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Zhao F, Zhang Z, Guo W. The 3-dimensional printing for dental tissue regeneration: the state of the art and future challenges. Front Bioeng Biotechnol 2024; 12:1356580. [PMID: 38456006 PMCID: PMC10917914 DOI: 10.3389/fbioe.2024.1356580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Tooth loss or damage poses great threaten to oral and general health. While contemporary clinical treatments have enabled tooth restoration to a certain extent, achieving functional tooth regeneration remains a challenging task due to the intricate and hierarchically organized architecture of teeth. The past few decades have seen a rapid development of three-dimensional (3D) printing technology, which has provided new breakthroughs in the field of tissue engineering and regenerative dentistry. This review outlined the bioactive materials and stem/progenitor cells used in dental regeneration, summarized recent advancements in the application of 3D printing technology for tooth and tooth-supporting tissue regeneration, including dental pulp, dentin, periodontal ligament, alveolar bone and so on. It also discussed current obstacles and potential future directions, aiming to inspire innovative ideas and encourage further development in regenerative medicine.
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Affiliation(s)
- Fengxiao Zhao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Zhijun Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Weihua Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
- Yunnan Key Laboratory of Stomatology, The Affiliated Hospital of Stomatology, School of Stomatology, Kunming Medical University, Kunming, China
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Lee M, Lee YS, Shon WJ, Park JC. Physiologic dentin regeneration: its past, present, and future perspectives. Front Physiol 2023; 14:1313927. [PMID: 38148896 PMCID: PMC10750396 DOI: 10.3389/fphys.2023.1313927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Regenerative dentistry has rapidly progressed since the advancement of stem cell biology and material science. However, more emphasis has been placed on the success of tissue formation than on how well the newly generated tissue retains the original structure and function. Once dentin is lost, tertiary dentinogenesis can be induced by new odontoblastic differentiation or re-activation of existing odontoblasts. The characteristic morphology of odontoblasts generates the tubular nature of dentin, which is a reservoir of fluid, ions, and a number of growth factors, and protects the inner pulp tissue. Therefore, understanding the dynamic but delicate process of new dentin formation by odontoblasts, or odontoblast-like cells, following dentinal defects is crucial. In this regard, various efforts have been conducted to identify novel molecules and materials that can promote the regeneration of dentin with strength and longevity. In this review, we focus on recent progress in dentin regeneration research with biological molecules identified, and discuss its potential in future clinical applications.
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Affiliation(s)
- Myungjin Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Yoon Seon Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Joo-Cheol Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Ballikaya E, Çelebi-Saltik B. Approaches to vital pulp therapies. AUST ENDOD J 2023; 49:735-749. [PMID: 37515353 DOI: 10.1111/aej.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
Tooth decay, which leads to pulpal inflammation due to the pulp's response to bacterial components and byproducts is the most common infectious disease. The main goals of clinical management are to eliminate sources of infection, to facilitate healing by regulating inflammation indental tissue, and to replace lost tissues. A variety of novel approaches from tissue engineering based on stem cells, bioactive molecules, and extracellular matrix-like scaffold structures to therapeutic applications, or a combination of all these are present in the literature. Shortcomings of existing conventional materials for pulp capping and the novel approches aiming to preserve pulp vitality highligted the need for developing new targeted dental materials. This review looks at the novel approches for vital pulp treatments after briefly addresing the conventional vital pulp treatment as well as the regenerative and self defense capabilities of the pulp. A narrative review focusing on the current and future approaches for pulp preservation was performed after surveying the relevant papers on vital pulp therapies including pulp capping, pulpotomy, and potential approaches for facilitating dentin-pulp complex regeneration in PubMed, Medline, and Scopus databases.
