Exposed Pulp

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Pamela Denbesten - One of the best experts on this subject based on the ideXlab platform.

  • Matricellular molecules and odontoblast progenitors as tools for dentin repair and regeneration
    Clinical Oral Investigations, 2008
    Co-Authors: M. Goldberg, D Septier, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, S. Lacerda-pinheiro, C. Chaussain-miller, A. Veis, Pamela Denbesten
    Abstract:

    This review summarizes the in vivo experiments carried out by our group after implantation of bioactive molecules (matricellular molecules) into the Exposed Pulp of the first maxillary molar of the rat or the mandibular incisor of rats and mice. We describe the cascade of recruitment, proliferation and terminal differentiation of cells involved in the formation of reparative dentin. Cloned immortalized odontoblast progenitors were also implanted in the incisors and in vitro studies aimed at revealing the signaling pathways leading from undifferentiated progenitors to fully differentiated polarized cells. Together, these experimental approaches pave the way for controlled dentin regenerative processes and repair.

  • bioactive molecules stimulate tooth repair and regeneration
    Journal of Hard Tissue Biology, 2006
    Co-Authors: Michel E. Goldberg, D Septier, Sally Lacerdapinheiro, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, Kevin Tompkins, H Chardin, Pamela Denbesten
    Abstract:

    Dentin extracellular matrix proteins display multifunctional properties. Firstly, they participate to the mineralization processes either as promotors or as inhibitors of crystal nucleation or crystal growth. Secondly, they act as signaling molecules implicated in the differentiation of odontoblast progenitors. These molecules may be used to promote the recruitment of odontoblast progenitors, the proliferation and the final differentiation into functional odontoblast-like or osteoblast-like cells implicated in Pulp repair. This has been evaluated through a series of experiments carried out in vivo on the rat first maxillary molar and in vitro on odonto/osteo progenitors. Along this line, BMP7 (OP1) induced in the crown a fibrous osteodentin-like structure where unmineralized Pulp remnants were seen. In addition, the mesial root canal was totally filled with a homogeneous dentin-like structure. The bone sialoprotein (BSP) stimulated within one month the formation of a reparative dentinal bridge and the complete closure of the coronal Pulp with an atubular homogeneous reparative dentin. Dentonin, a peptide from MEPE, implantated into the Exposed Pulp produced more rapidly than the two previous molecules reparative mineralization in the coronal Pulp and also occlusion of the lumen of the root canal. Implanted in the Exposed Pulp, A+4 and A-4, two spliced amelogenin gene products, induce either the formation of a reparative dentinal bridge (A+4) or a more diffuse mineralization (A-4). The mechanisms of proliferation and differentiation were studied in parallel in an in vivo situation after implantation in the first maxillary molar of the rat, and in vitro on odontoblast progenitor cell lines. These molecules may contribute to Pulp repair and promote new strategies in dental therapies.

  • the impact of bioactive molecules to stimulate tooth repair and regeneration as part of restorative dentistry
    Dental Clinics of North America, 2006
    Co-Authors: Michel E. Goldberg, D Septier, Sally Lacerdapinheiro, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, Kevin Tompkins, H Chardin, Pamela Denbesten
    Abstract:

    After implantation in the Exposed Pulp, some molecules of the den-tin extracellular matrix induce the formation of a reparative dentinal bridge in the coronal Pulp. In some cases, total occlusion of the root canal also is observed. This is the case for bone sialoprotein, bone morphogenetic protein-7, Dentonin (a fragment from matrix extracellular phosphoglycoprotein), and two small amelogenin gene splice products (A+4 and A-4). Cells implicated in the reparative process are recruited, proliferate, and differentiate into osteoblast-like and odontoblast-like cells. The same results may be obtained by direct implantation of odontoblast progenitor cell into the Pulp.

Helena Fransson - One of the best experts on this subject based on the ideXlab platform.

  • European Society of Endodontology position statement: Management of deep caries and the Exposed Pulp.
    International endodontic journal, 2019
    Co-Authors: Henry F. Duncan, Kerstin M. Galler, Phillip Tomson, S Simon, I A El-karim, Rita Kundzina, Gabriel Krastl, T Dammaschke, Helena Fransson, Merete Markvart
    Abstract:

    This position statement on the management of deep caries and the Exposed Pulp represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Preserving the Pulp in a healthy state with sustained vitality, preventing apical periodontitis and developing minimally invasive biologically based therapies are key themes within contemporary clinical endodontics. The aim of this statement was to summarize current best evidence on the diagnosis and classification of deep caries and caries-induced Pulpal disease, as well as indicating appropriate clinical management strategies for avoiding and treating Pulp exposure in permanent teeth with deep or extremely deep caries. In presenting these findings, areas of controversy, low-quality evidence and uncertainties are highlighted, prior to recommendations for each area of interest. A recently published review article provides more detailed information and was the basis for this position statement (Bjorndal et al. 2019, International Endodontic Journal, doi:10.1111/iej.13128). The intention of this position statement is to provide the practitioner with relevant clinical guidance in this rapidly developing area. An update will be provided within 5 years as further evidence emerges.

