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Alzoubi F, Alajmi S, Alkandari A, Alqahtani S, Alanezi A, Setzer FC. Post-operative pain in non-surgical root canal treatment after sealer-based obturation versus warm vertical compaction: A randomized clinical trial. Int Endod J 2024; 57:1168-1179. [PMID: 38813933 DOI: 10.1111/iej.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/04/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
AIM Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS). METHODOLOGY This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. CLINICALTRIALS gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively. RESULTS The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05). CONCLUSIONS Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.
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Affiliation(s)
- Fahad Alzoubi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | - Samhan Alajmi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | | | - Saad Alqahtani
- Kuwait Institute for Medical Specializations, Sulaibkhat, Kuwait
| | - Amer Alanezi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | - Frank C Setzer
- Department of Endodontics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Aka A, Matsuura T, Yoshimura A. An Evaluation of the Cytocompatibility of Endodontic Bioceramics in Human Periodontal-Ligament-Derived Cells. J Funct Biomater 2024; 15:231. [PMID: 39194670 DOI: 10.3390/jfb15080231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/17/2024] [Accepted: 08/17/2024] [Indexed: 08/29/2024] Open
Abstract
The present study evaluated the cytocompatibility of three endodontic bioceramics in human periodontal-ligament-derived cells (hPDLCs): MTA Repair HP (HP), MTA Flow White (F), and Nishika Canal Sealer BG multi (BG). In addition, we also evaluated the effect of the powder-liquid (paste) ratio of F and BG on cytocompatibility. Discs of endodontic bioceramics (diameter = 8 mm, thickness = 1 mm) were prepared with HP, F, and BG. hPDLCs obtained from extracted teeth and cultured for three to five passages were used in the experiment. The prepared discs were placed at the bottom of a 48-well plate, seeded with hPDLCs at 100,000 cells/well, cultured for 7 or 28 days, and subjected to a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. hPDLCs cultured without any discs were used as a negative control (NC) group. Discs made of F or BG mixed in three different consistencies were also used in this experiment. The absorbance values at days 7 and 28 were high in the order of HP > NC > BG > F. Furthermore, F or BG with higher consistency showed higher absorbance values. MTA Repair HP had the highest cytocompatibility among the three materials. Furthermore, it also showed that higher consistency improved cytocompatibility.
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Affiliation(s)
- Asuka Aka
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City 852-8588, Nagasaki, Japan
| | - Takashi Matsuura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City 852-8588, Nagasaki, Japan
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City 852-8588, Nagasaki, Japan
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Amnuaykan P, Juntrapirom S, Kanjanakawinkul W, Chaiyana W. Enhanced Antioxidant, Anti-Aging, Anti-Tyrosinase, and Anti-Inflammatory Properties of Vanda coerulea Griff. Ex Lindl. Protocorm through Elicitations with Chitosan. PLANTS (BASEL, SWITZERLAND) 2024; 13:1770. [PMID: 38999610 PMCID: PMC11243638 DOI: 10.3390/plants13131770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024]
Abstract
This study aimed to investigate the effects of elicitors on Vanda coerulea Griff. Ex Lindl. protocorms to enhance bioactive compound production and evaluate their biological activities relevant to cosmeceutical applications. The protocorms were developed from the callus treated with different elicitors, including 6-benzylaminopurine (BA), methyl jasmonate (MeJA), and chitosan. Both the adult plant and protocorms were extracted by maceration in 80% methanol and investigated for their chemical compositions using high-performance liquid chromatography. The extracts were evaluated for antioxidant, anti-collagenase, anti-elastase, and anti-tyrosinase activities. In addition, anti-inflammatory properties were assessed using a real-time polymerase chain reaction. The irritation potency was evaluated using the hen's egg test-chorioallantoic membrane test. The findings revealed that protocorms treated with BA and chitosan developed a greener color, while those treated with MeJA exhibited a distinct darker coloration. Elicitation with BA and chitosan resulted in protocorms with comparable or higher levels of syringic acid, rutin, and quercin compared with the adult plant, with rutin being the most prominent identified compound. Furthermore, rutin was reported as the compound responsible for all biological activities. The chitosan-treated protocorm extract exhibited potent inhibition against oxidation, collagenase, elastase, tyrosinase, and inflammatory cytokines, along with a nonirritating effect, making it a promising candidate for cosmeceutical applications.
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Affiliation(s)
- Piyatida Amnuaykan
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Saranya Juntrapirom
- Chulabhorn Royal Pharmaceutical Manufacturing Facilities by Chulabhorn Royal Academy, Chon Buri 20180, Thailand; (S.J.); (W.K.)
| | - Watchara Kanjanakawinkul
- Chulabhorn Royal Pharmaceutical Manufacturing Facilities by Chulabhorn Royal Academy, Chon Buri 20180, Thailand; (S.J.); (W.K.)
| | - Wantida Chaiyana
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand;
- Center of Excellence in Pharmaceutical Nanotechnology, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Multidisciplinary and Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
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Kazak M, Sarialioglu Gungor A, Ozman Z, Donmez N. Comparative cell viability of dentin-bonding adhesive systems on human dental pulp stem cells: time-dependent analysis. BMC Oral Health 2024; 24:663. [PMID: 38849812 PMCID: PMC11157729 DOI: 10.1186/s12903-024-04438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Restorative materials are in prolonged contact with living tissues such as oral mucosa, dentin, pulp, periodontal, and periapical tissues. Therefore, the potentially harmful effects of these materials and their components on oral tissues should be evaluated before clinical use. This study aimed to compare the cell viability of different adhesive systems (ASs) on human dental pulp stem cells (hDPSCs). METHODS Three ASs that combining methacryloyloxydecyl dihydrogen phosphate (MDP) monomer with new hydrophilic amide monomers [Clearfil Universal Bond Quick(CUBQ), Kuraray Noritake], self-reinforcing 3D monomer [Bond Force II(BFII), Tokuyama)], and dual-cure property [Futurabond DC(FBDC), VOCO] were used. Three (n = 3) samples were prepared for each group. Dental pulp stem cells were isolated from ten patients' extracted third molar teeth. Samples were incubated in Dulbecco's modified Eagle's medium (DMEM) for 24 h (h), 72 h, and 7 days (d) to obtain extracts. For the control group, cells were cultured without DBA samples. Cell viability of ASs extracts was measured using a cell proliferation detection kit (WST-1, Roche). Statistical analysis was performed using two-way ANOVA and post-hoc (Duncan) tests (p < 0.05). RESULTS At 24 and 72 h statistically significant differences were determined between control and BFII, control and FBDC groups (p < 0.05), while no differences between control and CUBQ groups (p > 0.05). On the 7th d, statistically significant differences were found between the control and experimental groups (p < 0.05), while no differences between experimental groups (p > 0.05). A statistically significant difference was detected for the BFII group over the three-time interval (p < 0.05). The lowest cell viability was observed for the FBDC group at 24 h, and the difference was statistically significant when compared with 72 h and 7th d (p < 0.05). CONCLUSION All ASs showed different cell viability values at various exposure times. It should be taken into consideration that pH values, as well as the contents of ASs, have a significant effect on the cell viability.
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Affiliation(s)
- Magrur Kazak
- Department of Restorative Dentistry, Bahcesehir University School of Dental Medicine, Istanbul, Türkiye.
- School of Medicine and Health Science, Department of Therapeutic Dentistry, BAU International University, Batumi, Georgia.
| | - Ayca Sarialioglu Gungor
- Faculty of Dentistry, Department of Restorative Dentistry, Istanbul Galata University, Istanbul, Türkiye
| | - Zeynep Ozman
- Faculty of Medicine, Department of Biochemistry, Bezmialem Vakif University, Istanbul, Türkiye
| | - Nazmiye Donmez
- Faculty of Dentistry, Department of Restorative Dentistry, Bolu Abant İzzet Baysal University, Bolu, Türkiye
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Xiao S, Sun G, Huang S, Lin C, Li Y. Nanoarchitectonics-Based Materials as a Promising Strategy in the Treatment of Endodontic Infections. Pharmaceutics 2024; 16:759. [PMID: 38931881 PMCID: PMC11207628 DOI: 10.3390/pharmaceutics16060759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/19/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Endodontic infections arise from the interactive activities of microbial communities colonizing in the intricate root canal system. The present study aims to update the latest knowledge of nanomaterials, their antimicrobial mechanisms, and their applications in endodontics. A detailed literature review of the current knowledge of nanomaterials used in endodontic applications was performed using the PubMed database. Antimicrobial nanomaterials with a small size, large specific surface area, and high chemical activity are introduced to act as irrigants, photosensitizer delivery systems, and medicaments, or to modify sealers. The application of nanomaterials in the endodontic field could enhance antimicrobial efficiency, increase dentin tubule penetration, and improve treatment outcomes. This study supports the potential of nanomaterials as a promising strategy in treating endodontic infections.
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Affiliation(s)
- Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen 361018, China;
| | - Shan Huang
- Department of Stomatology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361005, China;
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
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López-García S, Sanz JL, Murcia L, García-Bernal D, Lozano A, Forner L, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Assessment of the anti-inflammatory and biological properties of Bioroot Flow: A novel bioceramic sealer. Tissue Cell 2024; 88:102391. [PMID: 38657320 DOI: 10.1016/j.tice.2024.102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION BioRoot Flow (BRF) is a novel premixed bioceramic sealer indicated for endodontic treatments, but the biological and immunomodulatory effects of this endodontic sealer on human periodontal ligament stem cells (hPDLSCs) have not been elucidated. METHODS To ascertain the biological impact of BRF, TotalFill BC Sealer (TFbc), and AH Plus (AHP) on human Periodontal Ligament Stem Cells (hPDLSCs), assessments were conducted to evaluate the cytocompatibility, cellular proliferation, migratory capacity, osteo/cementogenic differentiation potential, the ability to form mineralized nodules, and the immunomodulatory characteristics of hPDLSCs following treatment with these endodontic sealers. RESULTS Biological assays showed adequate cell metabolic activity and cell migration in BRF, while SEM assay evidenced that TFbc and BRF groups demonstrated a superior cell adhesion process, including substrate adhesion, cytoskeleton development, and spreading on the niche-like structures of the cement as compared to the AHP group. TFbc and BRF-treated groups exhibited a significantly lower IL6 and IL8 production than AHP (* p <.05). The bioceramic sealers stimulated heightened expression of BSP, CEMP-1, and CAP genes within a 7-14 day period. Notably, BRF and TFbc demonstrated a significant enhancement in the mineralization of hPDLSCs when compared to the negative control. Among these, cells treated with BRF showed a more substantial accumulation of calcium (*** p < .001). CONCLUSIONS Taken together, these findings indicate that BRF can potentially enhance cell differentiation by promoting the expression of essential genes related to bone and cement formation. In addition, BRF and TFbc displayed anti-inflammatory effects.
