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Fig. 1 | BMC Oral Health

Fig. 1

From: Specialized pro-resolving lipid mediators in endodontics: a narrative review

Fig. 1

Pulp and periapical inflammatory disease and their ideal outcomes. a Pulp and periapical inflammatory process. The pulp inflammatory process is linked to the infiltration of bacteria and toxins. Odontoblasts initiate the immune response. Without therapeutic intervention (upper and lower left panel), inflammation and bacteria cause chronic inflammation, which leads to total pulp necrosis and apical periodontitis. The objective of vital pulp therapies and root canal treatment is to obtain inflammation resolution (central panel). The resolution of inflammation occurs after the first vascular and cellular phases. The resolution of inflammation is coordinated by a large number of mediators termed SPMs. These mediators promote the switch from a proinflammatory (M1) to an anti-inflammatory macrophage phenotype (M2), and nonapoptotic cells ultimately return to the vasculature or lymph. b Healing and regeneration phase. Dental pulp has the capacity to produce tertiary dentin when inflammation is resolved. According to the intensity of the stimulus, reactionary or reparative dentinogenesis can be mediated by odontoblasts or odontoblast-like cells, respectively (upper panel). At the apical bone level, the resolution of inflammation allows bone healing and bone regeneration (lower panel)

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