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Vital pulp therapy (VPT) is deliberated as an ultraconservative/minimally invasive approach for the conservation of vital pulpal tissues, preservation of dental structure, and maintenance of tooth function in the oral cavity. In VPT, following the exposure of the dental pulp, the environment is prepared for the possible healing and probable refunctionalisation of pulpal connective tissue. However, to succeed in VPT, specific biomaterials are used to cover and/or dress the exposed pulp, lower the inflammation, heal the dental pulp, provoke the remaining odontoblastic cells, and induce the formation of a hard tissue, i.e., the dentinal bridge. It can be assumed that if the employed biomaterial is transferred to the target site using a specially designed micro-/nanosized local drug delivery system (LDDS), the biomaterial would be placed in closer proximity to the connective tissue, may be released in a controlled and sustained pattern, could properly conserve the remaining dental pulp and might appropriately enhance hard-tissue formation. Furthermore, the loaded LDDS could help VPT modalities to be more ultraconservative and may minimise the manipulation of the tooth structure as well as pulpal tissue, which could, in turn, result in better VPT outcomes.

This study describes a conservative approach to surgical management of root canal perforation in maxillary lateral incisors. A patient was referred for retreatment of a maxillary lateral incisor. Her chief complaint was discomfort in the buccal mucosa. Periapical radiography showed radiopaque material consistent with sealing material inside the root canal. A CBCT scan was acquired and revealed a gutta-percha cone outside the root canal, from the middle third to beyond the root apex. The imaging examination showed that the pulp cavity had not been affected. Thus, we took the clinical alternative of surgically managing the perforation by sealing with MTA, thereby avoiding endodontic treatment, and followed up with only clinical and radiographic control. At the two-year follow-up, after the surgical procedure to remove the extruded filling material, we observed bone tissue formation and positive response to pulp tests, without any clinical signs or symptoms. Root perforation is considered an unpleasant error in an operative procedure. Once a perforation is properly diagnosed, located, and sealed with biomaterial, a favorable prognosis is often achieved. MTA offered good sealing of the perforation, with promising results. Decision-making using the CBCT scan enabled us to adopt a conservative approach and favored more reliable treatment predictability.

Human dental pulp cells (HDPCs) play a vital role in dentin formation and reparative dentinogenesis, which indicated their potential application in regenerative medicine. However, HDPCs, which can only be obtained from scarce human pulp tissues, also have a limited lifespan in vitro, and stem cells usually lose their original characteristics over a large number of passages. To overcome these challenges, we successfully immortalized human dental pulp cells using the piggyBac system which was employed to efficiently overexpress the SV40 T-Ag, and we then comprehensively described the cell biological behavior. The immortalized human dental pulp cells (iHDPCs) acquired long-term proliferative activity and expressed most HDPC markers. The iHDPCs maintained multiple differentiation potential and could be induced to differentiate into chondrogenic, osteogenic, and adipogenic cells in vitro. We also proved that the iHDPCs gained a stronger ability to migrate than the primary cells, while apoptosis was inhibited. Furthermore, highly proliferative iHDPCs displayed no oncogenicity when subcutaneously implanted into athymic nude mice. Finally, iHDPCs exhibited odontogenic differentiation ability and secreted dentin sialophosphoprotein (DSPP) when combined with a beta-tricalcium phosphate scaffold and bone morphogenetic protein-2 (BMP2) in vivo. Conclusively, the established iHDPCs are a valuable resource for mechanistic study of dental pulp cell differentiation and dental pulp injury repair, as well as for applications in tooth regeneration.

This study was conducted to investigate whether dietary supplementation of black soldier fly (Hermetia illucens Linnaeus) pulp (BSFP) affects growth performance, antioxidant capacity and intestinal health of juvenile mirror carp (Cyprinus carpio var. specularis). A total of 270 juvenile mirror carp (13.68 ± 0.02 g) were randomly allotted to five dietary treatments, BSFP0, BSFP25, BSFP50, BSFP75 and BSFP100, in which BSFP was included in the basal diet at 0, 43.7, 87.3, 131 and 174.7 g/kg, respectively. Then, fish were fed to apparent satiation for 8 weeks. Fish growth performance and nutrient utilization were not different among the five groups (p > .05). Increasing BSFP dietary content significantly decreased whole‐body lipid content but increased kidney index (p .05). In conclusion, this study indicated that BSFP at the level below 131 g/kg could be added in diet of juvenile mirror carp without any negative effect on growth performance and intestinal health. Dietary BSFP inclusion at low levels decreased the whole‐body lipid content and increased the antioxidant activity of juvenile mirror carp.

Musa balbisiana Colla (Family: Musaceae), commonly known as banana and native to India and other parts of Asia, is very rich in nutritional value and has strong antioxidant potential. In the present study, we have developed Musa balbisiana (MB) fruit pulp powder and evaluated its cardioprotective effect in cardiac hypertrophy, which is often associated with inflammation and oxidative stress. An ultra-high-pressure liquid chromatography-mass spectrometer (UPLC-MS/MS) has been used for the detection and systematic characterization of the phenolic compounds present in Musa balbisiana fruit pulp. The cardioprotective effect of MB was evaluated in a rat model of isoproterenol- (ISO-) induced cardiac hypertrophy by subcutaneous administration of isoproterenol (5 mg/kg-1/day-1), delivered through an alzet minipump for 14 days. Oral administration of MB fruit pulp powder (200 mg/kg/day) significantly (p<0.001) decreased heart weight/tail length ratio and cardiac hypertrophy markers like ANP, BNP, β-MHC, and collagen-1 gene expression. MB also attenuated ISO-induced cardiac inflammation and oxidative stress. The in vivo data were further confirmed in vitro in H9c2 cells where the antihypertrophic and anti-inflammatory effect of the aqueous extract of MB was observed in the presence of ISO and lipopolysaccharide (LPS), respectively. This study strongly suggests that supplementation of dried Musa balbisiana fruit powder can be useful for the prevention of cardiac hypertrophy via the inhibition of inflammation and oxidative stress.