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Affiliation(s)
- Sergio López-García
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia 46010, Spain
| | - José L Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia 46010, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, Murcia 30107, Spain
| | - David García-Bernal
- Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia 30120, Spain
| | - Adrián Lozano
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia 46010, Spain
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia 46010, Spain
| | - Francisco J Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia 30008, Spain.
| | - Ricardo E Oñate-Sánchez
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia 30008, Spain
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Scelza MFZ, Tavares SJO, Scelza P, Ramos GS, Lima Aboud LRD, Piasecki L, Leite PEC, Silva JDD, Soares-Lima SC, Alves GG. A three-dimensional cell culture approach to investigate cytotoxic effects and production of inflammatory mediators by epoxy resin-based and calcium silicate-based endodontic sealer. Clin Oral Investig 2024; 28:344. [PMID: 38809444 DOI: 10.1007/s00784-024-05743-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/24/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES The aim of the present study was to assess the cytocompatibility of epoxy resin-based AH Plus Jet (Dentsply De Trey, Konstanz, Germany), Sealer Plus (MK Life, Porto Alegre, Brazil), calcium silicate-based Bio-C Sealer (Angelus, Londrina, PR, Brazil), Sealer Plus BC (MK Life) and AH Plus BC (Dentsply) through a tridimensional (3D) culture model of human osteoblast-like cells. METHODS Spheroids of MG-63 cells were produced and exposed to fresh root canal sealers extracts by 24 h, and the cytotoxicity was assessed by the Lactate Dehydrogenase assay (LDH). The distribution of dead cells within the microtissue was assessed by fluorescence microscopy, and morphological effects were investigated by histological analysis. The secreted inflammatory mediators were detected in cell supernatants through flow luminometry (XMap Luminex). RESULTS Cells incubated with AH Plus Jet, AH Plus BC, Sealer Plus BC and Bio-C Sealer extracts showed high rates of cell viability, while the Sealer Plus induced a significant reduction of cell viability, causing reduction on the spheroid structure. Sealer Plus and Seaker Plus BC caused alterations on 3D microtissue morphology. The AH Plus BC extract was associated with the downregulation of secretion of pro-inflammatory cytokines IL-5, IL-7, IP-10 and RANTES. CONCLUSIONS The new AH Plus BC calcium silicate-based endodontic sealer did not reduce cell viability in vitro, while led to the downregulation of pro-inflammatory cytokines. CLINICAL SIGNIFICANCE Choosing the appropriate endodontic sealer is a crucial step. AH Plus BC demonstrated high cell viability and downregulation of pro-inflammatory cytokines, appearing reliable for clinical use, while Sealer Plus presented lower cytocompatibility.
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Affiliation(s)
- Miriam F Z Scelza
- Post-graduation Program in Dentistry of Fluminense Federal University (UFF), Niterói,, RJ, Brazil.
- Department of Endodontics, Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Sandro J O Tavares
- Post-graduation Program in Dentistry of Fluminense Federal University (UFF), Niterói,, RJ, Brazil
- Department of Endodontics, Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Gabriel S Ramos
- Undergraduate of Faculty of Biology Science, Fluminense Federal University, 24210-201, RJ, Niterói, Brazil
| | | | - Lucila Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, NY, USA
| | - Paulo Emílio C Leite
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, RJ, Niterói, Brazil
| | - Jéssica Dornelas da Silva
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, RJ, Niterói, Brazil
- NanoOnco3D, RJ, Niterói, Brazil
| | - Sheila Coelho Soares-Lima
- Molecular Carcinogenesis Program of National Cancer Institute (INCA), 20231-050, Rio de Janeiro, André Cavalcante Street, no 37, Brazil
| | - Gutemberg G Alves
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, RJ, Niterói, Brazil
- Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Rio de Janeiro, Niterói, Brazil
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Malta CP, Santi SS, Barcelos RCS, Zanatta FB, Bier CAS, Morgental RD. Premixed calcium silicate-based root canal sealers have better biological properties than AH Plus: A systematic review and meta-analysis of in vivo animal studies and in vitro laboratory studies. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:345-359. [PMID: 38779200 PMCID: PMC11108423 DOI: 10.4103/jcde.jcde_24_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
Objectives The aim was to determine whether premixed calcium silicate-based root canal sealers have better biological properties than AH Plus. Materials and Methods Searches of studies published up to January 2023 were performed in the PubMed/MEDLINE and EMBASE and via other methods (databases of the International Endodontic Journal, Journal of Endodontics, and gray literature). The inclusion criteria were in vivo animal and in vitro studies that analyzed the response in the dorsal subcutaneous tissue of rats, cell viability, and genotoxicity. Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias (RoB) tool for in vivo studies and modified CONSORT checklist for in vitro were appraised. Meta-analysis was performed using the Stata. Results Fifty-two studies were included. In the RoB, in vivo studies fulfilled 20%-50% of the items and in vitro 60%-100%. The studies included in the meta-analysis demonstrated better histocompatibility with the premixed calcium silicate-based sealers at 30 days and greater cell viability with these sealers when used in undiluted extracts in experimental period of 72 h and in extracts with 1:2 and 1:4 dilution in 24 and 72 h. In contrast, no difference between materials was found concerning genotoxicity. Conclusion Premixed calcium silicate-based root canal sealers have better histocompatibility and are less cytotoxic than the epoxy resin-based sealer AH Plus, demonstrating favorable biological behavior.
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Affiliation(s)
- Cristiana Pereira Malta
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Samantha Simoni Santi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Fabrício Batistin Zanatta
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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Sanz JL, López-García S, García-Bernal D, Rodríguez-Lozano FJ, Forner L, Lozano A, Murcia L. Comparative bioactivity and immunomodulatory potential of the new Bioroot Flow and AH Plus Bioceramic sealer: An in vitro study on hPDLSCs. Clin Oral Investig 2024; 28:195. [PMID: 38441709 PMCID: PMC10914906 DOI: 10.1007/s00784-024-05593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To evaluate the cytocompatibility, bioactivity, and anti-inflammatory potential of the new pre-mixed calcium silicate cement-based sealers Bioroot Flow (BrF) and AH Plus Bioceramic Sealer (AHPbcs) on human periodontal ligament stem cells (hPDLSCs) compared to the epoxy resin-based sealer AH Plus (AHP). MATERIALS AND METHODS Standardized discs and 1:1, 1:2, and 1:4 eluates of BrF, AHPbcs and AHP after setting were prepared. The following assays were performed: cell attachment and morphology via SEM, cell viability via a MTT assay, cell migration/proliferation via a wound-healing assay, cytoskeleton organization via immunofluorescence staining; cytokine release via ELISA; osteo/cemento/odontogenic marker expression via RT-qPCR, and cell mineralized nodule formation via Alizarin Red S staining. HPDLSCs were isolated from extracted third molars from healthy patients. Comparisons were made with hPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media. Statistical significance was established at p < 0.05. RESULTS Both BrF and AHPbcs showed significantly positive results in the cytocompatibility assays (cell metabolic activity, migration, attachment, morphology, and cytoskeleton organization) compared with a negative control group, while AHP showed significant negative results. BrF exhibited an upregulation of at least one osteo/cementogenic marker compared to the negative and positive control groups. BrF showed a significantly higher calcified nodule formation than AHPbcs, the negative and positive control groups, while AHPbcs was higher than the negative control group. Both were also significantly higher than AHP group. CONCLUSION BrF and AHPbcs exhibit adequate and comparable cytocompatibility on hPDLSCs. BrF also promoted the osteo/cementogenic differentiation of hPDLSCs. Both calcium silicate-based sealers favored the downregulation of the inflammatory cytokine IL-6 and the calcified nodule formation from hPDLSCs. BrF exerted a significantly higher influence on cell mineralization than AHPbcs. CLINICAL RELEVANCE This is the first study to elucidate the biological properties and immunomodulatory potential of Bioroot Flow and AH Plus Bioceramic Sealer. The results act as supporting evidence for their use in root canal treatment.
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Affiliation(s)
- José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Sergio López-García
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - David García-Bernal
- Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Biomedical Research Institute (IMIB), 30120, Murcia, Spain
| | - Francisco Javier Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008, Murcia, Spain.
- School of Dentistry, Hospital Morales Meseguer2 Pl.Av. Marqués de los Vélez, S/NUniversity of Murcia, 30008, Murcia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Adrián Lozano
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, 30107, Murcia, Spain
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Radwanski M, Rozpedek-Kaminska W, Galita G, Siwecka N, Sokolowski J, Majsterek I, Özcan M, Lukomska-Szymanska M. Cytotoxicity and genotoxicity of bioceramic root canal sealers compared to conventional resin-based sealer. Sci Rep 2024; 14:4124. [PMID: 38374199 PMCID: PMC10876547 DOI: 10.1038/s41598-024-54726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
The aim of this study was to evaluate cytotoxicity and genotoxicity of calcium-silicate based sealers and comparing them with a gold standard-an epoxy-based sealant. Two experimental cell lines were used, gingival fibroblasts (hGF) and monocyte/macrophage peripheral blood cell line (SC). The cytotoxicity (XTT assay) and genotoxicity (comet assay) were evaluated both after 24-h and 48-h incubation. Additionally, after 48-h incubation, the cell apoptosis and cell cycle progression was detected. BioRoot Flow induced a significant decrease in hGF cells viability compared to the negative control groups both after 24-h (p < 0.001) and 48-h incubation (p < 0.01). In group with SC cells, after 24-h incubation significant increase in cells viability was detected for AH Plus Bioceramic Sealer in comparison to negative control (p < 0.05). BioRoot Flow and BioRoot RCS can be considered potentially genotoxic for the hGF cells after 48-h incubation (> 20% DNA damage). BioRoot Flow and BioRoot RCS, may have potential genotoxic effects and induce apoptosis in hGF cells which may irritate periapical tissues, resulting in a delayed healing. The findings of the study would be useful in selection of an appropriate sealant for root canal filling without causing cytotoxicity and genotoxicity.
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Affiliation(s)
| | | | - Grzegorz Galita
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Natalia Siwecka
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Mutlu Özcan
- Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland.
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Büker M, Sümbüllü M, Ali A, Ünal O, Arslan H. The Effects of Calcium Silicate- and Calcium Hydroxide-based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial. J Endod 2023; 49:1588-1594. [PMID: 37683888 DOI: 10.1016/j.joen.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION This study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide-based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. METHODS A total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). RESULTS The statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). CONCLUSIONS Patients treated with calcium silicate- and calcium hydroxide-based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.
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Affiliation(s)
- Mine Büker
- Department of Endodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
| | - Meltem Sümbüllü
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Türkiye.
| | - Afzal Ali
- Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Oğuzhan Ünal
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Türkiye
| | - Hakan Arslan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medeniyet University, Istanbul, Türkiye
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12
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Carneiro VF, Alcalde MP, do Vale MS, Vivan RR, Duarte MAH, Vasconcelos BC. Effect of ultrasonic agitation on marginal adaptation, intratubular penetration and bonding strength of calcium-silicate-based endodontic sealers: A laboratory study. AUST ENDOD J 2023; 49:690-699. [PMID: 37363860 DOI: 10.1111/aej.12769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
The effect of ultrasonic activation (UA) on marginal adaptation, intratubular penetration and bond strength provided by three calcium silicate-based sealers was evaluated. Ninety-six distobuccal root canals of maxillary molars were randomly divided into 8 groups (n = 12) according to the sealer and UA application: EndoSequence BC sealer (ESBC), Sealer Plus BC (SPBC) and Bio-C Sealer (BCS), using AH Plus (AH) as a control group. The specimens were sectioned at 2, 4 and 6 mm from the apex. The data were statistically analysed using Kruskall-Wallis, Dunn, Mann-Whitney and chi-squared tests. UA improved the marginal adaptation of ESBC (6 mm), SPBC (all levels), BCS (2/4 mm) and AH (4 mm) (p < 0.05); the bond strength of SBPC (2 mm) and BCS (6 mm) were also improved (p < 0.05). The UA of endodontic silicate-based sealers improved the marginal adaptation in all levels and the bond strength of SBPC and BCS sealer.
