Effect of the Periapical “Inflammatory Plug” on Dental Pulp Regeneration: A Histologic In Vivo Study |
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| Institution: | 1. Center for Craniofacial Regeneration, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;2. Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;3. Department of Restorative Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;6. Department of Endodontics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;5. Department of Periodontics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;4. McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China;2. Department of Epidemiology, Capital Institute of Pediatrics, Peking Union Medical College, Beijing, China;1. Department of Endodontics, Division of Oral and Maxillofacial Radiology, Rutgers School of Dental Medicine, Newark, New Jersey;2. Department of Oral Diagnostics, Division of Oral and Maxillofacial Radiology, Rutgers School of Dental Medicine, Newark, New Jersey;1. Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;2. Division of Anatomy, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Japan;1. Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Course for Oral Life Science, Niigata, Japan;2. Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata, Japan;3. Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;1. Posgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil;2. Posgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil;3. School of Dentistry, Positivo University, Curitiba, Paraná, Brazil;1. Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium;4. Department of Oral Health Sciences, Orthodontics, Katholieke Universiteit Leuven, Leuven, Belgium;6. Department of Translational Cell and Tissue Research, Katholieke Universiteit Leuven, Leuven, Belgium;2. Biomaterials, BIOMAT, Leuven, Belgium;3. Laboratory of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium |
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| Abstract: | IntroductionIn the current study, we investigate the effect of the inflammation occupying the apical foramen—a phenomenon we refer to as “inflammatory plug”—on the regenerative potential of a root canal therapy.MethodsWe performed root canal treatment (RCT) in 12 canine root canals while aseptically instrumenting the apex to a 0.5-mm-wide foramen and obturating the canals with the following materials: collagen sponge, platelet-rich fibrin, and blood clot (no material introduced).ResultsWe were successful in maintaining the integrity of the periapical tissue in 8 of 12 RCTs. Injury to the periapical tissue occurred during the remaining 4 RCTs, which initiated inflammation accompanied by bone and dentin resorption. Our histologic analyses showed that the resulting inflammatory plug contained abundant M1 macrophages and was associated with an absence of intracanal cellular infiltration. On the contrary, noninflamed samples showed signs of repair, as indicated by the migration of periapical cells throughout the root canal.ConclusionsWe conclude that controlling periapical inflammation is key while attempting to achieve dental pulp regeneration. |
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| Keywords: | Apical plug cell differentiation cell infiltration inflammation modulation pulp regeneration regenerative endodontics |
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