Immunolocalization of fibronectin during the early response of dog dental pulp to demineralized dentine or calcium hydroxide-containing cement

In Vivo Assessment of the Calcium Salt-Forming Ability of a New Calcium Silicate-Based Intracanal Medicament: Bio-C Temp

Calcium salt precipitation induced by intracanal medicaments contributes to the formation of apical hard tissue during apexification. This study compared the calcium salt-forming ability of a new calcium silicate-based intracanal medicament (Bio-C Temp) with that of two commercial calcium hydroxide pastes (Calcipex Plane II and Vitapex) in a rat subcutaneous implantation model. Polytetrafluoroethylene tubes containing each of the three materials were subcutaneously implanted in 4-week-old male Wistar rats. After 28 days, the composition and amount of calcium salts formed at the material–tissue interface were assessed using micro-Raman spectroscopy, X-ray diffraction, and elemental mapping. The tested materials produced white precipitates that had Raman spectra with peaks corresponding to hydroxyapatite and calcite. X-ray diffraction detected hydroxyapatite formation on Calcipex Plane II and Vitapex implants, as well as calcite formation on all three materials. Elemental mapping revealed that Bio-C Temp generated significantly smaller calcium- and phosphorus-rich calcified regions within the subcutaneous connective tissue than Vitapex. These results indicate that Bio-C Temp produced less calcium salt in rat subcutaneous tissue than Vitapex, although all materials formed hydroxyapatite and calcite in rat subcutaneous tissue. Bio-C Temp could be less effective than Vitapex in promoting apical hard tissue formation during apexification.

Effect of Magnesium on Dentinogenesis of Human Dental Pulp Cells

Introducing therapeutic ions into pulp capping materials has been considered a new approach for enhancing regeneration of dental tissues. However, no studies have been reported on its dentinogenic effects on human dental pulp cells (HDPCs). This study was designed to investigate the effects of magnesium (Mg2+) on cell attachment efficiency, proliferation, differentiation, and mineralization of HDPCs. HDPCs were cultured with 0.5 mM, 1 mM, 2 mM, 4 mM, and 8 mM concentrations of supplemental Mg2+ and 0 mM (control). Cell attachment was measured at 4, 8, 12, 16, and 20 hours. Cell proliferation rate was evaluated at 3, 7, 10, 14, and 21 days. Crystal violet staining was used to determine cell attachment and proliferation rate. Alkaline phosphatase (ALP) activity was assessed using the fluorometric assay at 7, 10, and 14 days. Mineralization of cultures was measured by Alizarin red staining. Statistical analysis was done using multiway analysis of variance (multiway ANOVA) with Wilks' lambda test. Higher cell attachment was shown with 0.5 mM and 1 mM at 16 hours compared to control (P < 0.0001). Cells with 0.5 mM and 1 mM supplemental Mg2+ showed significantly higher proliferation rates than control at 7, 10, 14, and 21 days (P < 0.0001). However, cell proliferation rates decreased significantly with 4 mM and 8 mM supplemental Mg2+ at 14 and 21 days (P < 0.0001). Significantly higher levels of ALP activity and mineralization were observed in 0.5 mM, 1 mM, and 2 mM supplemental Mg2+ at 10 and 14 days (P < 0.0001). However, 8 mM supplemental Mg2+ showed lower ALP activity compared to control at 14 days (P < 0.0001), while 4 mM and 8 mM supplemental Mg2+showed less mineralization compared to control (P < 0.0001). The study indicated that the optimal (0.5-2 mM) supplemental Mg2+ concentrations significantly upregulated HDPCs by enhancing cell attachment, proliferation rate, ALP activity, and mineralization. Magnesium-containing biomaterials could be considered for a future novel dental pulp-capping additive in regenerative endodontics.

Characterization of Odontoblast-like Cell Phenotype and Reparative Dentin Formation In Vivo: A Comprehensive Literature Review

INTRODUCTION

The primary aim was to explore the criteria used in characterization of reparative cells and mineralized matrices formed after treatment of pulp exposures, and the sequence of relative events. The secondary aim was to evaluate whether the reparative events depend on the experimental model species, age, and therapeutic intervention.

METHODS

A literature search of databases using different combinations of the key words was undertaken. Data analysis was based only on studies having histological or histochemical assessment of the pulp tissue responses. The search yielded 86 studies, 47 capping material-based and 39 bioactive application-based experiments, which provided data on morphological or functional characterization of the mineralized matrices and the associated cells.

