Publications by authors named "Alexis Gaudin"

13 Publications

  • Page 1 of 1

Specialized pro-resolving lipid mediators in endodontics: a narrative review.

BMC Oral Health 2021 May 24;21(1):276. Epub 2021 May 24.

Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042, Nantes, France.

Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is a highly dynamic tissue equipped with a network of resident immunocompetent cells that play major roles in the defense against pathogens and during tissue injury. However, the efficiency of these mechanisms during dental pulp inflammation (pulpitis) varies due to anatomical and physiological restrictions. Uncontrolled, excessive, or unresolved inflammation can lead to pulp tissue necrosis and subsequent bone infections called apical periodontitis. In most cases, pulpitis treatment consists of total pulp removal. Although this strategy has a good success rate, this treatment has some drawbacks (lack of defense mechanisms, loss of healing capacities, incomplete formation of the root in young patients). In a sizeable number of clinical situations, the decision to perform pulp extirpation and endodontic treatment is justifiable by the lack of therapeutic tools that could otherwise limit the immune/inflammatory process. In the past few decades, many studies have demonstrated that the resolution of acute inflammation is necessary to avoid the development of chronic inflammation and to promote repair or regeneration. This active process is orchestrated by Specialized Pro-resolving lipid Mediators (SPMs), including lipoxins, resolvins, protectins and maresins. Interestingly, SPMs do not have direct anti-inflammatory effects by inhibiting or directly blocking this process but can actively reduce neutrophil infiltration into inflamed tissues, enhance efferocytosis and bacterial phagocytosis by monocytes and macrophages and simultaneously inhibit inflammatory cytokine production. Experimental clinical application of SPMs has shown promising result in a wide range of inflammatory diseases, such as renal fibrosis, cerebral ischemia, marginal periodontitis, and cancer; the potential of SPMs in endodontic therapy has recently been explored. In this review, our objective was to analyze the involvement and potential use of SPMs in endodontic therapies with an emphasis on SPM delivery systems to effectively administer SPMs into the dental pulp space.
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http://dx.doi.org/10.1186/s12903-021-01619-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142493PMC
May 2021

An Extrudable Partially Demineralized Allogeneic Bone Paste Exhibits a Similar Bone Healing Capacity as the "Gold Standard" Bone Graft.

Front Bioeng Biotechnol 2021 20;9:658853. Epub 2021 Apr 20.

INSERM, UMR 1229, RMeS, Regenerative Medicine and Skeleton, CHU Nantes, ONIRIS, Université de Nantes, Nantes, France.

Autologous bone grafts (BGs) remain the reference grafting technique in various clinical contexts of bone grafting procedures despite their numerous peri- and post-operative limitations. The use of allogeneic bone is a viable option for overcoming these limitations, as it is reliable and it has been widely utilized in various forms for decades. However, the lack of versatility of conventional allogeneic BGs (e.g., blocks, powders) limits their potential for use with irregular or hard-to-reach bone defects. In this context, a ready- and easy-to-use partially demineralized allogeneic BG in a paste form has been developed, with the aim of facilitating such bone grafting procedures. The regenerative properties of this bone paste (BP) was assessed and compared to that of a syngeneic BG in a pre-clinical model of intramembranous bone healing in critical size defects in rat calvaria. The microcomputed tridimensional quantifications and the histological observations at 7 weeks after the implantation revealed that the bone regeneration of critical-size defects (CSDs) filled with the BP was similar to syngeneic bone grafts (BGs). Thus, this ready-to-use, injectable, and moldable partially demineralized allogeneic BP, displaying equivalent bone healing capacity than the "gold standard," may be of particular clinical relevance in the context of oral and maxillofacial bone reconstructions.
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http://dx.doi.org/10.3389/fbioe.2021.658853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098662PMC
April 2021

A partially demineralized allogeneic bone graft: in vitro osteogenic potential and preclinical evaluation in two different intramembranous bone healing models.

Sci Rep 2021 Mar 1;11(1):4907. Epub 2021 Mar 1.

