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1.
Sci Rep ; 14(1): 13861, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38879635

RESUMEN

For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue. 40 extracted bovine mandibular anterior teeth (n = 10) were used for the study. Bovine pulp pieces (25 ± 5 mg) were placed in 1.5 ml Eppendorf tubes. Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl, Group 3 with Irritrol, and Group 4 with Saline. Samples were left at room temperature for 30 min, then dried and reweighed. The efficacy of tissue dissolution ranked from highest to lowest was found to be NaOCl, Boric Acid, Irritrol, and saline (p < 0.05). It was observed that the decrease in the NaOCl group was greater than the decrease in the Irritrol and saline groups, and the decrease in the Boric acid group was significantly greater than the decrease in the saline group (p < 0.05). It also emphasizes the need for future studies to further investigate the effects of Irritrol and Boric Acid on tissue dissolution.


Asunto(s)
Ácidos Bóricos , Irrigantes del Conducto Radicular , Animales , Bovinos , Ácidos Bóricos/farmacología , Irrigantes del Conducto Radicular/farmacología , Pulpa Dental/efectos de los fármacos , Hipoclorito de Sodio/farmacología , Irrigación Terapéutica/métodos
2.
J Contemp Dent Pract ; 25(3): 267-275, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38690701

RESUMEN

AIM: To study the effect of glycyrrhizin (GA) on the viability and proliferation of dental pulp stem cells (DPSCs) compared with intracanal medicaments. MATERIALS AND METHODS: Third molars of an adult donor were used to obtain the DPSCs. Flow cytometry was utilized to conduct phenotypic analysis for DPSCs. The methyl-thiazol tetrazolium (MTT) test was used to detect the cell viability. Cell proliferation assay was conducted at distinct time intervals: 3, 5, and 7 days. RESULTS: The flow cytometry analysis verified the positive expression of mesenchymal cell surface antigen molecules (CD73, CD90, and CD105) and the absence of hematological markers (CD14, CD34, and CD45) in the DPSCs. The cells that treated with concentrations more than 0.5 mg/mL of Ca(OH2) and triple antibiotic paste (TAP) gave significant decrease in viability in comparison to the untreated cells (p < 0.05). Also, the cells treated with concentrations 50 and 25 µM of GA showed no significant difference compared with the untreated cells (p > 0.05), while concentrations 12.5 and 6.25 µM expressed a significant increase in viability compared with the untreated cells (p < 0.05). At 7 days, cells treated with the three different concentrations of GA (12.5, 25, and 50 µM) demonstrated a significant increase in cell density compared with Ca(OH)2 and TAP-treated cells (p < 0.05). CONCLUSION: Based upon the potential of GA on DPSCs proliferation compared with Ca(OH)2 and TAP, It is conceivable to acknowledge that GA could be used as an intracanal medicaments for revascularization process of necrotic immature teeth. CLINICAL SIGNIFICANCE: This study emphasizes the significance of assessing alternative root canal medicaments and their impact on the proliferation and viability of DPSCs. The results regarding GA, specifically its impact on the viability and growth of DPSCs, provide essential understanding for its potential application as an intracanal medicine. This study adds to the continuous endeavors in identifying safer and more efficient intracanal therapies, which are essential for improving patient outcomes in endodontic operations. How to cite this article: Alrashidi MA, Badawi MF, Elbeltagy MG, et al. The Effect of Glycyrrhizin on the Viability and Proliferation of Dental Pulp Stem Cells Compared to Intracanal Medicaments. J Contemp Dent Pract 2024;25(3):267-275.


Asunto(s)
Proliferación Celular , Supervivencia Celular , Pulpa Dental , Ácido Glicirrínico , Irrigantes del Conducto Radicular , Células Madre , Humanos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Ácido Glicirrínico/farmacología , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Irrigantes del Conducto Radicular/farmacología , Células Madre/efectos de los fármacos , Citometría de Flujo , Hidróxido de Calcio/farmacología , Células Cultivadas , Adulto
3.
Int J Med Sci ; 21(6): 1155-1164, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38774749

RESUMEN

Introduction: Clinical studies have shown that endodontically-treated nonvital teeth exhibit less root resorption during orthodontic tooth movement. The purpose of this study was to explore whether hypoxic dental pulp stem cells (DPSCs) can promote osteoclastogenesis in orthodontically induced inflammatory root resorption (OIIRR). Methods: Succinate in the supernatant of DPSCs under normal and hypoxic conditions was measured by a succinic acid assay kit. The culture supernatant of hypoxia-treated DPSCs was used as conditioned medium (Hypo-CM). Bone marrow-derived macrophages (BMDMs) from succinate receptor 1 (SUCNR1)-knockout or wild-type mice were cultured with conditioned medium (CM), exogenous succinate or a specific inhibitor of SUCNR1 (4c). Tartrate-resistant acid phosphatase (TRAP) staining, Transwell assays, qPCR, Western blotting, and resorption assays were used to evaluate osteoclastogenesis-related changes. Results: The concentration of succinate reached a maximal concentration at 6 h in the supernatant of hypoxia-treated DPSCs. Hypo-CM-treated macrophages were polarized to M1 proinflammatory macrophages. Hypo-CM treatment significantly increased the formation and differentiation of osteoclasts and increased the expression of osteoclastogenesis-related genes, and this effect was inhibited by the specific succinate inhibitor 4c. Succinate promoted chemotaxis and polarization of M1-type macrophages with increased expression of osteoclast generation-related genes. SUCNR1 knockout decreased macrophage migration, M1 macrophage polarization, differentiation and maturation of osteoclasts, as shown by TRAP and NFATc1 expression and cementum resorption. Conclusions: Hypoxic DPSC-derived succinate may promote osteoclast differentiation and root resorption. The regulation of the succinate-SUCNR1 axis may contribute to the reduction in the OIIRR.


