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FASEB Journal : Official Publication of... Jan 2024Bacterial infection is the main cause of pulpitis. However, whether a dominant bacteria can promote the progression of pulpitis and its underlying mechanism remains...
Bacterial infection is the main cause of pulpitis. However, whether a dominant bacteria can promote the progression of pulpitis and its underlying mechanism remains unclear. We provided a comprehensive assessment of the microbiota alteration in pulpitis using 16S rRNA sequencing. Fusobacterium nucleatum was the most enriched in pulpitis and played a pathogenic role accelerating pulpitis progression in rat pulpitis model. After odontoblast-like cells cocultured with F. nucleatum, the stimulator of interferon genes (STING) pathway and autophagy were activation. There was a float of STING expression during F. nucleatum stimulation. STING was degraded by autophagy at the early stage. At the late stage, F. nucleatum stimulated mitochondrial Reactive Oxygen Species (ROS) production, mitochondrial dysfunction and then mtDNA escape into cytosol. mtDNA, which escaped into cytosol, caused more cytosolic mtDNA binds to cyclic GMP-AMP synthase (cGAS). The release of IFN-β was dramatically reduced when mtDNA-cGAS-STING pathway inhibited. STING mice showed milder periapical bone loss and lower serum IFN-β levels compared with wildtype mice after 28 days F. nucleatum-infected pulpitis model establishment. Our data demonstrated that F. nucleatum exacerbated the progression of pulpitis, which was mediated by the STING-dependent pathway.
Topics: Mice; Rats; Animals; Fusobacterium nucleatum; Signal Transduction; Pulpitis; RNA, Ribosomal, 16S; Nucleotidyltransferases; DNA, Mitochondrial
PubMed: 38085169
DOI: 10.1096/fj.202301648R -
Dental Research Journal 2022To establish an endodontic diagnosis, a clinician should consider a variety of factors. Various studies have failed to demonstrate a strong correlation between...
BACKGROUND
To establish an endodontic diagnosis, a clinician should consider a variety of factors. Various studies have failed to demonstrate a strong correlation between histological findings with clinical and radiographic assessments. This study sought to evaluate the histopathological features of reversible and irreversible pulpitis diseases and their correlation with clinical diagnosis in extracted human molar teeth.
MATERIALS AND METHODS
In this experimental study, 75 molars with caries and three intact molars were used. According to the radiographic findings and clinical criteria and the need for root canal therapy, samples were categorized as having normal/reversible pulpitis and irreversible pulpitis. Immediately after extraction, an exposure was made at 2 mm below the cementoenamel junction. Formalin-fixed specimens were decalcified, sectioned and stained with hematoxylin and eosin for histological examinations using light microscopy. Variables including the type and severity of the inflammation, hyperemia, necrosis, fibrosis and the existence of an odontoblastic layer and dentin bridge were evaluated. The Fisher's exact test and the Chi-squared test were used for statistical analysis. <0.05 was considered as significant.
RESULTS
Acute inflammation, hyperemia and pulp exposure were significantly more common among subjects with irreversible pulpitis ( < 0/005). However, fibrosis was significantly higher in the reversible group ( < 0/005). There were no statistically significant differences between the groups regarding the other variables.
CONCLUSION
Some discrepancies between clinical, radiographic and histological findings were observed in our experimental study. Indeed, effective clinical practice requires consideration of all discrepancies found.
