Introduction: The endodontic management of necrotic permanent immature teeth is a challenge for the practitioner. These teeth are treated by apexification. However, because of the complications associated with this tr...Introduction: The endodontic management of necrotic permanent immature teeth is a challenge for the practitioner. These teeth are treated by apexification. However, because of the complications associated with this treatment, researchers have developed other therapies. Currently, a new technique called pulp revascularization has emerged. This technique allows the continuation of root completion thanks to a healthy tissue newly formed at the intra root canal level. Material and method: A literature search of articles dealing with pulp revascularization of immature permanent teeth was conducted using two types of search strategy, a literature search using keywords on databases and then a manual “bottom-up” search of references of previously identified articles. Results: 112 articles were identified based on inclusion and exclusion criteria. Discussion: This work showed that pulp revascularization is a new therapy that aims to restart root development on an immature permanent tooth. It is based on the principle of tissue engineering and uses the differentiation potential of stem cells. Conclusion: Currently, the literature values revascularization as it allows root development, sidewall thickening, apical closure and a decrease in periapical lesion and ensures a good sealing. Clinical and radiographic success rates appear to be encouraging, except that factors influencing treatment must be taken into consideration.展开更多
Dental pulp-dentin complex defects remain a major unresolved problem in oral medicines.Clinical therapeutic methods including root canal therapy and vital pulp therapy are both considered as conservative strategies,wh...Dental pulp-dentin complex defects remain a major unresolved problem in oral medicines.Clinical therapeutic methods including root canal therapy and vital pulp therapy are both considered as conservative strategies,which are incapable of repairing the pulpdentin complex defects.Although biomaterial-based strategies show remarkable progress in antibacterial,anti-inflammatory,and pulp regeneration,the important modulatory effects of nerves within pulp cavity have been greatly overlooked,making it challenging to achieve functional pulp-dentin complex regeneration.In this study,we propose an injectable bioceramicscontaining composite hydrogel in combination of Li-Ca-Si(LCS)bioceramics and gelatin methacrylate matrix with photocrosslinking properties.Due to the sustained release of bioactive Li,Ca and Si ions from LCS,the composite hydrogels possess multiple functions of promoting the neurogenic differentiation of Schwann cells,odontogenic differentiation of dental pulp stem cells,and neurogenesis-odontogenesis couples in vitro.In addition,the in vivo results showed that LCS-containing composite hydrogel can significantly promote the pulp-dentin complex repair.More importantly,LCS bioceramics-containing composite hydrogel can induce the growth of nerve fibers,leading to the re-innervation of pulp tissues.Taken together,the study suggests that LCS bioceramics can induce the innervation of pulp-dentin complex repair,offering a referable strategy of designing multifunctional filling materials for functional periodontal tissue regeneration.展开更多
BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its en...BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.展开更多
文摘Introduction: The endodontic management of necrotic permanent immature teeth is a challenge for the practitioner. These teeth are treated by apexification. However, because of the complications associated with this treatment, researchers have developed other therapies. Currently, a new technique called pulp revascularization has emerged. This technique allows the continuation of root completion thanks to a healthy tissue newly formed at the intra root canal level. Material and method: A literature search of articles dealing with pulp revascularization of immature permanent teeth was conducted using two types of search strategy, a literature search using keywords on databases and then a manual “bottom-up” search of references of previously identified articles. Results: 112 articles were identified based on inclusion and exclusion criteria. Discussion: This work showed that pulp revascularization is a new therapy that aims to restart root development on an immature permanent tooth. It is based on the principle of tissue engineering and uses the differentiation potential of stem cells. Conclusion: Currently, the literature values revascularization as it allows root development, sidewall thickening, apical closure and a decrease in periapical lesion and ensures a good sealing. Clinical and radiographic success rates appear to be encouraging, except that factors influencing treatment must be taken into consideration.
基金funded by the National Key R&D Program of China(2022YFC2405904)the National Natural Science Foundation of China(52272284,32225028)+1 种基金Joint Research Unit Plan of the Chinese Academy of Sciences(121631ZYLH20240014)the Science and Technology Commission of Shanghai Municipality(24520750100)。
文摘Dental pulp-dentin complex defects remain a major unresolved problem in oral medicines.Clinical therapeutic methods including root canal therapy and vital pulp therapy are both considered as conservative strategies,which are incapable of repairing the pulpdentin complex defects.Although biomaterial-based strategies show remarkable progress in antibacterial,anti-inflammatory,and pulp regeneration,the important modulatory effects of nerves within pulp cavity have been greatly overlooked,making it challenging to achieve functional pulp-dentin complex regeneration.In this study,we propose an injectable bioceramicscontaining composite hydrogel in combination of Li-Ca-Si(LCS)bioceramics and gelatin methacrylate matrix with photocrosslinking properties.Due to the sustained release of bioactive Li,Ca and Si ions from LCS,the composite hydrogels possess multiple functions of promoting the neurogenic differentiation of Schwann cells,odontogenic differentiation of dental pulp stem cells,and neurogenesis-odontogenesis couples in vitro.In addition,the in vivo results showed that LCS-containing composite hydrogel can significantly promote the pulp-dentin complex repair.More importantly,LCS bioceramics-containing composite hydrogel can induce the growth of nerve fibers,leading to the re-innervation of pulp tissues.Taken together,the study suggests that LCS bioceramics can induce the innervation of pulp-dentin complex repair,offering a referable strategy of designing multifunctional filling materials for functional periodontal tissue regeneration.
文摘BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.
