Emmanuelle Renard

Inserm

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Brigitte Alliot‐Licht

Nantes Université

Alexis Gaudin

Nantes Université

Jean‐Christophe Farges

Hospices Civils de Lyon

Laurence Bouchet‐Delbos

Inserm

Octave Nadile Bandiaky

Nantes Université

Assem Soueidan

Ascension Providence Hospital

Tchilalo Boukpessi

Université Paris Cité

Sandra Minic

Government College Kodanchery

Maxime Ducret

Université Claude Bernard Lyon 1

G Eraldine Bienvenu-Louvet

Nantes Université

Cooperative Institutions

Inserm

Nantes Université

Centre National de la Recherche Scientifique

Centre Hospitalier Universitaire de Nantes

Division of Undergraduate Education

American Association of Endodontists

Clinical Research Management

Regenerative Medicine Institute

Université de Caen Normandie

Universidade Estadual Paulista (Unesp)

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Post‐operative discomforts in children after extraction of primary teeth

Clinical and Experimental Dental Research (2020)

Claire Baillargeau Séréna Lopez-Cazaux Hubert Charles Aline Ordureau Sylvie Dajean‐Trutaud

Abstract Objectives This prospective observational study aimed to evaluate discomfort after extraction of deciduous teeth under local anesthesia. The primary objective was to describe the prevalence of post‐extraction pain (PEP), post‐extraction bleeding (PEB), post‐extraction biting injury (PEBI), and analgesic usage in children. The secondary objective was to define whether it is possible to determine a profile of patients or a type of extraction procedure predictive to PEP, administration of analgesics, PEB, or PEBI. Methods One hundred and twenty‐five children, aged 3–13 years, with indications of at least one deciduous tooth extraction, were included. Immediately after extraction, information concerning the patient and the extraction were collected. Eighteen to 32 hr after extraction, parents were called by phone to request reports concerning the onset and intensity of PEP assessed using the Wong‐Baker Faces (WBF) scale, the administration of paracetamol (acetaminophen) to their children, and the appearance of PEB and/or PEBI. Results Of the children, 37.3% reported PEP (WBF ≥2), but 23.3% of these children did not receive any analgesic drugs to help relieve pain. Pain appeared before 3 hr after extraction in 69% of the children. Higher incidences of PEP and usage of analgesics were found both in the group of children with unfavorable socioeconomic level compared to favorable level and in the group with pre‐operative pain compared to no pre‐operative pain ( p < .05). Conclusions About a third of the children reported pain after extraction, but the instructions for pain relief were not followed by all parents. The socioeconomic level of the young patient and the pain felt during the extraction were important predictors of discomfort. Therefore, our study could help the dentist to provide information on predicted post‐operative discomfort and to allow suitable care depending on the patient's profile or procedure.

FLACC scale

Dental extraction

Acetaminophen

10.1002/cre2.316

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Citations (5)

Electrophysiological characterization of a 19-years-old male marathon runner suffering a sudden cardiac death

Archives of Cardiovascular Diseases Supplements (2023)

Néstor Pallares Lupon E. Surget M.E. Martı́nez Emmanuelle Renard Bastien Guillot

Effective refractory period

10.1016/j.acvdsp.2023.03.125

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Citations (0)

Phenotypic Analysis of Immunocompetent Cells in Healthy Human Dental Pulp

Journal of Endodontics (2015)

Alexis Gaudin Emmanuelle Renard Marcelo Hill Laurence Bouchet‐Delbos G Eraldine Bienvenu-Louvet

Cell Sorting

CD16

Immunostaining

Immunophenotyping

10.1016/j.joen.2015.01.005

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Citations (46)

Current Data on Oral Peri-Implant and Periodontal Microbiota and Its Pathological Changes: A Systematic Review

Microorganisms (2022)

Virginie Gazil Octave Nadile Bandiaky Emmanuelle Renard Katia Idiri Xavier Struillou

