151
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Clinical Perspective of Electrospun Nanofibers as a Drug Delivery Strategy for Regenerative Endodontics. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s40496-016-0103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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152
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Roudsari RV, Jawad S, Taylor C, Darcey J, Qualtrough A. Modern Endodontic Principles. Part 8: The Future of Endodontics. DENTAL UPDATE 2016; 43:430-441. [PMID: 27529911 DOI: 10.12968/denu.2016.43.5.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although the principles of endodontics have remained unchanged for many decades, root canal treatment has been subject to major changes in the past few years. This paper outlines the cutting-edge advances including the materials and techniques used. CPD/Clinical Relevance: This article provides an overview of bioactive materials and insight into regenerative endodontics, vital pulp therapy and intentional replantation.
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153
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Elisa G, Mario A, Maria CA, Narcisa M, Anna L, Janira R, Daminano P, Nicola S, Elio B. Confocal scanner laser evaluation of bactericidal effect of different antibiotic mixtures used for dental pulp regeneration: a preliminary study. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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154
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Žižka R, Buchta T, Voborná I, Harvan L, Šedý J. Root Maturation in Teeth Treated by Unsuccessful Revitalization: 2 Case Reports. J Endod 2016; 42:724-9. [DOI: 10.1016/j.joen.2016.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/31/2016] [Accepted: 02/08/2016] [Indexed: 12/11/2022]
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155
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156
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Widbiller M, Eidt A, Hiller KA, Buchalla W, Schmalz G, Galler KM. Ultrasonic activation of irrigants increases growth factor release from human dentine. Clin Oral Investig 2016; 21:879-888. [DOI: 10.1007/s00784-016-1824-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/13/2016] [Indexed: 11/24/2022]
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157
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Antibiofilm efficacy of photoactivated curcumin, triple and double antibiotic paste, 2% chlorhexidine and calcium hydroxide against Enterococcus fecalis in vitro. Sci Rep 2016; 6:24797. [PMID: 27097667 PMCID: PMC4838845 DOI: 10.1038/srep24797] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/05/2016] [Indexed: 01/12/2023] Open
Abstract
Root canal disinfection is one of the most important factors governing success of root canal treatment, especially when regenerative strategies are used. This study evaluated the efficacy of 5 intracanal medicaments against mature biofilms of Enterococcus fecalis in vitro: Light activated curcumin, triple antibiotic paste (TAP), double antibiotic paste (DAP), chlorhexidine, calcium hydroxide. Untreated teeth with biofilms served as controls. Confocal microscopy was used to analyse the biofilm mass and percentage of live/dead bacteria within the root canal as well as dentinal tubules. Dentinal shavings obtained from the root canal walls (at 200 and 400 microns depth) were used to quantify the colony forming units/mL. The results showed that light activated curcumin and triple antibiotic paste brought about complete disruption of the biofilm structure (P < 0.05) while chlorhexidine and calcium hydroxide were not significantly different from the control (P > 0.05). Light activated curcumin brought about the highest percentage of dead cells at both depths, but this was not significantly different from triple antibiotic paste (P > 0.05). Curcumin, TAP and DAP brought about a significant reduction of CFU/mL at both depths compared to the control and other groups (P < 0.05). Light activated curcumin brought about a 7 log reduction of bacteria at both depths.
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158
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Kahler B, Rossi-Fedele G. A Review of Tooth Discoloration after Regenerative Endodontic Therapy. J Endod 2016; 42:563-9. [DOI: 10.1016/j.joen.2015.12.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/21/2015] [Accepted: 12/22/2015] [Indexed: 12/31/2022]
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159
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Dentin Conditioning with Bioactive Molecule Releasing Nanoparticle System Enhances Adherence, Viability, and Differentiation of Stem Cells from Apical Papilla. J Endod 2016; 42:717-23. [PMID: 26960576 DOI: 10.1016/j.joen.2016.01.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/30/2016] [Accepted: 01/30/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Temporal-controlled bioactive molecule (BM) releasing systems allow the delivery of appropriate concentration of BM to enhance the interaction of stem cells to dentin matrix and subsequent odontogenic differentiation in regenerative endodontics. OBJECTIVES The goal of this study was to evaluate the effect of dentin conditioning with 2 variants of dexamethasone (Dex) releasing chitosan nanoparticles (CSnp), (1) Dex-CSnpI (slow releasing) and (2) Dex-CSnpII (rapid releasing), on adherence, viability, and differentiation of stem cells from apical papilla (SCAP) on root dentin exposed to endodontic irrigants. METHODS Slab-shaped dentin specimens were prepared parallel to the root canal and treated with 5.25% sodium hypochlorite (NaOCl) for 10 minutes and/or 17% EDTA for 2 minutes. Dentin was then conditioned accordingly by (1) no nanoparticle treatment, (2) CSnp, (3) Dex-CSnpI, and (4) Dex-CSnpII. The effect of nanoparticle conditioning on SCAP viability was determined by cell count and a circularity index. SCAP adherence and viability on dentin were assessed by fluorescence and scanning electron microscopy and odontogenic differentiation by immunofluorescence. RESULTS SCAP on dentin treated with NaOCl alone or NaOCl as the last irrigant showed the least adherence, minimal cytoplasmic extensions, and higher circularity. SCAP adherence and viability on Dex-CSnpI and Dex-CSnpII conditioned dentin were increased and had a well-developed cytoplasmic matrix and significantly lower circularity (P < .05). SCAP cultured in Dex-CSnpII group expressed higher levels for DSPP and DMP-1 than in CSnp or Dex-CSnpI groups. CONCLUSIONS Dex-CSnpI and Dex-CSnpII conditioning of dentin enhanced SCAP adherence and viability. Temporal-controlled release of Dex from Dex-CSnpII enhanced odontogenic differentiation of SCAP. This study highlighted the ability of dentin conditioning with temporal-controlled BM releasing nanoparticles to improve the local environment in regenerative endodontics.
