3D-printed polycaprolactone scaffolds coated with beta tricalcium phosphate for bone regeneration.

BACKGROUND/PURPOSE: 3D-printing technology is an important tool for the bone tissue engineering (BTE). The aim of this study was to investigate the interaction of polycaprolactone (PCL) scaffolds and modified mesh PCL coated with beta TCP (PCL/ß-TCP) scaffolds with MG-63. METHODS: This study used the fused deposition modeling (FDM) technique with the 3D printing technique to fabricate the thermoplastic polymer and composite scaffolds. Scaffold structure and coating quality were observed under a scanning electron microscope (SEM). MG-63 cells were injected and attached to the mesh-manufactured PCL scaffolds. The biocompatibility of mesh structured PCL and PCL/ß-TCP scaffolds could be examined by measuring the viability of MG-63 cells of MTT assay. Bone cell differentiation was evaluated ALP activity by mineralization assay. RESULTS: The results showed that both mesh PCL scaffolds and PCL/ß-TCP scaffolds were non-toxic to the cells. The ALP activities of cells in PCL/ß-TCP scaffolds groups were significant differences and better than PCL groups in all groups at all experimental dates. The mineralization process was time-dependent, and significantly higher mineralization of osteosarcoma cells was observed on PCL/ß-TCP scaffolds at experimental dates. CONCLUSION: We concluded that both meshes structured PCL and PCL/ß-TCP scaffolds could promote the MG-63 cell growth, and PCL/ß-TCP was better than the PCL scaffolds for the outcome of MG63 cell differentiation and mineralization.

Comparison of periodontal health of primary teeth restored with zirconia and stainless steel crowns: A systemic review and meta-analysis.

BACKGROUND/PURPOSE: In children, the use of stainless steel crowns to treat caries has a high success rate. However, due to the unnatural color of stainless steel crowns, it still needs to modify crown types. The present meta-analysis study aims to explore the previous articles on the comparison of stainless steel crowns and zirconia crowns. METHODS: The systematic search of studies on the comparison of zirconia crowns and stainless steel crowns for primary teeth was mainly in PubMed and Cochrane database. The standardized mean differences (SMDs) of gingival health between zirconia crowns and stainless steel crowns comprised the primary outcome, and the SMDs of plaque index compared two crown treatments was treated as the secondary outcome. RESULTS: The meta-analysis extracted 187 papers from various databases and collected five randomized controlled trials, four comparisons on deciduous molars and one comparison on deciduous incisors. 160 children were included, ranging in age from 3-9 years old. The quantitative analysis showed a significantly lower gingival index of zirconia crowns in the primary molar group and the primary incisor group. The plaque index between two crown treatments groups was -4.51, indicating less accumulation of plaque on zirconia crown. However, the heterogeneity of included trials still need to be considered. CONCLUSION: Zirconia crowns for deciduous teeth had its advantages for gingival health. Although stainless steel crowns were more likely to have plaque deposition and gingival inflammation, zirconia crowns relatively caused the opposite tooth wearing and chipping. Therefore, the comprehensive consideration is important to choose deciduous tooth crown.

Efficacy of polyacrylate silver salt/polyvinylpyrrolidone-based liquid oral gel in management of concurrence chemoradiotherapy-induced oral mucositis.

