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Materials (Basel, Switzerland) Sep 2022The regeneration of dental pulp remains a challenge. Although several treatment modalities have been proposed to promote pulpal regeneration, these treatments have... (Review)
Review
INTRODUCTION
The regeneration of dental pulp remains a challenge. Although several treatment modalities have been proposed to promote pulpal regeneration, these treatments have several drawbacks. More recently, decellularized dental pulp extracellular matrix (DP-ECM) has been proposed to regenerate dental pulp. However, to date, no systematic review has summarized the overall outcome and assessed the available literature focusing on the endodontic use of DP-ECM. The aim of this systematic review is to critically appraise the literature, summarize the overall outcomes, and provide clinical recommendations about DP-ECM.
METHODOLOGY
Following the Participants Intervention Control and Outcomes (PICO) principle, a focused question was constructed before conducting a search of the literature and of electronic research databases and registers. The focused question was: 'Compared to controls, does decellularized dental pulp extracellular matrix (DP-ECM) stimulate the regeneration of dental pulp cells and tissue?' Quality assessment of the studies was carried out using Guidelines for Reporting Pre-Clinical in Vitro Studies on Dental Materials and ARRIVE guidelines.
RESULTS
12 studies were included in this review. Data from five in vitro experiments and eight in vivo experiments were extracted and the quality of the experiments was assessed. In majority of the studies, DP-ECM appeared to have stimulated pulpal regeneration. However, several sources of bias and methodological deficiencies were found during the quality assessment.
CONCLUSION
Within the limitations of this review and the included studies, it may be concluded that there is insufficient evidence to deduce the overall efficacy of DP-ECM for pulpal regeneration. More research, clinical and pre-clinical, is required for more conclusive evidence.
PubMed: 36143698
DOI: 10.3390/ma15186386 -
Cells Aug 2021The dental pulp can be affected by thermal, physical, chemical, and bacterial phenomena that stimulate the inflammatory response. The pulp tissue produces an...
The dental pulp can be affected by thermal, physical, chemical, and bacterial phenomena that stimulate the inflammatory response. The pulp tissue produces an immunological, cellular, and vascular reaction in an attempt to defend itself and resolve the affected tissue. The expression of different microRNAs during pulp inflammation has been previously documented. MicroRNAs (miRNAs) are endogenous small molecules involved in the transcription of genes that regulate the immune system and the inflammatory response. They are present in cellular and physiological functions, as well as in the pathogenesis of human diseases, becoming potential biomarkers for diagnosis, prognosis, monitoring, and safety. Previous studies have evidenced the different roles played by miRNAs in proinflammatory, anti-inflammatory, and immunological phenomena in the dental pulp, highlighting specific key functions of pulp pathology. This systematized review aims to provide an understanding of the role of the different microRNAs detected in the pulp and their effects on the expression of the different target genes that are involved during pulp inflammation.
Topics: Cell Differentiation; Dental Pulp; Down-Regulation; Gene Expression Regulation; Humans; Inflammation; MicroRNAs; RNA, Messenger; Signal Transduction; Up-Regulation
PubMed: 34440911
DOI: 10.3390/cells10082142 -
Imaging Science in Dentistry Jun 2023This systematic review aimed to investigate the correlation between chronological age and dental pulp volume in cone-beam computed tomography (CBCT). (Review)
Review
PURPOSE
This systematic review aimed to investigate the correlation between chronological age and dental pulp volume in cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
The literature was searched in 4 databases (PubMed, Scopus, Web of Science, and Google Scholar). Within each study, the outcome of interest was the correlation (r) between chronological age and pulp volume. A random-effect meta-analysis was conducted. Subgroup analysis was carried out according to sex and tooth type.
RESULTS
Of 5693 identified studies, 27 fulfilled the inclusion criteria and were selected for meta-analysis. These articles focused on single-rooted teeth (n=21), multi-rooted teeth (n=6), maxillary teeth (n=14), mandibular teeth (n=6), and maxillary and mandibular teeth (n=12). The relationship between chronological age and dental pulp volume was examined in the entire population (r=-0.67), men (r=-0.75), and women (r=-0.77) in single- and multi-rooted teeth. The results of the total population analysis showed a relatively strong negative relationship between age and pulp volume.
CONCLUSION
This study suggested that CBCT is a reliable and repeatable tool for dental age estimation. A strong inverse relationship was observed between pulp chamber volume and age. Further studies on the correlation between chronological age and pulp volume of multi-rooted teeth may be beneficial.
PubMed: 37405204
DOI: 10.5624/isd.20221226 -
Journal of the American Dental... Sep 2023A guideline panel convened by the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of...
Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh School of Dental Medicine, and the Center for Integrative Global Oral Health at...
BACKGROUND
A guideline panel convened by the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of Pittsburgh School of Dental Medicine, and Center for Integrative Global Oral Health at the University of Pennsylvania conducted a systematic review and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after 1 or more simple and surgical tooth extractions and the temporary management of toothache (that is, when definitive dental treatment not immediately available) associated with pulp and furcation or periapical diseases in children (< 12 years).
