Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

As metaloproteinases da matriz (MMPs) foram relacionadas a diversas doenças inflamatórias como artrite e também ao câncer. O presente trabalho tem por objetivo estabelecer o papel da MMP-2, MMP-9 e MMP-8 no processo de inflamação pulpar. Foram adotadas as seguintes hipóteses nulas: (1) o padrão de expressão das MMP-2, MMP-9 e MMP-8 não sofre alteração nos diferentes estágios da polpa humana: normal, reversível, transição, irreversível ou necrose; (2) não há diferença de expressão das MMP-2, -9 e MMP-8, considerando-se um mesmo estágio de inflamação tecidual pulpar. Os métodos utilizados foram: (I) Obtenção dos espécimes, que foram divididos em grupos de acordo com critérios adotados de semiologia subjetiva e objetiva. Obtiveram-se os seguintes grupos: GI (Controle) dentes hígidos (n=7); GII (Pulpite Reversível n=4); GIII (Pulpite Transição n=4); GIV (Pulpite Irreversível/Necrose n=8). Logo após exodontia, os dentes obtidos foram cortados ligeiramente abaixo da junção amelodentinária e fixados em formol a 10% por 48h. Foram lavados em água corrente (24h) para então serem processados histologicamente. Foram obtidas secções de 4m, aderidas em lâminas silanizadas e submetidas à imunomarcação (Técnica da Peroxidase), utilizando os anticorpos anti MMP-2, MMP-9 e MMP-8 humanos. A presença de imunomarcação foi realizada através da análise semi-quantitativa por escores, sendo que a quantificação de marcação por corte seguiu o seguinte escore: 0= ausente; 1= leve; 2= moderada; 3= intensa. Realizou-se teste estatístico não paramétrico Kruskal-Wallis, p<0,05. As comparações intergrupos revelaram, para CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0,01) e GII>GIV (p<0,05); (2)MMP-9 GI=GII=GIV, GII=GIII e GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. Na região central da polpa, obteve-se: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0,001) e GII>GIV (p<0,01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI (p<0,001) e GIV>GII (p<0,01); (3)MMP-8 GI=GII, GIII=GIV, GIII>GI (p<0,05), GIV>GI (p<0,01), GIII>GII (p<0,05) e GIV>GII (p<0,05). Quanto às comparações intragrupos, na CO mostraram: (1)GI - MMP-2>MMP9 (p<0,001), MMP-2=MMP-8 e MMP-9=MMP-8; (2)GII MMP-2>MMP-9 (p<0,01); MMP-2=MMP-8 e MMP-9=MMP-8; (3)GIII e GIV MMP-2=MMP-9=MMP-8. Para a região mais central da polpa: (1)GI e GII MMP-2=MMP-9=MMP-8; (2)GIII MMP9>MMP-2 (p<0,05), MMP- 2=MMP-8 e MMP-9=MMP-8; (3)GIV MMP-9>MMP-2 (p<0,01), MMP-2=MMP-8 e MMP-9=MMP-8. Sendo assim, as duas hipóstese nulas foram rejeitadas. Conclui-se ainda que MMP-2, MMP-9 e MMP-8 atuam no processo de inflamação pulpar de maneira distinta na CO e polpa central; MMP-2 é mais expressa em polpa sadia; a maior expressão de MMP-9 relaciona-se à presença de inflamação pulpar; em polpas inflamadas, a expressão de MMP- 8 é maior quando comparadas a polpas normal, embora tal enzima seja também levemente expressada em tecido pulpar normal. / The matrix metalloproteinases (MMPs) have been related to various inflammatory diseases, such as arthritis, as well as to cancer. The aim of the present study was to establish the role of MMP-2, MMP-9 and MMP-8 in the process of dental pulp inflammation. The following null hypotheses were adopted: (1) the pattern of MMP-2, MMP-9 and MMP-8 expression does not undergo alteration in the following different stages of human pulp: normal, reversible, transition, irreversible or necrosis; (2) there is no difference in the expression of MMP-2, -9 and MMP-8, when considering the same stage of pulp tissue inflammation. The methods used were: (I) Obtainment of specimens, which were divided into groups according to the subjective and objective criteria of semiology adopted. The following groups were obtained: GI (Control) healthy teeth (n=7); GII (Reversible Pulpitis n=4); GIII (Transition Pulpitis n=4); GIV (Irreversible Pulpitis/Necrosis n=8). Soon after extraction the teeth obtained were cut slightly below the amelodentinal junction and fixed in 10% formol for 48h. They were washed under running water (24h) and were histologically processed afterwards. Sections of 4m were