BACKGROUND/PURPOSE: Acute oral mucositis (OM) is a painful complication of concurrent chemoradiotherapy (CCRT). This severe adverse symptom may impact on patient's quality of life, lead to malnutrition. Thus, finding more effective methods in OM management is very important. The purpose of this study is to evaluate the efficacy of polyacrylate silver salt/Polyvinylpyrrolidone-based liquid oral gel (named as polyacrylate silver salt oral gel) in improving the symptomatic relief of CCRT-induced oral mucositis and oral dysfunction in neck and head cancer patients. METHODS: In this study, 24 oral cancer patients underwent CCRT and having OM grade 2 or higher were randomly assigned into the test group and the control group. Both groups followed Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines for the management of mucositis, but adding rinsing with 15 g oral gel right after oral hygiene treaded the test group. Clinical OM and oral function were assessed weekly for 4 consecutive weeks till 5-10 days after the completion of radiotherapy. For evaluation, Common Terminology Criteria for Adverse Events (CTCAE) v3.0 was used for collecting the data of OM grade. RESULTS: The results showed that polyacrylate silver salt oral gel had better effect for relieving the oral mucositis. There were statistically significant differences in OM grades (1.59 vs. 2.8, p < 0.0001) between the test group and the control group. CONCLUSION: Our clinical studies demonstrated that polyacrylate silver salt oral gel is an effective interventional option in terms of rapid mucositis healing.

Preclinical evaluation of a 3D-printed hydroxyapatite/poly(lactic-co-glycolic acid) scaffold for ridge augmentation.

BACKGROUND/PURPOSE: Supracrestal ridge augmentation (SRA) is a major challenge for clinicians. This study investigated the efficacy of a 3D-printed (3DP) hydroxyapatite/poly(lactic-co-glycolic acid) (HA/PLGA) scaffold as a potential biologic for SRA. METHODS: Scaffolds that were 5 mm in diameter and 2.5-mm thick with a 1.2-mm diameter through-and-through central hole composed of 90% HA and 10% PLGA were printed using an extrusion-based bioprinter. The HA/PLGA scaffold was fixed with a 1.2-mm titanium mini-implant on the buccal surface of rat mandible (Ti-HPS), and the outcome of SRA were compared with sites treated with a titanium mini-implant alone (control) and a titanium mini-implant covered with deproteinized bovine bone-derived matrix (Ti-DBBM) at 4 and 8 weeks by microcomputed tomography (micro-CT), back-scattered SEM, and histology assessments. RESULTS: The HA/PLGA scaffolds were 2.486 ± 0.082 mm thick with an outer diameter of 4.543 ± 0.057 mm and an inner diameter of 1.089 ± 0.045 mm, and the pore dimensions were 0.48-0.52 mm. There was significantly more mineralized tissue in the Ti-DBBM and Ti-HPS groups than in the control group at both time points. Newly formed bone (NB) was well-integrated with the DBBM and HA/PLGA scaffolds. The framework of the 3DP-HA/PLGA scaffold remained in place, and NB-implant contact (NBIC) was advanced to the middle level in the Ti-HPS group until 8 weeks, whereas dispersion of DBBM with a lower level NBIC was noted in the Ti-DBBM group at both time points. CONCLUSION: The 3DP HA/PLGA scaffold maintains supracrestal space and demonstrates osteoconductivity to facilitate SRA.

Characterization of designed directional polylactic acid 3D scaffolds for neural differentiation of human dental pulp stem cells.

BACKGROUND/PURPOSE: In recent years, 3D printing technology has flourished and applied to tissue engineering regeneration. The purpose of this study is to investigate the effects of gap width between struts (GWbS) of three-dimensional-printed polylactic acid scaffolds (3DP-PLASs) on neural differentiation of human dental pulp stem cells (hDPSCs). METHODS: Both the 3DP-PLASs with the GWbS of 150 µm and 200 µm were experimental groups and the 3DP-PLAS without microfilament struts was the control group. Properties of 3DP-PLASs were observed by water contact angles (WCA), atomic force microscope (AFM), and differential scanning calorimeter (DSC). The cell culture of hDPSCs on 3DP-PLASs was performed, and cytotoxicities were measured with Alamar Blue assay. The neural differentiation of hDPSCs on different 3DP-PLASs was compared after neural induction. Expressions of neural markers Nestin, MAP2, beta III tubulin, and GFAP were evaluated with immunocytochemical staining. RESULTS: Our results demonstrated no cytotoxicities among scaffolds, whereas they may differ in crystal sizes and directions resulting from different orders of cooling time, contact surface, and temperature distribution during the building process. In addition, hDPSCs could successfully adhere to 3DP-PLAS modified by alcohol or poly-l-Lysine and demonstrate morphological change and related protein performance. CONCLUSION: We conclude that 3DP-PLASs with 150 µm gaps can induce cellular orientations more easily than those with 200 µm gaps. In addition, 3DP-PLASs seem to improve cell adhesion after being coated with poly-l-lysine or soaked with alcohol.

