected with LPS showed substantially decreased expression of SIRT6. The overexpression of SIRT6, induced by plasmid-transfection of DPCs with SIRT6 overexpressing vector, led to a marked decrease in proinflammatory cytokines (IL-6, IL-1β, and TNF-α) and deactivation of NF kappa B pathway. Additionally, dentin matrix protein-1 (DMP1), a promoter of inflammation in dental pulp tissues, was downregulated. Further investigation revealed that SIRT6 promotes ubiquitination of the transient receptor potential vanilloid 1 (TRPV1) channel, leading to its degradation and deactivation. The role of TRPV1 in the anti-inflammatory effects of SIRT6 was determined through incubation of SIRT6-expressing dental pulp stem cells (DPSCs) with capsaicin. This incubation counteracted the effect of SIRT6 on cytokines and DMP1. The injection of lentivirus-SIRT6 attenuated LPS-induced pulpitis in vivo by suppressing TRPV1 activity. Thus, SIRT6 inhibits the TRPV1 channel during LPS-induced inflammation of dental pulp. SIGNIFICANCE OF THE STUDY: This study discussed the effect of sirtuin 6 (SIRT6) on lipopolysaccharide (LPS)-induced pulpitis as well as its mechanism of action and found that SIRT6 may be a negative regulator of pulpitis. Additionally, low expression of SIRT6 and high expression of transient receptor potential vanilloid 1 (TRPV1) in LPS-treated human dental pulp cells are closely associated with proinflammatory cytokines, dentin matrix protein 1 expression, and activation of the NF-κB pathway, which indicated that TRPV1 may be a biomarker for pulpitis and the SIRT6-TRPV1-CGRP axis maybe a clinical target due to their role regulating inflammation and neuropathic pain.
Topics: Adolescent; Adult; Animals; Child; Cytokines; Dental Pulp; Humans; Lipopolysaccharides; Male; Pulpitis; Rats; Rats, Sprague-Dawley; Sirtuins; TRPV Cation Channels; Young Adult
PubMed: 32236974
DOI: 10.1002/cbf.3528 -
Iranian Endodontic Journal 2023Over recent decades, the definition of irreversible pulpitis (IP), as an irrevocable condition of a compromised dental pulp tissue, has forced clinicians towards... (Review)
Review
Challenging the Misnomer of Irreversible Pulpitis and Deliberating the Urgent Need for Reclassification of Pulpal Diseases Based on the Efficacy of Vital Pulp Therapies: An Overview of Systematic Reviews.
Over recent decades, the definition of irreversible pulpitis (IP), as an irrevocable condition of a compromised dental pulp tissue, has forced clinicians towards invasive root canal treatments. However, the current best evidence challenges the alignment between clinical symptoms and the perceived irreversibility of a negotiated dental pulp tissue. In the above-mentioned context, vital pulp therapy (VPT) has emerged as a revolutionary and transformative approach; introducing minimally invasive techniques to sustain pulp vitality in cases of IP. The present paper aimed to rigorously examine the corresponding published systematic reviews to explore the diverse spectrum of VPT modalities and their outcomes in managing IP cases. Besides, the current review seems to have asserted the need to discard the conventional terminology of , based on the effectiveness of VPTs in the achievement of pulp tissue healing within cases clinically diagnosed as IP.
PubMed: 37829832
DOI: 10.22037/iej.v18i4.43035 -
International Endodontic Journal Jul 2023To comparatively analyse the levels of culturable bacteria, endotoxins (LPS), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and substance P in teeth...
Quantitative analysis of culturable bacteria, levels of endotoxins, inflammatory mediators and substance P in teeth with symptomatic irreversible pulpitis and in teeth with vital normal pulp tissues.
AIM
To comparatively analyse the levels of culturable bacteria, endotoxins (LPS), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and substance P in teeth with symptomatic irreversible pulpitis (SIP) and vital normal pulp (VNP) tissues.
METHODOLOGY
Thirty-two patients were included (20 teeth with SIP and 12 teeth with VNP tissues) in this cross-sectional study. Samples were collected from the full length of the root canals (microbial analysis) and periapical tissues (2 mm beyond the apex for immunological analysis), using sterile absorbent paper points. The levels of culturable bacteria (culture method), endotoxins (LAL Pyrogent 5000), TNF-α, IL-1β and substance P (ELISA) were assessed. The Mann-Whitney test was used for comparisons between the levels of CFU/mL, LPS, TNF-α, IL-1β and substance P in the SIP and VNP groups. The statistical analysis was performed with the significance level set at 5%.
