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The dentin-pulp complex is a unique structure in teeth that contains both hard and soft tissues. Generally, deep caries and trauma cause damage to the dentin-pulp complex, and if left untreated, this damage will progress to irreversible pulpitis. The aim of this study was to fabricate a layered cell sheet composed of rat dental pulp (DP) cells and odontogenic differentiation of pulp (OD) cells and to investigate the ability to regenerate the dentin-pulp complex in a scaffold tooth. We fabricated two single cell sheets composed of DP cells (DP cell sheet) or OD cells (OD cell sheet) and a layered cell sheet made by layering both cells. The characteristics of the fabricated cell sheets were analyzed using light microscopy, scanning electron microscopy (SEM), hematoxylin-eosin (HE) staining, and immunohistochemistry (IHC). Furthermore, the cell sheets were transplanted into the subrenal capsule of immunocompromised mice for 8 weeks. Following this, the regenerative capacity to form dentin-like tissue was evaluated using micro-computed tomography (Micro-CT), HE staining, and IHC. The findings of SEM and IHC confirmed that layered cell sheets fabricated by stacking OD cells and DP cells maintained their cytological characteristics. Micro-CT of layered cell sheet transplants revealed a mineralized capping of the access cavity in the crown area, similar to that of natural dentin. In contrast, the OD cell sheet group demonstrated the formation of irregular fragments of mineralized tissue in the pulp cavity, and the DP cell sheet did not develop any hard tissue. Moreover, bone volume/tissue volume (BV/TV) showed a significant increase in hard tissue formation in the layered cell sheet group compared to that in the single cell sheet group (p

Active learning is a concept that allows students to study and learn actively by themselves to get knowledge. There are several methods of active learning, including flipped classroom (FC) and team-based learning (TBL). In FC, students are required to study before classes. In TBL, students also study before class, take individual readiness assurance test (iRAT) and team readiness assurance test (tRAT), then discuss group assignment projects (GAPs) during class. The purpose of this study was to compare the effectiveness between FC and TBL. The effectiveness of FC and TBL was assessed from the results of the term-end examinations, questionnaires and practice examinations. To check the difficulty of the term-end examinations, control dentists took the same examinations and we calculated the equating score with item response theory. Statistical analysis showed that the correct answer rate in term-end examinations was significantly different in comparison with the time of the trial, and for the participants (students and dentists). The term-end examination score of FC and TBL did not show a statistical difference. The student questionnaire showed that TBL had higher scores than FC on various factors such as student positive attitude, preparation, ingenuity of teacher and achieving the class goals. The crown & bridge score from the practice examination of 6th-year students who had FC + TBL were constantly higher than the Japanese national average score. The identification index of FC and TBL did not show the statistical difference and there was no statistical difference on item response theory between FC and TBL.

Bone marrow-derived mesenchymal stem cells (BMSCs) have considerable potential for self-renewal and multi-differentiation. Tumor necrosis factor-α (TNF-α) is an inflammatory cytokine and is involved in tissue regeneration during wound healing. It was already reported that cultured human dental pulp cells acquire stem cell properties following short-term stimulation by TNF-α. However, it has not been clarified if BMSCs acquire stem cell properties after TNF-α treatment. The purpose of this study was to investigate the effect of short-term stimulation with TNF-α on BMSCs. Rat BMSCs were cultured up to 60% confluence and then incubated with 1–100 ng/ml of recombinant rat TNF-α (rTNF-α) for a further 2 days. After reaching subconfluence, cells were passaged once to remove rTNF-α completely before subsequent assays. Cells in the control group were passaged without stimulation. Expression levels of Nanog and Oct4 stem cell markers were significantly increased in the rTNF-α 10 ng/ml stimulation group. rTNF-α stimulation did not affect cell proliferation compared with the control group. However, rTNF-α stimulation led to a delay in cell differentiation. This study suggests that short-term TNF-α stimulation of BMSCs significantly increased their stem cell phenotype, but delayed their osteogenic cell differentiation.

