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Li XL, Fan W, Fan B. Dental pulp regeneration strategies: A review of status quo and recent advances. Bioact Mater 2024; 38:258-275. [PMID: 38745589 PMCID: PMC11090883 DOI: 10.1016/j.bioactmat.2024.04.031] [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: 11/27/2023] [Revised: 02/18/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
Microorganisms, physical factors such as temperature or mechanical injury, and chemical factors such as free monomers from composite resin are the main causes of dental pulp diseases. Current clinical treatment methods for pulp diseases include the root canal therapy, vital pulp therapy and regenerative endodontic therapy. Regenerative endodontic therapy serves the purpose of inducing the regeneration of new functional pulp tissues through autologous revascularization or pulp tissue engineering. This article first discusses the current clinical methods and reviews strategies as well as the research outcomes regarding the pulp regeneration. Then the in vivo models, the prospects and challenges for regenerative endodontic therapy were further discussed.
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Affiliation(s)
- Xin-Lu Li
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, 430079, Wuhan, China
| | - Wei Fan
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, 430079, Wuhan, China
| | - Bing Fan
- The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, 430079, Wuhan, China
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2
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Wu J, Li J, Mao S, Li B, Zhu L, Jia P, Huang G, Yang X, Xu L, Qiu D, Wang S, Dong Y. Heparin-Functionalized Bioactive Glass to Harvest Endogenous Growth Factors for Pulp Regeneration. ACS APPLIED MATERIALS & INTERFACES 2024; 16:30715-30727. [PMID: 38833722 DOI: 10.1021/acsami.4c03118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Pulp and periapical diseases can lead to the cessation of tooth development, resulting in compromised tooth structure and functions. Despite numerous efforts to induce pulp regeneration, effective strategies are still lacking. Growth factors (GFs) hold considerable promise in pulp regeneration due to their diverse cellular regulatory properties. However, the limited half-lives and susceptibility to degradation of exogenous GFs necessitate the administration of supra-physiological doses, leading to undesirable side effects. In this research, a heparin-functionalized bioactive glass (CaO-P2O5-SiO2-Heparin, abbreviated as PSC-Heparin) with strong bioactivity and a stable neutral pH is developed as a promising candidate to addressing challenges in pulp regeneration. Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and thermogravimetric analysis reveal the successful synthesis of PSC-Heparin. Scanning electron microscopy and X-ray diffraction show the hydroxyapatite formation can be observed on the surface of PSC-Heparin after soaking in simulated body fluid for 12 h. PSC-Heparin is capable of harvesting various endogenous GFs and sustainably releasing them over an extended duration by the enzyme-linked immunosorbent assay. Cytological experiments show that developed PSC-Heparin can facilitate the adhesion, migration, proliferation, and odontogenic differentiation of stem cells from apical papillae. Notably, the histological analysis of subcutaneous implantation in nude mice demonstrates PSC-Heparin is capable of promoting the odontoblast-like layers and pulp-dentin complex formation without the addition of exogenous GFs, which is vital for clinical applications. This work highlights an effective strategy of harvesting endogenous GFs and avoiding the involvement of exogenous GFs to achieve pulp-dentin complex regeneration, which may open a new horizon for regenerative endodontic therapy.
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Affiliation(s)
- Jilin Wu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Jingyi Li
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Sicong Mao
- Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Baokui Li
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Lin Zhu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Peipei Jia
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Guibin Huang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xule Yang
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Liju Xu
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Sainan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Yanmei Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
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Fu X, Kim HS. Dentin Mechanobiology: Bridging the Gap between Architecture and Function. Int J Mol Sci 2024; 25:5642. [PMID: 38891829 PMCID: PMC11171917 DOI: 10.3390/ijms25115642] [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: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
It is remarkable how teeth maintain their healthy condition under exceptionally high levels of mechanical loading. This suggests the presence of inherent mechanical adaptation mechanisms within their structure to counter constant stress. Dentin, situated between enamel and pulp, plays a crucial role in mechanically supporting tooth function. Its intermediate stiffness and viscoelastic properties, attributed to its mineralized, nanofibrous extracellular matrix, provide flexibility, strength, and rigidity, enabling it to withstand mechanical loading without fracturing. Moreover, dentin's unique architectural features, such as odontoblast processes within dentinal tubules and spatial compartmentalization between odontoblasts in dentin and sensory neurons in pulp, contribute to a distinctive sensory perception of external stimuli while acting as a defensive barrier for the dentin-pulp complex. Since dentin's architecture governs its functions in nociception and repair in response to mechanical stimuli, understanding dentin mechanobiology is crucial for developing treatments for pain management in dentin-associated diseases and dentin-pulp regeneration. This review discusses how dentin's physical features regulate mechano-sensing, focusing on mechano-sensitive ion channels. Additionally, we explore advanced in vitro platforms that mimic dentin's physical features, providing deeper insights into fundamental mechanobiological phenomena and laying the groundwork for effective mechano-therapeutic strategies for dentinal diseases.
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Affiliation(s)
- Xiangting Fu
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Republic of Korea;
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science and BK21 NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Republic of Korea
| | - Hye Sung Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Republic of Korea;
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science and BK21 NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Republic of Korea
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Mascarenhas R, Hegde S, Manaktala N. Chitosan nanoparticle applications in dentistry: a sustainable biopolymer. Front Chem 2024; 12:1362482. [PMID: 38660569 PMCID: PMC11039901 DOI: 10.3389/fchem.2024.1362482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
The epoch of Nano-biomaterials and their application in the field of medicine and dentistry has been long-lived. The application of nanotechnology is extensively used in diagnosis and treatment aspects of oral diseases. The nanomaterials and its structures are being widely involved in the production of medicines and drugs used for the treatment of oral diseases like periodontitis, oral carcinoma, etc. and helps in maintaining the longevity of oral health. Chitosan is a naturally occurring biopolymer derived from chitin which is seen commonly in arthropods. Chitosan nanoparticles are the latest in the trend of nanoparticles used in dentistry and are becoming the most wanted biopolymer for use toward therapeutic interventions. Literature search has also shown that chitosan nanoparticles have anti-tumor effects. This review highlights the various aspects of chitosan nanoparticles and their implications in dentistry.
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Affiliation(s)
- Roma Mascarenhas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Shreya Hegde
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nidhi Manaktala
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
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El-Kateb NM, Abdallah AM, ElBackly RN. Correlation between pulp sensibility and magnetic resonance signal intensity following regenerative endodontic procedures in mature necrotic teeth- a retrospective cohort study. BMC Oral Health 2024; 24:330. [PMID: 38481211 PMCID: PMC10935898 DOI: 10.1186/s12903-024-04095-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND With increasing studies being published on regenerative endodontic procedures (REPs) as a treatment modality for mature necrotic teeth, the assessment of outcomes following regenerative endodontic procedures has become more challenging and the demand for a better understanding of the regenerated tissues following this treatment is rising. The study aimed to correlate cold, electric pulp testing (EPT), and magnetic resonance imaging (MRI) signal intensity (SI) in mature necrotic teeth treated with regenerative endodontic procedures. METHODOLOGY This retrospective cohort study included eighteen adult patients who experienced tooth necrosis in mature maxillary anterior teeth recruited from the outpatient clinic, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt from July 2017 until December 2018 with 12 months of follow-up. regenerative endodontic procedures via blood clot were performed. The canals were instrumented by ProTaper Next (PTN) files until final sizes X3 or X5. Biodentine was used as cervical plug material. Pre and post-operative clinical follow-up was done where the patients' responses to cold and electric pulp testing were given a scoring system and were compared to the normal contralateral tooth. Pre and post-operative magnetic resonance imaging signal intensity of both the involved tooth and its contralateral at the middle and the apical thirds of the root canals were assessed after 3, 6, and 12 months. Data was analyzed using the ANOVA, Friedman and Bonferroni tests. Significance was set at a p-value < 0.05. RESULTS All 18 teeth scored a baseline score of "2" for cold and electric pulp testing. There was a significant difference between scores of the cold test at baseline and 12-month follow-up (p < 0.001). There was a significant difference between scores of the electric pulp testing of baseline and 12-month follow-up (p < 0.001). There was a moderately significant indirect (inverse) correlation between magnetic resonance imaging signal intensity and cold test in both the middle and apical thirds at 12 months. No significant correlations were detected between magnetic resonance imaging signal intensity and electric pulp testingat any of the time intervals (p > 0.05). CONCLUSION Magnetic resonance imaging is a successful non-invasive method to assess outcomes of regenerative endodontic procedures and correlating it with another reliable method of assessing pulpal responses, cold test, could validate these outcomes. CLINICAL TRIAL REGISTRATION The study was registered with ClinicalTrials.gov (ID: NCT03804450).
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Affiliation(s)
- Noha Mohamed El-Kateb
- Conservative Dentistry Department, Endodontics Division, Faculty of Dentistry, Alexandria University, Champollion Street, El Azareta., Alexandra, Egypt.
| | - Amr Mohamed Abdallah
- Conservative Dentistry Department, Endodontics Division, Faculty of Dentistry, Alexandria University, Champollion Street, El Azareta., Alexandra, Egypt
| | - Rania Noaman ElBackly
- Conservative Dentistry Department, Endodontics Division, Faculty of Dentistry, Alexandria University, Champollion Street, El Azareta., Alexandra, Egypt
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Kong L, Li J, Bai Y, Xu S, Zhang L, Chen W, Gao L, Wang F. Inhibition of soluble epoxide hydrolase enhances the dentin-pulp complex regeneration mediated by crosstalk between vascular endothelial cells and dental pulp stem cells. J Transl Med 2024; 22:61. [PMID: 38229161 DOI: 10.1186/s12967-024-04863-y] [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: 07/20/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Revascularization and restoration of normal pulp-dentin complex are important for tissue-engineered pulp regeneration. Recently, a unique periodontal tip-like endothelial cells subtype (POTCs) specialized to dentinogenesis was identified. We have confirmed that TPPU, a soluble epoxide hydrolase (sEH) inhibitor targeting epoxyeicosatrienoic acids (EETs) metabolism, promotes bone growth and regeneration by angiogenesis and osteogenesis coupling. We hypothesized that TPPU could also promote revascularization and induce POTCs to contribute to pulp-dentin complex regeneration. Here, we in vitro and in vivo characterized the potential effect of TPPU on the coupling of angiogenesis and odontogenesis and investigated the relevant mechanism, providing new ideas for pulp-dentin regeneration by targeting sEH. METHODS In vitro effects of TPPU on the proliferation, migration, and angiogenesis of dental pulp stem cells (DPSCs), human umbilical vein endothelial cells (HUVECs) and cocultured DPSCs and HUVECs were detected using cell counting kit 8 (CCK8) assay, wound healing, transwell, tube formation and RT-qPCR. In vivo, Matrigel plug assay was performed to outline the roles of TPPU in revascularization and survival of grafts. Then we characterized the VEGFR2 + POTCs around odontoblast layer in the molar of pups from C57BL/6 female mice gavaged with TPPU. Finally, the root segments with DPSCs mixed with Matrigel were implanted subcutaneously in BALB/c nude mice treated with TPPU and the root grafts were isolated for histological staining. RESULTS In vitro, TPPU significantly promoted the migration and tube formation capability of cocultured DPSCs and HUVECs. ALP and ARS staining and RT-qPCR showed that TPPU promoted the osteogenic and odontogenic differentiation of cultured cells, treatment with an anti-TGF-β blocking antibody abrogated this effect. Knockdown of HIF-1α in HUVECs significantly reversed the effect of TPPU on the expression of angiogenesis, osteogenesis and odontogenesis-related genes in cocultured cells. Matrigel plug assay showed that TPPU increased VEGF/VEGFR2-expressed cells in transplanted grafts. TPPU contributed to angiogenic-odontogenic coupling featured by increased VEGFR2 + POTCs and odontoblast maturation during early dentinogenesis in molar of newborn pups from C57BL/6 female mice gavaged with TPPU. TPPU induced more dental pulp-like tissue with more vessels and collagen fibers in transplanted root segment. CONCLUSIONS TPPU promotes revascularization of dental pulp regeneration by enhancing migration and angiogenesis of HUVECs, and improves odontogenic differentiation of DPSCs by TGF-β. TPPU boosts the angiogenic-odontogenic coupling by enhancing VEGFR2 + POTCs meditated odontoblast maturation partly via upregulating HIF-1α, which contributes to increasing pulp-dentin complex for tissue-engineered pulp regeneration.