INSERM, UMR 1229, RMeS, Regenerative Medicine and Skeleton, CHU Nantes, Université de Nantes, Oniris, 1 Place Alexis Ricordeau, 44042, Nantes, France.

In skeletal surgical procedures, bone regeneration in irregular and hard-to-reach areas may present clinical challenges. In order to overcome the limitations of traditional autologous bone grafts and bone substitutes, an extrudable and easy-to-handle innovative partially demineralized allogenic bone graft in the form of a paste has been developed. In this study, the regenerative potential of this paste was assessed and compared to its clinically used precursor form allogenic bone particles. Compared to the particular bone graft, the bone paste allowed better attachment of human mesenchymal stromal cells and their commitment towards the osteoblastic lineage, and it induced a pro-regenerative phenotype of human monocytes/macrophages. The bone paste also supported bone healing in vivo in a guide bone regeneration model and, more interestingly, exhibited a substantial bone-forming ability when implanted in a critical-size defect model in rat calvaria. Thus, these findings indicate that this novel partially demineralized allogeneic bone paste that combines substantial bone healing properties and rapid and ease-of-use may be a promising alternative to allogeneic bone grafts for bone regeneration in several clinical contexts of oral and maxillofacial bone grafting.
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http://dx.doi.org/10.1038/s41598-021-84039-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7921404PMC
March 2021

Periodontitis, erectile dysfunction, reproductive hormones, and semen quality: A systematic review.

Andrology 2021 05 2;9(3):769-780. Epub 2021 Jan 2.

Université de Nantes, UFR Odontologie, Nantes, France.

Background: There is increasing evidence that periodontitis may affect male sexual health (MSH) (erectile function, production of sex hormones, and semen quality). However, a limited number of clinical studies demonstrate the association between MSH and periodontitis.

Objectives: The aim of this study was to explore the relationship between periodontitis and MSF.

Materials And Methods: A comprehensive systematic review of the published literature in MEDLINE, PubMed, Scopus, Cochrane, EMBASE, and Web of Science databases from the earliest available online indexing year until October 2020 was performed, in accordance with the PRISMA guidelines. Keywords related to periodontitis were combined with words describing MSH.

Result: A total of 19 studies were included and discussed in the systematic review. The number of study participants ranged from 53 to 197,136 individuals, aged between 18 and 95 years (mean age, 41.2 years). Six studies did not report the age of the participants. Out of nine studies, eight found a significant association between erectile dysfunction (ED) and periodontitis. Only three studies evaluated the association between sex hormone levels and periodontitis, and two of these studies showed that patients with periodontitis are expected to exhibit higher levels of testosterone. Finally, out of five studies, two demonstrated a significant association between semen quality and periodontitis.

Discussion: The findings in this review were limited by the quality and the few available studies. Results from the observational studies might have been affected by recall bias and confounded by cofactors.

Conclusion: The results of this systematic review revealed a significant association between periodontitis and ED, although the responsible mechanisms remain unclear. The potential associations between sex hormone levels, semen quality, and periodontitis are yet to be demonstrated. In order to improve patient management, dentists and physicians need to be aware of the association between male sexual health problems and periodontitis.
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http://dx.doi.org/10.1111/andr.12961DOI Listing
May 2021

Comparative assessment of complete-coverage, fixed tooth-supported prostheses fabricated from digital scans or conventional impressions: A systematic review and meta-analysis.

J Prosthet Dent 2020 Oct 31. Epub 2020 Oct 31.

Professor of Periodontology, Department of Periodontology, Rmes U1229, University of Nantes, Nantes, France. Electronic address:

Statement Of Problem: Intraoral scanners have significantly improved over the last decade. Nevertheless, data comparing intraoral digital scans with conventional impressions are sparse.

Purpose: The purpose of this systematic review and meta-analysis was to determine the impact of impression technique (digital scans versus conventional impressions) on the clinical time, patient comfort, and marginal fit of tooth-supported prostheses.

