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ACS Omega Feb 2024Pulpitis is a common dental emergency that presents with intense pain; there is still no specific medicine to treat pulpitis-induced pain to date. Herein, differentially...
Pulpitis is a common dental emergency that presents with intense pain; there is still no specific medicine to treat pulpitis-induced pain to date. Herein, differentially expressed genes in mouse anterior cingulate cortex (ACC) were investigated 7 days after pulp exposure via a combination of high-throughput transcriptomic and proteomic analyses. We screened 34 key genes associated with 8 critical pathways. Among these, genes (Elovl5, Ikbke, and Nbeal2) involved in immune or inflammatory responses exhibited exclusive regulation at the transcriptomic level, as confirmed by qRT-PCR. We also investigated the comprehensive expression profiles of genes (Erg1, Shank2, Bche, Serinf1, and Pax6) related to synaptic plasticity. Furthermore, the underlying mechanisms for pulpitis-induced pain through immune or inflammatory responses and synaptic plasticity were discussed. Taken together, our findings shed light on the mechanisms underlying pulpitis-induced pain, deepening our understanding of the molecular pathways and providing potential therapeutic and diagnostic targets.
PubMed: 38343959
DOI: 10.1021/acsomega.3c09759 -
BMC Oral Health Feb 2024Ideally, health services and interventions to improve dental health should be tailored to local target populations. But this is not the standard. Little is known about...
BACKGROUND
Ideally, health services and interventions to improve dental health should be tailored to local target populations. But this is not the standard. Little is known about risk clusters in dental health care and their evaluation based on small-scale, spatial data, particularly among under-represented groups in health surveys. Our study aims to investigate the incidence rates of major oral diseases among privately insured and self-paying individuals in Germany, explore the spatial clustering of these diseases, and evaluate the influence of social determinants on oral disease risk clusters using advanced data analysis techniques, i.e. machine learning.
METHODS
A retrospective cohort study was performed to calculate the age- and sex-standardized incidence rate of oral diseases in a study population of privately insured and self-pay patients in Germany who received dental treatment between 2016 and 2021. This was based on anonymized claims data from BFS health finance, Bertelsmann, Dortmund, Germany. The disease history of individuals was recorded and aggregated at the ZIP code 5 level (n = 8871).
RESULTS
Statistically significant, spatially compact clusters and relative risks (RR) of incidence rates were identified. By linking disease and socioeconomic databases on the ZIP-5 level, local risk models for each disease were estimated based on spatial-neighborhood variables using different machine learning models. We found that dental diseases were spatially clustered among privately insured and self-payer patients in Germany. Incidence rates within clusters were significantly elevated compared to incidence rates outside clusters. The relative risks (RR) for a new dental disease in primary risk clusters were min = 1.3 (irreversible pulpitis; 95%-CI = 1.3-1.3) and max = 2.7 (periodontitis; 95%-CI = 2.6-2.8), depending on the disease. Despite some similarity in the importance of variables from machine learning models across different clusters, each cluster is unique and must be treated as such when addressing oral public health threats.
CONCLUSIONS
Our study analyzed the incidence of major oral diseases in Germany and employed spatial methods to identify and characterize high-risk clusters for targeted interventions. We found that private claims data, combined with a network-based, data-driven approach, can effectively pinpoint areas and factors relevant to oral healthcare, including socioeconomic determinants like income and occupational status. The methodology presented here enables the identification of disease clusters of greatest demand, which would allow implementing more targeted approaches and improve access to quality care where they can have the most impact.
Topics: Humans; Retrospective Studies; Residence Characteristics; Incidence; Spatial Analysis; Socioeconomic Factors; Germany
PubMed: 38331748
DOI: 10.1186/s12903-024-03897-4 -
Cureus Jan 2024Strict protocols for evaluating the pulp's preoperative state should be developed, along with a new classification scheme for the different pulp states, as case...
Strict protocols for evaluating the pulp's preoperative state should be developed, along with a new classification scheme for the different pulp states, as case selection plays a major role in the effectiveness of adult pulpotomy. In this case report, a male patient, age 15, who had a carious lower left first molar underwent pulpotomy. The pulp's initial state was ascertained by pulse oximetry, electric pulp testing (EPT), and cold testing. The final diagnosis was symptomatic irreversible pulpitis. A 12-month follow-up period following the placement of mineral trioxide aggregate (MTA) (MTA Angelus Angelus, Londrina, Brazil; Clinician's Choice, New Milford, CT) and tooth-colored composite restoration revealed no visible anomalies in the postoperative radiographs, and the tooth remained functional and free of symptoms.