RESULTS

In 64% of capping material-based and 72% of bioactive application-based experiments, a 2-zone mineralized matrix formation (atubular followed by tubular) was detected, whereas characterization of odontoblastic differentiation is provided in only 25.5% and 46.1% of the studies, respectively. In 93.3% of the studies showing odontoblast-like cells, differentiated cells were in association with tubular mineralized matrix formation. Analyses further showed that cell- and matrix-related outcomes do not depend on experimental model species, age, and therapeutic intervention.

CONCLUSIONS

The evidence of the reviewed scientific literature is that dental pulp cells secrete a dentin-like matrix of tubular morphology in relation to primitive forms of atubular or osteotypic mineralized matrix. Furthermore, data analysis showed that dental pulp cells express in vivo the odontoblastic phenotype, and secrete matrix in a predentin-like pattern, regardless of the model species, age, and therapeutic intervention used.

Dentinogenic Specificity in the Preclinical Evaluation of Vital Pulp Treatment Strategies: A Critical Review

Reviews on the clinical performance of vital pulp treatment strategies and capping materials repeatedly showed an insufficient grade of evidence concerning their therapeutic validity. The biological mechanisms underlying the regenerative potential of pulp-dentin complex have attracted much attention during the last two decades, since new pulp treatment modalities have been designed and tested at the preclinical level. It has been recognized that evaluation should be based on the specific ability of therapeutic interventions to signal recruitment and differentiation of odontoblast-like cells forming a matrix in a predentin-like pattern, rather than uncontrolled hard tissue deposition in a scar-like form. The aim of the present article was to critically review data from histological experimental studies on pulp capping, published during the last 7 decades. A comprehensive literature search covering the period from 1949 to 2015 was done using the Medline/Pubmed database. Inclusion of a study was dependent on having sufficient data regarding the type of capping material used and the unit of observation (human permanent tooth in vivo or animal permanent dentition; primary teeth were excluded). The post-operatively deposited matrix was categorized into three types: unspecified, osteotypic, or dentin-like matrix. One hundred fifty-two studies were included in the final evaluation. Data from the present systematic review have shown that only 30.2% of the 152 experimental histological pulp capping studies described the heterogenic nature of the hard tissue bridge formation, including osteotypic and tubular mineralized tissue. Structural characteristics of the new matrix and the associated formative cells were not provided by the remaining 106 studies. Analysis showed that more careful preclinical evaluation with emphasis on the evidence regarding the dentinogenic specificity of pulp therapies is required. It seems that selection of appropriate vital pulp treatment strategies and pulp capping materials would be further facilitated in terms of their therapeutic validity if international consensus could be reached on a select number of mandatory criteria for tissue-specific dentinogenic events.

Immunohistochemical Evaluation of Fibronectin and Tenascin Following Direct Pulp Capping with Mineral Trioxide Aggregate, Platelet-Rich Plasma and Propolis in Dogs' Teeth

Introduction:

The aim of the present study was to evaluate the expression of fibronectin (FN) and tenascin (TN) after direct pulp capping (DPC) in dogs’ teeth with either mineral trioxide aggregate (MTA), Propolis or Platelet-rich plasma (PRP), by means of immunohistochemistry.

Methods and Materials:

A total of 48 sound molars and premolars with mature apices from four dogs, were included. The teeth were randomly divided into 4 groups according to the material used for DPC: PRP, Propolis, MTA, and glass-ionomer (as the negative control group). Each group was divided into two 7-day and 30-day subgroups. The teeth were restored at the same session. The animals were sacrificed at the mentioned time intervals and the expression of FN and TN in each test group and between each time intervals was assessed with Wilcoxon and Mann-Whitney U tests, respectively. The Kruskal-Wallis test was used to compare FN and TN staining among the test groups. The significance level was set at 0.05.

Results:

The amount of FN in the MTA group in the 30-day interval was significantly higher than the 7-day interval; however, there were no significant differences among the other groups. The amount of TN in the MTA and Propolis groups in the 30-day interval was significantly higher than that in the 7-day interval; no recognizable difference was observed in the other groups. Moreover, the difference in expression of FN and TN in the 7-day interval was not significant in the experimental groups. Nevertheless, the difference was significant in the 30-day interval, with the highest and lowest expressions belonging to the MTA and glass-ionomer groups, respectively.