This study explored the effects of a silk fibroin-RGD-stem cell factor (SF-RGD-SCF) scaffold on the migration, proliferation, and attachment of stem cells of apical papilla (SCAPs). SF, SF-RGD, SF-SCF, and SF-RGD-SCF scaffolds were prepared, and laser confocal microscopy was used to observe the adhesion and growth status of SCAPs on the scaffolds. Furthermore, the numbers of SCAPs on the scaffolds were counted by a digestion counting method to evaluate their proliferation. Cells on the SF-RGD-SCF scaffold proliferated more than those on the other scaffolds and showed a more obvious tendency to migrate to the scaffold’s deep porous structure after 7 d seeding. Live/dead cell staining results showed that almost all the adhered cells were alive after 7 d. Furthermore, cell counting showed that the number of cells on the SF-RGD-SCF scaffold was highest after both 1 and 7 d ( P < 0.05 ). Thus, the SF-RGD-SCF composite is biocompatible and promotes the migration, adhesion, and proliferation of SCAPs, making it of potential use as a scaffold for cell-homing pulp regeneration.

The appropriate endodontic material should eliminate the infection and inflammation to provide a situation for regeneration and healing of pulp tissue besides biomineralization. Chrysin is one of the active ingredients of plant flavonoids, which has significant anti-inflammatory and antimicrobial properties. In the present study, this natural substance was evaluated for antioxidant, anti-inflammatory, and mineralization properties on dental pulp stem cells (DPSCs). SEM, FTIR, and TGA tests were used to determine the successful synthesize of chrysin-loaded scaffolds. The antimicrobial effects of the synthesized scaffold against Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis were assessed by the agar diffusion test and live/dead assay. The proliferation of DPSCs on these scaffolds was determined by the MTT assay, DAPI staining, and DNA extraction. Moreover, the antioxidant and anti-inflammation activity of chrysin-loaded scaffolds on inflamed DPSCs was evaluated. Alkaline phosphatase activity and Alizarin Red S Stain tests were done to evaluate the mineralization of DPSCs seeded on these scaffolds. The chrysin-loaded scaffolds reported antimicrobial effects against evaluated bacterial strains. The proliferation of DPSCs seeded on these scaffolds was increased significantly ( p < 0.05 ). The TNF α and DCF levels in inflamed DPSCs showed a significant decrease in the presence of chrysin-loaded scaffolds ( p < 0.05 ). The ALP activity and formation of mineralized nodules of DPSCs on these scaffolds were significantly increased compared with the control group ( p < 0.05 ). These results indicated that chrysin as an ancient therapeutic agent can accelerate the healing and regeneration of damaged pulp tissue, and this active ingredient can be a potential natural substance for regenerative endodontic procedures.

Background. The regeneration of dental pulp, especially in cases of pulp death of immature teeth, is the goal of the regenerative endodontic procedures (REPs) that are based on tissue engineering principles, consisting of stem cells, growth factors, and scaffolds. Photobiomodulation therapy (PBMT) showed to improve dental pulp regeneration through cell homing approaches in preclinical studies and has been proposed as the fourth element of tissue engineering. However, when a blood clot was used as a scaffold in one of these previous studies, only 30% of success was achieved. The authors pointed out the instability of the blood clot as the regeneration shortcoming. Then, to circumvent this problem, a new scaffold was developed to be applied with the blood clot. The hypothesis of the present study was that an experimental injectable chitosan hydrogel would facilitate the three-dimensional spatial organization of endogenous stem cells in dental pulp regeneration with no interference on the positive influence of PBMT. Methods. For the in vitro analysis, stem cells from the apical papilla (SCAPs) were characterized by flow cytometry and applied in the chitosan scaffold for evaluating adhesion, migration, and proliferation. For the in vivo analysis, the chitosan scaffold was applied in a rodent orthotopic dental pulp regeneration model under the influence of PBMT (660 nm; power output of 20 mW, beam area of 0.028 cm2, and energy density of 5 J/cm2). Results. The scaffold tested in this study allowed significantly higher viability, proliferation, and migration of SCAPs in vitro when PBMT was applied, especially with the energy density of 5 J/cm2. These results were in consonance to those of the in vivo data, where pulp-like tissue formation was observed inside the root canal. Conclusion. Chitosan hydrogel when applied with a blood clot and PBMT could in the future improve previous results of dental pulp regeneration through cell homing approaches.

Regenerative dentistry has paved the way for a new era for the replacement of damaged dental tissues. Whether the causative factor is dental caries, trauma, or chemical insult, the loss of the pulp vitality constitutes one of the major health problems worldwide. Two regenerative therapies were introduced for a fully functional pulp-dentin complex regeneration, namely, cell-based (cell transplantation) and cell homing (through revascularization or homing by injection of stem cells in situ or intravenously) therapies, with each demonstrating advantages as well as drawbacks, especially in clinical application. The present review is aimed at elaborating on these two techniques in the treatment of irreversibly inflamed or necrotic pulp, which is aimed at regenerating a fully functional pulp-dentin complex.

Intrusive luxation is a severe form of dental injury which causes damage to the pulp and supporting structures of a tooth because of its dislocation into the alveolar process. This paper shows the case of the reeruption of maxillary incisors accompanied by complicated crown fractures after 3 months. An 8-year-old boy patient was referred to the Department of Pedodontic Dentistry of Tehran University of Medical Science, Tehran, Iran, 18 hours after a fall at school. Clinical and radiographic examinations revealed intrusive luxation of both incisors with complicated crown fractures. Cervical pulpotomy is the treatment of choice for traumatized immature intruded teeth with pulp exposure. Two months later, the right central incisor teeth reerupted to a normal position and the final aesthetic restorations were done. The left central incisor was spontaneously repositioned with external root resorption, and the team decided to use interim medication (calcium hydroxide) in the root canal for stopping the process of resorption, and by the 9-month follow-up, the process of resorption had been stopped. An MTA plug was placed into the canal, and the final esthetic restorations were done.