The 5- and 10-year implant success rates in dentistry are nearly 90%. Prevalence of peri-implant diseases is 10% for peri-implantitis and 50% for peri-implant mucositis. To better understand these inflammatory pathologies of infectious origin, it is important to know if the composition of the peri-implant microbiota is comparable with the periodontal microbiota in healthy and pathological conditions. New generation sequencing (NGS) is a recent metagenomic method that analyzes the overall microorganisms present in an ecological niche by exploiting their genome. These methods are of two types: 16S rRNA sequencing and the shotgun technique. For several years, they have been used to explore the oral, periodontal, and, more specifically, peri-implant microbiota. The aim of this systematic review is to analyze the recent results of these new explorations by comparing the periodontal and peri-implant microbiota in patients with healthy and diseased sites and to explore the microbiological characteristics of peri-implantitis. A better knowledge of the composition of the peri-implant microbiota would enable us to optimize our therapeutic strategies. An electronic systematic search was performed using the medical databases PubMed/Medline, Cochrane Library, and ScienceDirect, and Periodontology 2000. The selected articles were published between January 2015 and March 2021. Inclusion criteria included clinical studies comparing healthy and pathological periodontal and peri-implant microbiota exclusively using 16S rRNA sequencing or shotgun sequencing, with enrolled populations free of systemic pathology, and studies without substantial bias. Eight articles were selected and reviewed. All of them used 16S rRNA sequencing exclusively. The assessment of these articles demonstrates the specific character of the peri-implant microbiota in comparison with the periodontal microbiota in healthy and pathological conditions. Indeed, peri-implant diseases are defined by dysbiotic bacterial communities that vary from one individual to another, including known periodontopathogens such as Porphyromonas gingivalis (P.g.) and genera less mentioned in the periodontal disease pattern such as Filifactor alocis. Examination of peri-implant microbiota with 16S rRNA sequencing reveals differences between the periodontal and peri-implant microbiota under healthy and pathological conditions in terms of diversity and composition. The pattern of dysbiotic drift is preserved in periodontal and peri-implant diseases, but when comparing the different types of pathological sites, the peri-implant microbiota has a specificity in the presence of bacteria proper to peri-implantitis and different relative proportions of the microorganisms present.

Mucositis

Peri-implantitis

10.3390/microorganisms10122466

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Dental Pulp Defence and Repair Mechanisms in Dental Caries

Mediators of Inflammation (2015)

Jean‐Christophe Farges Brigitte Alliot‐Licht Emmanuelle Renard Maxime Ducret Alexis Gaudin

Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and reducing innate repair capacities. For complete tooth healing the formation of a reactionary/reparative dentin barrier to distance and protect the pulp from infectious agents and restorative materials is required. Clinical and in vitro experimental data clearly indicate that dentin barrier formation only occurs when pulp inflammation and infection are minimised, thus enabling reestablishment of tissue homeostasis and health. Therefore, promoting the resolution of pulp inflammation may provide a valuable therapeutic opportunity to ensure the sustainability of dental treatments. This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries‐induced inflammation and dentinogenic‐based repair. We report, using selected examples, different strategies potentially used by odontoblasts and specialized immune cells to combat dentin‐invading bacteria in vivo .

10.1155/2015/230251

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Citations (403)

Study of the impacts of patient‐educators on the course of basic sciences in dental studies

European Journal Of Dental Education (2014)

Emmanuelle Renard Brigitte Alliot‐Licht Olivia Gross Valérie Roger‐Leroi Claire Marchand