Conclusion:

Based on the results of the present animal study, MTA is still a better choice for direct pulp capping

Effects of Laser Irradiation on Pulp Cells Exposed to Bleaching Agents

The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on odontoblast-like cells exposed to a bleaching agent. Mouse dental papilla cell-23 cells were seeded in wells of 24-well plates. Eight groups were established according to the exposure to the bleaching agent and LLLT (0, 4, 10 and 15 J cm(-2) ). Enamel-dentin disks were adapted to artificial pulp chambers, which were individually placed in wells containing Dulbecco's modified Eagle's medium (DMEM). A bleaching agent (35% hydrogen peroxide [BA35%HP]) was applied on enamel (15 min) to obtain the extracts (DMEM + BA35%HP components diffused through enamel/dentin disks). The extracts were applied (1 h) to the cells, and then subjected to LLLT. Cell viability (Methyl tetrazolium assay), alkaline phosphatase (ALP) activity, as well as gene expression of ALP, fibronectin (FN) and type I collagen, were evaluated. The bleaching procedures reduced the cell viability, ALP activity and gene expression of dentin proteins. Laser irradiation did not modulate the cell response; except for FN, as LLLT decreased the gene expression of this protein by the cells exposed to the BA35%HP. It can be concluded that BA35%HP decreased the activities of odontoblasts that were not recovered by the irradiation of the damaged cells with low-level laser parameters tested.

Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms

Calcium hydroxide has been used extensively in dentistry for a century. Despite its widespread use as a pulp-capping agent, its mechanisms of action still remain ambiguous. Understanding its modes of action will lead to a broader understanding of the mechanisms associated with induced dentinogenesis and help in optimizing the currently available agents to target specific regenerative processes to obtain the best possible clinical outcomes. A literature search relating to mechanisms of dentinogenesis of calcium hydroxide up to December 2011 was carried out using pubmed and MEDLINE database searches as well as manual searching of cross-references from identified studies. Resulting suggestions regarding dentinogenic mechanisms of calcium hydroxide range from direct irritating action of the material to induction of release of biologically active molecules. The purpose of this article is to discuss various mechanisms through which calcium hydroxide may induce tertiary dentinogenesis in the light of observations made in included studies.

Immunohistochemical expression of fibronectin and tenascin in human tooth pulp capped with mineral trioxide aggregate and a novel endodontic cement

INTRODUCTION

The purpose of the present study was the immunohistochemical study of fibronectin (FN) and tenascin (TN) in human tooth pulp capped with mineral trioxide aggregate (MTA) and novel endodontic cement (NEC) (calcium enriched mixture cement) after 2 and 8 weeks.

METHODS

Thirty-two premolar teeth that were scheduled for extraction for orthodontic reasons were exposed and capped with either MTA or NEC. The teeth were randomly divided into 4 groups: group 1 (NEC for 2 weeks), group 2 (NEC for 8 weeks), group 3 (MTA for 2 weeks), and group 4 (MTA for 8 weeks). After capping the exposed pulps with either NEC (groups 1 and 2) or MTA (groups 3 and 4), half of the specimens underwent extraction and were prepared for histologic and immunohistochemical evaluation for FN and TN after 2 weeks, and the remaining half were assessed after 8 weeks. FN and TN expression was scored by a blinded pathologist on a scale of I-IV, and the results were analyzed by the Wilcoxon and Mann-Whitney U statistical tests.

RESULTS

FN and TN staining was observed in all 4 experimental groups, and there was no significant difference between expression of FN and TN in any groups. FN and TN staining was observed in the dentinal bridge matrix after 2 weeks under MTA. Expression of both markers reduced significantly after 8 weeks under MTA, and staining was observed only in unmineralized parts of dentinal bridge. FN and TN expression was observed in the matrix of the dentinal bridge after 2 weeks under NEC, and staining of both markers was reduced after 8 weeks compared with 2 weeks. The staining pattern of TN in NEC groups was higher than in MTA groups in both time intervals. However, the difference was not significant.

CONCLUSIONS

The present study demonstrated that both MTA and NEC are suitable biomaterials for direct pulp capping and are able to stimulate dentinal bridge formation. Moreover, the role of FN and TN as 2 major components of the matrix of a reparative dentinal bridge was observed.