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Affiliation(s)
- Lingwenyao Kong
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China
| | - Juanjuan Li
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China
| | - Yuwen Bai
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China
| | - Shaoyang Xu
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
| | - Lin Zhang
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
| | - Weixian Chen
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China
| | - Lu Gao
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China.
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China.
- The Affiliated Stomatological Hospital of Dalian Medical University, Dalian, China.
| | - Fu Wang
- School of Stomatology, Dalian Medical University, No. 9 West Section, Lvshun South Road, Dalian, 116044, People's Republic of China.
- Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China.
- The Affiliated Stomatological Hospital of Dalian Medical University, Dalian, China.
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Qian Y, Gong J, Lu K, Hong Y, Zhu Z, Zhang J, Zou Y, Zhou F, Zhang C, Zhou S, Gu T, Sun M, Wang S, He J, Li Y, Lin J, Yuan Y, Ouyang H, Yu M, Wang H. DLP printed hDPSC-loaded GelMA microsphere regenerates dental pulp and repairs spinal cord. Biomaterials 2023; 299:122137. [PMID: 37172537 DOI: 10.1016/j.biomaterials.2023.122137] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
Dental pulp regeneration is ideal for irreversible pulp or periapical lesions, and in situ stem cell therapy is one of the most effective therapies for pulp regeneration. In this study, we provided an atlas of the non-cultured and monolayer cultured dental pulp cells with single-cell RNA sequencing and analysis. Monolayer cultured dental pulp cells cluster more closely together than non-cultured dental pulp cells, suggesting a lower heterogeneous population with relatively consistent clusters and similar cellular composition. We successfully fabricated hDPSC-loaded microspheres by layer-by-layer photocuring with a digital light processing (DLP) printer. These hDPSC-loaded microspheres have improved stemness and higher multi-directional differentiation potential, including angiogenic, neurogenic, and odontogenic differentiation. The hDPSC-loaded microspheres could promote spinal cord regeneration in rat spinal cord injury models. Moreover, in heterotopic implantation tests on nude mice, CD31, MAP2, and DSPP immunofluorescence signals were observed, implying the formation of vascular, neural, and odontogenetic tissues. In situ experiments in minipigs demonstrated highly vascularized dental pulp and uniformly arranged odontoblast-like cells in root canals of incisors. In short, hDPSC-loaded microspheres can promote full-length dental pulp regeneration at the root canals' coronal, middle, and apical sections, particularly for blood vessels and nerve formation, which is a promising therapeutic strategy for necrotic pulp.
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Affiliation(s)
- Ying Qian
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Jiaxing Gong
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Kejie Lu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Yi Hong
- Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Ziyu Zhu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Jingyu Zhang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Yiwei Zou
- Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Feifei Zhou
- Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Chaoying Zhang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Siyi Zhou
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Tianyi Gu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Miao Sun
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Shaolong Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Jianxiang He
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
| | - Yang Li
- The State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Junxin Lin
- Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China; Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, And Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Hangzhou, 310058, China
| | - Yuan Yuan
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China; Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, And Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Hangzhou, 310058, China.
| | - Hongwei Ouyang
- Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China; Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, And Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Hangzhou, 310058, China.
| | - Mengfei Yu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China.
| | - Huiming Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
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Polymeric Scaffolds Used in Dental Pulp Regeneration by Tissue Engineering Approach. Polymers (Basel) 2023; 15:polym15051082. [PMID: 36904323 PMCID: PMC10007583 DOI: 10.3390/polym15051082] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
Currently, the challenge in dentistry is to revitalize dental pulp by utilizing tissue engineering technology; thus, a biomaterial is needed to facilitate the process. One of the three essential elements in tissue engineering technology is a scaffold. A scaffold acts as a three-dimensional (3D) framework that provides structural and biological support and creates a good environment for cell activation, communication between cells, and inducing cell organization. Therefore, the selection of a scaffold represents a challenge in regenerative endodontics. A scaffold must be safe, biodegradable, and biocompatible, with low immunogenicity, and must be able to support cell growth. Moreover, it must be supported by adequate scaffold characteristics, which include the level of porosity, pore size, and interconnectivity; these factors ultimately play an essential role in cell behavior and tissue formation. The use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix in dental tissue engineering has recently received a lot of attention because it shows great potential with good biological characteristics for cell regeneration. This review describes the latest developments regarding the usage of natural or synthetic scaffold polymers that have the ideal biomaterial properties to facilitate tissue regeneration when combined with stem cells and growth factors in revitalizing dental pulp tissue. The utilization of polymer scaffolds in tissue engineering can help the pulp tissue regeneration process.
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Liu L, Wu D, Tu H, Cao M, Li M, Peng L, Yang J. Applications of Hydrogels in Drug Delivery for Oral and Maxillofacial Diseases. Gels 2023; 9:gels9020146. [PMID: 36826316 PMCID: PMC9956178 DOI: 10.3390/gels9020146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023] Open
Abstract
Oral and maxillofacial diseases have an important impact on local function, facial appearance, and general health. As a multifunctional platform, hydrogels are widely used in the biomedical field due to their excellent physicochemical properties. In recent years, a large number of studies have been conducted to adapt hydrogels to the complex oral and maxillofacial environment by modulating their pore size, swelling, degradability, stimulus-response properties, etc. Meanwhile, many studies have attempted to use hydrogels as drug delivery carriers to load drugs, cytokines, and stem cells for antibacterial, anticancer, and tissue regeneration applications in oral and maxillofacial regions. This paper reviews the application and research progress of hydrogel-based drug delivery systems in the treatment of oral and maxillofacial diseases such as caries, endodontic diseases, periodontal diseases, maxillofacial bone diseases, mucosal diseases, oral cancer, etc. The characteristics and applications of hydrogels and drug-delivery systems employed for the treatment of different diseases are discussed in order to provide a reference for further research on hydrogel drug-delivery systems in the future.
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Affiliation(s)
- Lijia Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Dan Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Heng Tu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mengjiao Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mengxin Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Peng
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, China
| | - Jing Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence:
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10
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Muacevic A, Adler JR, Ikhar A, Reche A, Paul P. Evolution of Biomimetic Approaches for Regenerative and Restorative Dentistry. Cureus 2023; 15:e33936. [PMID: 36819376 PMCID: PMC9937676 DOI: 10.7759/cureus.33936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/18/2023] [Indexed: 01/20/2023] Open
Abstract
Biomimetics refers to human-made processes, substances, systems, or devices that imitate nature. The art and science of designing and building biomimetic apparatus are called biomimetics. This method can be widely used in dentistry to restore the structure and function of normal tooth structure. Traditional approaches to treating damaged and decayed teeth require more aggressive preparation to place a "strong," stiff restoration. The emphasis was made on the strength of the restoration as well as its function and mechanical properties, despite several disadvantages like tooth fracture, making future treatment more difficult and invasive. This review paper will seek to provide a clear explanation of its scope, different fields of biomimetic dentistry, and materials used in biomimetics that improve the strength of the tooth.
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11
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Kearney M, Duncan HF. Micro-RNA Profiling in Dental Pulp Cell Cultures. Methods Mol Biol 2023; 2588:353-367. [PMID: 36418697 DOI: 10.1007/978-1-0716-2780-8_20] [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: 11/24/2022]
Abstract
Recently, the central role of microRNAs (miRNAs) and epigenetic modifiers in biological and pathological processes, such as stem cell differentiation and inflammation, has stimulated interest. In particular, their influence in dental pulp stem cell (DPSC) differentiation has been highlighted as an exciting avenue of research in the field of Regenerative Endodontics. Although specific miRNAs have been shown to be altered in expression during dental pulp mineralization and repair processes, their interaction with epigenetic modifiers, such as histone deacetylase inhibitors (HDACi) or DNA methyltransferase inhibitors (DNMTi), has not been explored. Currently available next-generation sequencing (NGS) technologies offer the potential to explore in detail the miRNA expression profile of cells, and to investigate the effects of pharmacological inhibitors such as epigenetic modifiers on this profile. This chapter describes the experimental methods required to induce mineralization of DPCs in the presence and absence of epigenetic modifiers and analyze the resulting miRNA expression profiles using RNA sequencing (RNAseq), with a focus on bioinformatic analysis.
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Affiliation(s)
- Michaela Kearney
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland.
| | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
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12
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Neural Regeneration in Regenerative Endodontic Treatment: An Overview and Current Trends. Int J Mol Sci 2022; 23:ijms232415492. [PMID: 36555133 PMCID: PMC9779866 DOI: 10.3390/ijms232415492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Pulpal and periapical diseases are the most common dental diseases. The traditional treatment is root canal therapy, which achieves satisfactory therapeutic outcomes-especially for mature permanent teeth. Apexification, pulpotomy, and pulp revascularization are common techniques used for immature permanent teeth to accelerate the development of the root. However, there are obstacles to achieving functional pulp regeneration. Recently, two methods have been proposed based on tissue engineering: stem cell transplantation, and cell homing. One of the goals of functional pulp regeneration is to achieve innervation. Nerves play a vital role in dentin formation, nutrition, sensation, and defense in the pulp. Successful neural regeneration faces tough challenges in both animal studies and clinical trials. Investigation of the regeneration and repair of the nerves in the pulp has become a serious undertaking. In this review, we summarize the current understanding of the key stem cells, signaling molecules, and biomaterials that could promote neural regeneration as part of pulp regeneration. We also discuss the challenges in preclinical or clinical neural regeneration applications to guide deep research in the future.
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13
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Kumar N, Maher N, Amin F, Ghabbani H, Zafar MS, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Biomimetic Approaches in Clinical Endodontics. Biomimetics (Basel) 2022; 7:biomimetics7040229. [PMID: 36546929 PMCID: PMC9775094 DOI: 10.3390/biomimetics7040229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.
