Colombo John S, Moore Amanda N, Hartgerink Jeffrey D, D'Souza Rena N
School of Dentistry, University of Utah, Salt Lake City, Utah; Department of Chemistry and Bioengineering, Rice University, Houston, Texas.
Department of Chemistry and Bioengineering, Rice University, Houston, Texas.
J Endod. 2014 Apr;40(4 Suppl):S6-12. doi: 10.1016/j.joen.2014.01.019.
In dentistry, the maintenance of a vital dental pulp is of paramount importance because teeth devitalized by root canal treatment may become more brittle and prone to structural failure over time. Advanced carious lesions can irreversibly damage the dental pulp by propagating a sustained inflammatory response throughout the tissue. Although the inflammatory response initially drives tissue repair, sustained inflammation has an enormously destructive effect on the vital pulp, eventually leading to total necrosis of the tissue and necessitating its removal. The implications of tooth devitalization have driven significant interest in the development of bioactive materials that facilitate the regeneration of damaged pulp tissues by harnessing the capacity of the dental pulp for self-repair. In considering the process by which pulpitis drives tissue destruction, it is clear that an important step in supporting the regeneration of pulpal tissues is the attenuation of inflammation. Macrophages, key mediators of the immune response, may play a critical role in the resolution of pulpitis because of their ability to switch to a proresolution phenotype. This process can be driven by the resolvins, a family of molecules derived from fatty acids that show great promise as therapeutic agents. In this review, we outline the importance of preserving the capacity of the dental pulp to self-repair through the rapid attenuation of inflammation. Potential treatment modalities, such as shifting macrophages to a proresolving phenotype with resolvins are described, and a range of materials known to support the regeneration of dental pulp are presented.
在牙科领域，维持牙髓活力至关重要，因为经根管治疗失去活力的牙齿可能会随着时间推移变得更加脆弱且易于发生结构破坏。严重的龋损会通过在整个组织中引发持续的炎症反应而不可逆转地损害牙髓。尽管炎症反应最初会驱动组织修复，但持续的炎症对牙髓活力具有极大的破坏作用，最终导致组织完全坏死并需要将其去除。牙齿失活的影响引发了人们对开发生物活性材料的浓厚兴趣，这些材料通过利用牙髓的自我修复能力来促进受损牙髓组织的再生。在考虑牙髓炎驱动组织破坏的过程时，很明显，支持牙髓组织再生的一个重要步骤是减轻炎症。巨噬细胞作为免疫反应的关键介质，可能在牙髓炎的消退中发挥关键作用，因为它们能够转变为促消退表型。这个过程可以由消退素驱动，消退素是一类源自脂肪酸的分子，作为治疗剂具有很大的前景。在这篇综述中，我们概述了通过迅速减轻炎症来保留牙髓自我修复能力的重要性。描述了潜在的治疗方式，例如用消退素使巨噬细胞转变为促消退表型，并介绍了一系列已知能支持牙髓再生的材料。