The effect of scaffold architecture on odontogenic differentiation of human dental pulp stem cells

Previous studies have shown the superiority of nanofibrous (NF) poly(l-lactic acid) (PLLA) scaffolds in supporting the osteogenic differentiation of a few cell types and bone regeneration. The aim of the current study was to investigate whether NF-PLLA scaffolds are advantageous for the odontogenic differentiation and mineralization of human dental pulp stem cells (DPSCs) over solid-walled (SW) PLLA scaffolds. The in vitro studies demonstrated that, compared with SW scaffolds, NF scaffolds enhanced attachment and proliferation as well as odontogenic differentiation of human DPSCs. The alkaline phosphatase (ALP) activity and the expression of odontogenic genes of human DPSCs were increased on NF scaffolds compared with that on SW scaffolds. In addition, more mineral deposition was observed on the NF scaffolds, as demonstrated by von Kossa staining, calcium content measurement and scanning electron microscopy. Consistent with the in vitro studies, NF scaffolds promoted odontogenic differentiation and hard tissue formation compared with SW scaffolds after 8 weeks of ectopic transplantation in nude mice, as confirmed by von Kossa staining, Masson's trichrome staining and immunohistochemical staining for dentin sialoprotein. In conclusion, NF-PLLA scaffolds enhanced the odontogenic differentiation of human DPSCs and mineralization both in vitro and in vivo, and are promising scaffolds for dentin regeneration.

Calcium ion release from calcium hydroxide stimulated fibronectin gene expression in dental pulp cells and the differentiation of dental pulp cells to mineralized tissue forming cells by fibronectin

AIM

The effect of calcium ions on dental pulp cells was examined and the mechanism of dentine bridge formation by calcium hydroxide was investigated.

METHODOLOGY

Human dental pulp cells were treated with high concentration of calcium or magnesium ions for 24 h and fibronectin gene expression was measured by the quantitative PCR method. Human dental pulp cells were then cultured on fibronecin-coated dishes for 24 h, and osteocalcin and osteopontin gene expression, which are typical phenotypes of mineralized tissue forming cells, were measured by the quantitative PCR method.

RESULTS

Fibronectin gene expression was stimulated by calcium ions dose-dependently. On the other hand, magnesium ions did not influence fibronectin gene expression. Furthermore, pulp cells cultured on fibronectin-coated dishes enhanced the expression of phenotypes of mineralized tissue forming cells.

CONCLUSIONS

Calcium ions released from calcium hydroxide stimulates fibronectin synthesis in dental pulp cells. Fibronectin might induce the differentiation of dental pulp cells to mineralized tissue forming cells that are the main cells to form dentine bridges, via contact with cells.

Direct capping of human pulps with a dentin bonding system and calcium hydroxide: an immunohistochemical analysis

Pulp capping is a treatment where a protective agent is applied to an exposed pulp to allow the maintenance of its vitality and function. The present study analyzed the immunohistochemical expression of fibronectin and type III collagen in human dental pulps submitted to direct pulp capping with calcium hydroxide [Ca(OH)2] or the Single Bond adhesive system (SBAS). The results demonstrated that both proteins were not expressed in the SBAS group, although in the group capped with Ca(OH)2 a diffuse labeling in the extracellular matrix was initially observed, followed by a late expression in the odontoblast-like layer and beneath the dentin bridge. It seems that application of adhesive systems in direct contact with healthy pulps will not lead to expression of proteins that are believed to be essential for pulpal repair. Moreover, Ca(OH)2 showed good biocompatibility properties with the dental pulp tissue, inducing the expression of reparative molecules, and therefore remains the material of choice for the treatment of accidental pulp exposures.

Immunohistochemical expression of fibronectin and tenascin after direct pulp capping with calcium hydroxide

The aim of this study was to investigate the expression of 2 extracellullar matrix glycoproteins, fibronectin (FNC) and tenascin (TNC), following direct pulp capping with calcium hydroxide (CH). Third molars scheduled for extraction were used. Standardized class I cavities with pulp exposures were prepared. After control of bleeding, CH powder was applied in the exposure sites, which were covered with CH cement (Dycal; Dentsply) and the cavities were filled with zinc oxide-eugenol cement. Three teeth were extracted at each post-treatment period (1, 7, 14, and 30 days). Demineralized and paraffin-embedded specimens were stained for histologic technique (hematoxylin-eosin) and for immunohistochemical analysis. Anti-TNC and anti-FNC monoclonal antibodies were used with the streptavidin-biotin complex method. Generally, similar patterns of immunohistochemical expression were observed for TNC and FNC in the pulp tissue as a whole. In the exposure site, TNC immunostaining increased over time, exhibiting a thicker immunostaining pattern within 30 days. The imunohistochemical technique showed expression of both glycoproteins during pulp healing process.

