Roles of Pyroptosis in the Progression of Pulpitis and Apical Periodontitis

Pyroptosis is a type of programmed cell death that induces proinflammatory cytokine release and is closely related to inflammatory diseases. Pulpitis and apical periodontitis are common inflammatory diseases that lead to alveolar bone destruction and tooth loss. Recent studies have revealed that pyroptosis is crucial in the progression of pulpitis and apical periodontitis, which involves various cell types and leads to different results. Odontoblasts are located at the periphery of dental pulp tissue and are susceptible to various irritants, the lysates from odontoblasts act as alerts and induce immune reactions in the inner pulp after pyroptosis. The expression levels of inflammasomes in dental pulp cells (DPCs) change with the progression of pulpitis, which may serve as a diagnostic marker of pulpitis. Periodontal ligament fibroblasts (PDLFs) undergo pyroptosis when stimulated by bacterial infection or cyclic stretch and are associated with both infection-induced and trauma-induced apical periodontitis. Immune cells can undergo pyroptosis directly after infection or are influenced by the pyroptotic secretome of other cells, which changes their composition. In this review, we briefly introduce the location and function of different cell types involved in the progression of pulpitis and apical periodontitis, summarize the roles of pyroptosis in different cells, and discuss the effects of drugs targeting pyroptosis in the treatment of pulpitis and apical periodontitis.