Material And Methods: The authors conducted a literature search based on the Population, Intervention, Comparison, and Outcome (PICO) framework in 3 databases to identify clinical trials with no language or date restrictions. The mean clinical time, patient comfort, and marginal fit values of each study were independently extracted by 2 review authors and categorized according to the scanning or impression method. The authors assessed the study-level risk of bias.

Results: A total of 16 clinical studies met the inclusion criteria. The mean clinical time was statistically similar for digital scan procedures (784 ±252 seconds) and for conventional impression methods (1125 ±159 seconds) (P>.05). The digital scan techniques were more comfortable for patients than conventional impressions; the mean visual analog scale score was 67.8 ±21.7 for digital scans and 39.6 ±9.3 for conventional impressions (P<.05). The mean marginal fit was 80.9 ±31.9 μm and 92.1 ±35.4 μm for digital scan and conventional impressions, respectively, with no statistically significant difference (P>.05).

Conclusions: Digital scan techniques are comparable with conventional impressions in terms of clinical time and marginal fit but are more comfortable for patients than conventional impression techniques.
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http://dx.doi.org/10.1016/j.prosdent.2020.09.017DOI Listing
October 2020

The Efficiency of the Er: YAG Laser and PhotonInduced Photoacoustic Streaming (PIPS) as an Activation Method in Endodontic Irrigation: A Literature Review.

J Lasers Med Sci 2020 21;11(3):316-334. Epub 2020 Jun 21.

Clinical Investigation Unit 11 Odontology, CHU Nantes, Nantes, France.

In the field of endodontics, lasers have been used for a long time for the optimization of Endodontic irrigation in particular. The laser-activated irrigation (LAI) technique is based on the photomechanical effects of the lasers at low settings. They create specific cavitation phenomena and acoustic streaming in intracanal fluids. More recently, a new technique with a Er:YAG laser has been used with sub-ablative energy (20 mJ, 15 Hz) and ultra-short pulses (50 µs). This leads to intracanal cavitation and shockwaves as a result of photoacoustic and photomechanical effects. This phenomenon is called photon-induced photoacoustic streaming (PIPS). PIPS and Laser activated irrigation are described in the literature as a revolutionary and powerful method to activate the irrigant; however, systematic literature on this topic is missing. This review compares the literature on Er:YAG LAI and PIPS on endodontic irrigation with other irrigation methods. An article search was performed on the PubMed database using a series of keywords related to endodontic irrigation, including Er:YAG LAI and PIPS; 59 articles were selected for the review according to the inclusion and exclusion criteria. No study was found. The Er:YAG LAI and PIPS outperformed other methods in 33 of the 59 articles. There was a great variety in the study designs including bacterial incubation time, laser parameters, irrigation protocols, and irrigating solution used. The evidence suggests that the Er:YAG LAI and PIPS are promising in canal disinfection as well as debris and smear layer removal. However, the large variety in the study methods makes the results less significant. Further studies are needed to better evaluate the efficiency of these techniques, especially studies.
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http://dx.doi.org/10.34172/jlms.2020.53DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369550PMC
June 2020

Periodontal pockets: A potential reservoir for SARS-CoV-2?

Med Hypotheses 2020 Oct 30;143:109907. Epub 2020 May 30.

Department of Periodontology (Rmes U1229, UIC 11), Faculty of Dental Surgery, University of Nantes (CHU de Nantes), Nantes, France. Electronic address:

Periodontal pockets are the major clinical manifestation of Periodontitis, a chronic inflammatory oral disease affecting the teeth-supporting tissues and has high prevalence in the adult population. Periodontal pockets are ideal environments for subgingival bacterial biofilms, that interact with the supragingival oral cavity, mucosal tissues of the pocket and a peripheral circulatory system. Periodontal pockets have been found to harbor viral species such as the Herpes simplex viruses' family. Recently, the SARS-CoV-2 has gained major interest of the scientific/medical community as it caused a global pandemic (Covid-19) and paralyzed the globe with high figures of infected people worldwide. This virus behavior is still partially understood, and by analyzing some of its features we hypothesized that periodontal pocket could be a favorable anatomical niche for the virus and thus acting as a reservoir for SARS-CoV-2.
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http://dx.doi.org/10.1016/j.mehy.2020.109907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833827PMC
October 2020

Cytokine Production and Cytotoxicity of Calcium Silicate-based Sealers in 2- and 3-dimensional Cell Culture Models.

