Dental pulp is a highly specialized mesenchymal tissue that has a limited regeneration capacity due to anatomical arrangement and postmitotic nature of odontoblastic cells. Entire pulp amputation followed by pulp space disinfection and filling with an artificial material cause loss of a significant amount of dentin leaving as life-lasting sequelae a non-vital and weakened tooth. However, regenerative endodontics is an emerging field of modern tissue engineering that has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. Thereby, this article reviews the most recent endeavors to regenerate pulp tissue based on tissue engineering principles and provides insightful information to readers about the different aspects involved in tissue engineering. Here, we speculate that the search for the ideal combination of cells, scaffolds, and morphogenic factors for dental pulp tissue engineering may be extended over future years and result in significant advances in other areas of dental and craniofacial research. The findings collected in this literature review show that we are now at a stage in which engineering a complex tissue, such as the dental pulp, is no longer an unachievable goal and the next decade will certainly be an exciting time for dental and craniofacial research.
This study evaluated the effects of immediate and delayed polishing on the surface roughness, microhardness and microleakage of a microfilled (Filtek A110) and a hybrid (Filtek Z250) resin composite. Standardized preparations were made on the buccal surfaces of 256 bovine teeth; half were restored with each composite (128 teeth per composite). Immediately after curing, gross finishing was carried out with #280 sandpaper. The specimens restored with each composite were divided into two subgroups. The first group (IM) was polished immediately after gross finishing, using three different systems (n=16): Sequence A, Sof-Lex; Sequence B, Flexicups and Sequence C, Flexicups + Jiffy Polishing Brush + Flexibuffs. The specimens were then stored for three weeks in saline 37 degrees C. The second group (DE) was stored for two weeks, then polished with the same systems and stored for one additional week. The controls (n=16) were analyzed without polishing. Five readings per specimen were taken for surface roughness and hardness. After immersion in basic fuchsin, microleakage was evaluated (40x) using standardized scores. The data were analyzed at a significance level of 0.05, with analysis of variance and an SNK test (surface roughness and microhardness) or with Kruskal-Wallis (microleakage). In both composites, only for the sequential technique was there an influence of delay in polishing on roughness (Ra). Flexicups exhibited the highest Ra of the three systems. The IM and Filtek Z-250 groups showed higher hardness than the DE and Filtek A-110 groups, respectively. Dentin margins showed more leakage than enamel margins; the sequential technique produced more leakage than the other techniques in dentin (p<0.05) and delay of polishing was not significant in the majority of situations. In conclusion, several conditions--composite, time and polishing technique--had a significant influence on surface roughness, hardness and microleakage. Generally, immediate polishing produced no detrimental effect compared to delayed polishing.
Mental and oral health are among the main disabilities worldwide. This article helps to understand more about the relationship between both conditions, highlighting the importance for both clinicians and policy makers of considering individual's psychological status in management of oral health.
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