The mechanism of pulpal wound healing

The favourable response of exposed pulp tissue against a variety of materials used for pulp capping in experimental conditions, as observed by hard tissue (reparative dentine) formation, demonstrates an intrinsic capacity of pulp tissue for healing. However, in the clinical situation, in which a pulpal exposure is usually accompanied by a long-term external irritation with the subsequent long-term inflammatory response to that irritation, the outcome of pulp capping procedures is not as predictable. While some of the factors related to the defensive reactions and healing after pulp exposure and capping procedures are well understood, the mechanisms and importance of others remain less well-known. Understanding the mechanisms regulating the spread of inflammation and necrosis in pulp tissue, and the factors regulating healing after closure of the wound, would facilitate the development of new and better treatment procedures with more predictable outcomes. In this review, some of the aspects considered to be important in pulpal wound healing are discussed.

The dentinogenic effect of mineral trioxide aggregate (MTA) in short-term capping experiments

AIM

The objective of the present experiment was to study the early pulpal cell response and the onset of reparative dentine formation after capping application of MTA in mechanically exposed pulps.

METHODOLOGY

Thirty-three teeth from three dogs, 12-18 months of age were mechanically exposed via class V cavities. Light pressure was applied to control haemorrhage. ProRoot MTA (Dentsply Simfra, Paris) was placed at the exposure site and light pressure was applied with a wet cotton pellet. The cavities were restored with amalgam and the pulpal tissue reactions were assessed by light and electron microscopy (transmission and scanning) after healing intervals of 1, 2 or 3 weeks.

RESULTS

A homogenous zone of crystalline structures was initially found along the pulp-MTA interface, whilst pulpal cells showing changes in their cytological and functional state were arranged in close proximity to the crystals. Deposition of hard tissue of osteotypic form was found in all teeth in direct contact with the capping material and the associated crystalline structures. Formation of reparative dentine (tubular matrix formation in a polar predentine-like pattern by elongated polarized cells) was consistently related to a firm osteodentinal zone.

CONCLUSIONS

The present experiments indicate that MTA is an effective pulp-capping material, able to stimulate reparative dentine formation by the stereotypic defensive mechanism of early pulpal wound healing.

Differential repair responses in the coronal and radicular areas of the exposed rat molar pulp induced by recombinant human bone morphogenetic protein 7 (osteogenic protein 1)

Bone morphogenetic protein 7 (BMP 7), also termed osteogenic protein 1, a member of the transforming growth-factor superfamily, was examined for its efficacy in inducing reparative dentinogenesis in the exposed pulps of rat molars. To determine if the reaction was dose-dependent, collagen pellets containing 1, 3 or 10 microgram of recombinant BMP 7 were inserted in intentionally perforated pulps (10-12 pulps per group) in the deepest part of half-moon class V-like cavities cut in the mesial aspect of upper first molars. As controls, the collagen carrier (CC group) alone and calcium hydroxide (Ca group) were used as capping agents. All cavities were then restored with a glass-ionomer cement. Half of the animals were killed after 8 days and the other half after 28 days, by intracardiac perfusion of fixative. The molars were processed for histological evaluation by light microscopy. No difference in effect could be detected between the three concentrations of BMP 7 groups at either time interval. After 8 days, all groups showed varying inflammation, from mild of severe, and the Ca group demonstrated early formation of a reparative dentine bridge. At 28 days the CC group displayed irregular osteodentine formation, leaving some unmineralized areas at the exposure site and interglobular unmineralized areas containing pulp remnants. In the Ca-treated pulps, the initial formation of thick reparative osteodentine bridges that sealed more or less completely the pulp perforation was followed, in the deeper part, by irregular tubular dentine. In most BMP 7-treated specimens, the initial inflammation has resolved at 8 days and at 28 days heterogeneous mineralization or osteodentine filled the mesial coronal pulp. They also had complete filling of the radicular pulp by homogenous mineralization in the mesial root; this reaction was found in 11 teeth in the BMP 7 group, one tooth in the CC group an none of the Ca group. These results emphasize the biological differences the coronal and radicular parts of the pulp, and the potential of bioactive molecules such as BMP 7 to provide an a alternative conventional endodontic treatments.

