Immunomodulation stimulates the innervation of engineered tooth organ

The sensory innervation of the dental mesenchyme is essential for tooth function and protection. Sensory innervation of the dental pulp is mediated by axons originating from the trigeminal ganglia and is strictly regulated in time. Teeth can develop from cultured re-associations between dissociated dental epithelial and mesenchymal cells from Embryonic Day 14 mouse molars, after implantation under the skin of adult ICR mice. In these conditions however, the innervation of the dental mesenchyme did not occur spontaneously. In order to go further with this question, complementary experimental approaches were designed. Cultured cell re-associations were implanted together with trigeminal ganglia for one or two weeks. Although axonal growth was regularly observed extending from the trigeminal ganglia to all around the forming teeth, the presence of axons in the dental mesenchyme was detected in less than 2.5% of samples after two weeks, demonstrating a specific impairment of their entering the dental mesenchyme. In clinical context, immunosuppressive therapy using cyclosporin A was found to accelerate the innervation of transplanted tissues. Indeed, when cultured cell re-associations and trigeminal ganglia were co-implanted in cyclosporin A-treated ICR mice, nerve fibers were detected in the dental pulp, even reaching odontoblasts after one week. However, cyclosporin A shows multiple effects, including direct ones on nerve growth. To test whether there may be a direct functional relationship between immunomodulation and innervation, cell re-associations and trigeminal ganglia were co-implanted in immunocompromised Nude mice. In these conditions as well, the innervation of the dental mesenchyme was observed already after one week of implantation, but axons reached the odontoblast layer after two weeks only. This study demonstrated that immunodepression per se does stimulate the innervation of the dental mesenchyme

Electromechanical Imaging of Biological Systems with Sub-10 nm Resolution

Electromechanical imaging of tooth dentin and enamel has been performed with sub-10 nm resolution using piezoresponse force microscopy. Characteristic piezoelectric domain size and local protein fiber ordering in dentin have been determined. The shape of a single collagen fibril in enamel is visualized in real space and local hysteresis loops are measured. Because of the ubiquitous presence of piezoelectricity in biological systems, this approach is expected to find broad application in high-resolution studies of a wide range of biomaterials.Comment: 12 pages, 4 figures, submitted for publication in Appl. Phys. Let

Classification review of dental adhesive systems: from the IV generation to the universal type

Adhesive dentistry has undergone great progress in the last decades. In light of minimal-invasive dentistry, this new approach promotes a more conservative cavity design, which relies on the effectiveness of current enamel-dentine adhesives. Adhesive dentistry began in 1955 by Buonocore on the benefits of acid etching. With changing technologies, dental adhesives have evolved from no-etch to total-etch (4th and 5th generation) to self-etch (6th, 7th and 8th generation) systems. Currently, bonding to dental substrates is based on three different strategies: 1) etch-and-rinse, 2) self-etch and 3) resin-modified glass-ionomer approach as possessing the unique properties of self-adherence to the tooth tissue. More recently, a new family of dentin adhesives has been introduced (universal or multi-mode adhesives), which may be used either as etch-and-rinse or as self-etch adhesives. The purpose of this article is to review the literature on the current knowledge for each adhesive system according to their classification that have been advocated by many authorities in most operative/restorative procedures. As noted by several valuable studies that have contributed to understanding of bonding to various substrates helps clinicians to choose the appropriate dentin bonding agents for optimal clinical outcomes

Immediate versus water-storage performance of Class V flowable composite restoratives