  • formation of a hard tissue barrier after experimental Pulp capping or partial Pulpotomy in humans an updated systematic review
    International Endodontic Journal, 2016
    Co-Authors: Helena Fransson, Eva Wolf, Kerstin Petersson
    Abstract:

    The aim was to update a systematic review of Pulp capping and partial Pulpotomy by Olsson et al. (2006), by evaluating new evidence on formation of a hard tissue barrier after Pulp capping and partial Pulpotomy of experimental exposures in humans. PubMed (01-01-2005 to 01-03-2014) and CENTRAL were searched using specific keywords. Hand searches were made and the level of evidence for each included article was evaluated by the authors. The evidence of the conclusions was graded as strong, moderately strong, limited or insufficient. The initial search in PubMed yielded 215 abstracts. Hand searches of reference lists yielded no additional original scientific articles. After a selection process and interpretation, 22 articles were included and rated for level of evidence: no article was rated as high and seven as moderate. Overall the methodological quality of studies has improved since the previous systematic review was published in 2006. The conclusions are that there is limited scientific evidence that application of calcium hydroxide or mineral trioxide aggregate to an Exposed Pulp frequently results in formation of a hard tissue barrier, whereas adhesives or enamel matrix derivatives do not. There is insufficient scientific evidence that mineral trioxide aggregate promotes hard tissue formation more frequently than calcium hydroxide.

Merete Markvart - One of the best experts on this subject based on the ideXlab platform.

  • European Society of Endodontology position statement: Management of deep caries and the Exposed Pulp.
    International endodontic journal, 2019
    Co-Authors: Henry F. Duncan, Kerstin M. Galler, Phillip Tomson, S Simon, I A El-karim, Rita Kundzina, Gabriel Krastl, T Dammaschke, Helena Fransson, Merete Markvart
    Abstract:

    This position statement on the management of deep caries and the Exposed Pulp represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Preserving the Pulp in a healthy state with sustained vitality, preventing apical periodontitis and developing minimally invasive biologically based therapies are key themes within contemporary clinical endodontics. The aim of this statement was to summarize current best evidence on the diagnosis and classification of deep caries and caries-induced Pulpal disease, as well as indicating appropriate clinical management strategies for avoiding and treating Pulp exposure in permanent teeth with deep or extremely deep caries. In presenting these findings, areas of controversy, low-quality evidence and uncertainties are highlighted, prior to recommendations for each area of interest. A recently published review article provides more detailed information and was the basis for this position statement (Bjorndal et al. 2019, International Endodontic Journal, doi:10.1111/iej.13128). The intention of this position statement is to provide the practitioner with relevant clinical guidance in this rapidly developing area. An update will be provided within 5 years as further evidence emerges.

Je Seon Song - One of the best experts on this subject based on the ideXlab platform.

  • Comparative study of Pulpal responses to ProRoot MTA, Vitapex, and Metapex in canine teeth
    'Elsevier BV', 2021
    Co-Authors: Woojin Kwon, Chung-min Kang, Yooseok Shin, Ik-hwan Kim, Byurira Kim, Je Seon Song
    Abstract:

    Background/purpose: ProRoot MTA, Vitapex, and Metapex are widely used for Pulp treatment of primary tooth. The aim of this study was to compare the Pulpal responses to ProRoot MTA, Vitapex, and Metapex in a canine model of Pulpotomy. Materials and methods: Pulpotomy procedure was performed to 34 teeth (21 incisors and 13 premolars) and ProRoot MTA, Vitapex or Metapex was applicated to artificially Exposed Pulp tissues. After 13 weeks, the teeth were extracted and processed with hematoxylin-eosin staining for histologic evaluation. All specimens were evaluated in several categorys related to calcific barrier, inflammatory responses and the area of calcific barrier formation was measured. Results: Most of the specimens in the ProRoot MTA group developed a calcific barrier at the Pulp amputation site and showed a low level of inflammatory response. However, in comparison to ProRoot MTA group, a small amount of calcific barrier formed in Vitapex and Metapex groups. Conclusion: This in vivo study found that Vitapex and Metapex induced similar Pulpal responses but showed poor outcomes compared with using ProRoot MTA. Vitapex and Metapex are therefore not good substitutes for ProRoot MTA in direct Pulp capping and Pulpotomy

