Tooth Pulp Research Articles

Age determination by measurement of pulp volume of canine teeth in patients with cleft lip and palate: a retrospective study.

This study evaluates the potential of pulp volume/total tooth-volume measurements of canine teeth in relation to chronologic age in patients with cleft lip and palate (CLP). The significance of this study lies in its exploration of the usability of these measurements for age determination in CLP patients, providing a novel perspective to the existing literature. Cone beam computed tomography images of 33 patients (16 females, 17 males) with unilateral CLP aged 14-45years and 33 age- and sex-matched healthy individuals (16 females, 17 males) were retrospectively evaluated. Using ITK-SNAP software, pulp and whole tooth volumes of canine teeth on the non-defect side of CLP patients and the corresponding side of healthy individuals were measured. Their relationship with chronologic age was evaluated, and comparisons were made between the CLP and control groups. No statistically significant difference was observed between the whole tooth volume, pulp volume, and pulp volume/total tooth-volume ratios of the control and CLP groups. A paired t test comparing chronologic age and calculated mean age of both groups found no significant difference. The results show that the pulp and total tooth-volume ratios of canine teeth in the non-defect areas of individuals with unilateral CLP correlate with chronologic age and can be used reliably for age determination. This indicates that individuals with CLP can be evaluated similarly to healthy individuals, allowing accurate age estimation based on dental measurements.

The influence of fructose on structural and metabolic features of the tooth-jaw system of rats under conditions of iodine deficiency

The aim of the study was to investigate an oxidative processes intensity and structural organisation of hard and soft periodontal tissues in rats under conditions of high-fructose diet against the background of iodine deficiency (research group) and standard diet and drinking regime (intact animals). It was found that carbohydrate metabolism was impaired in rats of the research group (glucose content increased by 63.3%, insulin – by 48.2% in blood serum, glycated haemoglobin of whole blood – by 2.1 time, HOMAIR index – by 2.1 times compared to the data in intact rats) and thyroid status (free triiodothyronine and thyroxine content in blood serum decreased by 46.8 and 42.7%, respectively, compared to the control). Under such conditions, the intensity of lipid and protein peroxidation processes in periodontal tissues increases. In particular, the accumulation of diene conjugates and products that react to thiobarbituric acid in the mucous membrane of the alveolar process (by 19.0 and 7.1 times), in the teeth pulp (by 2.2 and 6.3 times) compared to the values in intact animals was found. The activation of peroxidative destruction of proteins is confirmed by an increase in the content of all fractions of their oxidative modification in the studied tissues by 2.8-8.4 times compared to the control values. The results of the histological examination of the alveolar process indicate thinning of the periosteum, disruption of the structural organisation of osteon, reduction in the thickness of bone trabeculae (by 21.8%), optical density of the osteogenic matrix (by 8.9%), area of intertrabecular connective tissue (by 61.0%). Mucosal edema of connective tissue, accumulation of glycosaminoglycans, hypertrophy of all epithelial layers (basal, prickle, keratinized layers – by 25.5-55.9%, granular layer – by 2.3 times), changes of the microcirculatory net were observed in the mucous membrane of the alveolar process. Thus, the combination of high-fructose and iodine-deficient diets causes the development of oxidative stress and destructive changes of the dentoalveolar complex of research animals, which characterises an increase of the risks of dental pathology development.

Microiontophoretic Application of Dynorphin in Dental Pain: Excitatory or Inhibitory Effects.