obtained, adhered to silanized slides, and submitted to immunomarking (Peroxidase Technique), using human anti MMP-2, MMP-9 and MMP- 8 antibodies. The presence of immunomarking was determined through semi-quantitative analysis by scores, and marking by cut was quantified using the following score: 0= absent; 1= slight; 2= moderate; 3= intense. The Kruskal-Wallis non-parametric statistical test was performed, p<0.05. Intergroup comparisons revealed the following: for CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0.01) and GII>GIV (p<0.05); (2)MMP-9 GI=GII=GIV, GII=GIII and GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. In the central region of the pulp, the following results were obtained: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0.001) and GII>GIV (p<0.01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI (p<0.001) and GIV>GII (p<0.01); (3)MMP-8 GI=GII, GIII=GIV, GIII>GI (p<0.05), GIV>GI (p<0.01), GIII>GII (p<0.05) and GIV>GII (p<0.05). With regard to intragroup comparisons, in CO the following were shown: (1)GI - MMP-2>MMP9 (p<0.001), MMP-2=MMP-8 and MMP-9=MMP-8; (2)GII MMP-2>MMP-9 (p<0.01); MMP-2=MMP-8 and MMP-9=MMP-8; (3)GIII and GIV MMP- 2=MMP-9=MMP-8. For the most central region of the pulp: (1)GI and GII MMP-2=MMP- 9=MMP-8; (2)GIII MMP9>MMP-2 (p<0.05), MMP-2=MMP-8 and MMP-9=MMP-8; (3)GIV MMP-9>MMP-2 (p<0.01), MMP-2=MMP-8 and MMP-9=MMP-8. Therefore, the two null hypotheses were rejected. Moreover, it was concluded that MMP-2, MMP-9 and MMP-8 act in the process of pulp inflammation in a distinct manner in CO and central pulp; more MMP-2 is expressed in healthy pulp; the highest expression of MMP-9 is related to the presence of pulp inflammation; in inflamed pulp, the expression of MMP-8 is higher when compared with that of normal pulp, although this enzyme is also slightly expressed in normal pulp tissue.

Made available in DSpace on 2017-07-24T19:22:24Z (GMT). No. of bitstreams: 1 Roderjan.pdf: 8332840 bytes, checksum: 16000477bd78492b7c55966d4d4c03c5 (MD5) Previous issue date: 2012-12-13 / The use of bleaching gels with low hydrogen peroxide (HP) concentration, as well as the reduction of application times or its association with calcium-containing agents may be clinical approaches to reduce the amount of HP that reaches the pulp tissue to cause local damage. However, only a few data have been published about the pulp response of human teeth subjected to in-office bleaching protocols. Therefore, the objectives of this study were to evaluate the in vivo pulp response of human lower incisors after in-office bleaching. In the experiment 1, a bleaching gel with two different HP concentrations (Whiteness HP Maxx 20 and 35%) as evaluated. In the experiment 2, the HP was applied in three 15-min applications and in a single 45-min application using a calcium-containing (Whiteness HP Blue) or calcium-free (Whiteness HP Maxx) HP agent. In the experiment 3, the pulp response of human incisors of young and older patients was evaluated after in-office bleaching with 35% HP. In all experiments, the bleaching agents were applied on the buccal surface of lower human incisors and two days after the procedure they were extracted. The pulp tissue from the crown portion of all teeth was histologically evaluated and the data subjected to appropriate statistical analysis. The bleaching efficacy and the tooth sensitivity (yes/no) were also evaluated. In all bleached teeth, a whitening of 2 to 3 shade guide units were observed and all patients reported tooth pain;findings not observed in the control (non-bleached) teeth. In general, all in-office bleaching protocols regardless of the tooth age showed partial necrosis of the crown pulp tissue associated with a deposition of reactionary dentin. Only the application of the Whiteness HP Blue 35% showed better pulp response with reduced areas of pulp necrosis in a reduced number of teeth. It was conclude that the in-office bleaching with HP 20 or 35% of human lower incisors applied in three 15-min or in a single 45-min applications produced pulp damage with partial tissue necrosis and deposition of reactionary dentin