Mounir Maha M F, Rashed Fatma M, Bukhary Sahar M
Department of Oral Diagnostic Sciences, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia.
Faculty of Dentistry, Future University, Cairo, Egypt.
J Oral Biol Craniofac Res. 2022 Sep-Oct;12(5):721-726. doi: 10.1016/j.jobcr.2022.08.008. Epub 2022 Aug 28.
Vitality of the dentin-pulp complex depends on cell activity and signalling processes. Amelogenin protein regulates cell signalling pathways during tooth development by activating the Wnt/β-catenin intercellular signalling pathway. This study aimed to regenerate a vascularized pulp using recombinant amelogenin protein, in necrotic root canals by cell homing. Access opening was performed for a total of 120 root canals and were left open to become contaminated with oral microbes for 14 days then cleaned. Canals were divided into 2 groups; in the First group, the canals were filled with amelogenin, while in the 2nd group the canals were left empty. Samples were evaluated histologically and with immunodetection of Sox2, Oct4, Vascular endothelial growth factor (VEGF), Wnt1a, Wnt 3a, Wnt 10b, and Glial Fibrillary Acidic Proteins (GFAP). IC50 was used to determine the cytotoxicity of amelogenin. Regenerated dense cellular tissue was seen in the apical part of amelogenin-treated root canals, and regenerated delicate vascularized tissue was observed in the radicular and pulp chamber. Cells found in the regenerated soft tissue expressed Wnt family members that regulate stem cell pluripotency. Also, Sox2 and Oct4, Pluripotency markers, could be identified in the newly formed apical papilla and dental follicle. Furthermore, VEGF in the regenerated pulps indicated neovascularization. While the GFAP immune reactivity demonstrated that the neuro-sensory organ was being replicated in the regenerated dental pulps. Finally, IC50 test showed that recombinant amelogenin protein has a safe dose at high-level concentrations. Recombinant amelogenin protein induces pulp regeneration most likely from the Sox2 identified stem cells within the apical papilla and can enhance apex formation in non-vital immature teeth.
牙本质-牙髓复合体的活力取决于细胞活性和信号传导过程。釉原蛋白在牙齿发育过程中通过激活Wnt/β-连环蛋白细胞间信号通路来调节细胞信号通路。本研究旨在通过细胞归巢，利用重组釉原蛋白在坏死根管中再生血管化牙髓。对总共120个根管进行开髓，使其开放并被口腔微生物污染14天，然后进行清理。根管分为2组；第一组根管填充釉原蛋白，而第二组根管保持空置。对样本进行组织学评估，并对Sox2、Oct4、血管内皮生长因子（VEGF）、Wnt1a、Wnt 3a、Wnt 10b和胶质纤维酸性蛋白（GFAP）进行免疫检测。使用IC50来确定釉原蛋白的细胞毒性。在釉原蛋白处理的根管根尖部分可见再生的致密细胞组织，在根管和髓腔中观察到再生的精细血管化组织。在再生软组织中发现的细胞表达调节干细胞多能性的Wnt家族成员。此外，在新形成的根尖乳头和牙囊中可以鉴定出多能性标记物Sox2和Oct4。此外，再生牙髓中的VEGF表明有新血管形成。而GFAP免疫反应性表明神经感觉器官在再生牙髓中得以复制。最后，IC50测试表明重组釉原蛋白在高浓度下具有安全剂量。重组釉原蛋白最有可能诱导根尖乳头内已鉴定的Sox2干细胞进行牙髓再生，并可促进非活髓未成熟牙齿的根尖形成。
