This study was designed to investigate the pulpal effects of the glass ionomer cement. (Lining cement, G-C Co. Japan) For this purpose, 10 cats were selected, and Class V cavities were prepared on canines of the cats. One experimental group was filled with glass ionomer cement and the other group was filled with zinc phosphate cement . (G-C Co, Japan) The animals of the experimental and control group were sacrificed at 1,2,3,4,6, weeks after the experiment. For comparison of reparative dentin formation pattern in direction of the pulpal and fractured lateral surface, each of them was observed with scanning electron microscope. The findings led to the following conclusions; 1. Reparative dentin of the glass ionomer cement and zinc phosphate cement filling groups were formed on the internal surface of dentin as the shape of hemispherical and spherical with a rough surface. 2. Some of reparative dentin of the glass ionomer cement filling group was started to form at 1 week after experiment, and at 6 weeks after experiment, it had been increased gradually in number and size. 3. Reparative dentin of zinc phosphate cement filling group was formed vigorously, however, gradually was decreased in number and size, and disappeared at 6 weeks after experiment. 4. During the formation of reparative dentin, peritubular dentins were indistinguishable. 5. The diameter of dentinal tubules of reparative dentin has been decreased, during the reparative dentin formed, and it became very irregularly at 6 weeks after experiment.
We investigated the pulpal response to direct pulp capping in rat molar teeth using mineral trioxide aggregate (MTA) and calcium hydroxide (CH). A palatal cavity was prepared in rat maxillary molar teeth. Either MTA or CH was placed on the exposed pulp and all cavities were restored with composite. Rats were sacrificed for histological evaluation after 12 hours and at 2, 7, 14 and 21 days. In both the MTA and CH groups, reparative dentin formation was clearly observed on histology after 14 days. The MTA-capped pulps were found to be mostly free from inflammation, and hard tissue of a tubular consistent barrier was observed. In contrast, in CH-capped teeth, excessive formation of reparative dentin toward residual pulp was evident. The pulpal cell response beneath the reparative dentin layer was examined by immunofluorescence using antibodies against DSP. After 2 days, a few DSP immunopositive cells, most of which showed a cuboidal shape, appeared beneath the predentin layer. At 7 days, DSP-immunopositive cells with columnar odontoblast-like cells were seen beneath the newly formed hard tissues. At 14 and 21 days, DSP was more abundant in the vicinity of the odontoblastic process along the dentinal tubules than in the mineralized reparative dentin. The CH group showed strong expression patterns in terms of DSP immunoreactivity. Our results thus indicate that MTA may be a more effective pulp capping material as it induces the differentiation of odontoblast-like cells and the formation of reparative dentin without the loss of residual pulp functions.
The purpose of this study was to investigate the pulpal responses of dental adhesive resins. A total of 40 cavities of the permanent healthy teeth from 4 dogs were prepared. In the experimental group, the cavities were etched for 1 minute with citric acid and filled with experimental resins (ie. Super-Bond C & B$^{(R)}$). In the control group, the cavities were filled with calcium hydroxide base materials (ie. Dycal$^{(R)}$) without etching. The dogs were sacrificed at one, two, three and four weeks after the time of filling and the specimens were routinely prepared and stained with Hematoxylin-Eosin. The microscopic findings were as follows: Infiltration of inflammatory cells was not observed in both experimental and control groups. Change in the odontoblastic layer was not observed in all control groups but severe swelling was observed in deep dental pulp tissue of the control two and three week cases. Pulp tissue was recovered with plenty of fibrous component in the control four week case and reparative dentin formation was not occurred in all cases. Slight changes of the odontoblastic layer beneath the cavity were observed in the experimental one week case. In experimental two and three week cases, swelling of deep pulp tissue was increased and localized reparative dentin formation was observed. In the experimental four week case, odontoblastic layer was recovered with regular appearance and fibrous component of the pulp was increased, but reparative dentin formation was not evident.