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Affiliation(s)
- Naresh Kumar
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
| | - Nazrah Maher
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Faiza Amin
- Department of Science of Dental Materials, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Ricardo E. Oñate-Sánchez
- Department of Special Care in Dentistry, Hospital Morales Meseguer, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
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14
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El-Hady AYA, Badr AES. The Efficacy of Advanced Platelet-rich Fibrin in Revascularization of Immature Necrotic Teeth. J Contemp Dent Pract 2022; 23:725-732. [DOI: 10.5005/jp-journals-10024-3367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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15
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Al-Maswary AA, O’Reilly M, Holmes AP, Walmsley AD, Cooper PR, Scheven BA. Exploring the neurogenic differentiation of human dental pulp stem cells. PLoS One 2022; 17:e0277134. [PMID: 36331951 PMCID: PMC9635714 DOI: 10.1371/journal.pone.0277134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Human dental pulp stem cells (hDPSCs) have increasingly gained interest as a potential therapy for nerve regeneration in medicine and dentistry, however their neurogenic potential remains a matter of debate. This study aimed to characterize hDPSC neuronal differentiation in comparison with the human SH-SY5Y neuronal stem cell differentiation model. Both hDPSCs and SH-SY5Y could be differentiated to generate typical neuronal-like cells following sequential treatment with all-trans retinoic acid (ATRA) and brain-derived neurotrophic factor (BDNF), as evidenced by significant expression of neuronal proteins βIII-tubulin (TUBB3) and neurofilament medium (NF-M). Both cell types also expressed multiple neural gene markers including growth-associated protein 43 (GAP43), enolase 2/neuron-specific enolase (ENO2/NSE), synapsin I (SYN1), nestin (NES), and peripherin (PRPH), and exhibited measurable voltage-activated Na+ and K+ currents. In hDPSCs, upregulation of acetylcholinesterase (ACHE), choline O-acetyltransferase (CHAT), sodium channel alpha subunit 9 (SCN9A), POU class 4 homeobox 1 (POU4F1/BRN3A) along with a downregulation of motor neuron and pancreas homeobox 1 (MNX1) indicated that differentiation was more guided toward a cholinergic sensory neuronal lineage. Furthermore, the Extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor U0126 significantly impaired hDPSC neuronal differentiation and was associated with reduction of the ERK1/2 phosphorylation. In conclusion, this study demonstrates that extracellular signal-regulated kinase/Mitogen-activated protein kinase (ERK/MAPK) is necessary for sensory cholinergic neuronal differentiation of hDPSCs. hDPSC-derived cholinergic sensory neuronal-like cells represent a novel model and potential source for neuronal regeneration therapies.
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Affiliation(s)
- Arwa A. Al-Maswary
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- * E-mail: , (AAA-M); (BAS)
| | - Molly O’Reilly
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Andrew P. Holmes
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - A. Damien Walmsley
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Paul R. Cooper
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Ben A. Scheven
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- * E-mail: , (AAA-M); (BAS)
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16
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Louvrier A, Kroemer M, Terranova L, Meyer F, Tissot M, Euvrard E, Gindraux F, Meyer C, Rolin G. Development of a biomimetic bioreactor for regenerative endodontics research. J Tissue Eng Regen Med 2022; 16:998-1007. [PMID: 36005295 DOI: 10.1002/term.3346] [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: 02/17/2022] [Revised: 06/02/2022] [Accepted: 07/26/2022] [Indexed: 12/15/2022]
Abstract
In the context of regenerative endodontics research with the development of biomaterials, this work aimed to develop and test a prototype biomimetic bioreactor of a human tooth. The bioreactor was designed to reproduce a shaped dental canal connected with a cavity reproducing the periapical region and irrigated through two fluidic channels intended to reproduce the apical residual vascular supply. A test biomaterial composed of polylactic acid/polycaprolactone-tannic acid (PLA/PCL-TA) was produced by electrospinning/electrospraying and calibrated to be inserted in a dental canal. This biomaterial was first used to evaluate its imbibition capacity and the oximetry inside the bioreactor. Then, Dental Pulp Stem Cells (DPSCs) were cultured on PLA/PCL-TA cones for 1-3 weeks in the bioreactor; afterward cell adhesion, proliferation, and migration were histologically assessed. Complete imbibition biomaterial was obtained in 10 min and oximetry was stable over time. In the bioreactor, DPSCs were able to adhere, proliferate and migrate onto the surface and inside the biomaterial. In conclusion, this bioreactor was used successfully to test a biomaterial intended to support pulp regeneration and constitutes a new in vitro experimental model closer to clinical reality.
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Affiliation(s)
- Aurélien Louvrier
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Marie Kroemer
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France.,Pharmacie Centrale, CHU Besançon, Besançon, France
| | - Lisa Terranova
- Université de Strasbourg, INSERM, UMR_S 1121 Biomatériaux et Bioingénierie, FMTS, Strasbourg, France
| | - Florent Meyer
- Université de Strasbourg, INSERM, UMR_S 1121 Biomatériaux et Bioingénierie, FMTS, Strasbourg, France
| | - Marion Tissot
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Edouard Euvrard
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, Laboratoire Nano Médecine, Imagerie, Thérapeutique, Besançon, France
| | - Florelle Gindraux
- University Bourgogne Franche-Comté, Laboratoire Nano Médecine, Imagerie, Thérapeutique, Besançon, France
| | - Christophe Meyer
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, Laboratoire Nano Médecine, Imagerie, Thérapeutique, Besançon, France
| | - Gwenaël Rolin
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France
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17
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Minic S, Vital S, Chaussain C, Boukpessi T, Mangione F. Tissue Characteristics in Endodontic Regeneration: A Systematic Review. Int J Mol Sci 2022; 23:ijms231810534. [PMID: 36142446 PMCID: PMC9504778 DOI: 10.3390/ijms231810534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 12/01/2022] Open
Abstract
The regenerative endodontic procedure (REP) represents a treatment option for immature necrotic teeth with a periapical lesion. Currently, this therapy has a wide field of pre-clinical and clinical applications, but no standardization exists regarding successful criteria. Thus, by analysis of animal and human studies, the aim of this systematic review was to highlight the main characteristics of the tissue generated by REP. A customized search of PubMed, EMBASE, Scopus, and Web of Science databases from January 2000 to January 2022 was conducted. Seventy-five human and forty-nine animal studies were selected. In humans, the evaluation criteria were clinical 2D and 3D radiographic examinations. Most of the studies identified a successful REP with an asymptomatic tooth, apical lesion healing, and increased root thickness and length. In animals, histological and radiological criteria were considered. Newly formed tissues in the canals were fibrous, cementum, or bone-like tissues along the dentine walls depending on the area of the root. REP assured tooth development and viability. However, further studies are needed to identify procedures to successfully reproduce the physiological structure and function of the dentin–pulp complex.
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Affiliation(s)
- Sandra Minic
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
| | - Sibylle Vital
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Louis Mourier Hospital, AP-HP, DMU ESPRIT, 92700 Colombes, France
| | - Catherine Chaussain
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Bretonneau Hospital Dental Department and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, AP-HP, 75018 Paris, France
| | - Tchilalo Boukpessi
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Pitié Salpétrière Hospital, DMU CHIR, AP-HP, 75013 Paris, France
| | - Francesca Mangione
- URP 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), Laboratoire d’excellence INFLAMEX, UFR Odontology, Université Paris Cité, 92120 Montrouge, France
- Henri Mondor Hospital, AP-HP, 94000 Créteil, France
- Correspondence:
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18
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Cells and material-based strategies for regenerative endodontics. Bioact Mater 2022; 14:234-249. [PMID: 35310358 PMCID: PMC8897646 DOI: 10.1016/j.bioactmat.2021.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/29/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022] Open
Abstract
<p class = "Abstract" style = "margin: 0 cm; line-height: 32px; font-size: 12 pt; font-family: "Times New Roman", serif; color: rgb(0, 0, 0); "><span lang = "EN-US">The carious process leads to inflammation of pulp tissue. Current care options include root canal treatment or apexification. These procedures, however, result in the loss of tooth vitality, sensitivity, and healing. Pulp capping and dental pulp regeneration are continually evolving techniques to regenerate pulp tissue, avoiding necrosis and loss of vitality. Many studies have successfully employed stem/progenitor cell populations, revascularization approaches, scaffolds or material-based strategies for pulp regeneration. Here we outline advantages and disadvantages of different methods and techniques which are currently being used in the field of regenerative endodontics. We also summarize recent findings on efficacious peptide-based materials which target the dental niche.<o:p></o:p></span></p> Pulp infection necessitates removal of necrotic, inflamed and infected tissue. Materials used clinically are inert (such as gutta percha, mineral trioxide aggregate). Recent developments in materials (angiogenic hydrogels, stem cell composites) have tuneable bioactivity. Dental pulp regeneration may now be possible through the use of bioactive systems, that guide regeneration.
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19
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Wu J, Mao S, Xu L, Qiu D, Wang S, Dong Y. Odontogenic Differentiation Induced by TGF-β1 Binding Peptide-Modified Bioglass. J Dent Res 2022; 101:1190-1197. [PMID: 35411824 DOI: 10.1177/00220345221089238] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Emerging evidence suggests that growth factors are crucial in regenerative endodontic therapy. To achieve the desired effects, the systematic administration of supraphysiologic concentrations of exogenous growth factors is commonly performed, but this is usually associated with high costs, technique, and safety issues. Here, we describe a novel biomaterial that can manipulate endogenous growth factors without the need for adding exogenous growth factors. Transforming growth factor β1 binding peptide (TGFp) was grafted onto the surface of a neutral pH phytic acid-derived bioactive glass (PSC) to synthesize modified bioactive glass (PSC-TGFp). Fourier transform infrared spectroscopy and thermogravimetric analysis results demonstrated that the TGFp was successfully grafted to the surface of the PSC. Scanning electron microscopy and x-ray diffraction showed that PSC-TGFp possessed good in vitro bioactivity. After soaking in simulated body fluid for 24 h, hydroxyapatite formed on the surface of PSC-TGFp. Enzyme-linked immunosorbent assay showed that PSC-TGFp could capture endogenous transforming growth factor β1 from dentin matrix-extracted proteins (DMEP) and release it slowly over 21 d. Cytologic experiments revealed that PSC-TGFp after adsorbing DMEP could enhance the adhesion, migration, viability, and odontogenic differentiation of stem cells from apical papilla. The results highlight that PSC-TGFp may be a promising biomaterial to manipulate endogenous growth factors for regenerative endodontic therapy in the future.