both in young and older teeth. Only in-office bleaching with a 35% calcium-containing HP showed reduced pulp damage. / O uso de gel clareador a base de peróxido de hidrogênio (PH) com menor concentração, diminuindo o número de vezes a ser aplicado ou adicionando cálcio na composição pode reduzir a quantidade de PH que atinge a câmara pulpar durante o clareamento dentário. Entretanto, poucos estudos sobre a resposta pulpar de dentes humanos in vivo têm sido avaliados. Os objetivos deste estudo foram avaliar in vivo a resposta de polpas de incisivos inferiores humanos sadios frente ao clareamento em consultório. No experimento 1, géis clareadores com diferentes concentrações de PH (Whiteness HP Maxx 35 e 20%) foi avaliado. No experimento 2, o gel de PH foi aplicado por três vezes de 15 min ou em uma única aplicação de 45 min usando um gel sem (Whiteness HP Maxx) e com (Whiteness HP Blue) cálcio. No experimento 3, a resposta pulpar frente ao clareamento de consultório foi verificada em dentes de pacientes jovens e idosos. Em todos os experimentos os agentes clareadores foram aplicados sobre a superfície vestibular dos incisivos humanos inferiores e após 2 dias do clareamento foram extraídos. O tecido pulpar da porção coronária foi submetido à análise histológica. Também foram avaliadas a efetividade do clareamento e a sensibilidade dental (sim/não). Clareamento médio de 2 a 3 unidades de escala vita foi observado em todos os dentes clareados assim como presença de sensibilidade, fato que não ocorreu nos grupos controle (não clareados). Para praticamente todas as técnicas de clareamento utilizadas, independentemente se em dentes de pacientes jovens ou idosos, foi observada necrose parcial do tecido pulpar coronário associado à deposição de dentina reacional. Com a aplicação do Whiteness HP Blue ocorreu menor resposta pulpar, com pequenas áreas de necrose em um reduzido número de dentes. Pode-se concluir que o clareamento de consultório com géis de PH de 20 e 35% aplicados em três vezes de 15 min ou em única de 45 min em incisivos inferiores humanos causam danos pulpares, caracterizados por necrose parcial do tecido pulpar coronário associada à deposição de dentina reacional, tanto em dentes de pacientes jovens como de pacientes idosos. Exceção deve ser feita a aplicação de um PH a 35% com cálcio que demonstrou um menor padrão de dano pulpar.

As metaloproteinases da matriz (MMPs) foram relacionadas a diversas doenças inflamatórias como artrite e também ao câncer. O presente trabalho tem por objetivo estabelecer o papel da MMP-2, MMP-9 e MMP-8 no processo de inflamação pulpar. Foram adotadas as seguintes hipóteses nulas: (1) o padrão de expressão das MMP-2, MMP-9 e MMP-8 não sofre alteração nos diferentes estágios da polpa humana: normal, reversível, transição, irreversível ou necrose; (2) não há diferença de expressão das MMP-2, -9 e MMP-8, considerando-se um mesmo estágio de inflamação tecidual pulpar. Os métodos utilizados foram: (I) Obtenção dos espécimes, que foram divididos em grupos de acordo com critérios adotados de semiologia subjetiva e objetiva. Obtiveram-se os seguintes grupos: GI (Controle) dentes hígidos (n=7); GII (Pulpite Reversível n=4); GIII (Pulpite Transição n=4); GIV (Pulpite Irreversível/Necrose n=8). Logo após exodontia, os dentes obtidos foram cortados ligeiramente abaixo da junção amelodentinária e fixados em formol a 10% por 48h. Foram lavados em água corrente (24h) para então serem processados histologicamente. Foram obtidas secções de 4m, aderidas em lâminas silanizadas e submetidas à imunomarcação (Técnica da Peroxidase), utilizando os anticorpos anti MMP-2, MMP-9 e MMP-8 humanos. A presença de imunomarcação foi realizada através da análise semi-quantitativa por escores, sendo que a quantificação de marcação por corte seguiu o seguinte escore: 0= ausente; 1= leve; 2= moderada; 3= intensa. Realizou-se teste estatístico não paramétrico Kruskal-Wallis, p<0,05. As comparações intergrupos revelaram, para CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0,01) e GII>GIV (p<0,05); (2)MMP-9 GI=GII=GIV, GII=GIII e GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. Na