PubMed: 35432790
DOI: No ID Found -
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 -
International Endodontic Journal Mar 2023There is increased interest in outcome measures that complement the classic goal of endodontics, being the prevention and healing of apical periodontitis. Possible... (Review)
Review
There is increased interest in outcome measures that complement the classic goal of endodontics, being the prevention and healing of apical periodontitis. Possible outcome measures can be subdivided into patient-centred outcomes (PCOs), encompassing data collected by nonpatients aiming to assess the effectiveness of an intervention and patient-reported outcomes (PROs), which are reported directly by the patient. PROs can be subsequently classed into PRO measures that ascertain patients' view of their symptoms, their functional status, and their health-related quality of life, and patient-reported experience measures that focus on aspects including the humanity of care, patient satisfaction, patient preference and adherence, personal costs, expectation fulfilment, and decision regrets. The present review aims to define various patient-related outcomes and discuss the literature available regarding PCOs and PROs in endodontics. This includes those proposed to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of European Society of Endodontology S3-level clinical practice guidelines that have been included by all working groups, except for the radiographic assessment of apical periodontitis. Based on limited evidence in the field, it can be summarized that after recall periods of various lengths, endodontic treatment is associated with a high likelihood of tooth survival and limited need for further intervention, including extraction and further restorative procedures. Oral Health-Related Quality of Life (OHRQoL) is likely to improve following the completion of treatment. Nonetheless, the literature assessing the association between OHRQoL and endodontics is hampered by the use of instruments that have not been previously validated. Amongst the remaining outcome measures discussed in the present review, it is worth highlighting that there is only one study assessing exacerbations in teeth with the presence of endodontic pathosis, which suggests a very low incidence of this adverse effect following endodontic treatment. Patients' expectation fulfilment, adherence, and satisfaction are closely inter-related and depend also on various nonclinical factors. Further studies assessing PCOs and PROs, in association with healing and prevention of apical periodontitis, are required to better understand endodontic treatment from the perspective of patients.
Topics: Humans; Quality of Life; Endodontics; Pulpitis; Periapical Periodontitis; Dental Care
PubMed: 36102371
DOI: 10.1111/iej.13830 -
International Endodontic Journal Dec 2022Innate immunity is the first line of defence and fights against microorganisms. Nucleic acids are important pathogen-associated molecular patterns to be recognized in... (Review)
Review
Innate immunity is the first line of defence and fights against microorganisms. Nucleic acids are important pathogen-associated molecular patterns to be recognized in innate immunity. There are three types of nucleic acid sensors, including endosomal sensors (NA-sensing TLRs), cytosolic DNA sensors (cGAS and AIM2) and cytosolic RNA sensors (RLG-I, MDA5 and LGP2). Recent studies have shown that nucleic acid sensors are expressed differently in a variety of dental pulp cells and mediate inflammation through complex pathways. Nucleic acid sensing may play a vital role in the development of endodontic infection. This review aims to summarize and analyse the possible roles of various nucleic acid sensors in endodontic infection. It may help better understand the pathogenesis of these diseases and find new strategies for prevention and treatment.
Topics: Humans; DNA; Immunity, Innate; Inflammation; Nucleic Acids; Pulpitis
PubMed: 36104078
DOI: 10.1111/iej.13831 -
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 -
Clinical Oral Investigations Mar 2021Connexins are building blocks of membranous channels that form gap junctions and hemichannels. These channels are essential portals for information exchange and...
OBJECTIVES
Connexins are building blocks of membranous channels that form gap junctions and hemichannels. These channels are essential portals for information exchange and coordination during inflammation. Pathologic levels of these conduits may result in excessive inflammation and collateral destruction. This study aimed to analyse temporospatial levels of connexin 43 (Cx43) during pulpitis in extracted human teeth and in a rodent model. A specific interest was directed at the pulpal stroma as it is conserved during vital pulp therapy.
MATERIALS AND METHODS
Pulpal tissues were attained from human extracted teeth of various pulpal inflammatory stages and fixed for cryosections. Pulpal exposures were created in bilateral maxillary molars in Sprague-Dawley rats. Rats were sacrificed at days 1 to 5 post-exposure. Immunofluorescence histology was performed to detect Cx43, markers for inflammation, and cell death. Immunofluorescent levels in the pulpal stroma at 3 sites (wound/near/far) were matched to pulpal condition (human) or days post-exposure (rodent).
RESULTS
Cx43 upregulation was observed with increased severity of pulpitis both in humans and rodent model. The upregulation appeared to be global and included distant regions. Elevated levels of neutrophils were present in advanced pulpitis. Apoptosis and necroptosis seem to be upregulated in human samples as Cx43 levels rose.
CONCLUSIONS
We observed a disseminated upregulation of Cx43 throughout the pulpal stroma as inflammation became advanced. This observation may facilitate cell death signal transfer or represent overt levels of purinergic signalling that leads to pro-inflammatory conditions.
CLINICAL RELEVANCE
Cx43 downregulation may represent a potential therapeutic approach to enable resolution of pulpal inflammation.
Topics: Animals; Connexin 43; Dental Pulp; Pulpitis; Rats; Rats, Sprague-Dawley; Up-Regulation
PubMed: 32623525
DOI: 10.1007/s00784-020-03439-6 -
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