Abstract
Apical periodontitis is an inflammatory disorder of periradicular tissues developed from endodontic infections. Understanding its pathophysiology and the underlying molecular mechanisms is key to the advancement of endodontics. MicroRNAs (miRNAs), a group of evolutionarily conserved small non-coding RNAs, may be phenotypically and functionally associated with the pathogenesis of apical periodontitis. Several studies have focused on the role of miRNAs in the pulp and periradicular biology, and they have demonstrated their essential functions, such as initiating odontogenic differentiation and promoting pro- or anti-inflammatory responses in pulpitis. Up to date, over 2,000 miRNAs have been discovered in humans; however, only few have been reported to associate with apical periodontitis. Therefore, identifying miRNAs involved in diseased apical tissues and conducting functional studies are important in expanding our current knowledge of pulp and periradicular biology and exploring novel therapeutic avenues. In this review, we revisit current models of apical periodontitis and miRNA biogenesis, analyze existing evidence of the involvement of miRNAs in diseased apical tissues, and discuss their diverse functions and potential values. Based on their sheer abundance, prolonged stability in biofluid, and relative ease of sampling, miRNAs may be a useful tool to be developed as diagnostic biomarkers for apical periodontitis. Furthermore, it can be used as therapeutic targets in conjunction with conventional endodontic therapies.
Highlights
Microbes in the oral environment are the primary cause of infection in the root canal system as well as dental pulp and periapical tissues.1 Apical periodontitis – as one of the consequences of endodontic infections – is a chronic inflammatory disorder of periradicular tissues.2 It involves the dynamic interaction between host immune response and microbial factors at the interface between infected radicular pulp and periodontal ligament, and it is usually manifested by localized inflammation, hard tissue resorption, and destruction of other periapical tissues.3Root canal therapy aims to reduce microbial infection and restore an aseptic environment to minimize apical lesions and promote bone healing
As many known miRNAs being characterized and novel miRNAs being unveiled in apical periodontitis, it is promising that more therapeutic targets within this family of small non-coding RNAs will be identified, and apical periodontitis will be tackled from multiple biological pathways such as suppression of inflammation, promotion of wound healing, and differentiation of stem cells
Understanding the biology of pulpal and periradicular tissues is key to the advancement of endodontics
Summary
Microbes in the oral environment are the primary cause of infection in the root canal system as well as dental pulp and periapical tissues. Apical periodontitis – as one of the consequences of endodontic infections – is a chronic inflammatory disorder of periradicular tissues. It involves the dynamic interaction between host immune response and microbial factors at the interface between infected radicular pulp and periodontal ligament, and it is usually manifested by localized inflammation, hard tissue resorption, and destruction of other periapical tissues.. Apical periodontitis – as one of the consequences of endodontic infections – is a chronic inflammatory disorder of periradicular tissues.. Recent research advances have provided numerous molecular targets and novel endodontic techniques that may ease the development of biomarkers in early diagnosis and the translation of novel therapeutic tools to promote apical tissue regeneration. Among these targets, microRNAs – as a class of novel molecules – have recently emerged as essential regulators of these processes, and their therapeutic values have just begun to be appreciated
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