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Quigley RM, Kearney M, Kennedy OD, Duncan HF. Tissue engineering approaches for dental pulp regeneration: The development of novel bioactive materials using pharmacological epigenetic inhibitors. Bioact Mater 2024; 40:182-211. [PMID: 38966600 PMCID: PMC11223092 DOI: 10.1016/j.bioactmat.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/06/2024] Open
Abstract
The drive for minimally invasive endodontic treatment strategies has shifted focus from technically complex and destructive root canal treatments towards more conservative vital pulp treatment. However, novel approaches to maintaining dental pulp vitality after disease or trauma will require the development of innovative, biologically-driven regenerative medicine strategies. For example, cell-homing and cell-based therapies have recently been developed in vitro and trialled in preclinical models to study dental pulp regeneration. These approaches utilise natural and synthetic scaffolds that can deliver a range of bioactive pharmacological epigenetic modulators (HDACis, DNMTis, and ncRNAs), which are cost-effective and easily applied to stimulate pulp tissue regrowth. Unfortunately, many biological factors hinder the clinical development of regenerative therapies, including a lack of blood supply and poor infection control in the necrotic root canal system. Additional challenges include a need for clinically relevant models and manufacturing challenges such as scalability, cost concerns, and regulatory issues. This review will describe the current state of bioactive-biomaterial/scaffold-based engineering strategies to stimulate dentine-pulp regeneration, explicitly focusing on epigenetic modulators and therapeutic pharmacological inhibition. It will highlight the components of dental pulp regenerative approaches, describe their current limitations, and offer suggestions for the effective translation of novel epigenetic-laden bioactive materials for innovative therapeutics.
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Affiliation(s)
- Ross M. Quigley
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin (TCD), University of Dublin, Lincoln Place, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, and Tissue Engineering Research Group, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Michaela Kearney
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin (TCD), University of Dublin, Lincoln Place, Dublin, Ireland
| | - Oran D. Kennedy
- Department of Anatomy and Regenerative Medicine, and Tissue Engineering Research Group, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- The Trinity Centre for Biomedical Engineering (TCBE) and the Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland (RCSI) and Trinity College Dublin (TCD), Dublin, Ireland
| | - Henry F. Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin (TCD), University of Dublin, Lincoln Place, Dublin, Ireland
- The Trinity Centre for Biomedical Engineering (TCBE) and the Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland (RCSI) and Trinity College Dublin (TCD), Dublin, Ireland
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Liu Q, Gao Y, He J. Stem Cells from the Apical Papilla (SCAPs): Past, Present, Prospects, and Challenges. Biomedicines 2023; 11:2047. [PMID: 37509686 PMCID: PMC10377451 DOI: 10.3390/biomedicines11072047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Dental diseases occurring on young permanent teeth usually lead to the premature arrest of tooth root development. Sustained tooth root elongation is necessary to achieve the goal of long-term preservation of affected teeth. To this end, stem cell-based regenerative endodontic treatment has been regarded as one of the most promising strategies for treating young permanent teeth with pulp and periapical infections. Endogenous stem cells residing in the apical papilla, named stem cells from the apical papilla (SCAPs), have been intensively investigated due to their critical roles in pulp regeneration and root redevelopment. The present review summarizes advances in the field of SCAPs studies and discusses the challenges that need to be further addressed.
