Preservation Of Teeth Research Articles

Cu-Sil Denture – Replacement through Preservation

Esthetics along with function is the two most common concerns of patients. The need for patient’s esthetical concern should also be given prime concern when restoring the function. In most instances there is a need for irreversible alteration in the remaining hard tissue during a prosthodontics treatment. Preservation of natural teeth is gaining importance in dentistry in the present time. Diagnostic wax up and proper treatment planning is an important tool to establish the desired esthetic changes, to know how the final prosthesis looks like and for better understanding of the patient. This is a case report on a simplified approach in preservation of teeth and alveolar ridge along with esthetical correction of smile made with a newer type of transitional denture. It helps in promoting positive mental attitude among the patients by avoiding extractions.

CU-SIL DENTURE AS A TRANSITIONAL PROSTHESIS TO PRESERVE THE REMAINING NATURAL TEETH USING PERMANENT SILICONE LINER: CASE REPORTS

The goal of modern dentistry is to be conservative, preserving teeth but also maintaining the stability of the remaining alveolar ridge and the periodontium's proprioceptive capabilities. Cu-sil denture is the simplest approach in the preservation of teeth and maintaining proprioception. It is a type of transitional denture that provides an alternative treatment plan for the patients willing to replace their missing teeth while retaining their remaining natural teeth. It gives potential psychological benefits to the patients by avoiding extractions. It's a tissue-bearing acrylic appliance with a soft viscoelastic wrap that clasps the neck of each dentition, sealing out food and water simultaneously protecting and splinting each remaining tooth from the rigid acrylic denture base. This case reports series describes chairside techniques to fabricate Cu-sil dentures in the usual dental set-up.

CU-SIL DENTURE AS A TRANSITIONAL PROSTHESIS TO PRESERVE THE REMAINING NATURAL TEETH USING PERMANENT SILICONE LINER

The goal of modern dentistry is to be conservative, preserving teeth but also maintaining the stability of the remaining alveolar ridge and the periodontium's proprioceptive capabilities. Cu-sil denture is the simplest approach in the preservation of teeth and maintaining proprioception. It is a type of transitional denture that provides an alternative treatment plan for the patients willing to replace their missing teeth while retaining their remaining natural teeth. It gives potential psychological benefits to the patients by avoiding extractions. It's a tissue-bearing acrylic appliance with a soft viscoelastic wrap that clasps the neck of each dentition, sealing out food and water simultaneously protecting and splinting each remaining tooth from the rigid acrylic denture base. This case reports series describes chairside techniques to fabricate Cu-sil dentures in the usual dental set-up

Evaluation of Tooth Wear and its Causative Risk Factors Amongst Patients Attending Dental Hospital of Karachi

OBJECTIVE: Tooth wear is a term defined as the loss of dental hard tissue in a damaged tooth if there is no existing dental caries or trauma. Tooth wear rarely exists alone and is observed clinically and experimentally in combination. Excessive tooth wear leads to hypersensitivity and exposed dentin. Tooth wear can be classified as attrition, erosion, abrasion. The frequency of normal tooth preservation is greater than ever, thus a better prevalence of tooth wear is experiential in the population. Therefore, the objective of the present cross-sectional study was to evaluate tooth wear and its causative risk factors amongst patients attending the Dental Hospital of Karachi. METHODOLOGY: The current study was a cross-sectional study conducted on adult patients recruited from the Out-Patient Department of Oral Diagnosis from May 2018 - December 2018. A consecutive sampling method was used and 250 adult patients aged 18-45 years were included. Tooth wear was assessed by using Smith and Knight Tooth Wear Index (TWI index).Data was entered and analyzed by using SPSS, frequency, percentages were calculated, and a chi-square test was performed to find the association between gender and risk factors. RESULTS: The subject populations of 250 were assessed. Out of which 178 were male (71.2%) and 72 (28.8%) were female with age ranging between 18 to 48 years old. In this study, 92.4% of them were suffering from tooth wear and only 31.2% have extended to the severe stage of the tooth surface loss. CONCLUSION: The present study concluded that there is an association between tooth wear and its risk factors. KEYWORDS: Tooth Wear; Dental Wear; Tooth Wear Indices; Sensitivity and Specificity; Risk Factors.

