Pulp capping materials modulate the balance between inflammation and regeneration

Abstract

The interrelations between inflammation and regeneration are of particular significance within the dental pulp tissue inextensible environment. Recent data have demonstrated the pulp capacity to respond to insults by initiating an inflammatory reaction and dentin pulp regeneration. Different study models have been developed in vitro and in vivo to investigate the initial steps of pulp inflammation and regeneration. These include endothelial cell interaction with inflammatory cells, stem cell interaction with pulp fibroblasts, migration chambers to study cell recruitment and entire human tooth culture model. Using these models, the pulp has been shown to possess an inherent anti-inflammatory potential and a high regeneration capacity in all teeth and at all ages. The same models were used to investigate the effects of tricalcium silicate-based pulp capping materials, which were found to modulate the pulp anti-inflammatory potential and regeneration capacity. Among these, resin-containing materials such as TheraCal ® shift the pulp response towards the inflammatory reaction while altering the regeneration process. On the opposite, resin-free materials such as Biodentine TM have an anti-inflammatory potential and induce the pulp regeneration capacity. This knowledge contradicts the new tendency of developing resin-based calcium silicate hybrid materials for direct pulp capping. Additionally, it would allow investigating the modulatory effects of newly released pulp capping materials on the balance between tissue inflammation and regeneration. It would also set the basis for developing future capping materials targeting these processes.

Bio-Inductive Materials in Direct and Indirect Pulp Capping—A Review Article

“…It can be stated that compared with calcium silicates, resin-containing materials are not fully consistent with the spirit of DPC. On the contrary, calcium silicate materials such as Biodentine and MTA shift the balance towards regeneration, resulting in successful clinical outcomes [138]. However, a recent in vivo study concluded that ACTIVA BioACTIVE BASE/LINER exhibited excellent biocompatibility and healing for rat subcutaneous tissues in comparison with CSMs (MTA-HP and iRoot BP Plus) [139].…”

Evaluation of Chitosan Hydrogel for Sustained Delivery of VEGF for Odontogenic Differentiation of Dental Pulp Stem Cells

“…Numerous investigations have concerned that the biological behaviors of DPSCs could be affected and amplified by extracellular environment [35]. Nowadays, an increasing focus on the design of new materials has emerged which are capable of driving DPSC migration and differentiation in dental therapy [36]. Among these, the CS/β-GP hydrogel has been widely used in drug delivery or tissue engineering systems for its biodegradability, biocompatibility, and antibacterial property [37].…”

Diagnostic biomarker candidates for pulpitis revealed by bioinformatics analysis of merged microarray gene expression datasets

“…Different therapies for pulp disease can be selected according to the evaluation of pulp inflammation. Given the importance of tooth preservation, vital pulp therapies such as pulp capping, pulpotomy, and stepwise excavation of caries may be more appropriate than root canal treatment under some circumstances [8]. Currently, guided by the criteria of the American Association of Endodontists (AAE), medical history and clinical examination are the main methods used to evaluate pulp inflammation severity, considering information such as pain quality and history and responses to pulp sensitivity tests [9].…”