Pulpitis is a common infective oral disease in clinical situations.The regulatory mechanisms of immune defense in pulpitis are still being investigated.Osteomodulin(OMD)is a small leucine-rich proteoglycan family memb...Pulpitis is a common infective oral disease in clinical situations.The regulatory mechanisms of immune defense in pulpitis are still being investigated.Osteomodulin(OMD)is a small leucine-rich proteoglycan family member distributed in bones and teeth.It is a bioactive protein that promotes osteogenesis and suppresses the apoptosis of human dental pulp stem cells(hDPSCs).In this study,the role of OMD in pulpitis and the OMD-induced regulatory mechanism were investigated.The OMD expression in normal and inflamed human pulp tissues was detected via immunofluorescence staining.Intriguingly,the OMD expression decreased in the inflammatory infiltration area of pulpitis specimens.The cellular experiments demonstrated that recombined human OMD could resist the detrimental effects of lipopolysaccharide(LPS)-induced inflammation.A conditional Omd knockout mouse model with pulpal inflammation was established.LPS-induced inflammatory impairment significantly increased in conditional Omd knockout mice,whereas OMD administration exhibited a protective effect against pulpitis.Mechanistically,the transcriptome alterations of OMD overexpression showed significant enrichment in the nuclear factor-κB(NF-κB)signaling pathway.Interleukin-1 receptor 1(IL1R1),a vital membrane receptor activating the NF-κB pathway,was significantly downregulated in OMD-overexpressing hDPSCs.Additionally,the interaction between OMD and IL1R1 was verified using co-immunoprecipitation and molecular docking.In vivo,excessive pulpal inflammation in Omd-deficient mice was rescued using an IL1R antagonist.Overall,OMD played a protective role in the inflammatory response via the IL1R1/NF-κB signaling pathway.OMD may optimize the immunomodulatory functions of hDPSCs and can be used for regenerative endodontics.展开更多
BACKGROUND The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear.AIM To explore the role of epinephrine in the treatment of pulp capping in patients with reversible...BACKGROUND The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear.AIM To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis.METHODS A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study.They were categorized into an observation group(n=50;treatment with adrenaline)and a control group(n=50;treatment with zinc oxide eugenol paste).The 24-h postoperative pain,regression time of gingival congestion and redness,clinical efficacy,and incidence of adverse reactions were compared between the groups.Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy.Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment.RESULTS A significant difference in 24-h postoperative pain was observed between the groups(P<0.05),with a higher proportion of grade I pain noted in the observation group than in the control group(P<0.01).The regression time of gingival congestion and swelling was lower in the observation group(2.61±1.44 d and 2.73±1.36 d,respectively)than in the control group(3.85±1.47 d and 4.28±1.61 d,respectively)(P<0.05).The 2-wk postoperative total effective rate was lower in the control group(80.00%)than in the observation group(94.00%)(P<0.05).The incidence of adverse reactions was not significantly different between the control(14.00%)and observation(12.00%)groups(P>0.05).The proportion of adrenaline usage was lower(P<0.05)and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group(P<0.05).Logistic multiple regression analysis revealed adrenaline as a protective factor(P<0.05)and anaerobic digestion by Streptococcus and F.nucleatum as risk factors for pulp capping in reversible pulpitis(P<0.05).CONCLUSION Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis,reducing pain and improving clinical symptoms safely.It is a protective factor for pulp capping,whereas Streptococcus and F.nucleatum are risk factors.Targeted measures can be implemented to improve clinical efficacy.展开更多
Summary: In order to understand the roles of nitric oxide (NO) in pulpalgia and pulpitis, the histochemistry of nitric oxide synthase (NOS) in the neurons of trigeminal ganglion in experimental pulpitis rat and human ...Summary: In order to understand the roles of nitric oxide (NO) in pulpalgia and pulpitis, the histochemistry of nitric oxide synthase (NOS) in the neurons of trigeminal ganglion in experimental pulpitis rat and human inflammatory dental pulp tissues were histochemically studied by NADPH diaphorase (NADPH D) techniques. Results showed that NADPH D positive neurons were scattered in rat trigeminal ganglions, but the sizes of positive neurons were not changed. None of NOS positive fibers was found in human normal and inflammatory dental pulp tissues. The results suggested that NOS in trigeminal ganglion might play an important role in sensory transmission and regulation of pulpalgia. The absence of NOS positive nerves in human pulp suggested that NO may not be related to inflammatory stimulation and transmission in dental pulp tissues.展开更多