J Endod 2020 Jun 21;46(6):818-826. Epub 2020 Apr 21.

Department of Endodontics, University of the Pacific School of Dentistry, San Francisco, California; University of Queensland, School of Dentistry, Brisbane, Queensland, Australia.

Introduction: The aim of the present study was to assess the effects of different silicate-based sealers (ie, BioRoot RCS [Septodont, Saint Maur des Fosses, France], ProRoot ES [Dentsply Sirona, York, PA], and MTA Fillapex [Angelus, Londrina, PR, Brazil]) on cytokine production and viability of human periodontal ligament stem cells (PDLSCs). AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) was used as a reference material.

Methods: PDLSCs were cultured either in 2-dimensional or 3-dimensional conditions (in 0.15%-0.5% PuraMatrix [BD Biosciences, Bedford, MA]) for 24 hours with eluates from set endodontic sealers. Additionally, the toxicity of eluates from endodontic sealers was evaluated using an in vitro root model experimental procedure. PDLSC viability was determined using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. PDLSC culture medium was used for cytokine quantification (interleukin [IL]-6, IL-8, growth-regulated oncogene, IL,-4 and IL-10) using the HCYTMAG-60K-PX41 Milliplex kit (EMD Millipore, Burlington, MA).

Results: In 2-dimensional culture conditions, BioRoot RCS revealed a good PDLSC viability rate. ProRoot ES had no effect on PDLSC viability regardless of the dilution. MTA Fillapex was strongly cytotoxic even at the lowest extract dilutions (1:1, 1:2, and 1:4). Encapsulation of PDLSCs in PuraMatrix tended to decrease the cytotoxic effect of the sealers. In the 3-dimensional in vitro root model experimental procedure, BioRoot RCS, ProRoot ES, and MTA Fillapex revealed a cytocompatibility pattern. Different calcium silicate-based sealers exhibited different proinflammatory cytokine production. BioRoot RCS greatly stimulated the release of IL-10 and, to a lesser degree, IL-4 by PDLSCs (P < .05).

Conclusions: BioRoot RCS and ProRoot ES did not induce proinflammatory cytokines and promoted anti-inflammatory cytokine secretion by PDLSCs that may have a positive local impact by attenuating an initial inflammatory response.
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http://dx.doi.org/10.1016/j.joen.2020.03.011DOI Listing
June 2020

Educational gaming for dental students: Design and assessment of a pilot endodontic-themed escape game.

Eur J Dent Educ 2020 Aug 15;24(3):449-457. Epub 2020 Mar 15.

Department of Endodontics and Restorative Dentistry, Faculty of Dental Surgery, University of Nantes, Nantes, France.

Introduction: The concept of escape games dedicated to dental students is a new learning experience that has not yet been extensively explored. The aim of this pilot study was to assess the impact and perceived value of an endodontic-themed escape game as assessed by fourth-year dental students.

Methods: This study was conducted at the University of Nantes, Faculty of Dental Surgery using a cross-sectional pre- and post-test research design to assess students' changes in performance. Students in the fourth year of dental surgery study (n = 18) were divided in four groups for this study. The answers to the pre-test/post-test were 50 true/false questions. Moreover, a 20-question perception survey was given to all the participants after completion of the escape game. The study data were collected in May 2019. An unpaired t test analysed the mean differences between the groups.

Results: The results showed a statistically significant increase in post-test results (75.33% ± 10.17% of correct answers) compared to the pre-test results (67.33% ± 5.94% of correct answers) P < .05. Analysis of variance revealed that this change in score was not significantly different between the four groups. The students perceived the endodontic-themed escape game to be relevant. A one-sample t test indicated that students' mean (SD) perception 4.4 (0.7) was statistically significantly higher than the mean value of the evaluation scale P < .001. The students found this educational game to be a useful experience that helped them recall/apply knowledge whilst promoting teamwork.

