Dental Pulpitis Research Articles

A carbon dot nanozyme hydrogel enhances pulp regeneration activity by regulating oxidative stress in dental pulpitis

Preserving pulp viability and promoting pulp regeneration in pulpitis have attracted widespread attention. Restricted by the oxidative stress microenvironment of dental pulpitis, excessive reactive oxygen and nitrogen species (RONS) trigger uncontrolled inflammation and exacerbate pulp tissue destruction. However, modulating redox homeostasis in inflamed pulp tissue to promote pulp regeneration remains a great challenge. Herein, this work proposes an effective antioxidative system (C-NZ/GelMA) consisting of carbon dot nanozymes (C-NZ) with gelatin methacryloyl (GelMA) to modulate the pulpitis microenvironment for dental pulp regeneration by utilizing the antioxidant properties of C-NZ and the mechanical support of an injectable GelMA hydrogel. This system effectively scavenges RONS to normalize intracellular redox homeostasis, relieving oxidative stress damage. Impressively, it can dramatically enhance the polarization of regenerative M2 macrophages. This study revealed that the C-NZ/GelMA hydrogel promoted pulp regeneration and dentin repair through its outstanding antioxidant, antiapoptotic, and anti-inflammatory effects, suggesting that the C-NZ/GelMA hydrogel is highly valuable for pulpitis treatment.

Nd: YAG laser irradiation in the treatment of live pulp preservation in pediatric cariogenic pulpitis.

Dental pulpitis significantly impacts oral function and quality of life. Treatments like direct pulp capping aim to preserve pulp vitality. This study aims to investigate the application value of Nd:YAG laser irradiation in preserving pulp vitality in children with caries-induced pulpitis. This study, conducted from June 2019 to June 2023, included 89 children undergoing pulp vitality preservation treatment for caries-induced pulpitis. The children were divided into two groups using sealed envelopes: 44 in the control group received pulp capping treatment, while the study group received Nd:YAG laser-assisted pulp capping treatment. The efficacy, oral indicators, oral function, changes in root apex diameter and root length, changes in gingival crevicular fluid inflammatory factors, and incidence of complications were compared between the two groups before and 3 months after treatment. The total effective rates were 97.78% in the study group and 95.45% in the control group, with no significant difference between the groups (p> 0.05). Before treatment, there were no differences in gingival index, plaque index, and probing bleeding index between the groups (p> 0.05). After treatment, both groups showed decreased periodontal indexes compared to before treatment, with the study group showing lower values than the control group (p< 0.05). Chewing and biting function scores were similar between the groups before and after treatment (p> 0.05), but both groups showed decreased scores after treatment (p< 0.05). The study group had a higher percentage decrease in root apex diameter and a greater increase in root length compared to the control group (p< 0.05). During treatment, one case of tooth discoloration occurred in the study group (2.27%), while the control group had two cases of tooth discoloration and one case of secondary caries, resulting in a complication rate of 6.67%. There was no significant difference in the incidence of complications between the groups (p> 0.05). Nd:YAG laser irradiation effectively preserves pulp vitality in children with caries-induced pulpitis, improving periodontal health, reducing root apex diameter, and increasing root length with high safety.

The purinergic receptor P2X3 promotes facial pain by activating neurons and cytokines in the trigeminal ganglion

The mechanism underlying allodynia/hyperalgesia caused by dental pulpitis has remained enigmatic. This investigation endeavored to characterize the influence of the purinergic receptor P2X3 on pain caused by experimental pulpitis and the mechanism involved. An experimental model of irreversible pulpitis was produced by the drilling and exposure of the dental pulp of the left upper first and second molars in rats, followed by measuring nociceptive responses in the oral and maxillofacial regions. Subsequently, neuronal activity and the expression of P2X3 and pertinent cytokines in the trigeminal ganglion (TG) were meticulously examined and analyzed. Histological evidence corroborated that significant pulpitis was produced in this model, which led to a distinct escalation in nociceptive responses in rats. The activation of neurons, coupled with the upregulated expression of c-fos, P2X3, p-p38, TNF-α and IL-1β, was identified subsequent to the pulpitis surgery within the TG. The selective inhibition of P2X3 with A-317491 effectively restrained the abnormal allodynia/hyperalgesia following the pulpitis surgery and concurrently inhibited the upregulation of p-p38, TNF-α and IL-1β within the TG. These findings suggest that the P2X3 signaling pathway plays a pivotal role in instigating and perpetuating pain subsequent to the induction of pulpitis in rats, implicating its association with the p38 MAPK signaling pathway and inflammatory factors.