Objective: to analyze the clinical application of targeted nursing in the treatment of endodontic patients. Methods: 102 patients with pulpitis were selected for investigation and analysis in our hospital from May 201...Objective: to analyze the clinical application of targeted nursing in the treatment of endodontic patients. Methods: 102 patients with pulpitis were selected for investigation and analysis in our hospital from May 2018 to March 2019. The patients were divided into 2 groups with 51 cases in each group. The control group adopted the traditional routine nursing method. The study group was given targeted care. The final nursing results of the two groups were analyzed. Results: there was no difference in the preoperative pulp pain score between the control group and the study group (P > 0.05). The pulp pain score of the control group at 7 days after operation and the pulp pain score at 30 days after operation were significantly higher than those of the study group (P < 0.05). Conclusion: in the endodontic treatment of pulpitis, the targeted nursing plan should be the first choice. This plan is worthy of clinical application and popularization.展开更多
Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament （PDL） injection system to the local soft tissues as the primary technique in endodontic access to mandibular posteri...Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament （PDL） injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth： the premolar group （PM, z2=38）, first molar group （FM, n=66）, and second molar group （SM, n=58）. All the patients received computer-controlled PDL injection with 4% articaine and 1 ＇ 100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups （92.1%, 53.0%, 93.1%, respectively; 2 X =34.3, P〈0.01）. Both the PM and SM groups showed higher success rates than that of the FM group （v=l, f=16.73, P〈0.01, v=l, Z = 4.5, X2 2 P〈0.01）. No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups. Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.展开更多
BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only ...BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only a few studies have been conducted on palatal root canal variations.Herein,we report the presence of two separate root canals in a palatal root of the maxillary first molar.CASE SUMMARY A 39-year-old woman complained of pain in the maxillary right region for 1 year,which recently worsened.Clinical examination revealed a poorly restored right maxillary first molar and caries detected at the filling marginal.Cold and heat test results indicated severe pain in the right maxillary first molar.The patient was diagnosed with irreversible pulpitis,and subsequently,root canal treatment(RCT)was performed.In total,five root canals were found in the maxillary first molar,including two separate root canals in the palatal root.RCT was successfully performed using an endodontic microscope and cone-beam computed tomography(CBCT).The CBCT image revealed a vertucci type I canal morphology in the distobuccal root,while the MB and palatal root canals were typeⅣ.At the 1-mo follow-up,the maxillary first molar was completely asy-mptomatic,and the X-ray results indicated a successful RCT.Finally,the ceramic crown restoration was performed.CONCLUSION An endodontic microscope and CBCT are useful in effectively identifying and treating root canal variations.展开更多
Pulpitis,an inflammatory disease of dental pulp tissues,ultimately results in the loss of pulp defense properties.Existing clinical modalities cannot effectively promote inflamed pulp repair.Oxidative stress is a majo...Pulpitis,an inflammatory disease of dental pulp tissues,ultimately results in the loss of pulp defense properties.Existing clinical modalities cannot effectively promote inflamed pulp repair.Oxidative stress is a major obstacle inhibiting pulp repair.Due to their powerful antioxidative capacity,mesenchymal stem cell-derived small extracellular vesicles(MSC-sEVs)exhibit potential for treating oxidative stress-related disorders.However,whether MSC-sEVs shield dental pulp tissues from oxidative damage is largely unknown.Here,we showed that dental follicle stem cell-derived sEVs(DFSC-sEVs)have antioxidative and prohealing effects on a rat LPS-induced pulpitis model by enhancing the survival,proliferation and odontogenesis of H_(2)O_(2)-injured dental pulp stem cells(DPSCs).Additionally,DFSC-sEVs restored the oxidative/antioxidative balance in DPSC mitochondria and had comparable effects on ameliorating mitochondrial dysfunction with the mitochondrion-targeted antioxidant Mito-Tempo.To improve the efficacy of DFSC-sEVs,we fabricated an intelligent and injectable hydrogel to release DFSC-sEVs by combining sodium alginate(SA)and the ROS sensor RhB-AC.The newly formed SA-RhB hydrogel efficiently encapsulates DFSC-sEVs and exhibits controlled release of DFSC-sEVs in a HClO/ClO^(-)concentration-dependent manner,providing a synergistic antioxidant effect with DFSC-sEVs.These results suggest that DFSC-sEVs-loaded SA-RhB is a promising minimally invasive treatment for pulpitis by enhancing tissue repair in the pulp wound microenvironment.展开更多
