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Current Understanding and Future Applications in Dentine-Pulp Complex Inflammation and Repair

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Clinical Approaches in Endodontic Regeneration

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Abstract

Infecting oral microorganisms, which penetrate through the tooth’s enamel and dentine, are responsible for dental caries. During the caries process, bacterial by-products reach the inner dentine and trigger host defence responses within the peripheral area of the dental pulp. If the diseased hard tissue is removed and the infection is resolved by the dental practitioner, the defence events regress and pulp healing can occur. Ideally for complete pulp healing, there should be formation, at the dentine-pulp interface, of a reactionary/reparative dentine layer which distances and protects the pulp from any invading bacteria and restorative material irritation. In its absence, chronic pulpal inflammation can endure despite treatment, and this can result in progressive damage of pulp tissue, as well as reduced innate repair capabilities. Clinical and laboratory studies indicate that dentine barrier formation only occurs when the pulpal inflammation is at a relatively low level, such as at the early stage of infection or when it is subsiding after clinical intervention. This chapter focusses on our current understanding of key cellular and molecular mechanisms which are involved in the pulp’s response to bacteria and how these responses modulate local inflammation and dentinogenic repair events. Subsequently the control of infection and modulation of pulp inflammation may provide novel therapeutic opportunities which can be harnessed by the dental practitioner in the future.

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Acknowledgements

Conflict of Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.

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Authors and Affiliations

  1. Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

    Paul Roy Cooper

  2. Institut de Biologie et Chimie des Protéines, Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305 CNRS/Université Lyon 1, Lyon, France

    Jean-Christophe Farges

  3. Université Lyon 1, Faculté d’Odontologie, Université de Lyon, Lyon, France

    Jean-Christophe Farges

  4. Service de Consultations et de Traitements Dentaires, Hospices Civils de Lyon, Lyon, France

    Jean-Christophe Farges

  5. Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France

    Brigitte Alliot-Licht

  6. Faculté d’Odontologie, Université de Nantes, Nantes, France

    Brigitte Alliot-Licht

  7. Service Odontologie Conservatrice et Pédiatrique, CHU Nantes, Nantes, France

    Brigitte Alliot-Licht

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  1. Paul Roy Cooper
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  3. Brigitte Alliot-Licht
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Correspondence to Paul Roy Cooper .

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Editors and Affiliations

  1. Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland

    Henry F. Duncan

  2. School of Dentistry, University of Birmingham, Birmingham, UK

    Paul Roy Cooper

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Cooper, P.R., Farges, JC., Alliot-Licht, B. (2019). Current Understanding and Future Applications in Dentine-Pulp Complex Inflammation and Repair. In: Duncan, H., Cooper, P. (eds) Clinical Approaches in Endodontic Regeneration. Springer, Cham. https://doi.org/10.1007/978-3-319-96848-3_6

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