1
|
Tong D, Gobert S, Reuzeau A, Farges JC, Leveque M, Bolon M, Costantini A, Pasdeloup M, Lafont J, Ducret M, Bekhouche M. Dental pulp mesenchymal stem cells-response to fibrin hydrogel reveals ITGA2 and MMPs expression. Heliyon 2024; 10:e32891. [PMID: 39027533 PMCID: PMC11255596 DOI: 10.1016/j.heliyon.2024.e32891] [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: 11/13/2023] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Regenerative endodontic procedures (REP) aim at reestablishing tooth vitality by replacing the irreversibly damaged dental pulp removed by the dental practitioner with a new functional one. The current treatment of advanced caries relies on the replacement of the inflamed or necrosed dental pulp with an inert filling material. This leads to a functional but non-vital tooth, which lacks the ability to sense dental tissue damage, and to protect from further bacterial attack. Therapeutic strategies inspired by tissue engineering called REP propose to regenerate a fully functional dental pulp directly in the canal space. Promising results were obtained using dental pulp mesenchymal stem cells (DP-MSCs) in combination with bio-inspired artificial and temporary 3D hydrogels made of extracellular matrix molecules such as collagen and fibrin biomacromolecules. However, the uncontrolled mechanisms of DP regeneration from DP-MSCs in 3D biomacromolecules fail to regenerate a fully functional DP and can induce fibrotic scarring or mineralized tissue formation to a non-negligible extent. The lack of knowledge regarding the early molecular mechanisms initiated by DP-MSCs seeded in ECM-made hydrogels is a scientific lock for REP. In this study, we investigated the early DP-MSC-response in a 3D fibrin hydrogel. DP-MSCs isolated from human third molars were cultured for 24 h in the fibrin hydrogel. The differential transcript levels of extracellular and cell surface genes were screened with 84-gene PCR array. Out of the 84 genes screened, 9 were found to be overexpressed, including those coding for the integrin alpha 2 subunit, the collagenase MMP1 and stromelysins MMP3, MMP10 and MMP12. Over-expression of ITGA2 was confirmed by RT-qPCR. The expression of alpha 2 integrin subunit protein was assessed over time by immunoblot and immunofluorescence staining. The increase in the transcript level of MMP1, MMP3, MM10 and MMP12 was confirmed by RT-qPCR. The overexpression of MMP1 and 3 at the protein level was assessed by immunoblot. MMP3 expression by DP-MSCs was observed by immunofluorescence staining. This work demonstrates overexpression of ITGA2 and of MMP1, 3, 10 and 12 by DP-MSCs cultured in a fibrin hydrogel. The main preliminary extracellular and cell surface response of the DP-MSCs to fibrin hydrogel seems to rely on a ITGA2/MMP3 axis. Further investigations are needed to precisely decipher the role of this axis in dental pulp tissue building. Nevertheless, this work identifies extracellular and cell surface molecules that could be potential checkpoints to be targeted to guide proper dental pulp tissue regeneration.
Collapse
Affiliation(s)
- David Tong
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Stéphanie Gobert
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Alicia Reuzeau
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Jean-Christophe Farges
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Odontology Faculty of Lyon, University Lyon 1, France
- Hospices Civils de Lyon, France
| | - Marianne Leveque
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Marie Bolon
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Arthur Costantini
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Hospices Civils de Lyon, France
| | - Marielle Pasdeloup
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Jérôme Lafont
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Maxime Ducret
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Odontology Faculty of Lyon, University Lyon 1, France
| | - Mourad Bekhouche
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| |
Collapse
|
2
|
Abdellatif D, Iandolo A, De Benedetto G, Giordano F, Mancino D, Euvrard E, Pisano M. Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:458-484. [PMID: 38939542 PMCID: PMC11205167 DOI: 10.4103/jcde.jcde_140_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 06/29/2024]
Abstract
Background and Objectives The present systematic review aims to assess the success rate of the pulp regeneration treatment, according to the American Association of Endodontists (AAE) criteria, using different bioactive materials in permanent teeth of pediatric subjects (6-17 years of age). Materials and Methods The study protocol was registered on PROSPERO and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The question formulation was accomplished using the PICO model, and an electronic search was carried out on Scopus, MEDLINE/PubMed, Web of Science, and Cochrane databases till April 1, 2023. A total of 30 studies were established to fulfill the inclusion criteria of this systematic review. Results A total of 273 teeth have been treated with pulp regeneration treatment. By comparing different biomaterials and the success criteria defined by the AAE, the material associated with a higher success rate was found to be the white mineral trioxide aggregate. However, the overall success rate of pulp regeneration treatment was reported for 248 out of 273 teeth (91.20%). Conclusions Data obtained support the potential that regenerative endodontics aids in continuing root development in permanent immature teeth. Further studies are needed for a more extensive evaluation of the use of different biomaterials and the success rate in regenerative endodontics.