Dental Pain Season in a Pediatric Dental Clinic Makkah, Saudi Arabia

Objective: Dental pain is the most common reason for dental visits among children in many regions in the world. The weather changes can change the health lifestyle by increasing drinking cold drinks which may cause dental hypersensitivity or misdiagnosed dental pulpitis due to the limited ability to describe the dental pain by the children. Most children cannot observe the decay in the early sage and they need indeed their parent to guide them in a healthy lifestyle. Subject and Methods: Data were collected retrospectively of 600 children from the dental records of new pediatric patients attending a clinic. The collected data included all months in 2022. The frequency of each invasive procedure in each month was calculated as well the gender and other demographic variables. Aim: To determine the highest frequency of dental pain attenders among children under 14 years old during the four seasons of 2022 and using these results to enhance our health services to design future plans. Result: The highest frequency of dental pain cases was in summer (84%) and the lowest was in Spring (16%). Conclusion: This study could be the first study aiming to investigate the dental pain patients flow regarding the four seasons. It has been done in Makkah in which the weather temperature can reach 50 degrees in the summer. Further studies with the same aim in a different weather condition are needed to compare our results and enhance our health services in the future. Conclusion: Dental pain season is in the summer in our paediatric dental clinic. The high frequency of dental pain cases during the summer could be a result of the health lifestyle related to the hot weather. Keywords: Dental pain season, paediatric dental clinic, Makkah

Guanylate-binding protein 5-mediated cell-autonomous immunity suppresses inflammation in dental pulpitis: Aninvitro study.

Guanylate-binding protein 5 (GBP5) is an interferon (IFN)-inducible GTPase that plays a crucial role in the cell-autonomous immune response against microbial infections. In this study, we investigated the immunoregulatory role of GBP5 in the pathogenesis of dental pulpitis. Gene-set enrichment analysis (GSEA) was utilized to evaluate the IFN-γ signalling pathway, and the differential expression of GBP mRNA in normal versus inflamed dental pulp tissues was screened, based on Gene Expression Omnibus (GEO) datasets associated with pulpitis. Both normal pulp tissues and inflamed pulp tissues were used for experiments. The expression of IFNs and GBPs was determined by qRT-PCR. Immunoblotting and double immunofluorescence were performed to examine the cellular localization of GBP5 in dental pulp tissues. For the functional studies, IFN-γ priming or lentivirus vector-delivered shRNA was used to, respectively, overexpress or knock down endogenous GBP5 expression in human dental pulp stem cells (HDPSCs). Subsequently, LPS was used to stimulate HDPSCs (overexpressing or with knocked-down GBP5) to establish an invitro model of inflammation. qRT-PCR and ELISA were employed to examine the expression of proinflammatory cytokines (IL-6, IL-8 and IL-1β) and cyclooxygenase 2 (COX2). Every experiment has three times of biological replicates and three technical replicates, respectively. Statistical analysis was performed using the Student's t-test and one-way ANOVA, and a p-value of <.05 was considered statistically significant. GSEA analysis based on the GEO dataset revealed a significant activation of the IFN-γ signalling pathway in the human pulpitis group. Among the human GBPs evaluated, GBP5 was selectively upregulated in inflamed dental pulp tissues and predominantly expressed in dental pulp cells. Invitro experiments demonstrated that IFN-γ robustly induced the expression of GBP5 in HDPSCs. Knockdown of GBP5 expression in HDPSCs significantly amplified the LPS-induced upregulation of inflammatory mediators (IL-6, IL-8, IL-1β and COX2) both with and without IFN-γ priming. Our findings demonstrated that GBP5 partook in the pathogenesis of dental pulpitis. The involvement of GBP5 in pulpitis appeared to coordinate the regulation of inflammatory cytokines. Knockdown of GBP5 contributed to the exacerbation of LPS-mediated inflammation.