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Affiliation(s)
- Elif Ballikaya
- Department of Oral and Dental Health Research, Hacettepe University Graduate School of Health Sciences, Ankara, Turkey
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Betül Çelebi-Saltik
- Department of Oral and Dental Health Research, Hacettepe University Graduate School of Health Sciences, Ankara, Turkey
- Department of Stem Cell Sciences, Hacettepe University Graduate School of Health Sciences, Ankara, Turkey
- Center for Stem Cell Research and Development, Hacettepe University, Ankara, Turkey
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Luo N, Deng YW, Wen J, Xu XC, Jiang RX, Zhan JY, Zhang Y, Lu BQ, Chen F, Chen X. Wnt3a-Loaded Hydroxyapatite Nanowire@Mesoporous Silica Core-Shell Nanocomposite Promotes the Regeneration of Dentin-Pulp Complex via Angiogenesis, Oxidative Stress Resistance, and Odontogenic Induction of Stem Cells. Adv Healthc Mater 2023; 12:e2300229. [PMID: 37186211 DOI: 10.1002/adhm.202300229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/06/2023] [Indexed: 05/17/2023]
Abstract
Pulp exposure often leads to pulp necrosis, root fractures, and ultimate tooth loss. The repair of the exposure site with pulp capping treatment is of great significance to preserving pulp vitality, but its efficacy is impaired by the low bioactivity of capping materials and cell injuries from the local accumulation of oxidative stress. This study develops a Wnt3a-loaded hydroxyapatite nanowire@mesoporous silica (Wnt3a-HANW@MpSi) core-shell nanocomposite for pulp capping treatments. The ultralong and highly flexible hydroxyapatite nanowires provide the framework for the composites, and the mesoporous silica shell endows the composite with the capacity of efficiently loading/releasing Wnt3a and Si ions. Under in vitro investigation, Wnt3a-HANW@MpSi not only promotes the oxidative stress resistance of dental pulp stem cells (DPSCs), enhances their migration and odontogenic differentiation, but also exhibits superior properties of angiogenesis in vitro. Revealed by the transcriptome analysis, the underlying mechanisms of odontogenic enhancement by Wnt3a-HANW@MpSi are closely related to multiple biological processes and signaling pathways toward pulp/dentin regeneration. Furthermore, an animal model of subcutaneous transplantation demonstrates the significant reinforcement of the formation of dentin-pulp complex-like tissues and blood vessels by Wnt3a-HANW@MpSi in vivo. These results indicate the promising potential of Wnt3a-HANW@MpSi in treatments of dental pulp exposure.
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Affiliation(s)
- Nan Luo
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
| | - Yu-Wei Deng
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, 200011, P. R. China
| | - Jin Wen
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, 200011, P. R. China
| | - Xiao-Chen Xu
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
| | - Rui-Xue Jiang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, 200011, P. R. China
| | - Jing-Yu Zhan
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
| | - Yu Zhang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
| | - Bing-Qiang Lu
- Center for Orthopaedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Feng Chen
- Center for Orthopaedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Xi Chen
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, P. R. China
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Ghosh S, Qiao W, Yang Z, Orrego S, Neelakantan P. Engineering Dental Tissues Using Biomaterials with Piezoelectric Effect: Current Progress and Future Perspectives. J Funct Biomater 2022; 14:jfb14010008. [PMID: 36662055 PMCID: PMC9867283 DOI: 10.3390/jfb14010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Dental caries and traumatic injuries to teeth may cause irreversible inflammation and eventual death of the dental pulp. Nevertheless, predictably, repair and regeneration of the dentin-pulp complex remain a formidable challenge. In recent years, smart multifunctional materials with antimicrobial, anti-inflammatory, and pro-regenerative properties have emerged as promising approaches to meet this critical clinical need. As a unique class of smart materials, piezoelectric materials have an unprecedented advantage over other stimuli-responsive materials due to their inherent capability to generate electric charges, which have been shown to facilitate both antimicrobial action and tissue regeneration. Nonetheless, studies on piezoelectric biomaterials in the repair and regeneration of the dentin-pulp complex remain limited. In this review, we summarize the biomedical applications of piezoelectric biomaterials in dental applications and elucidate the underlying molecular mechanisms contributing to the biological effect of piezoelectricity. Moreover, we highlight how this state-of-the-art can be further exploited in the future for dental tissue engineering.