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Affiliation(s)
- J Wu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - S Mao
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Xu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
| | - D Qiu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
| | - S Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Y Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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20
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Kwack KH, Lee HW. Clinical Potential of Dental Pulp Stem Cells in Pulp Regeneration: Current Endodontic Progress and Future Perspectives. Front Cell Dev Biol 2022; 10:857066. [PMID: 35478967 PMCID: PMC9035692 DOI: 10.3389/fcell.2022.857066] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
Dental caries is a common disease that not only destroys the rigid structure of the teeth but also causes pulp necrosis in severe cases. Once pulp necrosis has occurred, the most common treatment is to remove the damaged pulp tissue, leading to a loss of tooth vitality and increased tooth fragility. Dental pulp stem cells (DPSCs) isolated from pulp tissue exhibit mesenchymal stem cell-like characteristics and are considered ideal candidates for regenerating damaged dental pulp tissue owing to their multipotency, high proliferation rate, and viability after cryopreservation. Importantly, DPSCs do not elicit an allogeneic immune response because they are non-immunogenic and exhibit potent immunosuppressive properties. Here, we provide an up-to-date review of the clinical applicability and potential of DPSCs, as well as emerging trends in the regeneration of damaged pulp tissue. In addition, we suggest the possibility of using DPSCs as a resource for allogeneic transplantation and provide a perspective for their clinical application in pulp regeneration.
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Affiliation(s)
- Kyu Hwan Kwack
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hyeon-Woo Lee
- Department of Pharmacology, School of Dentistry, Graduate School, Institute of Oral Biology, Kyung Hee University, Seoul, South Korea
- *Correspondence: Hyeon-Woo Lee,
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21
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Effects of Biomimetic Materials on Stem Cells from Human Exfoliated Deciduous Teeth. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2022. [DOI: 10.1007/s40883-022-00256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Antibiofilm and immunomodulatory resorbable nanofibrous filing for dental pulp regenerative procedures. Bioact Mater 2022; 16:173-186. [PMID: 35386316 PMCID: PMC8965695 DOI: 10.1016/j.bioactmat.2022.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 12/22/2022] Open
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23
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Arora S, Cooper PR, Ratnayake JT, Friedlander LT, Rizwan SB, Seo B, Hussaini HM. A critical review of in vitro research methodologies used to study mineralization in human dental pulp cell cultures. Int Endod J 2022; 55 Suppl 1:3-13. [PMID: 35030284 PMCID: PMC9303903 DOI: 10.1111/iej.13684] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/11/2022] [Indexed: 11/27/2022]
Abstract
Background The pulp contains a resident population of stem cells which can be stimulated to differentiate in order to repair the tooth by generating a mineralized extracellular matrix. Over recent decades there has been considerable interest in utilizing in vitro cell culture models to study dentinogenesis, with the aim of developing regenerative endodontic procedures, particularly where some vital pulp tissue remains. Objectives The purpose of this review is to provide a structured oversight of in vitro research methodologies which have been used to study human pulp mineralization processes. Method The literature was screened in the PubMed database up to March 2021 to identify manuscripts reporting the use of human dental pulp cells to study mineralization. The dataset identified 343 publications initially which were further screened and consequently 166 studies were identified and it was methodologically mined for information on: i) study purpose, ii) source and characterization of cells, iii) mineralizing supplements and concentrations, and iv) assays and markers used to characterize mineralization and differentiation, and the data was used to write this narrative review. Results Most published studies aimed at characterizing new biological stimulants for mineralization as well as determining the effect of scaffolds and dental (bio)materials. In general, pulp cells were isolated by enzymatic digestion, although the pulp explant technique was also common. For enzymatic digestion, a range of enzymes and concentrations were utilized, although collagenase type I and dispase were the most frequent. Isolated cells were not routinely characterized using either fluorescence‐activated cell sorting (FACS) and magnetic‐activated cell sorting (MACS) approaches and there was little consistency in terming cultures as dental pulp cells or dental pulp stem cells. A combination of media supplements, at a range of concentrations, of dexamethasone, ascorbic acid and beta‐glycerophosphate, were frequently applied as the basis for the experimental conditions. Alizarin Red S (ARS) staining was the method of choice for assessment of mineralization at 21‐days. Alkaline phosphatase assay was relatively frequently applied, solely or in combination with ARS staining. Further assessment of differentiation status was performed using transcript or protein markers, with dentine sialophosphoprotein (DSPP), osteocalcin and dentine matrix protein‐1 (DMP ‐1), the most frequent. Discussion While this review highlights variability among experimental approaches, it does however identify a consensus experimental approach. Conclusion Standardization of experimental conditions and sustained research will significantly benefit endodontic patient outcomes in the future.
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Affiliation(s)
- Shelly Arora
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
| | - Paul R Cooper
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
| | - Jithendra T Ratnayake
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
| | - Lara T Friedlander
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
| | | | - Benedict Seo
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
| | - Haizal M Hussaini
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin
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Terranova L, Louvrier A, Hébraud A, Meyer C, Rolin G, Schlatter G, Meyer F. Highly Structured 3D Electrospun Conical Scaffold: A Tool for Dental Pulp Regeneration. ACS Biomater Sci Eng 2021; 7:5775-5787. [PMID: 34846849 DOI: 10.1021/acsbiomaterials.1c00900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
New procedures envisioned for dental pulp regeneration after pulpectomy include cell homing strategy. It involves host endogenous stem cell recruitment and activation. To meet this cell-free approach, we need to design a relevant scaffold to support cell migration from tissues surrounding the dental root canal. A composite membrane made of electrospun poly(lactic acid) nanofibers and electrosprayed polycaprolactone with tannic acid (TA) microparticles which mimics the architecture of the extracellular matrix was first fabricated. After rolling the membrane in the form of a 3D conical scaffold and subsequently coating it with gelatin, it can be directly inserted into the root canal. The porous morphology of the construct was characterized by SEM at different length scales. It was shown that TA was released from the 3D conical scaffold after 2 days in PBS at 37 °C. Biocompatibility studies were first assessed by seeding human dental pulp stem cells (DPSCs) on planar membranes coated or not coated with gelatin to compare the surfaces. After 24 h, the results highlighted that the gelatin-coating increased the membrane biocompatibility and cell viability. Similar DPSC morphology and proliferation on both membrane surfaces were observed. The culture of DPSCs on conical scaffolds showed cell colonization in the whole cone volume, proving that the architecture of the conical scaffold was suitable for cell migration.
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Affiliation(s)
- Lisa Terranova
- Biomaterials and Bioengineering, Université de Strasbourg, Institut National de la Santé et de la Recherche Médicale, Unité mixte de recherche 1121, Strasbourg 67000, France.,Université de Strasbourg, Institut de Chimie et Procédés pour l'Energie, l'Environnement et la Santé ICPEES UMR 7515, CNRS, Strasbourg 67000, France
| | - Aurélien Louvrier
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon F-25000, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon F-25000, France
| | - Anne Hébraud
- Université de Strasbourg, Institut de Chimie et Procédés pour l'Energie, l'Environnement et la Santé ICPEES UMR 7515, CNRS, Strasbourg 67000, France
| | - Christophe Meyer
- Service de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHU Besançon, Besançon F-25000, France
| | - Gwenaël Rolin
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Besançon F-25000, France.,Inserm CIC-1431, CHU Besançon, Besançon F-25000, France
| | - Guy Schlatter
- Université de Strasbourg, Institut de Chimie et Procédés pour l'Energie, l'Environnement et la Santé ICPEES UMR 7515, CNRS, Strasbourg 67000, France
| | - Florent Meyer
- Biomaterials and Bioengineering, Université de Strasbourg, Institut National de la Santé et de la Recherche Médicale, Unité mixte de recherche 1121, Strasbourg 67000, France.,Pôle de médecine et chirurgie bucco-dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg 67000, France
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Nagendrababu V, Jacimovic J, Jakovljevic A, Rossi-Fedele G, Dummer PMH. A bibliometric analysis of the top 100 most-cited case reports and case series in Endodontic journals. Int Endod J 2021; 55:185-218. [PMID: 34817068 DOI: 10.1111/iej.13668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/22/2021] [Indexed: 12/21/2022]
Abstract
AIM To identify the top 100 most-cited case reports and case series published in Endodontic journals and to analyse their bibliometric characteristics. METHODOLOGY The Clarivate Analytics' Web of Science (WoS), Scopus and PubMed databases were used to identify the top 100 most-cited case reports and case series in Endodontic journals. Complete bibliographic records of the selected case reports and case series were exported in plain text or BibTeX format and imported into the R environment for statistical computing and graphics. The following parameters were then analysed: names and affiliations of the authors, title, year of publication, journal of publication, first author, corresponding author, literature cited within reports, language, citation counts, impact factor of the journal, keywords, Keywords Plus and research topic. RESULTS In total, 88 case reports and 12 case series published in English between 1977 and 2016 were identified as the most-cited reports in the field of Endodontics. The terms "case report(s)" or "case series" were not included in the title of 57 articles. The number of authors per report ranged from one to seven, with the average number of co-authors per report being 3.14. The most-cited author was M Trope (University of Pennsylvania, USA). The University of Washington and Private Practice, Cetraro, Italy, were the most productive institutions. The country whose case reports received the largest total number of citations was the United States. The largest number of the most-cited reports appeared in 2002, 2004 and 2007 (n = 7, respectively). According to the WoS database, the total number of citations ranged from 42 to 453, with the average number of citations per report being 79.97. The majority of the top 100 most-cited articles were published in the Journal of Endodontics and the International Endodontic Journal. The most frequently used author keywords were revascularization and mineral trioxide aggregate. The majority of the case reports and case series dealt with topics related to pulp regeneration. CONCLUSION This bibliometric study provides a comprehensive overview on the progress, trends and current directions in clinical practice within the field of Endodontics.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Jelena Jacimovic
- Central Library, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Gonmanee T, Arayapisit T, Vongsavan K, Phruksaniyom C, Sritanaudomchai H. Optimal culture conditions for neurosphere formation and neuronal differentiation from human dental pulp stem cells. J Appl Oral Sci 2021; 29:e20210296. [PMID: 34614124 PMCID: PMC8523122 DOI: 10.1590/1678-7757-2021-0296] [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: 05/25/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives Human dental pulp stem cells (DPSCs) have been used to regenerate damaged nervous tissues. However, the methods of committing DPSCs into neural stem/progenitor cells (NSPCs) or neurospheres are highly diverse, resulting in many neuronal differentiation outcomes. This study aims to validate an optimal protocol for inducing DPSCs into neurospheres and neurons. Methodology After isolation and characterization of mesenchymal stem cell identity, DPSCs were cultured in a NSPC induction medium and culture vessels. The durations of the culture, dissociation methods, and passage numbers of DPSCs were varied. Results Neurosphere formation requires a special surface that inhibits cell attachment. Five-days was the most appropriate duration for generating proliferative neurospheres and they strongly expressed Nestin, an NSPC marker. Neurosphere reformation after being dissociated by the Accutase enzyme was significantly higher than other methods. Passage number of DPSCs did not affect neurosphere formation, but did influence neuronal differentiation. We found that the cells expressing a neuronal marker, β-tubulin III, and exhibiting neuronal morphology were significantly higher in the early passage of the DPSCs. Conclusion These results suggest a guideline to obtain a high efficiency of neurospheres and neuronal differentiation from DPSCs for further study and neurodegeneration therapeutics.
