Pulp Tissue Research Articles

Microbial and organic manure fertilization alters rhizosphere bacteria and carotenoids of Citrus reticulata Blanco 'Orah'.

Citrus reticulata Blanco 'Orah' is one of the most widely grown citrus varieties in southern China. It has been proven that microbial and organic manure fertilization improve the yields and appearances of 'Orah' fruits. However, details regarding the mechanisms underlying the effects of combined fertilization on the agronomic traits and rhizosphere bacterial community of plants still need to be elucidated. This study compared the rhizosphere bacterial community and carotenoids of 'Orah' with (WYT group) and without (WYCK group) combined fertilization in a local orchard in Wuming town from Nanning, Guangxi, China. The WYT group was sprayed with 50ml Strongreen and 250g of Yumeiren five times while WYCK group did not sprayed. Combined fertilization increased fruit weight and the Citrus color index (CCI) significantly (p < 0.05). By 16s rRNA sequencing, 7,126 operational taxonomic units (OTU) were obtained. A higher Shannon index was observed in the WYT group compared to that in the WYCK group. Comparison between the two groups showed that Pseudomonas was enriched in the WYT group with LDA (log10) score of 4.32, and Cyanobacteria was enriched in the WYCK group with LDA (log10) score of -4.11. At the family level, Phyllobacteriaceae (abundance mean: 0.0046 in WYCK vs. 0.0073 in WYT) was significantly abundant in the WYT group, whereas Thermosporothrix (abundance mean: 0.00053 in WYCK vs. 0.0019 in WYT) and Sphingobium (abundance mean: 0.00053 in WYCK vs. 0.0013 in WYT) were significantly abundant in the WYCK group. A total of 51 carotenoid components were tested by UPLC-MS/MS. In the pulp tissues, 37 carotenoid components were decreased in the WYT group compared to those in the WYCK group. In fruit skin, 24 significantly different components (7 downregulated and 17 upregulated) were identified in WYT compared to those in WYCK. Correlation analysis revealed that the network between OTUs and carotenoids contained seven carotenoid components and four OTUs. Four OTUs, strain TRA3-20 (a eubacterium), Roseiflexus, OPB35, and Fictibacillus correlated to carotenoid accumulation regulation in fruit skin. This study demonstrates the impact of the fertilization on soil microorganisms and carotenoid components. It constructs the regulatory network contained four OTUs for seven carotenoid components, providing evidence on precise fertilization in Orah.

Pulpitis tendency in teeth with vital pulp restored with composite resins: a cross-sectional retrospective study

Background: This study evaluates pulpitis tendency in vital teeth restored with composite resin after at least one year, focusing on the effect of cavity depth and the use of a base material on pulp status. Methods: A retrospective analysis was conducted on 212 patients with one tooth restored by dental senior students. At the follow-up, periapical and bitewing radiographs, cold tests, percussion, and palpation were performed. Cavity depth was measured from bitewing radiographs, and the periapical index (PAI) was recorded. The restored teeth were compared with contralateral sound teeth to assess the impact of the resin on pulp tissue. Results: Composite resin restorations significantly affected pulp status compared to intact teeth (p=0.002). Five out of 212 teeth became necrotic, and four developed symptomatic irreversible pulpitis (SIP). Four necrotic cases occurred in cavities deeper than 3.60 mm, and all SIP cases were associated with cavities deeper than 3.10 mm. Cavity depth was a significant predictor of adverse pulpal outcomes. However, using calcium hydroxide as a base did not significantly affect pulp health. Conclusions: The study concludes that composite resin restorations, mainly in deep cavities, can negatively impact pulp vitality. Cavity depth is a key factor in the risk of pulp necrosis and SIP, while calcium hydroxide base did not reduce pulpitis incidence. Larger studies with longer follow-up periods are recommended to confirm these findings and explore potential protective factors.

