Journal of endodontics最新文献

{"title":"N-Acetyl Cysteine as an Adjuvant Medication for Regenerative Endodontics.","authors":"Carolina Fedel Gagliardi, Aline de Castro Santos, Kristy Warner, Marcia Carneiro Valera, Jacques Nor, Bruno Cavalcanti","doi":"10.1016/j.joen.2026.08.018","DOIUrl":"10.1016/j.joen.2026.08.018","url":null,"abstract":"<p><strong>Objective: </strong>To perform an in vitro evaluation of the effects of N-acetyl cysteine (NAC) on the viability and osteogenic expression of dental pulp stem cells, as well as its mechanical removability from root canals.</p><p><strong>Methods: </strong>Dental pulp stem cells were exposed to NAC at concentrations of 0.01, 0.1, and 1 mg/mL under stabilized and non-stabilized pH conditions for 24 or 48 hours. Cell viability was assessed using the sulforhodamine-B assay. Osteocalcin (OCN) expression, with or without induction of oxidative stress (H₂O₂), was quantified by ELISA. NAC removal was evaluated in bovine teeth by scanning electron microscopy after using three irrigation techniques: conventional irrigation, EasyClean, and passive ultrasonic irrigation. Data was analyzed by two-way analysis of variance (P < .05).</p><p><strong>Results: </strong>After 24 hours, NAC did not show cytotoxic effects at any concentration or pH condition. At 48 hours, a significant reduction in viability was observed at 0.1 and 1 mg/mL NAC (P < .05), while 0.01 mg/mL NAC maintained viability similar to the control. OCN was expressed in all groups but statistically reduced in the presence of reactive oxygen species. Scanning electron microscopy analysis showed no statistical differences between the groups or among root thirds (P > .05).</p><p><strong>Conclusion: </strong>NAC showed low cytotoxicity at short exposure times, especially at 0.01 mg/mL, and recovery of OCN expression. Its removal was feasible regardless of the irrigation technique or root third evaluated. The results provide relevant evidence regarding the safety, cellular behavior, and removal of NAC from the canal walls.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Microbiome Analyses for Regenerative Endodontic Therapy.","authors":"Ashraf F Fouad","doi":"10.1016/j.joen.2026.08.016","DOIUrl":"10.1016/j.joen.2026.08.016","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensive microbiome analyses include the study of all microbial taxa, including bacteria, archaea, viruses, and fungi, as well as their functional activities and antibiotic resistance gene expression. Regenerative endodontic therapy presents a clinical situation where the most effective antimicrobial approaches are needed in order to ensure clinical success.</p><p><strong>Methods and results: </strong>In this paper, different contemporary technologies for the identification of endodontic microorganisms, such as with next generation sequencing, and their functional characterization, such as with whole genome sequencing, are described. The role of transcriptomics, as well as resistome analysis, are also discussed. Furthermore, the manner in which all this work and knowledge could be incorporated into clinical endodontics in general, and regenerative endodontic therapy as a special treatment, is outlined.</p><p><strong>Conclusions: </strong>Comprehensive microbiome analysis can lead to the development of more effective and personalized antimicrobial treatment.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and Regeneration in the Dentine-Pulp Complex: Where Are We Now and Where Are We Going?","authors":"Paul R Cooper, Lara T Friedlander, Haizal M Hussaini, Jithendra Ratnayake, Henry F Duncan","doi":"10.1016/j.joen.2026.08.019","DOIUrl":"10.1016/j.joen.2026.08.019","url":null,"abstract":"<p><strong>Introduction: </strong>To develop new regenerative endodontic procedures we require an understanding of the basic biology of the dentin-pulp complex and its behavior in health, disease and healing. Clinicians and scientific research partnerships are essential for this field to advance. Translational-targeted tissue regenerative approaches can then be identified, developed in tandem with the development of novel next-generation diagnostics. Combined, these advancements will improve clinical outcomes.</p><p><strong>Methods: </strong>This narrative review aims to summarize developments over recent decades in the field of dentin-pulp complex biology focusing on our understanding of the intersection between inflammation and regeneration.