PubMed: 38327954
DOI: 10.7759/cureus.51837 -
Molecular Pain 2024Toothache is one of the most common types of pain, but the mechanisms underlying pulpitis-induced pain remain unknown. The ionotropic purinergic receptor family (P2X) is...
Toothache is one of the most common types of pain, but the mechanisms underlying pulpitis-induced pain remain unknown. The ionotropic purinergic receptor family (P2X) is reported to mediate nociception in the nervous system. This study aims to investigate the involvement of P2X3 in the sensitisation of the trigeminal ganglion (TG) and the inflammation caused by acute pulpitis. An acute tooth inflammation model was established by applying LPS to the pulp of SD rats. We found that the increased expression of P2X3 was induced by acute pulpitis. A selective P2X3 inhibitor (A-317491) reduced pain-like behavior in the maxillofacial region of rats and depressed the activation of neurons in the trigeminal ganglion induced by pulpitis. The upregulated MAPK signaling (p-p38, p-ERK1/2) expression in the ipsilateral TG induced by pulpitis could also be depressed by the application of the P2X3 inhibitor. Furthermore, the expression of markers of inflammatory processes, such as NF-κB, TNF-α and IL-1β, could be induced by acute pulpitis and deduced by the intraperitoneal injection of P2X3 antagonists. Our findings demonstrate that purinergic P2X3 receptor signaling in TG neurons contributes to pulpitis-induced pain in rats and that P2X3 signaling may be a potential therapeutic target for tooth pain.
Topics: Rats; Animals; Pulpitis; NF-kappa B; Rats, Sprague-Dawley; Pain; Signal Transduction; Inflammation; Receptors, Purinergic P2X3; Trigeminal Ganglion
PubMed: 38325814
DOI: 10.1177/17448069241234451 -
American Journal of Translational... 2024To evaluate the effectiveness of mineral trioxide aggregate (MTA) on pulpotomy in primary molars.
OBJECTIVE
To evaluate the effectiveness of mineral trioxide aggregate (MTA) on pulpotomy in primary molars.
METHODS
Two hundred and sixty-three cases (310 teeth) of children with early pulpitis of primary molars admitted between February 2019 to February 2022 were enrolled, and their clinical data were retrospectively analyzed. Of them, 130 cases with 155 teeth treated with root canal treatment were set as the control group (CG) and 133 cases with 155 teeth receiving MTA pulpotomy were set as the observation group (OG). Clinical data such as efficacy evaluation, inflammatory factor levels, postoperative adverse reactions, and quality of life (QoL) were compared.
RESULTS
After surgery, the overall response rate in the OG was statistically higher than that in the CG, while the levels of inflammatory factors in the OG were significantly lower than those in the CG (all P<0.05). Moreover, the total incidence of complications was significantly lower in OG at 3, 6, and 12 months after surgery (P=0.018, P=0.007, P=0.015, respectively). The QoL of the two groups differed insignificantly before surgery; however, after the treatment, the QoL in OG was significantly higher than those in the CG at 3, 6, and 12 months after surgery (P=0.037, P=0.012, P=0.028, respectively). Moreover, the teeth location and treatment method were independent factors of efficacy (P=0.047, P=0.001, respectively).
CONCLUSIONS
MTA pulpotomy outperformed root canal treatment for superior efficacy in children with early pulpitis of primary molars, with a positive effect on improving QoL, and patient prognosis.
PubMed: 38322556
DOI: 10.62347/XVVC1010 -
Cureus Jan 2024Mandibular molars display a wide spectrum of intricate anatomical variations among the Indian population. This case report details the diagnosis and successful...
Mandibular molars display a wide spectrum of intricate anatomical variations among the Indian population. This case report details the diagnosis and successful endodontic management of a mid-mesial canal in the mandibular first molar tooth, emphasizing the importance of radiographic imaging and meticulous instrumentation. The patient presented with symptoms of irreversible pulpitis that led to accurate relief of symptoms after shaping and cleaning protocols were followed. This case series discusses the challenges encountered during canal negotiation, cleaning, shaping, and obturation, providing insights into the complexities associated with mid-mesial canals.