Collapse
Affiliation(s)
- Dina Abdellatif
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | - Francesco Giordano
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Davide Mancino
- Faculty of Dental Surgery, Federation of Medicine Translational of Strasbourg and Federation of Materials and Nanoscience of Alsace, University of Strasbourg, Strasbourg, CHU Besançon, France
| | - Edouard Euvrard
- Service of Maxillofacial Surgery, Stomatology and Hospital Odontology, CHU Besançon, France
- Laboratoire Sinergies EA 4662, University of Franche-Comté, Besançon, France
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| |
Collapse
|
3
|
Ahmed YE, Ahmed GM, Ghoneim AG. Evaluation of postoperative pain and healing following regenerative endodontics using platelet-rich plasma versus conventional endodontic treatment in necrotic mature mandibular molars with chronic periapical periodontitis. A randomized clinical trial. Int Endod J 2023; 56:404-418. [PMID: 36565044 DOI: 10.1111/iej.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the post-operative pain and the healing of necrotic mature permanent mandibular molar teeth with peri-apical periodontitis after conventional endodontic treatment versus after platelet-rich plasma (PRP) revascularization. METHODOLOGY The protocol of this randomized clinical trial was registered at www. CLINICALTRIALS gov with identification number NCT03350841. Twenty-eight patients were included in the study after confirming the diagnosis clinically and radiographically. In the first visit, mandibular molar teeth of both groups were mechanically prepared. Double antibiotic paste was prepared and injected then the cavity that was sealed with glass ionomer. At the second visit, the patients were randomized either to control group where standard endodontic treatment was completed by lateral condensation technique or assigned to intervention group where PRP revascularization technique. The degree of spontaneous pain was assessed using numerical rating scale (NRS) pre-operatively, then post-operatively after 6, 12 h and daily for 5 days. Patients were given a placebo to be administrated in case of pain. An analgesic (ibuprofen 400mg) was prescribed in case of persistent pain. Clinical and radiographic healing was assessed after 6 and 12 months. All demographic, baseline and outcome data were collected and statistically analysed. RESULTS Regarding the post revascularization/obturation pain, there was no statistically significant difference between severity of pain in the two groups at all time intervals except after 12 h, revascularization group showed statistically significantly higher prevalence of no pain than endodontic treatment group. Regarding the healing; the periapical lesions decrease in size significantly from the pre-operative lesion size in both groups without significant difference between the both groups. CONCLUSION Within the limitation of this study, PRP revascularization could be an alternative treatment to root canal treatment but further randomized clinical trials with standardized techniques and long follow up periods are recommended for more reliable results.
Collapse
|
4
|
Youssef S, Tomson P, Akbari AR, Archer N, Shah F, Heran J, Kandhari S, Pai S, Mehrotra S, Batt JM. The Impact of the Preferred Reporting Items for Case Reports in Endodontics (PRICE) 2020 Guidelines on the Reporting of Endodontic Case Reports. Cureus 2023; 15:e37553. [PMID: 37197127 PMCID: PMC10184739 DOI: 10.7759/cureus.37553] [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] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Aim The aim of this study is to evaluate the impact of the Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guideline on the reporting of published endodontic case reports (CRs). Methodology All case reports published in the International Endodontic Journal, European Endodontic Journal, Journal of Endodontics and Restorative Dentistry and Endodontics, in the year before and after the release of PRICE 2020, were included for analysis. Two panels comprising dentists scored case reports against a scoring system adapted from the guideline. Individual items were scored up to a maximum of 1; scores were then summated to provide an overall maximum of 47 for each CR. Each report provided an overall percentage adherence, and panel agreement was calculated using the intraclass correlation coefficient (ICC). Disagreement on scoring was discussed until a consensus was reached. Scores before and after PRICE guideline publication were compared using an unpaired two-tailed t test. Results A total 19 CRs were identified in both the pre- and post-PRICE guideline publication. Mean adherence to PRICE 2020 increased by 7.9% (p=0.003) from 70.0%±8.89 to 77.9%±6.23 following its publication. Agreement between panels was moderate (ICC pre-PRICE: 0.673 {p=0.011}; ICC post-PRICE: 0.742 {p=0.003}). Items 1a, 6c, 6e, 6f, 6g, 6j, 6q, 6s, 7a, 9a, 11a, 12c and 12d experienced a fall in compliance. Conclusion The PRICE 2020 guideline has resulted in a modest improvement in the reporting of endodontic case reports. Greater awareness and a wider acceptance and implementation of the guideline in endodontic journals are needed to improve adherence to the novel guideline.