It is considered that etching solution or material itself of phosphoric ester cement will induce not a little pulpal irritation, if applied directly onto unsealed dentinal tubules. This study was designed to confirm above consideration by comparing two different conditions between $Ca(OH)_2$-based and non-$Ca(OH)_2$-based group. Posterior teeth of 15 male dogs were selected for this experiment. One experimental group was filled with cement after $Ca(OH)_2$-basing and enamel-etching, the other experimental group after enamel etching without $Ca(OH)_2$-basing. And both of two experimental groups were observed at 2 hours, 15 hours, 3 days, 1 week, 2 weeks, 4 weeks, and 6 weeks after filling. The findings reached to the following conclusions histologically. 1. In both groups, the damaged odontoblasts were atrophied and eventually disappeared. 2. In non-based group at early stage, odontoblasts were severely atrophied and defective areas were appeared between odontoblast cell layers. However, in based group, the odontoblasts were arranged slight irregularly. 3. In non-based group, a small number of undifferentiated cells below the odontoblast cell layers started to appear at 1 week after filling. However, in based group, the undifferentiated cells were appeared at 15 hours after filling. 4. In non-based group, formation of reparative dentin was not begun until late stage of experiment. However, in based group, formation of reparative dentin matrix was begun at 2 weeks after filling and very thickened reparative dentin was formed at 6 weeks after filling. 5. In odontoblast cell layers of both groups, dilated capillaries were observed. 6. Argyrophilic fibers were reticularly condensed in zone of Weil, and they were connected to the pulp tissue and dentin.
Objectives: The purpose of this study was to assess the ability of two new calcium silicate-based pulp-capping materials (Biodentine and BioAggregate) to induce healing in a rat pulp injury model and to compare them with mineral trioxide aggregate (MTA). Materials and Methods: Eighteen rats were anesthetized, cavities were prepared and the pulp was capped with either of ProRoot MTA, Biodentine, or BioAggregate. The specimens were scanned using a high-resolution micro-computed tomography (micro-CT) system and were prepared and evaluated histologically and immunohistochemically using dentin sialoprotein (DSP). Results: On micro-CT analysis, the ProRoot MTA and Biodentine groups showed significantly thicker hard tissue formation (p < 0.05). On H&E staining, ProRoot MTA showed complete dentin bridge formation with normal pulpal histology. In the Biodentine and BioAggregate groups, a thick, homogeneous hard tissue barrier was observed. The ProRoot MTA specimens showed strong immunopositive reaction for DSP. Conclusions: Our results suggest that calcium silicate-based pulp-capping materials induce favorable effects on reparative processes during vital pulp therapy and that both Biodentine and BioAggregate could be considered as alternatives to ProRoot MTA.
Purpose: Wnt signaling plays an essential role in the dental epithelium and mesenchyme during tooth morphogenesis. Deletion of the Wntless (Wls) gene in odontoblasts appears to reduce canonical Wnt activity, leading to inhibition of odontoblast maturation. However, it remains unclear if autonomous Wnt ligands are necessary for differentiation of dental pulp cells into odontoblast-like cells to induce reparative dentinogenesis, one of well-known feature of pulp repair to form tertiary dentin. Materials and Methods: To analyze the autonomous role of Wls for differentiation of dental pulp cells into odontoblast-like cells, we used primary dental pulp cells from unerupted molars of Wls-floxed allele mouse after infection with adenovirus for Cre recombinase expression to knockout the floxed Wls gene or control GFP expression. The differentiation of dental pulp cells into odontoblast-like cells was analyzed by quantitative real-time polymerase chain reaction. Result: Proliferation rate was significantly decreased in dental pulp cells with Cre expression for Wls knockout. The expression levels of Osterix (Osx), runt-related transcription factor 2 (Runx2), and nuclear factor I-C (Nfic) were all significantly decreased by 0.3-fold, 0.2-fold, and 0.3-fold respectively in dental pulp cells with Wls knockout. In addition, the expression levels of Bsp, Col1a1, Opn, and Alpl were significantly decreased by 0.7-fold, 0.3-fold, 0.8-fold, and 0.6-fold respectively in dental pulp cells with Wls knockout. Conclusion: Wnt ligands produced autonomously are necessary for proper proliferation and odontoblastic differentiation of mouse dental pulp cells toward further tertiary dentinogenesis.
