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Usta SN, Keskin C, Pirimoğlu B, Aksoy A. Histological response of inflamed pulp to hydraulic calcium silicate cements in direct pulp capping: Systematic review of pulpitis models. AUST ENDOD J 2024. [PMID: 38963183 DOI: 10.1111/aej.12873] [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: 04/16/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024]
Abstract
This systematic review aimed to compare the histological response of inflamed pulpodentinal complex to the hydraulic calcium silicate cements in experimental animal models of pulpitis. Articles that evaluated the histological response of inflamed pulp to mineral trioxide aggregate (MTA) in comparison with other restorative materials were selected and analysed in detail. The risk of bias assessment was conducted using SYRCLE's RoB tool. The GRADEpro tool was used to determine the overall quality of evidence. Out of the 2947 retrieved articles from databases, five articles fulfilled the inclusion criteria. MTA induced significantly more hard tissue formation compared to calcium hydroxide. The use of pulp-capping material containing fluocinolone acetonide and ASP/PLGA-ASP/ACP/PLLA-PLGA composite membrane was comparable. This systematic review could not demonstrate enhanced efficiency of capping materials compared to MTA. Future well-conducted animal studies are warranted for demonstrating the hard tissue formation abilities of pulp-capping materials with convenient inflammatory conditions.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, University of Ondokuz Mayıs, Samsun, Turkey
| | - Burcu Pirimoğlu
- Department of Endodontics, Faculty of Dentistry, University of Ondokuz Mayıs, Samsun, Turkey
| | - Abdurrahman Aksoy
- Department of Veterinary Pharmacology and Toxicology, University of Ondokuz Mayıs, Samsun, Turkey
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Talebi S, Nourbakhsh N, Talebi A, Nourbakhsh AA, Haghighat A, Manshayi M, Bakhsheshi HR, Karimi R, Nazeri R, Mackenzie KJD. Hard tissue formation in pulpotomized primary teeth in dogs with nanomaterials MCM-48 and MCM-48/hydroxyapatite: an in vivo animal study. BMC Oral Health 2024; 24:322. [PMID: 38468251 PMCID: PMC10926592 DOI: 10.1186/s12903-024-04098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA). METHODS This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent. RESULTS The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320). CONCLUSION MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.
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Affiliation(s)
- Sahar Talebi
- Dentist, Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nosrat Nourbakhsh
- Department of Pediatric Dentistry, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Talebi
- Department of Pathology, Medical School, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Amir Abbas Nourbakhsh
- Department of Materials Science, Shahreza Branch, Islamic Azad University, Shahreza, Iran
| | - Abbas Haghighat
- Department of Maxillofacial Surgery, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maziar Manshayi
- DVM. Dental Science Research Center. Dentistry faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Bakhsheshi
- Advanced Materials Research Center, Department of Materials Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Razieh Karimi
- Advanced Materials Research Center, Department of Materials Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Rahman Nazeri
- Dentist, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kenneth J D Mackenzie
- MacDiarmid Institute for Advanced Materials and Nanotechnology, Victoria University of Wellington, Wellington, New Zealand
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Montenegro Raudales JL, Okuwa Y, Honda M. Dental Pulp Cell Transplantation Combined with Regenerative Endodontic Procedures Promotes Dentin Matrix Formation in Mature Mouse Molars. Cells 2024; 13:348. [PMID: 38391961 PMCID: PMC10886544 DOI: 10.3390/cells13040348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024] Open
Abstract
Regenerative endodontic procedures (REPs) are promising for dental pulp tissue regeneration; however, their application in permanent teeth remains challenging. We assessed the potential combination of an REP and local dental pulp cell (DPC) transplantation in the mature molars of C57BL/6 mice with (REP + DPC group) or without (REP group) transplantation of DPCs from green fluorescent protein (GFP) transgenic mice. After 4 weeks, the regenerated tissue was evaluated by micro-computed tomography and histological analyses to detect odontoblasts, vasculogenesis, and neurogenesis. DPCs were assessed for mesenchymal and pluripotency markers. Four weeks after the REP, the molars showed no signs of periapical lesions, and both the REP and REP + DPC groups exhibited a pulp-like tissue composed of a cellular matrix with vessels surrounded by an eosin-stained acellular matrix that resembled hard tissue. However, the REP + DPC group had a broader cellular matrix and uniquely contained odontoblast-like cells co-expressing GFP. Vasculogenesis and neurogenesis were detected in both groups, with the former being more prominent in the REP + DPC group. Overall, the REP was achieved in mature mouse molars and DPC transplantation improved the outcomes by inducing the formation of odontoblast-like cells and greater vasculogenesis.