The tooth exhibits increased sensitivity to noxious stimuli due to the dense innervation of thin myelinated Aδ fibers and unmyelinated C fibers within the dental pulp. While prior research has identified dynorphin expression in layers I-II of the dorsal horn across the spinal cord in various pain models, its functional role in trigeminal nociception, including tooth pain, remains underexplored. This study examines the potential role of dynorphin in the nociceptive processing of dental stimuli. Experiments were performed on adult male ferrets weighing 0.9-1.4 kg. The effects of dynorphin on electrically evoked responses of tooth pulp neurons were recorded extracellularly. The results demonstrated that the microiontophoretic application of dynorphin A induced excitatory and inhibitory effects on N-methyl-D-aspartate (NMDA)-evoked responses in electrically stimulated tooth pulp neurons. Specifically, dynorphin A attenuated NMDA-evoked responses in 16 out of 32 neurons by 61 ± 6%, facilitated NMDA-evoked responses in 10 out of 32 neurons by 69 ± 17%, and elicited mixed inhibitory and facilitatory responses in six out of 32 neurons. The inhibitory effects of dynorphin were blocked by nor-binaltorphimine, a kappa receptor antagonist, whereas the facilitatory effects were inhibited by D,L-2-amino-5-phosphonovaleric acid, an NMDA receptor antagonist. These findings suggest that dynorphin A-induced excitatory responses are mediated by NMDA receptors, whereas its inhibitory responses are mediated through kappa opioid receptors in dental pain. Thus, dynorphin exerts diverse effects, highlighting its role in the perception and modulation of dental pain.

The Immunophenotype and the Odontogenic Commitment of Dental Pulp Stem Cells Co-Cultured with Macrophages Under Inflammatory Conditions Is Modulated by Complex Magnetic Fields

Dental inflammatory diseases remain a challenging clinical issue, whose causes and development are still not fully understood. During dental caries, bacteria penetrate the tooth pulp, causing pulpitis. To prevent pulp necrosis, it is crucial to promote tissue repair by recruiting immune cells, such as macrophages, able to secrete signal molecules for the pulp microenvironment and thus to recruit dental pulp stem cells (DPSCs) in the damaged site. To date, root canal therapy is the standard for dental caries, but alternative regenerative treatments are gaining attention. Complex Multifrequency Magnetoelectric Fields (CMFs) represent an interesting tool due to their potential anti-inflammatory activity. Against this background, the present work aims at investigating whether the CMF treatment might restore redox balance in a co-culture model of DPSCs and inflamed macrophages mimicking an inflammatory condition, like pulpitis. Results show that superoxide anion levels and markers related to the polarization of macrophages are modulated by the CMF treatment. In parallel, the use of CMFs discloses an impact on the odontogenic commitment of DPSCs, their immunophenotype being considerably modified. In conclusion, CMFs, by modulating the odontogenic commitment and the anti-inflammatory response of DPSCs, might represent a suitable therapeutic tool against pulpitis and, in general, towards dental inflammatory diseases.

Multivariate Regression Models for Predicting the Prognosis of Luxation Injuries of Permanent Teeth: Periodontal and Pulp Analyses.

This study aimed to analyse the relationships between injury variables, treatment variables and the status of the periodontium or pulp of luxated teeth. The electronic medical records and imaging data of patients who underwent treatment for luxation injuries of permanent teeth in the paediatric dentistry and dental emergency departments of the Stomatology Hospital, Zhejiang University School of Medicine between 1 January 2012 and 1 January 2022 were retrospectively analysed. First, the patients' records were reviewed to collect background and follow-up imaging data; then, all early clinical variables were reviewed and used to construct models to predict the periodontal and pulp status of the luxated teeth. The models included the significant factors identified in the univariate analysis, and multivariate analysis was performed to evaluate the relationships between the variables and the final status of the periodontium or dental pulp. The chi-square test and Fisher's exact test were employed to analyse the differences in the frequency of each variable. The variables were systematically screened based on their odds ratios, and significance levels were determined by Pearson's chi-square test. A total of 188 patients were initially identified and ultimately included. The age range of the patients was 7-56 years. Logistic regression models for periodontal and pulp prognosis of the luxated teeth were established. The models were refined by combining the results of feature selection, parameter testing and goodness-of-fit testing. The final model included four variables and accurately predicted the periodontal outcome in 65.79% of the cases. The prognostic model for the dental pulp included three significant factors and had an overall accuracy of 94.59%. The prognostic models developed to predict the influence of various factors on the status of the periodontium and dental pulp of luxated teeth demonstrated notable accuracy and practical utility. Therefore, these models are potentially valuable tools for long-term prognostic assessments. Approval no. ChiCTR2100044897.