The bone of yellowfin tuna (Thunnus albacares) contains high calcium and phosphor and can be synthesized into hydroxyapatite (HA). Due to its mineral content and similarity in chemical composition with human hard tissue, HA may have potency as a pulp capping material. The aim of this in vitro study was to evaluate the viability and alkaline phosphatase (ALP) activity of dental pulp cells after exposure to HA synthesized from yellowfin tuna bone (THA). Pulp cells were isolated from human-impacted third molar. To evaluate the viability of the pulp cells, the cells were cultured and exposed to various concentrations (6.25 to 200 μg/ml) of THA for 24, 48, and 72 hours. For ALP activity assay, pulp cells were cultured with odontoblastic differentiation media and exposed to THA for 7, 11, and 15 days. ALP activity was then determined using an ALP colorimetric assay kit. Results showed that the viability of the cells was more than 91% after exposure to various concentrations of THA and the cells demonstrated normal cell morphology in all observation periods. The ALP activity test revealed that groups exposed to THA for 7, 11, and 15 days showed higher ALP activity than the control groups ( p < 0.05 ). It is concluded that THA had no cytotoxic effect on pulp cells; furthermore, it enhanced proliferation as well as ALP activity of the pulp cells.

Human mesenchymal stem cells (hMSCs) are multipotent cells, which exhibit plastic adherence, express specific cell surface marker spectrum, and have multi-lineage differentiation potential. These cells can be obtained from multiple tissues. Dental tissue-derived hMSCs (dental MSCs) possess the ability to give rise to mesodermal lineage (osteocytes, adipocytes, and chondrocytes), ectodermal lineage (neurocytes), and endodermal lineages (hepatocytes). Dental MSCs were first isolated from dental pulp of the extracted third molar and till now they have been purified from various dental tissues, including pulp tissue of permanent teeth and exfoliated deciduous teeth, apical papilla, periodontal ligament, gingiva, dental follicle, tooth germ, and alveolar bone. Dental MSCs are not only easily accessible but are also expandable in vitro with relative genomic stability for a long period of time. Moreover, dental MSCs have exhibited immunomodulatory properties by secreting cytokines. Easy accessibility, multi-lineage differentiation potential, and immunomodulatory effects make dental MSCs distinct from the other hMSCs and an effective tool in stem cell-based therapy. Several preclinical studies and clinical trials have been performed using dental MSCs in the treatment of multiple ailments, ranging from dental diseases to nondental diseases. The present review has summarized dental MSC sources, multi-lineage differentiation capacities, immunomodulatory features, its potential in the treatment of diseases, and its application in both preclinical studies and clinical trials. The regenerative therapeutic strategies in dental medicine have also been discussed.

The analysis of the distribution of stress in dental organs is a poorly studied area. That is why computational mechanobiological analysis at the tissue level using the finite element method is very useful to achieve a better understanding of the biomechanics and the behaviour of dental tissues in various pathologies. This knowledge will allow better diagnoses, customize treatment plans, and establish the basis for the development of better restoration materials. In the present work, through the use of high-fidelity biomodels, computational mechanobiological analyses were performed on four molar models affected with four different degrees of caries, which are subjected to masticatory forces. With the analyses performed, it is possible to observe that the masticatory forces that act on the enamel are not transmitted to the dentin and to the bone and periodontal ligament to protect the nerve, as it happens in a healthy dental organ. With the presence of decay, these forces are transmitted partly to the pulp. The reactions to the external loads on the dental organs depend on the advances of the carious lesion that they present, since the distribution of stresses is different in a healthy tooth.

Rehabilitation of endodontically treated molar still remains a challenge. After endodontic treatment, molars lost their mechanical characteristics. In fact, they became fragile and that is in relation with the removal of pulp and surrounding dentin tissues. Endocrown which is a single partial restoration could be considered as a good alternative for restoring molars having large coronal destruction and presenting endodontic treatment difficulties. Through this work, we discuss the indication and use of endocrown to replace single crowns with intraradicular retention and to present a clinical case report of an endocrown-type restoration, fabricated from lithium disilicate ceramic (IPS e.Max CAD) in a mandibular first molar with extensive coronal destruction.

Dens evaginatus is a dental developmental anomaly that arises due to the folding of the inner dental epithelium that leads to the formation of an additional cusp or tubercle on the occlusal surface of the affected tooth. This accessory tissue projection may carry with it a narrow and constricted pulp horn extension. Occasionally, the tubercle easily fractures, thus leading to microexposure of the pulp horn and eventual pulp necrosis. Often, the pulp necrosis occurs at a time the root development of the affected tooth is incomplete. Apexification with calcium hydroxide and mineral trioxide aggregates has been the mainstay of treatment options before root canal obturation in immature nonvital permanent teeth. Lately, regenerative endodontics (maturogenesis) is becoming one of the preferred treatment modalities to manage such teeth. The current case highlights the possibility of a bioceramic material (EndoSequence Root Repair Material, BC RRM-Fast Set Putty™, Brasseler, USA) which supposed to provide apical root closure (apexification) and could also induce continuation of root growth (maturogenesis).

The sensory innervation of the dental pulp is essential for tooth function and protection. It is mediated by axons originating from the trigeminal ganglia and is spatio-temporally regulated. We have previously shown that the innervation of bioengineered teeth can be achieved only under immunosuppressive conditions. The aim of this study was to develop a model to determine the role of Semaphorin 3A (Sema3A) in the innervation of bioengineered teeth. We first analysed innervation of the dental pulp of mandibular first molars in newborn (postnatal day 0: PN0) mice deficient for Sema3A (Sema3A-/- ), a strong inhibitor of axon growth. While at PN0, axons detected by immunostaining for peripherin and NF200 were restricted to the peridental mesenchyme in Sema3A+/+ mice, they entered the dental pulp in Sema3A-/- mice. Then, we have implanted cultured teeth obtained from embryonic day-14 (E14) molar germs of Sema3A-/- mice together with trigeminal ganglia. The dental pulps of E14 cultured and implanted Sema3A-/- teeth were innervated, whereas the axons did not enter the pulp of E14 Sema3A+/+ cultured and implanted teeth. A "Membrane Targeting Peptide NRP1," suppressing the inhibitory effect of Sema3A, has been previously identified. The injection of this peptide at the site of implantation allowed the innervation of the dental pulp of bioengineered teeth obtained from E14 dental dissociated mesenchymal and epithelial cells reassociations of ICR mice. In conclusion, these data show that inhibition of only one axon repellent molecule, Sema3A, allows for pulp innervation of bioengineered teeth.