Conclusion: Therefore, this type of game can enhance students' learning and motivation.
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http://dx.doi.org/10.1111/eje.12521DOI Listing
August 2020

Effect of dental caries on periodontal inflammatory status: A split-mouth study.

Arch Oral Biol 2020 Feb 21;110:104620. Epub 2019 Nov 21.

ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Pza. Ramón y Cajal, s/n, Madrid, Spain; Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar despota Stefana 142, Belgrade, Serbia. Electronic address:

Objective: This controlled split-mouth study aimed to estimate the effect of caries and related treatment on concentrations of interleukin (IL)-2, interferon (IFN)-γ, IL-12, IL-17A, IL-13, IL-10, IL-6, IL-5, IL-4, IL-22, tumor necrosis factor (TNF)-α, and IL1-β in gingival crevicular fluid (GCF) of caries affected teeth before (B), 7 (7D) and 30 (30D) days post-treatment and to compare them with concentrations from healthy teeth.

Design: Study population included 81 systemically and periodontally healthy non-smokers exhibiting at least one shallow occlusal/ inter-proximal caries and one healthy tooth from the same morphologic group at the contralateral position. Following clinical exam, the GCF samples were collected baseline as well as 7D and 30D, while the biomarker measurement was performed using multiplex flowcytometry.

Results: Caries affected teeth exhibited significantly higher levels of IFN-γ, IL-1β, IL-2, IL-4 and IL-6 when compared to healthy teeth. Post-treatment cytokines levels showed general trend of increase when compared to baseline, that was significant for IL-22 and IL-17 at 7D, while IFN-γ was significantly increased at 7D compared to the healthy teeth. At 30D, IFN-γ, TNF-α, IL-17 and IL-4 levels were significantly increased when compared to healthy teeth, while IL-2 levels were significantly higher than baseline levels.

Conclusion: Considering significantly increased periodontal levels of inflammatory markers in caries affected teeth and in response to performed treatment, it seems that dental caries and related restorative treatment might contribute to periodontal inflammation via additive effects already in early-stage caries.
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http://dx.doi.org/10.1016/j.archoralbio.2019.104620DOI Listing
February 2020

The Effect of Magnification Loupes on Spontaneous Posture Change of Dental Students During Preclinical Restorative Training.

J Dent Educ 2019 Apr 11;83(4):407-415. Epub 2019 Feb 11.

Maxime Carpentier is an undergraduate student, University of Nantes, Nantes, France; Davy Aubeux, DDS, MS, is Assistant Professor, Department of Endodontics and Restorative Dentistry, University of Nantes, Nantes, France; Valérie Armengol, DDS, PhD, is Associate Professor, Department of Endodontics and Restorative Dentistry, University of Nantes, Nantes, France; Fabienne Pérez, DDS, PhD, is Professor and Chair, Department of Endodontics and Restorative Dentistry, University of Nantes, Nantes, France; Tony Prud'homme, DDS, MS, is Associate Practionner, Department of Pedodontics, University of Nantes, Nantes, France; and Alexis Gaudin, DDS, PhD, is Associate Professor, Department of Endodontics and Restorative Dentistry, University of Nantes, Nantes, France.

