Regulated Cell Death in Pulpitis

Regulated cell death (RCD) is a preferred term inclusive of all modes of cell death regulated by multiple intracellular signal transduction pathways under physiological and pathologic conditions. Although cell death programs ensure correct growth and developmental processes as well as protect the host against microbial pathogens, some necrotic cell death pathways, such as pyroptosis, NETosis, and necroptosis, release intracellular damage-associated molecular patterns and inflammatory cytokines, thereby skewing the milieu toward a proinflammatory state. Pulpitis is 1 of the most prevalent oral inflammatory diseases. In response to different types of pulpal injury, RCD may occur either in a “single” or an “overlapped mixed” form, including apoptosis, pyroptosis, and NETosis, which can indicate the severity of pulpal inflammation. RCD has received increasing attention because of the cross talk among cell death pathways. Hence, understanding the molecular switch nodes mediating cross talk between diverse RCD pathways may provide new insights into mechanisms underlying cell-fate decision in pulpitis. In this review, we outlined the potential roles of RCD in the progression of pulpitis and some switch nodes connecting different RCD pathways. Ultimately, an in-depth understanding of molecular mechanisms underlying RCD could be translated into effective approaches to preserve pulpal vitality and integrity under pathologic conditions.