Objectives The aims of this investigation were to clarify the effects of 24 h water-storage and finishing time on mechanical properties and marginal adaptation to a Class V cavity of eight modern flowable resin-composites. Methods Eight flowable composites, plus two controls (one microfilled and one hybrid composite), were investigated with specimen sub-groups (n = 10) for each property measured. The principal series of experiments was conducted in model Class V cavities with interfacial polishing either immediately (3 min) after setting or after 24 h water-storage. After the finishing procedure, each tooth was sectioned in a buccolingual direction through the center of the restoration, and the presence or absence of marginal-gaps was measured (and then summed for each cavity) at 14 points (each 0.5 mm apart) along the cavity restoration interface (n = 10 per group; total points measured = 140). The shear bond-strengths to enamel and to dentin, and flexural strengths and moduli data were also measured at 3 min and after 24 h water-storage. Results For all flowable composites, polished immediately after setting, 14–30 summed gaps were observed (controls: 64 and 42). For specimens polished after 24 h, a significantly (p &#60; 0.05) reduced number of 8–17 summed gaps occurred for only 3 flowable composites; whereas for 5 flowable composites there were non-significantly-different (p &#62; 0.05) numbers (11–17) of summed gaps (controls: 28 and 22). After 24 h storage, shear bond-strengths to enamel and to dentin, flexural strengths and moduli increased highly significantly (p &#60; 0.001) for all materials, except Silux Plus. Significance A post-cure interval of 24 h resulted in enhanced mechanical and adhesive properties of flowable dental composites. In a minority of cases there was also a reduced incidence of marginal-gap formation. However the latter effect may be partly attributed to 24 h delayed polishing, even though such a delay is not usual clinical practice.</p

Meeting report: a hard look at the state of enamel research.

The Encouraging Novel Amelogenesis Models and Ex vivo cell Lines (ENAMEL) Development workshop was held on 23 June 2017 at the Bethesda headquarters of the National Institute of Dental and Craniofacial Research (NIDCR). Discussion topics included model organisms, stem cells/cell lines, and tissues/3D cell culture/organoids. Scientists from a number of disciplines, representing institutions from across the United States, gathered to discuss advances in our understanding of enamel, as well as future directions for the field

The Efficacy of Selected Desensitizing OTC Products: A Systematic Review.

Licensed by the Creative Commons Attribution LicenseObjectives. The aim of the present study was to review the published literature in order to identify relevant studies for inclusion and to determine whether there was any evidence on the clinical effectiveness of selected desensitizing toothpastes, calcium sodium phosphosilicate (CSPS), amorphous calcium phosphate (ACP), nanohydroxyapatite, and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) on reducing dentine hypersensitivity (DH). Materials and Methods. Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals, only 5 papers were accepted for inclusion. Results. Analysis of the included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these products for reducing DH. No direct comparative studies were available to assess all these products under the same conditions neither were there any comparative randomised controlled studies that compared at least two of these products in determining their effectiveness in treating DH. Conclusions. Due to the small number of included studies, there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are therefore required to determine the efficacy of these products in well-controlled RCT studies with a larger sample size

Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta

AIM: The aim of the study was to report the use of an elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta, second class malocclusion, deep bite and lower arch crowding from the deciduous dentition to permanent one. CASE REPORT: At first, the 5-year-old patient was treated with an elastodontic device known as "Nite-Guide". When the patient was 7 years old, during her first permanent molars and incisors eruption and after optimal house-practices, an Occlus-o-Guide Series G was placed at night and on daylight (two hours a day) performing exercises aimed to activate facial muscles and facilitate the deep bite reopening. At 9 years of age, with totally deep bite resolution, she used the Occluso-Guide only at night to hold down previous results and follow patient's dental growth. At 11 years of age, after successful teeth switching, we prescribed an Occlus-o-Guide Series N, which is functional for permanent dentition and guaranteed an eruptive guide for last dental elements. CONCLUSIONS: This clinic case could be considered an example of approach for all those patients with systemic and/or dental diseases that do not allow adequate dental retention, which is necessary for most orthodontic appliances; elastodontic devices do not require adequate dental retention and define a minimum intervention on the surfaces of the teeth

Immediate performance of self-etching versus system adhesives with multiple light-activated restoratives