</p><p><strong>Results: </strong>Our knowledge of inflammation and regeneration in the pulp has rapidly expanded. As carious disease progresses the microflora changes, pulpal cells detect this infection and mount a defensive immune response. The cytokines released orchestrate immune cell infiltration and activation, with cells such as neutrophils utilizing their antimicrobial armamentarium, including the release of neutrophil extracellular traps. This response although defensive, can be double-edged, leading to detrimental effects on the host tissue. Damaged tissue signals, combined with bacterial components, then activate molecular pathways, such as the inflammasome, which further exacerbate immune activity. In individuals with systemic diseases, such as type 2 diabetes, the chronic inflammation can accelerate tissue aging and potentially increase pulpal mineralization events. Epigenetic and immunotherapeutic compounds have been shown to modulate inflammation and enable innate regenerative responses. The use of high-quality preclinical laboratory-based in vitro, ex vivo, and animal models is however essential to underpin the next stages of evidence-based clinical translation. Enhanced knowledge of the molecular response during pulpitis has the potential to facilitate accurate objective diagnosis and guide the most appropriate treatments.</p><p><strong>Conclusion: </strong>Sustained collaboration between scientist and clinicians with a translational-focus will continue to increase our understanding of the association between inflammation and regeneration within the dentin-pulp complex. Further research in this area will lead to clinical benefit in the form of new point-of-care diagnostics and therapeutics.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vital Pulp Treatment: A Minimally Invasive Approach in Daily Practice for Managing Caries-related Pulpal Disease.","authors":"Laura Ceballos, Olga González-Castro, Victoria Fuentes, Nuria Escribano","doi":"10.1016/j.joen.2026.08.024","DOIUrl":"10.1016/j.joen.2026.08.024","url":null,"abstract":"<p><p>Vital pulp treatments, particularly pulpotomy, have demonstrated outcomes similar to root canal therapy while reducing biological, technical, and economic burdens. Their success, however, relies on accurate assessment of pulpal status, an inherently challenging task due to the limitations of current diagnostic methods, as well as rigorous clinical execution. This requires careful removal of carious tissue, appropriate management of pulp exposure, and achievement of proper hemostasis, since the ability to control bleeding determines whether a more invasive treatment is indicated. Over the exposed pulp, a hydraulic calcium silicate cement must be placed, followed by a durable and bacteria-tight coronal restoration to ensure long-term prognosis.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Human Peripheral Neuronal Model for ATP-P2X3 Mediated Inflammatory Pain Signaling in the Dental Pulp.","authors":"Orla M Dunne, Lorcan P McGarvey, Imad About, Ikhlas El-Karim, Fionnuala T Lundy","doi":"10.1016/j.joen.2026.08.021","DOIUrl":"10.1016/j.joen.2026.08.021","url":null,"abstract":"<p><strong>Introduction: </strong>Extracellular adenosine triphosphate (ATP) is a key alarmin in inflammatory responses and amplifies pain signaling through the activation of P2X3 receptors. This study aimed to validate a peripheral neuronal model, differentiated from human pulp stem cells, for the study of neuronal immunomodulation with relevance to ATP-P2X3 signaling.</p><p><strong>Methods: </strong>Human dental pulp stem cells were enriched from dental pulp cells obtained by explant culture from the pulp tissue of extracted third molar teeth. DPSCs were differentiated to peripheral neuronal equivalents (PNEs) in neurogenic media for 14 days. Characterization of the neuronal transcriptome of PNEs was carried out by single-cell sequencing (ScRNA-seq). Transcriptomic and secretome changes in PNEs treated with the synthetic ATP analogue αβ-methylene ATP (αβmeATP) were analyzed using ScRNA-seq and antibody microarray respectively. ATP release was measured using the ATPlite luciferase assay (Perkin Elmer) following mechanical stimulation by stretch or lipopolysaccharide treatment of PNEs. The functional expression of P2X3 receptors was assessed by calcium mobilization assays.