PubMed: 38318573
DOI: 10.7759/cureus.51746 -
Scientific Reports Feb 2024The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable calcium silicate cement, as compared to mineral trioxide aggregate in mature permanent premolar and molar teeth with reversible pulpitis. Included teeth were randomly divided into two groups according to pulpotomy material (ProRoot MTA [PMTA] group, Endocem MTA Premixed [EPM] group). After pulp exposure, the superficial pulp was either removed to a depth of 2 mm (partial pulpotomy) or completely amputated to the level of the root canal orifice (full pulpotomy). A 3-mm layer of either material was randomly placed over the pulp wound, followed by the application of a thin layer of a light-cured glass ionomer composite liner. The restoration procedure was then carried out during the same visit. After one year of treatment, the pulpotomy success rate was 94.4% (67/71), with no significant difference between the PMTA and EPM groups. The success rate was 93.9% in the PMTA group and 97.1% in the EPM group. There were no significant factors related to the procedures. EPM is a viable alternative to PMTA for single-visit pulpotomies of permanent premolars and molars.
Topics: Humans; Calcium; Pulpotomy; Pulpitis; Calcium Compounds; Dentition, Permanent; Silicates; Glass Ionomer Cements; Calcium, Dietary; Bone Cements; Oxides; Drug Combinations; Aluminum Compounds; Treatment Outcome
PubMed: 38316823
DOI: 10.1038/s41598-024-52818-6 -
BioMed Research International 2024The present study evaluated the therapeutic effects of luteolin in alleviating pulpitis of dental pulp- (DP-) derived microvesicles (MVs) via the inhibition of protein...
AIM
The present study evaluated the therapeutic effects of luteolin in alleviating pulpitis of dental pulp- (DP-) derived microvesicles (MVs) via the inhibition of protein kinase R- (PKR-) mediated inflammation. . Proteomic analysis of immortalized human dental pulp (DP-1) cell-derived MVs was performed to identify PKR-associated molecules. The effect of luteolin on PKR phosphorylation in DP-1 cells and the expression of tumor necrosis factor- (TNF-) in THP-1 macrophage-like cells were validated. The effect of luteolin on cell proliferation was compared with that of chemical PKR inhibitors (C16 and 2-AP) and the unique commercially available sedative guaiacol-parachlorophenol. In the dog experimental pulpitis model, the pulps were treated with (1) saline, (2) guaiacol-parachlorophenol, and (3) luteolin. Sixteen teeth from four dogs were extracted, and the pulp tissues were analyzed using hematoxylin and eosin staining. Immunohistochemical staining was performed to analyze the expression of phosphorylated PKR (pPKR), myeloperoxidase (MPO), and CD68. Experimental endodontic-periodontal complex lesions were established in mouse molar through a silk ligature and simultaneous MV injection. MVs were prepared from DP-1 cells with or without pretreatment with 2-AP or luteolin. A three-dimensional microcomputed tomography analysis was performed on day 7 ( = 6). Periodontal bone resorption volumes were calculated for each group (nonligated-ligated), and the ratio of bone volume to tissue volume was measured.
RESULTS
Proteomic analysis identified an endogenous PKR activator, and a protein activator of interferon-induced PKR, also known as PACT, was included in MVs. Luteolin inhibited the expressions of pPKR in DP-1 cells and TNF- in THP-1 cells with the lowest suppression of cell proliferation. In the dog model of experimental pulpitis, luteolin treatment suppressed the expression of pPKR-, MPO-, and CD68-positive cells in pulp tissues, whereas guaiacol-parachlorophenol treatment caused coagulative necrosis and disruption. In a mouse model of endodontic-periodontal complex lesions, luteolin treatment significantly decreased MV-induced alveolar bone resorption.
CONCLUSION
Luteolin is an effective and safe compound that inhibits PKR activation in DP-derived MVs, enabling pulp preservation.
