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EzEldeen M, Pedano De Piero MNS, Xu L, Driesen RB, Wyatt J, Van Gorp G, Meschi N, Van Meerbeek B, Lambrichts I, Jacobs R. Multimodal Imaging of Dental Pulp Healing Patterns following Tooth Autotransplantation And Regenerative Endodontic Treatment. J Endod 2023:S0099-2399(23)00324-2. [PMID: 37315781 DOI: 10.1016/j.joen.2023.06.003] [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: 03/21/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Understanding the healing process of dental pulp after tooth autotransplantation (TAT) and regenerative endodontic treatment (RET) of immature teeth is important both clinically and scientifically. This study aimed to characterize the pattern of dental pulp healing in human teeth that underwent TAT and RET using state-of-the-art imaging techniques. MATERIALS AND METHODS This study examined four human teeth, two premolars that underwent TAT and two central incisors that received RET. The premolars were extracted after one year (case 1) and two years (case 2) due to ankylosis, while the central incisors were extracted after three years (cases 3 and 4) for orthodontic reasons. Nanofocus x-ray computed tomography was used to image the samples before being processed for histological and immunohistochemical analysis. Laser scanning confocal second harmonic generation imaging (SHG) was used to examine the patterns of collagen deposition. A maturity-matched premolar was included as a negative control for the histological and SHG analysis. RESULTS Analysis of the four cases revealed different patterns of dental pulp healing. Similarities were observed in the progressive obliteration of the root canal space. However, a striking loss of typical pulpal architecture was observed in the TAT cases, while a pulp-like tissue was observed in one of the RET cases. Odontoblast-like cells were observed in cases 1 and 3. CONCLUSION This study provided insights into the patterns of dental pulp healing after TAT and RET. The SHG imaging sheds light on the patterns of collagen deposition during reparative dentin formation.
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Affiliation(s)
- Mostafa EzEldeen
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
| | - Mariano N Simon Pedano De Piero
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Lianyi Xu
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Ronald B Driesen
- Biomedical Research Institute, Hasselt University, Campus Diepenbeek, Agoralaan Building C, B-3590 Diepenbeek, Belgium
| | - Jan Wyatt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Gertrude Van Gorp
- KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Nastaran Meschi
- Section of Endodontology, Department of Oral Health Sciences, Ghent University, C. Heymanslaan 10/P8, 9000 Ghent, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven, University Hospitals Leuven, Dentistry, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Ivo Lambrichts
- Biomedical Research Institute, Hasselt University, Campus Diepenbeek, Agoralaan Building C, B-3590 Diepenbeek, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Elhakim A, Kim S, Kim E, Elshazli AH. Preserving the vitality of teeth adjacent to a large radicular cyst in periapical microsurgery: a case report with 4-year follow-up. BMC Oral Health 2021; 21:382. [PMID: 34344347 PMCID: PMC8336380 DOI: 10.1186/s12903-021-01738-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
Background Radicular cysts may enlarge considerably, cause extensive bone destruction, and jeopardize the integrity of the associated vital teeth. The different treatment approaches are aimed mainly at eliminating the cystic epithelial membrane while reducing the risk of injury to vital structures. Contrary to other treatment modalities, preapical surgery offers an unequivocal single occasion resolution for the patient. However, it has been associated with higher risk of collateral damages. Case presentation A patient presented with a large radicular cyst originating from a maxillary lateral incisor. The adjacent central and canine teeth initially failed to exhibit responses to sensibility tests but showed signs of vitality. Microsurgical management was aimed at enucleating the cystic membrane while maintaining adjacent teeth vitality. Upon careful and controlled cyst enucleation under the dental operating microscope, the neurovascular bundle of one of the involved teeth was visualized and its integrity was maintained throughout the procedure. Results The procedure was successful and follow up recalls revealed recovery of normal sensibility of tooth 11 and 13 with complete bone regeneration around their apices. Conclusion Within the limitation of the present case report, we demonstrated that complete excision of large periapical cyst can be performed without sacrificing the vitality of the adjacent teeth, by preserving the integrity of their neurovascular supply through controlled microsurgical enucleation, and by a potential apical vascular repair ensuing unintended injury. Diagnosing the pulp vitality of non-offending teeth whose apices protrude into the cystic lumen is a complex process and can be misleading. Pressure from the growing cyst can inhibit vital teeth responses to neural-based sensibility tests leading to false negative results. Thus, in such cases, the use of blood perfusion-based vitality testing is recommended for correct initial diagnosis.