Perceived pain for orthodontic patients with conventional brackets or self-ligating brackets over 1 month period: A single-center, randomized controlled clinical trial.

BACKGROUND/PURPOSE: The objective of this 2-arm parallel trial was to test the superiority of self-ligating brackets (SLB) over conventional brackets (CB) in terms of perceived pain for orthodontic patients. METHODS: Patients about to undergo treatment were included to fixed appliance placed with CB or SLB. Eligibility criteria included malocclusion patients whose age between 12 to 40 years and suitable for orthodontic fixed appliance treatment. The main outcome was pain intensity measured by visual analog scale (VAS) with all patients followed at 4 h, 24 h, 3 days, 1 week and 1 month. Randomization was accomplished with a computer-generated list of random numbers. Blinding was applicable for outcome assessment only. Data were analyzed using multi-level nonlinear mixed effect model, Friedman's test and Wilcoxon signed rank test with the Bonferroni correction for multiple tests. RESULTS: Eight-eight patients were randomized in a 1:1 ratio to either SLB or CB. All patients completed the study, and none were lost to follow-up. There were no drop-outs after randomization. Baseline characteristics were similar between groups. The is no statistical significant difference in pain intensity between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month. Data were analyzed on an intention-to-treat basis. No serious harm was observed. CONCLUSION: The results of this study indicated no evidence that the pain intensity differs between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month.

Promoting dentinogenesis of DPSCs through inhibiting microRNA-218 by using magnetic nanocarrier delivery.

PURPOSE: The purposes of this study are to explore the roles of microRNA-218 (miR-218) delivered by a newly designed magnetic nanocarrier: GCC-Fe3O4 (GCC-Fe) in dentinogenesis potentials of human dental pulp stem cells (DPSCs). METHODS: Human DPSCs were obtained from impacted wisdom teeth of healthy donors under the permission of National Taiwan University Hospital institutional review board (NTUH IRB). Meanwhile, the transfection efficiency of GCC-Fe was evaluated. After transfecting miR-218 (GFm) and miR-218 inhibitor (GFmi) into DPSCs for 24 h, the dentinogenesis potentials of DPSCs were then evaluated with Alizarin Red S (ARS) staining with or without induction for 1, 4, and 9 days. Possible signaling pathway was further investigated by Western Blotting. RESULTS: We found that the magnetic GCC-Fe3O4 nanocarrier was serum endurable with about 90% transfection efficiency in DPSCs under normal culture condition. Results of ARS staining indicated that miR-218 was negatively regulating dentinogenesis potentials of DPSCs after induction. When the miR-218 inhibitor was delivered, calcium deposits in DPSCs were increased significantly. We also discovered that the effects of miR-218 were further regulated through the MAPK/ERK pathway. CONCLUSION: We identified that miR-218 had a negative regulation role in the dentinogenesis of DPSCs. By inhibiting miR-218, the mineralization potentials of DPSCs were promoted after induction. In addition, we also confirmed that the highly efficient magnetic GCC-Fe3O4 nanocarrier not only was suitable for gene manipulation in biomedical studies, but also ideal for future clinical applications due to its serum endurable property.

Curcumin inhibits TGF-ß1-induced connective tissue growth factor expression through the interruption of Smad2 signaling in human gingival fibroblasts.