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Affiliation(s)
- Thanasup Gonmanee
- Mahidol University, Faculty of Medicine Ramathibodi Hospital, Chakri Naruebodindra Medical Institute, Samut Prakan, Thailand
| | - Tawepong Arayapisit
- Mahidol University, Faculty of Dentistry, Department of Anatomy, Bangkok, Thailand
| | - Kutkao Vongsavan
- Walailak University, International College of Dentistry, Department of Pediatric Dentistry, Bangkok, Thailand
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Lee HN, Liang C, Liao L, Tian WD. Advances in Research on Stem Cell-Based Pulp Regeneration. Tissue Eng Regen Med 2021; 18:931-940. [PMID: 34536210 DOI: 10.1007/s13770-021-00389-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/17/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Although root canal therapy is the most common and widely used treatment at clinical presentation, there are still some postoperative complications. As cell biology and tissue engineering techniques advance rapidly, the use of biological therapy to regenerate dental pulp has become a new trend; Relevant literatures in recent five years were searched using key words such as "root canal therapy", "Dental pulp stem cells", "Dental pulp regeneration", and "Cell homing" in PubMed, Web of Science, etc; Dental pulp stem cells (DPSCs) have multi-differentiation potential, self-renewal capability, and high proliferative ability. Stem cell-based dental pulp regeneration has emerged as a new research hot spot in clinical therapy. Recently, dental pulp-like structures have been generated by the transplantation of exogenous DPSCs or the induction of homing of endogenous DPSCs. Studies on DPSCs are important and significant for dental pulp regeneration and dental restoration; In this review, the existing clinical treatment methods, dental pulp regeneration, and DPSC research status are revealed, and their application prospects are discussed. The stem cell-based pulp regeneration exerts promising potential in clinical therapy for pulp regeneration.
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Affiliation(s)
- Hua-Nien Lee
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China
| | - Cheng Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China
| | - Li Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China.
| | - Wei-Dong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China.
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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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Li Z, Liu L, Wang L, Song D. The effects and potential applications of concentrated growth factor in dentin-pulp complex regeneration. Stem Cell Res Ther 2021; 12:357. [PMID: 34147130 PMCID: PMC8214771 DOI: 10.1186/s13287-021-02446-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/06/2021] [Indexed: 02/06/2023] Open
Abstract
The dentin-pulp complex is essential for the long-term integrity and viability of teeth but it is susceptible to damage caused by external factors. Because traditional approaches for preserving the dentin-pulp complex have various limitations, there is a need for novel methods for dentin-pulp complex reconstruction. The development of stem cell-based tissue engineering has given rise to the possibility of combining dental stem cells with a tissue-reparative microenvironment to promote dentin-pulp complex regeneration. Concentrated growth factor, a platelet concentrate, is a promising scaffold for the treatment of dentin-pulp complex disorders. Given its characteristics of autogenesis, convenience, usability, and biodegradability, concentrated growth factor has gained popularity in medical and dental fields for repairing bone defects and promoting soft-tissue healing. Numerous in vitro studies have demonstrated that concentrated growth factor can promote the proliferation and migration of dental stem cells. Here, we review the current state of knowledge on the effects of concentrated growth factor on stem cells and its potential applications in dentin-pulp complex regeneration.
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Affiliation(s)
- Zixia Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14# Third Section, Renmin Nan Road, Chengdu, 610041, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14# Third Section, Renmin Nan Road, Chengdu, 610041, China
| | - Liu Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14# Third Section, Renmin Nan Road, Chengdu, 610041, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14# Third Section, Renmin Nan Road, Chengdu, 610041, China.
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Mota de Almeida FJ, Hassan D, Nasir Abdulrahman G, Brundin M, Romani Vestman N. CBCT influences endodontic therapeutic decision-making in immature traumatized teeth with suspected pulp necrosis: a before-after study. Dentomaxillofac Radiol 2021; 50:20200594. [PMID: 34086502 DOI: 10.1259/dmfr.20200594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To evaluate the impact of cone-beam computed tomography (CBCT) in endodontic therapeutic decision-making of immature traumatized teeth with suspected pulp necrosis. METHODS Over two years, consecutive patients with a dental trauma in their front teeth (apex >0.5 mm) and with suspected pulp necrosis based on clinical and radiographic findings were referred to a specialist clinic in Sweden. Fifteen patients aged 6-13 (18 teeth) were included and clinically examined by an endodontist. Intraoral radiographs and CBCT examinations were obtained. Five practitioners, three endodontists and two residents in endodontics, used these examinations to determine the most appropriate treatment for the 18 cases (all central incisors) on two occasions scheduled 19 weeks apart. On the first occasion, the practitioners had access to clinical information and the intraoral radiographs ('before' CBCT); on the second occasion, the practitioners had also access to a radiologist report and the CBCT images ('after' CBCT). Their treatment plans - no treatment, watchful waiting, endodontic orthograde treatment, or extraction - were made anonymously and independently. Results were analysed using descriptive statistics and Wilcoxon signed-rank test. RESULTS 'After' CBCT, practitioners changed treatment plans in 30% of the 90 assessments, 74% of which were more aggressive (p = 0.028). In 49% of the assessments, practitioners who chose the watchful and waiting treatment plan 'before' CBCT changed to a more aggressive therapy such as endodontic orthograde treatment and extraction 'after' CBCT (p = 0.005). CONCLUSION This study provides evidence that CBCT influences endodontic therapeutic decision-making regarding immature traumatised teeth with suspected pulp necrosis, chiefly when expectant management (i.e., watchful and waiting) was selected before access to CBCT.
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Affiliation(s)
| | - Dalya Hassan
- Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Malin Brundin
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Nelly Romani Vestman
- Department of Endodontics, Region of Västerbotten, Sweden; Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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Li Q, Hu Z, Liang Y, Xu C, Hong Y, Liu X. Multifunctional peptide-conjugated nanocarriers for pulp regeneration in a full-length human tooth root. Acta Biomater 2021; 127:252-265. [PMID: 33813092 DOI: 10.1016/j.actbio.2021.03.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 02/09/2023]
Abstract
Dental pulp is a highly vascularized tissue, situated in an inextensible environment surrounded by rigid dentinal walls. The pulp receives its blood supply solely from the small apical foramen of a tooth root. Due to the unique anatomy that controls nutrition supply, regeneration of pulp tissue in a full-length tooth root has long been a challenge in regenerative endodontics. In this study, we designed and synthesized a multifunctional peptide-conjugated, pH-sensitive, non-viral gene vector for fast revascularization and pulp regeneration in a full-length human tooth root. The multifunctional peptide was designed to have distinctive features, including a cell-penetrating peptide to enhance cellular uptake, a nuclear localization signal peptide to assist in the translocation of an angiogenic gene into the nucleus, and a fluorescent tryptophan residue to visualize and quantify the transfection efficiency. Furthermore, a pH-sensitive dimethylmaleic anhydride (DMA) was integrated with the multifunctional peptide to enhance the transfected gene complex to escape from endosomes/lysosomes after internalization. In vitro experiments showed that the multifunctional non-viral gene vector significantly increased internalization and gene transfection efficiency as well as reduced cytotoxicity. After dental pulp stem cells (DPSCs) were transfected with the multifunctional gene vector/pVEGF complexes, the expression of VEGF from the DPSCs was upregulated for more than eight folds, which in turn greatly enhanced endothelial cell migration and vascular-like tube formation. Six weeks after implantation, the VEGF-transfected DPSCs accelerated new blood vessel formation and the regenerated pulp tissue occupied most of the area in the canal of a full-length human tooth root. The multifunctional peptide conjugated non-viral gene delivery is a safe and effective approach for regenerative endodontics. STATEMENT OF SIGNIFICANCE: Pulp regeneration in a full-length tooth root canal has long been a challenge in regenerative endodontics. This is due to the unique root anatomy that allows the blood supply of the tooth root only from a small apical foramen (< 1 mm), leading to a severe barrier for revascularization during pulp regeneration. In this work, we designed a multifunctional peptide-conjugated, pH-sensitive, non-viral gene vector to address this challenge. Our work shows that the peptide-conjugated system was an excellent carrier for fast revascularization and pulp tissue regeneration in a full-length toot root. This study will interest the multidisciplinary readership in gene delivery, biomaterials, and dental/craniofacial tissue engineering community.
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Jauković A, Kukolj T, Trivanović D, Okić-Đorđević I, Obradović H, Miletić M, Petrović V, Mojsilović S, Bugarski D. Modulating stemness of mesenchymal stem cells from exfoliated deciduous and permanent teeth by IL-17 and bFGF. J Cell Physiol 2021; 236:7322-7341. [PMID: 33934350 DOI: 10.1002/jcp.30399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/12/2021] [Accepted: 04/05/2021] [Indexed: 12/18/2022]
Abstract
Mesenchymal stem cells (MSCs) have been identified within dental pulp tissues of exfoliated deciduous (SHEDs) and permanent (DPSCs) teeth. Although differences in their proliferative and differentiation properties were revealed, variability in SHEDs and DPSCs responsiveness to growth factors and cytokines have not been studied before. Here, we investigated the influence of interleukin-17 (IL-17) and basic fibroblast growth factor (bFGF) on stemness features of SHEDs and DPSCs by analyzing their proliferation, clonogenicity, cell cycle progression, pluripotency markers expression and differentiation after 7-day treatment. Results indicated that IL-17 and bFGF differently affected SHEDs and DPSCs proliferation and clonogenicity, since bFGF increased proliferative and clonogenic potential of both cell types, while IL-17 similarly affected SHEDs, exerting no effects on adult counterparts DPSCs. In addition, both factors stimulated NANOG, OCT4, and SOX2 pluripotency markers expression in SHEDs and DPSCs showing diverse intracellular expression patterns dependent on MSCs type. As for the differentiation capacity, both factors displayed comparable effects on SHEDs and DPSCs, including stimulatory effect of IL-17 on early osteogenesis in contrast to the strong inhibitory effect showed for bFGF, while having no impact on SHEDs and DPSCs chondrogenesis. Moreover, bFGF combined with IL-17 reduced CD90 and stimulated CD73 expression on both types of MSCs, whereas each factor induced IL-6 expression indicating its' role in IL-17/bFGF-modulated properties of SHEDs and DPSCs. All these data demonstrated that dental pulp MSCs from primary and permanent teeth exert intrinsic features, providing novel evidence on how IL-17 and bFGF affect stem cell properties important for regeneration of dental pulp at different ages.