Optical Characteristics of Halogen Lamp for Coronavirus, Tumors, Thrombus and Toothache Treatment

The effect of reducing the damaged organ cell number and size in different areas of the human body (in case of carcinomas, cerebral thrombosis, heart attacks, damaged chest and cervical vertebrae areas, in case of coronavirus and dental pulpitis) was studied using a halogen lamp. The tests were conducted on patients when curing different diseases using periodic implementation of halogen lamp (500 W) with duration from 0.5 to 1 hour, while controlling its light frequency and intensity. The tests were carried out on a group consisting of 170 patients. The results were successful when it came to curing: coronavirus – up to 80 % success rate; cancerous tumors, strokes, heart attacks, and damaged parts of the cervical vertebrae – up to 70 % success rate; and dental pulpits – up to 90 % success rate. By analyzing the practical results received, one can come to a conclusion that the effect of reducing the number and size of damaged organ cells by using a halogen lamp can be used to cure many diseases. The most important is to cure COVID-19.

A novel convolutional neural network–Fuzzy-based diagnosis in the classification of dental pulpitis

A novel convolutional neural network–Fuzzy-based diagnosis in the classification of dental pulpitis

Ligand-gated ion channel P2X7 regulates hypoxia-induced factor-1α mediated pain induced by dental pulpitis in the medullary dorsal horn.

Dental pulpitis often induces severe pain, and the molecular immune response is remarkable in both peripheral and central nervous system. Accumulating evidence indicates that activated microglia in the medullary dorsal horn (MDH) contribute to dental pulpitis induced pain. The P2X7 receptor plays an important role in driving pain and inflammatory processes, and its downstream target hypoxia-induced factor-1α (HIF-1α) has a crucial role in maintaining inflammation. However, the relationship between P2X7 and HIF-1α in dental inflammatory pain remains unclear. This study demonstrated that the degree of inflammation in the dental pulp tissue became more severe in a time-dependent manner by establishing a rat dental pulpitis model via pulp exposure. Meanwhile, the expression of P2X7, HIF-1α, IL-1β, and IL-18 in the MDH increased most on the seventh day when the pain threshold was the lowest in the dental pulpitis model. Furthermore, lipopolysaccharides (LPS) increased P2X7-mediated HIF-1α expression in microglia. Notably, the suppression of P2X7 caused less IL-1β and IL-18 release and lower HIF-1α expression, and P2X7 antagonist Brilliant Blue G (BBG) could alleviate pain behaviors of the dental pulpitis rats. In conclusion, our results provide further evidence that P2X7 is a key molecule, which regulates HIF-1α expression and inflammation in dental pulpitis-induced pain.

Application of a Remotely Controlled Artificial Intelligence Analgesic Pump Device in Painless Treatment of Children.

In order to effectively improve the application of analgesic pump devices in the treatment of children, a method based on remote control artificial intelligence is proposed. 100 children with dental pulpitis who were treated in a hospital from December 2018 to December 2020 were selected as the research subjects; they were randomly divided into control group and observation group by an equidistant sampling method, with 50 cases in each group. Children in the control group were given articaine and adrenaline anesthesia, and the observation group was treated with articaine and adrenaline combined with a computer-controlled anesthesia system, the anesthesia pain degree and satisfaction degree of the two groups of children were observed and compared. The results showed that the pain score in anesthesia and intraoperative pain score in the observation group was significantly lower than that in the control group, and the differences were statistically significant (P < 0.05). The total satisfaction of 96.6% patients in the observation group was significantly higher than that in the control group (84.7%) and the difference was statistically significant (P < 0.05). There were no serious complications in both groups. The application of the computer anesthesia system combined with articaine adrenaline in the painless treatment of children's dental pulp proved to have better effects, the treatment compliance is higher, and it is worthy of clinical promotion.

3D Visualization of Dynamic Cellular Reaction of Pulpal CD11c+ Dendritic Cells against Pulpitis in Whole Murine Tooth.