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Regeneration and Repair in Endodontics-A Special Issue of the Regenerative Endodontics-A New Era in Clinical Endodontics. Dent J (Basel) 2016; 4:dj4010003. [PMID: 29563445 PMCID: PMC5851202 DOI: 10.3390/dj4010003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/05/2016] [Accepted: 02/22/2016] [Indexed: 12/27/2022] Open
Abstract
Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis.
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Tagelsir A, Yassen GH, Gomez GF, Gregory RL. Effect of Antimicrobials Used in Regenerative Endodontic Procedures on 3-week-old Enterococcus faecalis Biofilm. J Endod 2016; 42:258-62. [DOI: 10.1016/j.joen.2015.09.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 12/31/2022]
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162
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Priya M H, Tambakad PB, Naidu J. Pulp and Periodontal Regeneration of an Avulsed Permanent Mature Incisor Using Platelet-rich Plasma after Delayed Replantation: A 12-month Clinical Case Study. J Endod 2016; 42:66-71. [DOI: 10.1016/j.joen.2015.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 07/03/2015] [Accepted: 07/24/2015] [Indexed: 01/09/2023]
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163
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Dhillon H, Kaushik M, Sharma R. Regenerative endodontics--Creating new horizons. J Biomed Mater Res B Appl Biomater 2015; 104:676-85. [PMID: 26699211 DOI: 10.1002/jbm.b.33587] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/05/2015] [Accepted: 11/18/2015] [Indexed: 12/28/2022]
Abstract
Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics.
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Affiliation(s)
- Harnoor Dhillon
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, India
| | - Mamta Kaushik
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, India
| | - Roshni Sharma
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, India
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Attachment Ability of Human Apical Papilla Cells to Root Dentin Surfaces Treated with Either 3Mix or Calcium Hydroxide. J Endod 2015; 42:89-94. [PMID: 26454719 DOI: 10.1016/j.joen.2015.08.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/07/2015] [Accepted: 08/27/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Tissue regeneration and root continuation are the ultimate goals in regenerative endodontics. Apical papilla cells (APCs) have been hypothesized to play roles in those processes. Therefore, preservation of cell vitality and promoting initial cell attachment seem to be crucial steps. The purposes of this study were to investigate the attachment ability and morphology of viable human APCs by using fibronectin immunofluoresence, alamarBlue assay, and scanning electron microscopy, when APCs were grown on human root dentin surfaces treated with 3Mix or calcium hydroxide (Ca(OH)2) at different concentrations. METHODS Human root dentin slices were divided into 6 groups: (1) control, (2) 3Mix 0.39 μg/mL, (3) 3Mix 100 μg/mL, (4) 3Mix paste, (5) Ca(OH)2 1 mg/mL, and (6) Ca(OH)2 1000 mg/mL. All samples were separately treated for 7 days and final rinsed with 17% EDTA. Then primary human APCs were seeded. Fibronectin immunofluorescence was used to evaluate the attachment ability of APCs on treated dentin. A vitality assay by using alamarBlue was monitored at specific time intervals. The morphology of the cells on the dentin was observed under scanning electron microscopy. RESULTS The lowest number of fibronectin-positive cells was observed on root dentin treated with 3Mix paste (P < .05). The 3Mix at 0.39 and 100 μg/mL did not affect the amount of APC attachment, whereas the viability of APCs on the dentin surface was significantly lower in the 100-μg/mL 3Mix-treated group than in the negative control group (P < .05). Both concentrations of Ca(OH)2 induced APC attachment (P < .05). Moreover, only cells grown on the surfaces treated with Ca(OH)2 exhibited cytoplasmic processes. CONCLUSIONS Human root dentin treated with 3Mix paste had significantly lower APC attachment. The 3Mix at 0.39 μg/mL and 100 μg/mL had no significant negative effect on APC attachment on dentin. Higher numbers of cells attaching on dentin were observed in calcium hydroxide-treated groups.
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165
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Meschi N, Hilkens P, Lambrichts I, Van den Eynde K, Mavridou A, Strijbos O, De Ketelaere M, Van Gorp G, Lambrechts P. Regenerative endodontic procedure of an infected immature permanent human tooth: an immunohistological study. Clin Oral Investig 2015; 20:807-14. [DOI: 10.1007/s00784-015-1555-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 07/28/2015] [Indexed: 11/27/2022]
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166
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Rodríguez-Benítez S, Stambolsky C, Gutiérrez-Pérez JL, Torres-Lagares D, Segura-Egea JJ. Pulp Revascularization of Immature Dog Teeth with Apical Periodontitis Using Triantibiotic Paste and Platelet-rich Plasma: A Radiographic Study. J Endod 2015; 41:1299-304. [DOI: 10.1016/j.joen.2015.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/30/2015] [Accepted: 05/08/2015] [Indexed: 01/12/2023]
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167
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Chrepa V, Henry MA, Daniel BJ, Diogenes A. Delivery of Apical Mesenchymal Stem Cells into Root Canals of Mature Teeth. J Dent Res 2015. [PMID: 26195498 DOI: 10.1177/0022034515596527] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Regenerative endodontic procedures are stem cell-based treatments for immature teeth with pulp necrosis. The translation of regenerative endodontic procedures into treating mature teeth depends, among other factors, on the availability and delivery of mesenchymal stem cells (MSCs) into the root canal system. The aim of this clinical study was to evaluate whether evoked bleeding from the periapical tissues elicits the influx of MSCs into the root canal system in mature teeth with apical lesions. Participants included in this study (N = 20) were referred for endodontic treatment of mature teeth with apical lesions. Following chemomechanical debridement, intracanal bleeding from the periapical tissues was achieved, and intracanal blood samples were collected. A positive blood aspirate was also collected in the cartridges during local anesthesia. Total RNA was isolated and used as a template in quantitative reverse transcription polymerase chain reactions using MSC-specific arrays. Data were analyzed with the Wilcoxon signed-rank test, and correlation between gene expression and sex or age was tested with Spearman's rank correlation coefficient test. In addition, MSCs were isolated from an intracanal bleeding sample and subjected to flow cytometry and quantitative osteogenesis assay. Last, the presence and distribution of MSCs within periradicular lesions were evaluated with immunohistochemistry (n = 4). The MSC markers CD73, CD90, CD105, and CD146 were significantly upregulated, with median fold change values of 2.9, 31.7, 4.6, and 6.8, respectively. Conversely, the negative marker for MSCs, CD45, was significantly downregulated (median, -2.7). There was no correlation with age, sex, tooth type, or treatment for any of the evaluated genes. Isolated intracanal cells coexpressed MSC markers and demonstrated robust mineralizing differentiation potential. Finally, immunohistochemical analysis revealed that MSCs were found compartmentalized mainly within vasculature structures located in periapical lesions. Collectively, findings indicate that the evoked-bleeding technique delivers MSCs into the root canal system in mature teeth with apical lesions.