Asunto(s)
Pulpa Dental , Ratones Noqueados , Osteoclastos , Osteogénesis , Resorción Radicular , Células Madre , Ácido Succínico , Animales , Ratones , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Pulpa Dental/metabolismo , Osteoclastos/efectos de los fármacos , Osteoclastos/metabolismo , Resorción Radicular/patología , Resorción Radicular/metabolismo , Humanos , Ácido Succínico/metabolismo , Osteogénesis/efectos de los fármacos , Células Madre/metabolismo , Células Madre/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Macrófagos/metabolismo , Macrófagos/efectos de los fármacos , Hipoxia de la Célula/efectos de los fármacos , Receptores Acoplados a Proteínas G/metabolismo , Receptores Acoplados a Proteínas G/genética , Medios de Cultivo Condicionados/farmacología , Células Cultivadas
4.
Braz Oral Res ; 38: e037, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38747824

RESUMEN

Dental pulp stem cells (DPSCs) and periodontal ligament stem cells (PDLSCs) can differentiate into osteoblasts, indicating that both are potential candidates for bone tissue engineering. Osteogenesis is influenced by many environmental factors, one of which is lipopolysaccharide (LPS). LPS-induced NF-κB activity affects the osteogenic potencies of different types of MSCs differently. This study evaluated the effect of LPS-induced NF-κB activity and its inhibition in DPSCs and PDLSCs. DPSCs and PDLSCs were cultured in an osteogenic medium, pretreated with/without NF-κB inhibitor Bay 11-7082, and treated with/without LPS. Alizarin red staining was performed to assess bone nodule formation, which was observed under an inverted light microscope. NF-κB and alkaline phosphatase (ALP) activities were measured to examine the effect of Bay 11-7082 pretreatment and LPS supplementation on osteogenic differentiation of DPSCs and PDLSCs. LPS significantly induced NF-κB activity (p = 0.000) and reduced ALP activity (p = 0.000), which inhibited bone nodule formation in DPSCs and PDLSCs. Bay 11-7082 inhibited LPS-induced NF-κB activity, and partially maintained ALP activity and osteogenic potency of LPS-supplemented DPSCs and PDLSCs. Thus, inhibition of LPS-induced NF-κB activity can maintain the osteogenic potency of DPSCs and PDLSCs.


Asunto(s)
Fosfatasa Alcalina , Diferenciación Celular , Pulpa Dental , Lipopolisacáridos , FN-kappa B , Nitrilos , Osteogénesis , Ligamento Periodontal , Células Madre , Humanos , Lipopolisacáridos/farmacología , Ligamento Periodontal/citología , Ligamento Periodontal/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Osteogénesis/fisiología , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , FN-kappa B/metabolismo , Fosfatasa Alcalina/análisis , Diferenciación Celular/efectos de los fármacos , Células Madre/efectos de los fármacos , Células Madre/fisiología , Células Cultivadas , Nitrilos/farmacología , Sulfonas/farmacología , Reproducibilidad de los Resultados , Factores de Tiempo , Adulto Joven , Adolescente
5.
J Appl Oral Sci ; 32: e20240017, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38775598

RESUMEN

OBJECTIVE: To compare the effect of submucosal cryotherapy using cold saline to dexamethasone sodium phosphate and diclofenac sodium injections on substance P and interleukin 6 release in experimentally induced pulpal inflammation in rabbits' molar teeth. METHODOLOGY: Fifteen rabbits were randomly classified into 3 groups according to the submucosal injection given: cold saline, dexamethasone sodium phosphate, and diclofenac sodium. A split-mouth design was adopted, the right mandibular molars were experimental, and the left molars served as the control without injections. Intentional pulp exposures were created and left for 6 hours to induce pulpitis. Pulpal tissue was extracted and examined for SP and IL-6 levels using ELISA. Within each group, the level of cytokines released was measured for both control and experimental groups for intragroup comparison to determine the effect of injection. The percentage reduction of each mediator was calculated compared with the control side for intergroup comparison then the correlation between SP and IL-6 levels was analyzed using Spearman's rank order correlation coefficient. Statistical analysis was performed, and the significance level was set at p<0.05. RESULTS: Submucosal cryotherapy, dexamethasone sodium phosphate, and diclofenac sodium significantly reduced SP and IL-6 pulpal release. Submucosal cryotherapy significantly reduced SP more than and IL-6 more than dexamethasone sodium phosphate and diclofenac sodium. Pulpal reduction of SP and IL-6 showed a strong positive significant correlation. CONCLUSIONS: Submucosal cryotherapy reduces the pulpal release of SP and IL-6 and could be tested as an alternative to premedication to potentiate the effect of anesthesia and control postoperative endodontic pain.


Asunto(s)
Antiinflamatorios no Esteroideos , Crioterapia , Pulpa Dental , Dexametasona , Diclofenaco , Ensayo de Inmunoadsorción Enzimática , Interleucina-6 , Pulpitis , Distribución Aleatoria , Sustancia P , Animales , Conejos , Pulpitis/terapia , Diclofenaco/farmacología , Dexametasona/farmacología , Dexametasona/análogos & derivados , Interleucina-6/análisis , Crioterapia/métodos , Sustancia P/análisis , Antiinflamatorios no Esteroideos/farmacología , Pulpa Dental/efectos de los fármacos , Factores de Tiempo , Reproducibilidad de los Resultados , Resultado del Tratamiento , Masculino , Estadísticas no Paramétricas , Modelos Animales de Enfermedad , Antiinflamatorios/farmacología , Solución Salina , Valores de Referencia
6.
Medicina (Kaunas) ; 60(5)2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38792973

