Changes in the pattern of horseradish peroxidase diffusion into predentin and dentin after cavity preparation in rat molars

Deciphering Reparative Processes in the Inflamed Dental Pulp

Research over several decades has increased our understanding of the nature of reparative and regenerative processes in the dental pulp, at both the cellular and molecular level. However, advances in scientific knowledge have not translated into novel clinical treatment strategies for caries-induced pulpitis. This narrative review explores the evidence regarding the ability of inflamed pulp tissue to heal and how this knowledge may be used therapeutically. A literature search and evidence analysis covering basic, translational and clinical pulp biology research was performed. The review focuses on (1) the regenerative and defense capabilities of the pulp during caries-induced inflammation; (2) the potential of novel biomaterials to harness the reparative and regenerative functions of the inflamed pulp; and (3) future perspectives and opportunities for conservative management of the inflamed pulp. Current conservative management strategies for pulpitis are limited by a combination of unreliable diagnostic tools and an outdated understanding of pulpal pathophysiological responses. This approach leads to the often unnecessary removal of the entire pulp. Consequently, there is a need for better diagnostic approaches and a focus on minimally-invasive treatments utilizing biologically-based regenerative materials and technologies.

Facilitatory effect of AC-iontophoresis of lidocaine hydrochloride on the permeability of human enamel and dentine in extracted teeth

OBJECTIVES

The objectives of the present study were to quantitatively evaluate chemical permeability through human enamel/dentine using conductometry and to clarify if alternating current (AC) iontophoresis facilitates such permeability.

MATERIALS AND METHODS

Electrical impedance of different concentrations of lidocaine hydrochloride was measured using a bipolar platinum impedance probe. A quadratic curve closely fitted to the response functions between conductance and lidocaine hydrochloride. For analysis of the passage of lidocaine hydrochloride through human enamel/dentine, eight premolars that were extracted for orthodontic treatment were sectioned at the cemento-enamel junction. The tooth crowns were held between two chambers with a double O-ring. The enamel-side chamber was filled with lidocaine hydrochloride, and the pulp-side chamber was filled with extrapure water. Two platinum plate electrodes were set at the end of each chamber to pass alternating current. A simulated interstitial pulp pressure was applied to the pulp-side chamber. The change in the concentration of lidocaine hydrochloride in the pulp-side chamber was measured every 2min using a platinum recording probe positioned at the centre of the pulp-side chamber. Passive entry without iontophoresis was used as a control.

RESULTS

The level of lidocaine hydrochloride that passed through enamel/dentine against the dentinal fluid flow increased with time. Electrical conductance (G, mho) correlated closely to the concentration (x, mmol/L) of lidocaine hydrochloride (G=2.16x(2)+0.0289x+0.000376, r(2)=0.999).

CONCLUSIONS

Lidocaine hydrochloride can pass through enamel/dentine. Conductometry showed that the level of lidocaine hydrochloride that passed through enamel/dentine was increased by AC iontophoresis.

Rapid penetration of lucifer yellow into vital teeth and dye coupling between odontoblasts and neighbouring pulp cells in the cat

The location and long process of odontoblasts appear well suited to detection of external stimuli. The odontoblasts may transmit the information not individually but as a syncytium via gap junction, which functions as a mechanism for intercellular linking cells and as the route for dye coupling. The aims of the present study were to examine dye penetration through enamel and dentin, and to confirm dye coupling between odontoblasts (OBs) or between odontoblasts and other pulpal cells beneath the odontoblastic layer (PCs). Either lucifer yellow (LY) or borate buffer (control) was applied to etched enamel surface of feline canines for 30 min at atmospheric pressure. In the decalcified sections, lucifer yellow positive cells were found not only in but also beneath the odontoblastic layer (experiment 1). In the isolated pulp cells, all OBs (27/27) and some PCs (6/9) that were immunocytochemically differentiated using two monoclonal antibodies were labelled with LY (experiment 2). These results indicate the remarkably quick movement of LYE through enamel and dentin into the superficial pulp. In experiment 3, fresh OBs and PCs were isolated from feline canines to which LY had not been applied. LY was iontophoretically injected into an OB-like cell that had an oval cell body and a long monopolar process. Some PCs and OBs identified immunocytochemically were labelled with LY, with the exception of a few LY-negative cells. These findings indicate that dye coupling exists not only between OBs but also between OBs and PCs. Thus, the coupling provides evidence for a functional link via which information is transmitted between OBs and PCs.

Influence of the pulpal components on human dentine permeability in vitro

AIM

To examine the influence of the retained pulpal components on permeability of human dentine by monitoring drug diffusion.

METHODOLOGY

Twelve intact dentine discs were prepared from freshly extracted human third molars. The dentine surface on the enamel side was etched with 10% polyacrylic acid for 30 s. The drug diffusion test was carried out before and after removal of the retained pulpal components. Each dentine disc was inserted between two plastic chambers; enamel- and pulpal-side chambers, which were filled with 0.05 mol L(-1) naproxen sodium (NA) and phosphate-buffered saline (PBS), respectively. After 10 min, the solution on the pulpal-side chamber was collected to determine the concentration of NA using a spectrophotometer. To remove the retained pulpal components and residual NA, the pulp chamber of each disc was washed out with PBS and placed in an ultrasonic cleaner. After removal of these components and the residual NA, the drug diffusion test was repeated. The inner surface of the pulp chamber was observed using scanning electron microscopy (SEM) before and after the removal of the retained pulpal components.

RESULTS

The amount of NA that diffused through dentine into the pulp was significantly higher after the pulp chamber was washed out with PBS (paired t-test, P < 0.05). SEM observation demonstrated the presence of the retained pulpal components, odontoblastic layer and some parts of subodontoblastic zone, covering the surface of predentine. These components were removed after the pulp chamber was washed out with PBS followed by cleaning in an ultrasonic cleaner.

CONCLUSIONS

The presence of retained pulpal components had a significant influence on drug diffusion through dentine discs.

Pulp biology: progress during the past 25 years

During the past 25 years there has been a rapid expansion in our knowledge of the dentine and pulp complex. This paper provides representative examples of important advances that researchers have made in this field. Topics to be considered include: differentiation of odontoblasts, dentine matrix proteins, extent of odontoblast processes, pulpal stem cells, apoptosis, interstitial fluid pressure in normal and inflamed pulps, class II antigen-presenting cells of the pulp, cytokines, antibodies, pulpal calcifications, tertiary dentine and pulpal inflammation associated with bacterial contamination of exposed dentine beneath restorations.