The aim of the present work is to identify the reactions of the dental organs to the different forces that occur during chewing and the transcendence of the union and contact maintained by the dental tissues. The study used a lower first molar biomodel with a real morphology and morphometry and consisting of the three dental tissues (enamel, dentin, and pulp) each with its mechanical properties. In it, two simulations were carried out, as would the process of chewing a food. One of the simulations considers the contact between the enamel and the dentin, and the other does not take it into account. The results obtained differ significantly between the simulations that consider contact and those that do not, establishing the importance of taking this contact into account. In this way, the theories that establish horizontal and lateral occlusion forces are present during the functional chewing process which are viable to be correct. The case studies carried out present not only the reasons for the failure of enamel but also the failure of the restoration materials used. This reflection will allow the development of more adequate materials, mechanical design of prostheses, implants, and treatment.

The selective caries removal is increasingly spreading in daily clinical practice because this minimally invasive technique treats deep carious lesion and decreases the risk of pulp exposure. This case report was aimed at describing the selective removal to firm dentin on the primary mandibular left first molar of a girl aged 7 years and 6 months. The Mineral Trioxide Aggregate (MTA Angelus™) was used as liner, and the tooth was definitively restored with resin-modified glass ionomer cement (Vitremer™). The clinical and radiographic following-up was performed at 6, 12, and 18 months after treatment. The treatment showed satisfactory results after 18-month following-up, suggesting that this minimally invasive approach for carious lesion removal can replace the total removal, when properly indicated. Notwithstanding, further randomized clinical trials with longer following-up periods are still necessary.

Preserving the vitality of the teeth is critical in maintaining the function and aesthetics of teeth during dental treatment. Dental pulp stem cells (DPSCs) are mesenchymal cells that are demonstrated to possess stem cell properties, such as self-renewal, proliferation, and pluripotency. DPSCs can be obtained through non-invasive procedure from the dental pulp and become potential resources for tissue regeneration. Neurotrophic factors are known to promote survival and growth of neurons. In the present study, we examined the expression of the glial cell-derived neurotrophic factor (GDNF) family ligands and receptors and characterized the intracellular localization of them in DPSCs. GDNF increased the migration of the DPSCs. In addition, we found that the AKT and MAPK pathways were downstream of GDNF in regulating the DPSC wound healing and migration. Our results indicate that neurotrophic factors play a role in dental pulp regeneration and may be potential novel therapies for post pulpotomy treatment in adult teeth.

Regeneration of the pulp-dentin complex with stem cells is a potential alternative to conventional root canal treatments. Human dental pulp stem cells (hDPSCs) have been extensively studied because of their ability to proliferate and differentiate into mineralized dental and non-dental tissues. Here we combined hDPSCs with two types of injectable poly-l-lactic acid (PLLA) microsphere with a nanofibrous or smooth surface to form bioactive injectable aggregates, and examined their ability to promote pulp regeneration in the root canal in an in vivo model. We investigated the biocompatibility, biosafety and odontogenic potential of fibrous (F-BIM) and smooth bioactive injectable microspheres (S-BIM) in vitro and in vivo. Our results demonstrated that PLLA microspheres and hDPSCs were able to form bioactive injectable aggregates that promoted dentin regeneration in both in vitro and in vivo models. Our results suggest that F-BIM and S-BIM may induce dentinogenesis upon in vivo grafting, and propose that the potential usefulness of the microsphere-hDPSC aggregates described here should be evaluated in clinical settings. Copyright © 2017 John Wiley & Sons, Ltd.

Regenerating dentin and preserving pulp vitality are the two key targets for the treatment of dental pulp exposure. Calcium hydroxide (CH), the widely used capping agent, may induce potential tunnel defect in reparative dentin and cause inflammation or even necrosis in pulp tissues. This study aimed to produce a novel pulp capping agent with better bioactivities. Treated dentin matrix (TDM) paste (TDMP) was fabricated consisting of TDM powder and aqueous TDM extract. The chemical and biological characteristics of TDMP were investigated, and its effect on the odontogenic differentiation of dental pulp stem cells explored at gene and protein level; the therapeutic effect for pulp exposure in miniature swine was further verified. TDMP possessed better biocompatibility with neutral pH value, significantly promoted the proliferation of dental pulp stem cells, and enhanced the gene and protein expressions of alkaline phosphatase, bone sialoprotein, dentin sialoprotein etc., compared with CH. In vivo pulp capping using TDMP presented the formation of continuous reparative dentin bridge thicker and denser than CH group. Moreover, pulp tissues under TDMP capping sites showed relatively slight angiectasis than those induced by CH. TDMP could achieve both dentin regeneration and vital pulp conservation, and might serve as a feasible substitute for CH in dental pulp repair procedure. Copyright © 2017 John Wiley & Sons, Ltd.

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth’s exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

The current study evaluated the immunomodulatory effects of Carica papaya pulp and seeds methanol (MeOH) extracts on mice infected with Listeria monocytogenes. Gas chromatography-mass spectrometry analysis identified 10 active constituents in C. papaya seed MeOH extract and 10 compounds in C. papaya pulp MeOH extract. The experimental animals were divided into negative control (G1) group, positive control (G2) group, pulp extract treated (G3) group, and seed extract treated (G4) group. After infection of animals (G2, G3, and G4), treatments were started for 3 weeks. Estimation of the immunological parameters showed a marked decrease in IgM levels and an increase in IgG levels in the treated groups (G3 and G4) compared with those in G2. The proinflammatory cytokines (IL-10, IL-12, IL-1β, IL-6, and TGF-β1) were decreased in the treated groups (G3 and G4) compared with those in G2. Nitric oxide levels were also decreased, and the percentages of phagocytosis increased compared with those of G2. The results demonstrated the immunomodulatory and anti-inflammatory effects of C. papaya pulp and seeds MeOH extracts. PRACTICAL APPLICATIONS: Based on the antioxidant and antibacterial activities exhibited by the pulp and seed MeOH extracts investigated in this study, Carica papaya might be considered as a natural source of phytochemicals that could be utilized in novel foods and pharmaceuticals. Further investigation are needed to identify and purify compounds that might be responsible for the observed effects.

