The dimethyloxalylglycine-functionalized nanofibers for in situ regeneration of infected developing dental roots

Abstract

In situ regeneration in restorative dentistry focuses on repairing tissues directly at the injury site by using engineered biomaterials to guide endogenous cell activity. This approach aims to simplify treatment processes and improve outcomes for conditions like developing teeth with necrotic pulp infections. This study explores the potential of poly(ε-caprolactone) fibers (PCLF) functionalized with dimethyloxalylglycine (DMOG) for in situ regeneration in the context of dental root repair in immature teeth with necrotic pulp and apical periodontitis. In vivo application to a model in beagle dogs demonstrated the effectiveness of PCLF/DMOG in promoting root development, apical closure, and clearing infectious lesions, contrasting with calcium hydroxide paste, contemporary regenerative endodontic treatment controls that showed thin root growth and resilient persistent infection. Mechanistically, the sustained release of DMOG from PCLF/DMOG significantly enhanced the expression of hypoxia-inducible factor 1-alpha and upregulated genes associated with angiogenesis and neurogenesis, including vascular endothelial growth factor-A and nerve growth factor. The PCLF/DMOG upregulated antimicrobial peptides, facilitated efferocytic activities, and promoted macrophage polarization to the M2 phenotype. These findings highlight the potential of PCLF/DMOG scaffolds for dental root regeneration, offering a promising approach for treating immature teeth with necrotic pulp and apical periodontitis through in situ regeneration.