RESUMEN

Background and Objectives: Stem cell-based regeneration strategies have shown therapeutic efficacy in various fields of regenerative medicine. These include bone healing after bone augmentation, often complicated by pain, which is managed by using nonsteroidal anti-inflammatory drugs (NSAIDs). However, information is limited about how NSAIDs affect the therapeutic potential of stem cells. Materials and Methods: We investigated the effects of ibuprofen and diclofenac on the characteristics, morphology, and immunophenotype of human mesenchymal stromal cells isolated from the dental pulp (DPSCs) and cultured in vitro, as well as their effects on the expression of angiogenic growth factors (VEGFA and HGF) and selected genes in apoptosis signalling pathways (BAX, BAK, CASP3, CASP9, and BCL2). Results: Ibuprofen and diclofenac significantly reduced the viability of DPSCs, while the expression of mesenchymal stem cell surface markers was unaffected. Both ibuprofen and diclofenac treatment significantly upregulated the expression of HGF, while the expression of VEGFA remained unchanged. Ibuprofen significantly altered the expression of several apoptosis-related genes, including the upregulation of CASP9 and BCL2, with decreased CASP3 expression. BAK, CASP3, CASP9, and BCL2 expressions were significantly increased in the diclofenac-treated DPSCs, while no difference was demonstrated in BAX expression. Conclusions: Our results suggest that concomitant use of the NSAIDs ibuprofen or diclofenac with stem cell therapy may negatively impact cell viability and alter the expression of apoptosis-related genes, affecting the efficacy of stem cell therapy.


Asunto(s)
Apoptosis , Supervivencia Celular , Pulpa Dental , Diclofenaco , Ibuprofeno , Humanos , Pulpa Dental/efectos de los fármacos , Pulpa Dental/citología , Diclofenaco/farmacología , Apoptosis/efectos de los fármacos , Ibuprofeno/farmacología , Supervivencia Celular/efectos de los fármacos , Antiinflamatorios no Esteroideos/farmacología , Antiinflamatorios no Esteroideos/uso terapéutico , Células Madre/efectos de los fármacos , Células Madre Mesenquimatosas/efectos de los fármacos , Células Cultivadas
7.
Biomater Adv ; 161: 213883, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38762928

RESUMEN

Maintaining the viability of damaged pulp is critical in clinical dentistry. Pulp capping, by placing dental material over the exposed pulp, is a main approach to promote pulp-dentin healing and mineralized tissue formation. The dental materials are desired to impact on intricate physiological mechanisms in the healing process, including early regulation of inflammation, immunity, and cellular events. In this study, we developed an injectable dental pulp-derived decellularized matrix (DPM) hydrogel to modulate macrophage responses and promote dentin repair. The DPM derived from porcine dental pulp has high collagen retention and low DNA content. The DPM was solubilized by pepsin digestion (named p-DPM) and subsequently injected through a 25G needle to form hydrogel facilely at 37 °C. In vitro results demonstrated that the p-DPM induced the M2-polarization of macrophages and the migration, proliferation, and dentin differentiation of human dental pulp stem cells from deciduous teeth (SHEDs). In a mouse subcutaneous injection test, the p-DPM hydrogel was found to facilitate cell recruitment and M2 polarization during the early phase of implantation. Additionally, the acute pulp restoration in rat models proved that injectable p-DPM hydrogel as a pulp-capping agent had excellent efficacy in dentin regeneration. This study demonstrates that the DPM promotes dentin repair by modulating macrophage responses, and has a potential for pulp-capping applications in dental practice.


Asunto(s)
Pulpa Dental , Dentina , Hidrogeles , Macrófagos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Animales , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Humanos , Dentina/efectos de los fármacos , Dentina/química , Hidrogeles/química , Ratones , Ratas , Matriz Extracelular Descelularizada/química , Matriz Extracelular Descelularizada/farmacología , Porcinos , Diferenciación Celular/efectos de los fármacos , Regeneración/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Células Madre/efectos de los fármacos , Células Madre/citología , Cicatrización de Heridas/efectos de los fármacos
8.
Dent Mater ; 40(6): 984-992, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38724333

RESUMEN

OBJECTIVE: to compare conventional nanohybrid (Ceram.x Spectra) and ormocer-based (Admira fusion) dental composite resins effects on human dental pulp stem cells (hDPSCs) in terms of cytotoxicity, self-renewal, migration and osteogenic differentiation. METHODS: hDPSCs were cultured in presence of different dilutions (undiluted, form 1:2 to 1:100) of CeramX (CX) and Admira fusion (AD) eluates and viability assay in standard or osteogenic conditions were performed. Samples and eluates were prepared according to ISO 10993-12. In addition, apoptosis, self-renewal and migration activity evaluations were carried out. Osteogenic differentiation potential was tested by Alkaline Phosphatase Activity, alizarin red staining and gene expression of specific markers (ALP, RUNX2, OCN, OPN and COL1α1). Statistical analysis was performed by means of a One-way analysis of variance (One-way ANOVA) followed by a Tukey's test for multiple comparison; results were presented as mean ± standard error of mean (SEM). RESULTS: Admira Fusion demonstrated to be highly biocompatible and showed positive effects on hDPSCs proliferation and differentiation; on the contrary, conventional nanohybrid composite showed to be more cytotoxic and without any notable effect on stem cells differentiation. Moreover, the obtained results were further corroborated by a significant upregulation of osteogenic differentiation markers obtained in presence of ormocer-based composite resin eluate. Specifically, in AD 1:50 group expression levels of ALP, Runx2, Col1α1 were double than control (ALP, p = 0.045; Runx2, p = 0.003; Col1α1, p = 0.001) and CX 1:50 (ALP, p = 0.006; RUNX2, p = 0.029; Col1α1, p = 0.005). Moreover, in the same group, OPN and OCN resulted about 5 times more expressed as compared to control (OPN, p = 0.009; OCN, p = 0.0005) and CX 1:50 (OPN, p = 0.012; OCN, p = 0.0006). SIGNIFICANCE: The less cytotoxicity obtained by AD than conventional nanohybrid composite may be attributed to a reduced monomers release in the oral environment, supporting the hypothesis of limited adverse effect and enhanced healing potential, mainly when the material is positioned in close contact with pulp tissue.


