Abstract
Control of blood clotting in root canal systems is one of the most critical and difficult concerns for regenerative endodontics therapy (RET). The purpose of this study was to investigate the effects of using gelatin- and fibrin-based hemostatic hydrogels as a scaffold on pulp regeneration in a minipig model. Cell viability of human dental pulp stem cells cultured three-dimensionally in gelatin-based and fibrin-based scaffolds was evaluated by MTT and live/dead assay. RET was performed on 24 immature premolars with an autologous blood clot (PC), gelatin-based and fibrin-based hemostatic matrices (GM and FM), or without the insertion of a scaffold (NC). The follow-up period was 12 weeks. Radiographic and histologic assessments for pulp regeneration were performed. Gelatin-based scaffolds exhibited significantly higher cell viability than fibrin-based scaffolds after 15 days (P < 0.05). The PC and GM groups showed favorable root development without inflammation and newly mineralized tissue deposited in the root canal system, while FM group presented inflammatory changes with the continuation of root development. The NC group exhibited internal root resorption with periapical lesions. The application of GM in RET led to favorable clinical outcomes of root development without inflammatory changes compared to conventional RET. Our results suggest that GM may serve as a viable regenerative scaffold for pulp regeneration.
Highlights
Control of blood clotting in root canal systems is one of the most critical and difficult concerns for regenerative endodontics therapy (RET)
We investigated the possibility of using commercial hemostatic matrices—gelatinbased and fibrin-based—to immediately control bleeding in root canal systems when used as scaffolds in pulp regeneration procedures
Our results demonstrated improved in vitro cell viability in 3-dimensional cultures in the gelatin-based matrix scaffold (GM) compared to the fibrin-based matrix scaffold (FM) group
Summary
Control of blood clotting in root canal systems is one of the most critical and difficult concerns for regenerative endodontics therapy (RET). As forms of hemostatic matrices, may facilitate control of the time and location of blood clot formation in the root canal system and using the functions of tissue engineering scaffold recognized in the literature, and the pulp regeneration procedure can be more effective and efficient with the matrices. To our knowledge, this conceptual approach has not been performed in any animal model and requires validation
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