Local Drug Delivery Systems for Vital Pulp Therapy: A New Hope.

Ardavan Parhizkar,Saeed Asgary,Carlo Galli

doi:10.1155/2021/5584268

Ardavan Parhizkar, Saeed Asgary + Show 1 more

Open Access

https://doi.org/10.1155/2021/5584268

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Abstract

Vital pulp therapy (VPT) is deliberated as an ultraconservative/minimally invasive approach for the conservation of vital pulpal tissues, preservation of dental structure, and maintenance of tooth function in the oral cavity. In VPT, following the exposure of the dental pulp, the environment is prepared for the possible healing and probable refunctionalisation of pulpal connective tissue. However, to succeed in VPT, specific biomaterials are used to cover and/or dress the exposed pulp, lower the inflammation, heal the dental pulp, provoke the remaining odontoblastic cells, and induce the formation of a hard tissue, i.e., the dentinal bridge. It can be assumed that if the employed biomaterial is transferred to the target site using a specially designed micro-/nanosized local drug delivery system (LDDS), the biomaterial would be placed in closer proximity to the connective tissue, may be released in a controlled and sustained pattern, could properly conserve the remaining dental pulp and might appropriately enhance hard-tissue formation. Furthermore, the loaded LDDS could help VPT modalities to be more ultraconservative and may minimise the manipulation of the tooth structure as well as pulpal tissue, which could, in turn, result in better VPT outcomes.

Highlights

Nowadays, vital pulp therapy (VPT) modalities are regarded as increasingly common ministrations and/or minimally invasive procedures [1] implemented to conserve/preserve the vitality of the dental pulp and maintain its function when the vital connective pulpal tissue has been compromised but not fully impaired by various stimuli [2, 3]
VPT is initiated with an access of the healthy layers of dental pulpal tissue following the removal of the inflamed pulp in different scales, from 1 mm in miniature pulpotomy to the entire tissue of the coronal chamber in full pulpotomy and haemorrhage control of the remaining vital pulp
VPT owes its success to the dental pulp, which is deliberated as a capable connective tissue with high potential for healing and regeneration [10, 11]

Summary

Introduction

Vital pulp therapy (VPT) modalities are regarded as increasingly common ministrations and/or minimally invasive procedures [1] implemented to conserve/preserve the vitality of the dental pulp and maintain its function when the vital connective pulpal tissue has been compromised but not fully impaired by various stimuli [2, 3]. Specific endodontic biomaterials have been introduced for use in VPT to (i) dress and protect the pulpal tissue from its surroundings, (ii) assist the dental pulp in the preparation of a proper matrix for hard-tissue formation, and (iii) help the dental pulp regain its normal condition [13], which sequentially could result in less complicated or aggressive treatment procedures

Local Drug Delivery Systems

Biomaterials