Microspheres of stem cells from human exfoliated deciduous teeth exhibit superior pulp regeneration capacity

ObjectivesEngineering spheroids to create three-dimensional (3D) cell cultures has gained increasing attention in recent years due to their potential advantages over traditional two-dimensional (2D) tissue culture methods. Stem cells derived from human exfoliated deciduous teeth (SHEDs) demonstrate significant potential for pulpal regeneration applications. Nevertheless, the feasibility of microsphere formation of SHEDs and its impact on pulpal regeneration remain unclear. MethodsIn this study, SHEDs were isolated, identified, and cultured in ultra-low attachment six-well plates to produce SHED microspheres. The biological properties of SHED microspheres were compared to those of traditional 2D culture using live-dead staining, Alizarin red staining, Oil-red O staining, scratch experiments, Immunofluorescence, Transmission electron microscopy scan, Western blotting, RNA sequencing, and a nude mice subcutaneous transplantation model. ResultsWe found SHED cells can form microspheres with a dense internal structure. SHED microspheres exhibited notable advantages over SHED cells in terms of biological properties, maintaining cell activity and enhancing cell differentiation, migration, and stemness in vitro. RNA-seq revealed that the SHED microspheres potentially influenced cell development, regulation of neurogenesis, skeletal system development, tissue morphogenesis singling pathway. In vivo, SHED microspheres promoted the generation of pulp tissue in dental pulp compared to traditional 2D culture. ConclusionsMicrosphereization of SHED through 3D cell culture enhances its pulp regeneration capacity, presenting a novel strategy for dental pulp regeneration and the clinical treatment of dental pulp diseases.

USO DA TERAPIA FOTODINÂMICA E DA CRIOTERAPIA NO CONTROLE DA DOR APÓS O TRATAMENTO ENDODÔNTICO: RELATO DE CASO CLÍNICO

Patients may undergo endodontic treatment for many reasons, including the presence of extensive decay that exposes pulp tissue and tooth fractures. The treatment, in turn, can generate, in some cases, the presence of painful symptoms, due to numerous reasons, such as incorrect removal of the smear layer and chemical injuries from the irrigating material. To reduce patient discomfort, alternative technical applications can be used to control post-operative pain, such as cryotherapy and laser therapy. The objective of this work, in the form of a case report, was to show the importance of controlling postoperative pain after endodontic treatment using laser therapy and cryotherapy techniques. Searches were carried out in electronic databases: Virtual Health Library (VHL), Scientifc Electronic Library Online (Scielo) and PubMed for the last 7 years (2017 to 2024), in addition to patient care where cryotherapy was used using serum physiological cold and laser therapy was performed. The results presented were satisfactory, as after 4 sessions, pain was assessed through telephone contact with the patient over periods of 24h, 72h and 7 days, where the patient’s pain-free response was verified and without need of analgesic use. The present study can conclude that performing cryotherapy concomitantly with the use of laser therapy presents a significant reduction in the postoperative pain response.

Histological Evaluation of Polyacid-Modified Composite Resin and Conventional Composite Resin Used for Primary Molars Restoration

Background: The present study evaluated the histological outcomes of two dental restorative materials, polyacid-modified composite resin (compomer) and conventional composite resin, in the primary molars of puppies. Materials and Methods: Twenty sound primary molars in four puppies were used. The puppies were rendered unconscious using general anesthesia. Similar cylindrical Class V cavities were prepared in 16 of the 20 selected primary molars. The teeth were divided into three groups: Group I: Eight cavities were restored with compomer; Group II: Eight cavities were restored with conventional composite resin; Group III: Four teeth remained untreated and were used as controls. In Groups I and II, four teeth were examined histologically after 2 weeks and the other four after 6 weeks. The histological findings were analyzed and compared to determine the effects of each type of resin material on the dentine and the pulp. Results: At 6 weeks, the specimens tested for compomer showed obvious destructive changes in the central region and the region of the pulp adjacent to the cavity. The specimens tested for conventional composite resin revealed, at 6 weeks, massive destruction of the pulp tissues and abscess formation was observed. All the specimens tested in the control group showed normal cellularity, normal vascularity, and proper alignment of odontoblast cells. Conclusions: The teeth restored with compomer demonstrated more favorable pulpal reactions when compared with the teeth restored with conventional composite resin after 6 weeks.