Long-Term Outcomes of Vital Pulp Therapy in Deep Carious Lesions Using Bioceramic Materials

ABSTRACT Background: Vital pulp treatment (VPT) is an essential clinical intervention used to maintain the integrity of the tooth pulp in situations with severe carious lesions. Due to their bioactivity, sealing ability, and compatibility with pulp tissues, bioceramic materials have attracted considerable interest. Materials and Methods: This research included a sample of 100 individuals who had acquired deep carious lesions. The participants were randomly allocated into two groups: Group A (n = 50) had ventral prosthetic treatment (VPT) using a bioceramic material, whereas Group B (n = 50) underwent VPT with a traditional calcium hydroxide-based material. Initial, 6 months, 12 months, and 24 months after treatment, clinical and radiographic assessments were conducted. The main outcome measures consisted of dental pulp vitality, lack of discomfort, and radiographic evidence of the development of a hard tissue barrier. Results: By the 24-month follow-up, 92% of the teeth in Group A, which used bioceramic material, retained their pulp vitality, but just 80% of the teeth in Group B, which used calcium hydroxide, did the same. Significantly reduced rates of postoperative discomfort were seen in Group A (10%) compared to Group B (25%). The radiographic examination revealed that 88% of patients in Group A displayed effective creation of a hard tissue barrier, whereas only 72% of cases in Group B exhibited comparable results. Conclusion: The research verifies that bioceramic materials provide better long-term results in vital pulp treatment for severe carious lesions as compared to traditional materials based on calcium hydroxide.

The traumatized immature permanent incisor with pulpal involvement: what conservative treatment options?

Traumatology is the second most common dental pathology, after caries and before periodontal pathologies. It is currently accepted that one child in two suffers an alveolar-dental trauma before leaving school, with a peak incidence between the ages of 8 and 12, all types of trauma combined. The maxillary central incisors are most affected (79.6%), with mainly "simple" or "complex" coronal fractures when the pulp is involved. The main objective in managing these complex fractures is to preserve pulpal vitality within an acceptable timeframe. The author presents three pulp vitality preservation therapies involving tissue preservation and regeneration techniques using bioactive materials applied directly to the pulp. Materials and clinical protocols are described. Knowledge of pulp biology and healing processes has led to the development of vitality-preserving therapeutic strategies that have become essential in the management of traumatized teeth in children and adolescents. The regenerative potential of immature tooth pulp is considerable, enabling dentine repair through the use of bioactive materials. These therapies require a rigorous surgical approach that determines prognosis, and precise monitoring to ensure that any complications are intercepted.

In Vivo and In Vitro Response to a Regenerative Dental Scaffold.

As dental pulp contains the stem cells necessary for regeneration, the tooth should hold the intrinsic capacity for self-repair. A triphasic hybrid dental biocomposite (3HB) composed of biocompatible biopolymers to provide strength, antibacterial properties and protein-based cell support could provide a conducive microenvironment for the regeneration of dental structures. 3HB was incorporated into Mineral Trioxide Aggregate (ProRoot MTA) to construct a malleable injectable implant. Human tooth pulp cells (hDPCs) significantly increased proliferation in the presence of 3HB+MTA compared to 3HB or MTA alone. Cell viability decreased with MTA alone but increased with 3HB and 3HB+MTA. 3HB+MTA was implanted into the residual tooth of drilled Wistar rat M2 molars for up to 45 days. Stereological analysis from micro-CT images showed the volume of the tooth remaining. Histologically, regenerative pulpal architecture was seen invading 3HB. A continuous odontoblastic profile lined a deposit of dentin-like material suggesting reparative dentinogenesis. Overall, no infection or encapsulation was seen. Immunohistochemically, odontoblasts were seen along the margins of the wounded tooth undergoing repair. Mesenchymal cells (MSCs) were seen at the base of the drilled tooth and by 21 days had translocated into the implant itself. Cells stimulating remineralization were highly expressed in the tooth undergoing repair. CD146-positive MSCs were seen in the center of the implant, possibly stimulating remineralization. In conclusion, behavior of 3HB+ in vitro and in vivo provided a promising start as 3HB+MTA may serve as a viable regenerative scaffold for pulp regeneration; however, this should be further studied before clinical use can be considered.