PREDICTION OF VERTICAL IMPACTION OF LOWER WISDOM TOOTH ACCORDING ORTHOPANTOMOGRAPHY OF LOWER JAW

Topic relevance. The dental surgeon often is left alone with the dilemma: to save or remove the third lower molars. The justification of indications for tooth extraction must have objective criteria. It should be noted that a patient with this problem does not always have the opportunity to receive comprehensive advice from an orthodontist. In view of this, the solution to this problem requires the search for radiological data, which are the most available today and would help to justify treatment tactics for preservation or removal of the tooth.
 The conditions of tooth preservation in the dentition are most favorable with a slight medio-distal inclination and a vertical position of the third lower molars. However, this does not exclude the possibility of tooth impaction, which is often accompanied by periodic inflammatory phenomena in the tissues adjacent to the tooth and motivates both the patient and the dental surgeon to solve this problem.
 The aim of our study was to research of radiographic indicators of orthopantomography of the mandible to predict the vertical retention of the third lower molars.
 Material and methods of research. The platforms of Google Scholar, Research Gate and PubMed are used for research and analysis of the scientific literature on the application of objective criteria of mandibular orthopantomography data in the prediction of vertical impaction of the third lower molars.
 Impaction of mandibular molars is the result of a number of factors, including heredity, racial characteristics, muscle function, the nature of the food consumed, insufficient growth of the mandible, the size of the retromolar space. The accurately determination the positions of the molars and the size of the retromolar space of the mandible by available methods of X-ray diagnosis (the most common of which is the method of orthopantomography of the jaws) are necessary to prediction of tooth retention. The accuracy of imaging and measurements on orthopantomograms of the jaws was studied by both domestic and foreign authors.
 The angle of inclination of lower wisdom tooth, the size of the retromolar space of the mandible and the mesiodistal size of the teeth are determined on OPTG of jaws in the vast majority of publications. The age aspect of patients is also important for prediction of tooth impaction. In particular, most researchers state the fact that up to 20 years of life there is a significant probability of changing the position of the teeth during their eruption and therefore it is quite appropriate to wait.
 To predict the nature of the impaction of the third lower molars, the authors provide indicators of the angle of the tooth, the structure of their roots, the degree of impact and age of the patient.
 The publication of Maria Mersedes Gallas-Torreira and co-authors, which compared two methods of linear measurements on OPTG – Olive-Basford’s and Olmos ’methods have greatest interest. Both methods can be used to predict of impaction of lower wisdom tooth. However, if the prognostic estimate is based on orthopantomogram data rather than cone-beam computed tomography, the Olmos` method demonstrates a lower error rate and a more plausible prediction.
 To substantiate the algorithm for predicting the vertical retention of third lower molar in order to improve treatment tactics for the preservation or removal of the tooth which based on the obtained search data and the results of our own clinical observations and it is planned in the future.

The effect of JD005 compound on odontogenic differentiation of human dental pulp stem cells

Preservation of natural teeth and their structure is critical for chewing, swallowing, and better speech. Dentin and dental tissues are crucial in maintaining natural teeth and their structure, but treatment of dental tissue and dentin fracture is chal-lenging for dentistry. Hence, scientific understanding needs to be translated to discover novel dental treatments. Dental pulp stem cells (DPSCs) are mesenchymal stem cells (MSCs) isolated from the third molar pulp. These cells have similar characteristics to MSCs with a unique property where DPSCs can differentiate into dentin forming odontoblast-like cells. Here, we made an effort to evaluate the potential substrate that induces odontoblastic differentiation of DPSCs. In this study, JD005, a modified A2A antagonist from ZM-241385, was determined to enhance OD. Specifically, JD005 treatment signifi-cantly enhanced the OD markers like alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), OPN, dentin sialophosphoprotein (DSPP), and dentin matrix protein 1 (DMP1). Additionally, the DPSCs treated with JD005 showed enhanced SMAD phosphorylation associated with differentiation. These observations distinctively suggest that JD005 po-tentially contributes to dentin regeneration via odontoblast differentiation.

Effects of different remineralization agents on MIH defects: a randomized clinical study.