RESULTS
Culturable bacteria were recovered from all teeth with SIP. On the other hand, no positive cultures were observed in the VNP tissues group (p > .05). The levels of LPS were approximately four times higher in teeth with SIP than in teeth with VNP tissues (p < .05). Higher levels of TNF-α and substance P were detected in teeth with SIP (p < .05). On the other hand, no difference in the levels of IL-1β was detected between the two groups (p > .05).
CONCLUSION
Teeth with symptomatic irreversible pulpitis present higher levels of culturable bacteria, endotoxins, TNF-α and substance P than those with vital normal pulp tissues. On the other hand, the levels of IL-1β were similar in teeth from both groups suggesting reduced implications of this inflammatory mediator in the early stages of infection.
Topics: Humans; Pulpitis; Substance P; Endotoxins; Lipopolysaccharides; Inflammation Mediators; Tumor Necrosis Factor-alpha; Cross-Sectional Studies; Dental Pulp; Bacteria
PubMed: 37070606
DOI: 10.1111/iej.13922 -
Journal of Endodontics Jun 2020The composition and relative abundance of bacterial species change throughout the development of dental caries; however, how these changes relate to clinical symptoms...
INTRODUCTION
The composition and relative abundance of bacterial species change throughout the development of dental caries; however, how these changes relate to clinical symptoms remains elusive. In this study, we explored the relationship between clinical symptoms and specific microorganisms in advanced dentinal caries.
METHODS
A total of 111 permanent premolars and molars were used to simulate the progression from caries to pulpitis indirectly. Clinical symptoms were evaluated, and teeth were diagnosed according to the diagnostic criteria of the American Association of Endodontics. Samples were collected for 16S ribosomal DNA sequencing. Associations between the microbiota and clinical symptoms/diagnosis and the relationship between alpha diversity and clinical symptoms/diagnosis were evaluated independently by the linear discriminant analysis effect size and Spearman rank correlation analyses.
RESULTS
The 16S ribosomal DNA sequences were assigned to 13,852 operational taxonomic units. The linear discriminant analysis effect size and Spearman correlations unveiled negative associations between the relative abundance of Bacteroidia and Gammaproteobacteria and referred pain, Gammaproteobacteria and the electric pulp test response, and Actinomyces and Propionibacterium and diagnosis (r < 0.0, P < .05). Conversely, the relative abundance of Lactobacillus was positively correlated to referred pain, the cold test, the percussion response, and diagnosis (r > 0, P < .05). Lactobillus reuteri, a probiotic bacterium, was more abundant in teeth with referred pain and teeth diagnosed with symptomatic irreversible pulpitis. The Spearman correlation between alpha diversity and clinical symptoms/diagnosis was not significant (P > .05).
CONCLUSIONS
Clinical symptoms and diagnosis were significantly associated with specific microorganisms in the most advanced layers of dentinal caries.
Topics: Bacteria; Dental Caries; Humans; Lactobacillus; Microbiota; Pulpitis
PubMed: 32295705
DOI: 10.1016/j.joen.2020.02.011 -
BMC Oral Health Jan 2023Pulpitis is a common disease mainly caused by bacteria. Conventional approaches of diagnosing the state of dental pulp are mainly based on clinical symptoms, thereby...
BACKGROUND
Pulpitis is a common disease mainly caused by bacteria. Conventional approaches of diagnosing the state of dental pulp are mainly based on clinical symptoms, thereby harbor deficiencies. The accurate and rapid diagnosis of pulpitis is important for choosing the suitable therapy. The study aimed to identify pulpits related key genes by integrating micro-array data analysis and systems biology network-based methods such as weighted gene co-expression network analysis (WGCNA).
METHODS
The micro-array data of 13 inflamed pulp and 11 normal pulp were acquired from Gene Expression Omnibus (GEO). WGCNA was utilized to establish a genetic network and categorize genes into diverse modules. Hub genes in the most associated module to pulpitis were screened out using high module group members (MM) methods. Pulpitis model in rat was constructed and iRoot BP plus was applied to cap pulp. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used for validation of hub genes.
RESULTS
WGCNA was established and genes were categorized into 22 modules. The darkgrey module had the highest correlation with pulpitis among them. A total of 5 hub genes (HMOX1, LOX, ACTG1, STAT3, GNB5) were identified. RT-qPCR proved the differences in expression levels of HMOX1, LOX, ACTG1, STAT3, GNB5 in inflamed dental pulp. Pulp capping reversed the expression level of HMOX1, LOX, ACTG1.
CONCLUSION
The study was the first to produce a holistic view of pulpitis, screen out and validate hub genes involved in pulpitis using WGCNA method. Pulp capping using iRoot BP plus could reverse partial hub genes.
Topics: Animals; Rats; Dental Pulp Capping; Gene Expression Profiling; Gene Regulatory Networks; Pulpitis
PubMed: 36593446
DOI: 10.1186/s12903-022-02638-9 -
Pain Feb 2024Dental pulp tissue is densely innervated by afferent fibers of the trigeminal ganglion. When bacteria cause dental decay near the pulpal tissue, a strong neuronal and...
