Tenascin and Fibronectin Expression after Pulp Capping with Different Hemostatic Agents: A Preliminary Study

This study investigated the expression of extracellular matrix glycoproteins tenascin (TN) and fibronectin (FN) in pulp repair after capping with calcium hydroxide (CH), following different hemostasis protocols. Class I cavities with a pulp exposure were prepared in 42 human third molars scheduled for extraction. Different hemostatic agents (0.9% saline solution, 5.25% sodium hypochlorite and 2% chlorhexidine digluconate) were used and pulps were capped with CH cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed, and prepared for immunohistochemical technique. Hemostatic agents did not influence the expression of TN and FN. Both glycoproteins were found in the entire the pulp tissue and around collagen fibers, but were absent in the mineralized tissues. In the predentin, TN showed positive immunostaining and FN had a variable expression. Within 7 days post-treatment, a slightly more pronounced immunostaining on the pulp exposure site was observed. Within 30 days, TN and FN demonstrated a positive expression around the dentin barrier and at 90 days, a thin and linear expression of TN and FN was delimitating the reparative dentin. In conclusion, hemostatic agents did not influence TN and FN expression. Immunostaining for TN and FN was seen in different regions and periods, demonstrating their role in pulp repair.

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Biosealer versus Biodentine for direct pulp capping in dog’s teeth: A histopathological evaluation

10.21203/rs.2.12852/v1 ◽

2019 ◽

Author(s):

Inas M. Al-Sherbiny ◽

Mona H. Farid ◽

Ashraf M. Abu-Seida ◽

Inas Motawea ◽

Hagar A. Bastawy

Keyword(s):

Blood Vessels ◽

Tissue Response ◽

Control Group ◽

Image Analyzer ◽

Pulp Tissue ◽

Bridge Formation ◽

Pulp Capping ◽

Exposure Site ◽

Reparative Dentin ◽

Pulp Exposure

Abstract BackgroundThis study compared the effect of Biodentine (BD) and Tech Biosealer Capping (BS) on the pulpal tissue response after pulp capping in dogs, teeth.MethodsThree mongrel dogs were enrolled in this study. Class V cavities with pulp exposure were performed on the buccal surface of 30 teeth (2 experimental groups) and left without pulp exposure in 15 teeth (control group). The cavities of experimental groups were capped with either Biodentine (BD Group, N= 15 teeth) or Tech-Biosealer Capping (BS Group, N= 15 teeth). All cavities (experimental and control groups) were restored with resin-modified glass ionomer. Dentine bridge formation, architechecture of the odontoblastic layers and signs of inflammation were assessed after 1, 2 and 3 months using the computer image analyzer (Leica Qwin 500).ResultsBD group showed a thick newly formed reparative dentin bridge completely closing the exposure site with cell inclusions and mineralization, variable amount of odontoblast-like cells, preserved pulp tissue, marked numerous collagen fibers and blood vessels. While BS group showed an incomplete newly formed reparative dentin bridge with tunnel defect, vacuolated odontoblasts, complete pulp degeneration with multiple edematous spaces, hyperemic blood vessels, extravasated RBCs, multiple calcified structures scattered just beneath the dentin bridge and through the pulp tissue, and newly ill-defined odontoblasts.ConclusionFor pulp capping, Biodentine has better dentine bridge formation and pulp preservation than Tech Biosealer Capping.

