Complement activation links inflammation to dental tissue regeneration

• Bergmann Madison
• Jeanneau Charlotte
• Giraud Thomas
• Richard Gilles
• About Imad

• Complement links inflammation to regeneration Pulp biology
• Stem cell recruitment
• Dental tissue regeneration
• Complement
• Pulp inflammation
• Nerve sprouting

Objectives: Complement is an efficient plasma immune surveillance system. It initiates inflammation by inducing vascular modifications and attracting immune cells expressing Complement receptors. Investigating Complement receptors in non-immune cells pointed out Complement implication in the regeneration of tissue such as liver, skin or bone. This review will shed the light on its Complement implication in the initial steps of dental tissue regeneration. Materials and methods: Review of literature was conducted on Complement local expression and implication in oral tissue regeneration in vivo and in vitro. Results: Recent data reported expression of Complement receptors and soluble proteins in dental tissues. Cultured pulp fibroblasts secrete all Complement components. Complement C3b and MAC have been shown to control bacteria growth in the dental pulp while C3a and C5a are involved in the initial steps of pulp regeneration. Indeed, C3a induces pulp stem cell/fibroblast proliferation, and fibroblast recruitment, while C5a induces neurite growth, guides stem cell recruitment and odontoblastic differentiation. Similarly, cultured periodontal ligament cells produce C5a which induces bone marrow mesenchymal stem cell recruitment. Conclusions: Overall, this review highlights that local Complement synthesis in dental tissues plays a major role, not only in eliminating bacteria, but also in the initial steps of dental tissue regeneration, thus, providing a link between dental tissue inflammation and regeneration. Clinical relevance: Complement provides an explanation for understanding why inflammation preceeds regeneration. This may also provide a biological rational for understanding the reported success conservative management of mature permanent teeth with carious pulp exposure.