The aim of this study was to present a comparative evaluation of the long-term efficacy of fluoride varnish and pastes containing CPP-ACP and CPP-ACP with fluoride (CPP-ACFP) in the remineralization of creamy-white and yellow-brown defects in permanent first molars with MIH. The study included 120 teeth with yellow-brown or creamy-white defects in 67 children (37 girls, 30 boys) aged 6-9 years (mean, 7.2) who were newly diagnosed with MIH with no substance loss or caries or prior restorative treatment. The patients were randomly divided into the experiment groups; control (oral hygiene motivation only), fluoride varnish, and pastes containing CPP-ACP and CPP-ACPF, and followed up for 24 months. The evaluations were made based on the ICDAS criteria and the measurements which were performed using the laser fluorescence method (DIAGNOdent, KaVo, Biberach, Germany) in the follow-ups. The research was completed with 49 patients (23 females, 26 males; mean age, 7.7) and 90 teeth. All remineralization agents increased remineralization rates in both creamy-white and yellow-brown colored defects without presenting any statistically significant difference at the end of the follow-up period (p > 0.05). However, the effects of fluoride varnishes were late to observe when compared to pastes containing CPP-ACP and CPP-ACPF. Pastes containing calcium and phosphate may be recommended for the longer-term preservation of teeth with yellow-brown defects which showed a post-eruptive breakdown in a shorter time. There is a lack of studies investigating MIH treatments in which lesion appearance was recorded. This study evaluated creamy-white and yellow-brown MIH defects separately and reported long-term results of different remineralization agents.

Adjunctive use of antimicrobial photodynamic therapy in the surgical treatment of periapical lesions: A case series

BackgroundAntimicrobial photodynamic therapy (aPDT) is used in endodontics to improve orthograde root canal disinfection as an adjunct to standard treatments. Conversely, evidence concerning the application of aPDT in retrograde endodontic surgery is limited. Thus, the aim of the present study was to provide additional data regarding the use of aPDT in the surgical endodontic treatment of periapical lesions. MethodsA total of 25 consecutive patients presenting teeth with periapical radiolucency eventually associated with clinical signs and symptoms of apical periodontitis were included. Following access flap completion, osteotomy, mechanical debridement, root apical third resection, and preparation of the root-end cavity, aPDT was applied to decontaminate the surgical site using phenothiazine chloride dye at a concentration of 10 mg/mL and irradiation with a hand-held 100-mW diode laser with a wavelength of 660 ± 10 nm. At the latest follow-up visit, healing was evaluated as successful, uncertain, or failure according to well-established clinical and radiological criteria. ResultsOverall, 31 periapical lesions were treated with aPDT. Healing proceeded uneventfully. The mean follow-up time was 36.19 months, with times ranging from 12 to 85 months. A total of 25 (80.65%) cases were classified as successful, 5 (16.13%) as uncertain, and only one (3.22%) as failure. Irrespective of the treatment outcome, all treated teeth were still functional, with no symptoms reported by the patients. ConclusionaPDT as an adjunctive treatment modality in the surgical endodontic treatment of periapical lesions showed promising medium-term results associated with preservation of all diseased teeth.

Non surgical retreatment of central incisor in endodontics: A case report

Introduction: Preservation of tooth has continuously been of maximum problem to dental practitioners on the grounds that ages. Also on this growing technology sufferers are greater aware of to be had remedy plan and its outcome. Long time period fulfillment of endodontic remedy is predicated on thorough debridement of the foundation canal gadget accompanied with the aid of using 3 dimensional obturation. Endodontic disasters aren't exception and consequently want retreatment. Case report: A 23 yr antique male affected person turned into noted the endodontist with a first-rate grievance of ache in higher the front teeth. Clinical exam found out a discoloured maxillary central incisor. The affected person directly supplied a records of root canal treatment attributed to the discoloured enamel which turned into accomplished one and a 1/2 of month in the past through a widespread practitioner. A prognosis primarily based totally on medical symptoms and symptoms i.e. lack of coronal seal with insufficient obturation turned into hooked up and affected person turned into satisfied for a nonsurgical endodontic retreatment. Conclusion: At only a graduate degree the information concerning remedy like root canal treatment is minimum and basic. This case file is a easy endodontic retreatment case, finished via way of means of the conventional technique of eliminating the gutta-percha. Every dentist ought to have a complete information of the basis canal anatomy and its feasible versions earlier than taking off root canal treatment.