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Affiliation(s)
- Jorge Luis Montenegro Raudales
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Aichi, Japan; (Y.O.); (M.H.)
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4
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La Rosa GRM, Pedullà E. Effectiveness of probiotics in apical periodontitis progression: A scoping review and implications for research. AUST ENDOD J 2023; 49 Suppl 1:528-536. [PMID: 36524834 DOI: 10.1111/aej.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
To synthesise the current knowledge on the effects of probiotics in apical periodontitis progression by a scoping review of animal and human studies. Reporting was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. The literature search and screening was performed on PubMed and Scopus databases by two independent reviewers selecting human and animal studies that evaluated the effectiveness of probiotics in reducing the severity of apical periodontitis. Two animal studies with 3 publications met the eligibility criteria for qualitative synthesis. The most common probiotics were Lactobacillus rhamnosus and Lactobacillus acidophilus orally administered for gavage in Wistar rats with induced apical periodontitis. Overall, probiotics significantly reduced inflammation and bone resorption with an improvement in the apical periodontitis progression. Although results in animal studies are promising, the use of probiotics in apical periodontitis progression requires caution due to the insufficient available evidence.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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5
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Yang D, Solidum JGN, Park D. Dental Pulp Stem Cells and Current in vivo Approaches to Study Dental Pulp Stem Cells in Pulp Injury and Regeneration. J Bone Metab 2023; 30:231-244. [PMID: 37718901 PMCID: PMC10509030 DOI: 10.11005/jbm.2023.30.3.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 08/20/2023] [Indexed: 09/19/2023] Open
Abstract
Dental pulp stem cells (DPSCs) have garnered significant interest in dental research for their unique characteristics and potential in tooth development and regeneration. While there were many studies to define their stem cell-like characteristics and osteogenic differentiation functions that are considered ideal candidates for regenerating damaged dental pulp tissue, how endogenous DPSCs respond to dental pulp injury and supply new dentin-forming cells has not been extensively investigated in vivo. Here, we review the recent progress in identity, function, and regulation of endogenous DPSCs and their clinical potential for pulp injury and regeneration. In addition, we discuss current advances in new mouse models, imaging techniques, and its practical uses and limitations in the analysis of DPSCs in pulp injury and regeneration in vivo.