Success in root canal treatment demands a thorough knowledge of usual root canal anatomy and its variations pertaining to every tooth. Variations in root canal anatomy are often accompanied by complex orientation of pulp tissues making a thorough mechanical and chemical debridement a challenge. Inability to treat such complexities often leads to endodontic failure. Upon a quick review of the literature, it has been noted that very few root canal complexities in maxillary canines have been reported. To be a successful clinician, one must be aware of such rare anatomical instances in maxillary canines. Based on possible branching of the root canal system, root canal configurations of permanent teeth were divided into eight different types by Vertucci. The classification included single to three separate root canals. This case report presents a permanent right maxillary canine which is single rooted having a single canal orifice and a root canal dividing into two canals (buccal and palatal) at the middle third of the root and then joining at the apical third, before exiting with a single apical foramen (Vertucci type III).

The pulpotomy with pulp capping is aimed at retaining vital pulp with reparative dentin formation. Vascular endothelial growth factor (VEGF) plays a crucial role in dentin regeneration; however, its constant administrations in the human body is still problematic. Chitosan was widely studied as an effective carrier to deliver bioactive molecules in regenerative medicine. In this study, we conducted a chitosan/β-glycerophosphate (CS/β-GP) hydrogel as a VEGF-sustained release system and explored its effects on dental pulp stem cells (DPSCs). CS/β-GP hydrogel was manufactured using a sol-gel method. SEM assay showed the spongy and porous microstructure of the lyophilized hydrogels. DPSCs cultured in the CS/β-GP hydrogel kept adhesion and vitality. CCK-8 assay tested the promoted proliferation activity of DPSCs on the hydrogel. Besides, the added VEGF protein could continually release from VEGF/CS/β-GP hydrogel. The VEGF/CS/β-GP hydrogel could promote the odontogenic differentiation of DPSCs better than VEGF treatment without hydrogel. Our results suggested that CS/β-GP hydrogel could continually release VEGF and contribute to odontogenic differentiation of DPSCs, thus may become a potential carrier of bioactive molecules in pulp capping therapy.

The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.

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.

Dentin dysplasia type I (DDI) is an autosomal-dominant genetic disorder resulting from dentin defects. The molecular basis of DDI remains unclear. DDI exhibits unique characteristics with phenotypes featuring obliteration of pulp chambers and diminutive root, thus providing a useful model for understanding the genetics of tooth formation. Using a large Chinese family with 14 DDI patients, we mapped the gene locus responsible for DDI to 3p26.1-3p24.3 and further identified a missense mutation, c.353C>A (p.P118Q) in the SSUH2 gene on 3p26.1, which co-segregated with DDI. We showed that SSUH2 (p.P118Q) perturbed the structure and significantly reduced levels of mutant (MT) protein and mRNA compared with wild-type SSUH2. Furthermore, MT P141Q knock-in mice (+/- and -/-) had a unique partial obliteration of the pulp cavity and upregulation or downregulation of six major genes involved in odontogenesis: Dspp, Dmp1, Runx2, Pax9, Bmp2, and Dlx2. The phenotype of missing teeth was determined in zebrafish with morpholino gene knockdowns and rescued by injection of normal human mRNA. Taken together, our observations demonstrate that SSUH2 disrupts dental formation and that this novel gene, together with other odontogenesis genes, is involved in tooth development.

This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.

Mesenchymal stem cells (MSCs) can be isolated from dental tissues, such as pulp and periodontal ligament; the dental apical papilla (DAP) is a less-studied MSC source. These dental-derived MSCs are of great interest because of their potential as an accessible source for cell-based therapies and tissue-engineering (TE) approaches. Much of the interest regarding MSCs relies on the trophic-mediated repair and regenerative effects observed when they are implanted. TGFβ3 is a key growth factor involved in tissue regeneration and scarless tissue repair. We hypothesized that human DAP-derived MSCs (hSCAPs) can produce and secrete TGFβ3 in response to micro-environmental cues. For this, we encapsulated hSCAPs in different types of matrix and evaluated TGFβ3 secretion. We found that dynamic changes of cell-matrix interactions and mechanical stress that cells sense during the transition from a monolayer culture (two-dimensional, 2D) towards a three-dimensional (3D) culture condition, rather than the different chemical composition of the scaffolds, may trigger the TGFβ3 secretion, while monolayer cultures showed almost 10-fold less secretion of TGFβ3. The study of these interactions is provided as a cornerstone in designing future strategies in TE and cell therapy that are more efficient and effective for repair/regeneration of damaged tissues. Copyright © 2015 John Wiley & Sons, Ltd.

Aim. (1) The aim of the clinical study revolves around the accurate diagnosis, proper case selection, and the management of acute irreversible pulpitis in permanent molars with closed apices using conservative and economical treatment modalities like vital pulpotomies with regenerative approaches over conventional root canal procedures. (2) To evaluate the use of autologous substances such as platelet concentrates and calcium silicate based materials in promoting the healing and regeneration of the inflamed pulp.Summary. Vital pulpotomy was performed on 5 carious involved, permanent molars diagnosed with acute irreversible pulpitis in 17- to 22-year-old patients. Taking into consideration the patient’s age and the condition of the underlying pulp tissue, PRF pulpotomy was planned in view of preserving the vitality of the intact radicular pulps. Regenerative procedures with second generation blood matrices were chosen to encourage the recovery of the inflamed pulps. The systematic follow-up examinations performed at 3, 6, 9, 12, 18, 22, and 24 months revealed a successful clinical and radiological outcome. Within the limits of the present clinical study and correlating the success across the treated clinical cases, we safely conclude the potential scope of regenerative pulpotomy approaches in acute irreversible pulpitis in adult permanent teeth.