Clinical, paraclinical and therapeutic factors implicated in the recurrence of benign jaw tumors in three tertiary hospitals in Yaounde

IntroductionBenign jaw tumors or tumor-like swellings of the jaws can be classified as odontogenic or non-odontogenic. The type of surgery undertaken or the histological typing of the tumor could be the cause of the recurrence of these tumors. Our objective was to determine clinical and paraclinical features implicated in or that signal the recurrence of benign tumors. Material and methodsWe carried out a case control study during the period from January 2010 to April 2020 in the units of Stomatology and maxillofacial surgery, radiology and pathology units of Yaoundé University Teaching Hospital, Yaoundé Central Hospital and Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital. Participants who had been operated for a benign jaw tumor were included in this study. For the statistical analysis: the significant threshold was set at 0.05 that is all p values less than 0.05 were considered statistically significant. ResultsWe retained 89 study participants with a recurrence rate of 7.51%. In our study, we had 61.8% females and 38.2% males with a sex ratio of 0.62. The localization at the level of the angle and ramus of the mandible, tooth preservation, type of anesthesia, radiological tumor aspect and histomorphology (ameloblastic fibroma and osteoma) were statistically significant for recurrence. ConclusionThe recurrence of jaw tumors is associated with several clinical and paraclinical factors. These factors can help predict recurrences and hence reduce the complications associated with late treatment plan.

FISTULA MANAGEMENT DUE TO CHRONIC INFECTION OF RADICULAR CYST

A radicular cyst is the most common odontogenic cyst that arises from the epithelial residues in the periodontal ligament due to periapical periodontitis following death and necrosis of the pulp. A fistula may form a cyst with a pulp infection that produces pus and seeks its way out to the gingival surface to create a canal. The purpose of this case report is to report the management of a patient with a chronically infected radicular cyst with fistula while retaining the involved tooth. A case report was a 13-year-old female patient who came to Department Oral Surgery of a hospital with a complaint of a lump in the front gum and palate that didn't heal for two years ago and often discharged pus. Intraoral examination showed a lump in the gingiva and palate with fistula in the interdental gingiva of teeth 11-12 with soft consistency and pain with palpation. Panoramic results showed characteristics of the radicular cyst at the 13-11 tooth region. The lesion is diagnosed as a chronic infection of a radicular cyst due to pulp necrosis in teeth 12-11 with interdental fistulas. Biopsy enucleation of the cyst was performed with teeth preservation. The patient was advised to have regular check-ups. On the sixth month of control, the surgical wound was good, without any complaints and signs of recurrence. The result is that a radicular cyst can become chronically infected and form a fistula that oozes pus into the oral cavity. The cyst can be treated with enucleation biopsy and fistulectomy with the preservation, without any recurrences.

RECENT ADVANCES IN POST SYSTEMS -A REVIEW

Preservation of natural tooth in dental arch is ultimate objective of dental treatment. After endodontic treatment, tooth becomes brittle and prone to fracture which results in reduction of strength of crown causing fracture of cusp or sometimes weakness of the roots. In order to strengthen crown some anchorage within teeth has to be made and that anchorage and support is gained by rigid structure which is known as post. This article focuses on recent advances in post systems and their application, merits and demerits in endodontics.

Influence of Root Canal Fillings on Alveolar Bone Crest Level—An Observational Cross Sectional CBCT Analysis

The aim of this study was to compare the alveolar bone crest (ABC) level of root canal filled (RCF) teeth without apical periodontitis with corresponding non-filled teeth in the same individual using three-dimensionally cone-beam computed tomography (CBCT) data. Two hundred and thirty-five matching pairs of RCF teeth and corresponding teeth without RCF were selected from a pool of 580 random CBCT-images (voxel size 160–200 µm). Teeth with apical periodontitis, perio-endodontic lesions or surgical endodontic treatment were excluded. The distance between the cemento–enamel-junction (CEJ) and the ABC was assessed centrally mesial, distal, palatal/lingual and buccal at each tooth (∑1880 measuring points) in a standardized manner. Topographic, gender, and age-related relationships were also noted. Data were analyzed using the Kruskal–Wallis-test. The ABC-level between RCF teeth (2.64 ± 1.25 mm) and teeth without RCF (2.61 ± 1.16 mm) did not differ significantly (p > 0.05). No differences concerning localization (maxilla/mandible, tooth type) and gender (p > 0.05) occurred. Overall, ABC-level in the maxilla (2.74 ± 1.48 mm) was significantly lower (p < 0.001) compared to mandibular teeth (2.50 ± 1.41 mm). Patients > 41 years had significantly lower ABC-levels than younger patients (p < 0.05). Men showed a reduced bone level compared to women (p < 0.05). In conclusion, RCF teeth are identical to their non-RCF counterparts, at least in terms of crestal bone level, regardless of the location or type of tooth and the gender of the patient. Thus, root canal treatment is an essential pillar for long-term tooth preservation.