Designing new treatment strategies in vital pulp therapy

OBJECTIVES

The development of strategies in vital pulp therapy, which aim to maintain vitality and function of the dentine-pulp complex, represents a major focus of attention. Recent progress in understanding the molecular and cellular changes during tooth development and how they are mimicked during dental tissue repair offers the opportunity to now assess whether this knowledge can be exploited to design new treatment strategies in vital pulp therapy.

DATA SOURCES AND STUDY SELECTION

Current literature on the molecular and cellular basis of tooth development and dental tissue repair has been reviewed in the context of stimulating dentinogenic responses in the tooth together with pertinent published abstracts of relevant conferences and personal communications. Tissue events of direct relevance to clinical application for vital pulp therapy are discussed.

CONCLUSIONS

The involvement of growth factors and extracellular matrix molecules in signalling and regulating dentinogenic events during tooth development has been identified. During dental tissue repair, many of the processes are mimicked leading to responses of focal deposition of tertiary dentine at injury sites. The nature and specificity of these responses are determined in part by the extent of tissue injury. Traditional clinical strategies are capable of exploiting endogenous signalling molecules in the tissues to develop more effective treatment modalities. Application of exogenous signalling molecules offers opportunities for development of new therapies, although a number of delivery considerations must be addressed before these can be introduced into clinical practice.

Formation of crystals on the surface of calcium hydroxide-containing materials in vitro

The purpose of the present study was to examine the surface of calcium hydroxide-containing materials when treated in different in vitro conditions. Five calcium hydroxide-containing materials (Dycal, Nu-Cap, Life, Sealapex, and Apexit) and two control calcium hydroxide-free materials (Roth 811 and AH26) were tested. The materials were placed onto Teflon discs or root dentin samples; maintained in distilled water or phosphate-buffered saline, or culture medium supplemented or not supplemented with fetal calf serum; incubated at 37 degrees C in humidified atmosphere containing or not containing 5% CO2; and examined by scanning electron microscope. The results demonstrated precipitation of simple crystal units or organized crystalline structures in the calcium hydroxide-containing specimens treated in all experimental conditions, except those maintained in distilled water without 5% CO2. X-ray elemental microanalysis of the different crystalline structures showed one or two peaks corresponding to calcium or calcium and phosphorus. These data indicate that the crystals formed by reactions of calcium ions released from the calcium hydroxide-containing materials with the environmental ions might modify the material surface, especially in the presence of substrate adhesion molecules, such as fibronectin. This modification might play an important role in the regulation of cell adhesion and the initiation of new matrix synthesis.

The role of integrin beta 1 in human dental pulp cell adhesion on laminin and fibronectin

OBJECTIVE

This study is to identify the expression of integrin beta 1 in human dental pulp cells and the role of integrin beta 1 in pulp cell adhesion on extracellular matrix protein laminin and fibronectin.

STUDY DESIGN

Immunoblot detection of integrin beta 1 in human pulp cells was with the use of monoclonal anti-beta 1 antibody. Dental pulp cell adhesion assay on extracellular matrix protein laminin and fibronectin and blocking cell adhesion was performed with monoclonal anti-beta 1 antibody.

RESULT

Integrin beta 1 was identified in human dental pulp cells. Pulp cells adhered and spread on both laminin and fibronectin. Monoclonal anti-beta 1 antibody inhibited human dental pulp cells adhesion on laminin but not on fibronectin.

CONCLUSIONS

Integrin beta 1 was expressed on human dental pulp cells and mediated cell adhesion on laminin. Human dental pulp cells also adhered on fibronectin but the adhesion was not regulated by beta 1 integrin.

