Effects of EDTA and saline as the final irrigation in regenerative endodontic procedures on the migration, proliferation, and differentiation of human stem cells from the apical papilla

Napas Meeprasert, Jeeraphat Jantarat, Wassana Wichai, Rudee Surarit, Kenneth M. Hargreaves

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: To evaluate the effect of EDTA and saline as the final irrigation in regenerative endodontic procedures (REPS) on the attachment, proliferation, migration, and differentiation of stem cells from the apical papilla (SCAPs). Materials and methods: Dentin specimens from 140 human third molars were irrigated with various protocols—group 1: normal sterile saline (NSS), group 2: EDTA, group 3: EDTA then 5 mL NSS, or group 4: EDTA then 20 mL NSS. The specimens were used in cell assays. For cell proliferation, SCAPs were seeded on dentin, and the cell viability on days 1, 3, and 7 was determined using an MTT assay. At day 3, the attached cells’ morphology was observed using SEM, and cell migration was investigated using a transwell migration assay. The ALP activity and odonto/osteogenic differentiation gene expression were evaluated at days 7, 14, and 21 using an ALP activity assay and RT-qPCR. Results: On days 3 and 7, group 4 demonstrated more viable cells than group 1 (p < 0.01). The amount of migrated cells in groups 2, 3, and 4 was greater compared with group 1 (p < 0.05). Moreover, SCAP differentiation was similar between groups. Conclusions: Irrigating dentin with EDTA alone or with EDTA then NSS promoted SCAP migration. However, a final irrigation with 20 mL NSS after EDTA promoted SCAP proliferation without affecting their differentiation. Clinical relevance: When using a blood clot as a scaffold, a final flushing with 20 mL NSS after EDTA could be beneficial for clinical REP protocols.

Original languageEnglish (US)
Pages (from-to)1973-1980
Number of pages8
JournalClinical Oral Investigations
Volume27
Issue number5
DOIs
StatePublished - May 2023

Keywords

  • Cell differentiation
  • Cell migration
  • Cell proliferation
  • Irrigation protocol
  • Regenerative endodontic procedure
  • Stem cells of the apical papilla

ASJC Scopus subject areas

  • Dentistry(all)

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