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Review
. 2019 Nov;55(1):5-11.
doi: 10.1016/j.jdsr.2018.09.001. Epub 2018 Sep 29.

Current and future options for dental pulp therapy

Takahiko Morotomi  1 , Ayako Washio  1 , Chiaki Kitamura  1
Affiliations
Review

Current and future options for dental pulp therapy

Takahiko Morotomi et al. Jpn Dent Sci Rev. 2019 Nov.

Abstract

Dental pulp is a connective tissue and has functions that include initiative, formative, protective, nutritive, and reparative activities. However, it has relatively low compliance, because it is enclosed in hard tissue. Its low compliance against damage, such as dental caries, results in the frequent removal of dental pulp during endodontic therapy. Loss of dental pulp frequently leads to fragility of the tooth, and eventually, a deterioration in the patient's quality of life. With the development of biomaterials such as bioceramics and advances in pulp biology such as the identification of dental pulp stem cells, novel ideas for the preservation of dental pulp, the regenerative therapy of dental pulp, and new biomaterials for direct pulp capping have now been proposed. Therapies for dental pulp are classified into three categories; direct pulp capping, vital pulp amputation, and treatment for non-vital teeth. In this review, we discuss current and future treatment options in these therapies.

Keywords: Dentin-pulp complex; Direct pulp capping; Endodontics; Pulpotomy; Regeneration therapy; Tissue engineering.

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Figures

Figure 1
Figure 1
Current and future direct capping materials/agents. Current direct pulp capping is the reaction of dental pulp to the chemical stimulation. Ideal direct pulp capping materials/agents is inducing dentinogenesis similar with natural biological process to pulp. Application of anti-stimuli and/or anti-inflammatory agents in combination with the direct pulp capping materials/agents will be affective.
Figure 2
Figure 2
Two strategies for pulp regeneration therapy to non-vital mature permanent tooth. In the cell homing strategy, growth factor(s) and scaffold are implanted into root canal. Released growth factor(s) from root canal induced stem/progenitor cell migration, vascular invasion, and neuronal outgrowth from periapical tissue. In the cell transplantation strategy, stem/progenitor cells are injected into root canal with growth factor(s) and scaffold. Released growth factor(s) induced vascular invasion and neuronal outgrowth from periapical tissue into the root canal.
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