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Affiliation(s)
- V F Carneiro
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - M P Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M S do Vale
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - R R Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M A H Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - B C Vasconcelos
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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13
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Bae KB, Choi Y, Lee BN, Chang HS, Hwang IN, Oh WM, Hwang YC. A comparison of osteogenic effect of newly manufactured calcium silicate-based sealers in vitro. Dent Mater J 2023; 42:860-867. [PMID: 37914232 DOI: 10.4012/dmj.2023-048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
This study aimed to assess the effect of different calcium silicate-based root canal sealers (CSRS) on osteogenic effect in human periodontal ligament cells (hPDLCs). hPDLCs were cultured in a medium containing extract of 5 types of CSRS. The specimens were assessed by the cell cytotoxicity test, alkaline phosphatase staining, alizarin red S staining, quantitative real-time PCR, Western blot analysis, and enzyme-linked immunosorbent assay. The diluted concentrations of extracted solutions had no significant effect on the viability of hPDLCs. There was a statistically significant difference in the mRNA expression level of bone sialoprotein (BSP), osteocalcin (OCN), and runt-related transcription factor 2 (RUNX2) among some groups. The protein expressions of BSP, OCN, and RUNX2 were significantly higher in some groups compared to the control group. The CSRS did not interfere with the osteogenic differentiation of hPDLCs, compared to the control group. CSRS are shown to have biocompatibility and osteogenic differentiation effect on hPDLCs.
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Affiliation(s)
- Kkot-Byeol Bae
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
| | - Yoorina Choi
- Department of Conservative Dentistry, College of Dentistry, Wonkwang University
| | - Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
| | - Hoon-Sang Chang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
| | - In-Nam Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
| | - Won-Mann Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
| | - Yun-Chan Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University
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14
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Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Victorino FR, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Postoperative pain after root canal filling with bioceramic sealers: a systematic review and meta-analysis of randomized clinical trials. Odontology 2023; 111:793-812. [PMID: 37378833 DOI: 10.1007/s10266-023-00830-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to assess postoperative pain (PP) after endodontic treatment with bioceramic root canal sealer compared to AH Plus® sealer. This SRM was carried out in accordance with the items on the PRISMA 2020 checklist and Cochrane guidelines and registered in PROSPERO (CRD42021259283). Only randomized clinical trials (RCTs) were included. Meta-analysis was conducted using R software, the standardized means difference (SMD) measure of effect was calculated for quantitative variables, and the odds ratio (OR) for binary variables. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Qualitative and quantitative analysis included 18 and 17 studies, respectively. For quantitative variables, the bioceramic root canal sealer presented less occurrence of postoperative pain than the AH Plus® sealer in 24 h (SMD - 0.17 [- 0.34; - 0.01], p = 0.0340). For binary variables, there was no difference observed between the sealers evaluated, except for sealer extrusion where the bioceramic group had lower post-filling material extrusion (OR 0.52 [0.32; 0.84], p = 0.007). Regarding the risk of bias analysis, low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence ranged from moderate to low. The results showed that bioceramics sealers reduced postoperative endodontic pain only after 24 h and showed less sealer extrusion compared to the AH Plus® sealer. However, more robust and standardized clinical trials are needed to confirm the results with less heterogeneity and higher quality of evidence.
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Affiliation(s)
- Marcelo Augusto Seron
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gabriel Pereira Nunes
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | | | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Luciano Tavares Angelo Cintra
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gustavo Sivieri-Araujo
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
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15
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Alchawoosh A, Hashimoto K, Kawashima N, Noda S, Nozaki K, Okiji T. Hydraulic calcium silicate-based root canal sealers mitigate proinflammatory cytokine synthesis and promote osteogenesis in vitro. J Dent Sci 2023; 18:1731-1739. [PMID: 37799856 PMCID: PMC10547950 DOI: 10.1016/j.jds.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/26/2022] [Indexed: 01/09/2023] Open
Abstract
Background/purpose The mineralized tissue-inductive ability and anti-inflammatory properties of hydraulic calcium silicate-based (HCSB) sealers have not been fully elucidated. This study aimed to evaluate the effects of the HCSB sealers Bio-C sealer (BioC), Well-Root ST (WST), and EndoSequence BC sealer (BC), on osteoblastic differentiation/mineralization and proinflammatory cytokine synthesis by macrophages. Materials and methods Diluted extracts of set sealers or calcium chloride solutions of approximately equivalent Ca2+ concentrations were applied to a mouse osteoblastic cell line (Kusa-A1 cells) and lipopolysaccharide-stimulated mouse macrophage cell line (RAW264.7 cells). Expressions of osteoblastic markers in Kusa-A1 cells and proinflammatory cytokines in RAW264.7 cells were evaluated by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assays. Mineralized nodules were detected by Alizarin red S staining. Cell proliferation was assessed by WST-8 assay and cell attachment on set sealers was examined by scanning electron microscopy. Results The three sealer extracts significantly upregulated osteocalcin and osteopontin mRNA, and promoted significant mineralized nodule formation in Kusa-A1 cells. The three sealer extracts significantly downregulated the mRNA expressions of interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor (TNF)-α and protein levels of IL-6 and TNF-α in RAW264.7 cells. Calcium chloride solutions induced osteoblastic differentiation/mineralization. AH Plus Jet (a control sealer) extract did not. The three HCSB sealers did not interfere with the growth and attachment of Kusa-A1 cells. Conclusion BioC, WST, and BC were biocompatible, upregulated osteoblastic differentiation/mineralization, and downregulated proinflammatory cytokine expression. Ca2+ released from HCSB sealers might be involved, at least in part, in the induction of osteoblastic differentiation/mineralization.
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Affiliation(s)
- Aseel Alchawoosh
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kentaro Hashimoto
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobuyuki Kawashima
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sonoko Noda
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kosuke Nozaki
- Department of Advanced Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Küden C, Karakaş SN. Effect of three different photosensitizers in photodynamic therapy on bond strength of a calcium silicate-based sealer to radicular dentin. AUST ENDOD J 2023; 49 Suppl 1:265-272. [PMID: 36524845 DOI: 10.1111/aej.12730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
To evaluate the effect of the photodynamic therapy (PDT) using with different photosensitizers on the bond strength of BioRoot RCS (BR) to radicular dentin by comparing with AH Plus (AH). The shaped root canals of 80 human mandibular premolars were divided into four groups based on the final disinfection protocol: NaOCl/EDTA, PDT with methylene Blue (MB), PDT with curcumin (CUR) and PDT with toluidine blue O (TBO) (n = 20). Each group was randomly divided into two subgroups (n = 10), according to the endodontic sealer used for obturation (n = 10). The test of push-out bond strength (PBS) was performed using an universal test machine. The data were analysed using ANOVA, Tukey post-hoc, and independent sample t-test (α = 0.05). MB-BR group showed the highest PBS at the cervical level (p < 0.05). The selection of the photosensitizer in PDT influenced adhesion of root canal sealers to radicular dentin.
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Affiliation(s)
- Cihan Küden
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Seda Nur Karakaş
- Department of Restorative Dentistry, Faculty of Dentistry, Cukurova University, Adana, Turkey
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17
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Yang X, Zheng T, Yang N, Yin Z, Wang W, Bai Y. A Review of the research methods and progress of biocompatibility evaluation of root canal sealers. AUST ENDOD J 2023; 49 Suppl 1:508-514. [PMID: 36480411 DOI: 10.1111/aej.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/22/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
The function of root canal sealer was to achieve an appropriate three-dimensional filling effect by filling the root canal and some irregular lumen, thereby inhibiting the residual bacteria. There were many types of sealers, but research to find the most suitable ones was still ongoing. In recent years, researchers had continuously improved the performance of sealers by developing new sealers or adding active ingredients to the sealers. However, most sealers exhibit varying degrees of cytotoxicity and tissue responses, which affect clinical therapy efficacy. This review describes different technical approaches, and recent research progress in the biocompatibility evaluation of root canal sealers and provides brief insights into this field by summarising the performance studies of different root canal sealers.
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Affiliation(s)
- Xiliang Yang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Tianxia Zheng
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Nuoya Yang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Zihan Yin
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Wuliang Wang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Yuhong Bai
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
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18
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Stanley E, Strother KK, Kirkpatrick T, Jeong JW. Calcium Silicate-based Sealer Extrusion into the Mandibular Canal: Three Different Recovery Outcomes: A Report of Three Cases. J Endod 2023:S0099-2399(23)00216-9. [PMID: 37098401 DOI: 10.1016/j.joen.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
The use of calcium silicate-based sealers (CSS) is increasing in dentistry as result of their favorable properties. The inadvertent extrusion of these sealers into the mandibular canal (MC) can result in temporary or permanent neurosensory alterations. Three different recovery outcomes of CSS extrusion into the MC after endodontic treatment of mandibular molars, confirmed by cone beam computed tomography (CBCT) imaging, are described. In Case 1, CSS from the mesiolingual canal of #31 was extruded into the MC during obturation. The patient reported paresthesia. The symptoms of paresthesia were completely resolved by nine months. In Case 2, CSS from the mesial canals of #30 was extruded into the MC during obturation. "Plasma-like spreading pattern" of the extruded sealer was observed on the radiographs. The patient reported paresthesia and dysesthesia. In addition, the patient complained of hyperalgesia with heat and mechanical allodynia. The symptoms continued to persist during follow up. At 22 months, the patient still reported persistent paresthesia, hyperalgesia and mechanical allodynia, affecting the ability to eat. In Case 3, CSS from the distal canal of #31 was extruded into the MC during obturation. The patient did not report any paresthesia or dysesthesia. All three patients elected a follow up approach and monitoring rather than surgical intervention. These cases illustrate the need for the development of guidelines for the management of iatrogenic CSS extrusion into the MC because such an occurrence may not necessarily result in permanent, temporary or no neurosensory alterations.
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Affiliation(s)
- Eva Stanley
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Kortnie K Strother
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Timothy Kirkpatrick
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Ji Wook Jeong
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry.