  • Effects of Three Calcium Silicate Cements on Inflammatory Response and Mineralization-Inducing Potentials in a Dog Pulpotomy Model
    MDPI AG, 2018
    Co-Authors: Chung-min Kang, Jiwon Hwang, Je Seon Song, Jae-ho Lee, Hyung-jun Choi, Yooseok Shin
    Abstract:

    This beagle Pulpotomy study compared the inflammatory response and mineralization-inducing potential of three calcium silicate cements: ProRoot mineral trioxide aggregate (MTA) (Dentsply, Tulsa, OK, USA), OrthoMTA (BioMTA, Seoul, Korea), and Endocem MTA (Maruchi, Wonju, Korea). Exposed Pulp tissues were capped with ProRoot MTA, OrthoMTA, or Endocem MTA. After 8 weeks, we extracted the teeth, then performed hematoxylin-eosin and immunohistochemical staining with osteocalcin and dentin sialoprotein. Histological evaluation comprised a scoring system with eight broad categories and analysis of calcific barrier areas. We evaluated 44 teeth capped with ProRoot MTA (n = 15), OrthoMTA (n = 18), or Endocem MTA (n = 11). Most ProRoot MTA specimens formed continuous calcific barriers; these Pulps contained inflammation-free palisading patterns in the odontoblastic layer. Areas of the newly formed calcific barrier were greater with ProRoot MTA than with Endocem MTA (p = 0.006). Although dentin sialoprotein was highly expressed in all three groups, the osteocalcin expression was reduced in the OrthoMTA and Endocem MTA groups. ProRoot MTA was superior to OrthoMTA and Endocem MTA in all histological analyses. ProRoot MTA and OrthoMTA resulted in reduced Pulpal inflammation and more complete calcific barrier formation, whereas Endocem MTA caused a lower level of calcific barrier continuity with tunnel defects

  • biological efficacy of two mineral trioxide aggregate mta based materials in a canine model of Pulpotomy
    Dental Materials Journal, 2017
    Co-Authors: Myeongyeon Lee, Chung-min Kang, Je Seon Song, Yooseok Shin, Seongoh Kim, Seungh Ye Kim, Hyung-jun Choi
    Abstract:

    The aim of this study was to compare the biocompatibility of Endocem Zr® and ProRoot MTA® by histopathologic analysis in a canine model of Pulpotomy. This study utilized 39 teeth of two beagle dogs. The Exposed Pulp tissues were treated by Pulpotomy using ProRoot MTA (n=19) or Endocem Zr (n=20). After 8 weeks, the teeth were extracted and processed with hematoxylin-eosin staining for histologic evaluation. Most of the specimens in both groups developed a calcific barrier at the Pulp amputation site and formed an odontoblast layer. However, some of the Endocem Zr specimens showed less calcific barrier formation with a greater inflammatory response and less odontoblast layer formation when compared with the ProRoot MTA specimens. ProRoot MTA and Endocem Zr specimens developed a calcific barrier; however, ProRoot MTA was more biocompatible than Endocem Zr.

  • comparative study of Pulpal responses to Pulpotomy with proroot mta retromta and theracal in dogs teeth
    Journal of Endodontics, 2015
    Co-Authors: Haewon Lee, Hyung-jun Choi, Yooseok Shin, Seongoh Kim, Hyo Seol Lee, Je Seon Song
    Abstract:

    Abstract Introduction This study was conducted to evaluate and compare Pulpal responses to ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), RetroMTA (Meta Biomed Co, Ltd, Seoul, Korea), and TheraCal (Bisco Inc, Schamburg, IL) in dog partial Pulpotomy models. Methods Partial Pulpotomies were performed on 60 beagle teeth. The Exposed Pulp tissues were randomly capped with either ProRoot MTA ( n  = 15), RetroMTA ( n  = 15), TheraCal ( n  = 15), or interim restorative material as a negative control ( n  = 15). After 4 weeks, the teeth were extracted and processed for histologic and immunohistochemical examinations using osteocalcin and dentin sialoprotein. Calcific barrier formation, inflammatory reaction, and the odontoblastic layer were evaluated and scored in a blind manner. The areas of newly formed calcific barriers were measured for each group. Results In most of the ProRoot MTA and RetroMTA specimens, continuous calcific barriers were formed, and the Pulps contained palisading patterns in the odontoblastic layer that were free of inflammation. However, the TheraCal specimens had lower quality calcific barrier formation, extensive inflammation, and less favorable odontoblastic layer formation. Overall, areas of newly formed calcific barrier were higher in the ProRoot MTA and RetroMTA specimens than in the TheraCal specimens. Also, immunohistochemistry revealed that osteocalcin and dentin sialoprotein were more clearly visible in the ProRoot MTA and RetroMTA specimens than in the TheraCal specimens. Conclusions RetroMTA could provide an alternative to ProRoot MTA. Both materials produced favorable Pulpal responses that were similar in nature, whereas TheraCal produced less favorable Pulpal responses.