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Affiliation(s)
- V Chrepa
- Department of Endodontics at the University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - M A Henry
- Department of Endodontics at the University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - B J Daniel
- Department of Microbiology and Immunology at the University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - A Diogenes
- Department of Endodontics at the University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Sabrah AH, Yassen GH, Spolnik KJ, Hara AT, Platt JA, Gregory RL. Evaluation of Residual Antibacterial Effect of Human Radicular Dentin Treated with Triple and Double Antibiotic Pastes. J Endod 2015; 41:1081-4. [DOI: 10.1016/j.joen.2015.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/12/2015] [Accepted: 03/02/2015] [Indexed: 02/04/2023]
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169
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Kim KW, Yassen GH, Ehrlich Y, Spolnik K, Platt JA, Windsor LJ. The effects of radicular dentine treated with double antibiotic paste and ethylenediaminetetraacetic acid on the attachment and proliferation of dental pulp stem cells. Dent Traumatol 2015; 31:374-9. [PMID: 26040200 DOI: 10.1111/edt.12181] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 11/29/2022]
Abstract
AIM This study explored the effects of dentine treated with two concentrations of double antibiotic paste (DAP) and ethylenediaminetetraacetic acid (EDTA) on the attachment and proliferation of dental pulp stem cells (DPSCs). MATERIALS AND METHODS Radicular dentine samples were prepared with identical dimensions and randomized into six groups (n = 4). Four groups were treated with double antibiotic paste (DAP) at concentrations of 500 mg ml(-1) or 1 mg ml(-1) with or without EDTA. The other two groups were treated with EDTA only or received no treatment. DPSCs were seeded on each dentine sample (10 000 cells per sample). Lactate dehydrogenase activity assays were used to calculate the attached DPSCs after 1 day of incubation. Water soluble tetrazolium assays were performed to investigate DPSCs proliferation on the treated dentine samples after three additional days of incubation. Two-way anova followed by Tukey-Kramer tests was used for statistical analyses (α = 0.05). RESULTS Dentine treated with 1 or 500 mg ml(-1) of DAP followed by EDTA caused significant increases in DPSCs attachment compared to the dentine treated with the DAP alone. The 500 mg ml(-1) of DAP with or without EDTA caused significant reductions in DPSCs proliferation. However, the treatment of dentine with 1 mg ml(-1) of DAP did not have significant negative effects on DPSCs proliferation regardless of the use of EDTA. CONCLUSION The use of 1 mg ml(-1) of DAP followed by 10 min of irrigation with EDTA in endodontic regeneration procedure may have no negative effects on the attachment and proliferation of DPSCs.
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Affiliation(s)
- Ki Wan Kim
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Ghaeth H Yassen
- Division of Dental Biomaterials, Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Ygal Ehrlich
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Kenneth Spolnik
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Jeffrey A Platt
- Division of Dental Biomaterials, Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - L Jack Windsor
- Department of Oral Biology, Indiana University School of Dentistry, Indianapolis, IN, USA
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Effect of Different Endodontic Regeneration Protocols on Wettability, Roughness, and Chemical Composition of Surface Dentin. J Endod 2015; 41:956-60. [DOI: 10.1016/j.joen.2015.02.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/04/2015] [Accepted: 02/15/2015] [Indexed: 11/20/2022]
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171
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Revitalization of Open Apex Teeth with Apical Periodontitis Using a Collagen-Hydroxyapatite Scaffold. J Endod 2015; 41:966-73. [DOI: 10.1016/j.joen.2014.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/28/2014] [Accepted: 12/13/2014] [Indexed: 11/22/2022]
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172
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Haapasalo M, Parhar M, Huang X, Wei X, Lin J, Shen Y. Clinical use of bioceramic materials. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/etp.12078] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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173
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CXC Chemokine Receptor 4 Is Expressed Paravascularly in Apical Papilla and Coordinates with Stromal Cell-derived Factor-1α during Transmigration of Stem Cells from Apical Papilla. J Endod 2015; 41:1430-6. [PMID: 26003008 DOI: 10.1016/j.joen.2015.04.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 02/28/2015] [Accepted: 04/03/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Stem cells from the apical papilla (SCAPs) at the apex may be attracted into the root canal space as a cell source for pulp-dentin regeneration. To test this possibility, we used in vitro transmigration models to investigate whether SCAPs can be chemoattracted by the delivery of the chemotactic cytokine stromal cell-derived factor-1α (SDF-1α). METHODS We first examined the expression of CXC chemokine receptor 4 (CXCR4) for SDF-1α in the apical papilla and in cultured SCAPs using immunofluorescence, reverse-transcription polymerase chain reaction (RT-PCR), and flow cytometric analyses. A standard Transwell migration assay and a 3-dimensional cell migration assay were used to analyze transmigration of SCAPs via the SDF-1α/CXCR4 axis. RESULTS CXCR4 was expressed in the paravascular region of the apical papilla and detected in SCAP cultures. Most cultured SCAPs harbored intracellular CXCR4 (58%-99%, n = 4), whereas only a few cells had detectable CXCR4 on the cell surface (0.3%-2.34%, n = 4). Although SDF-1α had no significant effect on SCAP proliferation, it significantly promoted a higher number of migrated cells; this effect was abolished by anti-CXCR4 antibodies. Interestingly, cell surface CXCR4 on SCAPs was not detectable until after transmigration. The 3-dimensional migration assay revealed that SDF-1α significantly enhanced SCAP migration in the collagen gel. CONCLUSIONS SCAPs can be chemoattracted via the SDF-1α/CXCR4 axis, suggesting that SDF-1α may be used clinically to induce CXCR4-expressing SCAPs in the apical papilla to transmigrate into the root canal space as an endogenous cell source for pulp regeneration.
