Pulpal Response to Early Dental Caries

Brännström, M; Lind, Per

doi:10.1177/00220345650440050701

Cited by 104 publications

(39 citation statements)

References 2 publications

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“…114,115 Although several species of bacteria have been identified, there is no absolute correlation with clinical signs and symptoms; and it is noteworthy that the pulp may become inflamed long before the bacteria physically reach the pulp. 103 Superficial caries in pits and fissures may cause pulp inflammation. 118 Substances such as bacterial toxins, enzymes, antigens, chemotoxins, organic acids and products of tissue destruction may diffuse through the dentinal tubules to cause pulp irritation.…”

Section: Bacteriamentioning

confidence: 99%

An overview of the dental pulp: its functions and responses to injury

Yu¹,

Abbott²

2007

Australian Dental Journal

230

158

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The dental pulp is a unique tissue and its importance in the long-term prognosis of the tooth is often ignored by clinicians. It is unique in that it resides in a rigid chamber which provides strong mechanical support and protection from the microbial rich oral environment. If this rigid shell loses its structural integrity, the pulp is under the threat of the adverse stimuli from the mouth, such as caries, cracks, fractures and open restoration margins, all of which provide pathways for micro-organisms and their toxins to enter the pulp. The pulp initially responds to irritation by becoming inflamed and, if left untreated, this will progress to pulp necrosis and infection. The inflammation will also spread to the surrounding alveolar bone and cause periapical pathosis. The magnitude of pulp-related problems should not be underestimated since their most serious consequence is oral sepsis, which can be life threatening, and hence correct diagnosis and management are essential. Clinicians must have a thorough understanding of the physiological and pathological features of the dental pulp as well as the biological consequences of treatment interventions.

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Section: Bacteriamentioning

confidence: 99%

An overview of the dental pulp: its functions and responses to injury

Yu¹,

Abbott²

2007

Australian Dental Journal

230

158

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“…However, sections are very thick and preclude the use of transillumination to analyse tooth crystal structure [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Histological preparation of teeth and tooth growth

Williamson¹

2015

Oral Biol Dent

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“…A chronic pulpal inflammation under caries is likely elicited by bacterial antigens that diffuse into the pulp through dentinal tubules (2,3,14). Immunohistological studies of dental pulps under shallow caries have revealed a lesion that is restricted almost exclusively to T cells, with CD8 ϩ T cells predominating (9, 14).…”

mentioning

confidence: 99%

Cytokine Induction byStreptococcus mutansand Pulpal Pathogenesis

2000

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Chronic pulpal inflammation under caries appears to be elicited by bacterial antigens that diffuse into the pulp through dentinal tubules. This prompted the hypothesis that cytokines elicited by antigens from Streptococcus mutans, which frequently dominates shallow lesions, could play a major role in eliciting the initial T-cell response in the pulp. To test this, we examined the ability of S. mutans to stimulate T cells and elicit cytokines and used Lactobacillus casei, which often predominates in deep carious lesions where B cells and plasma cells predominate, as a control. In addition, the presence of cytokines in the pulp was analyzed at the mRNA level. S. mutans elicited potent gamma interferon (IFN-␥) responses in peripheral blood mononuclear cell cultures and reduced the CD4/CD8 ratio by promoting CD8 ؉ T cells. Multiple inflammatory cytokine mRNAs (IFN-␥, interleukin 4 [IL-4], and IL-10) were detected in human dental pulp. A higher prevalence of IFN-␥ (67%) than IL-4 (19%) or IL-10 (29%) was obtained in shallow caries, suggesting a type 1 cytokine mechanism in early pulpitis where S. mutans predominates. In contrast, in deep caries no differences in cytokine frequency were observed. Furthermore, the presence of IFN-␥ in the pulp correlated with the presence of S. mutans. The extraordinary induction of type 1 cytokines and the preferential activation of CD8 ؉ T cells by S. mutans offers an explanation for the etiology of the CD8 ؉ T-cell-dominant lesion in early pulpitis and suggests that S. mutans may have a major impact on the initial lesion and pulpal pathology.Although the dental pulp is equipped with cells of the immune system (16), the immune response in the pulp to caries pathogens is poorly understood. A chronic pulpal inflammation under caries is likely elicited by bacterial antigens that diffuse into the pulp through dentinal tubules (2,3,14). Immunohistological studies of dental pulps under shallow caries have revealed a lesion that is restricted almost exclusively to T cells, with CD8 ϩ T cells predominating (9, 14). As the carious lesion enlarges and invades the inflamed dental pulp, CD8 ϩ T cells continue to dominate but CD4 ϩ T cells, B cells, and plasma cells appear in substantial numbers (9,14). We are interested in understanding why the immune cell types shift during caries progression. We reasoned that antigens associated with the caries pathogens may preferentially elicit different immune cell types during caries invasion. The dominant organisms in the lesions, which likely elicit host responses, shift from Streptococcus mutans in shallow caries to Lactobacillus casei in deep carious lesions.A type 1 cytokine response is defined as promoting cellmediated response, with gamma interferon (IFN-␥) as the prototypic cytokine and a clear association with interleukin 2 (IL-2), tumor necrosis factor beta, and IL-12. A type 2 response is characterized as promoting one or more B-cell activities, with IL-4 as the prototypic cytokine and an association with IL-5, IL-6, IL-10, and IL-13 (18). This ...

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Pulpal Response to Early Dental Caries

Cited by 104 publications

References 2 publications

An overview of the dental pulp: its functions and responses to injury

An overview of the dental pulp: its functions and responses to injury

Histological preparation of teeth and tooth growth

Cytokine Induction byStreptococcus mutansand Pulpal Pathogenesis

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