N Six - One of the best experts on this subject based on the ideXlab platform.

  • Matricellular molecules and odontoblast progenitors as tools for dentin repair and regeneration
    Clinical Oral Investigations, 2008
    Co-Authors: M. Goldberg, D Septier, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, S. Lacerda-pinheiro, C. Chaussain-miller, A. Veis, Pamela Denbesten
    Abstract:

    This review summarizes the in vivo experiments carried out by our group after implantation of bioactive molecules (matricellular molecules) into the Exposed Pulp of the first maxillary molar of the rat or the mandibular incisor of rats and mice. We describe the cascade of recruitment, proliferation and terminal differentiation of cells involved in the formation of reparative dentin. Cloned immortalized odontoblast progenitors were also implanted in the incisors and in vitro studies aimed at revealing the signaling pathways leading from undifferentiated progenitors to fully differentiated polarized cells. Together, these experimental approaches pave the way for controlled dentin regenerative processes and repair.

  • bioactive molecules stimulate tooth repair and regeneration
    Journal of Hard Tissue Biology, 2006
    Co-Authors: Michel E. Goldberg, D Septier, Sally Lacerdapinheiro, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, Kevin Tompkins, H Chardin, Pamela Denbesten
    Abstract:

    Dentin extracellular matrix proteins display multifunctional properties. Firstly, they participate to the mineralization processes either as promotors or as inhibitors of crystal nucleation or crystal growth. Secondly, they act as signaling molecules implicated in the differentiation of odontoblast progenitors. These molecules may be used to promote the recruitment of odontoblast progenitors, the proliferation and the final differentiation into functional odontoblast-like or osteoblast-like cells implicated in Pulp repair. This has been evaluated through a series of experiments carried out in vivo on the rat first maxillary molar and in vitro on odonto/osteo progenitors. Along this line, BMP7 (OP1) induced in the crown a fibrous osteodentin-like structure where unmineralized Pulp remnants were seen. In addition, the mesial root canal was totally filled with a homogeneous dentin-like structure. The bone sialoprotein (BSP) stimulated within one month the formation of a reparative dentinal bridge and the complete closure of the coronal Pulp with an atubular homogeneous reparative dentin. Dentonin, a peptide from MEPE, implantated into the Exposed Pulp produced more rapidly than the two previous molecules reparative mineralization in the coronal Pulp and also occlusion of the lumen of the root canal. Implanted in the Exposed Pulp, A+4 and A-4, two spliced amelogenin gene products, induce either the formation of a reparative dentinal bridge (A+4) or a more diffuse mineralization (A-4). The mechanisms of proliferation and differentiation were studied in parallel in an in vivo situation after implantation in the first maxillary molar of the rat, and in vitro on odontoblast progenitor cell lines. These molecules may contribute to Pulp repair and promote new strategies in dental therapies.

  • the impact of bioactive molecules to stimulate tooth repair and regeneration as part of restorative dentistry
    Dental Clinics of North America, 2006
    Co-Authors: Michel E. Goldberg, D Septier, Sally Lacerdapinheiro, Nadege Jegat, N Six, Fabienne Priam, Mireille Bonnefoix, Kevin Tompkins, H Chardin, Pamela Denbesten
    Abstract:

    After implantation in the Exposed Pulp, some molecules of the den-tin extracellular matrix induce the formation of a reparative dentinal bridge in the coronal Pulp. In some cases, total occlusion of the root canal also is observed. This is the case for bone sialoprotein, bone morphogenetic protein-7, Dentonin (a fragment from matrix extracellular phosphoglycoprotein), and two small amelogenin gene splice products (A+4 and A-4). Cells implicated in the reparative process are recruited, proliferate, and differentiate into osteoblast-like and odontoblast-like cells. The same results may be obtained by direct implantation of odontoblast progenitor cell into the Pulp.