</p><p><strong>Results: </strong>PNEs were shown to express a neuronal gene signature, without the expression of genes typical of odontogenic cells. Transcriptomic analysis of PNEs following αβmeATP treatment demonstrated an enriched expression of pain and neuropathy pathways (P < .05). Antibody microarray results indicated that the increased expression of 9 cytokines with αβmeATP treatment was attenuated by a P2X3 antagonist. Mechanical stretch or lipopolysaccharide treatment of PNEs resulted in increased ATP release (P < .05). Responses to ATP were inhibited by a specific P2X3 antagonist indicating functional expression of P2X3 receptors in PNEs (P < .001).</p><p><strong>Conclusions: </strong>ScRNA-seq of the PNE model confirms a neuronal gene signature following differentiation, supporting its use as a relevant human model for studying neuronal immunomodulation and evaluating potential P2X3 receptor-targeted therapies for dental pain.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical Periodontitis: A Hidden Non-Communicable Disease in Global Health - A Narrative Review of Longitudinal Research.","authors":"Sadia Ambreen Niazi, Yuchen Zhang","doi":"10.1016/j.joen.2026.08.028","DOIUrl":"10.1016/j.joen.2026.08.028","url":null,"abstract":"<p><strong>Introduction: </strong>Apical periodontitis (AP) is a highly prevalent oral inflammatory disease increasingly recognized as a hidden noncommunicable disease with potential systemic consequences.</p><p><strong>Methods: </strong>This narrative review integrates findings from longitudinal studies conducted in a well-characterized AP cohort to elucidate the links between AP and systemic health.</p><p><strong>Results: </strong>Evidence highlights AP as a reservoir for low-grade bacteremia and systemic inflammatory burden. Elevated baseline levels of inflammatory markers, including fibroblast growth factor-23, interleukin 1β, high-sensitivity C-reactive protein, and asymmetric dimethylarginine were observed in patients with AP, correlating with lesion size and microbial profiles in both the root canal and blood microbiomes. AP is also associated with altered metabolic syndrome indicators-including hemoglobin A1C, triglycerides, low-density lipoprotein, and changes in serum metabolomic profiles involving glucose, lipid, branched-chain amino acid, and tryptophan metabolism. Importantly, successful endodontic treatment resulted in significant reductions in inflammatory biomarkers, improved metabolic syndrome indicators, and restoration of glucose and lipid metabolism.</p><p><strong>Conclusions: </strong>Collectively, these findings position AP as an important noncommunicable disease with effects extending beyond the oral cavity through its associations with systemic conditions and cardiometabolic risk. These observations highlight the importance of timely diagnosis and successful management of AP to support both oral and systemic health.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Cues from Extracellular Matrix Proteins Drive the Differentiation of Dental Pulp Stem Cells into Endothelial Cells in the Presence of Dentin Matrix Protein 1.","authors":"Amudha Ganapathy, Yinghua Chen, Velavan Bakthavachalam, Anne George","doi":"10.1016/j.joen.2026.08.017","DOIUrl":"10.1016/j.joen.2026.08.017","url":null,"abstract":"<p><strong>Introduction: </strong>Dental pulp stem cells (DPSCs) have the potential to differentiate into endothelial cells (ECs) because they express the key cell surface markers like VEGFR1 and VE-cadherin and can be stimulated by various growth factors. We have previously demonstrated that DPSCs, when stimulated by DMP1 combined with cues from human umbilical vein endothelial cells matrix, promoted their differentiation into ECs. In this study, we explored the response of DPSCs to specific extracellular matrix components such as laminin and Matrigel combined with DMP1 stimulation. The extracellular matrix plays a vital role in tissue development by providing structural support, anchorage for cell adhesion, mechanical cues, and the capacity to sequester soluble factors.</p><p><strong>Methods: </strong>DPSCs were seeded onto plates coated with laminin and Matrigel, treated with recombinant DMP1 (500 ng/mL), and cultured for 7 days. Various biological assays, such as gene expression (quantitative real-reverse transcription PCR) and protein expression assessments (flow cytometry), alongside functional characteristics as assessed by tubule assays, were performed to evaluate the response of DPSCs to DMP1 stimulation in the presence of laminin or Matrigel.