Deep caries and pulp exposures management preferences in permanent teeth: A survey amongst Spanish dentists.

To assess Spanish dentists' management preferences for deep caries removal and exposed pulps in permanent teeth. A web-based open and anonymous survey was distributed by social media and a specific website for this project amongst dentists practicing in Spain. The questionnaire comprised 40 questions, divided into five sections: (1) demographic data and professional activity; (2) carious tissue removal; (3) decision-making regarding pulp exposure; (4) direct pulp capping and (5) pulpotomy procedures in permanent teeth. Results were descriptively analysed. Logistic regression (95% CI) analyses and X2 tests were carried out. A total of 538 responses were received. Half the respondents (53.7%) preferred to perform complete caries excavation for shallow and moderate carious dentin lesions, and selective excavation to firm dentin for deep lesions (57.8%). Selective removal to soft dentin and stepwise removal were much less indicated (15.4% and 10.9%, respectively). Exposed pulps in asymptomatic teeth were treated by direct pulp capping (over 80%), decreasing in the presence of reversible pulpitis symptoms (57.1%). If irreversible pulpitis was diagnosed, a pulpectomy would be performed by 53.5% and 89.9% of the respondents in, respectively, immature and mature teeth. Pulpotomy was performed routinely only by 26.4% of the clinicians. Patients' attitudes and priorities were the most relevant criteria when performing direct pulp capping and pulpotomy, together with the history of pain and the presence of bleeding. Regarding the clinical procedure, dry cotton was preferred to obtain haemostasis and Biodentine was the material of election. Caries removal preferences and management of pulp exposure by dentists practicing in Spain deviated from vital pulp treatment guidelines, mainly regarding indications and case selection. Pulp exposure was managed by direct pulp capping in asymptomatic cases, whilst immature permanent molars favoured the indication of pulpotomy when pulpitis was diagnosed. Most clinicians used hydraulic calcium silicate cement, specifically Biodentine, to perform vital pulp treatments. Postgraduate formation and continuing education in caries lesions management and vital pulp treatments were consistently related to more conservative and updated decisions.

Radiographic association of chronological age based on the root pulp and periodontal ligament visibility in lower second molar teeth in a subset of the Pakistani population.

To find radiographic association of the root pulp visibility and periodontal ligament visibility stages of lower second molar teeth with chronological age. The prospective, analytical, cross-sectional study was conducted after approval from the ethics review committee of Ziauddin University, Karachi, and comprised digital orthopantomograms from 2020 to 2022. The orthopantomograms related to lower second molar teeth from the left side of the mandible of individuals of either gender aged 18-40 years. The orthopantomograms were subjected to stage classification to assess the radiographic root pulp visibility and periodontal ligament visibility of the lower second molar teeth. Data was analysed using SPSS 25. Of the 260 orthopantomograms, 140(53.8%) belonged to female subjects and 120(46.2%) to male. The overall median age of the subjects was 24 years (interquartile range: 7 years). There were 164(63.1%) subjects aged 18-25 years, 70(26.9%) aged 26-33 years, and 26(10%) aged 34-40 years. A positive correlation was noted between age and stages of radiographic root pulp visibility and periodontal ligament visibility (p<0.05). The individuals found at stages 0 and 1 for root pulp visibility were aged at least 18 years, and for stage 2, the corresponding value was 21 years. For periodontal ligament visibility, the minimum age for stage 0 was 18 years, while for stages 1 and 2, the corresponding values were 21 and 25 years. Lower age was found to be associated more with stage 0 of root pulp visibility and periodontal ligament visibility.