Immunolocalization of fibronectin during reparative dentinogenesis in human teeth after pulp capping with calcium hydroxide

Exposed dental pulp is known to possess the ability to form a hard-tissue barrier (dentin bridge). The exact mechanisms by which pulp cells differentiate into odontoblasts in this process are unknown. Fibronectin has been demonstrated to play a crucial role in odontoblast differentiation during tooth development. This study tested the hypothesis that fibronectin is involved in the initial stages of replacement odontoblast differentiation and reparative dentin formation. We observed its immunohistochemical localization during dentin bridge formation in human teeth, after pulp was capped with calcium hydroxide [Ca(OH)2]. One day after the capping, precipitation of crystalline structures was observed at the TEM level in association with cell debris at the interface between the superficial necrotic zone and underlying pulp tissue. This layer of dystrophic calcification showed positive reaction for fibronectin, and pulp cells appeared to be closely associated with this layer, seven to ten days post-operatively. At 14 days, an alignment of cells, some of which were elongated and odontoblast-like, was observed adjacent to the fibronectin-positive irregular matrix. Between the cells, corkscrew fiber-like fluorescence was visible. At 28 days, the irregular fibrous matrix was followed by the formation of tubular dentin-like matrix lined with odontoblast-like cells. Therefore, it would seem that fibronectin associated with the initially formed calcified layer might play a mediating role in the differentiation of pulp cells into odontoblasts during reparative dentinogenesis, after pulp was capped with Ca(OH)2.

Effects of a functional agar surface on in vitro dentinogenesis induced in proteolytically isolated, agar-coated dental papillae in rat mandibular incisors

In an attempt to study the effects of a three-dimensional agar surface on in vitro dentinogenesis both in the growing end and in incisally cross-cut pulp, the possible expression of odontoblast phenotype was investigated morphologically, autoradiographically and immunohistochemically. Explants were incubated for 8 days. In the growing end, during the last 4 days, mitotic cells differentiated into [3H]-thymidine-labelled, tubular matrix-forming cells. In cross-cut pulp, however, during the first 4 days, mitotic cells differentiated into [3H]-thymidine-labelled, tubular matrix-forming cells. Electron microscopy demonstrated that, in both regions, tubular matrix-forming cells had characteristics similar to those of primary odontoblasts. When agar was incubated alone, exogenous fibronectin was deposited on it rapidly. After 12 h, endogenous fibronectin appeared on explant peripheral cells. Collagen and materials reacting positively to periodic acid-Schiff (PAS) were first interposed between agar and explant after 4 days. After 8 days, an inner immunonegative layer corresponding to materials reacting positively to PAS or toluidine blue and an outer immunopositive layer of fibronectin or collagen were visible adjacent to the rows of elongated columnar cells. In the presence of Gly-Arg-Gly-Asp-Ser-Pro (GRGDSP), a competitive inhibitor of attachment of cells to fibronectin, explants became detached from the agar surface, and no dentinogenesis occurred. These results indicate that, when in contact with an agar surface that becomes modified by fibronectin and/or by a complex of fibronectin with deposited matrix, dental mesenchymal cells progressively differentiate into tubular matrix-forming cells. Possibly the functional agar surface has the important role of providing a foothold for cell attachment, which is the first step towards in vitro odontoblast differentiation. This system of inducing tubular matrix-forming cells constitutes a useful model for the study of in vitro dentinogenesis.

Induction of odontoblast-like cell differentiation in dog dental pulps after in vivo implantation of dentine matrix components

The effects of dentine extracellular matrix components on dental mesenchymal cells were studied by light and transmission electron microscopy after their implantation at central sites of mechanically exposed pulps in dog molar teeth. The implants were Millipore filters that had been soaked with solutions containing 30 or 300 micrograms/ml of an EDTA-soluble fraction of rabbit incisor dentine. Control filters were soaked with dog albumin or phosphate buffered saline. Columnar, polarized cells were consistently seen after 8 days in close proximity to the filters coated with both concentrations of dentine matrix components. Characteristic features of these polarized cells included widened cisternae of the rough endoplasmic reticulum, a rich microfilamentous network in the long cytoplasmic extensions invading the filter pores and numerous cytoplasmic bodies. These cells also showed evidence of functional as well as cytological differentiation. Polarized processing of secretory granules could be observed after 8 days' implantation, and also the presence of matrix vesicles and deposition of a fine, collagenous matrix into the filters apically to the distal end of the cytoplasmic processes. After 24 days' implantation, secretion of a tubular matrix could be consistently seen in association with the odontoblast-like cells. No changes in cell organization or matrix synthesis were seen after implantation of control filters. These studies demonstrate that bioactive components present in the EDTA-soluble dentine matrix fraction are able to directly induce cell polarization and apical secretion of tubular matrix when implanted in contact with dental pulp cells at sites remote from the odontoblast layer.