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Induction of reparative dentin by calcium silicate-based material as direct pulp capping agent

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v12i4.43857 ◽

2019 ◽

Vol 12 (4) ◽

pp. 182-186

Author(s):

Mozammal Hossain ◽

Mahmood Sajedeen ◽

Yukio Nakamura

Keyword(s):

Calcium Hydroxide ◽

Calcium Silicate ◽

Normal Function ◽

Direct Pulp Capping ◽

Pulp Tissue ◽

Pulp Capping ◽

Exposure Site ◽

Reparative Dentin ◽

Dentin Formation ◽

Reparative Dentin Formation

This study was performed to examine whether calcium silicate could induce reparative dentin formation without eliciting any adverse effect in direct pulp capping of premolar teeth. Twenty participants who need extraction of their 4 healthy permanent premolar teeth for orthodontic reasons were included in this study. Following the surgical procedure, the exposed pulp tissue was treated either with calcium silicate or covered with calcium hydroxide paste. On day 3, 7, 14 and 28, the experimental teeth was extracted and examined using light microscopy and histometric analysis to observe the inflammatory changes and the amount of reparative dentin formation. The results showed that in the calcium silicate treated teeth, substantial amounts of dentine-like tissue was formed on day 14 and mostly located on the exposure site. It was also observed in the calcium hydroxide treated teeth but dentin-like tissue located at a distance from the exposure site. The total amount of reparative dentine formed in the calcium silicate-treated teeth was significantly higher (p<0.005) than in the calcium hydroxide-treated specimens. In conclusion that the calcium silicate indices pulpal wound healing and reparative formation in the exposed teeth without affecting the normal function of the remaining pulp.

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Wnt-Responsive Odontoblasts Secrete New Dentin after Superficial Tooth Injury

Journal of Dental Research ◽

10.1177/0022034518763151 ◽

2018 ◽

Vol 97 (9) ◽

pp. 1047-1054 ◽

Cited By ~ 7

Author(s):

Y. Zhao ◽

X. Yuan ◽

B. Liu ◽

U.S. Tulu ◽

J.A. Helms

Keyword(s):

Wnt Signaling ◽

Proof Of Concept ◽

Pulp Tissue ◽

Dentinal Tubules ◽

Acute Trauma ◽

Injury Model ◽

Pulp Exposure ◽

Pulp Cells ◽

Dentin Formation ◽

Pulp Repair

The objective of our experiments was to identify new therapeutic strategies to stimulate dentin formation in an adult tooth. To address this objective, we evaluated dentin production in 2 acute trauma models: one involving a pulp exposure and the other involving a superficial dentin injury. Molecular, cellular, and histologic analyses revealed that in response to a severe injury, where the pulp is exposed to the oral cavity, cell death is rampant and the repair response initiates from surviving pulp cells and, to a lesser extent, surviving odontoblasts. When an injury is superficial, as in the case of a dentin injury model, then disturbances are largely confined to pulp tissue immediately underneath the damaged dentin tubules. We found that the pulp remained vital and innervated; primary odontoblasts upregulated HIF1α; and the rate of mineralization was significantly increased. A tamoxifen-inducible Axin2CreERT2/+; R26R mTmG/+ reporter strain was then used to demonstrate that a population of long-lived Wnt-responsive odontoblasts, which secreted dentin throughout the life of the animal, were responsible for depositing new dentin in response to a superficial injury. Amplifying Wnt signaling in the pulp stimulates dentin secretion, and in the dentin injury model, we show that a liposomal formulation of human WNT3A protein passes through dentinal tubules and is capable of upregulating Wnt signaling in the pulp. These data provide strong proof of concept for a therapeutic pulp-capping material to stimulate Wnt signaling in odontoblasts and thus improve the pulp repair response.

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Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation

Pharmaceutics ◽

10.3390/pharmaceutics12070644 ◽

2020 ◽

Vol 12 (7) ◽

pp. 644

Author(s):

Tien Thuy Vu ◽

Minh Truong Nguyen ◽

Polkit Sangvanich ◽

Quang Ngoc Nguyen ◽

Pasutha Thunyakitpisal

Keyword(s):