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Affiliation(s)
- Dongwook Yang
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX,
USA
- Center for Skeletal Biology, Baylor College of Medicine, Houston, TX,
USA
| | - Jea Giezl Niedo Solidum
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX,
USA
- Department of Biochemistry & Molecular Biology, College of Medicine, University of the Philippines Manila, Manila,
Philippines
| | - Dongsu Park
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX,
USA
- Center for Skeletal Biology, Baylor College of Medicine, Houston, TX,
USA
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX,
USA
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6
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Huang H, Okamoto M, Watanabe M, Matsumoto S, Moriyama K, Komichi S, Ali M, Matayoshi S, Nomura R, Nakano K, Takahashi Y, Hayashi M. Development of Rat Caries-Induced Pulpitis Model for Vital Pulp Therapy. J Dent Res 2023; 102:574-582. [PMID: 36913545 PMCID: PMC10152557 DOI: 10.1177/00220345221150383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Rodent animal models for vital pulp therapy are commonly used in dental research because their tooth anatomy and cellular processes are similar to the anatomy and processes in humans. However, most studies have been conducted using uninfected sound teeth, which makes it difficult to adequately assess the inflammatory shift after vital pulp therapy. In the present study, we aimed to establish a caries-induced pulpitis model based on the conventional rat caries model and then evaluate inflammatory changes during the wound-healing process after pulp capping in a model of reversible pulpitis induced by carious infection. To establish the caries-induced pulpitis model, the pulpal inflammatory status was investigated at different stages of caries progression by immunostaining targeted to specific inflammatory biomarkers. Immunohistochemical staining revealed that both Toll-like receptor 2 and proliferating cell nuclear antigen were expressed in moderate and severe caries-stimulated pulp, indicating that an immune reaction occurred at both stages of caries progression. M2 macrophages were predominant in moderate caries-stimulated pulp, whereas M1 macrophages were predominant in the severe caries-stimulated pulp. Pulp capping in teeth with moderate caries (i.e., teeth with reversible pulpitis) led to complete tertiary dentin formation within 28 d after treatment. Impaired wound healing was observed in teeth with severe caries (i.e., teeth with irreversible pulpitis). During the wound-healing process in reversible pulpitis after pulp capping, M2 macrophages were predominant at all time points; their proliferative capacity was upregulated in the early stage of wound healing compared with healthy pulp. In conclusion, we successfully established a caries-induced pulpitis model for studies of vital pulp therapy. M2 macrophages have an important role in the early stages of the wound-healing process in reversible pulpitis.
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Affiliation(s)
- H Huang
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Okamoto
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Watanabe
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - S Matsumoto
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - K Moriyama
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - S Komichi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Ali
- Department of Restorative Dentistry, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - S Matayoshi
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - R Nomura
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan.,Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima
| | - K Nakano
- Department of Pediatric Dentistry, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - Y Takahashi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
| | - M Hayashi
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Suita-shi, Osaka, Japan
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7
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Yang X, Zhan C, Cheng T, Huang M, Ge W, Zhang Y, Chen T, Lu Y, Cui ZK, Hou J. Evaluation of the transdentinal capability of the intrinsic antibacterial cetylpyridinium chloride/cholesterol sterosomes in vitro and in vivo. Int Endod J 2023; 56:245-258. [PMID: 36336782 DOI: 10.1111/iej.13865] [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: 05/02/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
AIM Dentinal tubules serve as disease-causing channels for infiltration and penetration of bacteria and their by-products; which are regarded as the major driver of pathogenesis in pulpal inflammation and infection. In this study, we aimed to evaluate the transdentinal potential of nanoscale cetylpyridinium chloride/cholesterol (CPC/Chol) sterosomes, which are a recently developed type of cationic non-phospholipid liposomal nanocarrier; as well as their intrinsic and universal antibacterial activity. METHODOLOGY Cetylpyridinium chloride/cholesterol sterosomes were formulated, with a hydrodynamic diameter of 134 ± 4 nm, a low polydisperse index of 0.161 ± 0.007, and a positive zeta potential of 41 ± 3 mV at pH 7.4. Transdentinal diffusion ability of sterosomes was evaluated using human dentine blocks in vitro, and Wistar rat molar teeth in vivo. The intrinsic antibacterial activities of CPC/Chol sterosomes against Enterococcus faecalis, Streptococcus mutans, Fusobacterium nucleatum, and Porphyromonas gingivalis were further examined. RESULTS Cetylpyridinium chloride/cholesterol sterosomes successfully penetrated through the dentinal tubules, and diffused into the pulp, which could be internalized by dental pulp cells with a high efficiency. In addition, they exhibited substantial levels of intrinsic antibacterial activity against these Gram-positive and Gram-negative endodontic bacteria and their biofilms. CONCLUSIONS Given its high penetration and diffusion ability through the dentine and pulp, great potential for multi-drug delivery, and distinct intrinsic antibacterial activity; sterosome-based nanocarriers might serve as a promising therapeutic strategy aimed at targeting various specific pathways associated with pulpal diseases. This will help determine and characterize the most appropriate prophylactic and therapeutic targets for early intervention in our future dentistry practice.