Scientific evidence validating the beneficial effect of loupes in preventing musculoskeletal disorders is very scarce. The aim of this study was to assess the impact of dental loupes on dental students' posture during a preclinical restorative dentistry course. Using a randomized crossover design, this study was conducted at the School of Dentistry, University of Nantes, France, in 2017. Forty students in their second year of dental study were randomly divided into two groups of 20 each: group A used loupes, whereas group B did not. The week after, students reversed configurations (each subject served as his or her own treatment and control group). Students were video-recorded during cavity preparation. Trunk, head and neck, and upper arm positions were analyzed using continuous scores based on the modified Posture Assessment Instrument. Additionally, cavities were rated, and students completed a questionnaire on their perceptions of the loupes. On a scale on which lower scores indicated better posture, the results showed significantly higher posture ergonomic scores per minute for students without loupes (146.3±6.64 points/min) than with loupes (123.2±6.77 points/min; p<0.05). The majority of the students (32/39, 82%) showed improvements in ergonomic postures with the use of loupes. Trunk, head, and neck were positively impacted by the use of loupes, but not the upper arms. Cavity preparations were not improved by the use of loupes. The questionnaire revealed negative aspects (pain and difficulty adapting) but underlined the perceived positive impact on posture. This study documented the ergonomic advantages and challenges of introducing magnification near the beginning of the dental training program.
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http://dx.doi.org/10.21815/JDE.019.044DOI Listing
April 2019

Dental Pulp Defence and Repair Mechanisms in Dental Caries.

Mediators Inflamm 2015 11;2015:230251. Epub 2015 Oct 11.

Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham B4 6NN, UK.

Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and reducing innate repair capacities. For complete tooth healing the formation of a reactionary/reparative dentin barrier to distance and protect the pulp from infectious agents and restorative materials is required. Clinical and in vitro experimental data clearly indicate that dentin barrier formation only occurs when pulp inflammation and infection are minimised, thus enabling reestablishment of tissue homeostasis and health. Therefore, promoting the resolution of pulp inflammation may provide a valuable therapeutic opportunity to ensure the sustainability of dental treatments. This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries-induced inflammation and dentinogenic-based repair. We report, using selected examples, different strategies potentially used by odontoblasts and specialized immune cells to combat dentin-invading bacteria in vivo.
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http://dx.doi.org/10.1155/2015/230251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619960PMC
August 2016

Phenotypic analysis of immunocompetent cells in healthy human dental pulp.

J Endod 2015 May 18;41(5):621-7. Epub 2015 Feb 18.

Faculty of Odontology, University of Nantes, Nantes, France; INSERM, Institut de Transplantation et de Recherche en Transplantation, Nantes, France.

Introduction: Like other tissues in the body, the human dental pulp is equipped with a network of immune cells that can be mobilized against pathogens when they invade the tooth. Very little data, mostly obtained with classic histologic methods, have reported their quantities and relative percentages. The objective of this study was to characterize and precisely quantify immunocompetent cells in healthy human dental pulp by using fluorescence-activated cell sorting, together with identifying specific cell subsets in the leukocyte (CD45(+)) cells.

Methods: Healthy human third molars were collected from 42 young patients. Dental pulps were separated from the hard tissues and prepared for flow cytometry or immunostaining analyses.

Results: CD45(+) cells represented 0.94% ± 0.65% of cells obtained from the enzymatic digestion of whole dental pulps (n = 34). CD16(+)CD14(+) granulocytes/neutrophils (50.01% ± 9.08%, n = 7) were found to represent the major subpopulation in CD45(+) cells followed by CD3(+) T lymphocytes (32.58% ± 11%, n = 17), CD14(+) monocytes (8.93% ± 5.8%, n = 7), and HLA-DR(high) Lin1(-) dendritic cells (4.51% ± 1.12%, n = 7). Minor subpopulations included CD3(-)CD56(+) natural killer cells (2.63% ± 1.15%, n = 7) and CD19(+) B lymphocytes (1.65% ± 0.89%, n = 17). We further identified cells harboring a phenotype compatible with Foxp3/CD25-expressing regulatory T lymphocytes (CD45(+)CD3(+)CD4(+)CD127(low)). Fluorescence-activated cell sorting analysis and confocal microscopy also revealed expression of HO-1 in HLA-DR(+) cells.

Conclusions: For the first time, this study identifies and precisely quantifies the relative proportion of immunocompetent cells potentially involved in tissue homeostasis of healthy human dental pulp.
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http://dx.doi.org/10.1016/j.joen.2015.01.005DOI Listing
May 2015