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Affiliation(s)
- Sumanta Ghosh
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Wei Qiao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Zhengbao Yang
- Department of Mechanical Engineering & Department of Materials Science and Engineering, City University of Hong Kong, Hong Kong, China
| | - Santiago Orrego
- Oral Health Sciences Department, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19140, USA
- Bioengineering Department, College of Engineering, Temple University, Philadelphia, PA 19140, USA
| | - Prasanna Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Correspondence:
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Yan H, Oshima M, Raju R, Raman S, Sekine K, Waskitho A, Inoue M, Inoue M, Baba O, Morita T, Miyagi M, Matsuka Y. Dentin-Pulp Complex Tissue Regeneration via Three-Dimensional Cell Sheet Layering. Tissue Eng Part C Methods 2021; 27:559-570. [PMID: 34583551 DOI: 10.1089/ten.tec.2021.0171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The dentin-pulp complex is a unique structure in teeth that contains both hard and soft tissues. Generally, deep caries and trauma cause damage to the dentin-pulp complex, and if left untreated, this damage will progress to irreversible pulpitis. The aim of this study was to fabricate a layered cell sheet composed of rat dental pulp (DP) cells and odontogenic differentiation of pulp (OD) cells and to investigate the ability to regenerate the dentin-pulp complex in a scaffold tooth. We fabricated two single cell sheets composed of DP cells (DP cell sheet) or OD cells (OD cell sheet) and a layered cell sheet made by layering both cells. The characteristics of the fabricated cell sheets were analyzed using light microscopy, scanning electron microscope (SEM), hematoxylin-eosin (HE) staining, and immunohistochemistry (IHC). Furthermore, the cell sheets were transplanted into the subrenal capsule of immunocompromised mice for 8 weeks. After this, the regenerative capacity to form dentin-like tissue was evaluated using micro-computed tomography (micro-CT), HE staining, and IHC. The findings of SEM and IHC confirmed that layered cell sheets fabricated by stacking OD cells and DP cells maintained their cytological characteristics. Micro-CT of layered cell sheet transplants revealed a mineralized capping of the access cavity in the crown area, similar to that of natural dentin. In contrast, the OD cell sheet group demonstrated the formation of irregular fragments of mineralized tissue in the pulp cavity, and the DP cell sheet did not develop any hard tissue. Moreover, bone volume/tissue volume (BV/TV) showed a significant increase in hard tissue formation in the layered cell sheet group compared with that in the single cell sheet group (p < 0.05). HE staining also showed a combination of soft and hard tissue formation in the layered cell sheet group. Furthermore, IHC confirmed that the dentin-like tissue generated from the layered cell sheet expressed characteristic markers of dentin but not bone equivalent to that of a natural tooth. In conclusion, this study demonstrates the feasibility of regenerating dentin-pulp complex using a bioengineered tissue designed to simulate the anatomical structure. Impact statement The dentin-pulp complex can be destroyed by deep caries and trauma, which may cause pulpitis and progress to irreversible pulpitis, apical periodontitis, and even tooth loss. Current treatments cannot maintain pulp health, and teeth can become brittle. We developed a three-dimensional (3D) layered cell sheet using dental pulp cells and odontogenic differentiation of pulp cells for dentin-pulp complex regeneration. Our layered cell sheet enables the regeneration of an organized 3D dentin-pulp-like structure comparable with that of natural teeth. This layered cell sheet technology may contribute to dentin-pulp complex regeneration and provide a novel method for complex tissue engineering.
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Affiliation(s)
- Huijiao Yan
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Masamitsu Oshima
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Resmi Raju
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Swarnalakshmi Raman
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kazumitsu Sekine
- Department of Biomaterials and Bioengineering, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Arief Waskitho
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Miho Inoue
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Masahisa Inoue
- Laboratories for Structure and Function Research, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, Japan
| | - Otto Baba
- Department of Oral and Maxillofacial Anatomy, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tsuyoshi Morita
- Department of Oral and Maxillofacial Anatomy, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Mayu Miyagi
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yoshizo Matsuka
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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Yang S, Fan W, Li Y, Liu Q, He H, Huang F. Autophagy in tooth: Physiology, disease and therapeutic implication. Cell Biochem Funct 2021; 39:702-712. [PMID: 33929054 DOI: 10.1002/cbf.3636] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 01/07/2023]
Abstract
Autophagy is an evolutionarily conserved cellular process, in which damaged organelles and proteins are engulfed in autophagic vesicles and subsequently fuse with lysosomes for degradation. Autophagy is widely involved in different physiologic or pathologic processes in human. Accumulating evidence indicates that autophagy operates as a critical quality control mechanism to maintain pulp homeostasis and structural integrity of the dentin-pulp complex. Autophagy is activated during stresses and is involved in the pathogenesis of pulpitis and periapical infection. Recent discoveries have also provided intriguing insights into the roles of autophagy in tooth development, pulp aging and stress adaptation. In this review, we provide an update on the multifaceted functions of autophagy in physiology and pathophysiology of tooth. We also discuss the therapeutic implications of autophagy modulation in diseases and the regeneration of dentin-pulp complex.