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Affiliation(s)
- Xiaojun Yang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chaoning Zhan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tianjiao Cheng
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Minchun Huang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weiwen Ge
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yiqing Zhang
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Ting Chen
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanli Lu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhong-Kai Cui
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Jin Hou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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8
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Igna A, Igna C, Miron MI, Schuszler L, Dascălu R, Moldovan M, Voicu AA, Todea CD, Boariu M, Mârțu MA, Stratul ȘI. Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model. Diagnostics (Basel) 2022; 12:diagnostics12082022. [PMID: 36010372 PMCID: PMC9407383 DOI: 10.3390/diagnostics12082022] [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: 08/04/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: This study aimed to assess the pulpal response of primary teeth by pulse-oximetry (PO) in a canine model, following direct pulp capping (DPC). (2) Methods: Forty-eight primary teeth from eight canine subjects were divided into three treatment groups, based on the DPC material—calcium hydroxide (CH), MTA, BiodentineTM)—and three corresponding control groups. Data from PO pulp testing were correlated with laser Doppler flowmetry (LDF) testing, computer tomographic (CT) densitometry and histological analysis; the experiment lasted 14 days. (3) Results: SpO₂ recordings revealed statistically significant differences (p = 0.002, <0.05) between the treatment and control groups, and no significant differences (p = 0.257, >0.05) were observed between treatment groups. LDF recordings showed significant differences (p = 0.002, <0.05) between the treatment and control groups and identified significant differences between materials (p = 0.001, <0.05). CT densitometry indicated vital pulps in all teeth, with pulpal inflammation detected in 6/8 CH-capped teeth and 2/8 MTA-capped teeth. Histologic evaluation confirmed vital pulp in all specimens, with different degrees of inflammation. (4) Conclusions: Within its limitations, the present study confirms the diagnostic value of PO evaluation of pulpal status in primary teeth with histologic means after pulp-capping procedures in a canine model. However, various degrees of pulpal inflammation elicited by different pulp-capping materials seem not to correlate with the obtained PO values.
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Affiliation(s)
- Andreea Igna
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (A.I.); (M.I.M.)
| | - Cornel Igna
- Department of Surgery, Faculty of Veterinary Medicine, Banat University of Agricultural Sciences and Veterinary Medicine “Regele Mihai I al Romaniei”, 300645 Timisoara, Romania
| | - Mariana Ioana Miron
- Department of Oral Rehabilitation and Dental Emergencies, Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (A.I.); (M.I.M.)
| | - Larisa Schuszler
- Department of Surgery, Faculty of Veterinary Medicine, Banat University of Agricultural Sciences and Veterinary Medicine “Regele Mihai I al Romaniei”, 300645 Timisoara, Romania
| | - Roxana Dascălu
- Department of Imagistic Diagnosis, Faculty of Veterinary Medicine, Banat University of Agricultural Sciences and Veterinary Medicine “Regele Mihai I al Romaniei”, 300645 Timisoara, Romania
| | - Mihaela Moldovan
- Department of Pathological Anatomy, Municipal Emergency Clinical Hospital, 300231 Timisoara, Romania
| | - Adrian Aristide Voicu
- Department of Functional Sciences, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Carmen Darinca Todea
- Department of Oral Rehabilitation and Dental Emergencies, Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Maria-Alexandra Mârțu
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ștefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Hosseinpour S, Gaudin A, Peters OA. A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials. Int Endod J 2022; 55 Suppl 2:346-369. [PMID: 35124840 PMCID: PMC9315036 DOI: 10.1111/iej.13701] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.
