Adipokines in dental pulp: Physiological, pathological, and potential therapeutic roles.

BACKGROUND: Hundreds of adipokines have been identified, and their extensive range of endocrine functions-regulating distant organs such as oral tissues-and local autocrine/paracrine roles have been studied. In dentistry, however, adipokines are poorly known proteins in the dental pulp; few of them have been studied despite their large number. This study reviews recent advances in the investigation of dental-pulp adipokines, with an emphasis on their roles in inflammatory processes and their potential therapeutic applications. HIGHLIGHTS: The most recently identified adipokines in dental pulp include leptin, adiponectin, resistin, ghrelin, oncostatin, chemerin, and visfatin. They have numerous physiological and pathological functions in the pulp tissue: they are closely related to pulp inflammatory mechanisms and actively participate in cell differentiation, mineralization, angiogenesis, and immune-system modulation. CONCLUSION: Adipokines have potential clinical applications in regenerative endodontics and as biomarkers or targets for the pharmacological management of inflammatory and degenerative processes in dental pulp. A promising direction for the development of new therapies may be the use of agonists/antagonists to modulate the expression of the most studied adipokines.

Comparación de tres técnicas de irrigación en la remoción de hidróxido de calcio / Comparison of three irrigation techniques in the removal of calcium hydroxide

Objetivos: Comparar la eficacia de tres de protocolos de irrigación en la remoción de hidróxido de calcio (Ca(OH)2) Material y Métodos: Mediante un diseño de estudio comparativo in vitro, se instrumentaron 106 conductos radiculares de incisivos bovinos hasta una lima de diámetro 60, la raíces se fraccionaron en dos mitades siguiendo el eje mayor del diente y se creó un surco estandarizado a 2 mm del agujero apical que fue rellenado con una pasta de hidróxido de calcio, luego se reensamblaron las mitades, se incubaron por 7 días y se realizaron los protocolos de irrigación: ultrasónica pasiva (PUI), sónica con Endo Activator (EA) y activación dinámica manual (MDA), donde se usó como irrigante hipoclorito de sodio (NaOCl) al 5%. Se utilizó un control negativo y positivo. Con un estereomicroscópio se observó la cantidad de residuo, las imágenes se examinaron y se les asignó una puntación de acuerdo a la escala de van der Sluis, finalmente los datos se analizaron con la prueba estadística del Chi Cuadrado. Resultados: Los porcentajes de eficacia para los protocolos de irrigación PUI, EA y MDA fueron del 87,5%; 46,9% y 28,1% respectivamente, la técnica PUI fue superior a EA y MDA y obtuvo diferencias estadísticamente significativas (p<0,001). Conclusiones: PUI fue el método más efectivo en la remoción de Ca(OH)2 de los surcos simulados en los conductos radiculares.

Objectives: To compare efficacy of three irrigation protocols in the removal of calcium hydroxide (Ca(OH)2). Materials and Methods: Through an in vitro comparative study design, 106 root canals of bovine incisors were instrumented up to a file of diameter 60, the roots were fractioned into two halves following the major axis of the tooth and a standardized groove was created 2mm from the apical foramen that was filled with a paste of calcium hydroxide, then the halves were reassembled, incubated for 7 days and the irrigation protocols were carried out: passive ultrasonic (PUI), sonic with Endo Activator (EA) and manual dynamic activation (MDA), where 5% sodium hypochlorite (NaOCl) was used as irrigant. A negative and positive control was used. With a stereomicroscope the amount of residue was observed, the images were examined and assigned a score according to the van der Sluis scale, finally the data were analyzed with the statistical test of Chi-square. Results: The percentages of efficacy for PUI, EA and MDA irrigation protocols were 87.5%; 46.9% and 28.1% respectively, the PUI technique was superior to EA and MDA and obtained statistically significant differences (p <0.001). Conclusions: PUI was the most effective method in the removal of Ca(OH)2 from the simulated grooves in the root canals.

Elaboración de un biodiente: enfoque actual y desafíos / Making a Bio-tooth: Current Approaches and Challenges

Antecedentes: El edentulismo es uno de los mayores problemas de salud oral que cause alteraciones fisiológicas, sociales, estéticas, fonéticas y nutricionales. Las terapias actuales para el remplazo dental son artificiales y no satisfacen los requisitos básicos de un diente natural. La bioingeniería de tejidos constituye una alternativa para la sustitución de dientes perdidos. Objetivo: Identificar los enfoques/técnicas disponibles actualmente para obtener un diente completo por bioingeniería (biodiente), así como puntualizar sus desafíos y perspectivas futuras. Métodos: Se realizó una revisión integrativa de la literatura, por medio de las siguientes palabras clave: biodiente, bioingeniería de tejidos, diente entero y células madre. Los años de la búsqueda fueron 2000-2018, en las bases de datos: PubMed, Scopus, EBSCO, Science Direct, Wiley Online Library, Lilacs y Google Académico/Scholar, en inglés y español. Se seleccionaron únicamente artículos y libros de mayor relevancia y pertinencia. Resultados: Se obtuvieron 53 artículos y 10 libros. Para la elaboración de un biodiente se emplean los siguientes métodos: andamios, sin andamios, células madre pluripotentes inducidas, germen de órganos, diente quimérico y estimulación de la formación de la tercera dentición. El tamaño y forma normales del diente, así como la obtención de células epiteliales, son los principales desafíos. Conclusiones: La posibilidad de crear y desarrollar un biodiente en un ambiente oral adulto es cada vez más real gracias a los avances biotecnológicos que ocurren diariamente. Es posible que estos conceptos sean la base de la odontología restauradora en un futuro próximo.

Background: Edentulism is one of the major oral health problems that cause physiological, social, aesthetic, phonetic, and nutritional issues. Current therapies for dental replacement are artificial and do not satisfy the basic requirements of a natural tooth. Tissue bioengineering could be a viable alternative to substitute lost teeth. Objective: To identify current available approaches/techniques to obtain a complete bioengineered tooth (bio-tooth) and to point out future challenges and perspectives. Methods: This was an integrative literature review. Search keywords used were: bio-tooth, tissue bioengineering, whole tooth, stem cells. The search included the years 2000 through 2018, using the databases PubMed, Scopus, EBSCO, Science Direct, Wiley Online Library, Lilacs and Google Scholar, both in English and Spanish. Only relevant and pertinent articles and books were selected. Results: 53 articles and 10 books were obtained. Methods for bio-tooth generation found were: scaffolds, scaffold-free, induced pluripotent stem cells, tooth organ germ, chimeric tooth, and stimulation of third dentition formation. Achieving normal tooth size and shape and obtaining epithelial cells are the main challenges. Conclusions: The possibility of creating and developing a whole bioengineered tooth (bio-tooth) in an adult oral environment is becoming more realistic, considering the daily biotechnological advances. It is possible that these concepts will be the basis of restorative dentistry in a near future.