Dentin regeneration in vital pulp therapy: design principles. 2001

D Tziafas, and G Belibasakis, and A Veis, and S Papadimitriou
Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, 54006 Thessaloniki, Greece. dtziaf@dent.auth.gr

The nature and specificity of the mechanisms by which the amputated dentin-pulp interface is therapeutically healed determine the properties of the barrier at this site and play a critical role in the outcome of vital pulp therapy. Healing of the dentin-pulp complex proceeds either by natural repair-which results in defensive hard-tissue formation, or therapeutically regulated dentin regeneration, which aims to reconstitute the normal tissue architecture at the pulp periphery. Progress in biomedical research opens new directions for the design of biologically effective pulp therapies. Application of biocompatible and biodegradable carrier vehicles for local delivery of signaling molecules in pulp-capping situations showed induction of fibrodentin/reparative dentin formation, but often at the expense of underlying pulp tissue. An alternative pre-clinical model aiming to reconstitute normal tissue architecture directly at the dentin-pulp interface should be designed on the basis of the direct induction of odontoblast-like cell differentiation and reparative dentin formation at the pulp-capping material interface. Experimental data clearly showed that pulpal cells can differentiate directly into odontoblast-like cells in association with specific extracellular matrices (dentinal or fibrodentinal matrix) or TGF beta 1-containing artificial substrates. Dentin-induced dentinogenesis can be used as a master plan for the achievement of new therapeutic opportunities. In the present study, several short-term experimental studies on dog teeth for potential direct induction of odontoblast-like cell differentiation at the surface of rhTGF beta 1-containing artificial substrates (Millipore filters, hydroxyapatite granules, calcium hydroxide, pure titanium) failed to induce any specific reparative dentinogenic effects.

UI MeSH Term Description Entries
D008567 Membranes, Artificial Artificially produced membranes, such as semipermeable membranes used in artificial kidney dialysis (RENAL DIALYSIS), monomolecular and bimolecular membranes used as models to simulate biological CELL MEMBRANES. These membranes are also used in the process of GUIDED TISSUE REGENERATION. Artificial Membranes,Artificial Membrane,Membrane, Artificial
D008851 Micropore Filters A membrane or barrier with micrometer sized pores used for separation purification processes. Millipore Filters,Filter, Micropore,Filter, Millipore,Filters, Micropore,Filters, Millipore,Micropore Filter,Millipore Filter
D009804 Odontoblasts The mesenchymal cells which line the DENTAL PULP CAVITY and produce DENTIN. They have a columnar morphology in the coronal pulp but are cuboidal in the root pulp, or when adjacent to tertiary dentin. Odontoblast
D012038 Regeneration The physiological renewal, repair, or replacement of tissue. Endogenous Regeneration,Regeneration, Endogenous,Regenerations
D002126 Calcium Hydroxide A white powder prepared from lime that has many medical and industrial uses. It is in many dental formulations, especially for root canal filling. Hydroxide, Calcium
D002454 Cell Differentiation Progressive restriction of the developmental potential and increasing specialization of function that leads to the formation of specialized cells, tissues, and organs. Differentiation, Cell,Cell Differentiations,Differentiations, Cell
D003782 Dental Pulp A richly vascularized and innervated connective tissue of mesodermal origin, contained in the central cavity of a tooth and delimited by the dentin, and having formative, nutritive, sensory, and protective functions. (Jablonski, Dictionary of Dentistry, 1992) Dental Pulps,Pulp, Dental,Pulps, Dental
D003785 Dental Pulp Capping Application of a protective agent to an exposed pulp (direct capping) or the remaining thin layer of dentin over a nearly exposed pulp (indirect capping) in order to allow the pulp to recover and maintain its normal vitality and function. Pulp Capping,Capping, Dental Pulp,Capping, Pulp,Pulp Capping, Dental,Cappings, Dental Pulp,Cappings, Pulp,Dental Pulp Cappings,Pulp Cappings,Pulp Cappings, Dental
D003789 Dental Pulp Exposure The result of pathological changes in the hard tissue of a tooth caused by carious lesions, mechanical factors, or trauma, which render the pulp susceptible to bacterial invasion from the external environment. Exposure, Dental Pulp,Pulp Exposure, Dental
D003804 Dentin The hard portion of the tooth surrounding the pulp, covered by enamel on the crown and cementum on the root, which is harder and denser than bone but softer than enamel, and is thus readily abraded when left unprotected. (From Jablonski, Dictionary of Dentistry, 1992) Dentine,Dentines,Dentins

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