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.

The Effect of Larger Orthodontic Forces and Movement Types over a Dental Pulp and Neuro-Vascular Bundle of Lower Premolars in Intact Periodontium-A Numerical Analysis.

This numerical analysis of stress distribution in the dental pulp and neuro-vascular bundle (NVB) of lower premolars assessed the ischemic and degenerative-resorptive risks generated by 2 and 4 N during orthodontic movements (rotation, translation, tipping, intrusion and extrusion) in intact periodontium. The numerical analysis was performed on nine intact periodontium 3D models of the second lower premolar of nine patients totaling 90 simulations. In intact periodontium, both forces displayed a similar stress distribution for all five orthodontic movements but different amounts of stress (a doubling for 4 N when compared with 2 N), with the highest values displayed in NVB. In intact periodontium, 2 N and 4 N induced stresses lower than the maximum hydrostatic pressure (MHP) with no ischemic risks for healthy intact teeth. The rotation was seen as the most stressful movement, closely followed by intrusion and extrusion. Translation was quantitatively seen as the least stressful when compared with other movements. Larger orthodontic forces of 2 N and 4 N are safe (with any expected ischemic or resorptive risks) for the dental pulp and NVB of healthy intact teeth and in intact periodontium. Nevertheless, rotation and translation movements can induce localized circulatory disturbances in coronal pulp (i.e., vestibular and proximal sides) generating ischemic and resorptive risks on previously treated teeth (i.e., direct and indirect dental pulp capping). The intrusion and extrusion movements, due to the higher NVB-induced deformation when compared with the other three movements, could trigger circulatory disturbances followed by ischemia on previously traumatized teeth (i.e., occlusal trauma).

Guided Endodontics in Calcified Canals: Literature Review

Endodontic treatment controls the root canal microbiota by shaping, disinfecting and filling the canals to promote periapical healing. The calcification process is linked to pulp alterations, usually caused by an inflammatory process due to caries, loss of tooth surface, trauma or pulp exposure. This study aimed to emphasize the influence of computed tomography-guided endodontics on the accuracy and efficacy of endodontic treatments compared to conventional techniques. Articles were selected from PubMed, SCIELO and BVS databases using the descriptors "endodontics OR root canal treatment AND dental calcification AND pulp cavity AND cone beam computed tomography". The study included articles published from 2013 to 2023. After analyzing the inclusion and exclusion criteria, 20 articles were selected. Endodontic treatment of calcified teeth is challenging and can result in failures in root canal instrumentation and disinfection. Also, it leads to complications such as perforation and weakening of the tooth structure due to excessive wear. Thus, minimally invasive endodontics is gaining prominence in contemporary endodontics. New techniques, such as guided endodontics, are emerging and have helped to reduce the risk of root perforation.

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.

Evaluation of platelet-rich fibrin (PRF) as a scaffold in regeneration of pulp in young permanent anterior teeth

Evaluation of platelet-rich fibrin (PRF) as a scaffold in regeneration of pulp in young permanent anterior teeth

Panoramic evaluation of external root resorption in mandibular molars during orthodontic treatment: a comparison between root-filled and vital teeth treated with fixed appliances or clear aligners