região central da polpa, obteve-se: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0,001) e GII>GIV (p<0,01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI (p<0,001) e GIV>GII (p<0,01); (3)MMP-8 GI=GII, GIII=GIV, GIII>GI (p<0,05), GIV>GI (p<0,01), GIII>GII (p<0,05) e GIV>GII (p<0,05). Quanto às comparações intragrupos, na CO mostraram: (1)GI - MMP-2>MMP9 (p<0,001), MMP-2=MMP-8 e MMP-9=MMP-8; (2)GII MMP-2>MMP-9 (p<0,01); MMP-2=MMP-8 e MMP-9=MMP-8; (3)GIII e GIV MMP-2=MMP-9=MMP-8. Para a região mais central da polpa: (1)GI e GII MMP-2=MMP-9=MMP-8; (2)GIII MMP9>MMP-2 (p<0,05), MMP- 2=MMP-8 e MMP-9=MMP-8; (3)GIV MMP-9>MMP-2 (p<0,01), MMP-2=MMP-8 e MMP-9=MMP-8. Sendo assim, as duas hipóstese nulas foram rejeitadas. Conclui-se ainda que MMP-2, MMP-9 e MMP-8 atuam no processo de inflamação pulpar de maneira distinta na CO e polpa central; MMP-2 é mais expressa em polpa sadia; a maior expressão de MMP-9 relaciona-se à presença de inflamação pulpar; em polpas inflamadas, a expressão de MMP- 8 é maior quando comparadas a polpas normal, embora tal enzima seja também levemente expressada em tecido pulpar normal. / The matrix metalloproteinases (MMPs) have been related to various inflammatory diseases, such as arthritis, as well as to cancer. The aim of the present study was to establish the role of MMP-2, MMP-9 and MMP-8 in the process of dental pulp inflammation. The following null hypotheses were adopted: (1) the pattern of MMP-2, MMP-9 and MMP-8 expression does not undergo alteration in the following different stages of human pulp: normal, reversible, transition, irreversible or necrosis; (2) there is no difference in the expression of MMP-2, -9 and MMP-8, when considering the same stage of pulp tissue inflammation. The methods used were: (I) Obtainment of specimens, which were divided into groups according to the subjective and objective criteria of semiology adopted. The following groups were obtained: GI (Control) healthy teeth (n=7); GII (Reversible Pulpitis n=4); GIII (Transition Pulpitis n=4); GIV (Irreversible Pulpitis/Necrosis n=8). Soon after extraction the teeth obtained were cut slightly below the amelodentinal junction and fixed in 10% formol for 48h. They were washed under running water (24h) and were histologically processed afterwards. Sections of 4m were obtained, adhered to silanized slides, and submitted to immunomarking (Peroxidase Technique), using human anti MMP-2, MMP-9 and MMP- 8 antibodies. The presence of immunomarking was determined through semi-quantitative analysis by scores, and marking by cut was quantified using the following score: 0= absent; 1= slight; 2= moderate; 3= intense. The Kruskal-Wallis non-parametric statistical test was performed, p<0.05. Intergroup comparisons revealed the following: for CO: (1)MMP-2 - GI=GII=GIII, GIII=GIV, GI>GIV (p<0.01) and GII>GIV (p<0.05); (2)MMP-9 GI=GII=GIV, GII=GIII and GIII>GI (p<0,01); (3)MMP-8 GI=GII=GIII=GIV. In the central region of the pulp, the following results were obtained: (1)MMP-2 GI=GII=GIII, GIII=GIV, GI>GIV (p<0.001) and GII>GIV (p<0.01); (2)MMP-9 GI=GII=GIII, GIII=GIV, GIV>GI (p<0.001) and GIV>GII (p<0.01); (3)MMP-8 GI=GII, GIII=GIV, GIII>GI (p<0.05), GIV>GI (p<0.01), GIII>GII (p<0.05) and GIV>GII (p<0.05). With regard to intragroup comparisons, in CO the following were shown: (1)GI - MMP-2>MMP9 (p<0.001), MMP-2=MMP-8 and MMP-9=MMP-8; (2)GII MMP-2>MMP-9 (p<0.01); MMP-2=MMP-8 and MMP-9=MMP-8; (3)GIII and GIV MMP- 2=MMP-9=MMP-8. For the most central region of the pulp: (1)GI and GII MMP-2=MMP- 9=MMP-8; (2)GIII MMP9>MMP-2 (p<0.05), MMP-2=MMP-8 and MMP-9=MMP-8; (3)GIV MMP-9>MMP-2 (p<0.01), MMP-2=MMP-8 and MMP-9=MMP-8. Therefore, the two null hypotheses were rejected. Moreover, it was concluded that MMP-2, MMP-9 and MMP-8 act in the process of pulp inflammation in a distinct manner in CO and central pulp; more MMP-2 is expressed in healthy pulp; the highest expression of MMP-9 is related to the presence of pulp inflammation; in inflamed pulp, the expression of MMP-8 is higher when compared with that of normal pulp, although this enzyme is also slightly expressed in normal pulp tissue.