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Pontoriero DIK, Ferrari Cagidiaco E, Maccagnola V, Manfredini D, Ferrari M. Outcomes of Endodontic-Treated Teeth Obturated with Bioceramic Sealers in Combination with Warm Gutta-Percha Obturation Techniques: A Prospective Clinical Study. J Clin Med 2023; 12:jcm12082867. [PMID: 37109206 PMCID: PMC10143487 DOI: 10.3390/jcm12082867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The objective of this clinical study was to collect short-term endodontic outcomes of endodontic-treated teeth (ETT) obturated with different kinds of bioceramic sealers used in combination with warm gutta-percha obturation techniques. Methods: A total of 210 endodontic treatments in 168 patients were performed. At baseline, 155 sample teeth (73.8%) showed symptoms (tenderness or pain to percussion) and 125 (59.5%) showed periapical radiolucency. Periapical radiolucency was present in 125 cases (59.5%); of these, 79 showed a lesion of 5 mm or bigger (63.2%) while lower than 5 mm in 46 cases (36.8%). Regarding ETT with radiolucency, 105 of them (84%) were in coincidence with their need for retreatment and the other 20 (16%) were necrotic teeth. The obturation techniques that were used in this study were: the continuous wave of condensation technique in 75% of cases, and carrier-based technique in 25%. Four bioceramic sealers were used: CeraSeal in 115 cases, BioRoot in 35 cases, AH Plus Bio in 40 cases, and in 20 cases, BIO-C SEALER ION. Preoperative and recall radiographs of the roots were each assigned a periapical index (PAI) score by 2 blinded, independent, and calibrated examiners. The teeth were divided into outcome categories based on the following classification: healed, unhealed, and healing. The healed and healing categories were classified as success, and the unhealed category was classified as failure on the basis of loose criteria. Minimum follow-up period was 18 months. Results: The overall success rate was 99%, with 73.3% healed, 25.7% healing, and 0.95% not healed. The success rate was 100% for initial treatment and 98.2% for retreatment. Fifty-four (N = 54) teeth showed ongoing healing. All of them were retreatment cases with periapical lesions. Regarding the success (healed and healing) versus not healed, no significant difference was found between teeth with or without periapical lesions (p < 0.05). A statistically significant difference in the distribution of healed, healing, and not-healed teeth was found between the groups of teeth with baseline lesions < 5 mm and >5 mm in diameter (p < 0.01) and those with sealer groups (p < 0.01). The success rate of used bioceramic sealers was not statistically significant different (99.1%, 100%, 97.5% and 100%, respectively, for CeraSeal, BioRoot, AH Plus Bio, and BIO-C SEALER ION). Nonetheless, the distribution of healed, healing, and not-healed teeth was different between teeth sealed with different materials (p < 0.01). From the findings of this clinical study, the following conclusion can be drawn: a correct filling of root canals made with warm gutta-percha technique combined with a bioceramic sealer allows a high success rate in endodontically treated teeth.
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Affiliation(s)
| | | | | | - Daniele Manfredini
- Department of Prosthodontics and Dental Materials, University of Siena, 53100 Siena, Italy
| | - Marco Ferrari
- Department of Prosthodontics and Dental Materials, University of Siena, 53100 Siena, Italy
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20
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Immunomodulatory Effects of Endodontic Sealers: A Systematic Review. Dent J (Basel) 2023; 11:dj11020054. [PMID: 36826199 PMCID: PMC9955805 DOI: 10.3390/dj11020054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Inflammation is a crucial step prior to healing, and the regulatory effects of endodontic materials on the immune response can influence tissue repair. This review aimed to answer whether endodontic sealers can modulate the immune cells and inflammation. An electronic search in Scopus, Web of Science, PubMed, and Google Scholar databases were performed. This systematic review was mainly based on PRISMA guidelines, and the risk of bias was evaluated by SYRCLEs and the Modified CONSORT checklist for in vivo and in vitro studies, respectively. In total, 28 articles: 22 in vitro studies, and six in vivo studies were included in this systematic review. AH Plus and AH 26 can down-regulate iNOS mRNA, while S-PRG sealers can down-regulate p65 of NF-κB pathways to inhibit the production of TNF-α, IL-1, and IL-6. In vitro and in vivo studies suggested that various endodontic sealers exhibited immunomodulatory impact in macrophages polarization and inflammatory cytokine production, which could promote healing, tissue repair, and inhibit inflammation. Since the paradigm change from immune inert biomaterials to bioactive materials, endodontic materials, particularly sealers, are required to have modulatory effects in clinical conditions. New generations of endodontic sealers could hamper detrimental inflammatory responses and maintain periodontal tissue, which represent a breakthrough in biocompatibility and functionality of endodontic biomaterials.
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Martorano AS, Messias NS, Bighetti-Trevisan RL, de Oliveira PT, de Castro Raucci LMS, Raucci Neto W. In vitro inflammatory modulation of bioceramic endodontic sealer in macrophages stimulated by bacterial lipopolysaccharide. Int Endod J 2023; 56:213-226. [PMID: 36314853 DOI: 10.1111/iej.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
AIM To evaluate the effects of AH Plus (Dentsply), Sealer 26 (Dentsply), and Sealer Plus BC (Produtos Médicos e Odontológicos) on cytotoxicity and inflammation in macrophage cultures exposed to bacterial lipopolysaccharide (LPS). METHODOLOGY After initial setting, the sealers were conditioned with serum-free culture medium for 24 h (1 ml/cm2 ). Macrophages from the RAW 264.7 strain were exposed to sealer extracts in a 1:16 ratio in a culture medium with or without LPS. Cell morphology, viability, mitochondrial activity, oxidative stress and gene expression of interleukin 1β (IL-1β) and tumour necrosis factor-alpha (TNF-α) were evaluated. Data on mitochondrial activity, oxidative stress and TNF-α were analysed using a two-way analysis of variance (anova) test, followed by the Student-Newman-Keuls post-test. IL-1β data were analysed using one-way anova, followed by SNK, and the t-test was used for intragroup comparison. The significance level was set at 5%. RESULTS In the absence of LPS, only AH Plus and Sealer 26 showed a reduction in cell density, while in the presence of LPS, Sealer 26 had the lowest density compared to the other groups. In terms of mitochondrial activity, at 24 and 48 h, Sealer Plus BC had significantly higher mean values than Sealer 26 and AH Plus (p < .05). Sealer 26 exhibited the lowest levels of oxidative stress and IL-1β and TNF-α expression, regardless of the presence of LPS (p < .05). CONCLUSIONS Although all sealers interfere with the response of macrophages to LPS, contact with epoxy resin-based sealers can impair cell activity in vitro, while bioceramic sealer seems to favour the inflammatory functions of these cells.
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Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111853. [PMID: 36430988 PMCID: PMC9697500 DOI: 10.3390/life12111853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
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Sheela S, Nassar M, AlGhalban FM, Gorduysus MO. In Vitro Cytotoxicity and Mineralization Potential of an Endodontic Bioceramic Material. Eur J Dent 2022. [PMID: 36191594 DOI: 10.1055/s-0042-1750778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022] Open
Abstract
OBJECTIVE The interest in bioceramic materials has been steadily growing for different applications in endodontics. With the continued introduction of new bioceramic-based materials into the market, it is of great importance to assess the biocompatibility before providing recommendations on their clinical use. This study evaluated the in vitro cytotoxicity and mineralization potential of two consistencies of unset premixed bioceramic material (TotalFill BC RRM putty and TotalFill BC sealer) compared with an epoxy resin-based sealer (AH Plus) on osteoblast cells. MATERIALS AND METHODS Overall, 100% extracts were obtained by weighing 0.1 g of each material in 1 mL of cell culture media. Primary human osteoblast (HOB) cells (n = 4) were treated with different concentrations (100, 50, 25, 12.50, and 6.25%) of each extract. XTT assay and Alizarin Red S staining were used to evaluate the cytotoxic effect and the biomineralization potential, respectively. STATISTICAL ANALYSIS Data were analyzed by one-way analysis of variance followed by Tukey's post hoc tests. RESULTS The cytotoxicity assay after 24 h treatment showed that all materials at high concentrations of the extract (100 and 50%) were toxic to HOB (p < 0.001). On the contrary to TotalFill BC RRM Putty, AH Plus and TotalFill BC sealer were toxic at 25% concentration. However, at 12.5% concentration and lower, all materials were nontoxic. The mineralization potential analyzed after 7 and 14 days showed that TotalFill BC material-treated cells could deposit mineralized nodules in the normal and osteogenic medium unlike AH plus-treated cells. CONCLUSION At low concentrations, TotalFill BC materials showed higher biocompatibility to HOB cells than AH Plus, enhanced the viability of the cells, maintained their typical morphology, and induced the formation of mineralized nodules. Despite the encouraging data, clinical trials are needed to identify the effect of this material on the long-term outcome of endodontic treatment.
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Affiliation(s)
- Soumya Sheela
- Dental Biomaterials and Biomimetics Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma M AlGhalban
- Dental Biomaterials and Biomimetics Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Mehmet O Gorduysus
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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24
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Silva GFD, Coelho LAS, Costa VAS, Conti LC, Lima ACDA, Sodré GCDS, Martins MRL, Duarte MAH, Vivan RR. Laboratory study of tissue repair of resin-based endodontic sealers in critical surgical defects. J Appl Oral Sci 2022; 30:e20220108. [PMID: 35920449 PMCID: PMC9365338 DOI: 10.1590/1678-7757-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility.
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Affiliation(s)
| | - Letycia Accioly Simões Coelho
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Vanessa Abreu Sanches Costa
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Letícia Citelli Conti
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Ana Carolina de Almeida Lima
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Gabriela Cristina de Santi Sodré
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Mateus Rinaldi Lucio Martins
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
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Clinical and Radiographic Outcome of Non-Surgical Endodontic Treatment Using Calcium Silicate-Based Versus Resin-Based Sealers-A Systematic Review and Meta-Analysis of Clinical Studies. J Funct Biomater 2022; 13:jfb13020038. [PMID: 35466220 PMCID: PMC9036224 DOI: 10.3390/jfb13020038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of this paper is to systematically analyse the effect of calcium silicate-based sealers in comparison to resin-based sealers on clinical and radiographic outcomes of non-surgical endodontic treatment in permanent teeth. Methods: The study was conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. The literature search was performed using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ and OpenGrey with no language restrictions. Two reviewers critically assessed the studies for eligibility. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was carried out using the RevMan software (p < 0.05). Results: Results from the included studies showed that there were no significant differences between the groups in the 24 h post-obturation pain levels (mean difference (MD), −0.19, 95% CI = −0.43−0.06, p = 0.14, I2 = 0%), but at 48 h (MD, −0.35, 95% CI = −0.64−0.05, p = 0.02, I2 = 0%), a significant difference was observed in favour of calcium silicate sealers. Furthermore, there were no significant differences between the two sealers due to risk of onset or intensity of postoperative pain, need for analgesic and extrusion of the sealer. The heterogeneity assessed using Q test between the included studies was 97% (I2). Conclusions: Within the limitations of this review, the paper shows that calcium silicate-based sealers exhibited optimal performance with similar results to resin-based sealers in terms of average level of post-obturation pain, risk of onset and pain intensity at 24 and 48 h. The observations from the included studies are informative in the clinical evaluation of calcium silicate-based sealers and provide evidence for the conduction of well-designed, controlled randomised clinical trials for a period of at least four years in the future.