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Affiliation(s)
- S Hosseinpour
- School of Dentistry The University of Queensland Herston QLD Australia
| | - A Gaudin
- Inserm UMR 1229 RMeS, Regenerative Medicine and Skeleton Université de Nantes ONIRIS Nantes France
- Université de Nantes UFR Odontologie Nantes France
| | - O A Peters
- School of Dentistry The University of Queensland Herston QLD Australia
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10
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Richert R, Ducret M, Alliot-Licht B, Bekhouche M, Gobert S, Farges JC. A critical analysis of research methods and experimental models to study pulpitis. Int Endod J 2022; 55 Suppl 1:14-36. [PMID: 35034368 DOI: 10.1111/iej.13683] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as reversible or irreversible, a classification for therapeutic purposes that determines the capability of the pulp to heal. Recently, new knowledge about dental pulp physiopathology led to orientate therapeutics towards more frequent preservation of pulp vitality. However, full adoption of these vital pulp therapies by dental practitioners will be achieved only following better understanding of cell and tissue mechanisms involved in pulpitis. The current narrative review aimed to discuss the contribution of the most significant experimental models developed to study pulpitis. Traditionally, in vitro two(2D)- or three(3D)-dimensional cell cultures or in vivo animal models were used to analyse the pulp response to pulpitis inducers at cell, tissue or organ level. In vitro 2D cell cultures were mainly used to decipher the specific roles of key actors of pulp inflammation such as bacterial by-products, pro-inflammatory cytokines, odontoblasts or pulp stem cells. However, these simple models did not reproduce the 3D organisation of the pulp tissue and, with rare exceptions, did not consider interactions between resident cell types. In vitro tissue/organ-based models were developed to better reflect the complexity of the pulp structure. Their major disadvantage is that they did not allow the analysis of blood supply and innervation participation. On the contrary, in vivo models have allowed researchers to identify key immune, vascular and nervous actors of pulpitis and to understand their function and interplay in the inflamed pulp. However, inflammation was mainly induced by iatrogenic dentine drilling associated with simple pulp exposure to the oral environment or stimulation by individual bacterial by-products for short periods. Clearly, these models did not reflect the long and progressive development of dental caries. Lastly, the substantial diversity of the existing models makes experimental data extrapolation to the clinical situation complicated. Therefore, improvement in the design and standardization of future models, for example by using novel molecular biomarkers, databased models and artificial intelligence, will be an essential step in building an incremental knowledge of pulpitis in the future.
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Affiliation(s)
- Raphaël Richert
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Mécanique des Contacts et Structures, UMR 5259, Villeurbanne, France
| | - Maxime Ducret
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Brigitte Alliot-Licht
- Université de Nantes, Faculté d'Odontologie, Nantes, France.,CHU de Nantes, Odontologie Conservatrice et Pédiatrique, Service d, Nantes, France
| | - Mourad Bekhouche
- Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Stéphanie Gobert
- Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Jean-Christophe Farges
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
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11
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Kwon M, Jung IY, Cha M, Lee BH. Inhibition of the Nav1.7 Channel in the Trigeminal Ganglion Relieves Pulpitis Inflammatory Pain. Front Pharmacol 2021; 12:759730. [PMID: 34955831 PMCID: PMC8694709 DOI: 10.3389/fphar.2021.759730] [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: 08/17/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Pulpitis causes significant changes in the peripheral nervous system, which induce hyperalgesia. However, the relationship between neuronal activity and Nav1.7 expression following pulpal noxious pain has not yet been investigated in the trigeminal ganglion (TG). The aim of our study was to verify whether experimentally induced pulpitis activates the expression of Nav1.7 peripherally and the neuronal activities of the TGs can be affected by Nav1.7 channel inhibition. Acute pulpitis was induced through allyl isothiocyanate (AITC) application to the rat maxillary molar tooth pulp. Three days after AITC application, abnormal pain behaviors were recorded, and the rats were euthanized to allow for immunohistochemical, optical imaging, and western blot analyses of the Nav1.7 expression in the TG. A significant increase in AITC-induced pain-like behaviors and histological evidence of pulpitis were observed. In addition, histological and western blot data showed that Nav1.7 expressions in the TGs were significantly higher in the AITC group than in the naive and saline group rats. Optical imaging showed that the AITC group showed higher neuronal activity after electrical stimulation of the TGs. Additionally, treatment of ProTxII, selective Nav1.7 blocker, on to the TGs in the AITC group effectively suppressed the hyperpolarized activity after electrical stimulation. These findings indicate that the inhibition of the Nav1.7 channel could modulate nociceptive signal processing in the TG following pulp inflammation.