Preparation and characterization of bovine dental pulp-derived extracellular matrix hydrogel for regenerative endodontic applications: an in vitro study

BackgroundThe use of biological scaffolds in regenerative endodontics has gained much attention in recent years. The search for a new biomimetic scaffold that contains tissue-specific cell homing factors could lead to more predictable tissue regeneration. The aim of this study was to prepare and characterize decellularized bovine dental pulp-derived extracellular matrix (P-ECM) hydrogels for regenerative endodontic applications.MethodsFreshly extracted bovine molar teeth were collected. Bovine dental pulp tissues were harvested, and stored at -40º C. For decellularization, a 5-day protocol was implemented incorporating trypsin/EDTA, deionized water and DNase treatment. Decellularization was evaluated by DNA quantification and histological examination to assess collagen and glycosaminoglycans (GAGs) content. This was followed by the preparation of P-ECM hydrogel alone or combined with hyaluronic acid gel (P-ECM + HA). The fabricated scaffolds were then characterized using protein quantification, hydrogel topology and porosity, biodegradability, and growth factor content using Enzyme-linked immunosorbent assay (ELISA): transforming growth factor beta-1(TGF-β1), basic fibroblast growth factor (bFGF), bone morphogenetic protein 2 (BMP-2) and vascular endothelial growth factor (VEGF).ResultsDecellularization was histologically confirmed, and DNA content was below (50 ng/mg tissue). P-ECM hydrogel was prepared with a final ECM concentration of 3.00 mg/ml while P-ECM + HA hydrogel was prepared with a final ECM concentration of 1.5 mg/ml. Total protein content in P-ECM hydrogel was found to be (439.0 ± 123.4 µg/µl). P-ECM + HA showed sustained protein release while the P-ECM group showed gradual decreasing release. Degradation was higher in P-ECM + HA which had a significantly larger fiber diameter, while P-ECM had a larger pore area percentage. ELISA confirmed the retention and release of growth factors where P-ECM hydrogel had higher BMP-2 release, while P-ECM + HA had higher release of TGF-β1, bFGF, and VEGF.ConclusionsBoth P-ECM and P-ECM + HA retained their bioactive properties demonstrating a potential role as functionalized scaffolds for regenerative endodontic procedures.

Bovine pulp extracellular matrix hydrogel for regenerative endodontic applications: in vitro characterization and in vivo analysis in a necrotic tooth model

BackgroundRegenerative endodontic procedures (REPs) offer the promise of restoring vitality and function to a previously necrotic and infected tooth. However, the nature of regenerated tissues following REPs remains unpredictable and uncontrollable. Decellularized extracellular matrix scaffolds have gained recent attention as scaffolds for regenerative endodontics.ObjectivesPreparation and characterization of a bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel for regenerative endodontic applications. Biocompatibility and regenerative capacity of the prepared scaffold were evaluated in vivo in a canine animal model.MethodsFifteen freshly extracted bovine molar teeth were used to prepare P-ECM hydrogels following approval of the institutional review board of the faculty of dentistry, Alexandria University. Decellularization and lyophilization of the extracted pulp tissues, DNA quantification and histological examination of decellularized P-ECM were done. P-ECM hydrogel was prepared by digestion of decellularized pulps. Prepared scaffolds were evaluated for protein content and release as well as release of VEGF, bFGF, TGF-β1 and BMP2 using ELISA. Rabbit dental pulp stem cells’ (rDPSCs) viability in response to P-ECM hydrogels was performed. Finally, proof-of-concept of the regenerative capacity of P-ECM scaffolds was assessed in an infected mature canine tooth model following REPs versus blood clot (BC), injectable platelet-rich fibrin (i-PRF) or hyaluronic acid (HA). Statistical analysis was done using independent t test, the Friedman test and chi-square tests (p value ≤ 0.05).ResultsDNA was found to be below the cut-off point (50 ng/mg tissue). Histological evaluation revealed absence of nuclei, retention of glycosaminoglycans (GAGs) and collagen content, respectively. P-ECM hydrogel had a total protein content of (493.12 µg/µl) and protein release was detected up to 14 days. P-ECM hydrogel also retained VEGF, bFGF, TGF-β1 and BMP2. P-ECM hydrogel maintained the viability of rDPSCs as compared to cells cultured under control conditions. P-ECM hydrogel triggered more organized tissues compared to BC, i-PRF and HA when used in REPs for necrotic mature teeth in dogs. Periapical inflammation was significantly less in HA and P-ECM groups compared to blood-derived scaffolds.ConclusionBovine dental pulp-derived extracellular matrix (P-ECM) hydrogel scaffold retained its bioactive properties and demonstrated a promising potential in regenerative endodontic procedures compared to conventional blood-derived scaffolds.

Efficacy of vital pulp therapy for carious pulp injury in permanent teeth: a study protocol for an open-label randomized controlled noninferiority trial.