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26
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Pedrosa MDS, Vilela HDS, Rahhal JG, Bueno NP, Lima FS, Nogueira FN, Sipert CR. Response of periodontal ligament stem cells to lipopolysaccharide and calcium silicate-based materials. Braz Dent J 2022; 33:73-82. [PMID: 35508039 PMCID: PMC9645152 DOI: 10.1590/0103-6440202204659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/08/2021] [Indexed: 12/31/2022] Open
Abstract
This study was conducted to assess the in vitro response of human periodontal ligament stem cells (hPDLSCs) to bacterial lipopolysaccharide (LPS) activation and application of three calcium silicate-based materials (CSBM): Bio-C Sealer, MTA Fillapex and Cimmo HP. Characterization of the CSBM was performed by FTIR (n = 3). Extracts of Bio-C Sealer, MTA Fillapex and Cimmo HP were prepared and diluted (1:1, 1:4 and 1:16). Culture of hPDLSCs was established and treated or not with LPS from Escherichia coli (1 µg/mL) for 7 days. MTT assay was used to assess cell viability at 24, 48 and 72 h (n = 9). Alkaline phosphatase (ALP) activity was indirectly assayed at day 7 (n = 5). TNF-α and Il -1 0 cytokines were quantified by ELISA at 24h-cell supernatants (n = 6). Data were analyzed by ANOVA and Tukey's test (α = 0.05). The cell viability of the LPS-activated hPDLSCs were higher than untreated control (p < 0.05). The application of CSBM affected the cell viability of untreated and LPS-activated cells (p < 0.05). ALP activity was higher for Bio-C Sealer and Cimmo HP in untreated and LPS-activated cells, respectively (p < 0.05). Application of CSBM normalized the TNF-α secretion in the LPS-activated cells (p < 0.05). Only MTA Fillapex in untreated hPDLSCs presented higher values of Il -1 0 (p < 0.05). Taken collectively, the results suggests that the simulation of the inflammatory process by LPS affect the in vitro response the hPDLSCs to the application of the CSBM.
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Affiliation(s)
- Marlus da Silva Pedrosa
- University of São Paulo - USP, School of Dentistry, Department of
Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Handially dos Santos Vilela
- University of São Paulo - USP, School of Dentistry, Department of
Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Juliana Garuba Rahhal
- University of São Paulo - USP, School of Dentistry, Department of
Restorative Dentistry, São Paulo, SP, Brazil
| | - Natália Pieretti Bueno
- University of São Paulo- USP, School of Dentistry, Department of
Oral and Maxillofacial Surgery, Prosthesis and Traumatology, São Paulo, SP,
Brazil
| | - Fabianne Soares Lima
- University of São Paulo - USP, School of Dentistry, Department of
Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Fernando Neves Nogueira
- University of São Paulo - USP, School of Dentistry, Department of
Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Carla Renata Sipert
- University of São Paulo - USP, School of Dentistry, Department of
Restorative Dentistry, São Paulo, SP, Brazil
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A comprehensive in vitro comparison of the biological and physicochemical properties of bioactive root canal sealers. Clin Oral Investig 2022; 26:6209-6222. [PMID: 35660956 PMCID: PMC9525420 DOI: 10.1007/s00784-022-04570-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the biological and physicochemical features of bioactive root canal sealers. MATERIALS AND METHODS Human periodontal ligament fibroblasts (hPDLF) and human osteoblasts (hOB) were exposed to eluates of three bioactive root canal sealers, GuttaFlow® bioseal (GF), BioRoot™ RCS (BR), and TotalFill® BC Sealer (TF), and the epoxy resin-based sealer AH plus® (AH). Cytotoxicity and cellular inflammatory response were evaluated. The osteogenic potential was examined using human mesenchymal stem cells (hMSC). Film thickness, flowability, and pH were assessed. Root canal treatment was performed on human extracted teeth to evaluate the sealers' tightness towards bacterial penetration. The antibacterial activity against common pathogens in primary root canal infections was tested. RESULTS AH was severely cytotoxic to hPDLF and hOB (p < 0.001). The bioactive sealers were generally less cytotoxic. IL-6 levels in hPDLF were elevated in the presence of AH (p < 0.05). AH and GF suppressed IL-6 production in hOB (p < 0.05). AH and BR stimulated the PGE2 production in hPDLF and hOB (p < 0.05). BR was the only sealer that led to calcium deposits in hMSC (p < 0.05). TF and AH showed the lowest film thickness and the highest flowability. Bacterial tightness was best in teeth filled with AH and BR. All sealers showed similar antimicrobial activity, but the overall antimicrobial efficacy was moderate as the bacteria were reduced by just one log scale (p < 0.05). CONCLUSIONS This study revealed favorable in vitro results regarding the biocompatibility of the bioactive root canal sealers. CLINICAL RELEVANCE Bioactive root canal sealers may be a useful alternative to epoxy resin-based sealers.
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28
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Wang M, Li B, Liu Y, Tang L, Zhang Y, Xie Q. A Novel Bionic Extracellular Matrix Polymer Scaffold Enhanced by Calcium Silicate for Bone Tissue Engineering. ACS OMEGA 2021; 6:35727-35737. [PMID: 34984303 PMCID: PMC8717537 DOI: 10.1021/acsomega.1c05623] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
A novel porous calcium silicate (CS)-enhanced small intestinal submucosa (SIS) scaffold was prepared by freeze-drying to mimic the natural extracellular matrix environment for bone tissue engineering. The micro-morphology, physicochemical properties, biological characteristics, and effects on osteogenic differentiation in vitro were explored; the effects on promoting bone formation in vivo were evaluated. The composite scaffold had an ideal three-dimensional porous structure. The amount of calcium silicate played a significant role in improving mechanical properties and promoting osteogenic differentiation. The SIS/2CS scaffold promoted proliferation and osteogenic differentiation in human bone marrow mesenchymal stem cells; it also significantly increased osteogenesis in vivo. This novel composite polymer scaffold has potential applications in bone tissue engineering.
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Affiliation(s)
- Mei Wang
- Department
of Prosthodontics, Peking University School
and Hospital of Stomatology & National Center of Stomatology &National
Clinical Research Center for Oral Diseases & National Engineering
Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - Bowen Li
- Department
of Prosthodontics, Peking University School
and Hospital of Stomatology & National Center of Stomatology &National
Clinical Research Center for Oral Diseases & National Engineering
Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - Yuhua Liu
- Department
of Prosthodontics, Peking University School
and Hospital of Stomatology & National Center of Stomatology &National
Clinical Research Center for Oral Diseases & National Engineering
Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - Lin Tang
- Department
of Prosthodontics, Peking University School
and Hospital of Stomatology & National Center of Stomatology &National
Clinical Research Center for Oral Diseases & National Engineering
Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - Yi Zhang
- Department
of General Dentistry II, Peking University
School and Hospital of Stomatology & National Center of Stomatology
&National Clinical Research Center for Oral Diseases & National
Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - Qiufei Xie
- Department
of Prosthodontics, Peking University School
and Hospital of Stomatology & National Center of Stomatology &National
Clinical Research Center for Oral Diseases & National Engineering
Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
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29
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Kim JH, Cho SY, Choi Y, Kim DH, Shin SJ, Jung IY. Clinical Efficacy of Sealer-based Obturation Using Calcium Silicate Sealers: A Randomized Clinical Trial. J Endod 2021; 48:144-151. [PMID: 34856212 DOI: 10.1016/j.joen.2021.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This randomized controlled clinical trial compared the clinical efficacy and outcome of a sealer-based obturation technique (SBO) with calcium silicate sealers and a continuous wave of condensation technique (CWC) with a resin-based sealer. METHODS Root canals were prepared using rotary instruments and 2.5% sodium hypochlorite. At the next visit, patients were enrolled and randomly assigned into 2 groups on the basis of the obturation protocol: CWC with AH Plus sealer and SBO with Endoseal TCS. Patients were assessed for the level of postoperative pain using a numeric rating scale. The quality of root canal obturation was evaluated in terms of the sealer extrusion, root-filling voids, and level of root filling. The participants were recalled after at least 6 months. Healing of the teeth was determined as a decrease in Periapical Index score and resolution of symptoms. The results were statistically compared by using the χ2 test or Fisher exact test, followed by multivariate analysis with logistic regression. RESULTS A total of 74 teeth were included in the analysis (79% recalls), and the mean follow-up period was 17 months (6-29 months). Two groups expressed identical distribution of postoperative pain (P = .973) and similar quality of root canal obturation. The total success rates were 93.2% (CWC 92.3%, SBO 94.3%) by loose criteria and 60.8% (CWC 51.3%, SBO 71.4%) by strict criteria, with no significant differences between the 2 groups. The success rate by loose criteria in teeth with sealer extrusion was significantly lower than those in teeth without sealer extrusion (P = .049). CONCLUSIONS SBO using an Endoseal TCS could be a possible alternative to CWC using AH Plus. Sealer extrusion and postoperative pain were found to negatively impact prognosis of the endodontic treatment.
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Affiliation(s)
- Ji-Hyung Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sin-Yeon Cho
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Korea
| | - Yoonwoo Choi
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Do-Hyun Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Dental Hospital, Yonsei University, Seoul, Korea
| | - Il-Young Jung
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
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30
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Pedrosa MDS, Alves T, Nogueira FN, Holzhausen M, Sipert CR. Cytotoxicity and cytokine production by calcium silicate-based materials on periodontal ligament stem cells. Braz Dent J 2021; 32:65-74. [PMID: 34755791 DOI: 10.1590/0103-6440202104467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
Abstract
This study investigated the effect of three commercial calcium silicate-based materials (CSBM) on cytotoxicity and pro-and anti-inflammatory cytokines production in cultured human periodontal ligament stem cells (hPDLSCs). Culture of hPDLSCs was established and characterized. Extracts of Bio-C Sealer (Angelus, Londrina, PR, Brazil), MTA Fillapex (Angelus, Londrina, PR, Brazil) and PBS Cimmo HP (Cimmo Soluções em Saúde, Pouso Alegre, MG, Brazil) were prepared by placing cement specimens (5 x 3 mm) in culture medium. Then, the extracts were serially two-fold diluted (1, 1:2, 1:4, 1:8, 1:16) and inserted into the cell-seeded wells for 24, 48 and 72 h for MTT assays. TNF-α and IL-10 cytokines were quantified by ELISA at 24h-cell supernatants. Data were analyzed by ANOVA and Tukey's test (α = 0.05). All CSBM exhibited some cytotoxicity that varied according to extract concentration and time of evaluation. MTA Fillapex presented the highest cytotoxic effects with significant reduction of metabolic activity/cell viability when compared to Bio-C Sealer and Cimmo HP®. TNF-α was significantly upregulated by the three tested cements (p < 0.05) while only MTA Fillapex significantly upregulated IL-10 in comparison to control. Taken collectively, the results showed that PBS Cimmo HP®, Bio-C Sealer and MTA Fillapex present mild and transient cytotoxicity and slightly induced TNF-α production. MTA Fillapex upregulated IL-10 release by hPDLSCs.