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Affiliation(s)
- Minjee Kwon
- Department of Nursing, Kyungil University, Gyeongsan, South Korea
| | - Il Young Jung
- Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - Myeounghoon Cha
- Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Bae Hwan Lee
- Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
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12
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Minic S, Florimond M, Sadoine J, Valot-Salengro A, Chaussain C, Renard E, Boukpessi T. Evaluation of Pulp Repair after Biodentine TM Full Pulpotomy in a Rat Molar Model of Pulpitis. Biomedicines 2021; 9:biomedicines9070784. [PMID: 34356848 PMCID: PMC8301331 DOI: 10.3390/biomedicines9070784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022] Open
Abstract
Dental pulp is a dynamic tissue able to heal after injury under moderate inflammatory conditions. Our study aimed to evaluate pulp repair under inflammatory conditions in rats. For this purpose, we developed a rat model of controlled pulpitis followed by pulpotomy with a tricalcium silicate-based cement. Fifty-four cavities were prepared on the occlusal face of the maxillary upper first molar of 27 eight-week-old male rats. E. coli lipopolysaccharides at 10 mg/mL or phosphate-buffered saline PBS was injected after pulp injury. Non-inflamed molars were used as controls. Levels of inflammation-related molecules were measured 6 and 24 h after induction by enzyme-linked immunosorbent assay of coronal pulp samples. Pulp capping and coronal obturation after pulpotomy were performed with tricalcium silicate-based cement. Four and fifteen days after pulpotomy, histological and immunohistochemical analysis was performed to assess pulp inflammation and repair processes. Our results showed significantly higher levels of innate inflammatory proteins (IL-1β, IL-6, TNF-α and CXCL-1) compared with those in controls. Moderate residual inflammation near the capping material was demonstrated by histology and immunohistochemistry, with the presence of few CD68-positive cells. We showed that, in this model of controlled pulpitis, pulpotomy with BiodentineTM allowed the synthesis at the injury site of a mineralized bridge formed from mineralized tissue secreted by cells displaying odontoblastic characteristics. Analysis of these data suggests overall that, with the limitations inherent to findings in animal models, pulpotomy with a silicate-based cement is a good treatment for controlling inflammation and enhancing repair in cases of controlled pulpitis.
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Affiliation(s)
- Sandra Minic
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
| | - Marion Florimond
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
| | - Jérémy Sadoine
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
| | | | - Catherine Chaussain
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
| | - Emmanuelle Renard
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 1 Place Alexis Ricordeau, 44000 Nantes, France
- CHU de Nantes, Service d’Odontologie Restauratrice et Chirurgicale, 1 Place Alexis Ricordeau, 44000 Nantes, France
- Correspondence: (E.R.); (T.B.); Tel.: +33-2-40-41-29-86 (E.R.); +33-1-58-07-67-24 (T.B.)
| | - Tchilalo Boukpessi
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
- Correspondence: (E.R.); (T.B.); Tel.: +33-2-40-41-29-86 (E.R.); +33-1-58-07-67-24 (T.B.)
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