Objectives: Direct pulp capping is a treatment for mechanically exposed pulp in which a biocompatible capping material is used to preserve pulpal vitality. Biocompatibility tests in animal studies have used a variety of experimental protocols, particularly with regard to the exposure site. In this study, pulp exposure on the occlusal and mesial surfaces of molar teeth was investigated in a rat model. Materials and Methods: A total of 58 maxillary first molars of Wistar rats were used. Forty molars were mechanically exposed and randomly assigned according to 3 factors: 1) the exposure site (occlusal or mesial), 2) the pulp-capping material (ProRoot White MTA or Bio-MA), and 3) 2 follow-up periods (1 day or 7 days) (n = 5 each). The pulp of 6 intact molars served as negative controls. The pulp of 12 molars was exposed without a capping material (n = 3 per exposure site for each period) and served as positive controls. Inflammatory cell infiltration and reparative dentin formation were histologically evaluated at 1 and 7 days using grading scores. Results: At 1 day, localized mild inflammation was detected in most teeth in all experimental groups. At 7 days, continuous/discontinuous calcified bridges were formed at exposure sites with no or few inflammatory cells. No significant differences in pulpal response according to the exposure site or calcium-silicate cement were observed. Conclusions: The location of the exposure site had no effect on rat pulpal healing. However, mesial exposures could be performed easily, with more consistent results. The pulpal responses were not significantly different between the 2 capping materials.
This study investigated the effects of laser irradiation on the exposed pulp and the possibility of direct pulp capping with the $CO_2$ laser. Results were obtained from the observation of the residual pulpal healing process. Class V cavities on 48 anterior teeth from 8 adult dogs were prepared and pulp chambers were intentionally opened with dental explorer. The control group consisted of 16 teeth. $Dycal^{(R)}$(Caulk Co., U.S.A.) was applied to exposed site once bleeding was stopped. Cavities were sealed with $I.R.M^{(R)}$. In the experimental group 1 (16 teeth), laser(LASERSAT $CO_2^{(R)}$, Satelec Co.) was irradiated on the exposed pulp. The laser procedure followed the manufacturers recommendations for the treatment of human pulp(1.5 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. In the experimental group 2 (16 teeth), laser was irradiated on the exposed pulp in a more powerful dosage(5.0 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. Two dogs were sacrificed immediately after experiment and the others were sacrificed at intervals of one, three, and eight weeks respectively. All teeth were routinely processed and the pulpal tissues and odontoblastic layers were observed by the light microscope. The results were as follows; 1. In the control group, the initial mild inflammation had improved to normal by week eight. An active formation of reparative dentin was observed at week three, and at week eight, a firm dentin bridge was present beneath the $Dycal^{(R)}$ with no inflammatory responses in the remaining pulp. 2. In the experimental group 1, immediately following irradiation, the superficial shape of the exposed pulp was crater-like. And it was lined with the coagulated layer, $60{\sim}70{\mu}m$ in width. Moderate inflammatory pulpal conditions existing at week one were improved to mild at week eight. And from the week three specimens, a reparative dentin formation was observed in the adjacent odontoblastic layer of the exposed site. A dentin bridge at the exposed site, however, did not form during the experimental period. 3. In the experimental group 2, the width of the coagulation layer lining the crater was $70{\sim}130{\mu}m$. Beneath the coagulated layer, severe inflammatory pulpal responses were observed at week one, and conditions did not improve during the experimental period.
This study summarizes the recent cutting-edge approaches for dentin regeneration that still do not offer adequate solutions. Tertiary dentin is formed when odontoblasts are directly affected by various stimuli. Recent preclinical studies have reported that stimulation of the Wnt/β-catenin signaling pathway could facilitate the formation of reparative dentin and thereby aid in the structural and functional development of the tertiary dentin. A range of signaling pathways, including the Wnt/β-catenin pathway, is activated when dental tissues are damaged and the pulp is exposed. The application of small molecules for dentin regeneration has been suggested as a drug repositioning approach. This study reviews the role of Wnt signaling in tooth formation, particularly dentin formation and dentin regeneration. In addition, the application of the drug repositioning strategy to facilitate the development of new drugs for dentin regeneration has been discussed in this study.
Background: This study was performed to provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs). Methods: Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials. Results: BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05). Conclusion: Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.
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