Asunto(s)
Diferenciación Celular , Proliferación Celular , Resinas Compuestas , Pulpa Dental , Osteogénesis , Células Madre , Humanos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Células Madre/efectos de los fármacos , Resinas Compuestas/toxicidad , Resinas Compuestas/química , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Osteogénesis/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Cerámicas Modificadas Orgánicamente , Apoptosis/efectos de los fármacos , Ensayo de Materiales , Fosfatasa Alcalina/metabolismo , Movimiento Celular/efectos de los fármacos
9.
Oper Dent ; 49(3): 262-272, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38632866

RESUMEN

OBJECTIVES: This study evaluated the influence of hydrogen peroxide (HP) with or without titanium dioxide nanotubes (TiO2) associated with violet LED (VL) regarding: a) the temperature change in the pulp chamber and facial surface; b) the decomposition of HP; and c) the cytotoxicity of the gels on pulp cells. METHODS AND MATERIALS: The experimental groups were: HP35 (35% HP/Whiteness HP, FGM); HP35+VL; HP35T (HP35+TiO2); HP35T+VL; HP7 (7.5% HP/White Class 7.5%, FGM); HP7+VL; HP7T (HP7+TiO2); and HP7T+VL. TiO2 was incorporated into the bleaching gels at 1%. Eighty bovine incisors were evaluated to determine temperature change in 8 experimental groups (n=10/group). A k-type thermocouple was used to evaluate the temperatures of the facial surface and in the pulp chamber, achieved by enabling endodontic access to the palatal surface, throughout the 30-minute session. HP decomposition (n=3) of gels was evaluated by using an automatic potentiometric titrator at the initial and 30-minute time points. Trans-enamel and trans-dentinal cell viability were assessed with a pulp chamber device as well as enamel and dentin discs (n=6), and the treatment extracts (culture medium + diffused components) were collected and applied to MDPC-23 odontoblast cells to evaluate cell viability according to the MTT test. RESULTS: A temperature increase in the pulp chamber was observed in the presence of VL at 30 minutes (p<0.05) (Mann-Whitney test). Also at 30 minutes, HP35 showed greater decomposition in the presence of VL rather than in its absence (p<0.05) (mixed linear models and the Tukey-Kramer test). HP7 provided greater cell viability than the groups treated with HP35 (p<0.05) (generalized linear models test). Cell viability was significantly lower for HP7 in the presence of VL (p<0.05). CONCLUSION: Pulpal temperature increased with VL (maximum of 1.9°C), but did not exceed the critical limit to cause pulp damage. Less concentrated HP resulted in higher cell viability, even when associated with VL.


Asunto(s)
Pulpa Dental , Peróxido de Hidrógeno , Blanqueamiento de Dientes , Animales , Blanqueamiento de Dientes/métodos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Bovinos , Peróxido de Hidrógeno/farmacología , Supervivencia Celular/efectos de los fármacos , Blanqueadores Dentales/farmacología , Titanio , Temperatura Corporal , Cavidad Pulpar/efectos de los fármacos
10.
J Dent ; 146: 105020, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38670329

RESUMEN

OBJECTIVE: To design and evaluate a matrix metalloproteinase 9 (MMP-9)-responsive hydrogel for vital pulp therapy. METHODS: A peptide linker with optimized sensitivity toward MMP-9 was crosslinked with 4-arm poly (ethylene glycol)-norbornene (PEG-NB) by thiol-norbornene photo-polymerization. This resulted in the formation of a hydrogel network in which the peptide IDR-1002 was incorporated. Hydrogel characterization and gelation kinetics were examined with Fourier-transform infrared spectroscopy, scanning electron microscopy, rheological testing, and swelling evaluation. Hydrogel degradation was examined through multiple exposure to pre-activated MMP-9, to simulate flare-ups of dental pulp inflammation. The IDR-1002 released from degraded hydrogels was measured with high-performance liquid chromatography. Effect of IDR-1002 released from hydrogels on one-week-old multispecies oral biofilms was evaluated using confocal laser scanning microscopy. RESULTS: MMP-9-responsive, injectable, and photo-crosslinkable hydrogels were successfully synthesized. When hydrogel degradation and release of IDR-1002 were examined with exposure to pre-activated MMP-9, IDR-1002 release was significantly correlated with elevated levels of MMP-9 (p < 0.05). The effectiveness of IDR-1002 in killing bacteria in multispecies oral biofilms was significantly enhanced when the hydrogels were immersed in 10 nM or 20 nM pre-activated MMP-9, compared to immersion in phosphate-buffered saline (p < 0.05). CONCLUSIONS: The MMP-9-responsive hydrogel is a promising candidate for on-demand delivery of bioactive agent in vital pulp therapy. CLINICAL SIGNIFICANCE: MMP-9 is one of the most important diagnostic and prognostic biomarkers for pulpitis. An MMP-9-responsive hydrogel has potential to be used as an in-situ on-demand release system for the diagnosis and treatment of dental pulp inflammation.


