Nestin and dental pulp stones - a case report-driven hypothesis

The dental pulp stem cells (DPSCs) are mesenchymal stem/stromal cells (MSCs) with multilineage potential of differentiation. Different studies investigated dental pulp stones (PS), the calcified masses in the dental pulp, in regard to their prevalence, topography and structure. The etiology of PS is still unclear and, to our knowledge, the DPSCs were not attributed yet specific roles in PS formation. We report here an immunohistochemical study of a PS-embedding dental pulp from an impacted third mandibular molar of an adult patient, in which we used antibodies against CD34, Ki67, glial fibrillary acidic protein (GFAP), α-smooth muscle actin (α-SMA) and nestin. While endothelial cells expressed CD34 and pericytes or vascular smooth muscle cells expressed α-SMA, DPSCs and the osteoblasts coating the PS were exclusively labeled with nestin antibody. Stromal networks of nestin-expressing DPSCs were regarded as in situ providers of osteogenic progenitors involved in PS formation. Further experimental studies, with larger lots of tissue samples, as well as extended panels of markers, are needed in order to elucidate the DPSC hypothesis in the PS etiology.