One of the causes of dental pulpitis is lipopolysaccharide- (LPS-) induced inflammatory response. Following pulp tissue inflammation, odontoblasts, dental pulp cells (DPCs), and dental pulp stem cells (DPSCs) will activate and repair damaged tissue to maintain homeostasis. However, when LPS infection is too serious, dental repair is impossible and disease may progress to irreversible pulpitis. Therefore, the aim of this study was to examine whether static magnetic field (SMF) can attenuate inflammatory response of dental pulp cells challenged with LPS. In methodology, dental pulp cells were isolated from extracted teeth. The population of DPSCs in the cultured DPCs was identified by phenotypes and multilineage differentiation. The effects of 0.4 T SMF on DPCs were observed through MTT assay and fluorescent anisotropy assay. Our results showed that the SMF exposure had no effect on surface markers or multilineage differentiation capability. However, SMF exposure increases cell viability by 15%. In addition, SMF increased cell membrane rigidity which is directly related to higher fluorescent anisotropy. In the LPS-challenged condition, DPCs treated with SMF demonstrated a higher tolerance to LPS-induced inflammatory response when compared to untreated controls. According to these results, we suggest that 0.4 T SMF attenuates LPS-induced inflammatory response to DPCs by changing cell membrane stability.

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.

Introduction. To present and discuss the results of five clinical cases treated using the revascularization protocol, showing clinical and radiographic monitoring. Necrotic immature teeth with periapical pathology present a challenge to dentists because the techniques used in apexification leave the tooth susceptible to fracture, since the root does not continue to grow in length and the canal walls are thin. Revascularization has emerged as an alternative to resolve these deficiencies, enabling apical closure, continued development of the roots, and thickening of the dentinal walls. Case Series. Five clinically and radiographically diagnosed necrotic immature permanent teeth were treated using revascularization treatment. The therapeutic protocol involved accessing the pulp chamber; irrigating copiously with NaOCl; applying a triple antibiotic paste as intracanal dressing; then provisionally sealing it. After 3 weeks, the canal was cleaned and the apex irritated with a size 15 K-file to induce blood that would serve as a scaffold for pulp revascularization. MTA was used to seal the chamber before final obturation (composite or metallic crown). Conclusion. The discussion of the results leads to debate about different restorative materials and other published protocols.

Endodontic regeneration shows promise in treating dental pulp diseases; however, no suitable scaffolds exist for pulp regeneration. Acellular natural extracellular matrix (ECM) is a favorable scaffold for tissue regeneration since the anatomical structure and ECM of the natural tissues or organs are well-preserved. Xenogeneic ECM is superior to autologous or allogeneic ECM in tissue engineering for its unlimited resources. This study investigated the characteristics of decellularized dental pulp ECM from swine and evaluated whether it could mediate pulp regeneration. Dental pulps were acquired from the mandible anterior teeth of swine 12 months of age and decellularized with 10% sodium dodecyl sulfate (SDS) combined with Triton X-100. Pulp regeneration was conducted by seeding human dental pulp stem cells into decellularized pulp and transplanted subcutaneously into nude mice for 8 weeks. The decellularized pulp demonstrated preserved natural shape and structure without any cellular components. Histological analysis showed excellent ECM preservation and pulp-like tissue, and newly formed mineralized tissues were regenerated after being transplanted in vivo. In conclusion, decellularized swine dental pulp maintains ECM components favoring stem cell proliferation and differentiation, thus representing a suitable scaffold for improving clinical outcomes and functions of teeth with dental pulp diseases.

Summary Polypterus senegalus is a freshwater fish belonging to the earliest diverged group of the actinopterygian lineage with currently living representatives. Its dentition has been well characterized in terms of distribution and shape of teeth in different life stages. Additionally, structural features of the first-generation teeth have been briefly described. However, at present it is not known how the primary dentition is patterned and if this pattern is similar to that found in juveniles. In this preliminary study, to answer this question we investigate the tooth pattern of a larval P. senegalus based on serial sections and 3D reconstructions, and compare dental features in larvae and juveniles. Polypterus senegalus passive apterolarvae possess a well developed primary dentition. Dentigerous bones develop either prior to the teeth (dentary, retroarticular), or as an attachment site concomitant with the expanding dentition (coronoid 1). Most teeth are attached and erupted, and thus considered functional, and their pulp houses a blood vessel, two features that contrast with earlier findings. The primary teeth do not display a level of maturation that could reflect a particular order of development. New teeth are added anteriorly, and likely also posteriorly, to allow the tooth row to grow to keep pace with the growing jaw. Replacement teeth are absent at this stage. Thus, the pattern observed in juveniles, with alternate (odd and even) positions displaying a different level of tooth maturation, is not present in the larva. Most strikingly, in the larva, considerable symmetry exists between apparently random patterns on both dentaries, eliciting intriguing questions on left-right control to be addressed in future studies.

Objective. The aim of this study is to evaluate the effectiveness of Nd:YAP laser to seal dentinal tubules at different parameters.Material and Methods. 24 caries-free human wisdom impacted molars were used. The crowns were sectioned transversally in order to totally expose the dentin. The smear layer was removed by a 1 min application of EDTA. Each surface was divided into four quadrants, but only three quadrants were irradiated at a different output power setting (irradiation speed: 1 mm/sec; optical fiber diameter: 320 µm; tangential incidence of beam and in noncontact mode). Samples were smeared with a graphite paste prior to laser irradiation. All specimens were sent for SEM analysis. Pulp temperature increases in additional twenty teeth were measured by a thermocouple.Results. Morphological changes in dentin surfaces depend on the value of used energy density. Higher energy densities (2 W–4 W; 200–400 mJ; pulse duration: 100 m sec.; and 10 Hz) induce higher dentin modifications. Our results confirmed that Nd:YAP laser irradiations can lead to total or partial occlusion of dentin tubules without provoking fissures or cracks. Measurements of pulp temperature increases showed that Nd:YAP laser beam can be considered as harmless for pulp vitality for following irradiation conditions: 2 W (200 mJ) to 4 W (400 mJ) with an irradiation speed of 1 mm/sec; fiber diameter: 320 micrometers; 10 Hz; pulse duration: 100 m sec; noncontact mode and in tangential incidence to exposed dentin. The perpendicular incidence of the laser beam on exposed dentin may injure pulp vitality even at low output power of 3 W.Conclusions. Nd:YAP laser beam was able to seal the dentin tubules without damaging dentinal surfaces and without harming pulp vitality. Nd:YAP laser is effective and may be safely used for futurein vivotreatments of dentinal hypersensitivity under certain conditions.