BackgroundThis investigation compared the extent of external apical root resorption (EARR) in root-filled teeth (RFT) and their contralateral vital pulp teeth (VPT) counterparts during orthodontic treatment (OT) with clear aligner (CA) treatment or fixed appliance (FA) treatment.MethodsSixty-six patients with similar baseline American Board of Orthodontics (ABO) discrepancy index scores were divided into two groups: 37 patients (21 females, 16 males; mean age 17.45 ± 2.67 years) in the FA group, and 29 patients (18 females, 11 males; mean age 18.33 ± 1.96 years) in the CA group. Digital panoramic radiographs captured pre- and post-OT were used to measure tooth lengths and root surface measurements in mandibular molars. EARR in both RFT and contralateral VPT was evaluated pre- and post-OT. Statistical analysis employed paired t-tests, independent t-tests, and analysis of covariance (ANCOVA) (p < .05).ResultsAll teeth exhibited varying degrees of EARR following OT. FA treatment resulted in significantly longer treatment duration (p < .05) and greater EARR compared to CA treatment (p < .05). Moreover, statistically significant differences in EARR were observed within both groups between RFT and VPT (p < .05).ConclusionsComparison of pre- and post-OT radiographs revealed different degrees of EARR in all teeth. CA treatment resulted in less frequent and less severe EARR compared to FA treatment. RFT demonstrated greater resistance to EARR than VPT in both treatment groups.

A novel model of autologous tooth transplantation for the study of nerve recruitment

BackgroundLimited treatment options exist for damaged nerves and despite impressive advances in tissue engineering, scientists and clinicians have yet to fully replicate nerve development and recruitment. Innervation is a critical feature for normal organ function. While most organs are innervated prior to birth, a rare example of postnatal nerve recruitment occurs in the natural development of secondary teeth during adolescence. Many animals undergo postnatal shedding of deciduous teeth with development and eruption of secondary teeth, a process requiring recruitment of nerve and vasculature to each tooth pulp for viability. Here, the investigators created a novel model for the study of postnatal innervation by exploiting the natural phenomenon of tooth-driven nerve recruitment.MethodsThe investigators theorized that developing teeth possess a special capacity to induce innervation which could be harnessed in a clinical setting for nerve regeneration, and hyptothesized that a transplant model could be created to capture this phenomenon. In this descriptive study, a rat model of autologous tooth transplantation and de novo nerve recruitment was developed by surgically transferring whole developing molars to the autologous tibia.ResultsDownstream histological analysis performed 6 to 14 weeks after surgery demonstrated integration of molar into tibia in 81% of postoperative rats, with progressive pulpal expression of nerve marker ß-tubulin III suggestive of neuronal recruitment.ConclusionsThese findings provide a novel model for the study of organ transplantation and support the theory that developing dental tissues may retain nerve-inductive properties postnatally.

Enhancing Lung Recellularization with Mesenchymal Stem Cells via Photobiomodulation Therapy: Insights into Cytokine Modulation and Sterilization.

Several lung diseases can cause structural damage, making lung transplantation the only therapeutic option for advanced disease stages. However, the transplantation success rate remains limited. Lung bioengineering using the natural extracellular matrix (ECM) of decellularized lungs is a potential alternative. The use of undifferentiated cells to seed the ECM is practical; however, sterilizing the organ for recellularization is challenging. Photobiomodulation therapy (PBMT) may offer a solution, in which the wavelength is crucial for tissue penetration. This study aimed to explore the potential of optimizing lung recellularization with mesenchymal stem cells using PBMT (660 nm) after sterilization with PBMT (880 nm). The lungs from C57BL/6 mice were decellularized using 1% SDS and sterilized using PBMT (880 nm, 100 mW, 30 s). Recellularization was performed in two groups: (1) recellularized lung and (2) recellularized lung + 660 nm PBMT (660 nm, 100 mW, 30 s). Both were seeded with mesenchymal stem cells from human tooth pulp (DPSc) and incubated for 24 h at 37 °C and 5% CO2 in bioreactor-like conditions with continuous positive airway pressure (CPAP) at 20 cmH2O and 90% O2. The culture medium was analyzed after 24 h. H&E, immunostaining, SEM, and ELISA assays were performed. Viable biological scaffolds were produced, which were free of cell DNA and preserved the glycosaminoglycans; collagens I, III, and IV; fibronectin; laminin; elastin; and the lung structure (SEM). The IL-6 and IL-8 levels were stable during the 24 h culture, but the IFN-γ levels showed significant differences in the recellularized lung and recellularized lung + 660 nm PBMT groups. Greater immunological modulation was observed in the recellularized groups regarding pro-inflammatory cytokines (IL-6, IFN-γ, and IL-8). These findings suggest that PBMT plays a role in cytokine regulation and antimicrobial activity, thus offering promise for enhanced therapeutic strategies in lung bioengineering.

