Abstract
Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is a highly dynamic tissue equipped with a network of resident immunocompetent cells that play major roles in the defense against pathogens and during tissue injury. However, the efficiency of these mechanisms during dental pulp inflammation (pulpitis) varies due to anatomical and physiological restrictions. Uncontrolled, excessive, or unresolved inflammation can lead to pulp tissue necrosis and subsequent bone infections called apical periodontitis. In most cases, pulpitis treatment consists of total pulp removal. Although this strategy has a good success rate, this treatment has some drawbacks (lack of defense mechanisms, loss of healing capacities, incomplete formation of the root in young patients). In a sizeable number of clinical situations, the decision to perform pulp extirpation and endodontic treatment is justifiable by the lack of therapeutic tools that could otherwise limit the immune/inflammatory process. In the past few decades, many studies have demonstrated that the resolution of acute inflammation is necessary to avoid the development of chronic inflammation and to promote repair or regeneration. This active process is orchestrated by Specialized Pro-resolving lipid Mediators (SPMs), including lipoxins, resolvins, protectins and maresins. Interestingly, SPMs do not have direct anti-inflammatory effects by inhibiting or directly blocking this process but can actively reduce neutrophil infiltration into inflamed tissues, enhance efferocytosis and bacterial phagocytosis by monocytes and macrophages and simultaneously inhibit inflammatory cytokine production. Experimental clinical application of SPMs has shown promising result in a wide range of inflammatory diseases, such as renal fibrosis, cerebral ischemia, marginal periodontitis, and cancer; the potential of SPMs in endodontic therapy has recently been explored. In this review, our objective was to analyze the involvement and potential use of SPMs in endodontic therapies with an emphasis on SPM delivery systems to effectively administer SPMs into the dental pulp space.
Highlights
BackgroundThe word endodontics comes from the old Greek “endo” meaning “inside” and “odont” for “tooth.” Endodontics is the branch of dentistry concerned with the morphology,
Positive and negative aspects of pulp inflammation Bacteria are the main and initial cause of inflammation and pulp infection
This review aims to provide fundamental information on the involvement of Specialized Pro-resolving lipid Mediators (SPMs) in endodontics
Summary
The word endodontics comes from the old Greek “endo” meaning “inside” and “odont” for “tooth.” Endodontics is the branch of dentistry concerned with the morphology,. The benefits of VPT include the maintenance of defense mechanisms, pain perception as a warning system, healing and tissue regeneration, completion of root formation in young patients to strengthen thin dentin walls and prevention of longterm complications. Despite these advantages, VPT has not become standard practice among dentists or gained general acceptance in the dental community. The decision to perform endodontic treatment is justified only by the absence of other available therapeutic tools to limit the immune/inflammatory process that impairs the healing and regenerative potential of the remaining and surrounding healthy tissues. This review aims to provide fundamental information on the involvement of SPMs in endodontics
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