O condicionamento da dentina com soluções irrigadoras e materiais bioativos influencia na liberação de fatores de crescimento?

Abstract

Introduction: Several growth factors are fossilized in the dentin matrix, such as Transforming Growth Factor-beta 1 (TGF-b1). Objective: To describe studies on the influence of dentin conditioning with different types of irrigating solutions and bioactive materials on the release of growth factors, as well as their actions on undifferentiated mesenchymal cells. Methodology: The search and selection of scientific articles (n=15) was carried out in the PubMed database, involving international publications from 2006 to 2021, which described a comparison between different chemical substances (solutions or medications) in the release of risk factors. growth and what types of mediators were released. Results/Discussion: The irrigating solutions described in the articles with action potential in the release of dentin growth factors were 10% or 17% EDTA, 10% Citric Acid, 10% or 37% Phosphoric Acid, 1.5% NaOCl, Phytic Acid 1% (IP6) and Etidronic Acid 9% (HEDP), and associations such as, for example, NaOCl 1.5% + EDTA 17%. Regarding repair materials with conditioning action, the following substances were studied: Calcium Hydroxide Solutions, White MTA, Gray MTA, Biodentine, TAP and other Cements based on Calcium Silicate. The growth factor TGF-b1 was the main quantified mediator in the two themes. Among the studies addressing irrigating solutions, six articles showed that EDTA (10% or 17%) allowed a greater release of growth factors, mainly IGF-1, but three studies showed that Citric Acid 10% was superior to EDTA both in the release of TGF-b1 and in the recruitment, fixation and survival of stem cells. Regarding bioactive materials, there are few studies comparing the same substances. One article showed that Biodentine applied as capping material promoted a greater release of TGF-b1 from dentin than MTA. On the other hand, another study concluded that white/gray MTA released a broader profile of signaling molecules compared to Ca(OH)2. Conclusion: From this study, we observed the action potential of chemical substances routinely used in endodontic treatment as acting in the release of fossilized growth factors in dentin. However, more studies are needed to clarify the best conditioning protocol.