Dental pulp tissue is densely innervated by afferent fibers of the trigeminal ganglion. When bacteria cause dental decay near the pulpal tissue, a strong neuronal and immune response occurs, creating pulpitis, which is associated with severe pain and pulp tissue damage. Neuroimmune interactions have the potential to modulate both the pain and pathological outcome of pulpitis. We first investigated the role of the neuropeptide calcitonin gene-related peptide (CGRP), released from peptidergic sensory afferents, in dental pain and immune responses by using Calca knockout (Calca -/- ) and wild-type (Calca +/+ ) mice, in a model of pulpitis by creating a mechanical exposure of the dental pulp horn. We found that the neuropeptide CGRP, facilitated the recruitment of myeloid cells into the pulp while also increasing spontaneous pain-like behavior 20% to 25% at an early time point. Moreover, when we depleted neutrophils and monocytes, we found that there was 20% to 30% more sensory afferent loss and increased presence of bacteria in deeper parts of the tissue, whereas there was a significant reduction in mechanical pain response scores compared with the control group at a later time point. Overall, we showed that there is a crosstalk between peptidergic neurons and neutrophils in the pulp, modulating the pain and inflammatory outcomes of the disease.
Topics: Mice; Animals; Calcitonin Gene-Related Peptide; Pulpitis; Dental Pulp; Neurons; Neuropeptides; Pain; Neurons, Afferent
PubMed: 37903298
DOI: 10.1097/j.pain.0000000000003029 -
International Endodontic Journal Aug 2024The European Society of Endodontology published in 2023, the S3-level clinical practice guidelines, which supersede the Quality Guidelines for Endodontic Treatment... (Review)
Review
BACKGROUND
The European Society of Endodontology published in 2023, the S3-level clinical practice guidelines, which supersede the Quality Guidelines for Endodontic Treatment published in 2006.
OBJECTIVES
This review aims to summarize and compare the above guidelines to support their dissemination.
METHOD
A narrative synthesis of the main differences alongside tabulation according to the main themes.
RESULTS
Three tables were prepared according to the following themes: diagnosis of pulpal and apical condition; treatment of pulpitis; and treatment of nonvital pulp and apical periodontitis.
CONCLUSIONS
A compared and simplified message regarding the most recent clinical practice guidelines has been prepared.
REGISTRATION
Not applicable as a narrative review.
Topics: Humans; Endodontics; Europe; Practice Guidelines as Topic; Societies, Dental; Periapical Periodontitis; Pulpitis
PubMed: 38523348
DOI: 10.1111/iej.14067 -
Clinical Oral Investigations May 2021This study aimed to investigate the ability of the diode and Nd:YAG lasers to decrease postoperative pain/discomfort after intracanal application in vital and devital... (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluation of postoperative pain/discomfort after intracanal use of Nd:YAG and diode lasers in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps: a randomized control trial.
OBJECTIVES
This study aimed to investigate the ability of the diode and Nd:YAG lasers to decrease postoperative pain/discomfort after intracanal application in vital and devital endodontic cases.
MATERIAL AND METHODS
One hundred two patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps were selected and randomly divided into three groups. After chemomechanical preparation, Nd:YAG and diode laser was applied to first and second groups for final treatment of the root canals. In the control group, no further disinfection protocol was performed upon traditional procedures. Then all the teeth were obturated in the same appointment. Pre- and postoperative pain were recorded using the VAS at 0, 12th, 24th, 48th, and 72nd hours following the treatment Kruskal-Wallis and Dunn test.
RESULTS
VAS scores were significantly the most at 12-h period compared with other time periods after treatment for all groups. There was no significant difference among Nd:YAG laser, diode laser, and control groups in non-vital cases (p > 0.05). In vital cases, Nd:YAG laser group represented significantly fewer scores compared with diode laser and control groups at 48-h period (p < 0.05).
CONCLUSIONS
The processes involving the use of Nd:YAG and diode lasers after chemomechanical preparation was found to be equivalent in terms of postoperative pain intensity after completion of treatment in one session both in vital or non-vital cases except in vital cases in Nd:YAG group at 48 h.
CLINICAL RELEVANCE
Adjunct clinical use of Nd:YAG or diode lasers to traditional chemomechanical preparation did not cause any improvement or deterioration on postoperative discomfort and pain in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps.
Topics: Dental Pulp Necrosis; Humans; Lasers, Semiconductor; Lasers, Solid-State; Pain, Postoperative; Pulpitis
PubMed: 33409689
DOI: 10.1007/s00784-020-03588-8