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Affiliation(s)
- Qi Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jinzhi He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Queiroz A, Pelissari C, Paris AFC, Rodrigues MFSD, Trierveiler M. Periodontal ligament cells mobilized by transforming growth factor-beta 1 and migrated without stimuli showed enhanced osteogenic differentiation. Arch Oral Biol 2023; 147:105636. [PMID: 36738489 DOI: 10.1016/j.archoralbio.2023.105636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 12/29/2022] [Accepted: 01/29/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to analyze the ability of G-CSF and TGF-β1 to mobilize periodontal ligament stem cells to obtain populations with better potential for proliferation and osteogenic differentiation. DESIGN Primary cultures were established from the periodontal ligament of Wistar rats. After a cell migration assay, four experimental groups were obtained: PDLSC, composed of the primary culture, non-mobilized cells; MPDLSC, the spontaneously migrated cells; MPDLSC-GCSF, the cells mobilized with G-CSF; and MPDLSC-TGF-β1, the cells mobilized with TGF-β1. The expression of mesenchymal stem cell markers was assessed by flow cytometry. Clonogenicity, viability, proliferative potential, and osteogenic differentiation capacity were also analyzed. RESULTS All the study groups expressed well-known mesenchymal stem cell markers and exhibited clonogenic capacity. The higher proliferation potential was seen in the PDLSC and MPDLSC groups, while the MPDLSC and MPDLSC-TGFβ1 groups showed a higher number of mineralized deposits in vitro and higher ALP activity after osteogenic differentiation induction. Cells of all the groups also expressed mRNA of genes associated with osteogenic differentiation without previous induction. CONCLUSIONS Both agents were able to mobilize stem cells from the periodontal ligament, but G-CSF did not show an advantage, whereas TGF-β1 appears to direct the cells towards a state of increased osteogenic differentiation. Furthermore, spontaneous cell migration through a membrane was sufficient to enrich the cell population.
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Affiliation(s)
- Aline Queiroz
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Division, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Cibele Pelissari
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Division, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Adriana Fraga Costa Paris
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Division, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | | | - Marília Trierveiler
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Division, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
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Multiple growth factors accommodated degradable submicron calcium sulfate hemihydrate/porous hydroxyapatite for dentin-pulp regeneration. BIOMATERIALS ADVANCES 2022; 140:213045. [PMID: 35939956 DOI: 10.1016/j.bioadv.2022.213045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 12/31/2022]
Abstract
Vital pulp therapy (VPT) has gained significant consideration by utilizing the natural healing capacity of the inflamed pulp in healing process. However, the protective pulp capping materials that facilitate this healing process are still under investigation for the successful promotion of dentin-pulp regeneration. Herein, we developed a bioactive and biodegradable pulp capping material (denoted as sCSHA-GFs) by synthesizing inorganic submicron calcium sulfate hemihydrate (sCS)/porous hydroxyapatite (HA) loaded with growth factors (GFs) such as transforming growth factor-beta 1 (TGF-β1), fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF). Physiochemical characteristics of submicron CSHA-GFs (sCSHA-GFs) cement were determined. Human dental pulp stem cells (hDPSCs) were used for analyzing their biocompatibility and bioactivity for dentin mineralization. To evaluate the efficacy of sCSHA-GFs, we compared it with a commercial material, mineral trioxide aggregate (MTA), the reference standard used clinically on pulp capping. Our results showed that sCSHA-GFs cement presented good biodegradability with dissolution properties for sustained release of calcium (Ca2+) ions and GFs, and facilitated attachment, proliferation, differentiation and migration of hDPSCs. In addition, sCSHA-GFs cement was found to be more effective than MTA at prolonged incubation time in inducing the mRNA expression levels of odontoblastic differentiation markers, dentin sialophosphoprotein (DSPP) and dentin matrix protein (DMP-1), leading to increased mineralization (with calcium deposits) along with increased alkaline phosphatase (ALP) expressions, evident from Alizarin Red S and ALP staining assays. Our findings suggest that sCSHA-GFs cement may act as a suitable material in VPT for dentin-pulp regeneration.
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Human Oral Keratinocytes Challenged by Streptococcus sanguinis and Porphyromonas gingivalis Differentially Affect the Chemotactic Activity of THP-1 Monocytes. Int J Microbiol 2022; 2022:9112039. [PMID: 35519507 PMCID: PMC9064506 DOI: 10.1155/2022/9112039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Periodontal diseases are initiated by the shift from microbe-host symbiosis to dysbiosis, and the disrupted host response predominantly contributes to tissue destruction. This study investigated whether and to what extent human oral keratinocytes (HOKs) challenged by a periodontal commensal or pathogen could differentially affect the chemotactic activity of THP-1 monocytes. A selected periodontal commensal (Streptococcus sanguinis ATCC 10556) and a pathogen (Porphyromonas gingivalis ATCC 33277) were cultured and inoculated, respectively, into the lower chamber of Transwell® Permeable Supports with HOKs and incubated for 2 h or 18 h at 37°C under appropriate cell growth conditions. HOKs alone served as the control for the transwell migration assay. Well-stained THP-1 monocytes were seeded in the top chamber of the device, incubated for 2 h and then collected from the lower well for quantitation of the migrated fluorescence-labeled cells by the FACSCalibur™ flow cytometer. The statistical significance was determined using one-way ANOVA. The HOKs challenged by S. sanguinis attracted a significantly higher number of THP-1 cell migration as compared with the control after 2 h or 18 h interaction (
). By contrast, P. gingivalis-treated HOKs exhibited a markedly reduced chemotactic effect on THP-1 cells (
, 2 h;
, 18 h). There was no significant difference in THP-1 cell migration among the groups with either S. sanguinis or P. gingivalis alone. The current findings on P. gingivalis-HOKs interactions with resultant paralysis of THP-1 cell chemotaxis provide further evidence that the keystone periodontopathogen P. gingivalis can evade innate defense and contribute to periodontal pathogenesis.