Root Formation ◽

Treatment Success ◽

Permanent Teeth ◽

Pulp Tissue ◽

Pulp Therapy ◽

Exposure Site ◽

Vital Pulp Therapy ◽

Significant Difference ◽

Pulp Exposure

Direct pulp-capping, a vital pulp therapy, is used to protect and preserve pulp vitality by applying a biomaterial on the pulp exposure site. Acemannan, a polysaccharide extracted from Aloe vera, induces osteodentin-bridge formation to cover the exposure site in vivo. We evaluated the effect of acemannan sponges on partial pulpotomized permanent teeth with caries or accident-induced pulp exposure (n = 50). After removing infected dentin and inflamed pulp tissue, the teeth were randomly divided into acemannan or control (mineral trioxide aggregate (MTA) groups (n = 25). The teeth were examined immediately after treatment (baseline) and at 6- and 12-month follow-ups for clinical and cone beam computed tomography (CBCT) examination. The three-dimensional tooth length and root apex area were simulated to determine treatment success. We found that the overall success rate in the acemannan and MTA groups from baseline to 12-month follow-up was 90.91% and 95.65%, respectively, with no significant difference between the two groups (p > 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p < 0.05), indicating continued root formation. Our results suggest that acemannan is a promising low-cost biomaterial for partial pulpotomy treatment for immature permanent teeth requiring vital pulp therapy.

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Resolvin E1 accelerates pulp repair by regulating inflammation and stimulating dentin regeneration in dental pulp stem cells

Stem Cell Research & Therapy ◽

10.1186/s13287-021-02141-y ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Jie Chen ◽

Huaxing Xu ◽

Kun Xia ◽

Shuhua Cheng ◽

Qi Zhang

Keyword(s):

Dental Pulp ◽

Tissue Repair ◽

Pulp Tissue ◽

Tissue Repair And Regeneration ◽

Injury Model ◽

Tnf Α ◽

Pulp Inflammation ◽

Inflammation Resolution ◽

Pulp Repair ◽

Dentin Regeneration

Abstract Background Unresolved inflammation and tissue destruction are considered to underlie the failure of dental pulp repair. As key mediators of the injury response, dental pulp stem cells (DPSCs) play a critical role in pulp tissue repair and regeneration. Resolvin E1 (RvE1), a major dietary omega-3 polyunsaturated fatty-acid metabolite, is effective in resolving inflammation and activating wound healing. However, whether RvE1 facilitates injured pulp-tissue repair and regeneration through timely resolution of inflammation and rapid mobilization of DPSCs is unknown. Therefore, we established a pulp injury model and investigated the effects of RvE1 on DPSC-mediated inflammation resolution and injured pulp repair. Methods A pulp injury model was established using 8-week-old Sprague-Dawley rats. Animals were sacrificed on days 1, 3, 7, 14, 21, and 28 after pulp capping with a collagen sponge immersed in PBS with RvE1 or PBS. Hematoxylin-eosin and Masson’s trichrome staining, immunohistochemistry, and immunohistofluorescence were used to evaluate the prohealing properties of RvE1. hDPSCs were incubated with lipopolysaccharide (LPS) to induce an inflammatory response, and the expression of inflammatory factors after RvE1 application was measured. Effects of RvE1 on hDPSC proliferation, chemotaxis, and odontogenic differentiation were evaluated by CCK-8 assay, transwell assay, alkaline phosphatase (ALP) staining, alizarin red staining, and quantitative PCR, and possible signaling pathways were explored using western blotting. Results In vivo, RvE1 reduced the necrosis rate of damaged pulp and preserved more vital pulps, and promoted injured pulp repair and reparative dentin formation. Further, it enhanced dentin matrix protein 1 and dentin sialoprotein expression and accelerated pulp inflammation resolution by suppressing TNF-α and IL-1β expression. RvE1 enhanced the recruitment of CD146+ and CD105+ DPSCs to the damaged molar pulp mesenchyme. Isolated primary cells exhibited the mesenchymal stem cell immunophenotype and differentiation. RvE1 promoted hDPSC proliferation and chemotaxis. RvE1 significantly attenuated pro-inflammatory cytokine (TNF-α, IL-1β, and IL-6) release and enhanced ALP activity, nodule mineralization, and especially, expression of the odontogenesis-related genes DMP1, DSPP, and BSP in LPS-stimulated DPSCs. RvE1 regulated AKT, ERK, and rS6 phosphorylation in LPS-stimulated DPSCs. Conclusions RvE1 promotes pulp inflammation resolution and dentin regeneration and positively influences the proliferation, chemotaxis, and differentiation of LPS-stimulated hDPSCs. This response is, at least partially, dependent on AKT, ERK, and rS6-associated signaling in the inflammatory microenvironment. RvE1 has promising application potential in regenerative endodontics.