In dental pulp, diverse types of cells mediate the dental pulp immunity in a highly complex and dynamic manner. Yet, 3D spatiotemporal changes of various pulpal immune cells dynamically reacting against foreign pathogens during immune response have not been well characterized. It is partly due to the technical difficulty in detailed 3D comprehensive cellular-level observation of dental pulp in whole intact tooth beyond the conventional histological analysis using thin tooth slices. In this work, we validated the optical clearing technique based on modified Murray’s clear as a valuable tool for a comprehensive cellular-level analysis of dental pulp. Utilizing the optical clearing, we successfully achieved a 3D visualization of CD11c+ dendritic cells in the dentin-pulp complex of a whole intact murine tooth. Notably, a small population of unique CD11c+ dendritic cells extending long cytoplasmic processes into the dentinal tubule while located at the dentin-pulp interface like odontoblasts were clearly visualized. 3D visualization of whole murine tooth enabled a reliable observation of these rarely existing cells with a total number less than a couple of tens in one tooth. These CD11c+ dendritic cells with processes in the dentinal tubule were significantly increased in the dental pulpitis model induced by mechanical and chemical irritation. Additionally, the 3D visualization revealed a distinct spatial 3D arrangement of pulpal CD11c+ cells in the pulp into a front-line barrier-like formation in the pulp within 12 h after the irritation. Collectively, these observations demonstrated the unique capability of optical clearing-based comprehensive 3D cellular-level visualization of the whole tooth as an efficient method to analyze 3D spatiotemporal changes of various pulpal cells in normal and pathological conditions.

The Current and Potential Application of Medicinal Cannabis Products in Dentistry.

Oral and dental diseases are a major global burden, the most common non-communicable diseases (NCDs), and may even affect an individual’s general quality of life and health. The most prevalent dental and oral health conditions are tooth decay (otherwise referred to as dental caries/cavities), oral cancers, gingivitis, periodontitis, periodontal (gum) disease, Noma, oro-dental trauma, oral manifestations of HIV, sensitive teeth, cracked teeth, broken teeth, and congenital anomalies such as cleft lip and palate. Herbs have been utilized for hundreds of years in traditional Chinese, African and Indian medicine and even in some Western countries, for the treatment of oral and dental conditions including but not limited to dental caries, gingivitis and toothaches, dental pulpitis, halitosis (bad breath), mucositis, sore throat, oral wound infections, and periodontal abscesses. Herbs have also been used as plaque removers (chew sticks), antimicrobials, analgesics, anti-inflammatory agents, and antiseptics. Cannabis sativa L. in particular has been utilized in traditional Asian medicine for tooth-pain management, prevention of dental caries and reduction in gum inflammation. The distribution of cannabinoid (CB) receptors in the mouth suggest that the endocannabinoid system may be a target for the treatment of oral and dental diseases. Most recently, interest has been geared toward the use of Cannabidiol (CBD), one of several secondary metabolites produced by C. sativa L. CBD is a known anti-inflammatory, analgesic, anxiolytic, anti-microbial and anti-cancer agent, and as a result, may have therapeutic potential against conditions such burning mouth syndrome, dental anxiety, gingivitis, and possible oral cancer. Other major secondary metabolites of C. sativa L. such as terpenes and flavonoids also share anti-inflammatory, analgesic, anxiolytic and anti-microbial properties and may also have dental and oral applications. This review will investigate the potential of secondary metabolites of C. sativa L. in the treatment of dental and oral diseases.

Polarization of macrophages in the trigeminal ganglion of rats with pulpitis

Dental pulp tissues are rich in pain-related afferent nerve fibers, which originate from primary sensory neurons in the trigeminal ganglion (TG). The mechanisms of central nervous system (CNS) underlying ectopic pain following peripheral inflammation have been reported that the macrophages as inflammatory and immunologic mediators in the TG play an important role in the process of pulpitis and hyperalgesia. To observe the polarization response and dynamic distribution of macrophages in the TG during the development of dental pulp inflammation. A rat model of pulpitis was established using complete Freund's adjuvant (CFA). Hematoxylin-eosin (HE), immunohistochemistry (IHC), immunofluorescence (IF), toluidine blue (TB) staining, and RT-qPCR were performed to observe the expression of macrophage-related factors in the TG. The results of IHC staining showed that M2 macrophages labeled with CD206 were observed in the TG of both the control and CFA groups. The statistical analysis indicated that the number of CD206-positive macrophages in the TG increased significantly at 24h after CFA-induced pulpitis, reached a peak at 2weeks, and then returned to the normal level after 6weeks. The ratio of M2/M1 in the CFA groups was significantly lower than that in the control group from 24 to 72h, and this pattern was reversed at 2weeks after CFA-induced pulpitis; then, the ratio increased significantly and was maintained at a high level for 4weeks. RT-qPCR results showed that the expression of IL-10 in the TG increased significantly from 1 to 4weeks after CFA-induced pulpitis. The trend of M2 macrophages was opposite to that of M1 macrophages in the TG during the process of pulpitis induced by CFA, which is consistent with the expression of macrophage-related cytokines. Macrophage polarization in the TG may participate in the neuroinflammation response induced by dental pulpitis.