Vital pulp therapy (VPT) has recently been reported as an effective approach for preventing and treating carious pulp injury in permanent teeth. Compared with root canal treatment (RCT), which involves complete removal of the pulp tissue, VPT effectively maintains pulp vitality and retains the physiological functions of the pulp. In the research pool, large-scale randomized controlled trials evaluating the treatment outcome of VPT using calcium silicate cements and RCT in cariously exposed permanent teeth are lacking. Here, we present a monocentric clinical protocol to compare the effects of VPT using iRoot BP Plus (Innovative Bioceramix, Vancouver, BC, Canada) as a pulp-capping material with RCT. The proposed trial is an open-label, single-centre, randomized, controlled, noninferiority trial. In total, 462 patients will be included in this trial according to the following criteria: adult patients (18-50years old), pulp exposure during the treatment of deep caries in mature permanent teeth, a diagnosis of reversible or partially irreversible pulpitis without apical translucency on X-ray, without periodontitis or systemic disease. Patients with signed informed consent forms will be enrolled and randomly divided into two groups (VPT and RCT) with a balanced treatment allocation (1:1). Clinical evaluations will be conducted at baseline and at 3, 6, 12, and 24months after treatment, with the potential for extension. The primary outcome measure will be the duration of success. The secondary outcomes will include the success rate at the 1-year follow-up and any adverse reactions. The Kaplan‒Meier method and log-rank test will be used to compare the duration of success of both treatments. For other outcomes, the χ2 test or Fisher's exact test will be used for categorical variables, and the t test or Mann‒Whitney U test will be used for continuous variables to assess the differences between groups. The results of this trial will provide a clinical reference for selecting treatments for carious pulp injuries in permanent teeth. ClinicalTrials.gov ChiCTR2100051369. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn ). Registered on 21 September 2021.

Evaluation of hard tissue characteristics and calcifications in pulp tissue of hypomineralized permanent molars using micro-computed tomography

ObjectivesTo determine and compare pulp volume, dentin mineral density, presence of microcracks, pulp stones, and accessory canals, as well as their localizations in root regions for hypomineralized and healthy teeth. DesignThis study included 60 extracted permanent molar teeth, categorized into hypomineralized and healthy groups (n = 30 each). The hypomineralized group comprised molar teeth with limited white, yellow, or brown opacities, post-eruptive breakdown, or extensive restoration or crown damage. The healthy group included caries-free molar teeth without these characteristics. Using 3D micro-computed tomography images pulp volume, dentin mineral density, and the presence and locations of microcracks, pulp stones, and accessory canals were determined for each group. Statistical analyses were conducted using Independent T-test and Chi-square test, with significance set at p < 0.05. ResultsThere was no statistically significant difference between the groups regarding pulp volume and microcracks (p ≥ 0.05). The number of accessory canals was significantly greater in the cervical (p = 0.011; p < 0.05) and middle (p = 0.010; p < 0.05) regions of the hypomineralized teeth than healthy teeth. Dentin mineral density was statistically higher in the apical, middle, and cervical root regions (p < 0.001; p < 0.05); however, the number of pulp stones was found to be greater in the cervical regions of healthy teeth compared with those with hypomineralization (p = 0.026; p < 0.05). ConclusionThere were lower dentin mineral density measurements, a decreased number of pulp stones in the cervical region, and a greater number of accessory canals in the middle and cervical regions of hypomineralized teeth compared with healthy teeth.

Total Pulpotomy with MTA in Young Permanent Teeth: Case Series

Vital pulp therapy is a way to preserve the vitality and function of pulp damaged by trauma, caries or restorative procedures. Vital pulp therapy procedures include direct pulp capping, indirect pulp capping, partial and coronal pulpotomy treatments where diseased pulp tissue is removed. Over the years, the focus of vital pulp therapy has been on the preservation of the radicular pulp in immature permanent teeth to ensure the completion of root formation (apexogenesis). Today, it has been reported that vital pulp therapy can be considered as an alternative to root canal treatment, including in teeth with certain conditions that are considered to have irreversibly inflamed pulp. Coronal amputation therapy, a vital pulp treatment, involves complete removal of the coronal pulp, placement of a biologically acceptable material into the pulp chamber and restoration. The covering material must be able to relieve inflammation and initiate healing of the pulp tissue and allow new dentin tissue to form. The oldest material used in pulpotomy is calcium hydroxide. Mineral trioxide aggregate, which is a more recent material, is frequently preferred today due to its biocompatible and bioactive properties. In this case report, the results of 4 cases of coronal pulpotomy with mineral trioxide aggregate in young permanent teeth with a follow-up of 18 months are presented.

