Influence of Root Canal Disinfectants on Growth Factor Release from Dentin
Influence of Root Canal Disinfectants on Growth Factor Release from Dentin
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DOI：
10.1016/j.joen.2014.11.021
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发表时间：
2015-03-01
影响因子：
4.2
通讯作者：
Schmalz, Gottfried
中科院分区：
文献类型：
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作者：
Galler, Kerstin M.;Buchalla, Wolfgang;Schmalz, Gottfried
在牙本质形成过程中，生长因子被困在牙本质基质中，随后通过脱矿释放出来。它们对牙髓干细胞迁移、增殖和分化的影响可能有利于再生牙髓治疗。然而，与传统的根管治疗一样，成功的先决条件是对根管系统进行充分的消毒。各种冲洗液和管内敷料可供临床使用。本研究的目的有两个方面：确定一种适合直接从牙本质释放生长因子的脱矿溶液，并评估牙髓治疗中常用的消毒剂是否会损害这种效果。方法：取人拔牙制备牙本质盘，用不同浓度和pH的EDTA或柠檬酸处理不同暴露时间。转化生长因子- β 1 （tgf - β 1）、成纤维细胞生长因子2和血管内皮生长因子通过酶联免疫吸附法定量，并通过金标可视化。随后，测试了不同的冲洗溶液（5.25%次氯酸钠，0.12%二光酸氯己定）和管内敷料（皮质激素-抗生素膏体，氢氧化钙：水基和油基，三抗生素膏体，氯己定凝胶），并在随后的EDTA调理步骤后测量tgf - β 1的释放。结果：在pH为7的条件下，添加10% EDTA后，所有测试溶液中tgf - β 1的含量最高。EDTA处理后检测成纤维细胞生长因子2和血管内皮生长因子。EDTA预处理前用氯己定冲洗可增加tgf - β 1的释放；次氯酸钠则有相反的效果。除水基氢氧化钙外，所有测试的管内敷料均干扰tgf - β 1的释放。结论：生长因子可通过EDTA调节直接从牙本质释放。使用消毒液或药物可以增强或减弱这种效果。
Introduction: During dentinogenesis, growth factors become entrapped in the dentin matrix that can later be released by demineralization. Their effect on pulpal stem cell migration, proliferation, and differentiation could be beneficial for regenerative endodontic therapies. However, precondition for success, as for conventional root canal treatment, will be sufficient disinfection of the root canal system. Various irrigation solutions and intracanal dressings are available for clinical use. The aim of this study was 2-fold: to identify a demineralizing solution suitable for growth factor release directly from dentin and to evaluate whether commonly used disinfectants for endodontic treatment will compromise this effect. Methods: Dentin disks were prepared from extracted human teeth and treated with EDTA or citric acid at different concentrations or pH for different exposure periods. The amount of transforming growth factor-beta 1 (TGF-beta 1), fibroblast growth factor 2, and vascular endothelial growth factor were quantified via enzyme-linked immunosorbent assay and visualized by gold labeling. Subsequently, different irrigation solutions (5.25% sodium hypochloride, 0.12% chlorhexidine digluconate) and intracanal dressings (corticoid-antibiotic paste, calcium hydroxide: water-based and oil-based, triple antibiotic paste, chlorhexidine gel) were tested, and the release of TGF-beta 1 was measured after a subsequent conditioning step with EDTA. Results: Conditioning with 10% EDTA at pH 7 rendered the highest amounts of TGF-beta 1 among all test solutions. Fibroblast growth factor 2 and vascular endothelial growth factor were detected after EDTA conditioning at minute concentrations. Irrigation with chlorhexidine before EDTA conditioning increased TGF-beta 1 release; sodium hypochloride had the opposite effect. All tested intracanal dressings interfered with TGF-beta 1 release except water-based calcium hydroxide. Conclusions: Growth factors can be released directly from dentin via EDTA conditioning. The use of disinfecting solutions or medicaments can amplify or attenuate this effect.