BACKGROUND/PURPOSE: Many fibrotic processes are associated with an increased level of transforming growth factor-ß1 (TGF-ß1). TGF-ß1 can increase synthesis of matrix proteins and enhance secretion of protease inhibitors, resulting in matrix accumulation. Connective tissue growth factor (CTGF) is a downstream profibrotic effector of TGF-ß1 and is associated with the fibrosis in several human organs. Curcumin has been applied to reduce matrix accumulation in fibrotic diseases. This study was aimed to evaluate whether curcumin could suppress TGF-ß1-induced CTGF expression and its related signaling pathway involving in this inhibitory action in primary human gingival fibroblasts. METHODS: The differences in CTGF expression among three types of gingival overgrowth and normal gingival tissues were assessed by immunohistochemistry. Gingival fibroblast viability in cultured media with different concentrations of curcumin was studied by MTT assay. The effect of curcumin on TGF-ß1-induced CTGF expression in primary human gingival fibroblasts was examined by immunoblotting. Moreover, the proteins involved in TGF-ß1 signaling pathways including TGF-ß1 receptors and Smad2 were also analyzed by immunoblotting. RESULTS: CTGF was highly expressed in fibroblasts, epithelial cells and some of endothelial cells, smooth muscle cells, and inflammatory cells in phenytoin-induced gingival overgrowth tissues rather than in those of hereditary and inflammatory gingival overgrowth tissues. Moreover, CTGF expression in the epithelial and connective tissue layers was higher in phenytoin-induced gingival overgrowth tissues than in normal gingival tissues. Curcumin was nontoxic and could reduce TGF-ß1-induced CTGF expression by attenuating the phosphorylation and nuclear translocation of Smad2. CONCLUSION: Curcumin can suppress TGF-ß1-induced CTGF expression through the interruption of Smad2 signaling.

Specialized stem cell niche enables repetitive renewal of alligator teeth.

Reptiles and fish have robust regenerative powers for tooth renewal. However, extant mammals can either renew their teeth one time (diphyodont dentition) or not at all (monophyodont dentition). Humans replace their milk teeth with permanent teeth and then lose their ability for tooth renewal. Here, we study tooth renewal in a crocodilian model, the American alligator, which has well-organized teeth similar to mammals but can still undergo life-long renewal. Each alligator tooth is a complex family unit composed of the functional tooth, successional tooth, and dental lamina. Using multiple mitotic labeling, we map putative stem cells to the distal enlarged bulge of the dental lamina that contains quiescent odontogenic progenitors that can be activated during physiological exfoliation or artificial extraction. Tooth cycle initiation correlates with ß-catenin activation and soluble frizzled-related protein 1 disappearance in the bulge. The dermal niche adjacent to the dermal lamina dynamically expresses neural cell adhesion molecule, tenascin-C, and other molecules. Furthermore, in development, asymmetric ß-catenin localization leads to the formation of a heterochronous and complex tooth family unit configuration. Understanding how these signaling molecules interact in tooth development in this model may help us to learn how to stimulate growth of adult teeth in mammals.

Citrus polyphenol for oral wound healing in oral ulcers and periodontal diseases.

BACKGROUND/PURPOSE: Various polyphenolic compounds from plants have been confirmed to have different pharmaceutical functions. The purpose of this study was to evaluate citrus polyphenol (CP) for dental applications. A medium with CP was developed to improve oral wound healing. The CP could be used as a supplemental compound in mouthwash for periodontal diseases. METHOD: In this study, the metabolic activity and cell toxicity of CP (1%, 0.1%, and 0.01%) for fibroblasts were investigated by MTT and lactate dehydrogenase assays (n = 6). The effect of CP on motility of fibroblast was also evaluated via a wound healing model. RESULTS: The growth of Hs68 cells on TCPS was greatly increased in the presence of 0.01% CP. In addition, the significant difference (p<0.01) of cell toxicity of fibroblast was observed after 6 days in 0.01% CP medium. Using the wound healing model, it was also found that CP could enhance the migratory ability of fibroblasts. CONCLUSION: The results confirm the feasibility of CP be a supplemental compound in mouthwash for treatment of periodontal diseases in dental application to improve wound healing in the mouth.

