Tenascin and Fibronectin Expression after Pulp Capping with Different Hemostatic Agents: A Preliminary Study

Abstract

This study investigated the expression of extracellular matrix glycoproteins tenascin (TN) and fibronectin (FN) in pulp repair after capping with calcium hydroxide (CH), following different hemostasis protocols. Class I cavities with a pulp exposure were prepared in 42 human third molars scheduled for extraction. Different hemostatic agents (0.9% saline solution, 5.25% sodium hypochlorite and 2% chlorhexidine digluconate) were used and pulps were capped with CH cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed, and prepared for immunohistochemical technique. Hemostatic agents did not influence the expression of TN and FN. Both glycoproteins were found in the entire the pulp tissue and around collagen fibers, but were absent in the mineralized tissues. In the predentin, TN showed positive immunostaining and FN had a variable expression. Within 7 days post-treatment, a slightly more pronounced immunostaining on the pulp exposure site was observed. Within 30 days, TN and FN demonstrated a positive expression around the dentin barrier and at 90 days, a thin and linear expression of TN and FN was delimitating the reparative dentin. In conclusion, hemostatic agents did not influence TN and FN expression. Immunostaining for TN and FN was seen in different regions and periods, demonstrating their role in pulp repair.

Management of deep caries and the exposed pulp

“…A clinical trial investigated different methods of attaining haemostasis using either saline, NaOCl or chlorhexidine digluconate, prior to pulp capping with Ca(OH) 2 (Baldissera et al . ). It was shown that the various approaches did not affect the expression of bioactive glycoproteins related to repair (Baldissera et al .…”

“…It was shown that the various approaches did not affect the expression of bioactive glycoproteins related to repair (Baldissera et al . ). Furthermore, a randomized clinical trial has reported improved outcomes, if a disinfection agent such as NaOCl is applied the haemostatic protocol prior the application of a capping material (Tuzuner et al .…”

“…Practically, it is challenging to place a capping material on a wet surface such as a blood clot, whilst the presence of a blood clot has been linked to higher risk of post-operative infection (Schr€ oder & Granath 1972, Schr€ oder 1985. A clinical trial investigated different methods of attaining haemostasis using either saline, NaOCl or chlorhexidine digluconate, prior to pulp capping with Ca(OH) 2 (Baldissera et al 2013). It was shown that the various approaches did not affect the expression of bioactive glycoproteins related to repair (Baldissera et al 2013).…”

Influence of Poly-L-Lactic Acid Scaffold's Pore Size on the Proliferation and Differentiation of Dental Pulp Stem Cells

“…After differentiation, they are no longer able to multiply, which limits the regenerative capability of the pulp (1,2). Damage to dental pulp induces inflammatory responses with different degrees, corresponding to the nature and strength of injury (2). In pathological conditions, such as mild carious dentine lesions, odontoblastic activity is stimulated to elaborate reactionary dentine (3).…”

“…Also, there is an additional challenge to obtain an appropriated apical seal in IPT by applying CET (6). Currently, necrosed immature permanent teeth are subjected to multiple-visit apexification with Ca(OH) 2 -based materials to induce formation of an apical mineralized barrier (6,7). Despite the good prognosis, the long-term Ca(OH) 2 -based apexification presents a series of drawbacks (8), such as multiple treatment appointments, probable recontamination of the root canal system during treatment and increased brittleness of the root dentin, which increases the risk of future cervical root fractures (7).…”