Inflammatory Processes in the Dental Pulp

Cooper, Paul R.; Smith, Anthony J.

doi:10.1007/978-3-642-55160-4_7

Cited by 3 publications

(2 citation statements)

References 130 publications

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“…In experimental animal models, bacterial products diffuse through the dentinal tubules in test cavities inducing pulpitis even before the pulp is exposed (Warfvinge & Bergenholtz ); however, the permeability of dentine and pulpitis will likely be reduced in carious teeth due to the presence of tubular sclerosis subjacent to the carious dentine. Notably, as the external bacterial stimuli moves towards the pulp, the inflammatory response continues to intensify (Mjör & Tronstad , Bjørndal & Ricucci ); however, pulp has an innate ability to heal if the challenge is removed and the tooth is suitably restored (Mjör & Tronstad , Cooper & Smith ).…”

Section: Introductionmentioning

confidence: 99%

Management of deep caries and the exposed pulp

et al. 2019

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Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one‐visit as indirect pulp treatment or two‐visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re‐emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp–dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence‐based management strategies and education in management of the exposed pulp are critical in the future.

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Section: Introductionmentioning

confidence: 99%

Management of deep caries and the exposed pulp

et al. 2019

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“…In response to advancing caries, the dentine–pulp complex reacts by a combination of inflammation and the promotion of mineralization (Cooper et al, 2010). As a result of this interplay, the pulp of an affected tooth exhibiting deep caries can recover if the microbial irritation is removed and the tooth is restored with a high‐quality sealing restoration (Cooper & Smith, 2016; Mjör & Tronstad, 1974). Over the last 10 years, there has been a significant focus on the development of minimally invasive strategies aimed at supporting the vitality of the pulp by reducing the inflammatory insult (Bjørndal et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Preclinical 3D‐printed laboratory simulation of deep caries and the exposed pulp reduced student anxiety and stress, while increasing confidence and knowledge in vital pulp treatment

et al. 2022

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Aim: To evaluate the impact of a preclinical laboratory session using 3D printed teeth on dental student stress, anxiety, confidence and knowledge when treating deep caries and pulp exposure. Methodology:This was a two-centre controlled study, with randomized distribution of students into two groups: a vital pulp treatment (VPT) lecture-only (control) group and a VPT-lecture combined with a VPT-laboratory (experimental) group. In both universities, preclinical students with endodontic or operative dentistry laboratory sessions could participate. All students were invited to the lecture. Two weeks later (timepoint-T1), both groups completed validated and bespoke questionnaires and scales to evaluate their stress (Stress-VAS), anxiety (STAI Trait [T] and State [S]), self-confidence and knowledge. Thereafter, only the experimental group attended the hands-on laboratory session demonstrating the techniques of selective caries removal and partial pulpotomy on a commercial 3D-printed tooth. Two weeks later (timepoint-T2), the participants from both groups repopulated the same questionnaires and VAS. The control group had the laboratory session after the completion of the study. The statistical analysis was performed with Statistica® (significance p = .05). The homogeneity between the two samples was checked by Khi 2 and Student tests. Stress-VAS, STAI-S, confidence and knowledge scores were compared within each group, and between the two groups, at T1 and T2, with a repeated measures anova test (+/−Tukey post-hoc test). Results:The groups comprised 54 students each, with no statistical difference between the groups regarding demographic, academic data and STAI-T score. The two groups had no significant difference of Stress-VAS, STAI-S, confidence and knowledge scores at T1 while they presented a significant difference in stress, anxiety and confidence scores at T2, but with no significant difference in knowledge score.However, knowledge score, as other parameters, improved significantly between T1 and T2 in the experimental group.

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Pulpal expression of erythropoietin and erythropoietin receptor after direct pulp capping in rat

Papić

Živanović

Vučićević

et al. 2022

European J Oral Sciences

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This study aimed to evaluate the effect of direct pulp capping on the expression of erythropoietin (Epo) and Epo-receptor (Epor) genes in relation to the expression of inflammatory and osteogenic genes in rat pulp. Dental pulps of the first maxillary molars of Wistar Albino rats were exposed and capped with either calcium hydroxide or mineral trioxide aggregate, or were left untreated. After 4 wk, animals were euthanized, and maxillae were prepared for histological and real-time polymerase chain reaction analysis. Histological scores of pulp inflammation and mineralization, and relative expressions of Epo, Epor, inflammatory cytokines, and pulp osteogenic genes were evaluated. The capped pulps showed higher expressions of Epo, while the untreated pulps had the highest expression of Epor. Both calcium hydroxide and mineral trioxide aggregate downregulated the expression of tumor necrosis factor alpha compared to untreated controls, and upregulated transforming growth factor beta compared to healthy controls. Alkaline phosphatase expression was significantly higher in experimental groups. Relative expression of Epo negatively correlated with pulp inflammation, and positively correlated with pulp mineralization. Pulp exposure promoted expression of Epor and pro-inflammatory cytokines, while pulp capping promoted expression of Epo, alkaline phosphatase, and downregulated Epor and pro-inflammatory cytokines.

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Inflammatory Processes in the Dental Pulp

Cited by 3 publications

References 130 publications

Management of deep caries and the exposed pulp

Management of deep caries and the exposed pulp

Preclinical 3D‐printed laboratory simulation of deep caries and the exposed pulp reduced student anxiety and stress, while increasing confidence and knowledge in vital pulp treatment

Pulpal expression of erythropoietin and erythropoietin receptor after direct pulp capping in rat

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