Asunto(s)
Hidrogeles , Metaloproteinasa 9 de la Matriz , Polietilenglicoles , Metaloproteinasa 9 de la Matriz/metabolismo , Hidrogeles/química , Humanos , Polietilenglicoles/química , Pulpa Dental/efectos de los fármacos , Biopelículas/efectos de los fármacos , Espectroscopía Infrarroja por Transformada de Fourier , Péptidos/química , Péptidos/farmacología , Microscopía Electrónica de Rastreo , Pulpitis , Reología , Microscopía Confocal , Reactivos de Enlaces Cruzados/química
11.
J Dent ; 145: 105015, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38657726

RESUMEN

OBJECTIVES: To assess and compare the cell viability and ion release profiles of two conventional glass ionomer cements (GICs), Fuji IX and Ketac Molar EasyMix, modified with TiO2 and Mg-doped-HAp nanoparticles (NPs). METHODS: TiO2 NPs, synthesized via a sol-gel method, and Mg-doped hydroxyapatite, synthesized via a hydrothermal process, were incorporated into GICs at a concentration of 5 wt.%. The biocompatibility of prepared materials was assessed by evaluating their effects on the viability of dental pulp stem cells (DPSCs), together with monitoring ion release profiles. Statistical analysis was performed using One-way analysis of variance, with significance level p < 0.05. RESULTS: The addition of NPs did not significantly affect the biocompatibility of GICs, as evidenced by comparable decreased levels in cell viability to their original formulations. Distinct variations in cell viability were observed among Fuji IX and Ketac Molar, including their respective modifications. FUJI IX and its modification with TiO2 exhibited moderate decrease in cell viability, while other groups exhibited severe negative effects. While slight differences in ion release profiles were observed among the groups, significant variations compared to original cements were not achieved. Fluoride release exhibited an initial "burst release" within the initial 24 h in all samples, stabilizing over subsequent days. CONCLUSIONS: The addition of NPs did not compromise biocompatibility, nor anticariogenic potential of tested GICs. However, observed differences among FUJI IX and Ketac Molar, including their respective modifications, as well as induced low viability of DPSC by all tested groups, suggest the need for careful consideration of cement composition in their biological assessments. CLINICAL SIGNIFICANCE: The findings contribute to understanding the complex interaction between NPs and GIC matrices. However, the results should be interpreted recognizing the inherent limitations associated with in vitro studies. Further research avenues could explore long-term effects, in vivo performance, and potential clinical applications.


Asunto(s)
Supervivencia Celular , Pulpa Dental , Durapatita , Fluoruros , Cementos de Ionómero Vítreo , Magnesio , Ensayo de Materiales , Nanopartículas , Titanio , Titanio/química , Cementos de Ionómero Vítreo/química , Supervivencia Celular/efectos de los fármacos , Durapatita/química , Humanos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Nanopartículas/química , Fluoruros/química , Magnesio/química , Células Madre/efectos de los fármacos , Materiales Biocompatibles/química , Iones , Células Cultivadas
12.
Int Endod J ; 57(6): 727-744, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38436622

RESUMEN

AIMS: This study aimed to investigate the anti-inflammatory and odontoblastic effects of cerium-containing mesoporous bioactive glass nanoparticles (Ce-MBGNs) on dental pulp cells as novel pulp-capping agents. METHODOLOGY: Ce-MBGNs were synthesized using a post-impregnation strategy based on the antioxidant properties of Ce ions and proposed the first use of Ce-MBGNs for pulp-capping application. The biocompatibility of Ce-MBGNs was analysed using the CCK-8 assay and apoptosis detection. Additionally, the reactive oxygen species (ROS) scavenging ability of Ce-MBGNs was measured using the 2,7-Dichlorofuorescin Diacetate (DCFH-DA) probe. The anti-inflammatory effect of Ce-MBGNs on THP-1 cells was further investigated using flow cytometry and quantitative real-time polymerase chain reaction (RT-qPCR). Moreover, the effect of Ce-MBGNs on the odontoblastic differentiation of the dental pulp cells (DPCs) was assessed by combined scratch assays, RT-qPCR, western blotting, immunocytochemistry, Alizarin Red S staining and tissue-nonspecific alkaline phosphatase staining. Analytically, the secretions of tumour necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß) were detected with enzyme-linked immunosorbent assay (ELISA). RESULTS: Ce-MBGNs were confirmed to effectively scavenge ROS in THP-1-derived macrophages and DPCs. Flow cytometry and RT-qPCR assays revealed that Ce-MBGNs significantly inhibited the M1 polarization of macrophages (Mφ). Furthermore, the protein levels of TNF-α and IL-1ß were downregulated in THP-1-derived macrophages after stimulation with Ce-MBGNs. With a step-forward virtue of promoting the odontoblastic differentiation of DPCs, we further confirmed that Ce-MBGNs could regulate the formation of a conductive immune microenvironment with respect to tissue repair in DPCs, which was mediated by macrophages. CONCLUSIONS: Ce-MBGNs protected cells from self-produced oxidative damage and exhibited excellent immunomodulatory and odontoblastic differentiation effects on DPCs. As a pulp-capping agent, this novel biomaterial can exert anti-inflammatory effects and promote restorative dentine regeneration in clinical treatment. We believe that this study will stimulate further correlative research on the development of advanced pulp-capping agents.


Asunto(s)
Antiinflamatorios , Cerio , Pulpa Dental , Nanopartículas , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Cerio/farmacología , Humanos , Antiinflamatorios/farmacología , Especies Reactivas de Oxígeno/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Cerámica/farmacología , Diferenciación Celular/efectos de los fármacos , Vidrio , Odontoblastos/efectos de los fármacos , Regeneración/efectos de los fármacos , Células THP-1 , Materiales de Recubrimiento Pulpar y Pulpectomía/farmacología , Interleucina-1beta/metabolismo , Apoptosis/efectos de los fármacos , Porosidad , Células Cultivadas
13.
Toxicology ; 504: 153788, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38527609