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Li J, Zhai Y, Rao N, Yuan X, Yang J, Li J, Yu S, Zhao Y, Ge L. TGF-β2 and TGF-β1 differentially regulate the odontogenic and osteogenic differentiation of mesenchymal stem cells. Arch Oral Biol 2022; 135:105357. [DOI: 10.1016/j.archoralbio.2022.105357] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 01/09/2023]
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Liang J, Zhao YJ, Li JQ, Lan L, Tao WJ, Wu JY. A pilot study on biological characteristics of human CD24(+) stem cells from the apical papilla. J Dent Sci 2022; 17:264-275. [PMID: 35028047 PMCID: PMC8739277 DOI: 10.1016/j.jds.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE CD24 is a specific cell surface marker for undifferentiated dental stem cells from apical papilla (SCAPs) seen only during root development, before the tooth emerges through gum. But the comprehensive role of CD24 in the SCAPs is unclear. This study aims to clarify the exact roles of CD24 in SCAPs. MATERIALS AND METHODS SCAPs were divided into CD24 (+)-SCAPs (high percentage CD24) and CD24 (-)-SCAPs (low percentage CD24) via flow cytometry. The proliferation, migration and osteogenic/adipogenic differentiation of the two groups were detected, RT-PCR was performed to detect the expression of osteogenic/adipogenic related genes and thegene expression were analyzed. RESULTS The proliferative and migratory ability of CD24 (-)-SCAPs were significantly stronger than that of CD24 (+)-SCAPs. Although, the mineralization process and the osteogenic genes expression were not significantly difference in the two groups. Both CD24 (+)-SCAPs and CD24 (-)-SCAPs differentiated into adipocytes. The adipogenic differentiation in CD24 (+)-SCAPs was better than that in CD24 (-)-SCAPs, after 3 weeks of adipogenic induction. However, the expression of adipogenic related gene, PPAR γ2 mRNA in CD24 (+)-SCAPs was lower than that in CD24 (-)-SCAPs after 1 week of adipogenic induction. But the trend changed for the opposite after 3 weeks. CONCLUSION The study proposes that CD24 has a regulatory effect on the adipogenic differentiation of SCAPs, and this may be attained by targeting the PPAR γ2 mRNA. Concurrently, it was found that CD24 plays an inhibitory role in the proliferation and migration of SCAPs, which may minimize the manifestation of diseases caused by an abnormal cell growth.
