Odontogenic potential of dental pulp stem cells in response to bioactive root canal sealers combined with ultrasound stimulation

Bioactive root canal sealers have emerged as a promising innovation in regenerative endodontics, offering enhanced biocompatibility with dental pulp stem cells (DPSCs) and promoting their proliferation, migration, and differentiation. Despite these advances, optimizing conditions to maximize the biological potential of DPSCs remains a significant challenge. Ultrasound (US) stimulation has been identified as a non-invasive method to enhance cellular responses and improve biological outcomes in tissue engineering applications. US has been utilized recently in oral and dental tissue regeneration. This study investigates the combined effect of bioactive bioceramic root canal sealers and US stimulation on the behavior and odontogenic potential of DPSCs. To evaluate this dual approach, quantitative and qualitative assessments were performed using multiple techniques, including Alizarin red assay to measure mineral deposition, Alkaline phosphatase enzyme activity assay to determine early odontogenic differentiation, and gene expression analysis for odontogenic markers RUNX2, DMP-1, and DSPP. The results revealed that DPSCs exposed to the combined action of bioactive sealers and US stimulation exhibited significant enhancement in mineral deposition compared to cells treated with either approach alone. Furthermore, the dual treatment significantly upregulated the expression of odontogenic markers, indicating a synergistic effect in promoting DPSC differentiation toward an odontogenic lineage. These findings suggest that the integration of ultrasound (US) stimulation with bioactive root canal sealers can significantly enhance the biological properties of dental pulp stem cells (DPSCs). This synergistic approach not only promotes improved cell proliferation, migration, and differentiation but also drives odontogenic potential by enhancing mineral deposition and upregulating key markers associated with dental tissue regeneration.. Future research should focus on translating these in vitro findings into clinical applications to explore their potential in improving outcomes in endodontic therapy.