Table of Contents
Introduction:
The dental pulp is the ectomesenchyme-derived vital tissue which is known to originate from the embryonic or the initial interaction of mesenchyme with the neural crest cells. The dental pulp stem cells (DPSCs) can promote cellular proliferation, differentiation, immune regulation, anti-inflammatory, and anti-aging.
Despite the extensive research on dental pulp stem cells (DPSCs), isolating them can be challenging, particularly due to efforts by dental researchers to study DPSCs from dental tissues other than the primary or adult pulpal tissue of the tooth. So far, a few research studies have focused on the DPSCs isolated from deciduous teeth, the periodontal ligament of primary or permanent dentition, the dental follicle stage, and the apical papilla. Amongst these research studies, minimal research has been conducted in analyzing and evaluating the presence of stem cells in dental pathologic tissues of a condition like hyperplastic pulpitis that's done in the light of dental research for its possible DPSC isolation value.
What Is Hyperplastic Pulp Tissue?
Chronic hyperplastic pulpitis or pulp polyp is a dental pathologic condition in which there is either a mild, moderate, or severe pulpal disease of the tooth affecting the pulp. This condition would either occur in children or young adults when the endodontic infection is left untreated. In children, it is the primary molar tooth affected by pulp polyps and in young adults as well, the permanent molars would be the common tooth afflicted by this condition. It provides a distinctive viewpoint due to the lack of symptoms and abrupt clinical signs that indicate an infection occurs long after its initial onset. The main symptom in the later stages of the dental polyp, whether in children or young teenagers, also known as chronic hyperplastic pulpitis of the child or young adolescent, would mainly present as oral pain while eating, biting, or grinding on the affected tooth. It may be often concerning to the parents or the guardians when a child with healthy dentition complains of sudden or advancing pain during chewing or mastication. However, till there is enough pressure created due to the food bolus upon the afflicted tooth, these initial symptoms may often go unnoticed or unobserved which can lead to worsening or progression of the hyperplastic pulpitis of the tooth.
Upon a routine dental check-up or radiographic examination for detecting the presence of permanent teeth in children, often the dentist would encounter cases of hyperplastic pulpits stemming from a chronic nature. Further, these teeth may also not show any specific changes in response to either thermal or electrical stimuli applied by the dentist, which can often pose a challenging or unique diagnosis. The reason is the dead or necrosed pulp tissue within the tooth because of the pulp polyp growth or hyperplasia of pulpal cells that eventually leads to the tooth becoming nonvital. This is one of the reasons why the tooth would most often prove to be completely insensitive to electric pulp testing, and cold or dental thermal/ heat tests.
Can Dental Pulp Stem Cells Be Obtained from Pulp Polyp?
Yes, the answer according to current dental research is quite clear, and underway to investigate the exact mechanisms underlying why the stem cells would be found in this pathologically affected dental tissue in the pulp region.
The research results demonstrate clearly that the pulp polyps are the granulation tissues that would have formed as a result of long-time dental pulp inflammation. Further, because the dental pulp has the richest nerve and blood supply to the tooth, dental pulp stem cells tend to be activated whenever there is an injury to the tooth or traumatic force upon the tooth. The same situation would arise when extensive dental caries in children or young adolescents cause dentinal hypersensitivity and pulpal inflammation or diseases in the tooth in question. Hence the result of caries or odontoblastic injuries is the stimulation of these potential DPSCs that would have the potential to both undergo proliferation and migration. Theories demonstrating The clinical migration of DPSCs in headquarters by pulp polyps would indicate further the potent and great ability of the stem cells present in these injured pulpal tissues to respond to tooth injury.
Can Both Vital and Non-vital Teeth of This Condition Yield Dental Pulp Stem Cells?
The detailed and clinical characteristics outlined above concerning pulp polyps indicate that dental researchers have not dismissed the potential for non-vital teeth to contain pulp tissue capable of producing DPSCs. Nevertheless, during the initial inflammatory stages of pulp polyps affecting teeth, inflammatory hyperplasia or cellular proliferation consistently occurs in vital teeth. The vital tooth tends to be affected by either dental caries or dental trauma initiating the inflammation and cellular proliferation in the form of polyp tissue in the dental pulp. It is of crucial importance to note that the inflammatory tissue process in vital teeth or even nonvital teeth (when the tooth is left untreated), would still be considered suitable candidates for isolating DPSCs. This situation of non-vital teeth would arise in this pathology because the condition is chronic and often goes unobserved or unattended by the patients themselves, especially to children or young adolescents. However dental research shows that the inflammatory pulpal tissue irrespective of the tooth vitality would still prove to be possible research options that can be considered for the isolation of DPSCs/dental pulp stem cells.
Conclusion:
Recent advancements in cell biology research have been emphasizing familiar theories indicating that DPSCs extracted from damaged pulpal tissues, such as in instances of tooth polyps or dental hyperplastic pulpitis, could potentially offer numerous advantages and medical applications in the realm of stem cell studies.