Efficacy of proinflamatory cytokines in the clinical and radiograpic outcomes of different primary molar pulpotomy agents: a comperative randomised study featuring a novel biomarker for pulpal diagnosis

BackgroundWhile the effect of biomaterials covering the pulp tissue is considered in the success of pulpotomy treatment, the level of pulpal inflammation is still very important for treatment success. The aim of this study was to compare IL-6 and IL-8 levels, known as good indicators of pulpal inflammation, with a new biomarker, presepsin, and to evaluate the impact of biomarker levels along with the pulp capping agents used in the treatment on the one-year success of pulpotomy treatment.MethodsThe study included 120 primary second molar teeth with pulpotomy indications from 75 children. To determine the pulpal inflammation status, pulpal bleeding samples were taken during treatment, and the levels of IL-6, IL-8, and presepsin were measured. During the pulpotomy treatment, MTA, NeoMTA™, and Biodentine™, and ZOE were randomly applied to groups of thirty teeth each. Patients were monitored for a period of 12 months post-treatment.ResultsIL-8, IL-6, and presepsin levels were significantly higher in teeth with pathology (p < 0.001). Biomarker levels were found to be higher in the NeoMTA and Biodentine groups, but this did not result in a statistically significant difference. (p > 0.05) Following pulpotomy treatment, the most successful material groups in order were MTA, ZOE, NeoMTA™, and Biodentine™.ConclusionPresepsin may be a usable indicator in predicting the level of inflammation. At the end of the one-year follow-up of pulpotomy treatment, more pathology was observed in the NeoMTA and Biodentine groups, where biomarker levels were higher, while no pathology was found in the MTA group, where biomarker levels were lower.Trial registrationNCT06398327/ 20,240,503.

Integrating Phosphate Enhances Biomineralization Effect of Methacrylate Cement in Vital Pulp Treatment with Improved Human Dental Pulp Stem Cells Stimulation.

Vital pulp treatment (VPT) is crucial for preserving the health and function of the tooth in cases where the pulp tissue remains vital despite exposure. Various materials are introduced for this purpose. However, challenges such as low strength, high solubility, and tooth discoloration persist. Methylmethacrylate-based cement (MC) offers excellent sealing ability, feasibility, and mechanical properties, making it a promising alternative for VPT. Phosphate-based glass (PBG) has the potential to promote hard tissue regeneration by releasing key inducers, phosphorus (P) and calcium (Ca), for reparative odontogenesis. This study investigates PBG-integrated MC (PIMC) by characterizing its properties, assessing human dental pulp stem cell activity related to initial inflammatory adaptation and odontogenic differentiation, and evaluating hard tissue formation using an in vivo dog pulpotomy model. Results indicate that a 5% PBG-integrated MC (5PIMC) maintains the physicochemical properties of MC. Furthermore, 5PIMC demonstrates cytocompatibility, excellent expression of osteo/odontogenic markers, and resistance to inflammatory markers, significantly outperforming MC. Enhanced hard tissue formation is observed in the dental pulp of mongrel dog teeth treated with 5PIMC. These findings suggest that 5PIMC could be an optimal and suitable material for reparative odontogenesis through VPT.

Tri-Lineage Differentiation Potential of Stem Cells from Human Exfoliated Deciduous Teeth - An In-Vitro Study

ABSTRACT Background: The use of SHED might bring advantages for tissue engineering over the use of stem cells from adult human teeth as SHEDs were reported to have higher proliferation rate and increase cell population doublings as compared with stem cells from permanent teeth. Objective: The study’s objective was to assess the growth kinetics and tri-lineage differentiation capacity of stem cells derived from human exfoliated deciduous teeth. Material and Method: After being propagated through multiple sequential subcultures, adherent fibroblastic cells in the pulp tissue culture from human exfoliation teeth were evaluated to assess their tripotent differentiation potential into bone, cartilage, and adipose cell lineages. Result: The stem cells derived from dental pulp had a comparatively high ability for proliferation and successfully differentiated into chondrocytes and osteocytes while less significant for adipocytes. Conclusion: Stem cells from Human Exfoliated Deciduous teeth are mesenchymal stem cells which are multipotent and can serve as a promising incentive for therapeutic and future research purposes.

