[Response of odontoblastic and pulpal cells to carious lesions]

The odontoblast responds to caries by the formation of sclerotic as well as reparative dentin. Sclerotic dentin is deposited during the early stages of the dentinal injury. It is characterized by the amplification of the collagen synthesis and the increase in alkaline phosphatase activity in the odontoblastic cell layer. Reparative dentin will be deposited under the sclerotic zone after the destruction of odontoblasts. At this stage, specific components from damaged dentinal tissues and/or odontoblastic necrotic debris will trigger pulpal cells to elaborate a cartilage-like matrix layer (fibrodentin). The latter may induce pulpal odontoblast-like cells to give rise to the tubular reparative dentin. Thus, pulpal cell response seems to be similar to bone-cell response to injury. Molecular signals responsible for this tissular healing remain largely unknown, but dentin is a potential source of matrical or soluble organic molecules that may be released after demineralization. Some of these factors have been identified in the sound tissue (glycoproteins, proteoglycans, growth factors, ...), but their role in the stimulation of the elaboration of the cicatricial tissue remains to be elucidated.