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Affiliation(s)
- Aleksandra Jauković
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Tamara Kukolj
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Drenka Trivanović
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.,IZKF Research Group Tissue Regeneration in Musculoskeletal Diseases, University Clinics, Würzburg, Germany.,Bernhard-Heine-Center for Locomotion Research, University Würzburg, Würzburg, Germany
| | - Ivana Okić-Đorđević
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Hristina Obradović
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Maja Miletić
- Department of Pathophysiology, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vanja Petrović
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Slavko Mojsilović
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Diana Bugarski
- Laboratory for Experimental Hematology and Stem Cells, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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Arora S, Cooper PR, Friedlander LT, Rizwan S, Seo B, Rich AM, Hussaini HM. Potential application of immunotherapy for modulation of pulp inflammation: opportunities for vital pulp treatment. Int Endod J 2021; 54:1263-1274. [PMID: 33797765 DOI: 10.1111/iej.13524] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/15/2022]
Abstract
Caries results in the demineralization and destruction of enamel and dentine, and as the disease progresses, irreversible pulpitis can occur. Vital pulp therapy (VPT) is directed towards pulp preservation and the prevention of the progression of inflammation. The outcomes of VPT are not always predictable, and there is often a poor correlation between clinical signs and symptoms, and the events occurring at a molecular level. The inflamed pulp expresses increased levels of cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1α, IL-1β, IL-4, IL-6, IL-8, IL-17 and IL-23, which recruit and drive a complex cellular immune response. Chronic inflammation and sustained cytokine release can result in irreversible pulp damage and a decreased capacity for tissue healing. Other chronic inflammatory diseases, such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis, are also characterized by an dysregulated immune response composed of relatively high cytokine levels and increased numbers of immune cells along with microbial and hard-soft tissue destructive pathologies. Whilst anti-cytokine therapies have been successfully applied in the treatment of these diseases, this approach is yet to be attempted in cases of pulp inflammation. This review therefore focuses on the similarities in the aetiology between chronic inflammatory diseases and pulpitis, and explores how anti-cytokine therapies could be applied to manage an inflamed pulp and facilitate healing. Further proof-of-concept studies and clinical trials are justified to determine the effectiveness of these treatments to enable more predictable outcomes in VPT.
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Affiliation(s)
- S Arora
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - P R Cooper
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - L T Friedlander
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - S Rizwan
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - B Seo
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - A M Rich
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - H M Hussaini
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Huang X, Li Z, Liu A, Liu X, Guo H, Wu M, Yang X, Han B, Xuan K. Microenvironment Influences Odontogenic Mesenchymal Stem Cells Mediated Dental Pulp Regeneration. Front Physiol 2021; 12:656588. [PMID: 33967826 PMCID: PMC8100342 DOI: 10.3389/fphys.2021.656588] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/23/2021] [Indexed: 12/21/2022] Open
Abstract
Dental pulp as a source of nutrition for the whole tooth is vulnerable to trauma and bacterial invasion, which causes irreversible pulpitis and pulp necrosis. Dental pulp regeneration is a valuable method of restoring the viability of the dental pulp and even the whole tooth. Odontogenic mesenchymal stem cells (MSCs) residing in the dental pulp environment have been widely used in dental pulp regeneration because of their immense potential to regenerate pulp-like tissue. Furthermore, the regenerative abilities of odontogenic MSCs are easily affected by the microenvironment in which they reside. The natural environment of the dental pulp has been proven to be capable of regulating odontogenic MSC homeostasis, proliferation, and differentiation. Therefore, various approaches have been applied to mimic the natural dental pulp environment to optimize the efficacy of pulp regeneration. In addition, odontogenic MSC aggregates/spheroids similar to the natural dental pulp environment have been shown to regenerate well-organized dental pulp both in preclinical and clinical trials. In this review, we summarize recent progress in odontogenic MSC-mediated pulp regeneration and focus on the effect of the microenvironment surrounding odontogenic MSCs in the achievement of dental pulp regeneration.
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Affiliation(s)
- Xiaoyao Huang
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Zihan Li
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Anqi Liu
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Xuemei Liu
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Hao Guo
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Meiling Wu
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Xiaoxue Yang
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bing Han
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Kun Xuan
- State Key Laboratory of Military Stomatology, Fourth Military Medical University, Xi'an, China.,National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.,Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Xu X, Liang C, Gao X, Huang H, Xing X, Tang Q, Yang J, Wu Y, Li M, Li H, Liao L, Tian W. Adipose Tissue-derived Microvascular Fragments as Vascularization Units for Dental Pulp Regeneration. J Endod 2021; 47:1092-1100. [PMID: 33887305 DOI: 10.1016/j.joen.2021.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/02/2021] [Accepted: 04/09/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The transplantation of dental pulp stem cells (DPSCs) has emerged as a novel strategy for the regeneration of lost dental pulp after pulpitis and trauma. Dental pulp regeneration of the young permanent tooth with a wide tooth apical foramen has achieved significant progress in the clinical trials. However, because of the narrow apical foramen, dental pulp regeneration in adult teeth using stem cells remains difficult in the clinic. Finding out how to promote vascular reconstitution is essential for the survival of stem cells and the regeneration of dental pulp after transplantation into the adult tooth. METHODS Adipose tissue-derived microvascular fragments (ad-MVFs) were isolated from human adipose tissues. The apoptosis and senescence of DPSCs cultured in conditioned media were evaluated to explore the effects of ad-MVFs on DPSCs. DPSCs combined with ad-MVFs were inserted into the human tooth root segments and implanted subcutaneously into immunodeficient mice. Regenerated pulplike tissues were analyzed by hematoxylin and eosin and immunohistochemistry. The vessels in regenerated tissues were analyzed by Micro-CT and immunofluorescence. RESULTS The isolated ad-MVFs contained endothelial cells and pericytes. ad-MVFs effectively prevented the apoptosis and senescence of the transplanted DPSCs both in vivo and in vitro. Combined with DPSCs, ad-MVFs obviously facilitated the formation of vascular networks in the transplants. DPSCs combined with ad-MVFs formed dental pulp-like tissues with abundant cells and matrix after 4 weeks of implantation. The supplementation of ad-MVFs led to more odontoblastlike cells and increased the formation of mineralized substance around the root canal. CONCLUSIONS Cotransplantation with ad-MVFs promotes the angiogenesis and revascularization of transplanted DPSC aggregates, leading to robust regeneration of dental pulp.
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Affiliation(s)
- Xun Xu
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Liang
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Gao
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Haisen Huang
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaotao Xing
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jian Yang
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yutao Wu
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Maojiao Li
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Huanian Li
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Liao
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Weidong Tian
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Leite ML, Soares DG, Anovazzi G, Anselmi C, Hebling J, de Souza Costa CA. Fibronectin-loaded Collagen/Gelatin Hydrogel Is a Potent Signaling Biomaterial for Dental Pulp Regeneration. J Endod 2021; 47:1110-1117. [PMID: 33887309 DOI: 10.1016/j.joen.2021.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Guided tissue regeneration has been considered a promising biological strategy to replace conventional endodontic therapies of teeth with incomplete root formation. Therefore, in the present study, a collagen/gelatin hydrogel either containing dosages of fibronectin (FN), or not, was developed and assessed concerning their bioactive and chemotactic potential on human apical papilla cells (hAPCs). METHODS Hydrogels were prepared by varying the ratio of collagen and gelatin (Col/Gel; v/v), and used to establish the following groups: Collagen (positive control); Col/Gel 4:6; Col/Gel 6:4; Col/Gel 8:2. The viability, adhesion, and spreading of cells seeded on the hydrogels were evaluated. Different concentrations of FN (0, 5, or 10 μg/mL) were incorporated into the best formulation of the collagen/gelatin hydrogel selected. Then, the hAPCs seeded on the biomaterials were assessed concerning the cell migration, viability, adhesion and spreading, and gene expression of ITGA5, ITGAV, COL1A1, and COL3A1. RESULTS The Col/Gel 8:2 group exhibited better cell viability, adhesion and spreading in comparison with Control. Higher values of hAPC migration, viability, adhesion, spreading and gene expression of pulp regeneration markers were found, the higher the concentration was of FN incorporated into the collagen/gelatin hydrogel. CONCLUSION Collagen/gelatin hydrogel with 10 μg/mL of FN had potent bioactive and chemotactic effects on cultured hAPCs.
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Affiliation(s)
- Maria Luísa Leite
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, Univ. Estadual Paulista - UNESP, Araraquara, SP, Brazil
| | - Diana Gabriela Soares
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Giovana Anovazzi
- Departament of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil
| | - Caroline Anselmi
- Departament of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil
| | - Josimeri Hebling
- Departament of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil.
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Nakakura-Ohshima K, Quispe-Salcedo A, Sano H, Hayasaki H, Ohshima H. The effects of reducing the root length by apicoectomy on dental pulp revascularization following tooth replantation in mice. Dent Traumatol 2021; 37:677-690. [PMID: 33861506 DOI: 10.1111/edt.12679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/21/2021] [Accepted: 03/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND/AIM Root length is a critical factor for dental pulp regeneration following tooth replantation. The aim of this study was to analyze the effects of reducing the root length by apicoectomy on the pulp healing process using a model for tooth replantation. MATERIAL AND METHODS After extraction of the upper first molars (M1) of 3-week-old mice, the roots from the experimental group (EG) were shortened to half to two-thirds of their length before replantation, whereas in the control group (CG) the extracted teeth were immediately repositioned into their alveolar sockets. To determine the effects of root resection on the survival of inherent pulp cells, this study included tooth transplantation with root resection using wild-type (WT) and green fluorescent protein (GFP) transgenic mice. The M1 of GFP transgenic mice were transplanted into the alveolar socket of the M1 of WT mice. The roots of the right M1 were shortened (EG), whereas the left M1 remained untreated (CG). RESULTS Apoptotic cells in the EG significantly decreased in number compared with the CG at day 3. Cell proliferative activity in the EG was significantly higher than that in the CG in the root pulp during days 3-5, and nestin-positive odontoblast-like cells began to arrange themselves along the pulp-dentin border in the cusp area at day 5 in the EG but not in the CG. At week 2, tertiary dentin had formed throughout the pulp in the EG, whereas the combined tissue of dentin and bone occupied the pulp space in 60% of the CG. Root resection also positively affected the survival of inherent pulp cells to differentiate into odontoblast-like cells as demonstrated by transplantation using GFP transgenic mice. CONCLUSIONS Reducing the root length accelerated pulp regeneration following tooth replantation due to the better environment for revascularization.
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Affiliation(s)
- Kuniko Nakakura-Ohshima
- Division of Pediatric Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Angela Quispe-Salcedo
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,School of Stomatology, Faculty of Health Science, Universidad Científica del Sur, Lima, Peru
| | - Hiroto Sano
- Division of Clinical Chemistry, Department of Medical Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan.,Department of Pathology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Haruaki Hayasaki
- Division of Pediatric Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hayato Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Louvrier A, Terranova L, Meyer C, Meyer F, Euvrard E, Kroemer M, Rolin G. Which experimental models and explorations to use in regenerative endodontics? A comprehensive review on standard practices. Mol Biol Rep 2021; 48:3799-3812. [PMID: 33761086 DOI: 10.1007/s11033-021-06299-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/18/2021] [Indexed: 01/09/2023]
Abstract
Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.
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Affiliation(s)
- A Louvrier
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France.
