Ability of hydroxyapatite-bone morphogenetic (corrected from morphologenetic) protein (BMP) complex to induce dentin formation in dogs

Could the application of bioactive molecules improve vital pulp therapy success? A systematic review

This study aimed to systematically review the literature of animal studies to evaluate whether bioactive dentin proteins could improve vital pulp therapy success. The review is reported in accordance with the PRISMA Statement. Two reviewers independently conducted a literature search of seven databases: PubMed (Medline), Lilacs, IBECS, BBO, Web of Science, Scopus, and SciELO. Animal experiments in which bioactive dentin proteins were applied directly or indirectly to the pulp tissue were included. Data regarding the characteristics of the proteins evaluated, the delivery systems used and the main findings from each study were tabulated to assess the outcomes of interest (tertiary dentin formation, inflammatory response, intratubular mineralization). After screening, 32 papers were subjected to qualitative analysis. In 75% of the studies, direct pulp capping was performed. Additionally, the most studied proteins were BMP-7, TGF-β1, and extracted soluble dentin matrix proteins. In conclusion, there is evidence in the literature suggesting that bioactive dentin molecules could enhance tertiary dentin formation with fewer initial inflammatory responses in direct and indirect pulp therapy in animal models. There are potential areas to be explored for novel therapeutic approaches for dental tissue repair and regeneration with bioactive materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 941-956, 2017.

Designing new treatment strategies in vital pulp therapy

OBJECTIVES

The development of strategies in vital pulp therapy, which aim to maintain vitality and function of the dentine-pulp complex, represents a major focus of attention. Recent progress in understanding the molecular and cellular changes during tooth development and how they are mimicked during dental tissue repair offers the opportunity to now assess whether this knowledge can be exploited to design new treatment strategies in vital pulp therapy.

DATA SOURCES AND STUDY SELECTION

Current literature on the molecular and cellular basis of tooth development and dental tissue repair has been reviewed in the context of stimulating dentinogenic responses in the tooth together with pertinent published abstracts of relevant conferences and personal communications. Tissue events of direct relevance to clinical application for vital pulp therapy are discussed.

CONCLUSIONS

The involvement of growth factors and extracellular matrix molecules in signalling and regulating dentinogenic events during tooth development has been identified. During dental tissue repair, many of the processes are mimicked leading to responses of focal deposition of tertiary dentine at injury sites. The nature and specificity of these responses are determined in part by the extent of tissue injury. Traditional clinical strategies are capable of exploiting endogenous signalling molecules in the tissues to develop more effective treatment modalities. Application of exogenous signalling molecules offers opportunities for development of new therapies, although a number of delivery considerations must be addressed before these can be introduced into clinical practice.

Hydroxyapatite coated with insulin-like growth factor 1 (IGF1) stimulates human osteoblast activity in vitro

We studied the effects of a hydroxyapatite-tricalcium phosphate material coated with Insulin-like Growth Factor 1 (IGF1) on cell growth, collagen synthesis and alkaline phosphatase activity (ALP) of human osteoblasts in vitro. Cell proliferation was stimulated when osteoblasts were incubated with untreated hydroxyapatite (HA) and it was further increased by exposure to IGF1-coated HA. 3H-Proline uptake was significantly increased by treatment with either HA or IGF1-coated HA but no significant differences were found between these two groups. ALP activity was enhanced by exposure to HA, with respect to the control, and further increased by treatment with IGF1-coated HA. Our findings suggest that HA is useful for promoting osteoblast activity and IGF1 may help to improve its biological characteristics.