Novel microinjector for carrying bone substitutes for bone regeneration in periodontal diseases.

BACKGROUND/PURPOSE: Traditionally, guide bone regeneration (GBR) was a widely used method for repairing bone lost from periodontal disease. There were some disadvantages associated with the GBR method, such as the need for a stable barrier membrane and a new creative cavity during the surgical process. To address these disadvantages, the purpose of this study was to evaluate a novel microinjector developed for dental applications. The microinjector was designed to carry bone graft substitutes to restore bone defects for bone regeneration in periodontal diseases. The device would be used to replace the GBR method. METHODS: In this study, the injected force and ejected volume of substitutes (including air, water, and ethanol) were defined by Hooke's law (n = 3). The optimal particle size of bone graft substitutes was determined by measuring the recycle ratio of bone graft substitutes from the microinjector (n = 3). Furthermore, a novel agarose gel model was used to evaluate the feasibility of the microinjector. RESULTS: The current study found that the injected force was less than 0.4 N for obtaining the ejected volume of approximately 2 mL, and when the particle size of tricalcium phosphate (TCP) was smaller than 0.5 mm, 80% TCP could be ejected from the microinjector. Furthermore, by using an agarose model to simulate the periodontal soft tissue, it was also found that bone graft substitutes could be easily injected into the gel. CONCLUSION: The results confirmed the feasibility of this novel microinjector for dental applications to carry bone graft substitutes for the restoration of bone defects of periodontal disease.

Inhibition of growth and migration of oral and cervical cancer cells by citrus polyphenol.

BACKGROUND/PURPOSE: It has been confirmed that polyphenolic compounds present in food have various pharmaceutical functions. The purpose of this study was to evaluate citrus polyphenol (CP) for dental applications. The culture medium with CP was developed to inhibit the proliferation of oral cancer cells. CP could be used as a supplemental compound for topical application for oral cancer patients. METHODS: In this study, the metabolic activity and cell toxicity of CP (at concentrations of 1%, 0.1%, and 0.01%) for oral and cervical cancer cells were investigated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and lactate dehydrogenase assays (n = 6). Furthermore, the effects of CP on motilities of oral and cervical cancer cells were also evaluated using a scratch assay model. RESULTS: We found that the growth of Ca9-22 and HeLa cells on tissue culture polystyrene was greatly inhibited when 1% CP was added to the medium. In addition, significant differences (p < 0.01) in cytotoxicities of oral and cervical cancer cells were observed after 6 days in the culture medium to which 1% CP was added. Furthermore, using a scratch assay model to evaluate the migratory abilities of oral and cervical cancer cells, it was also found that CP could inhibit the migratory abilities of cancer cells. CONCLUSION: The results confirmed the feasibility of the topical application of CP as a supplemental compound for inhibition of cancer cell proliferation and migration.

Effects of chlorhexidine on stem cells from exfoliated deciduous teeth.

BACKGROUND/PURPOSE: Chlorhexidine (CHX) is a type of chemical antiseptic that is widely used in dental practice. Stem cells from human exfoliated deciduous teeth (SHED) are multipotent cells. However, there is little knowledge about the effects of chlorhexidine on SHED cells. The purpose of this study is to investigate the effects of CHX on SHED. METHODS: SHED cells were treated with 0.1%, 0.01%, 0.001%, and 0.0001% CHX for 10 seconds to test the effects of different concentrations of CHX on SHED cells. The cells were also treated with 0.01% CHX for 10 seconds, 1 minute, and 5 minutes to test the time effects of CHX on SHED cells. Cell proliferation was investigated by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and an autonomously replicating sequence (ARS) assay was used for the evaluation of the mineralization potential. RESULTS: This study demonstrated that different concentrations of CHX had cytotoxic effects on SHED cells in a dose- and time-dependent manner. The proliferation of SHED cells was inhibited by approximately 50% by the use of 0.01% CHX. It was also found that the cell proliferation and mineralization potential of SHED cells were inhibited to some degree by different concentrations of CHX. CONCLUSION: Different concentrations of CHX can inhibit SHED cell proliferation in a dose- and time-dependent manner. In addition, the mineralization potential of SHED cells is inhibited to some degree by different concentrations of CHX.