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France.
| | - L Terranova
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - C Meyer
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - F Meyer
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - E Euvrard
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - M Kroemer
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- Pharmacie Centrale, CHU Besançon, 25000, Besançon, France
| | - G Rolin
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- INSERM CIC-1431, CHU Besançon, 25000, Besançon, France
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iRoot SP Promotes Osteo/Odontogenesis of Bone Marrow Mesenchymal Stem Cells via Activation of NF- κB and MAPK Signaling Pathways. Stem Cells Int 2021; 2020:6673467. [PMID: 33424977 PMCID: PMC7775135 DOI: 10.1155/2020/6673467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/11/2022] Open
Abstract
The regeneration of bone and tooth tissues, and related cellular therapies, has attracted widespread attention. Bone marrow mesenchymal stem cells (BMSCs) are potential candidates for such regeneration. iRoot SP is a premixed bioceramic root canal sealer widely used in clinical settings. However, the effect of iRoot SP on the biological features of BMSCs has not been elucidated. In the present study, we found that 0.2 mg/ml iRoot SP conditioned medium promoted osteo/odontogenic differentiation and enhanced mineralization of BMSCs without affecting the proliferative ability. Mechanistically, the NF-κB and MAPK signaling pathways were activated in SP-treated BMSCs, and differentiation was inhibited when cultured with the specific inhibitor. Taken together, these findings demonstrate that iRoot SP promotes osteo/odontogenic differentiation of BMSCs via the NF-κB and MAPK signaling pathways, which could provide a new theoretical basis for clinical applications of iRoot SP and a new therapeutic target for the regeneration of bone and tooth tissue in the future.
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hDPSC-laden GelMA microspheres fabricated using electrostatic microdroplet method for endodontic regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 121:111850. [PMID: 33579484 DOI: 10.1016/j.msec.2020.111850] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023]
Abstract
The microsphere system has attracted considerable attention as a stem-cell delivery vehicle in regeneration medicine owing to its injectability, fast substance transfer ability, and mimicry of the three-dimensional native environment. However, suitable biomaterials for preparation of microspheres optimal for endodontic regeneration are still being explored. Owing to its excellent bioactivity and biodegradability, gelatin methacryloyl (GelMA) was used to fabricate hydrogel microspheres by the electrostatic microdroplet method, and the potential of GelMA microspheres applied in endodontic regeneration was studied. The average size of GelMA microspheres encapsulating human dental pulp stem cells (hDPSCs) was ~200 μm, and the Young's modulus was approximately 582.8 ± 66.0 Pa, which was close to that of the natural human dental pulp. The encapsulated hDPSCs could effectively adhere, spread, proliferate, and secrete extracellular matrix proteins in the microspheres, and tended to occupy the outer layer. Moreover, the cell-laden GelMA microsphere system could withstand cryopreservation, and the thawed cells exhibited normal functions. After subcutaneous implantation in a nude mouse model, more vascularized pulp-like tissues were generated in the cell-laden GelMA microsphere group compared with that in the cell-laden bulk GelMA group, and this was accompanied by a suitable degradation rate. The GelMA microspheres showed remarkable performances and great potential as cell delivery vehicles in endodontic regeneration.
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Abbass MMS, El-Rashidy AA, Sadek KM, Moshy SE, Radwan IA, Rady D, Dörfer CE, Fawzy El-Sayed KM. Hydrogels and Dentin-Pulp Complex Regeneration: From the Benchtop to Clinical Translation. Polymers (Basel) 2020; 12:E2935. [PMID: 33316886 PMCID: PMC7763835 DOI: 10.3390/polym12122935] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023] Open
Abstract
Dentin-pulp complex is a term which refers to the dental pulp (DP) surrounded by dentin along its peripheries. Dentin and dental pulp are highly specialized tissues, which can be affected by various insults, primarily by dental caries. Regeneration of the dentin-pulp complex is of paramount importance to regain tooth vitality. The regenerative endodontic procedure (REP) is a relatively current approach, which aims to regenerate the dentin-pulp complex through stimulating the differentiation of resident or transplanted stem/progenitor cells. Hydrogel-based scaffolds are a unique category of three dimensional polymeric networks with high water content. They are hydrophilic, biocompatible, with tunable degradation patterns and mechanical properties, in addition to the ability to be loaded with various bioactive molecules. Furthermore, hydrogels have a considerable degree of flexibility and elasticity, mimicking the cell extracellular matrix (ECM), particularly that of the DP. The current review presents how for dentin-pulp complex regeneration, the application of injectable hydrogels combined with stem/progenitor cells could represent a promising approach. According to the source of the polymeric chain forming the hydrogel, they can be classified into natural, synthetic or hybrid hydrogels, combining natural and synthetic ones. Natural polymers are bioactive, highly biocompatible, and biodegradable by naturally occurring enzymes or via hydrolysis. On the other hand, synthetic polymers offer tunable mechanical properties, thermostability and durability as compared to natural hydrogels. Hybrid hydrogels combine the benefits of synthetic and natural polymers. Hydrogels can be biofunctionalized with cell-binding sequences as arginine-glycine-aspartic acid (RGD), can be used for local delivery of bioactive molecules and cellularized with stem cells for dentin-pulp regeneration. Formulating a hydrogel scaffold material fulfilling the required criteria in regenerative endodontics is still an area of active research, which shows promising potential for replacing conventional endodontic treatments in the near future.
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Affiliation(s)
- Marwa M. S. Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (M.M.S.A.); (S.E.M.); (I.A.R.); (D.R.)
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
| | - Aiah A. El-Rashidy
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Khadiga M. Sadek
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (M.M.S.A.); (S.E.M.); (I.A.R.); (D.R.)
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (M.M.S.A.); (S.E.M.); (I.A.R.); (D.R.)
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (M.M.S.A.); (S.E.M.); (I.A.R.); (D.R.)
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, 24105 Kiel, Germany;
| | - Karim M. Fawzy El-Sayed
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (A.A.E.-R.); (K.M.S.)
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, 24105 Kiel, Germany;
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
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Diana R, Ardhani R, Kristanti Y, Santosa P. Dental pulp stem cells response on the nanotopography of scaffold to regenerate dentin-pulp complex tissue. Regen Ther 2020; 15:243-250. [PMID: 33426225 PMCID: PMC7770425 DOI: 10.1016/j.reth.2020.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/05/2020] [Accepted: 09/16/2020] [Indexed: 12/13/2022] Open
Abstract
The study of regenerative dentistry receives a fast growing interest. The potential ability of the dentin-pulp complex to regenerate is both promising and perplexing. To answer the challenging nature of the dental environment, scientists have developed various combinations of biomaterial scaffolds, stem cells, and incorporation of several growth factors. One of the crucial elements of this tissue engineering plan is the selection and fabrication of scaffolds. However, further findings suggest that cell behavior hugely depends on mechanical signaling. Nanotopography modifies scaffolds to alter cell migration and differentiation. However, to the best of the author's knowledge, there are very few studies addressing the correlation between nanotopography and dentin-pulp complex regeneration. Therefore, this article presents a comprehensive review of these studies and suggests a direction for future developments, particularly in the incorporation of nanotopography design for dentin-pulp complex regeneration.
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Key Words
- BDNF, brain-derived neurotrophic factor
- BMP, bone morphogenetic protein
- DPSC, dental pulp stem cell
- Dental pulp stem cell
- Dentin-pulp complex tissue
- ECM, extracellular matrix
- FGF2, fibroblast growth factor-2
- GDNF, glial cell line-derived neurotrophic factor
- GO, graphene oxide
- GelMA, methacrylated gelatin
- IGF, insulin-like growth factor
- ION-CPC, iron oxide nanoparticle-incorporating calcium phosphate cement
- LPS, lipopolysaccharide
- NGF, nerve growth factor
- Nanotopography
- PCL, polycaprolactone
- PDGF, platelet-derived growth factor
- PEGMA, poly(ethylene glycol) dimethacrylate
- PGA, polyglycolic acid
- PHMS, polyhydroxymethylsiloxane
- PLGA, poly-dl-lactic-co-glycolic acid
- PLLA, poly-l-lactic acid
- RGO, reduced graphene oxide
- Regenerative dentistry
- SACP, stem cells from apical papilla
- SDF-1, stromal cell-derived factor-1
- SHED, stem cells from human exfoliated deciduous teeth
- Scaffold
- TGF-β, transforming growth factor-β
- TNF-α, t umour necrosis factor-alpha
- VEGF, vascular endothelial growth factor
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Affiliation(s)
- Rasda Diana
- Department of Conservative Dentistry, Faculty of Dentistry Universitas Gadjah Mada, Jl Denta Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Retno Ardhani
- Department of Dental Biomedical Sciences, Faculty of Dentistry Universitas Gadjah Mada, Jl Denta Sekip Utara, Yogyakarta, 55281, Indonesia
- Corresponding author. Fax: +62274 515307.
| | - Yulita Kristanti
- Department of Conservative Dentistry, Faculty of Dentistry Universitas Gadjah Mada, Jl Denta Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Pribadi Santosa
- Department of Conservative Dentistry, Faculty of Dentistry Universitas Gadjah Mada, Jl Denta Sekip Utara, Yogyakarta, 55281, Indonesia
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Jiang L, Ayre WN, Melling GE, Song B, Wei X, Sloan AJ, Chen X. Liposomes loaded with transforming growth factor β1 promote odontogenic differentiation of dental pulp stem cells. J Dent 2020; 103:103501. [PMID: 33068710 DOI: 10.1016/j.jdent.2020.103501] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES This study investigated whether novel liposome formulations loaded with transforming growth factor β1 (TGF-β1) could promote the odontogenic differentiation of human dental pulp stem cells (hDPSCs) for dentine-pulp regeneration. METHODS 0-100 ng/mL of liposomal TGF-β1 was prepared using the thin-film hydration method. Release of TGF-β1 from the liposomes was quantified by an enzyme-linked immunosorbent assay (ELISA). The hDPSCs were treated with different concentrations of liposomal TGF-β1 and cell viability was tested using an MTT assay. "Osteodentine" differentiation capacity was assessed by RT-qPCR, ELISA and Alizarin red S staining. RESULTS The ELISA results showed that liposomal TGF-β1 achieved a controlled and prolonged release over time. The MTT results demonstrated that the liposomes (100 μg/mL) were not cytotoxic to the cells. Liposomal TGF-β1 up-regulated the expression of "osteodentine" markers, RUNX-2, DMP-1 and DSPP, in hDPSCs after 7 days of treatment and resulted in the accumulation of mineralised nodules. CONCLUSION This study indicated that liposomes are an effective carrier for delivering TGF-β1 over time. Liposomal TGF-β1 promoted dentinogenesis and increased mineralisation in hDPSCs. This highlights the potential of liposomal TGF-β1 for future use in dentine-pulp regeneration. CLINICAL SIGNIFICANCE Liposomal TGF-β1 may be used as a synergist for promoting dentine-pulp regeneration of immature permanent teeth or as a pulp capping agent for inducing reparative dentine formation.
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Affiliation(s)
- Liming Jiang
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China; Department of Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK.
| | - Wayne Nishio Ayre
- Department of Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK; Cardiff Institute for Tissue Engineering and Repair (CITER), Cardiff, UK.
| | - Genevieve E Melling
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK.
| | - Bing Song
- Department of Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK.
| | - Xiaoqing Wei
- Department of Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK.
| | - Alastair James Sloan
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China; Department of Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK; Cardiff Institute for Tissue Engineering and Repair (CITER), Cardiff, UK; Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Xu Chen
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.
