The Role of Cellular Metabolism in Maintaining the Function of the Dentine-Pulp Complex: A Narrative Review

Abstract

The cellular metabolic processes ensure the physiological integrity of the dentine-pulp complex. Odontoblasts and odontoblast-like cells are responsible for the defence mechanisms in the form of tertiary dentine formation. In turn, the main defence reaction of the pulp is the development of inflammation, during which the metabolic and signalling pathways of the cells are significantly altered. The selected dental procedures, such as orthodontic treatment, resin infiltration, resin restorations or dental bleaching, can impact the cellular metabolism in the dental pulp. Among systemic metabolic diseases, diabetes mellitus causes the most consequences for the cellular metabolism of the dentine-pulp complex. Similarly, ageing processes present a proven effect on the metabolic functioning of the odontoblasts and the pulp cells. In the literature, several potential metabolic mediators demonstrating anti-inflammatory properties on inflamed dental pulp are mentioned. Moreover, the pulp stem cells exhibit the regenerative potential essential for maintaining the function of the dentine-pulp complex.

Hypoxic dental pulp stem cells-released succinate promotes osteoclastogenesis and root resorption

“…The physical damage, bacterial involvement and necrosis of periodontal ligaments and pulp tissues in traumatized teeth may trigger an intense immuno-inflammatory response, resulting in both external replacement root resorption and inflammatory root resorption 20 . Orthodontic treatment can affect the cellular metabolism of the dental pulp 21 , shown by the increased activity of aspartate aminotransferase as a result of hypoxia following circulatory disruptions in the pulp tissues 22 . Based on the nature of inflammation and metabolism, we inferred that hypoxic DPSCs in the reduced PBF state may release metabolic signals to induce root resorption, increase apical restriction and restore the blood supply.…”

Optimization of a Photobiomodulation Protocol to Improve the Cell Viability, Proliferation and Protein Expression in Osteoblasts and Periodontal Ligament Fibroblasts for Accelerated Orthodontic Treatment

“…However, a reduction in ROS levels following irradiation was observed in oxidatively stressed cells or in animal models of disease [8,9], revealing the potential of PBM to differentially stimulate stressed and/or diseased cells and tissues so as to restore cellular homeostasis and normal activity. Altogether, these effects stimulate the proliferation, differentiation and activity of the mechanically stressed cells and tissues of the periodontium, promoting several cellular biological phenomena implicated in OTM, including improved regeneration and remodeling, root resorption control and angiogenesis [4,[10][11][12]. Moreover, the expression of specific bone remodeling mediators can be also modulated using PBM; different studies show the potential of PBM to impact the activity of alkaline phosphatase (ALP), osteoprotegerin (OPG) and the receptor activator of nuclear factor κ-B ligand (RANK-L), amongst other things, in favor of osteoclastogenesis or osteogenesis, depending on the PBM parameters [10,13,14].…”