EZH2 Promotes Extracellular Matrix Degradation via Nuclear Factor-κB (NF-κB) and p38 Signaling Pathways in Pulpitis.

Pulpitis is a complicated chronic inflammatory process which can be in a dynamic balance between damage and repair. The extracellular matrix plays an important regulatory role in wound healing and tissue repair. The aim of this study was to explore the role of the epigenetic mark, enhancer of zeste homolog 2 (EZH2) on the degradation of extracellular matrix during pulpitis. Quantitative polymerase chain reaction was used to assess the expression of matrix metalloproteinases (MMPs) and type I collagen in human dental pulp cells (HDPCs) upon EZH2 and EI1 (EZH2 inhibitor) stimulation. The mechanism of EZH2 affecting extracellular matrix was explored through quantitative polymerase chain reaction and Western blot. A rat model of dental pulp inflammation was established, and the expression of type I collagen in dental pulp under EZH2 stimulation was detected by immunohistochemical staining. EZH2 upregulated the expression of MMP-1, MMP-3, MMP-8, and MMP-10 and decreased the production of type I collagen in HDPCs, while EI1 had the opposite effect. EZH2 activated the nuclear factor-kappa B (NF-κB) and p38 signaling pathways in HDPCs, the inhibition of which reversed the induction of MMPs and the suppression of type I collagen. EZH2 can downregulate the type I collagen levels in an experimental model of dental pulpitis in rats. EZH2 promotes extracellular matrix degradation via nuclear factor-κB (NF-κB) and P38 signaling pathways in pulpitis. EZH2 can decrease the type I collagen levels in vivo and in vitro.

Efficacy of the osteocentric method of intraseptal anesthesia in mandibular molars treatment with dental caries and irreversible pulpitis

In the literature, various methods for the mandibular molars anesthesia are known, including periodontal pains as an adjunct to nerve block. However, these methods do not provide for amendments in the case of partial destruction of the vertices of the cortical substance of the bone tissue of the mandible. Aim: to perform a clinical and functional research of the possibility of using the osteocentric method of intraseptal anesthesia in mandibular molars treatment with dental caries and irreversible pulpitis. Materials and methods. In total, 324 patients aged 32—65 years (mean age 48.5 years). In all cases was used 4% solution of articaine with epinephrine 1: 200,000 (Septanest, 40 mg + 5 μg of epinephrine per 1 ml, Septodont) and short 30G Septaject Evolution dental needles (0.30×9 mm) with a scalpel-like cut. To assess the effectiveness of the anesthesia was performed pulp electrical stimulation before the study, after 2, 5 and 10 minutes after injection with the IVN-01 “Pulptest-Pro” electronic pulp test device (“Cascade-FTO”, Russia). Results. The treatment of the tooth decay (213 cases) was started at 3 minutes after the injection. Of 127 teeth treated with endodontic methods, for 104 (81.9%) teeth the duration of anesthesia was sufficient for amputation and extirpation of the pulp. With the removal of 23 (18.1%) teeth for acute pulpitis, the final stage of pulp extirpation was painful. Conclusion. This method of anesthesia can be especially recommended for people with somatic pathology because of a minimal amount of local anesthetic (0.36 ml for a two-canal tooth) with epinephrine 1:200,000.