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Epithelioid Trophoblastic Tumor: Review of a Rare Neoplasm of the Chorionic-Type Intermediate Trophoblast

Archives of Pathology & Laboratory Medicine ◽

10.5858/2006-130-1875-ettroa ◽

2006 ◽

Vol 130 (12) ◽

pp. 1875-1877

Author(s):

Kimberly H. Allison ◽

Jason E. Love ◽

Rochelle L. Garcia

Keyword(s):

Gestational Trophoblastic Disease ◽

Reproductive Age ◽

Placental Lactogen ◽

Variable Expression ◽

Trophoblastic Tumor ◽

Trophoblastic Cells ◽

Epithelioid Trophoblastic Tumor ◽

Positive Immunostaining ◽

Nodular Growth ◽

Type Intermediate

Abstract We present a brief review of epithelioid trophoblastic tumor, a rare trophoblastic neoplasm derived from chorionic-type intermediate trophoblastic cells that typically presents in reproductive-age women between 1 and 18 years following a previous gestation. Histologic features include a nodular growth pattern of monomorphic, epithelioid cells within a hyaline matrix. Areas of necrosis and mitotic activity (0–9 mitoses per 10 high-power fields) are additional features of this neoplasm. Positive immunostaining for p63 and cytokeratin, frequent location in the lower uterine segment and endocervix, as well as the epithelioid appearance can lead to confusion with squamous cell carcinoma. Inhibin-α is typically expressed, as well as focal, more variable expression of other trophoblastic markers including β-human chorionic gonadotropin, human placental lactogen, placental alkaline phosphate, and Mel-CAM (CD148). The clinical behavior of this rare form of gestational trophoblastic disease is difficult to predict. Although most cases follow a benign course following resection, there is a potential for metastatic disease.

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Translation Approach for Dentine Regeneration Using GSK-3 Antagonists

Journal of Dental Research ◽

10.1177/0022034520908593 ◽

2020 ◽

Vol 99 (5) ◽

pp. 544-551 ◽

Cited By ~ 4

Author(s):

L.K. Zaugg ◽

A. Banu ◽

A.R. Walther ◽

D. Chandrasekaran ◽

R.C. Babb ◽

...

Keyword(s):