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Affiliation(s)
- Jing Liang
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
| | - Ya-Jin Zhao
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
| | - Jun-Qing Li
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
| | - Lan Lan
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
| | - Wen-Jing Tao
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
| | - Jia-Yuan Wu
- Hospital of Stomatology, Zunyi Medical University, Zunyi, PR China
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi, PR China
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Chang MC, Chen NY, Chen JH, Huang WL, Chen CY, Huang CC, Pan YH, Chang HH, Jeng JH. bFGF stimulated plasminogen activation factors, but inhibited alkaline phosphatase and SPARC in stem cells from apical Papilla: Involvement of MEK/ERK, TAK1 and p38 signaling. J Adv Res 2021; 40:95-107. [PMID: 36100336 PMCID: PMC9481946 DOI: 10.1016/j.jare.2021.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/04/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
bFGF induced uPA, uPAR, PAI-1 production/expression in SCAP → bFGF induced decline of ALP and SPARC of SCAP → The effects of bFGF are regulated by ERK, p38, TAK1 and Akt signaling → Crucial for SCAP proliferation, matrix turnover and differentiation → These events are important for revascularization/root apexogenesis
Introduction Objectives Methods Results Conclusion
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Liu K, Yu S, Ye L, Gao B. The Regenerative Potential of bFGF in Dental Pulp Repair and Regeneration. Front Pharmacol 2021; 12:680209. [PMID: 34354584 PMCID: PMC8329335 DOI: 10.3389/fphar.2021.680209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023] Open
Abstract
Regenerative endodontic therapy intends to induce the host’s natural wound-healing process, which can restore the vitality, immunity, and sensitivity of the inflammatory or necrotic pulp tissue destroyed by infection or trauma. Myriads of growth factors are critical in the processes of pulp repair and regeneration. Among the key regulatory factors are the fibroblast growth factors, which have turned out to be the master regulators of both organogenesis and tissue homeostasis. Fibroblast growth factors, a family composed of 22 polypeptides, have been used in tissue repair and regeneration settings, in conditions as diverse as burns, ulcers, bone-related diseases, and spinal cord injuries. Meanwhile, in dentistry, the basic fibroblast growth factor is the most frequently investigated. Thereby, the aim of this review is 2-fold: 1) foremost, to explore the underlying mechanisms of the bFGF in dental pulp repair and regeneration and 2) in addition, to shed light on the potential therapeutic strategies of the bFGF in dental pulp–related clinical applications.
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Affiliation(s)
- Keyue Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sijing Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bo Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Sevari SP, Ansari S, Moshaverinia A. A narrative overview of utilizing biomaterials to recapitulate the salient regenerative features of dental-derived mesenchymal stem cells. Int J Oral Sci 2021; 13:22. [PMID: 34193832 PMCID: PMC8245503 DOI: 10.1038/s41368-021-00126-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023] Open
Abstract
Tissue engineering approaches have emerged recently to circumvent many limitations associated with current clinical practices. This elegant approach utilizes a natural/synthetic biomaterial with optimized physiomechanical properties to serve as a vehicle for delivery of exogenous stem cells and bioactive factors or induce local recruitment of endogenous cells for in situ tissue regeneration. Inspired by the natural microenvironment, biomaterials could act as a biomimetic three-dimensional (3D) structure to help the cells establish their natural interactions. Such a strategy should not only employ a biocompatible biomaterial to induce new tissue formation but also benefit from an easily accessible and abundant source of stem cells with potent tissue regenerative potential. The human teeth and oral cavity harbor various populations of mesenchymal stem cells (MSCs) with self-renewing and multilineage differentiation capabilities. In the current review article, we seek to highlight recent progress and future opportunities in dental MSC-mediated therapeutic strategies for tissue regeneration using two possible approaches, cell transplantation and cell homing. Altogether, this paper develops a general picture of current innovative strategies to employ dental-derived MSCs combined with biomaterials and bioactive factors for regenerating the lost or defective tissues and offers information regarding the available scientific data and possible applications.
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Affiliation(s)
- Sevda Pouraghaei Sevari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sahar Ansari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA.
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA, USA.
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Evaluation of Silk Fibroin-RGD-Stem Cell Factor Scaffold Effect on Adhesion, Migration, and Proliferation of Stem Cells of Apical Papilla. Stem Cells Int 2021; 2021:6612324. [PMID: 34046070 PMCID: PMC8128554 DOI: 10.1155/2021/6612324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/29/2021] [Indexed: 11/17/2022] Open
Abstract
This study explored the effects of a silk fibroin-RGD-stem cell factor (SF-RGD-SCF) scaffold on the migration, proliferation, and attachment of stem cells of apical papilla (SCAPs). SF, SF-RGD, SF-SCF, and SF-RGD-SCF scaffolds were prepared, and laser confocal microscopy was used to observe the adhesion and growth status of SCAPs on the scaffolds. Furthermore, the numbers of SCAPs on the scaffolds were counted by a digestion counting method to evaluate their proliferation. Cells on the SF-RGD-SCF scaffold proliferated more than those on the other scaffolds and showed a more obvious tendency to migrate to the scaffold's deep porous structure after 7 d seeding. Live/dead cell staining results showed that almost all the adhered cells were alive after 7 d. Furthermore, cell counting showed that the number of cells on the SF-RGD-SCF scaffold was highest after both 1 and 7 d (P < 0.05). Thus, the SF-RGD-SCF composite is biocompatible and promotes the migration, adhesion, and proliferation of SCAPs, making it of potential use as a scaffold for cell-homing pulp regeneration.