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Affiliation(s)
- Marlus da Silva Pedrosa
- University of São Paulo - USP, School of Dentistry, Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Tomaz Alves
- University of São Paulo - USP, School of Dentistry, Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Fernando Neves Nogueira
- University of São Paulo - USP, School of Dentistry, Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Marinella Holzhausen
- University of São Paulo - USP, School of Dentistry, Discipline of Periodontology, Department of Stomatology, São Paulo, SP, Brazil
| | - Carla Renata Sipert
- University of São Paulo - USP, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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31
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Thein HSS, Hashimoto K, Kawashima N, Noda S, Okiji T. Evaluation of the anti-inflammatory effects of surface-reaction-type pre-reacted glass-ionomer filler containing root canal sealer in lipopolysaccharide-stimulated RAW264.7 macrophages. Dent Mater J 2021; 41:150-158. [PMID: 34602587 DOI: 10.4012/dmj.2021-139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A prototype surface-reaction-type pre-reacted glass-ionomer (S-PRG) filler containing root canal sealer (S-PRG sealer) exhibits bioactive potential by releasing multiple ions. This study explored the suppressive effects and modes of action of S-PRG sealer extracts on proinflammatory cytokine expression in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Expression of proinflammatory cytokines was evaluated by RT-qPCR and ELISA. Expression of phosphorylated nuclear factor-kappa B (p-NF-kB) p65 was evaluated by western blotting. S-PRG sealer extracts significantly downregulated mRNA expression levels of interleukin (IL)-1α, IL-6, and TNF-α in LPS-stimulated RAW264.7 cells; the extracts also reduced the levels of IL-6 protein and p-NF-kB. In order to verify that Zn2+ was responsible for downregulation of proinflammatory cytokine expression, N,N,N',N'-tetrakis(2-pyridylmethyl) ethylenediamine (TPEN) was used as a heavy metal chelator with strong affinity for Zn2+. These effects were mitigated by TPEN. The application of ZnCl2 reproduced the actions of S-PRG sealer extracts. These data suggest that S-PRG sealer has anti-inflammatory potential involving heavy metal ions such as Zn2+.
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Affiliation(s)
- Htoo Shwe Sin Thein
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Paediatric Dentistry, University of Dental Medicine Mandalay
| | - Kentaro Hashimoto
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Nobuyuki Kawashima
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Sonoko Noda
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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32
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Yesildal Yeter K, Gunes B, Seker B. The effect of atmospheric cold plasma on the dentinal tubule penetration of calcium silicate-based sealer used with different obturation techniques: A confocal laser scanning microscopy study. AUST ENDOD J 2021; 48:151-157. [PMID: 34494689 DOI: 10.1111/aej.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the effect of atmospheric cold plasma (ACP) on dentinal tubule penetration of EndoSequence BC. Sixty premolars were divided into four groups according to the obturation technique and plasma treatment. Root canals were filled with single cone in Group 1 (SC), single cone after ACP application in Group 2 (SC-P), warm vertical compaction in Group 3 (WVC), warm vertical compaction after ACP application in Group 4 (WVC-P). Horizontal sections were imaged using confocal laser scanning microscopy. The maximum penetration and percentage of penetration values were measured. These data were statistically analysed (P < 0.01). In the coronal region, the percentage of penetration values were higher in SC-P and WVC-P than in SC and WVC. In the middle region, SC-P and SC showed a higher penetration percentage than WVC and WVC-P. In the apical region, WVC showed a higher percentage of penetration value than SC-P, WVC-P and SC did. Maximum penetration of WVC was higher than of SC and SC-P. Within the limitations of this study, ACP improved the percentage of penetration values of EndoSequence BC when used with single-cone technique.
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Affiliation(s)
- Kubra Yesildal Yeter
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Betul Gunes
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Basak Seker
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
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Zhao H, Shen S, Zhao L, Xu Y, Li Y, Zhuo N. 3D printing of dual-cell delivery titanium alloy scaffolds for improving osseointegration through enhancing angiogenesis and osteogenesis. BMC Musculoskelet Disord 2021; 22:734. [PMID: 34452607 PMCID: PMC8401189 DOI: 10.1186/s12891-021-04617-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/11/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The repair of large bone defects is a great challenge for orthopedics. Although the development of three-dimensional (3D) printed titanium alloy (Ti6Al4V) implants with optimized the pore structure have effectively promoted the osseointegration. However, due to the biological inertia of Ti6Al4Vsurface and the neglect of angiogenesis, some patients still suffer from postoperative complications such as dislocation or loosening of the prosthesis. METHODS The purpose of this study was to construct 3D printed porous Ti6Al4V scaffolds filled with bone marrow mesenchymal stem cells (BMSC) and endothelial progenitor cells (EPC) loaded hydrogel and evaluate the efficacy of this composite implants on osteogenesis and angiogenesis, thus promoting osseointegration. RESULTS The porosity and pore size of prepared 3D printed porous Ti6Al4V scaffolds were 69.2 ± 0.9 % and 593.4 ± 16.9 μm, respectively, which parameters were beneficial to bone ingrowth and blood vessel formation. The BMSC and EPC filled into the pores of the scaffolds after being encapsulated by hydrogels can maintain high viability. As a cell containing composite implant, BMSC and EPC loaded hydrogel incorporated into 3D printed porous Ti6Al4V scaffolds enhancing osteogenesis and angiogenesis to repair bone defects efficiently. At the transcriptional level, the composite implant up-regulated the expression levels of the osteogenesis-related genes alkaline phosphatase (ALP) and osteocalcin (OCN), and angiogenesis-related genes hypoxia-inducible factor 1 alpha (HIF-1α), and vascular endothelial growth factor (VEGF). CONCLUSIONS Overall, the strategy of loading porous Ti6Al4V scaffolds to incorporate cells is a promising treatment for improving osseointegration.
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Affiliation(s)
- Heng Zhao
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China
| | - Shi Shen
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China
| | - Lu Zhao
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China
| | - Yulin Xu
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China
| | - Yang Li
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China
| | - Naiqiang Zhuo
- Department of Department of Bone and Joint, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, People's Republic of China.
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Sfeir G, Zogheib C, Patel S, Giraud T, Nagendrababu V, Bukiet F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. MATERIALS 2021; 14:ma14143965. [PMID: 34300886 PMCID: PMC8306764 DOI: 10.3390/ma14143965] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide-eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners' clinical habits rather than manufacturers' recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Shanon Patel
- King’s College London Dental Institute, Guy’s Tower, Guy’s Hospital, St. Thomas’ Street, London SE1 9RT, UK;
| | - Thomas Giraud
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
- Correspondence: ; Tel.: +33-(0)6-4395-2183
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Gomes PS, Pinheiro B, Colaço B, Fernandes MH. The Osteogenic Assessment of Mineral Trioxide Aggregate-based Endodontic Sealers in an Organotypic Ex Vivo Bone Development Model. J Endod 2021; 47:1461-1466. [PMID: 34126159 DOI: 10.1016/j.joen.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/27/2021] [Accepted: 06/05/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Mineral trioxide aggregate (MTA)-based sealers are endodontic materials with widespread success in distinct clinical applications, potentially embracing direct contact with the bone tissue. Bone response to these materials has been traditionally addressed in vitro. Nonetheless, translational data are limited by the absence of native cell-to-cell and cell-to-matrix interactions that hinder the representativeness of the analysis. Ex vivo organotypic systems, relying on the culture of explanted biological tissues, preserve the cell/tissue composition, reproducing the spatial and organizational in situ complexity. This study was grounded on an innovative research approach, relying on the assessment of an ex vivo organotypic bone tissue culture system to address the osteogenic response to 3 distinct MTA-based sealers. METHODS Embryonic chick femurs were isolated and grown ex vivo for 11 days in the presence of MTA Plus (Avalon Biomed Inc, Bradenton, FL), ProRoot MTA (Dentsply Tulsa Dental, Hohnson City, Germany), Biodentine (Septodont, Saint Maurdes Fosses, France), or AH Plus (Dentsply Sirona, Konstanz, Germany); the latter was used as a control material. Femurs were characterized by histologic, histochemical, and histomorphometric analysis. Gene expression assessment of relevant osteogenic markers was conducted by quantitative polymerase chain reaction. RESULTS All MTA-based sealers presented an enhanced osteogenic performance compared with AH Plus. Histochemical and histomorphometric analyses support the increased activation of the osteogenic program by MTA-based sealers, with enhanced collagenous matrix deposition and tissue mineralization. Gene expression analysis supported the enhanced activation of the osteogenic program. Comparatively, ProRoot MTA induced the highest osteogenic functionality on the characterized femurs. CONCLUSIONS MTA-based sealers enhanced the osteogenic activity within the assayed organotypic bone model, which was found to be a sensitive system for the assessment of osteogenic modulation mediated by endodontic sealers.
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Affiliation(s)
- Pedro S Gomes
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Associated Laboratory for Green Chemistry/Network of Chemistry and Technology (LAQV/REQUIMTE), University of Porto, Porto, Portugal.
| | - Bruna Pinheiro
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Bruno Colaço
- Department of Zootechnics, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal; Center for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Maria H Fernandes
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Associated Laboratory for Green Chemistry/Network of Chemistry and Technology (LAQV/REQUIMTE), University of Porto, Porto, Portugal
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Bapat RA, Parolia A, Chaubal T, Dharamadhikari S, Abdulla AM, Sakkir N, Arora S, Bapat P, Sindi AM, Kesharwani P. Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry. Biomater Sci 2021; 9:3244-3283. [PMID: 33949464 DOI: 10.1039/d1bm00233c] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Dental treatment is provided for a wide variety of oral health problems like dental caries, periodontal diseases, periapical infections, replacement of missing teeth and orthodontic problems. Various biomaterials, like composite resins, amalgam, glass ionomer cement, acrylic resins, metal alloys, impression materials, bone grafts, membranes, local anaesthetics, etc., are used for dental applications. The physical and chemical characteristics of these materials influence the outcome of dental treatment. It also impacts on the biological, allergic and toxic potential of biomaterials. With innovations in science and their positive results, there is also a need for awareness about the biological risks of these biomaterials. The aim of dental treatment is to have effective, yet safe, and long-lasting results for the benefit of patients. For this, it is important to have a thorough understanding of biomaterials and their effects on local and systemic health. Materials used in dentistry undergo a series of analyses before their oral applications. To the best of our knowledge, this is the first and original review that discusses the reasons for and studies on the toxicity of commonly used biomaterials for applications in dentistry. It will help clinicians to formulate a methodical approach for the selection of dental biomaterials, thus providing an awareness for forecasting their risk of toxic reactions.