Tumor necrosis factor-alpha (TNF-α) is an inflammatory cytokine known to cause bone resorption, swelling and edema during tissue organization. Conversely, TNF-α has also been shown to participate in tissue regeneration during the wound healing process. We have previously investigated the effects of TNF-α on human dental pulp cell differentiation. Dental pulp cells are composed of different cell types including primary odontoblasts and fibroblasts. We determined that the ratio of stem cells within the pulp cell population was increased following short-term stimulation with TNF-α. The aim of this study therefore was to investigate the effect of short-term stimulation with TNF-α on osteoblast-like MC3T3-E1 cell growth and differentiation. MC3T3-E1 cells were cultured in standard growth medium and on reaching sub-confluence were exposed to recombinant TNF-α (10 and 100 ng/ml) for 2 days prior to assessing their cell proliferation and differentiation properties in comparison to non-stimulated MC3T3-E1 cells (control). Although no significant differences in cell proliferation were observed between the TNF-α-stimulated and control groups, cell differentiation was delayed in the TNF-α-stimulated groups. In summary, short-term stimulation of cultured MC3T3-E1 cells with TNF-α had only minimal effect on their growth and differentiation.

Periodontal tissue is a distinctive tissue structure composed three-dimensionally of cementum, periodontal ligament (PDL) and alveolar bone. Severe periodontal diseases cause fundamental problems for oral function and general health, and conventional dental treatments are insufficient for healing to healthy periodontal tissue. Cell sheet technology has been used in many tissue regenerations, including periodontal tissue, to transplant appropriate stem/progenitor cells for tissue regeneration of a target site as a uniform tissue. However, it is still difficult to construct a three-dimensional structure of complex tissue composed of multiple types of cells, and the transplantation of a single cell sheet cannot sufficiently regenerate a large-scale tissue injury. Here, we fabricated a three-dimensional complex cell sheet composed of a bone-ligament structure by layering PDL cells and osteoblast-like cells on a temperature responsive culture dish. Following ectopic and orthotopic transplantation, only the complex cell sheet group was demonstrated to anatomically regenerate the bone-ligament structure along with the functional connection of PDL-like fibers to the tooth root and alveolar bone. This study represents successful three-dimensional tissue regeneration of a large-scale tissue injury using a bioengineered tissue designed to simulate the anatomical structure.

Neuron-glia interactions contribute to pain initiation and sustainment. Intra-ganglionic (IG) secretion of calcitonin gene-related peptide (CGRP) in the trigeminal ganglion (TG) modulates pain transmission through neuron-glia signaling, contributing to various orofacial pain conditions. The present study aimed to investigate the role of satellite glial cells (SGC) in TG in causing cytokine-related orofacial nociception in response to IG administration of CGRP. For that purpose, CGRP alone (10 μL of 10-5 M), Minocycline (5 μL containing 10 μg) followed by CGRP with one hour gap (Min + CGRP) were administered directly inside the TG in independent experiments. Rats were evaluated for thermal hyperalgesia at 6 and 24 h post-injection using an operant orofacial pain assessment device (OPAD) at three temperatures (37, 45 and 10 ℃). Quantitative real-time PCR was performed to evaluate the mRNA expression of IL-1β, IL-6, TNF-α, IL-1 receptor antagonist (IL-1RA), sodium channel 1.7 (NaV 1.7, for assessment of neuronal activation) and glial fibrillary acidic protein (GFAP, a marker of glial activation). The cytokines released in culture media from purified glial cells were evaluated using antibody cytokine array. IG CGRP caused heat hyperalgesia between 6–24 h (paired-t test, p < 0.05). Between 1 to 6 h the mRNA and protein expressions of GFAP was increased in parallel with an increase in the mRNA expression of pro-inflammatory cytokines IL-1β and anti-inflammatory cytokine IL-1RA and NaV1.7 (one-way ANOVA followed by Dunnett’s post hoc test, p < 0.05). To investigate whether glial inhibition is useful to prevent nociception symptoms, Minocycline (glial inhibitor) was administered IG 1 h before CGRP injection. Minocycline reversed CGRP-induced thermal nociception, glial activity, and down-regulated IL-1β and IL-6 cytokines significantly at 6 h (t-test, p < 0.05). Purified glial cells in culture showed an increase in release of 20 cytokines after stimulation with CGRP. Our findings demonstrate that SGCs in the sensory ganglia contribute to the occurrence of pain via cytokine expression and that glial inhibition can effectively control the development of nociception.