Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and reducing innate repair capacities. For complete tooth healing the formation of a reactionary/reparative dentin barrier to distance and protect the pulp from infectious agents and restorative materials is required. Clinical and in vitro experimental data clearly indicate that dentin barrier formation only occurs when pulp inflammation and infection are minimised, thus enabling reestablishment of tissue homeostasis and health. Therefore, promoting the resolution of pulp inflammation may provide a valuable therapeutic opportunity to ensure the sustainability of dental treatments. This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries-induced inflammation and dentinogenic-based repair. We report, using selected examples, different strategies potentially used by odontoblasts and specialized immune cells to combat dentin-invading bacteria in vivo.
To overcome difficulties associated with conventional techniques, impressions with IOS (intraoral scanner) and CAD/CAM (computer-aided design and manufacturing) technologies were developed for dental practice. The last decade has seen an increasing number of optical IOS devices, and these are based on different technologies; the choice of which may impact on clinical use. To allow informed choice before purchasing or renewing an IOS, this article summarizes first the technologies currently used (light projection, distance object determination, and reconstruction). In the second section, the clinical considerations of each strategy such as handling, learning curve, powdering, scanning paths, tracking, and mesh quality are discussed. The last section is dedicated to the accuracy of files and of the intermaxillary relationship registered with IOS as the rendering of files in the graphical user interface is often misleading. This overview leads to the conclusion that the current IOS is adapted for a common practice, although differences exist between the technologies employed. An important aspect highlighted in this review is the reduction in the volume of hardware which has led to an increase in the importance of software-based technologies.
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