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Aspesi M, Kopper PMP, de Carvalho Deluca MC, Matte BF, Brand LM, Grecca FS, Casagrande L, Scarparo RK. Cytotoxic, migration, and angiogenic effects of intracanal irrigants on cells involved in revascularization of immature teeth. Arch Oral Biol 2020; 121:104980. [PMID: 33217606 DOI: 10.1016/j.archoralbio.2020.104980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate protocols of root canal irrigation and dentin pretreatment in a cell culture model simulating immature teeth. Cytotoxic, migration, and angiogenic effects of Sodium hypochlorite associated with EDTA (NaOCl/EDTA), NaOCl associated with Smear Clear (NaOCl/SC), and QMix were compared. DESIGN Three roots of mandibular first premolars had their length and root canal diameter standardized. Root canals were irrigated, and the resulting solutions were diluted in culture medium. Sulforhodamine B (SRB) assay was performed with apical papilla cells and with endothelial cells (HUVECs) to assess cytotoxicity. Polarity index and migration assays of apical papilla cells and sprouting of HUVECs were evaluated. Data were analyzed by ANOVA and Tukey post-hoc tests (p < .05). RESULTS In apical papilla cells, NaOCl/SC and QMix promoted higher cytotoxicity, decreased fraction of elongated cells, and had lower migration speed and shorter migration distance of cells compared to NaOCl/EDTA. Also, HUVECs treated with NaOCl/SC and QMix showed decreased tubule formation in comparison with NaOCl/EDTA. CONCLUSIONS NaOCl/SC and QMix showed unfavorable biological responses of cells involved in revascularization in comparison to NaOCl/EDTA. Further studies with other intracanal irrigants should be performed to improve the balance of root canal disinfection with biological responses.
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Affiliation(s)
- Marina Aspesi
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Patrícia Maria Poli Kopper
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Mariana Castello de Carvalho Deluca
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Bibiana Franzen Matte
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Luiza Meurer Brand
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Luciano Casagrande
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
| | - Roberta Kochenborger Scarparo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, CEP 90035-003, Porto Alegre, Brazil.
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Queiroz A, Wada MT, Rosin FCP, Pelissari C, Trierveiler M. Effects of serum-free culture media on human apical papilla cells properties. Arch Oral Biol 2020; 121:104962. [PMID: 33171394 DOI: 10.1016/j.archoralbio.2020.104962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/11/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Aiming at more effective and safer cell therapies, the objective of this study was to evaluate the biological properties of human apical papilla cells cultured in the absence of serum supplementation in comparison to cells cultured with fetal bovine serum (FBS). DESIGN Two apical papilla cell populations were isolated from third molars with incomplete rhizogenesis, and cultured in four different media: minimum essential Eagle medium - alpha modification (alpha-MEM); alpha-MEM supplemented with FBS (alpha-MEM + FBS); Dulbecco's modified Eagle medium/nutrient mixture F-12 (DMEM/F12); and DMEM/F12 supplemented with FBS (DMEM/F12 + FBS). We evaluated their proliferation, clonogenicity, and in vitro osteogenic and chondrogenic differentiation potential. RESULTS Apical papilla cells cultured in DMEM/F12 + FBS and alpha-MEM + FBS were more proliferative than those grown in serum-free media, and also exhibited greater efficiency in colony cell formation. Despite this, all study groups showed immunostaining for the marker of mitosis anti-PHH3. Also, alpha-MEM + FBS, alpha-MEM, and DMEM/F12 + FBS exhibited higher amount of mineralized deposits in vitro than DMEM/F12, while only cells cultured with FBS were able to form spheres in chondrogenic differentiation assay. CONCLUSIONS Our results showed that, although the cultivation of apical papilla cells in a serum-free medium has reduced the properties of cell proliferation and differentiation, these cells are still capable of maintaining their desirable characteristics.