Melanoma-inhibiting activity promotes the migration and odontoblastic differentiation of stem cells of apical papilla

ObjectiveMelanoma Inhibitory Activity (MIA) has been predominantly studied in the context of melanoma and cartilage development. However, its role in dental pulp development and stem cell behavior remains largely unexplored. This study investigates the expression pattern of MIA in dental pulp tissues and its potential role in the proliferation, migration, and odontoblastic differentiation of stem cells from the apical papilla (SCAPs). Design:MIA expression in human pulp tissue was demonstrated by immunohistochemistry. SCAPs were cultured in normal and mineralization induction media, with MIA levels monitored via RT-qPCR and Western blot. Cell proliferation was evaluated using the CCK8 assay, while transwell and cell scratch assays were conducted to examine cell migration. The effect of MIA on odontoblastic differentiation was examined by qRT-PCR, Alkaline phosphatase activity assay, and Western blot. siRNA was used to knock down MIA to investigate its effect. A mouse subcutaneous implantation model was used to assess whether MIA promotes odontoblastic differentiation in vivo. Results:MIA expression was observed in the papilla and odontoblasts layer of the developing pulp. In vitro, MIA expression increased during SCAPs differentiation and was found to significantly enhance migration, and odontoblastic differentiation but not proliferation. Gene knockdown experiments confirmed MIA’s pivotal role in promoting SCAPs migration and differentiation. In vivo, MIA facilitated the formation of dentin-like structures and enhanced pulp-dentin complex regeneration. Conclusion:MIA plays a crucial role in SCAPs’ migration and differentiation, suggesting its potential application in pulp-dentin regeneration therapies. Further studies are required to fully elucidate the underlying mechanisms.

Regenerative Endodontic Procedures With Minced Pulp Tissue Graft in Mature Permanent Teeth: A Clinical Study

IntroductionRegenerative endodontic procedures (REPs) using cell-based approaches have emerged as novel treatment modalities. This clinical study aimed to present the outcomes and explore factors influencing REPs with minced pulp tissue (MP) grafts in a mature tooth. MethodsSix healthy male patients aged 20–27 requiring nonsurgical root canal treatment were enrolled in this study. MP tissue obtained from third molars was introduced into the instrumented, disinfected, and blood-filled root canal. The canal was sealed with bioceramic cement, and the coronal access cavity was restored. ResultsFollow-ups for 6 cases ranged from 19 to 42 months. Radiographically, all the teeth showed favorable outcomes. Among the 6 teeth, 2 showed neither intracanal calcification nor recovery in sensibility tests, and one had no intracanal calcification with an inapplicable sensibility test evaluation. In 2 teeth, intracanal calcification was observed in the apical third; however, there was no recovery in the sensibility tests. One tooth exhibited intracanal calcification in the apical third and showed recovery in the sensibility tests. Considering these outcomes and clinical variables, the size of the apical foramen and the composition of the transplanted pulp tissue were identified as tentative influencing factors. ConclusionsThis study on simplified cell-based therapy using autologous MP for pulp/dentin regeneration in adult teeth not only enhances our understanding of REPs but also suggests its potential as an alternative treatment option to conventional endodontic treatment.

Effect of lateral extent of pulp tissue removal on the outcome of partial pulpotomy for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis: A randomized clinical trial.

The aim of this study is to compare the outcomes of restricted partial pulpotomy (R-PP) versus extended partial pulpotomy (E-PP) for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis (SIP). This double-arm, parallel designed randomized clinical trial was registered at clinicaltrials.gov (registration number: NCT05406557). Following random allocation, 43 participants of each group received the designated intervention. In the R-PP group, 2-3 mm of superficial pulp tissue was removed only from the exposure site, while chamber was completely de-roofed and 2-3 mm of superficial pulp tissue from entire chamber was removed in the E-PP group. Haemostasis was achieved using 3% sodium hypochlorite-soaked cotton pellets. Upon haemostasis, ProRoot mineral trioxide aggregate (ProRoot MTA) was placed over the pulpal wound, overlaid with a resin-modified glass ionomer liner, and restored with composite resin in the same visit. Outcome measures included clinical and radiographic success evaluation at 6 and 12 months, and pain assessment using the visual analogue scale pre-operatively and daily for 7 post-operative days. Nonparametric tests were used for variables including patient's age, pain intensities, mean analgesic consumption, and haemostasis time. Categorical variables including gender, caries type, analgesic intake, hard tissue barrier formation, clinical and radiographic success, and pulp sensibility responses were assessed using Chi-square or Fisher's exact test. Tooth survival was analysed using Kaplan-Meier analysis. A total of 81 cases were analysed at 12 months follow-up. Comparable success was observed in both groups (97.6% in E-PP & 97.5% in R-PP; p > .05). The R-PP group reported significantly lower pain scores on the 1st and 2nd post-operative days than E-PP (p < .05) and required significantly less analgesic intake (p < .05). Hard tissue barrier formation was significantly lower in the R-PP group (p < .05). No significant differences were observed between groups regarding haemostasis time, pulp sensibility responses, and tooth survival (p > .05). Both the PP approaches exhibited comparable success for managing cariously exposed mature permanent molars with SIP. Given the conservative nature of R-PP, it may be used as preferred PP approach for managing such cases. Being the first study of this kind, further work is necessary to draw definitive conclusions.

