Effect of a Residual Biofilm on Release of Transforming Growth Factor β1 from Dentin

Several studies have reported regeneration of the pulp-dentin complex when treating noninfected root canal systems. However, current protocols applied to infected root canal systems are much less predictable for the formation of dentin. Converging lines of evidence implicate residual biofilm as an important factor for these variable histologic outcomes. Here we studied the effect of a residual polymicrobial biofilm on the release of transforming growth factor beta 1 (TGF-β1) from dentin. We hypothesized that the presence of bacterial biofilm attenuates the release of bioactive molecules from dentin.

Using bacteria commonly found in infected immature teeth, we developed a multispecies biofilm in an organotypic root canal model. Root segments were then subjected to various irrigation or intracanal medicament protocols. Subsequently, the release of TGF-β1 from dentin was measured using the enzyme-linked immunosorbent assay.

Our data show that sterile root segments released greater amounts of TGF-β1 when conditioned with 17% EDTA alone (P < .001) or with the combination of 1.5% sodium hypochlorite and 17% EDTA (P < .05) compared with root segments infected with the multispecies biofilm. Similar results were also observed with the intracanal medicament protocol. Sterile root segments medicated with various concentrations of triple antibiotic paste and full-strength calcium hydroxide released greater amounts of TGF-β1 when compared with their infected counterparts.

This is the first study to report the detrimental effects of a residual biofilm on dentin conditioning and, therefore, the release of growth factors critical for regenerative procedures.