Diyabet Hastalarında Mineral Trioksit Agregat/1α,25-Dihidroksivitamin D3 Kombinasyonu İle Dental Pulpa Kök Hücrelerinde Odontojenik Farklılaşmanın Araştırılması

Abstract

Dental treatments in diabetic patients have been reported to fail in the long term and these patients have more tooth extraction. It is aimed to investigate the odonto/osteogenic differentiation potential of the combination of Vitamin D3, which is known to play an important role in the mineralization mechanism and is frequently deficient in diabetic patients, with the mineral trioxide aggregate (MTA) used in routine dental treatments, on dental pulp stem cells of diabetic patients. The specificity of mesenchymal stem cells isolated from dental pulps of three non-smoking patients with Type 1 diabetes who did not use drugs other than insulin and three non-smoking controls was evaluated by real-time polymerase chain reaction using CD34, CD45, Nanog Oct-4, CD73, CD90 and CD106 markers. Cells were exposed to four different media: normal medium (NM): DMEM, 10% FBS, antibiotic and antimycotic, differentiation medium (DM): NM plus ß-glycerophosphate and ascorbic acid, DM + MTA: DM plus 0.02mg/mL MTA and DM+ MTA + VitD3: FB plus MTA plus 10nM VitD3. At the end of the 14th day, the odonto/osteogenic differentiation amounts of the cells were evaluated by the alizarin red test, real-time polymerase chain reaction (DSPP, DMP1, COL1α1, OCN) and immunofluorescence (anti-BSP II, anti-DMP1, anti-COL1α1) methods. The mesenchymal stem cell characteristics of the cells were demonstrated by the presence of higher expressions of CD73, CD90 and CD106. Alizarin red staining, expression of odonto/osteogenic markers and immunofluorescence experiments showed that there was more differentiation in controls (p <0.05). In controls, while only MTA provides sufficient effect to induce differentiation, in diabetic patients VitD3 should be added to the medium in order to ensure this effect (p <0.05). Within the limitations of this study, it is recommended to study the combination of MTA with VitD3 in dental treatment of diabetic patients with further experiments and to establish dental treatment procedures considering systemic diseases.