Tooth Elongation of Maxillary Second Premolars and Mandibular Third Molars and Associated Periodontal Disease in Horses: A Retrospective Study.

Periodontal disease has been identified in horses and donkeys through the millennia at a prevalence of up to 75% and is a leading cause of tooth loss in horses. We hypothesize that there is a correlation between tooth elongations and periodontal disease. Dental records of all client owned horses examined by a single AVDC/equine board certified practitioner in 2016-2018 were analyzed. Inclusion criteria consisted of the examination finding of tooth elongation of one of the following teeth pairs 106/107, 206/207, 310/311, or 410-411. The included cases were then examined for the finding of periodontal disease in Stages 1-4 (PD 1-4). Bayesian correlation analysis revealed significant positive correlations of elongations and periodontal disease existed between PD1 and proximal tooth pairs 106-107 and 206-207, PD2 and PD4 with all four tooth pairs, and PD3 with 106-107. Clinically, early diagnosis and treatment of newly formed elongations, or prevention of their formation altogether through diligent dental prophylaxis could prove key in preservation of teeth through prevention of the associated development of periodontal disease in the horse.

Treatment of Teeth with an Insufficient Clinical Crown. Part 2: Treatment Cost and Time and Patient Outcomes.

This study involves a group of 168 teeth in 126 patients treated with crown lengthening and tooth reconstruction (experimental group), and a group of 75 teeth from 62 patients that were judged irrational to treat, extracted, and replaced (control group). In the control group, 13 teeth in 12 patients were not replaced; 37 were replaced with an implant-supported crown, 14 with a tooth-supported partial denture, 2 with a Maryland partial denture; and 9 patients requested a removable prosthesis. In the experimental group, 44 teeth in 37 patients received a conservative restoration (24 direct and 20 indirect), while 124 teeth in 94 patients received a full crown. All 168 teeth were surgically treated with minimally invasive crown lengthening. Endodontic treatment and orthodontic extrusion were applied when necessary. Treatment resulted in healthy periodontal and dental/implant conditions at the 1-year follow-up in both groups. Function and esthetics were described from satisfactory to extremely satisfactory by patients of both groups, with the exception of three patients in the control group who received a mobile prosthesis restoration and reported some difficulties in chewing. When comparing treatment cost and duration of the reconstructed teeth (experimental group) to the treatment cost and duration of extracted and replaced teeth (control group), the difference is significantly in favor of the preservation of natural teeth, both monetarily and in terms treatment time. Saving a tooth with a compromised crown is more favorable for the patient than extraction and replacement. This conservative approach is advisable to clinicians whenever the clinical conditions enable treatment.

Management of Dentigerous Cyst in Children and Adolescents

Background: The purpose of the present study was to evaluate the efficacy of marsupilization of dentigerous cyst in children and adolescents as a line of treatment and its role in involved teeth preservation, during the last three years in maxillofacial department, King Fahd specialist hospital, Qassim, Saudia Arabia. Methods: twelve patients with dentigerous cysts were included in this study, 7 males and 5 females. Age range was 9 – 15 years old. Follow up to one-year postoperatively, early and late radiological evaluation. Followed by orthodontic alignment of teeth if needed. Results: Marsupialization (decompression) is a reliable technique for management of dentigerous cysts in children and adolescents for cyst healing and involved tooth preservation, but it needs long periods of follow up, cooperative patient and sometimes orthodontic work up. Conclusions: Marsupialization of dentigerous cyst should be considered in children and young adults, especially in large cysts and when tooth preservation is desirable.

Endodontic Indications among Patients Visiting a Tertiary Care Center: A Descriptive Cross-sectional Study.