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Affiliation(s)
- Shengyan Yang
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Wenguo Fan
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yaoyin Li
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qing Liu
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hongwen He
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Anatomy and Physiology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Fang Huang
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Park MK, Kim S, Jeon M, Jung UW, Lee JH, Choi HJ, Choi JE, Song JS. Evaluation of the Apical Complex and the Coronal Pulp as a Stem Cell Source for Dentin-pulp Regeneration. J Endod 2019; 46:224-231.e3. [PMID: 31836138 DOI: 10.1016/j.joen.2019.10.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 01/09/2023]
Abstract
INTRODUCTION This study compared the stemness and differentiation potential of stem cells derived from the apical complex (apical complex cells [ACCs]) and coronal pulp (dental pulp stem cells [DPSCs]) of human immature permanent teeth with the aim of determining a more suitable source of stem cells for regeneration of the dentin-pulp complex. METHODS ACC and DPSC cultures were established from 13 human immature permanent teeth using the outgrowth method. The proliferation capacity and colony-forming ability of ACCs and DPSCs were evaluated. ACCs and DPSCs were analyzed for mesenchymal stem cell markers using flow cytometry. The adipogenic and osteogenic differentiation potential of ACCs and DPSCs were evaluated using the quantitative real-time polymerase chain reaction and histochemical staining. ACCs and DPSCs were transplanted subcutaneously in immunocompromised mice using macroporous biphasic calcium phosphate as a carrier. The histomorphologic characteristics of the newly formed tissues were verified using hematoxylin-eosin staining and immunohistochemical staining. Quantitative alkaline phosphatase analysis and quantitative real-time polymerase chain reaction using BSP, DSPP, POSTN, and ColXII were performed. RESULTS ACCs and DPSCs showed similar cell proliferation potential and colony-forming ability. The percentage of mesenchymal stem cell markers was similar between ACCs and DPSCs. In the in vitro study, ACCs and DPSCs showed adipogenic and osteogenic differentiation potential. In the in vivo study, ACCs and DPSCs formed amorphous hard tissue using macroporous biphasic calcium phosphate particles. The quantity and histomorphologic characteristics of the amorphous hard tissue were similar in the ACC and DPSC groups. Formation of periodontal ligament-like tissue, positive to Col XII, was observed in ACC transplants, which was absent in DPSC transplants. CONCLUSIONS ACCs and DPSCs showed similar stemness, proliferation rate, and hard tissue-forming capacity. The notable difference was the periodontal ligament-like fiber-forming capacity of ACCs, which indicates the presence of various lineages of stem cells in the apical complex compared with the coronal pulp. Regarding regeneration of the dentin-pulp complex, the coronal pulp can be a suitable source of stem cells considering its homogenous lineages of cells and favorable osteo/odontogenic differentiation potential.