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review to determine the effect of analgesics and corticosteroids in managing acute dental pain. They used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations.
RESULTS
The panel formulated 7 recommendations and 5 good practice statements across conditions. There is a small beneficial net balance favoring the use of nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen compared with not providing analgesic therapy. There is no available evidence regarding the effect of corticosteroids on acute pain after surgical tooth extractions in children.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Nonopioid medications, specifically nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen alone or in combination with acetaminophen, are recommended for managing acute dental pain after 1 or more tooth extractions (that is, simple and surgical) and the temporary management of toothache in children (conditional recommendation, very low certainty). According to the US Food and Drug Administration, the use of codeine and tramadol in children for managing acute pain is contraindicated.
Topics: United States; Humans; Child; Acetaminophen; Acute Pain; American Dental Association; Oral Health; Toothache; Academies and Institutes; Anti-Inflammatory Agents, Non-Steroidal
PubMed: 37634915
DOI: 10.1016/j.adaj.2023.06.014 -
Molecules (Basel, Switzerland) Jul 2021A wide range of mediators are released from the pulp tissue because of bacterial invasion which causes inflammation. Interleukins (ILs) and matrix metalloproteinases...
A wide range of mediators are released from the pulp tissue because of bacterial invasion which causes inflammation. Interleukins (ILs) and matrix metalloproteinases (MMPs) have a leading role in initiating and spreading of inflammation because of their synergic action. Biomarkers such as ILs and MMPs can be identified via several methods, establishing the inflammatory response of the dental pulp. The aim of this systematic review is to evaluate the levels of ILs and/or MMPs in human dental pulp. PubMed, OVID, Cochrane, Scopus, Web of Science and Wiley online library databases were searched for original clinical studies. After applying inclusion and exclusion criteria, a quality assessment of studies was performed based on a modified Newcastle-Ottawa scale. In the review were included articles that evaluated the presence of ILs and/or MMPs in pulp tissue using enzyme-linked immunosorbent assay (ELISA) or western blot or multiplex assay. Six articles were included in the present synthesis. Although various diagnostic methods were used, statistically significant higher levels of ILs and/or MMPs were mostly found in the experimental groups compared to healthy pulp samples. The biomarkers studied can be a promising tool to evaluate pulp tissue health or even in pulpitis treatment.
Topics: Dental Pulp; Humans; Inflammation; Interleukins; Matrix Metalloproteinases
PubMed: 34299403
DOI: 10.3390/molecules26144129 -
Journal of Dentistry Apr 2022This study aims to review systematically the dental pulp response to silver diamine fluoride (SDF) treatment, including the inflammatory response, pulp cells activity,... (Review)
Review
OBJECTIVE
This study aims to review systematically the dental pulp response to silver diamine fluoride (SDF) treatment, including the inflammatory response, pulp cells activity, dentinogenesis, silver penetration, and the presence of the bacteria in the dental pulp.
DATA
In vitro studies, animal studies, clinical studies, and case reports on the use of SDF on vital dental pulp were included. Quality assessment of the included studies was conducted. A narrative synthesis of the collected data was performed.
SOURCES
A systematic search was performed in ProQuest, PubMed, SCOPUS, and Web of Science databases for articles published from inception to Nov 1, 2021.
STUDY SELECTION
The initial search identified 1,433 publications, of which five publications met the inclusion criteria. These five publications reported the effect of direct/ indirect SDF application on the vital pulp of a total of 30 teeth. Direct SDF application on vital pulp caused pulp necrosis. Indirect SDF application caused none or mild inflammatory response of dental pulp. The odontoblasts in the dental pulp showed increased cellular activity. Tertiary dentine was formed in the pulpal side of the cavity with indirect SDF application. Accentuated incremental lines of tertiary dentine reflected disturbances in mineralisation. Silver ions were found to penetrate along the dentinal tubules but were not detected inside the pulp.
CONCLUSION
According to the limited available literature, direct SDF application causes pulp necrosis. Indirect SDF application is generally biocompatible to dental pulp tissue with a mild inflammatory response, increased odontoblastic activity, and increased tertiary dentine formation. Future studies with precise quantitative and qualitative tests, larger sample size and longer follow-up time are imperative to understand the biological activity of dental pulp to SDF treatment.
Topics: Animals; Dental Caries; Dental Pulp; Dental Pulp Necrosis; Dentin, Secondary; Fluorides, Topical; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 35139409
DOI: 10.1016/j.jdent.2022.104066 -
The Saudi Dental Journal Nov 2023This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific... (Review)
Review
This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific research articles during May 2021. The data search was performed in electronic search engines like PubMed, Scopus, Web of science, and Saudi Digital Library, and 6 original research articles which fulfilled the eligibility criteria were assessed for qualitative data. The prevalence of pulp stones among the KSA population ranged from 4.6% to 50.93% among the study participants and it ranged between 10.2%-13.34% in the teeth assessed. The pulp stones were more frequently reported in decayed teeth, periodontal diseases, attrition, teeth with dental restorations, and higher in the molar teeth in comparison with the premolar teeth. The data on the prevalence of pulp stones among the Saudi population will be helpful for clinicians in planning endodontic procedures.