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Hilkens P, Meschi N, Lambrechts P, Bronckaers A, Lambrichts I. Dental Stem Cells in Pulp Regeneration: Near Future or Long Road Ahead? Stem Cells Dev 2015; 24:1610-22. [PMID: 25869156 DOI: 10.1089/scd.2014.0510] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although regenerative endodontic procedures have yielded an impressive body of favorable outcomes, the treatment of necrotic immature permanent teeth in particular remains to be a challenge. Recent advances in dental stem cell (DSC) research have gained increasing insight in their regenerative potential and prospective use in the formation of viable dental tissues. Numerous studies have already reported successful dental pulp regeneration following application of dental pulp stem cells, stem cells from the apical papilla, or dental follicle precursor cells in different in vivo models. Next to responsive cells, dental tissue engineering also requires the support of an appropriate scaffold material, ranging from naturally occurring polymers to treated dentin matrix components. However, the routine use and banking of DSCs still holds some major challenges, such as culture-associated differences, patient-related variability, and the effects of culture medium additives. Only in-depth evaluation of these problems and the implementation of standardized models and protocols will effectively lead to better alternatives for patients who no longer benefit from current treatment protocols.
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Affiliation(s)
- Petra Hilkens
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
| | - Nastaran Meschi
- 2 Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Leuven, Belgium
| | - Paul Lambrechts
- 2 Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven , Leuven, Belgium
| | - Annelies Bronckaers
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
| | - Ivo Lambrichts
- 1 Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University , Diepenbeek, Belgium
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Shrestha S, Diogenes A, Kishen A. Temporal-controlled Dexamethasone Releasing Chitosan Nanoparticle System Enhances Odontogenic Differentiation of Stem Cells from Apical Papilla. J Endod 2015; 41:1253-8. [PMID: 25956605 DOI: 10.1016/j.joen.2015.03.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/26/2015] [Accepted: 03/29/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The spatial and temporal control of stem cell differentiation into odontoblast-like cells remains one of the major challenges in regenerative endodontic procedures. The current study aims to synthesize and compare the effect of dexamethasone (Dex) release from 2 variants of Dex-loaded chitosan nanoparticles (CSnp) on the odontogenic differentiation of stem cells from apical papilla (SCAP). METHODS Two variants of Dex-loaded CSnp were synthesized by encapsulation (Dex-CSnpI) and adsorption (Dex-CSnpII) methods. The physicochemical characterization of Dex-CSnpI and Dex-CSnpII was assessed by transmission electron microscopy, Zetasizer, and Fourier transform infrared spectroscopy, whereas the Dex release kinetics was assessed by spectrophotometry. A previously characterized SCAP cell line was cultured onto CSnp, Dex-CSnpI, or Dex-CSnpII. The biomineralization potential was determined by alizarin red staining. Alkaline phosphatase, dentin sialophosphoprotein, and dentin matrix protein-1 gene expressions were analyzed by real-time reverse-transcription polymerase chain reaction. RESULTS Dex-CSnpI resulted in slower release of Dex compared with Dex-CSnpII, but both demonstrated sustained release of Dex for 4 weeks. Biomineralization of SCAP was significantly higher (P < .05) in presence of Dex-CSnpII compared with that in Dex-CSnpI at 3 weeks. Alkaline phosphatase gene expression was significantly higher in the presence of Dex-CSnpII compared with Dex-CSnpI, with peak expression seen at 2 weeks (P < .05). The expression of odontogenic specific marker dentin matrix protein-1 was significantly higher in presence of Dex-CSnpII compared with Dex-CSnpI at 3 weeks (P < .05). CONCLUSIONS Collectively, these data suggest that sustained release of Dex results in enhanced odontogenic differentiation of SCAP. These findings highlight the potential of temporal-controlled delivery of bioactive molecules to direct the spatial- and temporal-controlled odontogenic differentiation of dental stem cells.