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Affiliation(s)
- Aline Queiroz
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo, Av Professor Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil.
| | - Mariana Taira Wada
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo, Av Professor Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil.
| | - Flávia Cristina Perillo Rosin
- General Pathology Department, School of Dentistry, University of São Paulo, Av Professor Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil.
| | - Cibele Pelissari
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo, Av Professor Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil.
| | - Marília Trierveiler
- Laboratory of Stem Cell Biology in Dentistry - LABITRON, Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo, Av Professor Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil.
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14
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Pan Y, Li Z, Wang Y, Yan M, Wu J, Beharee RG, Yu J. Sodium fluoride regulates the osteo/odontogenic differentiation of stem cells from apical papilla by modulating autophagy. J Cell Physiol 2019; 234:16114-16124. [PMID: 30767218 DOI: 10.1002/jcp.28269] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 01/24/2023]
Abstract
Fluoride (sodium fluoride) is thought to be essential in the development of tooth, and research shows that fluoride can modulate the differentiation of dental stem cells. However, the effects of fluoride on the committed differentiation of stem cells from apical papilla (SCAPs) and the underlying mechanisms remain unclear. Here, SCAPs were isolated from healthy extracted human third molars with immature roots and then were cultured with NaF conditioned media. Cell Counting Kit-8, EdU staining, and flow cytometry were performed to detected the proliferation activity. Alkaline phosphatase (ALP) activity, Alizarin Red staining, Western blot assay, and real-time reverse-transcription polymerase chain reaction were applied to assess the osteo/odontogenic differentiation NaF-treated SCAPs. Western blot assay and transmission electron microscope were used to evaluate the autophagy involved in the differentiation of SCAPs. ALP activity, ALP protein, and messenger RNA (mRNA) expression showed that 0.5 mM was the optimal concentration for the induction of SCAPs by NaF. 0.5 mM NaF-treated SCAPs induced more mineralized nodules as compared with untreated cells. Moreover, the osteo/odontogenic markers (RUNX2, OSX, DSP, and OCN) in mRNA levels were upregulated while the protein levels of these markers increased considerably in 0.5 mM NaF-treated SCAPs. Furthermore, the autophagy-related proteins (LC3, ATG5, and Beclin1) increased in NaF-treated SCAPs, and the osteo/odontogenic makers significantly decreased while silencing ATG5 to block autophagy. In all, sodium fluoride can regulate the osteo/odontogenic differentiation of SCAPs by modulating autophagy.
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Affiliation(s)
- Yin Pan
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zehan Li
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanqiu Wang
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ming Yan
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jintao Wu
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Romila Gobin Beharee
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinhua Yu
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
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15
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Bjørndal L, Simon S, Tomson PL, Duncan HF. Management of deep caries and the exposed pulp. Int Endod J 2019; 52:949-973. [PMID: 30985944 DOI: 10.1111/iej.13128] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/10/2019] [Indexed: 01/12/2023]
Abstract
Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one-visit as indirect pulp treatment or two-visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re-emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp-dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence-based management strategies and education in management of the exposed pulp are critical in the future.
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Affiliation(s)
- L Bjørndal
- Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Simon
- Paris Diderot University, Paris, France.,Hôpital de Rouen Normandie, Rouen, France.,Laboratoire IN SERM UMR 1138, Paris, France
| | - P L Tomson
- School of Dentistry, Institute of Clinical Sciences, Birmingham, UK
| | - H F Duncan
- Division of Restorative Dentistry & Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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16
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Stem Cells from the Apical Papilla: A Promising Source for Stem Cell-Based Therapy. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6104738. [PMID: 30834270 PMCID: PMC6374798 DOI: 10.1155/2019/6104738] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/15/2019] [Indexed: 12/17/2022]
Abstract
Stem cells are biological cells that can self-renew and can differentiate into multiple cell lineages. Stem cell-based therapy is emerging as a promising alternative therapeutic option for various disorders. Mesenchymal stem cells (MSCs) are multipotent adult stem cells that are isolated from various tissues and can be used as an alternative to embryonic stem cells. Stem cells from the apical papilla (SCAPs) are a novel population of MSCs residing in the apical papilla of immature permanent teeth. SCAPs present the characteristics of expression of MSCs markers, self-renewal, proliferation, migration, differentiation, and immunosuppression, which support the application of SCAPs in stem cell-based therapy, including the immunotherapy and the regeneration of dental tissues, bone, neural, and vascular tissues. In view of these properties and therapeutic potential, SCAPs can be considered as promising candidates for stem cell-based therapy. Thus the aim of our review was to summarize the current knowledge of SCAPs considering isolation, characterization, and multilineage differentiation. The prospects for their use in stem cell-based therapy were also discussed.