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Affiliation(s)
- Min-Kyoung Park
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Seunghye Kim
- Department of Pediatric Dentistry, Institute of Oral Health Science, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Mijeong Jeon
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Jae-Ho Lee
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Hyung-Jun Choi
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ja-Eun Choi
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
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Holder MJ, Wright HJ, Couve E, Milward MR, Cooper PR. Neutrophil Extracellular Traps Exert Potential Cytotoxic and Proinflammatory Effects in the Dental Pulp. J Endod 2019; 45:513-520.e3. [PMID: 30930016 DOI: 10.1016/j.joen.2019.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/14/2019] [Accepted: 02/06/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Neutrophil extracellular traps (NETs) are an important innate immune mechanism aimed at limiting the dissemination of bacteria within tissues and localizing antibacterial killing mechanisms. There is significant interest in the role of NETs in a range of infectious and inflammatory diseases; however, their role in diseased pulp has yet to be explored. Our aim was to determine their relevance to infected pulp and how their components affect human dental pulp cell (HDPC) responses. METHODS Diseased pulp tissue was stained for the presence of extracellular DNA and elastase to detect the presence of NETs. Bacteria known to infect pulp were also assayed to determine their ability to stimulate NETs. Coculture studies and NET component challenge were used to determine the effect of extracellular NET release on HDPC viability and inflammatory response. NET-stimulated HDPC secretomes were assessed for their chemotactic activity for lymphocytes and macrophages. RESULTS Data indicate that NETs are present in infected pulp tissue and whole NETs, and their histone components, particularly H2A, decreased HDPC viability and stimulated chemokine release, resulting in an attraction of lymphocyte populations. CONCLUSIONS NETs are likely important in pulpal pathogenesis with injurious and chronic inflammatory effects on HDPCs, which may contribute to disease progression. Macrophages are chemoattracted to NET-induced apoptotic HDPCs, facilitating cellular debris removal. NETs and histones may provide novel prognostic markers and/or therapeutic targets for pulpal diseases.
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Affiliation(s)
- Michelle J Holder
- Oral Biology, Birmingham Dental School and Hospital, College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - Helen J Wright
- Oral Biology, Birmingham Dental School and Hospital, College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - Eduardo Couve
- Centro Interdisciplinario de Neurociencia de Valparaíso, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile; Instituto de Biología, Laboratorio de Microscopía Electrónica, Universidad de Valparaíso, Valparaíso, Chile
| | - Michael R Milward
- Oral Biology, Birmingham Dental School and Hospital, College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - Paul R Cooper
- Oral Biology, Birmingham Dental School and Hospital, College of Medical and Dental Sciences, Birmingham, United Kingdom.
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10
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Moussa DG, Aparicio C. Present and future of tissue engineering scaffolds for dentin-pulp complex regeneration. J Tissue Eng Regen Med 2018; 13:58-75. [PMID: 30376696 DOI: 10.1002/term.2769] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 07/16/2018] [Accepted: 10/18/2018] [Indexed: 02/06/2023]
Abstract
More than two thirds of the global population suffers from tooth decay, which results in cavities with various levels of lesion severity. Clinical interventions to treat tooth decay range from simple coronal fillings to invasive root canal treatment. Pulp capping is the only available clinical option to maintain the pulp vitality in deep lesions, but irreversible pulp inflammation and reinfection are frequent outcomes for this treatment. When affected pulp involvement is beyond repair, the dentist has to perform endodontic therapy leaving the tooth non-vital and brittle. On-going research strategies have failed to overcome the limitations of existing pulp capping materials so that healthy and progressive regeneration of the injured tissues is attained. Preserving pulp vitality is crucial for tooth homeostasis and durability, and thus, there is a critical need for clinical interventions that enable regeneration of the dentin-pulp complex to rescue millions of teeth annually. The identification and development of appropriate biomaterials for dentin-pulp scaffolds are necessary to optimize clinical approaches to regenerate these hybrid dental tissues. Likewise, a deep understanding of the interactions between the micro-environment, growth factors, and progenitor cells will provide design basis for the most fitting scaffolds for this purpose. In this review, we first introduce the long-lasting clinical dental problem of rescuing diseased tooth vitality, the limitations of current clinical therapies and interventions to restore the damaged tissues, and the need for new strategies to fully revitalize the tooth. Then, we comprehensively report on the characteristics of the main materials of naturally-derived and synthetically-engineered polymers, ceramics, and composite scaffolds as well as their use in dentin-pulp complex regeneration strategies. Finally, we present a series of innovative smart polymeric biomaterials with potential to overcome dentin-pulp complex regeneration challenges.