Topics: Dogs; Humans; Mice; Animals; Pulpitis; Luteolin; Tumor Necrosis Factor-alpha; X-Ray Microtomography; Proteomics; Inflammation; Alveolar Bone Loss; Guaiacol; Dental Pulp; Chlorophenols
PubMed: 38304347
DOI: 10.1155/2024/8864513 -
Alternative Therapies in Health and... Dec 2023Acute pulpitis poses a significant clinical challenge. Traditional root canal treatment has been a standard approach, and the incorporation of adjunctive therapies, such...
BACKGROUND
Acute pulpitis poses a significant clinical challenge. Traditional root canal treatment has been a standard approach, and the incorporation of adjunctive therapies, such as eugenol cement, presents a potential avenue for enhanced efficacy and reduced complications.
OBJECTIVE
This study aimed to assess the clinical efficacy of root canal treatment combined with eugenol cement for acute pulpitis and its impact on inflammatory factor levels.
DESIGN
The study employed a parallel, randomized, controlled, experimental design.
SETTING
The research was conducted at Suzhou Ninth People's Hospital.
PARTICIPANTS
A total of 92 patients diagnosed with acute pulpitis and seeking treatment at our hospital between August 2020 and November 2021 were included in the study.
INTERVENTIONS
Participants were randomly assigned to two groups with 46 patients in each group: the control group receiving traditional root canal treatment and the experimental group receiving root canal treatment combined with eugenol cement.
PRIMARY OUTCOME MEASURES
The primary outcomes assessed included (1) treatment efficiency, (2) masticatory function, (3) complications, and levels of inflammatory factors.
RESULTS
In the study, root canal treatment combined with eugenol cement showed superior efficacy (95.7% vs. 76.1%, P < .05) compared to root canal treatment alone. After one month, both groups exhibited reduced bleeding and gingival indices, with a more significant reduction in the experimental group (P < .05). The combined treatment significantly improved masticatory efficiency and occlusal strength (P < .05). The experimental group had a lower complication rate (6.5% vs. 26.1%, P < .05) and reduced inflammatory markers (IL-6, IL-8, TNF-α, LTB4) compared to the control group (P < .05).
CONCLUSIONS
Root canal treatment plus eugenol cement enhances masticatory function, reduces complications and inflammatory response in patients with acute pulpitis, alleviates dental pain and looseness, and mitigates inflammatory responses with fewer adverse effects.
PubMed: 38295310
DOI: No ID Found -
International Journal of Molecular... Jan 2024This scoping review systematically evaluates the use of systemic antibiotics in treating acute irreversible pulpitis, integrating clinical practice patterns with recent... (Review)
Review
This scoping review systematically evaluates the use of systemic antibiotics in treating acute irreversible pulpitis, integrating clinical practice patterns with recent molecular insights. We analyzed clinical evidence on antibiotic prescription trends among dental professionals and examined molecular research advancements in relation to pulpitis. This review is intended to bridge the gap between clinical practice and molecular research, guiding more evidence-based approaches to treating acute irreversible pulpitis. Electronic databases were searched for relevant articles published in English based on the objective of the review. A second search using all identified keywords and index terms was undertaken across all the included databases. In addition, a reference list of identified articles was searched. Studies including original research, systematic reviews, meta-analyses, clinical trials, and observational and retrospective studies, all written in English and published from 2010 onwards, were included, and an analysis of the text words contained in the titles and abstracts of the retrieved papers and of the index terms used to describe the articles was performed. A total of N = 53 articles were selected. Altogether, N = 43 (76.79%) articles were cross-sectional studies, N = 4 (11.11%) were systematic reviews, and N = 3 (5.36%) were guidelines. The most frequent level of evidence was level VI (N = 43 (76.79%). The mean percentage of dentists who prescribed antibiotics to treat acute irreversible pulpitis was 23.89 ± 23.74% (range: 0.05-75.7). Similarly, for specialists, it was 22.41 ± 15.64 (range 2.2-50.4), and the percentage for undergraduates was 17.52 ± 20.59 (range 0-62.6). The significant developments in research models for pulpitis research and the characterisation of biomarkers have led to better management strategies. Concurrently, significant advancements in molecular research provide new understandings of pulpitis, suggesting alternative therapeutic approaches. Although there are guidelines available, increased rates of antibiotic prescription are still prevalent around the globe.
Topics: Humans; Anti-Bacterial Agents; Pulpitis; Retrospective Studies
PubMed: 38279358
DOI: 10.3390/ijms25021357