</p><p><strong>Results: </strong>An analysis of the data from this study demonstrates that DMP1 significantly enhances the differentiation of DPSCs to the endothelial lineage. This enhancement is evidenced by the upregulation of angiogenic genes, comprising CD31, VE-cadherin, vascular endothelial growth factor A, Angiopoietin 1, and Endoglin, under both laminin-coated and Matrigel-coated conditions in response to DMP1. At the gene expression level, all angiogenic markers, except CD31, exhibited higher expression in Matrigel conditions relative to laminin with DMP1 stimulation. However, CD31, CD144, and CD146 expression were elevated at the protein level in laminin-coated conditions. Several members of the integrin family, such as α5, αV, β1, β3, and β4, were upregulated in the presence of laminin. The binding of the integrin receptors with the laminin matrix plays a pivotal role in vascular differentiation. Thus, DMP1-mediated integrin expression on the cell surface of DPSCs would facilitate cell anchorage and promote their differentiation into ECs. Finally, the functional characterization of the de novo ECs shows a strong propensity to form tubules under laminin-coated conditions compared to DPSCs cultured on Matrigel matrix.</p><p><strong>Conclusions: </strong>Overall, findings reveal that DMP1 directs the DPSCs to endothelial-like cells in the presence of laminin and Matrigel.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibroblasts Modulate Pulp Inflammation and Initiate Healing: The Added Value of Fibroblast-Macrophage Interactions.","authors":"Thomas Giraud, Bilel Amiri, Chloé Le Fournis, Orla M Dunne, Fionnuala T Lundy, Ikhlas El Karim, Charlotte Jeanneau, Imad About","doi":"10.1016/j.joen.2026.08.023","DOIUrl":"10.1016/j.joen.2026.08.023","url":null,"abstract":"<p><p>Pulp tissue resides within rigid dentinal walls and depends on terminal circulation, making its healing capacity highly contingent on the degree of inflammation and suggesting the presence of intrinsic protective mechanisms to prevent necrosis. Multiple cell types including odontoblasts, fibroblasts, endothelial cells, and inflammatory cells, contribute to these mechanisms through the synthesis of bioactive molecules. Odontoblasts and pulp fibroblasts detect pathogen-associated molecular patterns via Toll-like receptors and release pro-inflammatory cytokines such as interleukin-6, interleukin-8, and tumor necrosis factor-alpha. These mediators, also produced during sterile inflammation, recruit phagocytic cells that clear pathogens and tissue debris. Pulp fibroblasts further contribute to innate defense by constitutively generating Complement components, including C3b, which opsonizes cariogenic bacteria, and the membrane attack complex, which lyses microbes. Physical injury or exposure to bacterial components enhances fibroblast production of these molecules, demonstrating potent local modulation during carious or traumatic insult. Beyond antimicrobial roles, fibroblasts influence repair by regulating stem cell recruitment and differentiation via Complement activation. They also participate in macrophage recruitment and polarization into M1 and M2 subsets. While M1 macrophages primarily mediate pathogen clearance, both phenotypes contribute to the early stages of pulp healing. This review examines key mechanisms governing local control of pulpal inflammation and repair, emphasizing emerging evidence that fibroblast-macrophage interactions and macrophage polarization are central regulators of both inflammatory resolution and initiation of tissue regeneration.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to Microengineer Vascularized, Mineralized, and Immunomodulatory Niches for Dental Regeneration.","authors":"Cristiane M Franca, Faisal Shakir, Luiz E Bertassoni","doi":"10.1016/j.joen.2026.08.020","DOIUrl":"10.1016/j.joen.2026.08.020","url":null,"abstract":"<p><strong>Introduction: </strong>Regenerative endodontic therapies aim to restore the vitality and function of the dentin-pulp complex, including the vascularized and innervated pulp and mineralized dentin. Although cell homing, stem cell transplantation, and scaffold-based approaches have shown promise in immature teeth, outcomes in previously infected, fully formed adult teeth remain inconsistent. These limitations highlight the need to better understand the interactions among vascular, immune, and microbiological factors within the pulp microenvironment.