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Current Oral Health Reports

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25-07-2023 | Caries

Dentin Degradation: From Tissue Breakdown to Possibilities for Therapeutic Intervention

Authors: Cristina M. P. Vidal, Marcela R. Carrilho

Published in: Current Oral Health Reports | Issue 3/2023

Abstract

Purpose of the Review

Presently, dental materials science is driven by the search for new and improved materials that can trigger specific reactions from the affected tissue to stimulate repair or regeneration while interacting with the oral environment to promote or maintain oral health. In parallel, evidence from the past decades has challenged the exclusive role of bacteria in dentin tissue degradation in caries, questioning our understanding of caries etiopathogenesis. The goal of this review is to recapitulate the current evidence on the host and bacterial contributions to degradation, inflammation, and repair of the dentin-pulp complex in caries.

Recent Findings

Contrasting findings attribute dentin breakdown to the activity of endogenous enzymes, such as matrix metalloproteinases (MMPs) and cathepsins, while the role of bacteria and their by-products in the destruction of dentin organic matrix and pulp inflammation has been for decades supported as an incontestable paradigm. Aiming to better understand the mechanisms involved in collagen degradation by host enzymes in caries, studies have showed that these proteinases are expressed in the mature dentin (i.e., after dentin formation) and become activated by the low pH in the acidic environment resulted by bacterial metabolism in caries. However, different host sources other than dentin-bound proteinases seem to also contribute to caries progression, such as saliva and pulp. Interestingly, studies evaluating pulp responses to bacteria invasion and inflammation in caries report higher levels of MMPs and cathepsins in inflamed tissue, but also showed MMP potential to resolve inflammation and stimulate wound healing. Notably, as reported for other tissues, MMPs exert dual roles in the dentin-pulp complex in caries, participating or regulating both degradative and reparative mechanisms.

Summary

The specific roles of host and bacteria and their by-products in caries progression have yet to be clarified. The complex interactions between inflammation and repair in caries pose challenges to a clear understanding of the dentin-pulp complex responses and changes to bacteria invasion. However, it opens new venues for the development of novel therapies and dental biomaterials based on the modulation of specific mechanisms to favor tissue repair and healing.

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Title: Dentin Degradation: From Tissue Breakdown to Possibilities for Therapeutic Intervention
Authors: Cristina M. P. Vidal
Marcela R. Carrilho
Publication date: 25-07-2023
Publisher: Springer International Publishing
Keyword: Caries
Published in: Current Oral Health Reports / Issue 3/2023
Electronic ISSN: 2196-3002
DOI: https://doi.org/10.1007/s40496-023-00341-4

2024 ASCO Annual Meeting

Springer Medicine

Dentin Degradation: From Tissue Breakdown to Possibilities for Therapeutic Intervention

Abstract

Purpose of the Review

Recent Findings

Summary

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose of the Review

Recent Findings

Summary

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Other articles of this Issue 3/2023

CAD Software and Its Influence on Complex Treatment Planning

Betel Quid and Oral Phenomenon: Current Review

Periodontal Health and Psychiatric Disorders

Dental Support for Feeding Function in Children

Effects of Maternal Nutrition on Oral Health in Offspring

Effect of Combined Oral Management, Rehabilitation, and Nutrition Interventions on Improving Systemic Problems in Older Adults