Objectives: The purpose of this study was to evaluate the performance of both single and double applications of (Adper Prompt L-Pop) self-etching dental adhesive, when used with three classes of light-activated restorative materials, in comparison to the performance of each restorative system adhesive. Evaluation parameters to be considered for the adhesive systems were (a) immediate marginal adaptation (or gap formation) in tooth cavities, (b) free setting shrinkage-strain determined by the immediate marginal gap-width in a non-bonding Teflon cavity, and (c) their immediate shear bond-strengths to enamel and to dentin. Methods: The maximum marginal gap-width and the opposing-width (if any) in the tooth cavities and in the Teflon cavities were measured immediately (3 min) after light-activation. The shear bond-strengths to enamel and to dentin were also measured at 3 min. Results: For light-activated restorative materials during early setting (&#60;3 min), application of Adper Prompt L-Pop exhibited generally superior marginal adaptation to most system adhesives. But there was no additional benefit from double application. The marginal-gaps in tooth cavities and the marginal-gaps in Teflon cavities were highly correlated (r=0.86–0.89, p&#60;0.02–0.01). For enamel and dentin shear bond-strengths, there were no significant differences between single and double applications, for all materials tested except Toughwell and Z 250 with enamel. Significance: Single application of a self-etch adhesive was a feasible and beneficial alternative to system adhesives for several classes of restorative. Marginal gap-widths in tooth cavities correlated more strongly with free shrinkage-strain magnitudes than with bond-strengths to tooth structure.</p

Insulin-like Growth Factor 1 and Transforming Growth Factor-β Stimulate Cystine/Glutamate Exchange Activity in Dental Pulp Cells

Introduction The growth factors insulin-like growth factor (IGF-1) and transforming growth factor-β (TGF-β) are protective to dental pulp cells in culture against the toxicity of the composite materials Durafill VS and Flow Line (Henry Schein Inc, New York, NY). Because the toxicity of these materials is mediated by oxidative stress, it seemed possible that the protective effects of IGF-1 and TGF-β were through the enhancement of an endogenous antioxidant mechanism. Methods We used cultured dental pulp cells to determine the mechanism of the protective effects of IGF-1 and TGF-β, focusing on the glutathione system and the role of cystine/glutamate exchange (system xc-). Results We found that the toxicity of Durafill VS and Flow Line was attenuated by the addition of glutathione monoethylester, suggesting a specific role for the cellular antioxidant glutathione. Supporting this hypothesis, we found that IGF-1 and TGF-β were protective against the toxicity of the glutathione synthesis inhibitor buthionine sulfoximine. Because levels of cellular cystine are the limiting factor in the production of glutathione, we tested the effects of IGF-1 and TGF-β on cystine uptake. Both growth factors stimulated system xc–mediated cystine uptake. Furthermore, they attenuated the glutathione depletion induced by Durafill VS and Flow Line. Conclusions The results suggest that IGF-1 and TGF-β are protective through the stimulation of system xc–mediated cystine uptake, leading to maintenance of cellular glutathione. This novel action of growth factors on dental pulp cells has implications not only for preventing toxicity of dental materials but also for the general function of these cells

Effect of Pulp Protection Technique on the Clinical Performance of Amalgam Restorations: Three-Year Results

This study evaluated the influence of the pulp protection technique on clinical performance of amalgam restorations after three years, with particular reference to post-operative sensitivity and secondary caries. One hundred and twenty (120) Class II amalgam restorations (68 premolars, 52 molars; 78 MOD, 42 OD/MO) were placed in 30 participants (four restorations per participant).The restorations were divided into four groups according to the pulp protection technique used: copal varnish; 2% neutral sodium fluoride; adhesive resin and no pulp protection. The parameters evaluated were post-operative sensitivity, staining of the dental structure, tooth vitality, partial or total loss of the restoration and secondary caries. One hundred and eight (108)restorations were available for evaluation after three years. No partial or total loss of restorations had occurred; all teeth were vital, no tooth structure staining or secondary caries was detected in any of the restored teeth. Post-operative sensitivity was observed only in two restorations at baseline and at seven-days. The three year clinical performance of teeth restored with a high copper dispersed phase amalgam was not affected by the choice of pulp protection technique