Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues.
Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues.
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DOI：
10.3390/ijms22031480
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发表时间：
2021-02-02
影响因子：
5.6
通讯作者：
Feuerer M
中科院分区：
文献类型：
--
作者：
Galler KM;Weber M;Korkmaz Y;Widbiller M;Feuerer M
口腔的宏观和微观解剖在人体中是复杂和独特的。软组织结构与矿化骨、牙本质、牙骨质和牙釉质有密切的相互作用。它们暴露在强烈的机械和化学压力以及密集的微生物定居下。牙齿容易受到损害，最常见的是龋齿，口腔中的微生物会降解牙釉质和牙本质的矿化组织，并侵入核心的软结缔组织，即牙髓。然而，纸浆具有良好的感知和抵御细菌及其产物的能力，并安装了各种复杂的防御机制。前牙列是由一层成牙本质细胞组成的，这些成牙本质细胞排列在牙髓腔内，朝向牙本质。这些高度特化的细胞不仅形成矿化组织，而且发挥着屏障细胞的重要功能。它们在这个过程的早期识别病原体，分泌抗菌化合物，中和细菌毒素，启动免疫反应，并提醒宿主防御的其他关键参与者。随着细菌离牙髓越来越近，牙髓中更多的细胞类型，包括成纤维细胞、干细胞和免疫细胞，以及血管和神经元网络，都具有各种不同的防御机制，而炎症反应机制对组织动态平衡至关重要。尽管如此，如果没有治疗干预，深度的龋损可能会导致组织坏死，这使得细菌能够滋生在根管系统中，并通过根尖的根尖孔侵入根尖周围的骨。牙周组织和牙槽骨对侮辱的反应是炎症反应，最常见的是通过形成根尖肉芽肿。病原体清除后可以愈合，这是通过根管治疗对牙髓空间进行消毒和封闭来实现的。本文综述了牙髓细胞和神经根周围组织病原体识别和防御的各种机制，解释了参与免疫反应的不同细胞类型，讨论了修复和修复机制，指出炎症与再生以及炎症与潜在恶变之间的密切联系。
The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized bone, but also dentine, cementum and enamel of our teeth. These are exposed to intense mechanical and chemical stress as well as to dense microbiologic colonization. Teeth are susceptible to damage, most commonly to caries, where microorganisms from the oral cavity degrade the mineralized tissues of enamel and dentine and invade the soft connective tissue at the core, the dental pulp. However, the pulp is well-equipped to sense and fend off bacteria and their products and mounts various and intricate defense mechanisms. The front rank is formed by a layer of odontoblasts, which line the pulp chamber towards the dentine. These highly specialized cells not only form mineralized tissue but exert important functions as barrier cells. They recognize pathogens early in the process, secrete antibacterial compounds and neutralize bacterial toxins, initiate the immune response and alert other key players of the host defense. As bacteria get closer to the pulp, additional cell types of the pulp, including fibroblasts, stem and immune cells, but also vascular and neuronal networks, contribute with a variety of distinct defense mechanisms, and inflammatory response mechanisms are critical for tissue homeostasis. Still, without therapeutic intervention, a deep carious lesion may lead to tissue necrosis, which allows bacteria to populate the root canal system and invade the periradicular bone via the apical foramen at the root tip. The periodontal tissues and alveolar bone react to the insult with an inflammatory response, most commonly by the formation of an apical granuloma. Healing can occur after pathogen removal, which is achieved by disinfection and obturation of the pulp space by root canal treatment. This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues, explains the different cell types involved in the immune response and discusses the mechanisms of healing and repair, pointing out the close links between inflammation and regeneration as well as between inflammation and potential malignant transformation.
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影响因子：
2.5
作者：
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