Liquid crystalline epoxy nanocomposite material for dental application.

BACKGROUND/PURPOSE: Novel liquid crystalline epoxy nanocomposites, which exhibit reduced polymerization shrinkage and effectively bond to tooth structures, can be applied in esthetic dentistry, including core and post systems, direct and indirect restorations, and dental brackets. The purposes of this study were to investigate the properties of liquid crystalline epoxy nanocomposites including biocompatibility, microhardness, and frictional forces of bracket-like blocks with different filler contents for further clinical applications. METHODS: In this study, we evaluated liquid crystalline epoxy nanocomposite materials that exhibited various filler contents, by assessing their cell activity performance using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and their microhardness with or without thermocycling. We also evaluated the frictional force between bracket-like duplicates and commercially available esthetic bracket systems using Instron 5566. RESULTS: The liquid crystalline epoxy nanocomposite materials showed good biocompatibility. The materials having high filler content demonstrated greater microhardness compared with commercially available bracket materials, before and after the thermocycling treatment. Thus, manufacturing processes are important to reduce frictional force experienced by orthodontic brackets. CONCLUSION: The microhardness of the bracket-like blocks made by our new material is superior to the commercially available brackets, even after thermocycling. Our results indicate that the evaluated liquid crystalline epoxy nanocomposite materials are of an appropriate quality for application in dental core and post systems and in various restorations. By applying technology to refine manufacturing processes, these new materials could also be used to fabricate esthetic brackets for orthodontic treatment.

Multiphoton microscopy imaging of developing tooth germs.

BACKGROUND/PURPOSE: Traditionally, tooth germ is observed by histological investigation with hematoxylin and eosin stain and information may loss during the process. The purpose of this study is to use multiphoton laser fluorescence microscopy to observe the developing tooth germs of mice for building up the database of the images of tooth germs and compare with those from conventional histological analysis. METHODS: Tooth germs were isolated from embryonic and newborn mice with age of Embryonic Day 14.5 and Postnatal Days 1, 3, 5, and 7. RESULTS: Comparison of the images of tooth germ sections in multiphoton microscopy with the images of histology was performed for investigating the molar tooth germs. It was found that various signals arose from different structures of tooth germs. Pre-dentin and dentin have strong second-harmonic generation signals, while ameloblasts and enamel tissues were shown with strong autofluorescence signals. CONCLUSION: In this study, a novel multiphoton microscopy database of images from developing tooth germs in mice was set up. We confirmed that multiphoton laser microscopy is a powerful tool for investigating the development of tooth germ and is worthy for further application in the study of tooth regeneration.

Improvements in dental care using a new mobile app with cloud services.

BACKGROUND/PURPOSE: Traditional dental care, which includes long-term oral hygiene maintenance and scheduled dental appointments, requires effective communication between dentists and patients. In this study, a new system was designed to provide a platform for direct communication between dentists and patients. METHODS: A new mobile app, Dental Calendar, combined with cloud services specific for dental care was created by a team constituted by dentists, computer scientists, and service scientists. This new system would remind patients about every scheduled appointment, and help them take pictures of their own oral cavity parts that require dental treatment and send them to dentists along with a symptom description. Dentists, by contrast, could confirm or change appointments easily and provide professional advice to their patients immediately. In this study, 26 dentists and 32 patients were evaluated by a questionnaire containing eight dental-service items before and after using this system. Paired sample t test was used for statistical analysis. RESULTS: After using the Dental Calendar combined with cloud services, dentists were able to improve appointment arrangements significantly, taking care of the patients with sudden worse prosthesis (p < 0.05). Patients also achieved significant improvement in appointment reminder systems, rearrangement of appointments in case of sudden worse prosthesis, and establishment of a direct relationship with dentists (p < 0.05). CONCLUSION: Our new mobile app, Dental Calendar, in combination with cloud services, provides efficient service to both dentists and patients, and helps establish a better relationship between them. It also helps dentists to arrange appointments for patients with sudden worsening of prosthesis function.