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Affiliation(s)
- Ranjeet Ajit Bapat
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Abhishek Parolia
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Tanay Chaubal
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Anshad Mohamed Abdulla
- Faculty, Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nasil Sakkir
- Registrar Endodontist, Central Security Hospital, Abha, Kingdom of Saudi Arabia
| | - Suraj Arora
- Faculty, Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Prachi Bapat
- Dentist, Modern Dental College, Indore 453112, Madhya Pradesh, India
| | - Amal M Sindi
- Faculty, Oral Diagnostic Sciences Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Prashant Kesharwani
- Faculty, Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
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Ochoa Rodríguez VM, Tanomaru-Filho M, Rodrigues EM, Bugança EDO, Guerreiro-Tanomaru JM, Faria G. Physicochemical properties and effect of bioceramic root canal filling for primary teeth on osteoblast biology. J Appl Oral Sci 2021; 29:e20200870. [PMID: 33950079 PMCID: PMC8092806 DOI: 10.1590/1678-7757-2020-0870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Bio-C Pulpecto (Bio-CP) was recently developed as the first bioceramic root filling material for primary teeth. To evaluate the physicochemical properties of radiopacity, setting time, pH, cytocompatibility and potential of Bio-CP to induce mineralisation, compared with (1) Calen thickened with zinc oxide (Calen-ZO), and (2) zinc oxide and eugenol (ZOE). METHODOLOGY Physicochemical properties were evaluated according to ISO 6876. Saos-2 (human osteoblast-like cell line) exposed to extracts of the materials were subjected to assays of methyl thiazolyl tetrazolium, neutral red, alkaline phosphatase (ALP) activity and mineralised nodule production. The results were analysed using one-way or two-way ANOVA and Tukey's or Bonferroni's post-tests (α=0.05). RESULTS All the materials showed radiopacity higher than 3 mm Al. Bio-CP had lower pH than Calen-ZO, but higher pH than ZOE. Calen-ZO and Bio-CP did not set. The setting time for ZOE was 110 min. The cytocompatibility order was Calen-ZO > Bio-CP > ZOE (1:2, 1:4 dilutions) and Calen-ZO > Bio-CP = ZOE (1:12, 1:24 dilutions) and Calen-ZO = Bio-CP > ZOE (1:32 dilution). Bio-CP induced greater ALP activity at 7 days, and greater mineralised nodule production, compared to Calen-ZO (p<0.05). Conclusions Bio-CP showed adequate physicochemical properties, cytocompatibility and potential to induce mineralisation.
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Affiliation(s)
- Victor Manuel Ochoa Rodríguez
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
| | - Mario Tanomaru-Filho
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
| | - Elisandra Márcia Rodrigues
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
| | - Eduarda de Oliveira Bugança
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
| | - Juliane Maria Guerreiro-Tanomaru
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
| | - Gisele Faria
- Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil
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Song G, Son JW, Jang JH, Choi SH, Jang WH, Lee BN, Park C. Comparing volumetric and biological aspects of 3D-printed interim restorations under various post-curing modes. J Adv Prosthodont 2021; 13:71-78. [PMID: 34025955 PMCID: PMC8110737 DOI: 10.4047/jap.2021.13.2.71] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/02/2021] [Accepted: 04/05/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE This study aims to compare the volumetric change, degree of conversion (DOC), and cytotoxicity of 3D-printed restorations post-cured under three different conditions. MATERIALS AND METHODS 3D-printed interim restorations were post-cured under three different conditions and systems: 5 min, 30 min, and 24 h. Three-unit and six-unit fixed dental prostheses (n = 30 for each case) were printed; ten specimens from each group were post-cured and then scanned to compare their volumetric changes. Root-mean-squared (RMS) values of the data were acquired by superimposing the scanned files with original files. Thirty disk-shaped specimens were printed to evaluate the DOC ratio. Fourier transform infrared spectroscopy was used to compare the DOCs of 10 specimens from each group. Human gingival fibroblasts were used to measure the cell viability of every specimen (n = 7). The data from this experiment were employed for one-way analysis of variance and Tukey's post-hoc comparisons. RESULTS Differences between the three-unit restorations were statistically insignificant, regardless of the post-curing conditions. However, for the six-unit restorations, a high RMS value was acquired when the post-curing duration was 30 min. The average DOC was approximately 56 - 62%; the difference between each group was statistically insignificant. All the groups exhibited cell viability greater than 70%, rendering them clinically acceptable. CONCLUSION The post-curing conditions influenced the volume when the length of the restoration was increased. However, this deviation was found to be clinically acceptable. Additionally, post-curing did not significantly influence the DOC and cytotoxicity of the restorations.
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Affiliation(s)
- Gun Song
- Department of Conservative Dentistry, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Ji-Won Son
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Ji-Hyun Jang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Sung-Hyeon Choi
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Woo-Hyung Jang
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Chan Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
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Ye M, Liu W, Yan L, Cheng S, Li X, Qiao S. 3D‑printed Ti6Al4V scaffolds combined with pulse electromagnetic fields enhance osseointegration in osteoporosis. Mol Med Rep 2021; 23:410. [PMID: 33786622 PMCID: PMC8025457 DOI: 10.3892/mmr.2021.12049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
The loosening and displacement of prostheses after dental implantation and arthroplasty is a substantial medical burden due to the complex correction surgery. Three-dimensional (3D)-printed porous titanium (pTi) alloy scaffolds are characterized by low stiffness, are beneficial to bone ingrowth, and may be used in orthopedic applications. However, for the bio-inert nature between host bone and implants, titanium alloy remains poorly compatible with osseointegration, especially in disease conditions, such as osteoporosis. In the present study, 3D-printed pTi scaffolds with ideal pore size and porosity matching the bone tissue, were combined with pulse electromagnetic fields (PEMF), an exogenous osteogenic induction stimulation, to evaluate osseointegration in osteoporosis. In vitro, external PEMF significantly improved osteoporosis-derived bone marrow mesenchymal stem cell proliferation and osteogenic differentiation on the surface of pTi scaffolds by enhancing the expression of alkaline phosphatase, runt-related transcription factor-2, osteocalcin, and bone morphogenetic protein-2. In vivo, Microcomputed tomography analysis and histological evaluation indicated the external PEMF markedly enhanced bone regeneration and osseointegration. This novel therapeutic strategy has potential to promote osseointegration of dental implants or artificial prostheses for patients with osteoporosis.
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Affiliation(s)
- Mingfu Ye
- Department of Oral Implantology, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, Fujian 361008, P.R. China
| | - Wenjun Liu
- Department of Oral Implantology, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, Fujian 361008, P.R. China
| | - Lihui Yan
- Department of Oral Implantology, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, Fujian 361008, P.R. China
| | - Shaolong Cheng
- Department of Oral Implantology, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, Fujian 361008, P.R. China
| | - Xiaoxiong Li
- Department of Pain, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201112, P.R. China
| | - Shichong Qiao
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P.R. China
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Li J, Wang S, Dong Y. Regeneration of pulp-dentine complex-like tissue in a rat experimental model under an inflammatory microenvironment using high phosphorous-containing bioactive glasses. Int Endod J 2021; 54:1129-1141. [PMID: 33657647 DOI: 10.1111/iej.13505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
AIM To investigate the effects of a bioactive glass with a high proportion of phosphorus (BG-hP) on the repair and regeneration of dental pulps in rats under an inflammatory microenvironment. METHODOLOGY Human dental pulp cells (hDPCs) stimulated with 1 μg mL-1 lipopolysaccharide (LPS) were co-cultured with 0.1 mg mL-1 BG-hP. Cell proliferation was detected by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT) assays. The expression of inflammation-related genes and odontogenic differentiation-related genes was determined by real-time PCR. Alizarin red staining was used to detect the formation of mineralized nodules. Coronal pulp tissues of rat molars were stimulated with 10 mg mL-1 LPS and then treated with BG-hP. The expression of inflammation-related genes in pulp tissue was determined by real-time PCR. Haematoxylin-eosin staining and Masson staining were performed to observe the inflammatory response and mineralized matrix formation, after subcutaneous implantation in nude mice, at 3 days and 4 weeks, respectively. Analysis of variance was performed to measure statistical significance (P < 0.05). RESULTS BG-hP significantly reduced expression of interleukin-6 (IL-6) and IL-8 and significantly upregulated the expression of IL-10, IL-4 and transforming growth factor-β1 of the LPS-stimulated hDPCs (P < 0.05). BG-hP significantly inhibited the initial cell number (P < 0.05), but the hDPCs stimulated by LPS and co-cultured with BG-hP maintained the same proliferation rate as the untreated hDPCs. BG-hP significantly promoted the expression of dentine matrix protein-1 and dentine sialophosphoprotein and the mineralization capacity of the LPS-stimulated hDPCs (P < 0.05). Furthermore, BG-hP significantly downregulated the expression of Il-6 and reduced the inflammatory response of the LPS-stimulated pulp tissue 3 days after subcutaneous implantation (P < 0.05). Four weeks after subcutaneous implantation, BG-hP induced the formation of a continuous layer of dentine-like structure with dentinal tubules and polarizing odontoblast-like cells aligned along it in the LPS-stimulated pulp tissue. CONCLUSION The present preliminarily results demonstrated that the bioactive glass with a high proportion of phosphorus inhibited the inflammatory response and promoted the formation of a pulp-dentine complex in a rat experimental model. This study provides a foundation for the construction of materials with the dual functions of exerting anti-inflammatory effects and promoting tissue regeneration to meet the needs of dental pulp repair and regeneration.
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Affiliation(s)
- J Li
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - S Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Y Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
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Guerreiro JCM, Ochoa-Rodrígez VM, Rodrigues EM, Chavez-Andrade GM, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Faria G. Antibacterial activity, cytocompatibility and effect of Bio-C Temp bioceramic intracanal medicament on osteoblast biology. Int Endod J 2021; 54:1155-1165. [PMID: 33638900 DOI: 10.1111/iej.13502] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/13/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
AIM To analyse the antimicrobial and biological properties of a new bioceramic intracanal medicament (Bio-C Temp), and to compare it with two calcium hydroxide-based intracanal medicaments (Calen® and UltraCal® XS). METHODOLOGY The direct contact and the crystal violet tests were performed to assess the antimicrobial activity of intracanal medicaments against Enterococcus faecalis. The cytocompatibility and the effect of the medication on the biology of the human osteoblast-like cell line (Saos-2) were evaluated with methylthiazole tetrazolium (MTT), neutral red, alkaline phosphatase activity and mineralization (alizarin red) assays. The data were analysed using one-way anova and Tukey's tests, two-way anova and Bonferroni's tests, or Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS Bio-C Temp had significantly less antibacterial activity and biofilm biomass reduction than the other intracanal medicaments (P < 0.05). There was no difference in the viability of Saos-2 exposed to the various intracanal medicaments, except regarding the 1 : 2 dilution, when the Bio-C Temp group had significantly lower cell viability than the UltraCal® XS and Calen® groups (P < 0.05). Bio-C Temp induced significantly greater ALP activity than the other intracanal medicaments (P < 0.05) at day 1. Calen® induced significantly greater deposition of mineralized nodules than the other intracanal medicaments (P < 0.05), and no difference was observed between Bio-C Temp and UltraCal® XS (P > 0.05). CONCLUSIONS Bio-C Temp had similar cytocompatibility at higher dilutions, and higher or similar induction of ALP activity and deposition of mineralized nodules in comparison with Calen® and UltraCal® XS. However, it had significantly less antibacterial and antibiofilm activity than Calen® and UltraCal® XS.