</p><p><strong>Methods: </strong>This narrative review examines the dentin-pulp complex from a microengineering perspective, synthesizing preclinical and clinical studies of strategies to engineer vascular, immune, and mineralized niches using bioactive and immune-informed materials.</p><p><strong>Results: </strong>Current evidence indicates that regeneration depends on the coordinated restoration of interconnected vascular, immune, and mineralized niches. Prevascularized constructs may accelerate integration with the host vasculature and support pulp-like tissue formation, whereas scaffold composition, architecture, and mechanical properties regulate vascular stability and immune-cell behavior. However, residual bacterial products, particularly lipopolysaccharide, may sustain inflammation and compromise the regenerative signals provided by these materials. Dentin-derived matrix molecules and premineralized scaffolds can support mineralized tissue formation and provide an early protective barrier, but reinnervation, intracanal calcification, repair rather than true regeneration, and the limited availability of clinically scalable cell and matrix sources remain important challenges.</p><p><strong>Conclusions: </strong>Predictable and functional regeneration of the dentin-pulp complex may require the integration of effective disinfection and lipopolysaccharide neutralization with immune modulation, prevascularized and premineralized scaffolds, and scalable sources of stem cells and dentin matrix. Strategies to restore functional innervation remain an important future direction.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunomodulatory Omega-3 Injectable Hydrogel for Vital Pulp Therapy.","authors":"Kamyar Khosravi, Maedeh Rahimnejad, Renan Dal-Fabbro, Caroline Anselmi, Arpita Roy, Pedro Henrique Chaves de Oliveira, Beatriz Ometto Sahadi, Marco C Bottino","doi":"10.1016/j.joen.2026.08.025","DOIUrl":"10.1016/j.joen.2026.08.025","url":null,"abstract":"<p><strong>Introduction: </strong>Biomaterials that both seal the pulp during direct pulp capping (DPC) and actively control inflammation are unusual. Here, we engineered injectable gelatin methacryloyl (GelMA) hydrogels carrying omega-3 polyunsaturated fatty acids. Our null hypothesis states that GelMA and GelMA-omega-3 hydrogels do not differ in their physicochemical, mechanical, cytocompatibility, immunomodulatory, or in vivo effects.</p><p><strong>Methods: </strong>Distinct omega-3 concentrations were added to GelMA, and the resulting hydrogel was photocrosslinked. Scanning electron microscopy and Fourier-transform infrared spectroscopy were used to examine the hydrogels' microstructure and composition. Swelling, degradation, compression, and rheological tests were also performed. Dental pulp stem cell viability and mineralization capacity were assessed with or without lipopolysaccharide (LPS). LPS-challenged RAW 264. Seven macrophages were exposed to hydrogel-conditioned media to measure TNF-α and IL-6 levels. In vivo implantation of the hydrogels was conducted to determine biocompatibility, macrophage polarization (iNOS/CD163), and TGF-β expression. Statistics used one-way ANOVA with Tukey's post-hoc test or two-way ANOVA with the Holm-Šídák test (P < .05).</p><p><strong>Results: </strong>Scanning electron microscopy revealed a more fibrous, heterogeneous network in the omega-3 hydrogels. Incorporating omega-3 reduced swelling and slowed mass loss compared to GelMA. Although a high omega-3 load decreased Young's modulus, the ultimate strength remained similar. Fourier-transform infrared spectroscopy confirmed omega-3 incorporation. Cross-linked hydrogels were solid-like, shear-thinning, thermally stable, and recovered post-shear. All formulations were cytocompatible. Without LPS, mineralization levels were similar across groups. With LPS, high omega-3 concentration decreased mineralization, while low concentration matched the control. All hydrogels suppressed LPS-induced TNF-α and IL-6; omega-3 further reduced IL-6 compared to GelMA. In vivo, omega-3 hydrogels increased early cell influx that resolved by day 28, enhanced M2 macrophage marker expression at 7 and 28 days, lowered the M1/M2 ratio over time, and elevated TGF-β expression early on with sustained levels.</p><p><strong>Conclusions: </strong>Omega-3 hydrogels are biocompatible and actively modulate inflammation, supporting their potential as an immunomodulatory strategy for DPC.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}