基金supported by grants from the National Natural Science Foundation of China (82071104)Science and Technology Commission of Shanghai Municipality (23XD1434200/22Y21901000)+9 种基金Shanghai Hospital Development Center(SHDC12022120)National Clinical Research Center for Oral Diseases (NCRCO2021-omics-07)Shanghai Clinical Research Center for Oral Diseases (19MC1910600)Major and Key Cultivation Projects of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine (JYZP006)Shanghai’s Top Priority Research Center (2022ZZ01017)CAMS Innovation Fund for Medical Sciences (2019-I2M-5-037)Fundamental research program funding of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine(JYZZ237)Eastern Talent Plan Leading Project (BJZH2024001)partly supported by the Shanghai Ninth People’s Hospital affiliated with Shanghai Jiao Tong University,School of Medicine(JYJC202223)Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases (14DZ2260300)
文摘Pulpitis is a common infective oral disease in clinical situations.The regulatory mechanisms of immune defense in pulpitis are still being investigated.Osteomodulin(OMD)is a small leucine-rich proteoglycan family member distributed in bones and teeth.It is a bioactive protein that promotes osteogenesis and suppresses the apoptosis of human dental pulp stem cells(hDPSCs).In this study,the role of OMD in pulpitis and the OMD-induced regulatory mechanism were investigated.The OMD expression in normal and inflamed human pulp tissues was detected via immunofluorescence staining.Intriguingly,the OMD expression decreased in the inflammatory infiltration area of pulpitis specimens.The cellular experiments demonstrated that recombined human OMD could resist the detrimental effects of lipopolysaccharide(LPS)-induced inflammation.A conditional Omd knockout mouse model with pulpal inflammation was established.LPS-induced inflammatory impairment significantly increased in conditional Omd knockout mice,whereas OMD administration exhibited a protective effect against pulpitis.Mechanistically,the transcriptome alterations of OMD overexpression showed significant enrichment in the nuclear factor-κB(NF-κB)signaling pathway.Interleukin-1 receptor 1(IL1R1),a vital membrane receptor activating the NF-κB pathway,was significantly downregulated in OMD-overexpressing hDPSCs.Additionally,the interaction between OMD and IL1R1 was verified using co-immunoprecipitation and molecular docking.In vivo,excessive pulpal inflammation in Omd-deficient mice was rescued using an IL1R antagonist.Overall,OMD played a protective role in the inflammatory response via the IL1R1/NF-κB signaling pathway.OMD may optimize the immunomodulatory functions of hDPSCs and can be used for regenerative endodontics.
基金The study was reviewed and approved by Anhui Jieshou People's Hospital Institutional Review Board,No.2019-11-001.
文摘BACKGROUND The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear.AIM To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis.METHODS A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study.They were categorized into an observation group(n=50;treatment with adrenaline)and a control group(n=50;treatment with zinc oxide eugenol paste).The 24-h postoperative pain,regression time of gingival congestion and redness,clinical efficacy,and incidence of adverse reactions were compared between the groups.Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy.Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment.RESULTS A significant difference in 24-h postoperative pain was observed between the groups(P<0.05),with a higher proportion of grade I pain noted in the observation group than in the control group(P<0.01).The regression time of gingival congestion and swelling was lower in the observation group(2.61±1.44 d and 2.73±1.36 d,respectively)than in the control group(3.85±1.47 d and 4.28±1.61 d,respectively)(P<0.05).The 2-wk postoperative total effective rate was lower in the control group(80.00%)than in the observation group(94.00%)(P<0.05).The incidence of adverse reactions was not significantly different between the control(14.00%)and observation(12.00%)groups(P>0.05).The proportion of adrenaline usage was lower(P<0.05)and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group(P<0.05).Logistic multiple regression analysis revealed adrenaline as a protective factor(P<0.05)and anaerobic digestion by Streptococcus and F.nucleatum as risk factors for pulp capping in reversible pulpitis(P<0.05).CONCLUSION Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis,reducing pain and improving clinical symptoms safely.It is a protective factor for pulp capping,whereas Streptococcus and F.nucleatum are risk factors.Targeted measures can be implemented to improve clinical efficacy.
文摘Summary: In order to understand the roles of nitric oxide (NO) in pulpalgia and pulpitis, the histochemistry of nitric oxide synthase (NOS) in the neurons of trigeminal ganglion in experimental pulpitis rat and human inflammatory dental pulp tissues were histochemically studied by NADPH diaphorase (NADPH D) techniques. Results showed that NADPH D positive neurons were scattered in rat trigeminal ganglions, but the sizes of positive neurons were not changed. None of NOS positive fibers was found in human normal and inflammatory dental pulp tissues. The results suggested that NOS in trigeminal ganglion might play an important role in sensory transmission and regulation of pulpalgia. The absence of NOS positive nerves in human pulp suggested that NO may not be related to inflammatory stimulation and transmission in dental pulp tissues.