Collapse
Affiliation(s)
- Sofian Youssef
- Academic Research, University of Nottingham, Nottingham, GBR
| | | | | | | | - Fayjel Shah
- Endodontics, University of Birmingham, Birmingham, GBR
| | - Jasmeet Heran
- Endodontics, University of Birmingham, Birmingham, GBR
| | | | - Sandeep Pai
- Endodontics, University of Birmingham, Birmingham, GBR
| | | | - Joanna M Batt
- Restorative Dentistry, University of Birmingham, Birmingham, GBR
| |
Collapse
|
5
|
Tang Q, Jin H, Lin S, Ma L, Tian T, Qin X. Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy of necrotic immature permanent teeth? A systematic review and meta-analysis. BMC Oral Health 2022; 22:589. [PMID: 36494711 PMCID: PMC9733063 DOI: 10.1186/s12903-022-02605-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The effectiveness of platelet concentrates in promoting root development of necrotic immature permanent teeth is unclear. The present study evaluated whether the platelet concentrate protocol was superior to the traditional blood clot protocol in regeneration therapy. METHODS We searched Electronic databases, such as PubMed, Cochrane Library, ClinicalTrials and EMBASE. Randomized controlled trial studies, cohort studies, case-control studies and cross-sectional studies were included, in which platelet-rich concentrates were tested for periapical healing and root development, with the blood clot treatment protocol as the control group. Clinical and radiographic outcomes were considered. Selected articles were assessed for risk of bias. Pooled risk ratios (risk ratio, RR) were calculated for clinical success, responses to cold and electric pulp tests, periapical lesions, apex closure, root lengthening, and thickening of the dentin walls. Subgroup meta-analysis were conducted according to the type of platelet concentrate used. RESULTS Of the 1272 screened studies, 13 randomized controlled studies, 2 case-control studies and 1 cohort study were selected, in which 465 immature necrotic permanent teeth, particularly incisors and premolars, were treated. Of these 465 teeth, 457 (98.2%) in both the control and experimental groups remained clinically asymptomatic for the entire study duration, whereas eight (1.8%) showed signs and symptoms of failure, including spontaneous pain, sensitivity to percussion or reinfection. Compared with control teeth, teeth treated with PRP achieved better apical healing than BC group (RR 1.13, 95% CI 1.01-1.26, P = 0.03), and teeth treated with platelet concentrates showed improved apical closure (RR 1.04, 95% CI 0.86-1.25, P = 0.69), root lengthening (RR 1.01, 95% CI 0.74-1.39, P = 0.93), and thickening of the dentin walls (RR 1.35, 95% CI 0.95-1.93, P = 0.09), although these differences were not statistically significant. CONCLUSIONS Platelet concentrates can be used as successful scaffolds for regenerative endodontic treatment of necrotic immature permanent teeth, and PRP as a scaffold may achieve better periapical healing of teeth with periapical inflammation, although they did not differ significantly from conventional blood clot scaffolds in development of the root.
Collapse
Affiliation(s)
- Qianwei Tang
- grid.256607.00000 0004 1798 2653College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guagnxi China
| | - Hua Jin
- grid.19373.3f0000 0001 0193 3564Department of Stomatology, Harbin Institute of Technology Hospital, Harbin, HeiLongjiang China
| | - Song Lin
- Department of Pediatric Dentistry, Jinan Stomatology Hospital, Jinan, 250001 Shandong Province China
| | - Long Ma
- Department of Pediatric Dentistry, Jinan Stomatology Hospital, Jinan, 250001 Shandong Province China
| | - Tingyu Tian
- Department of Pediatric Dentistry, Jinan Stomatology Hospital, Jinan, 250001 Shandong Province China
| | - Xiurong Qin
- Department of Pediatric Dentistry, Jinan Stomatology Hospital, Jinan, 250001 Shandong Province China
| |
Collapse
|
6
|
Lu J, Kahler B. Regenerative endodontic procedures for two traumatized mature anterior teeth with transverse root fractures. BMC Oral Health 2022; 22:124. [PMID: 35413867 PMCID: PMC9004023 DOI: 10.1186/s12903-022-02152-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
Background Regenerative endodontic procedures (REPs) are an alternative treatment in immature traumatized teeth with necrotic pulp/apical periodontitis. However, this procedure has been infrequently reported in multiple transverse root fractures of mature teeth. This case report describes management of a patient with multiple horizontal root fractures in 2 maxillary central incisors that were successfully treated with REPs. Case presentation A 17-year-old girl had a history of traumatic injury to mature teeth 11 and tooth 21 resulting in multiple transverse root fractures. Clinical examination showed that both teeth responded to electric and thermal pulp sensibility tests with prolonged severe pain and were tender to percussion and palpation. Periapical radiographic examination showed both teeth were fully developed and had multiple transverse fractures in the mid-root. The pulp diagnosis was consistent with symptomatic irreversible pulpitis. REPs were initiated with only the coronal fragments treated to preserve pulp vitality in the apical fragment for potential pulp tissue regeneration. After REPs, clinical signs/symptoms subsided, and the two teeth were followed for 48 months when cone beam computed tomography (CBCT) imaging was also undertaken. At the last review, the case demonstrated root fractures healing with calcified tissue and pulp calcification in the apical fragments. Both teeth were stable and in function. Conclusions REPs have the potential to be used to treat traumatized and symptomatic mature permanent teeth that have sustained transverse root fractures.
Collapse
Affiliation(s)
- Jing Lu
- Fujian Key Laboratory of Oral Disease, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, People's Republic of China
| | - Bill Kahler
- School of Dentistry, University of Queensland, 288 Herston Road, Herston, Brisbane, 4006, Australia.
| |
Collapse
|
7
|
ÇİMEN C, ŞEN S, ŞENAY E, BEZGİN T. PRF USED AS A SCAFFOLD IN PULP REGENERATION: CASE SERIES. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.833807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|