Current Approaches in Dental Alveolar Abscess in Sight of Bone Related Drugs

Dentoalveolar abscess, a localized accumulation of pus in the alveolar bone, can produce significant changes in alveolar bone proper that may be resulted by dental caries, trauma or pulpitis causing alveolar bone resorption or even loss. Unfortunately, it can extend vertically toward the apex of the tooth. Additionally, a periapical abscess may form in the alveolar bone adjacent to the apex of the tooth. Interestingly, many bacterial products can stimulate osteoclast formation and bone resorption of periapical tissues. This review displayed drugs that can affect bone resorption that classified as (1) Osteoclast inhibitors such as: bisphosphonates, gene therapeutic (Cathepsin K) estrogens, selective estrogen receptor modulators (SERMs), calcitonin monoclonal antibodies such as denosumab and (2) Osteoclast activators such as DMPPYT, nuclear factor-Kappa B (RANK) signaling and adrenomedullin.

Multi-faceted effects of mesenchymal stem cells (MSCs) determined by immune microenvironment and their implications on MSC/biomaterial-based inflammatory disease therapy

Inflammatory diseases result in destructive events, leading to tissue loss and functional impairment. Due to their anti-inflammatory effect and direct effect in tissue repair, mesenchymal stem cells (MSCs) are often exploited as ideal experimental cells to cure inflammatory tissue damage. Although a modicum of success has been reported, controversial therapeutic outcomes have also been observed, suggesting that MSCs may not be always beneficial and have multi-faceted functions with respect to inflammatory diseases. We chose dental pulpitis as a disease model and observed that human pulpitis tissue consists of infiltrating macrophages, whereas healthy tissue mainly consists of dental pulp stem cells (DPSCs), a type of MSC population. Through in vitro experiments, we found that lipopolysaccharide (LPS)-activated macrophages turned DPSCs into inflammatory cells with the upregulation of proinflammatory cytokines, IL-6, IL-1β, and TNFα. The underlying mechanism is related to the release of TNFα from macrophages, which led to a shutdown of the reparative capacity of DPSCs. Furthermore, the activated DPSCs became pro-inflammatory regulators, augmenting the inflammation response of macrophages via a mechanism related to the upregulation of WNT5a. Interestingly, when we applied a commonly used dental capping material (iRoot BP plus) to stimulate macrophages, the generated immune environment inhibited the inflammatory response of DPSCs and turned them into anti-inflammatory regulators with a high reparative capacity. This implies that manipulating the multi-faceted effects of DPSCs is vital for capping material-mediated pulpitis treatment. Our results collectively demonstrate the multi-faceted properties of MSCs in the progress of inflammatory disease as 1) reparative cells, 2) inflammatory cells, and 3) immunoregulatory cells. It should be noted that the immunoregulatory property of MSCs is not always anti-inflammatory; the immunoregulatory property is determined by the local immune environment. Such multi-faceted effects of MSCs should be considered when applying cell/biomaterial-based therapies to inflammatory tissue repair and regeneration.

Interleukin-17 plays a role in pulp inflammation partly by WNT5A protein induction

ObjectiveOur study aimed to investigate the role of interleukin (IL)-17 in dental pulp inflammation and the relationship between WNT5A and IL-17. MethodsImmunohistochemical staining was used to detect the expression of tumor necrosis factor-α (TNF-α), WNT5A and IL-17 in pulp tissues. Anti-IL-17 neutralizing antibody was used in rat pulpitis model and to study the role of IL-17 in pulpitis. TNF-α, WNT5A or IL-17 recombinant protein were used to treat human dental pulp cells. RT-PCR, Western blot, and Enzyme linked immunosorbent assay were used to detect the expression of mRNA and protein. Transwell assay was used to measure the migration of THP-1 cells, which is a human monocytic cell line. ResultsIL-17 and WNT5A are co-expressed in TNF-α high-expressed region in human and rat pulpitis tissue. IL-17 mainly contributes to its positive regulatory role in inflammation through up regulate cytokines and mediated macrophages migration. Anti-IL-17 neutralizing antibody can suppress the inflammatory cell infiltration and TNF-α expression in dental pulpitis. TNF-α promotes the expression of IL-17 partly through WNT5A and WNT5A regulates IL-17 expression by mitogen-activated protein kinase (MAPK)-(P38 and ERK) pathway. ConclusionsIL-17 acts as an inflammatory mediator in dental pulp inflammation. The expression of IL-17 can be partially regulated by WNT5A.