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Affiliation(s)
- Suja Shrestha
- Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Anil Kishen
- Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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Saoud TMA, Zaazou A, Nabil A, Moussa S, Aly HM, Okazaki K, Rosenberg PA, Lin LM. Histological observations of pulpal replacement tissue in immature dog teeth after revascularization of infected pulps. Dent Traumatol 2015; 31:243-9. [DOI: 10.1111/edt.12169] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 01/09/2023]
Affiliation(s)
| | - Ashraf Zaazou
- Faculty of Dentistry; Alexandria University; Alexandria Egypt
| | - Ahmed Nabil
- Faculty of Dentistry; Alexandria University; Alexandria Egypt
| | - Sybel Moussa
- Faculty of Dentistry; Alexandria University; Alexandria Egypt
| | | | | | | | - Louis M. Lin
- College of Dentistry; New York University; New York NY USA
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177
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Akman M, Akbulut MB, Aydınbelge HA, Belli S. Comparison of different irrigation activation regimens and conventional irrigation techniques for the removal of modified triple antibiotic paste from root canals. J Endod 2015; 41:720-4. [PMID: 25747378 DOI: 10.1016/j.joen.2015.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 12/23/2014] [Accepted: 01/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of this study was to compare the efficacy of irrigation activation regimens and conventional syringe irrigation technique in the removal of modified triple antibiotic paste (mTAP) from root canal walls. METHODS Fifty-six extracted human mandibular premolars were prepared using ProTaper rotary files (Dentsply Maillefer, Ballaigues, Switzerland) up to size F4. The root canals were filled with mTAP medicament, and after 21 days, the roots were randomly assigned to 5 groups (n = 10) according to the irrigation regimens used: conventional syringe irrigation (CI), Self-Adjusting File (SAF; ReDent-Nova, Ra'anana, Israel), EndoVac (Discus Dental, Culver City, CA), EndoActivator (Dentsply, Tulsa, OK), and passive ultrasonic irrigation (PUI). In 3 teeth, mTAP was not removed (positive controls), and another 3 teeth were not filled with mTAP (negative controls). The roots were sectioned, and the amount of remaining medicament at each root half (n = 20) was evaluated at 30× magnification using a 4-grade scoring system. Data were evaluated using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS There were statistically significant differences among all experimental groups; of which, the CI group was the significantly least efficient in removing mTAP from the root canal (P < .05). At the apical and middle third, the PUI, SAF, EndoVac, and EndoActivator groups removed significantly more mTAP medicament than the CI group (P < .05); however, there were no significant differences between these groups (P > .05). The SAF and PUI showed significantly better performances in removing mTAP from the coronal third (P < .05). CONCLUSIONS The use of irrigation activation regimens significantly improves the removal of mTAP from root canals when compared with CI.
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Affiliation(s)
- Melek Akman
- Department of Endodontics, Faculty of Dentistry, University of Necmettin Erbakan, Konya, Turkey.
| | - Makbule Bilge Akbulut
- Department of Endodontics, Faculty of Dentistry, University of Necmettin Erbakan, Konya, Turkey
| | - Hale Arı Aydınbelge
- Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey
| | - Sema Belli
- Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey
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The effect of diluted triple and double antibiotic pastes on dental pulp stem cells and established Enterococcus faecalis biofilm. Clin Oral Investig 2015; 19:2059-66. [DOI: 10.1007/s00784-015-1423-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 02/02/2015] [Indexed: 01/12/2023]
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179
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Kirchhoff AL, Raldi DP, Salles AC, Cunha RS, Mello I. Tooth discolouration and internal bleaching after the use of triple antibiotic paste. Int Endod J 2015; 48:1181-7. [DOI: 10.1111/iej.12423] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/11/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A. L. Kirchhoff
- Division of Endodontics; Pontificia Universidade Catolica do Parana; Curitiba Brazil
| | - D. P. Raldi
- Department of Dentistry; University of Taubate; Taubate Brazil
| | - A. C. Salles
- Division of Pediatric Dentistry; College of Dentistry; University of Manitoba; Winnipeg MB Canada
| | - R. S. Cunha
- Division of Endodontics; College of Dentistry; University of Manitoba; Winnipeg MB Canada
| | - I. Mello
- Division of Endodontics; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
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180
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Nerness AZ, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effect of triple antibiotic paste with or without ethylenediaminetetraacetic acid on surface loss and surface roughness of radicular dentine. Odontology 2015; 104:170-5. [DOI: 10.1007/s10266-014-0191-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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181
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A. Algarni A, H. Yassen G, L. Gregory R. Inhibitory effect of gels loaded with a low concentration of antibiotics against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis . J Oral Sci 2015; 57:213-8. [DOI: 10.2334/josnusd.57.213] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Amnah A. Algarni
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry
| | - Ghaeth H. Yassen
- Division of Dental Biomaterials, Department of Restorative Dentistry, Indiana University School of Dentistry
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182
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Yassen GH, Eckert GJ, Platt JA. Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restor Dent Endod 2014; 40:104-12. [PMID: 25984471 PMCID: PMC4432252 DOI: 10.5395/rde.2015.40.2.104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/03/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives This study was performed to investigate the effects of different intracanal medicaments on chemical structure and microhardness of dentin. Materials and Methods Fifty human dentin discs were obtained from intact third molars and randomly assigned into two control groups and three treatment groups. The first control group received no treatment. The second control group (no medicament group) was irrigated with sodium hypochlorite (NaOCl), stored in humid environment for four weeks and then irrigated with ethylenediaminetetraacetic acid (EDTA). The three treatment groups were irrigated with NaOCl, treated for four weeks with either 1 g/mL triple antibiotic paste (TAP), 1 mg/mL methylcellulose-based triple antibiotic paste (DTAP), or calcium hydroxide [Ca(OH)2] and finally irrigated with EDTA. After treatment, one half of each dentin disc was subjected to Vickers microhardness (n = 10 per group) and the other half was used to evaluate the chemical structure (phosphate/amide I ratio) of treated dentin utilizing attenuated total reflection Fourier transform infrared spectroscopy (n = 5 per group). One-way ANOVA followed by Fisher's least significant difference were used for statistical analyses. Results Dentin discs treated with different intracanal medicaments and those treated with NaOCl + EDTA showed significant reduction in microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.05) compared to no treatment control dentin. Furthermore, dentin discs treated with TAP had significantly lower microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.0001) compared to all other groups. Conclusions The use of DTAP or Ca(OH)2 medicaments during endodontic regeneration may cause significantly less microhardness reduction and superficial demineralization of dentin compared to the use of TAP.
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Affiliation(s)
- Ghaeth Hamdon Yassen
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - George Joseph Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jeffrey Allen Platt
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN, USA
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Albuquerque MTP, Valera MC, Nakashima M, Nör JE, Bottino MC. Tissue-engineering-based strategies for regenerative endodontics. J Dent Res 2014; 93:1222-31. [PMID: 25201917 PMCID: PMC4237634 DOI: 10.1177/0022034514549809] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/04/2014] [Accepted: 08/09/2014] [Indexed: 01/06/2023] Open
Abstract
Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on their potential translation to clinical settings.