Alveolar Bone ◽

Pulp Tissue ◽

Drug Induced ◽

Simple Method ◽

Pulp Exposure ◽

Pulp Cells ◽

Noncompetitive Inhibitor ◽

Canonical Wnt ◽

Direct Capping ◽

Rat Molars

The canonical Wnt/β-catenin signaling pathway is crucial for reparative dentinogenesis following tooth damage, and the modulation of this pathway affects the rate and extent of reparative dentine formation in damaged mice molars by triggering the natural process of dentinogenesis. Pharmacological stimulation of Wnt/β-catenin signaling activity by small-molecule GSK-3 inhibitor drugs following pulp exposure in mouse molars results in reparative dentinogenesis. The creation of similar but larger lesions in rat molars shows that the adenosine triphosphate (ATP)–competitive GSK-3 inhibitor, CHIR99021 (CHIR), and the ATP noncompetitive inhibitor, Tideglusib (TG), can equally enhance reparative dentine formation to fully repair an area of dentine damage up to 10 times larger, mimicking the size of small lesions in humans. To assess the chemical composition of this newly formed dentine and to compare its structure with surrounding native dentine and alveolar bone, Raman microspectroscopy analysis is used. We show that the newly formed dentine comprises equal carbonate to phosphate ratios and mineral to matrix ratios to that of native dentine, both being significantly different from bone. For an effective dentine repair, the activity of the drugs needs to be restricted to the region of damage. To investigate the range of drug-induced Wnt-activity within the dental pulp, RNA of short-term induced (24-h) molars is extracted from separated roots and crowns, and quantitative Axin2 expression is assayed. We show that the activation of Wnt/β-catenin signaling is highly restricted to pulp cells in the immediate location of the damage in the coronal pulp tissue with no drug action detected in the root pulp. These results provide further evidence that this simple method of enhancement of natural reparative dentinogenesis has the potential to be translated into a clinical direct capping approach.

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The Regenerative Potential of bFGF in Dental Pulp Repair and Regeneration

Frontiers in Pharmacology ◽

10.3389/fphar.2021.680209 ◽

2021 ◽

Vol 12 ◽

Author(s):

Keyue Liu ◽

Sijing Yu ◽

Ling Ye ◽

Bo Gao

Keyword(s):

Growth Factors ◽

Dental Pulp ◽

Spinal Cord Injuries ◽

Healing Process ◽

Fibroblast Growth Factors ◽

Wound Healing Process ◽

Fibroblast Growth ◽

Pulp Tissue ◽

Tissue Repair And Regeneration ◽

Pulp Repair

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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Fracture of upper incisors: a three-year follow-up of a multidisciplinary approach

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372021000920190008 ◽

2021 ◽

Vol 69 ◽

Author(s):

Ricardo Armini CALDAS ◽

Henrique Heringuer VIEIRA ◽

Lucas Alves MOURA ◽

Atais BACCHI ◽

Valentim Adelino Ricardo BARÃO ◽

...

Keyword(s):

Multidisciplinary Approach ◽

Buccal Cavity ◽

Term Treatment ◽

Restorative Dentistry ◽

Pulp Tissue ◽

Long Term Treatment ◽

Pulp Exposure ◽

Tissue Alteration

ABSTRACT Multiple clinical specialties are usually needed for a successful long-term treatment in buccal cavity. The aim of this article is to report a clinical case of multi-disciplinary rehabilitation of fracture upper incisors without pulp exposure, concerning about endodontics, periodontics and restorative dentistry comments or procedures. A case of a patient reporting trauma that resulted in fracture and substantial loss of hard tissue, in mesial angle of both upper central incisors (11 and 21). In palatal side, fracture extended beyond cingulum up to subgingival region. Periodontal surgery was performed in order to reestablish biological space. Clinical and radiographic assessments demonstrated no need for endodontic treatment, since pulp was vital and non-altered. Preparations for restorative procedures were minimally invasive, followed by composite direct. A three-year follow-up was performed, consisting in re-assessment of clinical and radiographic aspects, re-polishing of the restorations and photographic documentation. No pulp tissue alteration was observed after the follow-up period. Restorative procedures, adjacent tissues and pulp vitality were considered adequate, and the patient was satisfied with the treatment.

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Biodentine™ Partial Pulpotomy of a Young Permanent Molar with Signs and Symptoms Indicative of Irreversible Pulpitis and Periapical Lesion: A Case Report of a Five-Year Follow-Up

Case Reports in Dentistry ◽

10.1155/2019/8153250 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

W. Chinadet ◽

T. Sutharaphan ◽

P. Chompu-inwai

Keyword(s):

Signs And Symptoms ◽

Carious Lesion ◽

Periapical Lesion ◽

Pulp Tissue ◽

Permanent Molar ◽

Exposure Site ◽

Patient Reported ◽

Periapical Healing ◽

Irreversible Pulpitis

The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.

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