Endodontics is the study of prevention, diagnosis and treatment of diseases or injuries to the dental pulp. The ultimate goal of modern dental care is tooth preservation and root canal therapy/treatment is an available therapeutic strategy to retain teeth. The aim of the study is to find the prevalence of patients visiting a tertiary care center who had endodontic indications. The descriptive cross-sectional study included 516 patients accepted for endodontic treatment, between August 2019 and December 2019 in a tertiary care center. Ethical approval was taken from the ethical review board of Nepal Health Research Council (reference number: 425-2019). Convenience sampling method was used. The data were entered in Statistical Package for Social Sciences version 20 software and analysed using descriptive statistics. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Out of 1740 patients, 516 (29.66%) (95% Confidence Interval= 21.46% - 27.51%) had endodontic indications. Symptomatic irreversible pulpitis 306 (59.30%) was the most prevalent pulpal disease. Maxillary teeth 300 (58.13%) had more endodontic diseases. While in individual dental elements most affected by endodontic diseases was the mandibular molar teeth 149 (28.87%). Females 348 (67.44%) were predominant for demanding endodontic management than males 168 (32.5%). More female patients and of younger age group in this study population demanded endodontic treatment. Irreversible pulpitis was responsible for the majority of the cases treated and more affected were the posterior teeth.

Problems of dental preservation and complex therapy of chronic generalized periodontitis

Epidemiological studies have reported the prevalence of inflammatory periodontal diseases of 85%90% in individuals aged 30 years. Predicting the possibility of preserving teeth is an important integral part of treatment planning for periodontitis. Traditionally, the prognosis is based on the likelihood of tooth loss. The article presents a review of the literature characterizing the factors that affect the prognosis of the service life of teeth in case of periodontitis. For the literature review, a literature search was performed on the MedLine, EMBASE, CyberLeninka, and eLibrary databases. The following factors should be considered when assessing the long-term prognosis in patients with the highest risk for tooth loss: severity of periodontitis, smoking, bruxism, number of abutment teeth, age, type of tooth, depth of probing the periodontal pocket, bone loss, furcation involvement, root mobility and proportions, and tooth crowns. Indicators for molar loss include furcation lesion, bone loss progression, endodontic treatment, persistent periodontal pocket, age, female sex, smoking, and diabetes mellitus. A favorable treatment result and preservation of teeth depend on the entire group of teeth, with the following values: 85% in single-rooted anterior teeth, 78% in premolars, and 47% in molars. The low accuracy of standard predictive tooth loss indices can be explained by the point that the indices are mainly based on factors related to teeth and do not take into account the influence of patient-related factors. Thus, predicting the service life of teeth with periodontitis is a difficult task and requires taking into account both individual indicators of periodontal status and general factors.

Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach.

Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.

C5a complement receptor modulates odontogenic dental pulp stem cell differentiation under hypoxia

ABSTRACT Aim Alterations in the microenvironment change the phenotypes of dental pulp stem cells (DPSCs). The role of complement component C5a in the differentiation of DPSCs is unknown, especially under oxygen-deprived conditions. The aim of this study was to determine the effect of C5a on the odontogenic differentiation of DPSCs under normoxia and hypoxia. Material and Methods Human DPSCs were subjected to odontogenic differentiation in osteogenic media and treated with the C5a receptor antagonist-W54011 under normal and hypoxic conditions (2% oxygen). Immunochemistry, western blot, and PCR analysis for the various odontogenic differentiation genes/proteins were performed. Results Our results demonstrated that C5a plays a positive role in the odontogenic differentiation of DPSCs. C5a receptor inhibition resulted in a significant decrease in odontogenic differentiation genes, such as DMP1, ON, RUNX2, DSPP compared with the control. This observation was further supported by the Western blot data for DSPP and DMP1 and immunohistochemical analysis. The hypoxic condition reversed this effect. Conclusions Our results demonstrate that C5a regulates the odontogenic DPSC differentiation under normoxia. Under hypoxia, C5a exerts a reversed function for DPSC differentiation. Taken together, we identified that C5a and oxygen levels are key initial signals during pulp inflammation to control the odontogenic differentiation of DPSCs, thereby, providing a mechanism for potential therapeutic interventions for dentin repair and vital tooth preservation.