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Deluca MCDC, Scarparo RK, Aspesi M, Matte BF, Brand LM, Grecca FS, Casagrande L, Kopper PMP. Cytotoxic, Migration, and Angiogenic Effects of Photodynamic Therapy and Photobiomodulation Associated with a Revascularization Protocol. J Endod 2020; 47:69-77. [PMID: 33058937 DOI: 10.1016/j.joen.2020.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/26/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This study evaluated photodynamic therapy (PDT) and photobiomodulation therapy (PBM) as adjuncts to pulp revascularization using cultures of apical papilla cells (APCs) and endothelial cells (HUVECs). METHODS The root canal and apical foramen of 2 mandibular first premolars were enlarged to simulate immature teeth. The canal of 1 tooth was filled with 1 mL 0.005% methylene blue (MB). After that, the canals of both teeth were irrigated with 20 mL 1.5% sodium hypochlorite (NaOCl) and 20 mL 17% EDTA. The resulting solutions were diluted in cell culture media at a concentration of 0.5% (0.5% MB + NaOCl + EDTA and 0.5% NaOCl + EDTA). After PDT (0.5% MB + NaOCl + EDTA + PDT) and PBM (0.5% NaOCl + EDTA + PBM) applications, the effects were evaluated to determine cytotoxicity, polarity index, APC migration, and HUVEC sprouting, and results were compared with those of their controls (solutions without laser application). Cell culture media (CT) was also used as a control. Data were analyzed using 1-way analysis of variance and the Tukey post hoc test (P ≤ .05). RESULTS PDT and PBM promoted greater APC viability than their controls, and PDT had greater cell viability than CT (P < .05). All protocols reduced APC migration when compared with CT (P < .05). HUVEC sprouts grown out of spheroids in PBM had a greater ratio area than their control (P ≤ .01), and the PDT ratio of the spheroid area was similar to that of its control (P > .05). CONCLUSIONS PBM and PDT seem to be potentially effective adjuncts to revascularization in nonvital immature teeth.
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Affiliation(s)
| | | | - Marina Aspesi
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bibiana Franzen Matte
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luiza Meurer Brand
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciano Casagrande
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Maria Poli Kopper
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
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Sui B, Wu D, Xiang L, Fu Y, Kou X, Shi S. Dental Pulp Stem Cells: From Discovery to Clinical Application. J Endod 2020; 46:S46-S55. [DOI: 10.1016/j.joen.2020.06.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kim YH, Lee JS, Seo EJ, Park JK, Yea K, Shin J, Jang IH, Jeong T. Oncostatin M enhances osteogenic differentiation of dental pulp stem cells derived from supernumerary teeth. Biochem Biophys Res Commun 2020; 529:169-174. [PMID: 32703406 DOI: 10.1016/j.bbrc.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/03/2020] [Indexed: 01/09/2023]
Abstract
Supernumerary tooth (ST) may arise from uncertain developmental abnormalities or underlying genetic causes, and the extraction at the early age is recommended. Dental pulp stem cells (DPSCs) are the valuable resource for the regeneration of tooth and related craniofacial structures. DPSCs isolated from ST (sDPSCs) have not been fully characterized despite the potential in the applications. The objectives of this study are the efficient isolation of sDPSCs and the analysis of the properties as stem cells. sDPSCs were established by hammer-cracking and separation of the intact pulp from ST. sDPSCs in the culture were examined by light microscope and flow cytometer for the morphology and the surface marker expression. sDPSCs exhibited the cellular morphology of typical mesenchymal stem cells and expressed CD44, CD73, CD90, CD105 and CD166, but not CD14, CD34 or CD45. sDPSCs showed the differentiation potential toward osteogenic, chondrogenic and adipogenic lineages. During osteogenic differentiation, the stimulation by Oncostatin M enhanced the differentiation and significantly increased the expression of genes involved in the hard tissue repair, such as BMP2, BMP4, BMP6 and RUNX2. sDPSCs can be effectively derived from ST and displays the characteristics of mesenchymal stem cells in the maintenance and the differentiation. sDPSCs satisfies the quality as DPSCs thus provide the valuable resource to the regenerative therapy.
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Affiliation(s)
- Young Hwan Kim
- Department of Oral Biochemistry, Republic of Korea; Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, 50612, Republic of Korea
| | - Jeong Sang Lee
- Department of Pediatric Dentistry, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, 50612, Republic of Korea
| | - Eun Jin Seo
- Department of Oral Biochemistry, Republic of Korea; Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, 50612, Republic of Korea
| | - Jae Kyung Park
- Department of Oral Biochemistry, Republic of Korea; Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, 50612, Republic of Korea
| | - Kyungmoo Yea
- Department of New Biology, DGIST, Daegu, 42988, Republic of Korea
| | - Jonghyun Shin
- Department of Pediatric Dentistry, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, 50612, Republic of Korea
| | - Il Ho Jang
- Department of Oral Biochemistry, Republic of Korea; Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, 50612, Republic of Korea.
| | - Taesung Jeong
- Department of Pediatric Dentistry, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, 50612, Republic of Korea.
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Zafar MS, Amin F, Fareed MA, Ghabbani H, Riaz S, Khurshid Z, Kumar N. Biomimetic Aspects of Restorative Dentistry Biomaterials. Biomimetics (Basel) 2020; 5:biomimetics5030034. [PMID: 32679703 PMCID: PMC7557867 DOI: 10.3390/biomimetics5030034] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
Biomimetic has emerged as a multi-disciplinary science in several biomedical subjects in recent decades, including biomaterials and dentistry. In restorative dentistry, biomimetic approaches have been applied for a range of applications, such as restoring tooth defects using bioinspired peptides to achieve remineralization, bioactive and biomimetic biomaterials, and tissue engineering for regeneration. Advancements in the modern adhesive restorative materials, understanding of biomaterial–tissue interaction at the nano and microscale further enhanced the restorative materials’ properties (such as color, morphology, and strength) to mimic natural teeth. In addition, the tissue-engineering approaches resulted in regeneration of lost or damaged dental tissues mimicking their natural counterpart. The aim of the present article is to review various biomimetic approaches used to replace lost or damaged dental tissues using restorative biomaterials and tissue-engineering techniques. In addition, tooth structure, and various biomimetic properties of dental restorative materials and tissue-engineering scaffold materials, are discussed.
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Affiliation(s)
- Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
- Correspondence: ; Tel.: +966-14-8618888
| | - Faiza Amin
- Science of Dental Materials Department, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Muhmmad Amber Fareed
- Adult Restorative Dentistry, Dental Biomaterials and Prosthodontics Oman Dental College, Muscat 116, Sultanate of Oman;
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
| | - Samiya Riaz
- School of Dental Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudia Arabia;
| | - Naresh Kumar
- Department of Science of Dental Materials, Dow University of Health Sciences, Karachi 74200, Pakistan;
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Rizk HM, Salah AL-Deen MS, Emam AA. Pulp Revascularization/Revitalization of Bilateral Upper Necrotic Immature Permanent Central Incisors with Blood Clot vs Platelet-rich Fibrin Scaffolds-A Split-mouth Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2020; 13:337-343. [PMID: 33149405 PMCID: PMC7586471 DOI: 10.5005/jp-journals-10005-1788] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Clinical and radiographic evaluation of the regeneration of bilateral necrotic upper permanent central incisors with open apex using blood clot (BC) and platelet-rich fibrin (PRF) scaffolds. TRIAL DESIGN Split-mouth double-blind parallel arm randomized controlled clinical trial. MATERIALS AND METHODS Randomization and blinding: The study started with 15 patients with bilateral necrotic upper permanent central incisors with open apex. Computer-generated tables were used to allocate treatments. The two maxillary central incisors were randomly assigned to either the control (BC scaffold) or the examined (PRF scaffold) groups. Participants: Thirteen patients aged 8-14 years fulfilled the study requirements. Follow-up was performed for 3, 6, 9, and 12 months. Standardized radiographs were collected each 3 months, and difference in measurements was calculated using Image J software. Primary outcomes measured were sinus/fistula formation, pain complaint, mobility grade, and swelling presence/absence. Radiographic: Root length elongation and increase in root thickness. Secondary outcomes were sensibility test and crown color change. Radiographic: Change in bone density and apical diameter. Radiographs that were standardized used during the follow-up time, and occurred changes were calculated using Image J software. RESULTS One patient was lost during follow-up; therefore, 24 treated teeth were analyzed, they showed 100% success rate. Platelet-rich fibrin teeth displayed a statistically significant growth in radiographic root length and width, increased periapical bone density, and a reduction in apical diameter when compared with BC. At the end of the follow-up period, all treated teeth were negative to sensibility test. Blood clot displayed greater crown discoloration in comparison to PRF group. CONCLUSION For teeth with open apex and necrotic pulp, revascularization using PRF is an appropriate substitute to BC. HOW TO CITE THIS ARTICLE Rizk HM, Salah AL-Deen MS, Emam AA. Pulp Revascularization/Revitalization of Bilateral Upper Necrotic Immature Permanent Central Incisors with Blood Clot vs Platelet-rich Fibrin Scaffolds-A Split-mouth Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2020;13(4):337-343.
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Affiliation(s)
- Hazim Mohamed Rizk
- Department of Pediatric Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | | | - Asmaa Aly Emam
- Department of Pediatric Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Rizk HM, Salah Al-Deen MSM, Emam AA. Comparative evaluation of Platelet Rich Plasma (PRP) versus Platelet Rich Fibrin (PRF) scaffolds in regenerative endodontic treatment of immature necrotic permanent maxillary central incisors: A double blinded randomized controlled trial. Saudi Dent J 2020; 32:224-231. [PMID: 32647469 PMCID: PMC7336024 DOI: 10.1016/j.sdentj.2019.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVES The research aims to assess the regenerative potential of Platelet Rich Plasma (PRP) versus Platelet Rich Fibrin (PRF) scaffolds in immature permanent maxillary central incisors with necrotic pulps, clinically and radiographically. TRIAL DESIGN Double blinded parallel randomized controlled trial was implemented to identify the results. SUBJECT & METHODS The proposed study was conducted among 30 patients with maxillary necrotic permanent immature central incisors but only 26 patients fulfilled the study requirements. Group I was treated with PRP and Group II with PRF scaffolds. Follow up has been done every 3 months for one year. Primary outcomes were measured clinically: Pain, Mobility, Swelling, and Sinus/fistula. Radiographically: increase root length and width. Secondary outcomes were clinically: Discoloration and Sensibility test. Radiographically: increase in bone density measurements and decrease in apical diameter. Standardized radiographs were collected during the follow up period, and radiographic changes were measured by using Image J software. Statistical analysis was performed on 25 patients who had completed the study. RESULTS All 25 patients' teeth were survived during the 12-month follow-up period. PRP showed marginal increase in radiographic root length and width, periapical bone density and a decrease in apical diameter. No statistical significant differences were observed when it was compared with PRF. The teeth which were treated did not respond to sensibility test at the end of the study. PRF displayed statistical significant higher amount of crown discoloration when compared to PRP group. CONCLUSIONS For necrotic immature teeth, revascularization using PRP is an appropriate alternative to PRF and showed excellent 12-months prognosis.
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Affiliation(s)
- Hazim Mohamed Rizk
- Pediatric Dentistry, Preventive & Dental Public Health Department, Faculty of Dentistry, Suez Canal University, Egypt
| | | | - Asmaa Aly Emam
- Pediatric Dentistry, Preventive & Dental Public Health Department, Faculty of Dentistry, Suez Canal University, Egypt
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