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Affiliation(s)
- Dina G Moussa
- Minnesota Dental Research Centre for Biomaterials and Biomechanics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota.,Department of Conservative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Conrado Aparicio
- Minnesota Dental Research Centre for Biomaterials and Biomechanics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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11
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Zhang L, Chen Z. Autophagy in the dentin-pulp complex against inflammation. Oral Dis 2018; 24:11-13. [PMID: 29480617 DOI: 10.1111/odi.12749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 08/20/2017] [Accepted: 08/22/2017] [Indexed: 11/28/2022]
Abstract
The dentin-pulp complex is a highly specialized tissue for protecting the dental pulp. Odontoblasts are long-lived, hard-tissue-forming cells in the dentin-pulp complex and critically involved in inflammatory responses against invading pathogens. Autophagy is a highly conserved homeostasis mechanism of living cells under various stress conditions. Growing evidence in the literature addresses the role of autophagy in odontoblast differentiation and aging. This review summarizes the current knowledge about autophagy for the dentin-pulp complex in resisting inflammation.
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Affiliation(s)
- L Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOS and Key Laboratory for Oral Biomedicine of Ministry of Education [KLOBM]), School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Z Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOS and Key Laboratory for Oral Biomedicine of Ministry of Education [KLOBM]), School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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12
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Chu G, Zhang ZY, Zhou H, Yan CX, Chen T, Guo YC. [Research Progress of Age Estimation Based on Age-related Changes of Dentin-pulp Complex]. Fa Yi Xue Za Zhi 2018; 34:280-285. [PMID: 30051668 DOI: 10.12116/j.issn.1004-5619.2018.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 11/30/2022]
Abstract
Age estimation is a hot and difficult issue in forensic practice. Teeth are the most solid organs in human body and can be kept in vitro for a long time. With age, the secondary dentin gradually generates and the volume of pulp cavity constantly decreases. Therefore, forensic dentists proposed that age-related changes of dentin-pulp complex could be used to estimate age, which has been widely applied in forensic practice over the years. Due to the development of imaging technology, a variety of methods have been advocated by forensic dentists to detect the age-related changes of dentin-pulp complex for age estimation. However, different methods have their own advantages and limitations, forensic scientists should combine the use of different methods for improving the accuracy of age estimation according to the actual situation. This paper reviews current research of age estimation based on dentin-pulp complex, so as to provide reference for related research.
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Affiliation(s)
- G Chu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an 710004, China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Z Y Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an 710004, China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - H Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an 710004, China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - C X Yan
- College of Forensic Science, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - T Chen
- College of Forensic Science, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Y C Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an 710004, China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, Xi'an 710004, China
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13
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Kleinert A, Kleinert L, Ozimirska M, Chałas R. Endodontium - together or separately? Folia Morphol (Warsz) 2018; 77:409-415. [PMID: 29345716 DOI: 10.5603/fm.a2018.0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/02/2018] [Accepted: 01/02/2018] [Indexed: 11/25/2022]
Abstract
Endodontium, otherwise referred to as pulp-dentin complex or endodont. This term includes two tooth tissues: dentin and pulp, which constitute a structural and functional unity. These tissues have a huge, inseparable influence on each other - the pulp (inter alia) nourishes the dentine, while the dentin forms a protective barrier for the pulp. They develop from the papillary tissue (Latin: papilladentis) from mesenchymal tissue. Nevertheless, in clinical practice this structural-functional complex is often treated as two separate tissues, and not as a whole. Adequate knowledge of the structure, function and protective mechanisms of the endodontium produces successful results in the treatment. The appropriate choice and application of the therapeutic methods and materials to the dentin secures vitality of both tissues of this complex.
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Affiliation(s)
| | | | | | - R Chałas
- Chair and Department of Conservative Dentistry with Endodontics, Medical University of Lublin, Karmelicka 7, 20-081 Lublin, Poland.