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17
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Hong S, Li L, Cai W, Jiang B. The potential application of concentrated growth factor in regenerative endodontics. Int Endod J 2018; 52:646-655. [PMID: 30471228 DOI: 10.1111/iej.13045] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/20/2018] [Indexed: 12/12/2022]
Affiliation(s)
- S. Hong
- Department of Endodontics, School & Hospital of Stomatology Tongji University Shanghai Engineering Research Center of Tooth Restoration and Regeneration Shanghai China
| | - L. Li
- Department of Endodontics, School & Hospital of Stomatology Tongji University Shanghai Engineering Research Center of Tooth Restoration and Regeneration Shanghai China
| | - W. Cai
- Center for Translational Neurodegeneration and Regenerative Therapy Shanghai Tenth People's Hospital Tongji University School of Medicine Shanghai China
| | - B. Jiang
- Department of Endodontics, School & Hospital of Stomatology Tongji University Shanghai Engineering Research Center of Tooth Restoration and Regeneration Shanghai China
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18
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Abstract
Purpose of Review To summarize current views on the role and therapeutic potential of growth factors (GFs) within endodontic cell homing. Recent Findings Cell homing/revitalization techniques aim to regenerate dentin and pulp using endogenous cells. Clinically, revitalization has successfully created new vital tissue in necrotic permanent teeth with an open apex; however, there is no evidence of new odontoblasts, pulp tissue, or predictable extension in root length. Although the response is reparative rather than regenerative, exciting opportunities to improve these biologically-based strategies remain by (1) efficiently sequestering dentin-matrix-components (DMCs) using irrigants and dental materials (2) designing next-generation GF-releasing scaffold materials and (3) utilizing other sources of GF such as cells and plasma-rich plasma and plasma-rich fibrin. Summary GFs can promote reparative-dentinogenesis and pulp-like tissue formation. The future development and clinical approval of GF-functionalized-scaffolds is a priority; however, current focus should be to harness DMCs and target the interaction of stem cells and GFs.
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19
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Nada OA, El Backly RM. Stem Cells From the Apical Papilla (SCAP) as a Tool for Endogenous Tissue Regeneration. Front Bioeng Biotechnol 2018; 6:103. [PMID: 30087893 PMCID: PMC6066565 DOI: 10.3389/fbioe.2018.00103] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/03/2018] [Indexed: 12/19/2022] Open
Abstract
Stem cells extracted from developing tissues possibly exhibit not only unique but also superior traits against their developed counterparts. Indeed, stem cells from the apical papilla (SCAP); a unique group of dental stem cells related to developing roots have been shown to be a promising tool for regenerative endodontic procedures and regeneration in general. Studies have characterized the phenotypic traits as well as other regenerative potentials of these cells. Specific sub-populations have been highlighted as well as their neurogenic and angiogenic properties. Nevertheless, in light of the previously discussed features and potential applications of SCAP, there is still much to understand and a lot of information to unravel. The current review will discuss the role of specific markers for detection of different functional populations of SCAP; including CD146 and STRO-1, as well as their true multilineage differentiation potential. In particular, the role of the secretome in association with paracrine signaling in inflammatory microenvironments is also tackled. Additionally, the role of SCAP both in vitro and in vivo during regenerative approaches and in response to different growth factors and biologic scaffolds is highlighted. Finally, this review will shed light on current knowledge regarding the clinical translational potential of SCAP and elucidate possible areas for future research applications.
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Affiliation(s)
- Ola A Nada
- Oral Biology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania M El Backly
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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20
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Nagas E, Uyanik MO, Cehreli ZC. Revitalization of necrotic mature permanent incisors with apical periodontitis: a case report. Restor Dent Endod 2018; 43:e31. [PMID: 30135850 PMCID: PMC6103546 DOI: 10.5395/rde.2018.43.e31] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023] Open
Abstract
Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.
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Affiliation(s)
- Emre Nagas
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - M Ozgur Uyanik
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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