Exploiting bioactive molecules in the dentine matrix for the treatment of apical periodontitis

Green, David Jonathan Blears (2019). Exploiting bioactive molecules in the dentine matrix for the treatment of apical periodontitis. University of Birmingham. M.Sc.

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The main focus of endodontic treatment in to disinfect the root canal system with sodium hypochlorite (NaOCl) in order to facilitate periapical healing. Ethylenediaminetetraacetic acid (EDTA) has been shown to solubilise bioactive molecules sequestered in dentine, such as TGF-β1, which can modulate cell signalling pathways that enhance tissue healing. An in-vitro tooth model and sampling techniques were developed which investigated the ability of contemporary irrigant solutions to release TGF -β1 in order for it to be bioavailable at the interface between the root canal and periapical tissues. EDTA, chlorhexidine (CHX) and calcium hydroxide [Ca (OH) 2] all resulted in TGF- β1 release. EDTA released the highest concentration of TGF - β1, which increased in a time dependent manner. When a primary disinfectant stage of NaOCl was introduced, there were no detectable levels of TGF-β1 even after multiple rinses with EDTA. CHX released the lowest amounts of TGF- β1 but also attenuated the action of EDTA. When Ca (OH) 2 was introduced as an intern -appointment dressing between the disinfectant step of NaOCl and application of EDTA, TGF- β1 was released. Scanning electron microscopy showed the highest erosion of dentine occurred with a combination of CHX and EDTA. Clinically if both disinfection and growth factor release from dentine is to be achieved a two- visit endodontic procedure is supported using NaOCl at the first-visit, an inter-appointment dressing of Ca (OH)2 and with EDTA being used alone at the second-visit in order to maximise the bioavailability of TGF-β1.

Type of Work: Thesis (Masters by Research > M.Sc.)
Award Type: Masters by Research > M.Sc.
Licence: All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Dentistry
Funders: Other
Other Funders: The British Endodontic Society, The Royal College of Surgeons Edinburgh (Prime Pumping Grant)
Subjects: R Medicine > RK Dentistry
URI: http://etheses.bham.ac.uk/id/eprint/11837


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