Conservation of deciduous teeth with pulp alterations caused by caries and trauma is a major therapeutic challenge in pediatric dentistry as a result of the internal anatomy and life cycle characteristic. It is essential that the root canal procedures sanitizers have a performance in eliminating bacterial. In this context, antimicrobial photodynamic therapy (PAT) is promising and emerging as adjuvant therapy in an attempt to eliminate the microorganisms persistent to chemi-mechanical preparation. Since there is presence of oxygen in cells, photosensitizer activated by light can react with molecules in its vicinity by electrons’ or hydrogen’s transfer, leading to microorganism death. This paper reports the case of 4-year-old patient, female, with early childhood caries. The proposed endodontic treatment incuded chemomechanical treatment allied to PAT in the decontamination of root canals using methylene blue dye 50 μg/mL during 3–5 minutes and 40 J/cm2as energy density, taking into account the need for tissue penetration and effectiveness of PAT inside the dentinal tubules.

Stem cells isolated from exfoliated deciduous teeth (SHEDs) are highly capable of proliferation and differentiation, and they represent good cell sources for mesenchymal stem cell- (MSC-) mediated dental tissue regeneration, but the supply of SHEDs is limited. A previous study found that stem cells could be isolated from inflamed tissues, but it is unknown whether primary dental pulp diagnosed with irreversible pulpitis might contain stem cells with appropriate tissue regeneration capacity. In this study, we aimed to isolate stem cells from both inflamed pulps of deciduous teeth (SCIDs) and SHEDs from Chinese children and to compare their proliferation and differentiation potentials. Our results showed that SCIDs were positive for cell surface markers, including CD105, CD90, and CD146, and they had high proliferation ability and osteogenic, adipogenic, and chondrogenic differentiation potentials. There was no significant difference in proliferation and differentiation potentials between SCIDs and SHEDs. The mRNA of inflammatory factors, including IL-1β, IL-6, and TNF-α, was expressed at similar levels in SCIDs and SHEDs, but SCIDs secreted more TNF-αprotein. In conclusion, ourin vitroresults showed that SCIDs have proliferation and differentiation potentials similar to those of SHEDs. Thus, SCIDs represent a new potentially applicable source for MSC mediated tissue regeneration.

An electrospun nanocomposite fibrous material holds promise as a scaffold, as well as a drug-delivery device to aid in root maturogenesis and the regeneration of the pulp–dentine complex. A novel three-dimensional (3D) nanocomposite scaffold composed of polydioxanone (PDS II®) and halloysite nanotubes (HNTs) was designed and fabricated by electrospinning. Morphology, structure, mechanical properties and cell compatibility studies were carried out to evaluate the effects of HNTs incorporation (0.5–10 wt% relative to PDS w/w). Overall, a 3D porous network was seen in the different fabricated electrospun scaffolds, regardless of the HNT content. The incorporation of HNTs at 10 wt% led to a significant (p

Dental pulp/dentine complex regeneration is indispensable to the construction of biotissue-engineered tooth roots and represents a promising approach to therapy for irreversible pulpitis. We used a tissue-engineering method based on odontogenic stem cells to design a three-dimensional (3D) and scaffold-free stem-cell sheet-derived pellet (CSDP) with the necessary physical and biological properties. Stem cells were isolated and identified and stem cells from root apical papilla (SCAPs)-based CSDPs were then fabricated and examined. Compact cell aggregates containing a high proportion of extracellular matrix (ECM) components were observed, and the CSDP culture time was prolonged. The expression of alkaline phosphatase (ALP), dentine sialoprotein (DSPP), bone sialoprotein (BSP) and runt-related gene 2 (RUNX2) mRNA was higher in CSDPs than in cell sheets (CSs), indicating that CSDPs have greater odonto/osteogenic potential. To further investigate this hypothesis, CSDPs and CSs were inserted into human treated dentine matrix fragments (hTDMFs) and transplanted into the subcutaneous space in the backs of immunodeficient mice, where they were cultured in vivo for 6 weeks. The root space with CSDPs was filled entirely with a dental pulp-like tissue with well-established vascularity, and a continuous layer of dentine-like tissue was deposited onto the existing dentine. A layer of odontoblast-like cells was found to express DSPP, ALP and BSP, and human mitochondria lined the surface of the newly formed dentine-like tissue. These results clearly indicate that SCAP-CSDPs with a mount of endogenous ECM have a strong capacity to form a heterotopic dental pulp/dentine complex in empty root canals; this method can be used in the fabrication of bioengineered dental roots and also provides an alternative treatment approach for pulp disease. Copyright © 2013 John Wiley & Sons, Ltd.

Synthetic octacalcium phosphate (OCP) has been suggested to be a useful biomaterial for the regeneration of hard tissues, including bone. However, it remains unknown whether OCP induces dentine formation by dental pulp. We investigated biomineralization of dental pulp exposed to synthetic OCP in vitro and in vivo. When dental pulp was exposed directly to OCP, rapid formation of reparative dentine (RD) was induced and expression of dentine sialoprotein synthesis was observed in dental pulp adjacent to newly synthesized RD. OCP inhibited the proliferation of rat pulp cells and also promoted their odontoblastic differentiation in vitro, as alkaline phosphatase activity, mineralization of pulp cells and the expression level of dentine sialophosphoprotein were enhanced. Direct contact between OCP and pulp cells is required for OCP to exhibit its effects in vitro. The expression level of Runx2, a transcription factor whose downregulation is closely related to odontoblast differentiation, was downregulated in pulp cells cultured with OCP. Structural changes of OCP during culture were determined by Fourier transform infrared spectroscopy. OCP tended to be converted to carbonate hydroxyapatite after incubation with or without pulp cells, which may be analogous to biological apatite crystals. Taken together, our data suggest that synthetic OCP supports RD formation by dental pulp and downregulation of Runx2 may be involved in that stimulatory activity. Furthermore, OCP-apatite conversion is involved in this stimulatory capacity of OCP.