A tricalcium phosphate (TCP) and hydroxyapatite (HA) based light-cured biomaterial for vital pulp therapy.

OBJECTIVES: Evaluate a new light-cured material with better properties for vital pulp therapy. METHODS: Light-cured resin materials consisted of polyethylene glycol (600) diacrylate mixed with different ratios of TCP to HA. In addition to the temperature change (n = 5 for each subgroup) were tested, cell viability and Alizarin Red Staining (ARS) assay were also tested in vitro on human dental pulp cells (n = 6 for each subgroup). Lastly, the material was then compared with Biodentine and control groups in the molars of Wistar rats in vivo for histology assessment. RESULTS: The temperature change for the new materials were under 5 degrees Celsius. For the in vitro assessments, there was no significant difference on day 3 and day 7 for cell viability test. ARS assay showed significantly higher mineralized nodule formation when treated without induction medium for Group D and Biodentine on day 10 compared to Group C and control. On the contrary, Biodentine and control groups treated with induction medium showed significant higher mineralization than the new materials. Histology assessments demonstrated higher mineralized content in Group D and Biodentine on week 3 and week 6. The inflammatory cells in the dental pulp complex of the Biodentine group resolved on week 6 while the inflammation resolved in Group D on week 3. SIGNIFICANCE: The new material exhibits low heat production, low cytotoxicity, and good calcium ion release capability. Compared to traditional materials, it has shorter setting time and better aesthetic outcomes, making it highly suitable for use in vital pulp therapy.

The temporospatial relationship between mouse dental pulp stem cells and tooth innervation.

Background/purpose: Dental pulp stem cells (DPSCs) exhibit versatile differentiation capabilities, including neural differentiation, prompting the hypothesis that they may be implicated in the neurodevelopment of teeth. This study aimed to explore the temporospatial dynamics between DPSCs and tooth innervation, employing immunofluorescence staining and fluorescent dye injections to investigate the distribution of DPSCs, neural stem cells (NSCs), nerve growth cones, and sensory nerves in developing mouse tooth germs at various stages. Materials and methods: Immunofluorescence staining targeting CD146, Nestin, and GAP-43, along with the injection of AM1-43 fluorescent dye, were utilized to observe the distribution of DPSCs, NSCs, nerve growth cones, and sensory nerves in mouse tooth germs at different developmental stages. Results: Positive CD146 immunostaining was observed in microvascular endothelial cells and pericytes within and around the tooth germ. The percentage of CD146-positive cells remained consistent between 4-day-old and 8-day-old second molar tooth germs. Conversely, Nestin expression in odontoblasts and their processes decreased in 8-day-old tooth germs compared to 4-day-old ones. Positive immunostaining for GAP-43 and AM1-43 fluorescence revealed the entry of nerve growth cones and sensory nerves into the pulp in 8-day-old tooth germs, while these elements were confined to the dental follicle in 4-day-old germs. No co-localization of CD146-positive DPSCs with nerve growth cones and sensory nerves was observed. Conclusion: DPSCs and NSCs were present in dental pulp tissue before nerves penetrated the pulp. The decline in NSCs after nerve entry suggests a potential role for DPSCs and NSCs in attracting neural growth and/or differentiation within the pulp.