The effects of reducing the root length by apicoectomy on dental pulp revascularization following tooth replantation in mice

Abstract

Background/Aim Root length is a critical factor for dental pulp regeneration following tooth replantation. The aim of this study was to analyze the effects of reducing the root length by apicoectomy on the pulp healing process using a model for tooth replantation. Material and Methods After extraction of the upper first molars (M1) of 3‐week‐old mice, the roots from the experimental group (EG) were shortened to half to two‐thirds of their length before replantation, whereas in the control group (CG) the extracted teeth were immediately repositioned into their alveolar sockets. To determine the effects of root resection on the survival of inherent pulp cells, this study included tooth transplantation with root resection using wild‐type (WT) and green fluorescent protein (GFP) transgenic mice. The M1 of GFP transgenic mice were transplanted into the alveolar socket of the M1 of WT mice. The roots of the right M1 were shortened (EG), whereas the left M1 remained untreated (CG). Results Apoptotic cells in the EG significantly decreased in number compared with the CG at day 3. Cell proliferative activity in the EG was significantly higher than that in the CG in the root pulp during days 3–5, and nestin‐positive odontoblast‐like cells began to arrange themselves along the pulp‐dentin border in the cusp area at day 5 in the EG but not in the CG. At week 2, tertiary dentin had formed throughout the pulp in the EG, whereas the combined tissue of dentin and bone occupied the pulp space in 60% of the CG. Root resection also positively affected the survival of inherent pulp cells to differentiate into odontoblast‐like cells as demonstrated by transplantation using GFP transgenic mice. Conclusions Reducing the root length accelerated pulp regeneration following tooth replantation due to the better environment for revascularization.

Role of osteopontin in the process of pulpal healing following tooth replantation in mice

“…These findings may indicate a correlation between the up-regulation of Nestin expression and activation of the proliferative potential of dental pulp stem/progenitor cells. A reduction in root length can accelerate pulp regeneration by improving the revascularization of the replanted teeth [ 20 ]. The favorable ratio of broad apical foramen/short root canal is important, since the foramen is the primary access route for blood vessels and nerves to the coronal dental pulp.…”

Comparación entre reimplante intencional y apicectomía como última opción frente al fracaso endodóntico

“…Cuando las lesiones periapicales perduran después de haber realizado adecuadamente un tratamiento o retratamiento de endodoncia, es cuando se requiere realizar una apicectomía empleando cementos de retro obturación, siendo el MTA el más utilizado en cirugía endodóntica, el mismo que posee una adhesión muy baja a la dentina, por ello se necesitan diseñar cavidades retentivas como prevención de desprendimiento del cemento, además es difícil de manipular y su tiempo de ajuste es muy lento, lo que podría desencadenar un mayor grado de micro filtración por pérdida de adaptación marginal 12 Las lesiones apicales pueden presentarse incluso en órganos dentales con tratamiento endodóntico y esto puede ocurrir cuando no se ha desinfectado adecuadamente el sistema de conductos radiculares mediante la instrumentación y abundante irrigación, o cuando se va a restaurar un OD con una prótesis fija, ya que existe la posibilidad de contaminación como producto del contacto de los fluidos orales con el conducto radicular, la ausencia de desinfección y el secado de este antes de cementar la restauración 18 19 .…”

Mechanism of Linagliptin on Stromal Cell-Derived Factor 1 and Vascular Endothelial Growth Factor Protein after Molar Pulp Revascularization in Rats

“…When the root canal is filled with blood, the inflammatory reaction of the tooth apex can subside, which is conducive to the repair of the injury and increases the length of the root and the thickness of the canal wall. There are many factors that affect the revascularization after pulp infection, while the specific mechanism needs a further verification [2] . Vascular Endothelial Growth Factor (VEGF) is elevated in human dental pulp infected by bacteria, while its expression content decreases when the inflammatory response is irreversible [3] .…”