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14
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Jung JK, Gwon GJ, Neupane S, Sohn WJ, Kim KR, Kim JY, An SY, Kwon TY, An CH, Lee Y, Kim JY, Ha JH. Bortezomib Facilitates Reparative Dentin Formation after Pulp Access Cavity Preparation in Mouse Molar. J Endod 2017; 43:2041-2047. [PMID: 29032823 DOI: 10.1016/j.joen.2017.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/12/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate in vitro and ex vivo roles of bortezomib, a proteasome inhibitor that binds to the active site of the 26S proteasome, in tertiary dentin formation. METHODS We established pulpal access cavity preparation that was treated with or without bortezomib before direct pulp capping with a calcium hydroxide-based material. We also analyzed bone morphogenetic protein (Bmp)- and Wnt-related signaling molecules using quantitative real-time polymerase chain reaction. RESULTS In the short-term observation period, the bortezomib-treated pulp specimens showed the period-altered immunolocalization patterns of nestin, CD31, and myeloperoxidase, whereas the control specimens did not. The bortezomib-treated group showed a complete dentin bridge with very few irregular tubules after 42 days. The micro-computed tomographic images showed more apparent dentin bridge structures in the treated specimens than were in the controls. Quantitative real-time polymerase chain reaction analysis showed up-regulated Bmp and Wnt. CONCLUSIONS These findings revealed that treatment with 1 μmol/L bortezomib induced reparative dentin formation that facilitated the maintenance of the integrity of the remaining pulpal tissue via early vascularization and regulation of Bmp and Wnt signaling.
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Affiliation(s)
- Jae-Kwang Jung
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Gi-Jeong Gwon
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Sanjiv Neupane
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Wern-Joo Sohn
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Ki-Rim Kim
- Department of Dental Hygiene, Kyungpook National University, Daegu, Korea
| | - Ji-Youn Kim
- Department of Dental Hygiene, Gachon University College of Health Science, Incheon, Seoul, Korea
| | - Seo-Young An
- Department of Oral and Maxillofacial Radiology, Kyungpook National University, Daegu, Korea
| | - Tae-Yub Kwon
- Department of Dental Materials, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Chang-Hyeon An
- Department of Oral and Maxillofacial Radiology, Kyungpook National University, Daegu, Korea
| | - Youngkyun Lee
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea
| | - Jae-Young Kim
- Department of Biochemistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea.
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Institute for Hard Tissue and Bone Regeneration, Kyungpook National University, Daegu, Korea.
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Ahmed VKS, Krishnaswamy NR, Thavarajah R. Miniscrew implant fracture and effects of such retained tip on dentin-pulp complex: a histological report. Dent Traumatol 2015; 32:161-5. [PMID: 26382020 DOI: 10.1111/edt.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 01/21/2023]
Abstract
Miniscrew implants provide an excellent orthodontic anchorage. Besides the clinical benefits, miniscrew implants cause minor discomforts and in certain instances poses problematic complications. Damage to the adjacent tooth structure is the most feared complication of miniscrew implant placement, while fracture of miniscrew implants is the rarest. Miniscrew fracture could occur either during its placement or during its removal. An unusual case report is presented of a miniscrew implant tip fracture following root contact while attempting to remove it. This report highlights the effect of such miniscrew implant fracture on the dentin-pulp complex. The present case is probably the first to give direct histological evidence in humans that a miniscrew fracture or a retained miniscrew implant tip along the dentin/cementum without obvious miniscrew implant penetration could elicit pulp changes. Therefore this case report emphasizes the fact that prior to placing miniscrew implant, clinicians should have acquired proper training and adequate skills in terms of MSI placement and management of fractured MSI.
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Affiliation(s)
- Valai Kasim Shakeel Ahmed
- Department of Orthodontics and Dentofacial Orthopedics, Ragas Dental College and Hospital, Uthandi, Chennai, India
| | | | - Rooban Thavarajah
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Uthandi, Chennai, India
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Abstract
Biomarkers are functional elements at the cellular or molecular level, playing important roles in health and disease. The dentin-pulp complex of the tooth houses several biomarkers at different stages of development, and a lack of these biomarkers results in developmental disorders. Furthermore, biomarkers play a very important role in the pathogenesis of dental caries, pulpal and periapical pathoses in two ways - they are essential elements in the pathological process and their detection helps in accurate diagnosis of the pathological condition. The aim of this paper is to review the literature regarding the important biomarkers involved in the development of the dentin-pulp complex and in the pathological conditions involving the dentin-pulp complex.
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