Internal root resorption (IRR) is a particular category of pulp disease characterized by the loss of dentine as a result of the action of clastic cells stimulated by pulpal inflammation. This review article explains the etiology, the prevalence of IRR, and, in addition to the clinical data, the contribution of the three-dimensional imaging (CBCT) to the diagnosis, the clinical decision, and the therapeutic management of IRR. The authors discussed the various therapeutic options including the orthograde or retrograde fillings of the root canal resorption area. Root canal treatment remains the treatment of choice of internal root resorption as it removes the granulation tissue and blood supply of the clastic cells. The authors describe with different clinical cases the modern endodontic techniques including optical aids, ultrasonic improvement of chemical debridement, and the use of alternative materials such as calcium silicate combined with thermoplastic filling (warm gutta-percha). In these conditions, the prognosis of the conservative treatment of internal resorptions, even if root walls are perforated, is good.

Dentin dysplasia is a rare inherited autosomal dominant disorder characterized by rootless teeth. We hereby report a case of dentin dysplasia type 1b with typical radiographic findings: short and blunt roots, pulpal obliteration, horizontal/crescent shaped radiolucencies in pulp chambers, and multiple periapical radiolucencies. However, the present case did not show the autosomal dominant pattern of inheritance and the patient also exhibited concurrent dental fluorosis, transposition of 13 and 14, and multiple cusps in maxillary first molars. Moreover, on careful review of previously documented cases of radiographs of dentin dysplasia, the horizontal/crescent shaped radiolucencies in pulp chambers are a rare finding, which is characteristically seen in the present case.

Objectives.The aim of thisin vitrostudy was to assess thermal changes on tooth tissues during light exposure using two different LED curing units. The hypothesis was that no temperature increase could be detected within the dental pulp during polymerization irrespective of the use of a composite resin or a light-curing unit.Methods.Caries-free human first molars were selected, pulp residues were removed after root resection, and four calibrated type-J thermocouples were positioned. Two LED lamps were tested; temperature measurements were made on intact teeth and on the same tooth during curing of composite restorations. The data was analyzed by one-way analysis of variance (ANOVA), Wilcoxon test, Kruskal-Wallis test, and Pearson’sχ2. After ANOVA, the Bonferroni multiple comparison test was performed.Results.Polymerization data analysis showed that in the pulp chamber temperature increase was higher than that without resin. Starlight PRO, in the same condition of Valo lamp, showed a lower temperature increase in pre- and intrapolymerization. A control group (without composite resin) was evaluated.Significance.Temperature increase during resin curing is a function of the rate of polymerization, due to the exothermic polymerization reaction, the energy from the light unit, and time of exposure.

Recent advances in biomaterial science and tissue engineering technology have greatly spurred the development of regenerative endodontics. This has led to a paradigm shift in endodontic treatment from simply filling the root canal systems with biologically inert materials to restoring the infected dental pulp with functional replacement tissues. Currently, cell transplantation has gained increasing attention as a scientifically valid method for dentin-pulp complex regeneration. This multidisciplinary approach which involves the interplay of three key elements of tissue engineering—stem cells, scaffolds, and signaling molecules—has produced an impressive number of favorable outcomes in preclinical animal studies. Nevertheless, many practical hurdles need to be overcome prior to its application in clinical settings. Apart from the potential health risks of immunological rejection and pathogenic transmission, the lack of a well-established banking system for the isolation and storage of dental-derived stem cells is the most pressing issue that awaits resolution and the properties of supportive scaffold materials vary across different studies and remain inconsistent. This review critically examines the classic triad of tissue engineering utilized in current regenerative endodontics and summarizes the possible techniques developed for dentin/pulp regeneration.

Purpose. The aim of the present study was to evaluate the clinical response of the pulp in teeth with chronic periodontitis. Methods. Consecutive patients who had been admitted to the Clinics of Periodontology and fulfilled the criteria of inclusion were enrolled from January to December 2007. Ninety-eight single-root teeth from 27 patients with chronic periodontitis were evaluated clinically with regard to clinical attachment level (CAL), probing depth (PD), and gingival recession (REC). After periodontal measurements, Pulpal Sensitivity (PS) was evaluated with the use of a cooling stimulus test. Data was analyzed with Student’s t test and contingency C coefficient. Results. Teeth that responded positively to PS test presented lower values of CAL (7.8 ± 2.8 mm), PD (5.0 ± 2.3 mm), and REC (2.8 ± 1.8 mm) in comparison to those that responded negatively (CAL = 12.0 ± 2.2 mm; PD = 7.9 ± 1.6 mm; REC = 4.1 ± 2.4 mm) (P<0.01, Student’s t test). In addition, significant correlations were observed between PS and periodontal parameters. Conclusions. Within the limits of this study, it could be suggested that the progression of periodontitis may significantly influence the negative pulpal response.

Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. It typically affects permanent maxillary lateral incisors, central incisors, and premolars. This paper describes the root canal treatment of Oehlers’ type II dens invaginatus in maxillary left lateral incisors. A 16-year-old boy presented to the Faculty of Dentistry, University of Kocaeli, to receive his dental treatments. During the caries removal, the pulp was exposed then anendodontic treatment was initiated. Two canals, one of which represented the invagination, were instrumented, irrigated, and then obturated with a lateral condensation technique.

Three specific orthodontic tooth movement genes, that is,FCRL1,HSPG2, andLAMB2were detected at upper first premolar (with appliance) dental pulp tissue by using GeneFishing technique as compared to lower first premolar (without appliance). These three differentially expressed genes have the potential as molecular markers during orthodontic tooth movement by looking at molecular changes of pulp tissue.

A computational method has been developed for stress analysis of a restored tooth so that experimental effort can be minimized. The objectives of this study include (i) developing a method to create a 3D FE assembly model for a restored tooth based on CT images and (ii) conducting stress analysis of the restored tooth using the 3D FE model established. To build up a solid computational model of a tooth, a method has been proposed to construct a 3D model from 2D CT-scanned images. Facilitated with CAD tools, the 3D tooth model has been virtually incorporated with a Class II MO restoration. The tooth model is triphasic, including the enamel, dentin, and pulp phases. To mimic the natural constraint on the movement of the tooth model, its corresponding mandible model has also been generated. The relative high maximum principal stress values were computed at the surface under loading and in the marginal region of the interface between the restoration and the tooth phases.