On the formation of a hard tissue barrier after dental pulp capping
||2003-05-27 -- 2011-12-31
||Faculty of Odontology
- To evaluate the evidence for the formation of a hard tissue barrier after pulp capping in humans by making a systematic review
- To study the effect of an enamel matrix derivative (EmdogainâGel) as a pulp capping agent on experimentally exposed human dental pulps with regard to hard tissue formation and pulp inflammation
- To study if the hard tissue formed after pulp capping with EmdogainâGel can be regarded as non-specific hard tissue or dentin
- To study the influence on the hard tissue formation of inflammatory substances and products from consortia of bacteria from deep caries lesions in a cell culture using a mouse odontoblast-like cell line (MDPC-23)
Pulp capping is a treatment where an agent is applied to an exposed pulp in order to allow the pulp to recover and maintain its vitality and function. A systematic review on the formation of hard tissue after pulp capping in humans showed that the pulp can heal with hard tissue formation but there is a lack of evidence concerning for example the impact of the preoperative status and the materials used.
Clinical follow-up studies where pulp capping has been performed on pulps exposed mainly because of caries shows failure rates that are rather high and increases markedly over time. These unfavourable results may be due to the absence of or a dysfunctional hard tissue barrier with a risk for secondary infection, another reason might be a remaining pulp inflammation.
Our hypothesis is that formation of hard tissue with the functions of primary dentin is important in the long-term perspective in order to protect the pulp from the oral micro flora.
An enamel matrix derivative (EmdogainGel) has previously been shown to induce hard tissue formation. By applying it to human dental pulps in a clinical trial, we have studied the hard tissue formation morphologically. We have studied the expression of dentin sialoprotein (DSP) and collagen I (ColI) in the newly formed hard tissue. DSP and Col I staining was seen in both groups, indicating that the newly formed tissue may be regarded as dentin. No microorganisms could be detected after staining with the LIVE/DEAD® BacLight™ Bacterial Viability Kit, though false negative results are possible.
Further studies of pulpal hard tissue formation will be performed in a model where mouse odontoblast-like cells are grown on membranes. The influence on the hard tissue formation of pro-inflammatory substances and products from consortia of bacteria found in deep caries will be studied. Our hypothesis is that the hard tissue formation formed after pulp capping can be hampered by pro-inflammatory substances and microbial products.
H. Olsson, J. R. Davies, K.E. Holst, U. Schröder, K. Petersson. Dental pulp capping: Effect of Emdogain®Gel on experimentally exposed human dental pulps. Int Endod J 2005; 38: 186-194.
H. Olsson, K. Petersson, M. Rohlin: Formation of a hard tissue barrier after pulp cappings in humans. A systematic review. Int Endod J 2006; 39: 429-442.
H. Fransson, K. Petersson, J. R. Davies. Dentine sialoprotein and Collagen I expression after experimental pulp cappin in humans using Emdogain®Gel. Submitted to Int Endod J
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