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Affiliation(s)
- M T P Albuquerque
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN 46202, USA Department of Restorative Dentistry, Division of Endodontics, Universidade Estadual Paulista, São José dos Campos Dental School, São José dos Campos, São Paulo, 12245-000, Brazil
| | - M C Valera
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
| | - M Nakashima
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Research Institute, Obu, Aichi, 474-8511, Japan
| | - J E Nör
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - M C Bottino
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
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184
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Saoud TMA, Zaazou A, Nabil A, Moussa S, Lin LM, Gibbs JL. Clinical and radiographic outcomes of traumatized immature permanent necrotic teeth after revascularization/revitalization therapy. J Endod 2014; 40:1946-52. [PMID: 25443280 DOI: 10.1016/j.joen.2014.08.023] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 08/20/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Revascularization treatment is rapidly becoming an accepted treatment alternative for the management of endodontic pathology in immature permanent teeth with necrotic dental pulps. However, the success and timing of clinical resolution of symptoms, and radiographic outcomes of interest, such as continued hard tissue deposition within the root, are largely unknown. METHODS In this prospective cohort study, 20 teeth were treated with a standardized revascularization treatment protocol and monitored for clinical and radiographic changes for 1 year. Standardized radiographs were collected at regular intervals, and radiographic changes were quantified. RESULTS All 20 treated teeth survived during the 12-month follow-up period, and all 20 also met the clinical criteria for success at 12 months. As a group, the treated teeth showed a statistically significant increase in radiographic root width and length and a decrease in apical diameter, although the changes in many cases were quite small (such that the clinical significance is unclear). The within-case percent change in apical diameter after 3 months was 16% and had increased to 79% by 12 months, with 55% (11/20) showing complete apical closure. The within-case percent change in root length averaged less than 1% at 3 months and increased to 5% at 12 months. The within-case percent change in root thickness averaged 3% at 3 months and 21% at 12 months. CONCLUSIONS Although clinical success was highly predictable with this procedure, clinically meaningful radiographic root thickening and lengthening are less predictable after 1-year of follow-up. Apical closure is the most consistent radiographic finding.
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Affiliation(s)
- Tarek Mohamed A Saoud
- Faculty of Dentistry, Department of Endodontics, University of Benghazi, Benghazi, Libya
| | - Ashraf Zaazou
- Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt
| | - Ahmed Nabil
- Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt
| | - Sybel Moussa
- Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt
| | - Louis M Lin
- Department of Endodontics, College of Dentistry, New York University, New York, New York
| | - Jennifer L Gibbs
- Department of Endodontics, College of Dentistry, New York University, New York, New York.
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185
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Saoud TMA, Sigurdsson A, Rosenberg PA, Lin LM, Ricucci D. Treatment of a large cystlike inflammatory periapical lesion associated with mature necrotic teeth using regenerative endodontic therapy. J Endod 2014; 40:2081-6. [PMID: 25292168 DOI: 10.1016/j.joen.2014.07.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/08/2014] [Accepted: 07/20/2014] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Regenerative endodontic therapy is currently used to treat immature permanent teeth with necrotic pulp and/or apical periodontitis. However, mature teeth with necrotic pulp and apical periodontitis have also been treated using regenerative endodontic therapy. The treatment resulted in resolution of apical periodontitis, regression of clinical signs and symptoms but no apparent thickening of the canal walls, and/or continued root development. A recent study in an animal model showed that the tissues formed in the canals of mature teeth with apical periodontitis after regenerative endodontic therapy were cementumlike, bonelike, and periodontal ligament-like tissue with numerous blood vessels. These tissues are similar to the tissues observed in immature permanent teeth with apical periodontitis after regenerative endodontic therapy. METHODS A 23-year-old woman had a history of traumatic injury to her upper anterior teeth when she was 8 years old. Subsequently, #8 developed pulp necrosis and an acute apical abscess and #7 symptomatic apical periodontitis. The apex of #8 was slightly open, and the apex of #7 was completely formed. Instead of nonsurgical root canal therapy, regenerative endodontic therapy was attempted, including complete chemomechanical debridement on #8 and #7. This was based on the premise that filling of disinfected root canals with the host's biological vital tissue might be better than filling with foreign materials. RESULTS After regenerative endodontic therapy of #8 and #7, there was radiographic evidence of periapical osseous healing and regression of clinical signs and symptoms. The pulp cavity of #8 decreased in size, and the apex closed. The pulp cavity of #7 appeared to be obliterated by mineralized tissue. These indicated ingrowth of new vital tissue into the chemomechanically debrided canals. CONCLUSIONS Regenerative endodontic therapy of mature teeth with apical periodontitis and apical abscess can result in the regression of clinical signs and/or symptoms and healing of apical periodontitis but no apparent thickening of the canal walls or continued root development. Filling of the disinfected canals with the host's vital tissue may be better than with foreign materials because vital tissue has innate and adaptive immune defense mechanisms.
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Affiliation(s)
- Tarek Mohamed A Saoud
- Department of Endodontics, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Asgeir Sigurdsson
- Department of Endodontics, College of Dentistry, New York University, New York, New York
| | - Paul A Rosenberg
- Department of Endodontics, College of Dentistry, New York University, New York, New York
| | - Louis M Lin
- Department of Endodontics, College of Dentistry, New York University, New York, New York.