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Affiliation(s)
- Ahmed Elhakim
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.,Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, 03722, Republic of Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, 03722, Republic of Korea
| | - Alaa H Elshazli
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
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Arbel Y, Lvovsky A, Azizi H, Hadad A, Averbuch Zehavi E, Via S, Ben Itzhak J, Solomonov M. Autotransplantation after primary bone repair of a recipient site with a large periradicular lesion: a case report. Int Endod J 2019; 52:1789-1796. [DOI: 10.1111/iej.13191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Y. Arbel
- Department of Periodontology Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - A. Lvovsky
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - H. Azizi
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - A. Hadad
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - E. Averbuch Zehavi
- Department of Periodontology Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - S. Via
- Department of Periodontology Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - J. Ben Itzhak
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
| | - M. Solomonov
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Tel Hashomer Israel
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Nozu A, Hamano S, Tomokiyo A, Hasegawa D, Sugii H, Yoshida S, Mitarai H, Taniguchi S, Wada N, Maeda H. Senescence and odontoblastic differentiation of dental pulp cells. J Cell Physiol 2018; 234:849-859. [DOI: 10.1002/jcp.26905] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 06/12/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Aoi Nozu
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Sayuri Hamano
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
- OBT Research Center Faculty of Dental Science, Kyushu University Fukuoka Japan
| | - Atsushi Tomokiyo
- Division of Endodontology Kyushu University Hospital, Kyushu University Fukuoka Japan
| | - Daigaku Hasegawa
- Division of Endodontology Kyushu University Hospital, Kyushu University Fukuoka Japan
| | - Hideki Sugii
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Shinichiro Yoshida
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Hiromi Mitarai
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Shuntaro Taniguchi
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Naohisa Wada
- Division of General Dentistry, Kyushu University Hospital Kyushu University Fukuoka Japan
| | - Hidefumi Maeda
- Department of Endodontology and Operative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science Kyushu University Fukuoka Japan
- Division of Endodontology Kyushu University Hospital, Kyushu University Fukuoka Japan
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Ganz J, Shor E, Guo S, Sheinin A, Arie I, Michaelevski I, Pitaru S, Offen D, Levenberg S. Implantation of 3D Constructs Embedded with Oral Mucosa-Derived Cells Induces Functional Recovery in Rats with Complete Spinal Cord Transection. Front Neurosci 2017; 11:589. [PMID: 29163001 PMCID: PMC5671470 DOI: 10.3389/fnins.2017.00589] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/06/2017] [Indexed: 12/23/2022] Open
Abstract
Spinal cord injury (SCI), involving damaged axons and glial scar tissue, often culminates in irreversible impairments. Achieving substantial recovery following complete spinal cord transection remains an unmet challenge. Here, we report of implantation of an engineered 3D construct embedded with human oral mucosa stem cells (hOMSC) induced to secrete neuroprotective, immunomodulatory, and axonal elongation-associated factors, in a complete spinal cord transection rat model. Rats implanted with induced tissue engineering constructs regained fine motor control, coordination and walking pattern in sharp contrast to the untreated group that remained paralyzed (42 vs. 0%). Immunofluorescence, CLARITY, MRI, and electrophysiological assessments demonstrated a reconnection bridging the injured area, as well as presence of increased number of myelinated axons, neural precursors, and reduced glial scar tissue in recovered animals treated with the induced cell-embedded constructs. Finally, this construct is made of bio-compatible, clinically approved materials and utilizes a safe and easily extractable cell population. The results warrant further research with regards to the effectiveness of this treatment in addressing spinal cord injury.