RESUMEN

Cisplatin is a highly effective chemotherapy drug used to treat most solid tumors. However, one of its side effects is testicular toxicity, which can lead to fertility abnormalities. This study investigated the effectiveness of dental pulp mesenchymal stem cells conditioned medium (DPSC-CM) on cisplatin-induced testicular toxicity. In this study, 36 eight-week-old male Wistar rats were randomly divided into three groups equally (n = 12). Group 1 control "CTR", which received normal saline (0.5 ml) intraperitoneally (i.p), group 2 "Cis" which received an intraperitoneal dose of cisplatin (7 mg/kg), and group 3 "Cis+CM" which received an i.p injection of DPSC-CM (0.5 mg/kg) after cisplatin injection. Biochemical, histomorphometric, and histopathological studies were performed on the testis. Our results exhibited that cis administration led to a decline in total body weight, testis weight, diameter, and volume. A decrease in testosterone and IL-6 serum levels, as well as a decrease in IL-6 and TNFα levels, the activity of catalase and SOD enzymes, and an increase in MDA in testicular tissue were detected. Testicular tissue damage was associated with a significant decrease in tube diameter, germinal epithelium height, number of spermatogonia and Sertoli cells, along with a noticeable increase in basement membrane thickness, and perivascular fibrosis. DMSC-CM improved all the mentioned parameters. Taken together, our results demonstrated that DMSC-CM due to its antioxidant and anti-inflammatory properties, could be effective in reversing cisplatin-induced testicular toxicity.


Asunto(s)
Cisplatino , Pulpa Dental , Ratas Wistar , Testículo , Animales , Masculino , Cisplatino/toxicidad , Medios de Cultivo Condicionados/farmacología , Testículo/efectos de los fármacos , Testículo/patología , Testículo/metabolismo , Pulpa Dental/efectos de los fármacos , Pulpa Dental/citología , Ratas , Testosterona/sangre , Antineoplásicos/toxicidad , Estrés Oxidativo/efectos de los fármacos , Células Madre Mesenquimatosas/efectos de los fármacos
14.
Dent Mater ; 40(5): e14-e25, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38431482

RESUMEN

OBJECTIVES: The biological responses of MTA and Biodentine™ has been assessed on a three-dimensional, tissue-engineered organotypic deciduous pulp analogue. METHODS: Human endothelial (HUVEC) and dental mesenchymal stem cells (SHED) at a ratio of 3:1, were incorporated into a collagen I/fibrin hydrogel; succeeding Biodentine™ and MTA cylindrical specimens were placed in direct contact with the pulp analogue 48 h later. Cell viability/proliferation and morphology were evaluated through live/dead staining, MTT assay and Scanning Electron Microscopy (SEM), and expression of angiogenic, odontogenic markers through real time PCR. RESULTS: Viable cells dominated at day 3 after treatment presenting typical morphology, firmly attached within the hydrogel structures, as shown by live/dead staining and SEM images. MTT assay at day 1 presented a significant increase of cell proliferation in Biodentine™ group. Real-time PCR showed significant upregulation of odontogenic markers DSPP, BMP-2 (day 3,6), RUNX2, ALP (day 3) in contact with Biodentine™ compared to MTA and the control, whereas MTA promoted significant upregulation of DSPP, BMP-2, RUNX2, Osterix (day 3) and ALP (day 6) compared to the control. MSX1 presented downregulation in both experimental groups. Expression of angiogenic markers VEGFa and ANGPT-1 at day 3 was significantly upregulated in contact with Biodentine™ and MTA respectively, while the receptors VEGFR1, VEGFR2 and Tie-2, as well as PECAM-1 were downregulated. SIGNIFICANCE: Both calcium silicate-based materials are biocompatible and exert positive angiogenic and odontogenic effects, although Biodentine™ during the first days of culture, seems to induce higher cell proliferation and provoke a more profound odontogenic and angiogenic response from SHED.


Asunto(s)
Compuestos de Calcio , Proliferación Celular , Pulpa Dental , Combinación de Medicamentos , Silicatos , Ingeniería de Tejidos , Silicatos/farmacología , Silicatos/química , Compuestos de Calcio/farmacología , Compuestos de Calcio/química , Humanos , Ingeniería de Tejidos/métodos , Proliferación Celular/efectos de los fármacos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Compuestos de Aluminio/farmacología , Compuestos de Aluminio/química , Óxidos/farmacología , Óxidos/química , Supervivencia Celular/efectos de los fármacos , Reacción en Cadena en Tiempo Real de la Polimerasa , Células Madre Mesenquimatosas/efectos de los fármacos , Microscopía Electrónica de Rastreo , Diente Primario/citología , Cementos Dentales/farmacología , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Cultivadas
15.
Int Dent J ; 74(3): 482-491, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38431469

RESUMEN

OBJECTIVES: This study aimed to investigate the in vitro effects of root canal filling and repair paste (nRoot BP) on human dental pulp stem cells (hDPSCs). METHODS: The effects of nRoot BP and iRoot BP Plus on the adhesion, proliferation, migration, and differentiation of hDPSCs were examined in vitro for 72 hours. The adhesion of cells was observed using immunofluorescence rhodamine ghost pen cyclic peptide staining and scanning electron microscopy (SEM). Cell density and changes in migration area were measured under a fluorescence inverted microscope. Fluorescent quantitative PCR was performed to detect genes related to odontogenesis and osteogenesis. RESULTS: Cells adhering to the surfaces of nRoot BP and iRoot BP Plus exhibited similar irregular polygonal morphologies, with cells extending irregular pseudopods to adhere to the materials. CCK-8 results indicated that the density of living cells for nRoot BP and iRoot BP Plus was lower than that of the blank control group at 3 and 5 days of culture. There was no significant difference in cell migration between the groups (P > .05). The migration ability of iRoot BP Plus and nRoot BP was similar to that of the control group. Both nRoot BP and iRoot BP Plus increased the expression of the RUNX2 gene, but there was no significant difference between the groups (P < .05). Furthermore, both nRoot BP and iRoot BP Plus downregulated the expression of the DSPP gene, with no significant difference between them (P > .05). CONCLUSIONS: nRoot BP exhibited a slight inhibition of hDPSC proliferation but did not affect the adhesion and migration of hDPSCs. The impact of nRoot BP on the osteogenic and odontogenic differentiation of hDPSCs was similar to that of iRoot BP Plus.