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Lambricht L, De Berdt P, Vanacker J, Leprince J, Diogenes A, Goldansaz H, Bouzin C, Préat V, Dupont-Gillain C, des Rieux A. The type and composition of alginate and hyaluronic-based hydrogels influence the viability of stem cells of the apical papilla. Dent Mater 2014; 30:e349-61. [PMID: 25182372 DOI: 10.1016/j.dental.2014.08.369] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 07/08/2014] [Accepted: 08/08/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The goal of the present work was to evaluate in vitro and in vivo the influence of various types and compositions of natural hydrogels on the viability and metabolic activity of SCAPs. METHODS Two alginate, three hyaluronic-based (Corgel™) hydrogel formulations and Matrigel were characterized for their mechanical, surface and microstructure properties using rheology, X-ray photoelectron spectroscopy and scanning electron microscopy, respectively. A characterized SCAP cell line (RP89 cells) was encapsulated in the different experimental hydrogel formulations. Cells were cultured in vitro, or implanted in cyclosporine treated mice. In vitro cell viability was evaluated using a Live/Dead assay and in vitro cellular metabolic activity was evaluated with a MTS assay. In vivo cell apoptosis was evaluated by a TUNEL test and RP89 cells were identified by human mitochondria immunostaining. RESULTS Hydrogel composition influenced their mechanical and surface properties, and their microstructure. In vitro cell viability was above 80% after 2 days but decreased significantly after 7 days (60-40%). Viability at day 7 was the highest in Matrigel (70%) and then in Corgel 1.5 (60%). Metabolic activity increased over time in all the hydrogels, excepted in alginate SLM. SCAPs survived after 1 week in vivo with low apoptosis (<1%). The highest number of RP89 cells was found in Corgel 5.5 (140cells/mm(2)). SIGNIFICANCE Collectively, these data demonstrate that SCAP viability was directly modulated by hydrogel composition and suggest that a commercially available hyaluronic acid-based formulation might be a suitable delivery vehicle for SCAP-based dental pulp regeneration strategies.
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Affiliation(s)
- Laure Lambricht
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium
| | - Pauline De Berdt
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium
| | - Julie Vanacker
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium
| | - Julian Leprince
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium
| | - Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hadi Goldansaz
- Université catholique de Louvain, Institute of Condensed Matter and Nanosciences, Bio- and Soft Matter Unit, 1348 Louvain-la-Neuve, Belgium
| | - Caroline Bouzin
- Université catholique de Louvain, Institut de Recherche Expérimentale, 1200 Brussels, Belgium
| | - Véronique Préat
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium
| | - Christine Dupont-Gillain
- Université catholique de Louvain, Institute of Condensed Matter and Nanosciences, Bio- and Soft Matter Unit, 1348 Louvain-la-Neuve, Belgium
| | - Anne des Rieux
- Université catholique de Louvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, 1200 Brussels, Belgium.
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McCabe P. Revascularization of an immature tooth with apical periodontitis using a single visit protocol: a case report. Int Endod J 2014; 48:484-97. [DOI: 10.1111/iej.12344] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 07/23/2014] [Indexed: 01/30/2023]
Affiliation(s)
- P. McCabe
- The Oranhill Dental Suite; Oranmore, Co.; Galway Ireland
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188
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Berkhoff JA, Chen PB, Teixeira FB, Diogenes A. Evaluation of Triple Antibiotic Paste Removal by Different Irrigation Procedures. J Endod 2014; 40:1172-7. [DOI: 10.1016/j.joen.2013.12.027] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/08/2013] [Accepted: 12/29/2013] [Indexed: 11/28/2022]
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Vanacker J, Viswanath A, De Berdt P, Everard A, Cani PD, Bouzin C, Feron O, Diogenes A, Leprince JG, des Rieux A. Hypoxia modulates the differentiation potential of stem cells of the apical papilla. J Endod 2014; 40:1410-8. [PMID: 25146023 DOI: 10.1016/j.joen.2014.04.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 04/23/2014] [Accepted: 04/28/2014] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Stem cells from the apical papilla (SCAP) are a population of mesenchymal stem cells likely involved in regenerative endodontic procedures and have potential use as therapeutic agents in other tissues. In these situations, SCAP are exposed to hypoxic conditions either within a root canal devoid of an adequate blood supply or in a scaffold material immediately after implantation. However, the effect of hypoxia on SCAP proliferation and differentiation is largely unknown. Therefore, the objective of this study was to evaluate the effect of hypoxia on the fate of SCAP. METHODS SCAP were cultured under normoxia (21% O2) or hypoxia (1% O2) in basal or differentiation media. Cellular proliferation, gene expression, differentiation, and protein secretion were analyzed by live imaging, quantitative reverse-transcriptase polymerase chain reaction, cellular staining, and enzyme-linked immunosorbent assay, respectively. RESULTS Hypoxia had no effect on SCAP proliferation, but it evoked the up-regulation of genes specific for osteogenic differentiation (runt-related transcription factor 2, alkaline phosphatase, and transforming growth factor-β1), neuronal differentiation ( 2'-3'-cyclic nucleotide 3' phosphodiesterase, SNAIL, neuronspecific enolase, glial cell-derived neurotrophic factor and neurotrophin 3), and angiogenesis (vascular endothelial growth factor A and B). Hypoxia also increased the sustained production of VEGFa by SCAP. Moreover, hypoxia augmented the neuronal differentiation of SCAP in the presence of differentiation exogenous factors as detected by the up-regulation of NSE, VEGFB, and GDNF and the expression of neuronal markers (PanF and NeuN). CONCLUSIONS This study shows that hypoxia induces spontaneous differentiation of SCAP into osteogenic and neurogenic lineages while maintaining the release of the proangiogenic factor VEGFa. This highlights the potential of SCAP to promote pulp-dentin regeneration. Moreover, SCAP may represent potential therapeutic agents for neurodegenerative conditions because of their robust differentiation potential.
