Combination of Dental Capping Agents With LowLevel Laser Therapy Increases the Cell Viability Percent of Stem Cells From Apical Papilla (SCAPs)

Introduction: Dental pulp capping is a technique that is highly applicable in dental restorations. In this technique, a material is directly placed over the exposed pulp tissue, which promotes pulp healing and generates reparative dentin. Herein, we aimed to investigate the combined effect of different pulp capping agents, including mineral trioxide aggregate (MTA), Emdogain (EMD), calcium-enriched mixture (CEM), and low-level laser therapy (LLLT), on enhancing viability and proliferation of stem cells from apical papilla (SCAPs). Methods: SCAPs were isolated from two immature third molar teeth through collagenase type I enzymatic activity. Isolated stem cells were then cultured with DMEM and α-MEM media enriched with 15% and 10% FBS respectively. After reaching 70%-80% confluency, the cells were seeded in a 96-well plate. Cell viability percent was assessed using the MTT assay after treatment with MTA, EMD, CEM and LLLT (λ=630 nm, 5 mW, 4 J/cm2 ) alone and in combination for 24, 48 and 168 hours. Results: Combination of MTA, CEM, EMD and LLLT resulted in significantly increased SCAPs viability as compared with other treatment groups. Increased SCAPs proliferation and viability were also observed in groups treated with the combination of MTA and CEM with EMD. However, the SCAPs survival rate in all defined time spans was reduced after treatment with MTA and CEM alone. Conclusion: LLLT can be a stimulator of SCAPs cell viability when applied in combination with dental capping agents such as MTA, EMD and CEM, providing a therapeutic option for stem cell-based dental regeneration. Keywords: CEM; Emdogain; Low-level laser therapy (LLLT); MTA; SCAPs.