Ever since 2006, Nantes University dental educators have started organising lectures led by the mother of a young patient suffering from ectodermic dysplasia (patient-educator) to help second-year students to better understand how important it is for their future dental work to better understand basic sciences. In this study, we have analysed this training experience on students' motivation. For this purpose, students were asked to complete questionnaires 10 days after the patient-educator's lecture (early assessment; n = 193) and 4 years later, during the last year of their dental studies (delayed assessment; n = 47). Moreover, 3 years after the first lecture, we analysed the ability of students to diagnose a mother carrying the ectodermic dysplasia genetic disorder, using a case-based learning exercise with a patient showing dental features similar to those exposed by the patient-educator (measure of knowledge; n = 42). Ten days after the lecture, the early assessment shows that all the students were interested in the lecture and 59% of the students declared being motivated to find out more about genetics whilst 54% declared the same thing about embryology courses. Moreover, 4 years later, 67% of the students remembered the patient-educator's lecture a little or very well. Three years after the course, 83% of the students diagnosed ectodermal dysplasia whilst studying the case-based example that listed typical dental phenotypes. In conclusion, this study shows that this original educational approach enhances dental students' motivation in learning basic sciences and that patient-educators could offer many benefits for students and patients.

Dental education

10.1111/eje.12098

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Citations (13)

Immune Cells and Molecular Networks in Experimentally Induced Pulpitis

Journal of Dental Research (2015)

Emmanuelle Renard Alexis Gaudin G. Bienvenu Jérôme Amiaud Jean‐Christophe Farges

Dental pulp is a dynamic tissue able to resist external irritation during tooth decay by using immunocompetent cells involved in innate and adaptive responses. To better understand the immune response of pulp toward gram-negative bacteria, we analyzed biological mediators and immunocompetent cells in rat incisor pulp experimentally inflamed by either lipopolysaccharide (LPS) or saline solution (phosphate-buffered saline [PBS]). Untreated teeth were used as control. Expression of pro- and anti-inflammatory cytokines, chemokine ligands, growth factors, and enzymes were evaluated at the transcript level, and the recruitment of the different leukocytes in pulp was measured by fluorescence-activated cell-sorting analysis after 3 h, 9 h, and 3 d post-PBS or post-LPS treatment. After 3 d, injured rat incisors showed pulp wound healing and production of reparative dentin in both LPS and PBS conditions, testifying to the reversible pulpitis status of this model. IL6, IL1-β, TNF-α, CCL2, CXCL1, CXCL2, MMP9, and iNOS gene expression were significantly upregulated after 3 h of LPS stimulation as compared with PBS. The immunoregulatory cytokine IL10 was also upregulated after 3 h, suggesting that LPS stimulates not only inflammation but also immunoregulation. Fluorescence-activated cell-sorting analysis revealed a significant, rapid, and transient increase in leukocyte levels 9 h after PBS and LPS stimulation. The quantity of dendritic cells was significantly upregulated with LPS versus PBS. Interestingly, we identified a myeloid-derived suppressor cell-enriched cell population in noninjured rodent incisor dental pulp. The percentage of this population, known to regulate immune response, was higher 9 h after inflammation triggered with PBS and LPS as compared with the control. Taken together, these data offer a better understanding of the mechanisms involved in the regulation of dental pulp immunity that may be elicited by gram-negative bacteria.

Pulpitis

CXCL1

10.1177/0022034515612086

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Evaluation of Pulp Repair after BiodentineTM Full Pulpotomy in a Rat Molar Model of Pulpitis

Biomedicines (2021)

Sandra Minic Marion Florimond Jérémy Sadoine Anne Valot-Salengro Catherine Chaussain

Dental pulp is a dynamic tissue able to heal after injury under moderate inflammatory conditions. Our study aimed to evaluate pulp repair under inflammatory conditions in rats. For this purpose, we developed a rat model of controlled pulpitis followed by pulpotomy with a tricalcium silicate-based cement. Fifty-four cavities were prepared on the occlusal face of the maxillary upper first molar of 27 eight-week-old male rats. E. coli lipopolysaccharides at 10 mg/mL or phosphate-buffered saline PBS was injected after pulp injury. Non-inflamed molars were used as controls. Levels of inflammation-related molecules were measured 6 and 24 h after induction by enzyme-linked immunosorbent assay of coronal pulp samples. Pulp capping and coronal obturation after pulpotomy were performed with tricalcium silicate-based cement. Four and fifteen days after pulpotomy, histological and immunohistochemical analysis was performed to assess pulp inflammation and repair processes. Our results showed significantly higher levels of innate inflammatory proteins (IL-1β, IL-6, TNF-α and CXCL-1) compared with those in controls. Moderate residual inflammation near the capping material was demonstrated by histology and immunohistochemistry, with the presence of few CD68-positive cells. We showed that, in this model of controlled pulpitis, pulpotomy with BiodentineTM allowed the synthesis at the injury site of a mineralized bridge formed from mineralized tissue secreted by cells displaying odontoblastic characteristics. Analysis of these data suggests overall that, with the limitations inherent to findings in animal models, pulpotomy with a silicate-based cement is a good treatment for controlling inflammation and enhancing repair in cases of controlled pulpitis.

