This study investigated the effects of conditioned medium from stem cells of the apical papilla (CM-SCAP) modulated by the pro-resolution mediator docosahexaenoic acid (DHA), with or without a hydroxyapatite/tricalcium phosphate (HATCP) scaffold, on dental pulp-related outcomes. Human SCAP were isolated from extracted third molars, cultured, and exposed to DHA (1 μM) and/or HATCP. We assessed the effects of CM-SCAP, with or without treatments, on the viability, morphology, and mineralization rates of rat incisor dental pulp cells in vitro . Additionally, we evaluated the effects of CM-SCAP alone or pre-exposed to DHA and/or HATCP in a rat model of apical periodontitis. Outcomes included radiographic lesion size, histological inflammatory scores, and bacterial counts. CM from untreated SCAP reduced pulp cell viability only at high seeding density (10,000 cells/well), with no effect at lower densities. CM from DHA-treated SCAP increased pulp cell area and induced a spindle-to-cuboidal morphological change. After 21 days in osteogenic conditions, CM-SCAP combined with DHA and/or HATCP did not alter alkaline phosphatase activity but slightly increased mineral deposition, independent of HATCP. All treatments significantly reduced radiographic periapical lesions, while DHA-pretreated CM-SCAP decreased histological scores without affecting bacterial load. These findings suggest that DHA-modulated CM-SCAP, particularly in combination with HATCP, holds promise for dental pulp regeneration.
Pacheco et al. (Thu,) studied this question.