EDTA conditioning of circumpulpal dentine induces dentinogenic events in pulpotomized miniature swine teeth

Abstract

Aim To investigate pulp responses after pulpotomy and EDTA conditioning of pulp chamber dentinal walls with or without the placement of a collagenous scaffold in the experimental model of miniature swine teeth. Methodology Forty‐two fully developed permanent premolars and molars of healthy miniature swines were used. After preparation of pulp exposures through Class I cavities, the tissue of the pulp chamber was completely removed. The haemorrhage was controlled, and the root pulp was protected using a polyurethane film. The circumpulpal pulp chamber dentine was treated for 3 min with normal saline (group 1), or 17% EDTA solution (groups 2 and 3). The film was removed, and the pulp chamber cavities were left empty (groups 1 and 2), or filled with swine collagenous sponge (group 3). The access cavities were restored with a Teflon disc and glass ionomer. Teeth were evaluated histo‐morphologically after 10 weeks. Data were compared using the nonparametric Fisher's exact test. Results Teeth after treatment of dentine with saline (group 1) were associated with no or only traces of hard tissue formation along the root canal walls. Atubular tertiary dentine deposition in the form of matrix deposition along root canal walls, or dentine bridge formation at the orifice of root canals or complete pulp canal obliteration, was found after treatment of dentine with EDTA in both experiments (groups 2 and 3). Significantly different types of mineralization in the root canals of groups 2 and 3 were seen (P = 0.001). Tissue changes in the pulp cavity, characterized by soft tissue growth and osteodentine or atubular tertiary dentine formation, were only seen after EDTA conditioning of dentine, in 6.2% of the teeth without scaffold and 64.7% of the teeth with scaffold application. Newly deposited mineralized matrix in the pulp chamber was always in continuation with hard tissue deposited in the root canals. Conclusions The EDTA conditioning of pulp cavity dentinal walls after pulpotomy induced dentinogenic events in the root pulp. Application of collagenous scaffold in the pulp chamber enhanced soft tissue growth and mineralized tissue formation along the treated circumpulpal dentine.

Biomechanical performance of an immature maxillary central incisor after revitalization: a finite element analysis

“…Additionally, the use of sodium hypochlorite and antibiotic pastes in high concentrations compromised stem cell survival (Ruparel et al , Martin et al ). However, calcium hydroxide was less harmful and EDTA even promoted adhesion, migration and differentiation of pulp stem cells on dentine (Galler et al , Tziafas et al ). Accordingly, the European Society of Endodontology (ESE) released a position statement indicating a clinical protocol for revitalization in 2016 (ESE ).…”

Regenerative Endodontics and Minimally Invasive Dentistry: Intertwining Paths Crossing Over Into Clinical Translation

“…Additionally, according to a recent systematic review and meta-analysis, a significant increase in fracture resistance was noted when CEC preparation was performed with preservation of tooth marginal ridges ( Ballester et al, 2021 ). Thus this approach, accompanied by minimal mechanical preparation of root canal walls ( El-Kateb et al, 2020 ), would offer a chance to preserve the coronal tooth structure and maximize the release of growth factors sequestered within the pericervical dentin ( Tziafas et al, 2019 ).…”

“…Furthermore, the preservation of peri-cervical dentin in particular which has an anatomical pattern of a lesser inter-tubular dentin and wider dentinal tubule lumen can justify the evidence of greater sequestered growth factors including TGF-β1, FGF2, and VEGF found in this region ( Tziafas et al, 2019 ; Ferreira et al, 2020 ). This would thus preserve the physiologic and defensive function of dentin which has been proven to have a defensive mechanism that involves the release of pro-inflammatory cytokines and antibacterial agents ( Ayoub et al, 2020 ; Shah et al, 2020 ).…”

Early cellular activity of GelMA as a Photopolymerized Hydrogel using an ex vivo tooth slice model

“…Although the use of bioactive hard-setting materials such as MTA or Biodentine can provide mineralized tissue formation and good sealing, they cannot allow the penetration of the stem/progenitor cells through the damaged area [10]. On the other hand, a previous study showed that ethylenediaminetetraacetic acid (EDTA) conditioning of the dentin with a collagenous scaffold signi cantly enhanced soft tissue growth with tertiary dentin formation on the exposure site of Class 1 cavities of mini swine permanent teeth [11].…”