Asunto(s)
Adhesión Celular , Diferenciación Celular , Movimiento Celular , Proliferación Celular , Cerámica , Pulpa Dental , Materiales de Obturación del Conducto Radicular , Células Madre , Humanos , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Células Madre/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Movimiento Celular/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Adhesión Celular/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/farmacología , Nanopartículas , Osteogénesis/efectos de los fármacos , Microscopía Electrónica de Rastreo , Células Cultivadas , Combinación de Medicamentos , Subunidad alfa 1 del Factor de Unión al Sitio Principal , Técnicas In Vitro , Odontogénesis/efectos de los fármacos , Materiales Biocompatibles/farmacología , Silicatos
16.
Int Endod J ; 57(6): 759-768, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38436525

RESUMEN

AIM: Among numerous constituents of Panax ginseng, a constituent named Ginsenoside Rb1 (G-Rb1) has been studied to diminish inflammation associated with diseases. This study investigated the anti-inflammatory properties of G-Rb1 on human dental pulp cells (hDPCs) exposed to lipopolysaccharide (LPS) and aimed to determine the underlying molecular mechanisms. METHODOLOGY: The KEGG pathway analysis was performed after RNA sequencing in G-Rb1- and LPS-treated hDPCs. Reverse-transcription polymerase chain reaction (RT-PCR) and western blot analysis were used for the assessment of cell adhesion molecules and inflammatory cytokines. Statistical analysis was performed with one-way ANOVA and the Student-Newman-Keuls test. RESULTS: G-Rb1 did not exhibit any cytotoxicity within the range of concentrations tested. However, it affected the levels of TNF-α, IL-6 and IL-8, as these showed reduced levels with exposure to LPS. Additionally, less mRNA and protein expressions of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) were shown. With the presence of G-Rb1, decreased levels of PI3K/Akt, phosphorylated IκBα and p65 were also observed. Furthermore, phosphorylated ERK and JNK by LPS were diminished within 15, 30 and 60 min of G-Rb1 exposure; however, the expression of non-phosphorylated ERK and JNK remained unchanged. CONCLUSIONS: G-Rb1 suppressed the LPS-induced increase of cell adhesion molecules and inflammatory cytokines, while also inhibiting PI3K/Akt, phosphorylation of NF-κB transcription factors, ERK and JNK of MAPK signalling in hDPCs.


Asunto(s)
Pulpa Dental , Ginsenósidos , Lipopolisacáridos , FN-kappa B , Fosfatidilinositol 3-Quinasas , Proteínas Proto-Oncogénicas c-akt , Transducción de Señal , Ginsenósidos/farmacología , Humanos , Pulpa Dental/efectos de los fármacos , Pulpa Dental/citología , Pulpa Dental/metabolismo , Lipopolisacáridos/farmacología , FN-kappa B/metabolismo , FN-kappa B/efectos de los fármacos , Proteínas Proto-Oncogénicas c-akt/metabolismo , Proteínas Proto-Oncogénicas c-akt/efectos de los fármacos , Fosfatidilinositol 3-Quinasas/metabolismo , Transducción de Señal/efectos de los fármacos , Inflamación/metabolismo , Células Cultivadas , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Citocinas/metabolismo , Western Blotting
17.
Int Endod J ; 57(6): 630-654, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38470103

RESUMEN

BACKGROUND: Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high. OBJECTIVES: To investigate the influence of bleaching on the pulp tissue. METHODS: Electronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non-bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non-Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta-analysis was unfeasible. RESULTS: Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate-to-strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%-38% HP, for 30-40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%-38% HP in long-term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post-treatment. Other studies indicated an increase in pro-inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias. DISCUSSION: Despite the heterogeneity in bleaching protocols among studies, High-concentrations of HP shows the potential to induce significant pulp damage. CONCLUSIONS: High-concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well-described histological studies with long-term follow-up are encouraged due to the methodological limitations of these studies. REGISTRATION: PROSPERO (CRD42021230937).


Asunto(s)
Peróxido de Carbamida , Pulpa Dental , Peróxido de Hidrógeno , Blanqueadores Dentales , Blanqueamiento de Dientes , Blanqueamiento de Dientes/métodos , Blanqueamiento de Dientes/efectos adversos , Pulpa Dental/efectos de los fármacos , Pulpa Dental/patología , Humanos , Animales , Peróxido de Carbamida/farmacología
18.
J Appl Oral Sci ; 31: e20230006, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37283330