Pulpotomy

Pulpitis

Pulp capping

10.3390/biomedicines9070784

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Citations (16)

Modulators of Wnt Signaling Pathway Implied in Dentin Pulp Complex Engineering: A Literature Review

International Journal of Molecular Sciences (2022)

Marion Florimond Sandra Minic Paul T. Sharpe Catherine Chaussain Emmanuelle Renard

The main goal of vital pulp therapy (VPT) is to preserve the vitality of the pulp tissue, even when it is exposed due to bacterial invasion, iatrogenic mechanical preparation, or trauma. The type of new dentin formed as a result of VPT can differ in its cellular origin, its microstructure, and its barrier function. It is generally agreed that the new dentin produced by odontoblasts (reactionary dentin) has a tubular structure, while the dentin produced by pulp cells (reparative dentin) does not or has less. Thus, even VPT aims to maintain the vitality of the pulp. It does not regenerate the dentin pulp complex integrity. Therefore, many studies have sought to identify new therapeutic strategies to successfully regenerate the dentin pulp complex. Among them is a Wnt protein-based strategy based on the fact that Wnt proteins seem to be powerful stem cell factors that allow control of the self-renewal and proliferation of multiple adult stem cell populations, suitable for homeostasis maintenance, tissue healing, and regeneration promotion. Thus, this review outlines the different agents targeting the Wnt signaling that could be applied in a tooth environment, and could be a potential therapy for dentin pulp complex and bone regeneration.

10.3390/ijms231810582

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Dental pulp inflammatory/immune response to a chitosan-enriched fibrin hydrogel in the pulpotomised rat incisor

European Cells and Materials (2020)

Emmanuelle Renard J Amiaud Laurence Bouchet‐Delbos Céline Charrier Alexandra Montembault

Current pulpotomy is limited in its ability to induce regeneration of the dental-pulp (DP) complex.Hydrogels are reported to be well-suited for tissue engineering and are unlikely to induce an inflammatory response that might damage the remaining tissue.The present study investigated the molecular and cellular actors in the early inflammatory/immune response and deciphered M1/M2 macrophage polarisation to a chitosanenriched fibrin hydrogel in pulpotomised rat incisors.Both fibrin and fibrin-chitosan hydrogels induced a strong increase in interleukin-6 (IL-6) transcript in the DP when compared to the DP of untreated teeth.Gene expression of other inflammatory mediators was not significantly modified after 3 h.In the viable DP cell population, the percentage of leukocytes assessed by flow cytometry was similar to fibrin and fibrinchitosan hydrogels after 1 d.In this leukocyte population, the proportion of granulocytes increased beneath both hydrogels whereas the antigen-presenting cell, myeloid dendritic cells, T cells and B cells decreased.The natural killer (NK) cell population was significantly decreased only in DPs from teeth treated with fibrinchitosan hydrogel.Immunolabeling analysis of the DP/hydrogel interface showed accumulation of neutrophil granulocytes in contact with both hydrogels 1 d after treatment.The DP close to this granulocyte area contained M2 but no M1 macrophages.These data collectively demonstrated that fibrin-chitosan hydrogels induced an inflammatory/immune response similar to that of the fibrin hydrogel.The results confirmed the potential clinical use of fibrin-chitosan hydrogel as a new scaffold for vital-pulp therapies.

10.22203/ecm.v040a05

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Citations (18)