Abstract Dentin formation in physiological and pathological conditions has been widely studied, but the events and regulation are still not completely understood. Odontoblasts, terminally differentiated post-mitotic cells located in a single cell layer around pulp tissue, synthesize and mineralize dentin organic matrix. Growth factors, such as TGF-β1 and BMP-2, have been implicated in the regulation of the responses of odontoblasts and pulp tissue to external irritation. Matrix metalloproteinases (MMPs), a family of 28 endopeptidases collectively capable of degrading virtually all extracellular matrix components, and their specific tissue inhibitors (TIMPs) participate in the organo- and morphogenesis, physiological tissue turnover and pathological tissue destruction in many tissues, but very little is known about their presence, function, and regulation in the dentin-pulp complex cells and tissues. The aim of the work presented in this thesis was to analyze the expression and regulation of collagens, MMPs and TIMPs by TGF-β1 and BMP-2 in mature human odontoblasts and pulp tissue. Odontoblasts synthesize and secrete type I and type III collagens, with no clear effect of TGF-β1 on their expression levels. MMP-1, -2, -8, -9, -10, -11, -14, -15, -16, -19 and TIMP-1, -2, -3 and -4 were expressed by both odontoblasts and pulp tissue. MMP-3 and MMP-12 were not expressed in native odontoblasts or pulp tissue, and MMP-7, -24, and -25 were expressed only in odontoblasts. MMP-2, -10, -14, -20 and -23 were expressed more abundantly in odontoblasts, whereas pulp tissue expressed more MMP-13 and MMP-17. Growth factors differentially regulated the expression of different MMPs and TIMPs within and among the cells and tissues studied. In odontoblasts, MMP-1, -8 and -14 were down-regulated, but MMP-7, MMP-9, TIMP-1 and TIMP-3 up-regulated, by either TGF-β1 or BMP-2, alone or in combination. In pulp tissue, growth factors up-regulated the expression of MMP-1, -2, -10, -13, -17 and TIMP-3, but down-regulated TIMP-4. The widespread of expression of MMPs and TIMPs by mature human odontoblasts and pulp tissue suggests that they may participate in dentin matrix organization prior to mineralization, and that growth factors may further control dentin matrix modeling, not by regulating the synthesis of type I or III collagens as previously believed, but rather by differentially regulating each MMPs and TIMPs.

A Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree Of Master of Science in Medicine, 2016. / Dental stem cells (DSCs) have been identified in teeth and their supporting tissues. They represent an exclusive source of adult stem cells, easily isolated and manipulated for tissue repair and regeneration. This research project evaluated the neurogenic potential of the dental pulp stem cells (DPSCs) and stem cells from the pulp of human exfoliated deciduous teeth (SHEDs) in a South African cohort. Sixty non-carious permanent and deciduous teeth were extracted from healthy patients aged between 18 and 30 years and 5 and 10 years, at the University of the Witwatersrand's Oral Health Clinic in Johannesburg Charlotte Maxeke Academic Hospital, South Africa. The cells, isolated from the extracted pulp tissue were cultured, counted and then phenotyped by flow cytometry analysis. The cells were further expanded in a neural induction medium and immunocytochemistry analysis for Ki-67, doublecortin (DCX) and nestin were performed. Large colonies of both DPSCs and SHEDS were harvested from the extracted pulp tissues and positively cultured. Flow cytometry analysis confirmed the presence of CD44+ and CD29+ cells as well as the known mesenchymal stem cell markers CD90 and CD105. Both DPSCs and SHEDs demonstrated successful proliferation and neural differentiation. This study confirmed that DPSCs and SHEDs are highly proliferative human adult stem cells that exhibit a neurogenic potential that may contribute in the treatment of neurological disorders. / AC2017