文摘Objective: to analyze the clinical application of targeted nursing in the treatment of endodontic patients. Methods: 102 patients with pulpitis were selected for investigation and analysis in our hospital from May 2018 to March 2019. The patients were divided into 2 groups with 51 cases in each group. The control group adopted the traditional routine nursing method. The study group was given targeted care. The final nursing results of the two groups were analyzed. Results: there was no difference in the preoperative pulp pain score between the control group and the study group (P > 0.05). The pulp pain score of the control group at 7 days after operation and the pulp pain score at 30 days after operation were significantly higher than those of the study group (P < 0.05). Conclusion: in the endodontic treatment of pulpitis, the targeted nursing plan should be the first choice. This plan is worthy of clinical application and popularization.
文摘Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament （PDL） injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth： the premolar group （PM, z2=38）, first molar group （FM, n=66）, and second molar group （SM, n=58）. All the patients received computer-controlled PDL injection with 4% articaine and 1 ＇ 100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups （92.1%, 53.0%, 93.1%, respectively; 2 X =34.3, P〈0.01）. Both the PM and SM groups showed higher success rates than that of the FM group （v=l, f=16.73, P〈0.01, v=l, Z = 4.5, X2 2 P〈0.01）. No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups. Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.
基金Supported by The Health Discipline Construction Project in Pudong New Area,No.PWYts2021-20.
文摘BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only a few studies have been conducted on palatal root canal variations.Herein,we report the presence of two separate root canals in a palatal root of the maxillary first molar.CASE SUMMARY A 39-year-old woman complained of pain in the maxillary right region for 1 year,which recently worsened.Clinical examination revealed a poorly restored right maxillary first molar and caries detected at the filling marginal.Cold and heat test results indicated severe pain in the right maxillary first molar.The patient was diagnosed with irreversible pulpitis,and subsequently,root canal treatment(RCT)was performed.In total,five root canals were found in the maxillary first molar,including two separate root canals in the palatal root.RCT was successfully performed using an endodontic microscope and cone-beam computed tomography(CBCT).The CBCT image revealed a vertucci type I canal morphology in the distobuccal root,while the MB and palatal root canals were typeⅣ.At the 1-mo follow-up,the maxillary first molar was completely asy-mptomatic,and the X-ray results indicated a successful RCT.Finally,the ceramic crown restoration was performed.CONCLUSION An endodontic microscope and CBCT are useful in effectively identifying and treating root canal variations.
基金supported by the National Natural Science Foundation of China(No.82370943,82201037 and 81970925)the Young Elite Scientists Sponsorship Program by Guangzhou(QT-2023-030)Fundamental Research Funds for the Central Universities,Sun Yat-sen University(23qnpy157).
文摘Pulpitis,an inflammatory disease of dental pulp tissues,ultimately results in the loss of pulp defense properties.Existing clinical modalities cannot effectively promote inflamed pulp repair.Oxidative stress is a major obstacle inhibiting pulp repair.Due to their powerful antioxidative capacity,mesenchymal stem cell-derived small extracellular vesicles(MSC-sEVs)exhibit potential for treating oxidative stress-related disorders.However,whether MSC-sEVs shield dental pulp tissues from oxidative damage is largely unknown.Here,we showed that dental follicle stem cell-derived sEVs(DFSC-sEVs)have antioxidative and prohealing effects on a rat LPS-induced pulpitis model by enhancing the survival,proliferation and odontogenesis of H_(2)O_(2)-injured dental pulp stem cells(DPSCs).Additionally,DFSC-sEVs restored the oxidative/antioxidative balance in DPSC mitochondria and had comparable effects on ameliorating mitochondrial dysfunction with the mitochondrion-targeted antioxidant Mito-Tempo.To improve the efficacy of DFSC-sEVs,we fabricated an intelligent and injectable hydrogel to release DFSC-sEVs by combining sodium alginate(SA)and the ROS sensor RhB-AC.The newly formed SA-RhB hydrogel efficiently encapsulates DFSC-sEVs and exhibits controlled release of DFSC-sEVs in a HClO/ClO^(-)concentration-dependent manner,providing a synergistic antioxidant effect with DFSC-sEVs.These results suggest that DFSC-sEVs-loaded SA-RhB is a promising minimally invasive treatment for pulpitis by enhancing tissue repair in the pulp wound microenvironment.