RESUMEN

OBJECTIVE: To explore the potential for development of Thai propolis extract as a pulp capping agent to suppress pulpal inflammation from dental pulp infections. This study aimed to examine the anti-inflammatory effect of the propolis extract on the arachidonic acid pathway, activated by interleukin (IL)-1ß, in cultured human dental pulp cells. METHODOLOGY: Dental pulp cells, isolated from three freshly extracted third molars, were first characterized for their mesenchymal origin and treated with 10 ng/ml of IL-1ß in the presence or absence of non-toxic concentrations of the extract from 0.08 to 1.25 mg/ml, as determined by the PrestoBlue cytotoxic assay. Total RNA was harvested and analyzed for mRNA expressions of 5-lipoxygenase (5-LOX) and cyclooxygenase-2 (COX-2). Western blot hybridization was performed to investigate COX-2 protein expression. Culture supernatants were assayed for released prostaglandin E2 levels. Immunofluorescence was conducted to determine involvement of nuclear factor-kappaB (NF-kB) in the inhibitory effect of the extract. RESULTS: Stimulation of the pulp cells with IL-1ß resulted in the activation of arachidonic acid metabolism via COX-2, but not 5-LOX. Incubation with various non-toxic concentrations of the propolis extract significantly inhibited upregulated COX-2 mRNA and protein expressions upon treatment with IL-1ß (p<0.05), resulting in a significant decrease in elevated PGE2 levels (p<0.05). Nuclear translocation of the p50 and the p65 subunits of NF-kB upon treatment with IL-1ß was also blocked by incubation with the extract. CONCLUSIONS: Upregulated COX-2 expression and enhanced PGE2 synthesis upon treatment with IL-1ß in human dental pulp cells were suppressed by incubation with non-toxic doses of Thai propolis extract via involvement of the NF-kB activation. This extract could be therapeutically used as a pulp capping material due to its anti-inflammatory properties.


Asunto(s)
Antiinflamatorios , Pulpa Dental , Própolis , Humanos , Antiinflamatorios/farmacología , Ácido Araquidónico/farmacología , Células Cultivadas , Ciclooxigenasa 2/metabolismo , Pulpa Dental/citología , Pulpa Dental/efectos de los fármacos , Dinoprostona/metabolismo , FN-kappa B , Extractos Vegetales , Própolis/farmacología , ARN Mensajero/metabolismo
19.
Int Endod J ; 56(9): 1129-1146, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37358385

RESUMEN

AIM: Pulp vitality is essential for tooth integrity. Following pulp exposure, choosing a suitable pulp-capping material is crucial to maintain pulp vitality. However, the reparative dentine bridge created by calcium hydroxide (Ca(OH)2 ) is generally porous and incomplete. The aim of the current study is to assess the in vitro and in vivo bioactivities of nano eggshell-based slurry (NES), using NES as a direct pulp-capping material, compared with Ca(OH)2 in rabbit animal model. METHODOLOGY: Nano eggshell powder (NE) was characterized for particle morphology, chemical composition and ion release. In vitro bioactivity was tested by immersion in simulated body fluid (SBF) for 7 days. For histopathological evaluation, 36 adult New Zealand rabbits (72 pulp exposures) were divided into nine groups (n = 8) according to the pulp-capping material (NES, Ca(OH)2 and no capping as negative control group) and the animals were sacrificed after 7, 14 or 28 days. The pulps of the two lower central incisors were exposed and then directly capped by Ca(OH)2 or NES or left untreated. The cavities were then sealed with glass ionomer cement. Teeth were collected for histopathological evaluation using an optical microscope. Pulp haemorrhage, inflammation, fibrosis and calcific bridge formation were assessed. Results were statistically analysed using anova and Tukey's tests. RESULTS: Nano eggshell particles were spherical with a 20 nm diameter and were composed mainly of calcite. Statistical analysis showed that there was a significant increase in the release of all investigated ions between days 1 and 28, except for copper. NES group showed a significantly higher release of all elements as compared to Ca(OH)2 . Environmental scanning electron microscope micrographs of NES incubated for 7 days in SBF showed the formation of HAp with a Ca/P ratio (1.686). For histopathological evaluation, the difference between groups was statistically significant. At day 28, 75% of the pulps of the Ca(OH)2 group showed mild calcific bridge in comparison with 100% moderate calcific bridge in the NES group. The NES group showed significantly less inflammation at days 7 and 28, and higher fibrosis at day 7 compared with Ca(OH)2 . CONCLUSIONS: Nano eggshell-based slurry represents a promising novel direct pulp-capping material with favourable pulp tissue response.


Asunto(s)
Hidróxido de Calcio , Recubrimiento de la Pulpa Dental , Pulpa Dental , Cáscara de Huevo , Animales , Conejos , Hidróxido de Calcio/farmacología , Pulpa Dental/efectos de los fármacos , Recubrimiento de la Pulpa Dental/métodos , Dentina Secundaria , Inflamación , Modelos Animales
20.
Cells ; 11(21)2022 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-36359794

RESUMEN

Regenerative endodontic treatment based on tissue engineering has recently gained interest in contemporary restorative dentistry. However, low survival rates and poor potential differentiation of stem cells could undermine the success rate of pulp regenerative therapy. Human gingival fibroblast-conditioned medium (hGF-CM) has been considered a potential therapy for tissue regeneration due to its stability in maintaining multiple factors essential for tissue regeneration compared to live cell transplantation. This study aimed to investigate the potency of hGF-CM on stem cells from human dental pulp (DPSC) in pulp regeneration. A series of experiments confirmed that hGF-CM contributes to a significant increase in proliferation, migration capability, and cell viability of DPSC after H2O2 exposure. Moreover, it has been proved to facilitate the odontogenic differentiation of DPSC via qRT-PCR, ALP (alkaline phosphatase), and ARS (Alizarin Red S) staining. It has been discovered that such highly upregulated odontogenesis is related to certain types of ECM proteins (collagen and laminin) from hGF-CM via proteomics. In addition, it is found that the ERK pathway is a key mechanism via inhibition assay based on RNA-seq result. These findings demonstrate that hGF-CM could be beneficial biomolecules for pulp regeneration.


Asunto(s)
Medios de Cultivo Condicionados , Pulpa Dental , Peróxido de Hidrógeno , Ingeniería de Tejidos , Humanos , Fosfatasa Alcalina/metabolismo , Medios de Cultivo Condicionados/química , Medios de Cultivo Condicionados/farmacología , Pulpa Dental/efectos de los fármacos , Pulpa Dental/metabolismo , Fibroblastos/metabolismo , Regeneración , Encía/citología , Encía/metabolismo , Ingeniería de Tejidos/métodos
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