Decellularized extracellular matrix derived from dental pulp stem cells promotes gingival fibroblast adhesion and migration

BackgroundDecellularized extracellular matrix (dECM) has been proposed as a useful source of biomimetic materials for regenerative medicine due to its biological properties that regulate cell behaviors. The present study aimed to investigate the influence of decellularized ECM derived from dental pulp stem cells (DPSCs) on gingival fibroblast (GF) cell behaviors. Cells were isolated from dental pulp and gingival tissues. ECM was derived from culturing dental pulp stem cells in growth medium supplemented with ascorbic acid. A bioinformatic database of the extracellular matrix was constructed using Metascape. GFs were reseeded onto dECM, and their adhesion, spreading, and organization were subsequently observed. The migration ability of the cells was determined using a scratch assay. Protein expression was evaluated using immunofluorescence staining.ResultsType 1 collagen and fibronectin were detected on the ECM and dECM derived from DPSCs. Negative phalloidin and nuclei were noted in the dECM. The proteomic database revealed enrichment of several proteins involved in ECM organization, ECM–receptor interaction, and focal adhesion. Compared with those on the controls, the GFs on the dECM exhibited more organized stress fibers. Furthermore, cultured GFs on dECM exhibited significantly enhanced migration and proliferation abilities. Interestingly, GFs seeded on dECM showed upregulation of FN1, ITGB3, and CTNNB1 mRNA levels.ConclusionsECM derived from DSPCs generates a crucial microenvironment for regulating GF adhesion, migration and proliferation. Therefore, decellularized ECM from DPSCs could serve as a matrix for oral tissue repair.

Surgical Endodontic Management Of Maxillary Incisors: A Case Report

In the root canal system, infection of the pulp tissue caused by caries or other pathways is the primary cause of apical periodontitis. The ultimate goal of the endodontic treatment is to create adequate conditions for periradicular tissue healing. Nonsurgical endodontic treatment is a highly predictable treatment option in most cases, but surgery may be indicated for teeth with persistent periradicular pathosis unresponsive to nonsurgical approaches. The aim of this article is to highlight the possibility of the successful outcome of surgical endodontic treatment following failed non-surgical treatment of right maxillary central incisor. With proper case selection and operator skill, periradicular surgery can be considered predictable, cost-effective alternative to tooth extraction and tooth replacement.

Dentin Grafts: Navigating the Paradigm Shift in Regenerative Dentistry.

The biomaterial of dentin has emerged as a promising candidate for the tissue engineering of dental hard tissues. In bone tissue engineering, it may serve as either a scaffold or a reservoir of growth factors. The physical and chemical similarities between the dentin structure and bone have sparked scientific interest in using its features for the development of a new bone transplant material. Dentin, unlike hard and fragile enamel, is viscoelastic, making it a very effective bone replacement. The regeneration of pulp tissue has proven challenging due to its encasement in dentin, which lacks collateral blood flow except from the apical end of the root. Yet, the emergence of contemporary tissue engineering and the identification of dental stem cells have enabled experimentation with the regeneration of both pulp and dentin. This review will explain the different types of dentin grafts, their biocompatibility, safety, and effectiveness, along with difficulties. Additionally, the paper covers several strategies for creating autogenous dentin grafts and gives evidence-based insights into their clinical effectiveness. Overall, dentin grafts appear as a potential alternative to standard graft materials, stimulating tissue regeneration and enhancing patient outcomes in regenerative dentistry operations.

Investigation of Apoptosis in Healthy and Inflamed Pulp Tissue

Investigation of Apoptosis in Healthy and Inflamed Pulp Tissue