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Affiliation(s)
- Javier Ganz
- Department of Human Molecular Genetics and Biochemistry, Felsenstein Medical Research Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Erez Shor
- Department of Biomedical Engineering, Technion, Haifa, Israel
| | - Shaowei Guo
- Department of Biomedical Engineering, Technion, Haifa, Israel
| | - Anton Sheinin
- Department of Neurobiology, The George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ina Arie
- Department of Oral Biology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Izhak Michaelevski
- Department of Neurobiology, The George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel.,Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ariel, Israel
| | - Sandu Pitaru
- Department of Oral Biology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Offen
- Department of Human Molecular Genetics and Biochemistry, Felsenstein Medical Research Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Miyazaki T, Baba TT, Mori M, Moriishi T, Komori T. Microtubule-associated protein tau (Mapt) is expressed in terminally differentiated odontoblasts and severely down-regulated in morphologically disturbed odontoblasts of Runx2 transgenic mice. Cell Tissue Res 2015; 361:457-66. [PMID: 25707508 DOI: 10.1007/s00441-015-2135-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/23/2015] [Indexed: 10/24/2022]
Abstract
Runx2 is an essential transcription factor for osteoblast and odontoblast differentiation and the terminal differentiation of chondrocytes. We have previously shown that the terminal differentiation of odontoblasts is inhibited in Runx2 transgenic {Tg(Col1a1-Runx2)} mice under the control of the 2.3-kb Col1a1 promoter, which directs the transgene expression to osteoblasts and odontoblasts. Odontoblasts show severe reductions in Dspp and nestin expression and lose their characteristic polarized morphology, including a long process extending to dentin, in Tg(Col1a1-Runx2) mice. We study the molecular mechanism of odontoblast morphogenesis by comparing gene expression in the molars of wild-type and Tg(Col1a1-Runx2) mice, focusing on cytoskeleton-related genes. Using microarray, we found that the gene expression of microtubule-associated protein tau (Mapt), a neuronal phosphoprotein with important roles in neuronal biology and microtubule dynamics and assembly, was high in wild-type molars but severely reduced in Tg(Col1a1-Runx2) molars. Immunohistochemical analysis revealed that Mapt was specifically expressed in terminally differentiated odontoblasts including their processes in wild-type molars but its expression was barely detectable in Tg(Col1a1-Runx2) molars. Double-staining of Mapt and Runx2 showed their reciprocal expression in odontoblasts. Mapt and tubulin co-localized in odontoblasts in wild-type molars. Immunoelectron microscopic analysis demonstrated Mapt lying around α-tubulin-positive filamentous structures in odontoblast processes. Thus, Mapt is a useful marker for terminally differentiated odontoblasts and might play an important role in odontoblast morphogenesis.
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Affiliation(s)
- Toshihiro Miyazaki
- Department of Cell Biology, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
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Ahn SJ, Jang JH, Seo JS, Cho KM, Jung SH, Lee HW, Kim EC, Park SH. Influence of 2 cryopreservation methods to induce CCL-13 from dental pulp cells. J Endod 2013; 39:1562-6. [PMID: 24238447 DOI: 10.1016/j.joen.2013.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 07/25/2013] [Accepted: 07/25/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Cryopreservation preserves periodontal ligament cells but has a lower success rate with dental pulp cells (DPCs) because it causes inflammation. There are 2 well-known cryopreservation methods that reduce inflammation, slow freezing and rapid freezing, but the effects of the 2 methods on inflammation are not well-established. The purpose of this study was to compare the effects of the 2 different cryopreservation methods on CCL-13 induction from DPCs by using microarrays, real-time polymerase chain reaction (PCR), Western blotting, enzyme-linked immunosorbent assay, and confocal laser scanning microscopy (CLSM). METHODS In this study, the concentration of cryoprotectant was fixed, and the methods compared differed with respect to freezing speed. Initially we screened the DPCs of cryopreserved teeth with expression microarrays, and CCL-13 was identified as a differentially expressed gene involved in generalized inflammation. We then compared the expression of CCL-13 after exposing teeth to the 2 cryopreservation methods by using real-time PCR, Western blot, enzyme-linked immunosorbent assay, and CLSM. RESULTS Expression of CCL-13 was up-regulated significantly only in the rapid freezing group, except in measurements made by real-time PCR. CLSM analysis also confirmed this up-regulation visually. CONCLUSIONS Rapid freezing increased the expression of CCL-13 in DPCs compared with slow freezing. Understanding the inflammatory effect of cryopreservation should help to establish an optimal cryoprofile to minimize inflammation of DPCs and reduce the need for endodontic treatment.
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Affiliation(s)
- Su-Jin Ahn
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
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