Comparison of fibroblast cell regeneration in three different concentrations of Wharton’s Jelly mesenchymal stem cells conditioned medium (WJMSCs-CM)

Wharton’s Jelly-derived mesenchymal stem cells (WJMSCs) have gained interest as an alternative source of stem cells for regenerative medicine. Although many studies have characterized Wharton’s Jelly biologically, the effects of different concentrations in a cultured medium have not yet been compared. Damaged fibroblasts, the primary components of irreversible dental pulpitis, irreversibly impair the ability to regenerate and lead to the disruption of extracellular matrix. This study was performed to evaluate the potency of three WJMSCs-CM concentrations in improving serum-starved fibroblasts. Fibroblasts were cultivated in five passages, and divided into four groups. The first group (the control group) consisted of fibroblast cells that had been treated using starvation methods. The other groups (the treatment groups) were treated with various concentration of WJMSCs-CM (50%, 25% and 12.5%). Proliferative ability was evaluated using a cell count method and analyzed with a one-way ANOVA. Cultivation of serum-starved fibroblasts produced significantly higher cell counts in 12.5% WJMSCs-CM compared to the 50% group. It can be concluded that 12.5% WJMSCs-CM is the most efficient concentration for fibroblast proliferation.

Facial presentations of primary headache disorders.

Background Many patients with mid-face or lower face craniofacial pain are diagnosed, based on accompanying signs and symptoms and features other than location, as either atypical migraines or atypical TACs. Distinguishing features of headache disorders as a cause of facial pain include the temporal pattern of pain, associated symptoms including light and sound sensitivity and nausea, cranial autonomic symptoms, and the lack of local triggering among others. Results An intraoral neurovascular pain has been observed, and was termed neurovascular orofacial pain (NVOP). Due to its location, and signs imitating dental pulpitis, it has great diagnostic and therapeutic importance for differentiating NVOP from dental pathology. The hypothesized mechanism is neurogenic inflammatory activation within the space confined by dentine around the dental pulp, expressed in strong paroxysmal pain and typical allodynia to cold foods. Conclusion Facial manifestations of headache disorders and primary facial pain disorders share common trigeminal nerve input, yet they are highly distinct disorders. Somatotopic segregation may occur at the level of the trigeminal nucleus, thalamus, and somatosensory cortex, and distinct ionic or neurochemical signaling pathways may be involved. Further investigation of facial presentations of headache disorders has the potential to provide new insight into the interface between headache and facial pain.

Pain from Dental Implant Placement, Inflammatory Pulpitis Pain, and Neuropathic Pain Present Different Somatosensory Profiles.

To address the two following questions: (1) What kind of somatosensory abnormalities may be characterized in patients receiving dental implants (IMP), in ongoing inflammatory dental pulpitis (IP) patients, and in neuropathic pain (atypical odontalgia [AO]) patients? and (2) What sort of sensory and neural changes may result from dental implant placement surgery and pulpectomy? A total of 60 subjects were divided into three groups: the IMP (n = 20), IP (n = 20), and AO groups (n = 20). Quantitative sensory testing (QST) was performed preoperatively (baseline) for all three groups and postoperatively at 1 month and 3 months after dental implant placement or pulpectomy (in the IMP group and IP group, respectively). Statistical analyses were completed with one-way and two-way analysis of variance and z score transformations (α = 5%). The main findings of this study indicated that: (1) Elevations in mechanical detection threshold (MDT) and in current perception threshold (CPT) related to C-fiber activation, indicating a loss of function, were found at baseline in IP patients; (2) Somatosensory abnormalities such as allodynia, reduced MDT and mechanical pain threshold (MPT), and impaired pain modulation were found in AO patients; (3) No somatosensory alterations after implant placement were found in the IMP group; and (4) Somatosensory alterations in the form of reduction in the CPT related to C-fiber activation were reported 3 months after pulpectomy in the IP group. This study showed that somatosensory abnormalities were evident in AO and IP patients, and somatosensory alterations were seen in IP patients even 3 months after pulpectomy. However, no somatosensory alterations were seen after implant placement.