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Predentine is not a reliable barrier against internal root resorption in the presence of inflammation

Authors: Domenico Ricucci,Irina Milovidova,Reese K. Williams,Franklin Tay
Publisher: Elsevier BV
Publish date: 2025-4
ISSN: 0300-5712 DOI: 10.1016/j.jdent.2025.105626
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In Figure 3, the study presents histological evidence of odontoclast activity in close contact with predentine, challenging its traditionally assumed role as a protective barrier. A few points require clarification:

– The figure shows multinucleated odontoclasts within Howship’s lacunae in regions where predentine is still present. Were there cases where odontoclasts were attached but not actively resorbing, or was resorptive activity always observed upon contact?
– The surrounding tissue appears inflamed, suggesting a role of inflammatory mediators in odontoclast activation. Were there any differences in odontoclast behavior in highly inflamed versus mildly inflamed regions within the same sample?
– In Figure 3D-E, predentine appears fragmented in resorbed areas. Was this structural weakening observed in all cases, or were there instances where predentine remained intact despite odontoclast presence? Could enzymatic degradation by MMPs or acidic dissolution contribute to this breakdown before resorption occurs?

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