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Affiliation(s)
- Julie Vanacker
- Pharmaceutics and Drug Delivery Unit, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| | - Aiswarya Viswanath
- Pharmaceutics and Drug Delivery Unit, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Pauline De Berdt
- Pharmaceutics and Drug Delivery Unit, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Amandine Everard
- Metabolism and Nutrition Research Group, WELBIO (Walloon Excellence in Life Sciences and BIOtechnology), Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Patrice D Cani
- Metabolism and Nutrition Research Group, WELBIO (Walloon Excellence in Life Sciences and BIOtechnology), Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Caroline Bouzin
- Pole of Pharmacology, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | - Olivier Feron
- Pole of Pharmacology, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | - Anibal Diogenes
- University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Julian G Leprince
- Pharmaceutics and Drug Delivery Unit, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Anne des Rieux
- Pharmaceutics and Drug Delivery Unit, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
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Nagata JY, Figueiredo de Almeida Gomes BP, Rocha Lima TF, Murakami LS, de Faria DE, Campos GR, de Souza-Filho FJ, Soares ADJ. Traumatized Immature Teeth Treated with 2 Protocols of Pulp Revascularization. J Endod 2014; 40:606-12. [DOI: 10.1016/j.joen.2014.01.032] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 01/13/2014] [Accepted: 01/20/2014] [Indexed: 12/29/2022]
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Althumairy RI, Teixeira FB, Diogenes A. Effect of Dentin Conditioning with Intracanal Medicaments on Survival of Stem Cells of Apical Papilla. J Endod 2014; 40:521-5. [DOI: 10.1016/j.joen.2013.11.008] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 10/25/2022]
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Hargreaves KM, Diogenes A, Teixeira FB. Paradigm Lost: A Perspective on the Design and Interpretation of Regenerative Endodontic Research. J Endod 2014; 40:S65-9. [DOI: 10.1016/j.joen.2014.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Yan M, Wu J, Yu Y, Wang Y, Xie L, Zhang G, Yu J, Zhang C. Mineral trioxide aggregate promotes the odonto/osteogenic differentiation and dentinogenesis of stem cells from apical papilla via nuclear factor kappa B signaling pathway. J Endod 2014; 40:640-7. [PMID: 24767557 DOI: 10.1016/j.joen.2014.01.042] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 01/26/2014] [Accepted: 01/27/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Mineral trioxide aggregate (MTA) has been widely used in clinical apexification and apexogenesis. However, the effects of MTA on the stem cells from apical papilla (SCAPs) and the precise mechanism of apexogenesis have not been elucidated in detail. METHODS Multiple colony-derived stem cells were isolated from the apical papillae, and the effects of MTA on the proliferation and differentiation of SCAPs were investigated both in vitro and in vivo. Activation of nuclear factor kappa B (NFκB) pathway in MTA-treated SCAPs was analyzed by immunofluorescence assay and Western blot. RESULTS MTA at the concentration of 2 mg/mL did not affect the proliferation activity of SCAPs. However, 2 mg/mL MTA-treated SCAPs presented the ultrastructural changes, up-regulated alkaline phosphatase, increased calcium deposition, up-regulated expression of odontoblast markers (dentin sialoprotein and dentin sialophosphoprotein) and odonto/osteoblast markers (runt-related transcription factor 2 and osteocalcin), suggesting that MTA enhanced the odonto/osteoblastic differentiation of SCAPs in vitro. In vivo results confirmed that MTA can promote the regular dentinogenesis of SCAPs. Moreover, MTA-treated SCAPs exhibited the up-regulated cytoplasmic phos-IκBα and phos-P65, enhanced nuclear P65, and increased nuclear translocation of P65. When co-treated with BMS345541 (the specific NFκB inhibitor), MTA-mediated odonto/osteoblastic differentiation was significantly attenuated. CONCLUSIONS MTA at the concentration of 2 mg/mL can improve the odonto/osteogenic capacity of SCAPs via the activation of NFκB pathway.
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Affiliation(s)
- Ming Yan
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jintao Wu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Yu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanping Wang
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China
| | - Lizhe Xie
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guangdong Zhang
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Endodontic Department, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Endodontics, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China.
| | - Chengfei Zhang
- Comprehensive Dental Care, Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Regenerative Capacity of Human Dental Pulp and Apical Papilla Cells after Treatment with a 3-Antibiotic Mixture. J Endod 2014; 40:399-405. [DOI: 10.1016/j.joen.2013.09.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/16/2013] [Accepted: 09/17/2013] [Indexed: 01/09/2023]
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T. Prather B, Ehrlich Y, Spolnik K, A. Platt J, H. Yassen G. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. J Oral Sci 2014; 56:245-51. [DOI: 10.2334/josnusd.56.245] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Martin DE, De Almeida JFA, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB, Diogenes A. Concentration-dependent Effect of Sodium Hypochlorite on Stem Cells of Apical Papilla Survival and Differentiation. J Endod 2014; 40:51-5. [DOI: 10.1016/j.joen.2013.07.026] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/29/2013] [Accepted: 07/30/2013] [Indexed: 02/07/2023]
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Lin LM, Ricucci D, Huang GTJ. Regeneration of the dentine-pulp complex with revitalization/revascularization therapy: challenges and hopes. Int Endod J 2013; 47:713-24. [PMID: 24330275 DOI: 10.1111/iej.12210] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 11/01/2013] [Indexed: 12/12/2022]
Abstract
The concept of regenerative endodontics has gained much attention in clinical endodontics in the past decade. One aspect of this discipline is the application of revitalization/revascularization therapies for infected and/or necrotic immature pulps in permanent teeth. Following the publication of a case report (Iwaya et al. ), investigators have been rigorously examining the types of tissues formed in the canals as well as exploring strategies to regenerate the pulp-dentine complex in revitalized teeth. This review will provide an update on the types of tissues generated in the canals after revitalization/revascularization therapy in both animal and human studies. The understanding of the role of stem cells and microenvironment in the process of wound healing resulting in either regeneration or repair will be thoroughly discussed. Stem cells and microenvironmental cues introduced into the canal during revitalization/revascularization procedures will be examined. In addition, requirement of a sterile microenvironment in the canal and vital tissue generation in revitalization/revascularization therapy will be emphasized. The challenges that we face and the hopes that we have in revitalization/revascularization therapy for regenerative endodontics will be presented.
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Affiliation(s)
- L M Lin
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
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Yassen GH, Chu TMG, Gallant MA, Allen MR, Vail MM, Murray PE, Platt JA. A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation. Clin Oral Investig 2013; 18:1569-75. [DOI: 10.1007/s00784-013-1125-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/30/2013] [Indexed: 11/28/2022]
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