PubMed: 38077230
DOI: 10.1016/j.sdentj.2023.07.012 -
Annals of Anatomy = Anatomischer... Aug 2022The main objective of this systematic review is to carry out a qualitative synthesis of the available bibliography on the use of scaffolds used in dentistry for the... (Review)
Review
AIMS
The main objective of this systematic review is to carry out a qualitative synthesis of the available bibliography on the use of scaffolds used in dentistry for the revitalisation treatment of immature teeth with open apex.
MATERIAL AND METHODS
The search was carried out in the MEDLINE, Scopus and Cochrane databases. The search included the terms 'Pulp regeneration' OR 'Pulp revitalisation' AND 'scaffold'. The inclusion criteria were articles published in English, which carry out revitalisation treatments, with analysis of the results obtained and comparison of them, carried out in humans, in immature permanent teeth with open apex, and randomised clinical trials. The risk of bias assessment was performed with the RoB2 guideline.
RESULTS
Of 769 studies, 10 met the inclusion criteria. The scaffolds used were blood clot, platelet-rich plasma, platelet-rich fibrin, and blood clots combined with different membranes such as collagen membrane, collagen membrane and placentrex, chitosan membrane and hydrogel with basic growth factor for fibroblasts. The clinical success rate is excellent for all scaffolds used. The best scaffold for root development is platelet-rich plasma and it is the scaffold with the highest percentage of response to vitality test.
CONCLUSION
Our results suggested that platelet-rich plasma is the preferred scaffold of choice, although all the scaffolds analysed have acceptable results.
Topics: Collagen; Dental Pulp; Humans; Platelet-Rich Fibrin; Randomized Controlled Trials as Topic; Regeneration
PubMed: 35367348
DOI: 10.1016/j.aanat.2022.151936 -
Journal of Dentistry Dec 2023The aim of this scoping review was to summarize and discuss the morphological features and associated factors of pulpal mineralizations (PMs) as described within the...
OBJECTIVE
The aim of this scoping review was to summarize and discuss the morphological features and associated factors of pulpal mineralizations (PMs) as described within the literature.
DATA
The study protocol was registered on the Open Science Framework platform and is available at the following link: https://osf.io/hfqwe. This scoping review was developed according to the PRISMA-ScR guidelines.
SOURCES
A literature search of four electronic databases was performed in SCOPUS, MEDLINE (PubMed), EMBASE and Word of Science, with the last search on May 29, 2023. Study selection was completed by two reviewers independently. Data was extracted regarding study characteristics, types, and features of PM and associated factors.
STUDY SELECTION
Of 1016 studies initially identified ten which qualified were included in this scoping review. Systemic and local factors that result in pulpal insult can contribute to the development of PMs. Three forms of PM have been reported, pulp stones, diffuse mineralizations, and mineralized ectopic connective tissue, with discrete and diffuse mineralization being the two clinically relevant forms. The different forms of PMs exhibit dissimilar morphological features.
CONCLUSION
Pulpal mineralizations exist in two clinically relevant forms: diffuse and discrete mineralizations and are likely associated with a pulpal insult.
CLINICAL SIGNIFICANCE
Understanding the morphology of dental pulp mineralization is the first step to expanding the knowledge of pulp mineralization and could result in improved diagnosis of endodontic pathosis.
Topics: Dental Pulp; Dental Pulp Calcification; Humans
PubMed: 37866408
DOI: 10.1016/j.jdent.2023.104745 -
Biomolecules Feb 2022The aim of this systematic review was to evaluate the application of potential therapeutic signaling molecules on complete dentin-pulp complex and pulp tissue... (Review)
Review
The aim of this systematic review was to evaluate the application of potential therapeutic signaling molecules on complete dentin-pulp complex and pulp tissue regeneration in orthotopic and ectopic animal studies. A search strategy was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in the MEDLINE/PubMed database. Animal studies evaluating the application of signaling molecules to pulpectomized teeth for pulp tissue or dentin-pulp complex regeneration were included. From 2530 identified records, 18 fulfilled the eligibility criteria and were subjected to detailed qualitative analysis. Among the applied molecules, basic fibroblast growth factor, vascular endothelial growth factor, bone morphogenetic factor-7, nerve growth factor, and platelet-derived growth factor were the most frequently studied. The clinical, radiographical and histological outcome measures included healing of periapical lesions, root development, and apical closure, cellular recolonization of the pulp space, ingrowth of pulp-like connective tissue (vascularization and innervation), mineralized dentin-like tissue formation along the internal dentin walls, and odontoblast-like cells in contact with the internal dentin walls. The results indicate that signaling molecules play an important role in dentin/pulp regeneration. However, further studies are needed to determine a more specific subset combination of molecules to achieve greater efficiency towards the desired tissue engineering applications.
Topics: Animals; Dental Pulp; Dentin; Regeneration; Tissue Engineering; Vascular Endothelial Growth Factor A
PubMed: 35204786
DOI: 10.3390/biom12020285