Recommended procedures for managing carious lesions in primary teeth with pulp involvement—a scoping review

BackgroundManaging dental caries in primary teeth with pulp involvement is a significant challenge. Clinical guidelines offer recommendations for effective management.AimTo identify and analyze policies, guidelines, and recommendations for treating primary teeth with pulp-involved carious lesions, highlighting existing research gaps and setting the foundation for future research.MethodsA comprehensive search was conducted across databases (PubMed, Scopus, Embase, GIN, and LILACS) and grey literature sources (Trip and ProQuest) to identify guidelines, consensus, policy, and position statements on primary teeth pulp therapy and extraction thresholds. Two independent reviewers screened the abstracts and titles, followed by full-text screening.ResultsAfter removing duplication, of the 1098 records, 14 were selected for analysis. This review examined various treatments for deep caries lesions in primary teeth, including indirect/direct pulp capping, pulpotomy, pulpectomy, lesion sterilization/tissue restoration, and extraction. Time search was restricted to documents published from 30th January 2008 to 30th January 2024, offering insights into evolving clinical practices.ConclusionTreatment for carious lesions in primary teeth involving the pulp depends on clinical indications and may involve minimally invasive techniques. Recommended options are indirect pulp capping, pulpotomy, and pulpectomy, while direct capping and tooth removal are discouraged. Further research is needed to address gaps, improve guideline development, and enhance consistency of recommendations.

Heat-killed Lancefieldella Rimae Induces Bone Resorption by Promoting Osteoclast Differentiation

IntroductionApical periodontitis, mainly caused by bacterial infection in the dental pulp, is often accompanied by abscess, periapical inflammation, and alveolar bone loss. Lancefieldella rimae has been detected in the root canals of patients with apical periodontitis. Here, we investigated whether L. rimae is associated with bone resorption. MethodsL. rimae was anaerobically cultured and heat-killed (HKLr). A mouse calvarial implantation model was used to determine the bone resorption in vivo. Committed osteoclasts prepared from C57BL/6 wild-type or Toll-like receptor 2 (TLR2)-deficient mice were differentiated into mature osteoclasts in the presence or absence of HKLr. The mRNA expression of tartrate-resistant acid phosphatase (TRAP), ATPase H+ transporting V0 subunit D2, cathepsin K, interleukin-6, tumor necrosis factor-α, and glyceraldehyde 3-phosphate dehydrogenase was quantified using real-time reverse transcription-polymerase chain reaction. The protein levels of c-Fos and NFATc1 were determined by Western blot analysis. ResultsImplantation of HKLr onto the mouse calvaria induced the bone destruction with an increase of TRAP-positive areas. While HKLr enhanced the differentiation of osteoclasts, this effect was not observed in TLR2-deficient osteoclasts. HKLr dose-dependently increased the mRNA expression of genes associated with osteoclast differentiation including TRAP, ATPase H+ transporting V0 subunit D2, and cathepsin K. In addition, HKLr enhanced the expression of c-Fos and NFATc1, which are important transcription factors for osteoclast differentiation. Moreover, HKLr increased the expression of interleukin-6 and tumor necrosis factor-α. ConclusionL. rimae induces bone resorption by enhancing osteoclast differentiation through the TLR2 signaling pathway, implying that L. rimae is a causative agent responsible for the alveolar bone resorption accompanying apical periodontitis.