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Affiliation(s)
- J C M Guerreiro
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil.,Araraquara School of Pharmaceutical Sciences, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - V M Ochoa-Rodrígez
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - E M Rodrigues
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - G M Chavez-Andrade
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - M Tanomaru-Filho
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
| | - G Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, Araraquara, São Paulo, Brazil
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Effects of Ultrasonic Activation on Root Canal Filling Quality of Single-Cone Obturation with Calcium Silicate-Based Sealer. MATERIALS 2021; 14:ma14051292. [PMID: 33800442 PMCID: PMC7962949 DOI: 10.3390/ma14051292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/29/2022]
Abstract
Background: We evaluated the effects of ultrasonic activation on root canal filling quality of the single-cone (SC) obturation technique with calcium silicate sealers and gutta percha cones. Methods: Thirty-six human single-rooted premolars were obturated with gutta percha and sealer. For the continuous wave (CW) group (n = 12), AH Plus with a continuous wave technique was used. The SC group (n = 12) received EndoSequence BC sealer with a single-cone technique. The SCU (SC with the addition of ultrasonic activation) group (n = 12) received the same treatment. Micro-computed tomography was used to scan the teeth, and the void volume within the root canal was evaluated at the apical, middle, and coronal levels. Then cross-sections were observed under a light microscope and scanning electron microscope (SEM). Results: Void volume was significantly lower in the SCU group than in the CW and SC groups. There were no statistically significant differences between the CW and SC groups. The SCU group had fewer voids than the CW and SC groups in the coronal and middle third areas. Specimens showed no apparent gaps or voids in any group. SEM images revealed both gap-free and gap-containing regions at different levels in all groups. Conclusions: Single-cone obturation with calcium silicate-based sealers might obtain enhanced filling quality when used with ultrasonic activation.
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Ma R, Li Y, Wang J, Yang P, Wang K, Wang W. Incorporation of nanosized calcium silicate improved osteointegration of polyetheretherketone under diabetic conditions. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:98. [PMID: 33130931 DOI: 10.1007/s10856-020-06435-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
Diabetes can impair osteoblastic functions and negatively interfere with osteointegration at the bone/implant interface. Previously, we prepared a nanosized calcium silicate (CS) incorporated-polyetheretherketone (PK) biocomposite (CS/PK) and found that the CS/PK composite exhibited enhanced osteoblast functions in vitro and osteointegration in vivo, but its bioperformance under diabetic conditions remained elusive. In this study, MC3T3-E1 cells incubated on CS/PK and PK samples were subjected to diabetic serum (DS) and normal serum (NS); cell attachment, morphology, spreading, proliferation, and osteogenic differentiation were compared to assess in vitro osteoblastic functions on the surfaces of different materials. An in vivo test was performed on diabetic rabbits implanted with CS/PK or PK implants into the cranial bone defect to assess the osteointegration ability of the implants. In vitro results showed that diabetes inhibited osteoblastic functions evidenced by impaired morphology and spreading, and decreased attachment, proliferation, and osteogenic differentiation compared with the findings under normal conditions. Notably, CS/PK ameliorated osteoblastic disfunction under diabetic conditions in vitro. In vivo results from micro-CT and histologic examinations revealed that rabbits with CS/PK implants exhibited improved osteointegration at the bone/implant interface under diabetic conditions compared with PK. Therefore, the CS/PK composite improved the impaired osteointegration induced by diabetes and is a promising orthopedic or craniofacial implant material that may obtain good clinical performance in diabetic patients.
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Affiliation(s)
- Rui Ma
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China
| | - Yongwei Li
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China
| | - Jialin Wang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China
| | - Pei Yang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China
| | - Kunzheng Wang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China.
| | - Wei Wang
- Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China.
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Aslan T, Dönmez Özkan H. The effect of two calcium silicate-based and one epoxy resin-based root canal sealer on postoperative pain: a randomized controlled trial. Int Endod J 2020; 54:190-197. [PMID: 32929721 DOI: 10.1111/iej.13411] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/08/2020] [Indexed: 12/27/2022]
Abstract
AIM To compare the effect of two calcium silicate-based (Endoseal MTA and EndoSequence BC Sealer) and an epoxy resin-based (AH Plus) root canal sealer on postoperative pain following single-visit root canal treatment on molar teeth. METHODOLOGY Patients (n = 90) having one first or second molar tooth diagnosed with asymptomatic irreversible pulpitis were randomly divided into three groups according to the sealer used (n = 30) and were treated by two endodontists having at least 10 years of experience. All patients received a single-visit root canal treatment. After the treatments, postoperative pain scores and analgesic intake were recorded at 6, 12, 24 and 48 h, and 3, 4, 5, 6 and 7 days. The data were analysed statistically using non-parametric Kruskal-Wallis tests (for the comparisons of the age and VAS scores), Friedman tests (for the assessments of the changes in pain scores over time), chi-squared tests (for the comparisons of categorical variables) and Spearman's correlation test (for the correlation assessments of the age and gender factors with postoperative pain; α = 0.05). RESULTS There were no significant differences amongst the groups in terms of postoperative pain at any time-points assessed (P > 0.05) nor for analgesic intake of patients amongst the groups (P > 0.05). Analgesic intake decreased significantly after 12 h in all groups (P < 0.05). CONCLUSIONS The sealers tested in this study were associated with similar levels of postoperative pain and were associated with a similar intake of analgesics.
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Affiliation(s)
- T Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - H Dönmez Özkan
- Department of Endodontics, Faculty of Dentistry, Aydın Adnan Menderes University, Efeler, Turkey
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Baghdadi I, Zaazou A, Tarboush B, Zakhour M, Özcan M, Salameh Z. Physiochemical properties of a bioceramic-based root canal sealer reinforced with multi-walled carbon nanotubes, titanium carbide and boron nitride biomaterials. J Mech Behav Biomed Mater 2020; 110:103892. [DOI: 10.1016/j.jmbbm.2020.103892] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
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Kuramoto M, Kawashima N, Tazawa K, Nara K, Fujii M, Noda S, Hashimoto K, Nozaki K, Okiji T. Mineral trioxide aggregate suppresses pro-inflammatory cytokine expression via the calcineurin/nuclear factor of activated T cells/early growth response 2 pathway in lipopolysaccharide-stimulated macrophages. Int Endod J 2020; 53:1653-1665. [PMID: 32767860 DOI: 10.1111/iej.13386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/27/2020] [Accepted: 08/04/2020] [Indexed: 11/27/2022]
Abstract
AIM To elucidate mechanisms by which mineral trioxide aggregate (MTA) suppresses pro-inflammatory cytokine mRNA expression in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages. METHODOLOGY Mineral trioxide aggregate extracts were prepared by immersing set ProRoot MTA in culture medium. RAW264.7 cells were cultured in the presence of LPS and MTA extracts. mRNA expression levels of interleukin (IL)-1α, IL-6, early growth response 2 (Egr2), suppressor of cytokine signalling 3 (Socs3) and IL-10 were quantified with reverse transcription-quantitative polymerase chain reaction. Phosphorylation of nuclear factor-kappa B (NF-κB) p65 in RAW264.7 cells was analysed by Western blotting. Intracellular calcium imaging was performed with Fluo-4 AM. The activity of nuclear factor of activated T cells (NFAT) was determined by luciferase assays. Enforced expression and silencing of Egr2 in RAW264.7 cells were carried out using an expression vector and specific RNAi, respectively. In vivo kinetics of Egr2+ cells in MTA-treated rat molar pulp tissues were examined using immunohistochemistry. Data were analysed by one-way analysis of variance, followed by the Tukey-Kramer test (P < 0.05). RESULTS Exposure to MTA extracts resulted in reduced mRNA expression levels of IL-1α and IL-6, as well as reduced expression of phosphorylated NF-κB, in LPS-stimulated RAW264.7 cells. Exposure to MTA extracts induced Ca2+ influx, which was blocked by NPS2143, an antagonist of calcium-sensing receptor (CaSR); Ca2+ influx then triggered activation of calcineurin/NFAT signalling and enhanced mRNA expression of Egr2. Enforced expression of Egr2 in RAW264.7 cells promoted the expression of both IL-10 and Socs3. In vivo application of MTA onto rat molar pulp tissue resulted in the appearance of Egr2-expressing cells that coexpressed CD163, a typical M2 macrophage marker. CONCLUSIONS Mineral trioxide aggregate extracts induced downregulation of IL-1α and IL-6 in LPS-stimulated RAW264.7 cells via CaSR-induced activation of calcineurin/NFAT/Egr2 signalling and subsequent upregulation of IL-10 and Socs3.
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Affiliation(s)
- M Kuramoto
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - N Kawashima
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - K Tazawa
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - K Nara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - M Fujii
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - S Noda
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - K Hashimoto
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - K Nozaki
- Department of Restorative Sciences, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - T Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Lim M, Jung C, Shin DH, Cho YB, Song M. Calcium silicate-based root canal sealers: a literature review. Restor Dent Endod 2020; 45:e35. [PMID: 32839716 PMCID: PMC7431927 DOI: 10.5395/rde.2020.45.e35] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/23/2022] Open
Abstract
Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.
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Affiliation(s)
- Miyoung Lim
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chanyong Jung
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Yong-bum Cho
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
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Sun X, Sun A, Jia X, Jin S, Zhang D, Xiao K, Wang Q. In vitro bioactivity of AH plus with the addition of nano-magnesium hydroxide. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:313. [PMID: 32355757 PMCID: PMC7186602 DOI: 10.21037/atm.2020.02.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background AH Plus (AH) has been widely used as a root canal sealer in the endodontic field due to its superior physicochemical properties. However, clinical application of AH is limited due to its weak bioactivity. Methods In this study, we have developed an AH cement containing nano-magnesium hydroxide (NMH) as an additive to enhance the bioactivity of AH. The NMH can neutralize pH and facilitate bone formation. The objective of this study was to evaluate the effects of NMH and modified AH on osteoblasts behavior in vitro. The CCK-8, alkaline phosphatase (ALP) staining, and real-time polymerase chain reaction (PCR) assays were used to assess the proliferation and differentiation of MC3T3-E1 cells, respectively. The adhesion and spreading of MC3T3-E1 cells were investigated in vitro by scanning electron microscopy (SEM). Meanwhile, the flow and magnesium ion release of the modified AH was also concerned. Results In vitro cell assays further showed that the addition of NMH into AH cement, which was denoted as modified AH (especially AH+3%NMH), could effectively improve the proliferation and osteogenic differentiation of MC3T3-E1 cells. Conclusions Taken all together, we believe that the modified AH samples (especially AH+3%NMH) have outstanding biocompatibility and osteogenic properties and may have great potential in endodontic field.
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Affiliation(s)
- Xiujuan Sun
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Aoteng Sun
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Xingya Jia
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Shi Jin
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Dan Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China.,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang 110002, China
| | - Keshen Xiao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110002, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China.,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang 110002, China
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Bai H, Zhao Y, Wang C, Wang Z, Wang J, Liu H, Feng Y, Lin Q, Li Z, Liu H. Enhanced osseointegration of three-dimensional supramolecular bioactive interface through osteoporotic microenvironment regulation. Theranostics 2020; 10:4779-4794. [PMID: 32308749 PMCID: PMC7163459 DOI: 10.7150/thno.43736] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/10/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose: Osteoporosis is more likely to cause serious complications after joint replacement, mainly due to physiological defects of endogenous osteogenic cells and the pathological osteoclast activity. It is a feasible solution to design a prosthetic surface interface that specifically addresses this troublesome situation. Methods: A novel "three-dimensional (3D) inorganic-organic supramolecular bioactive interface" was constructed consisting of stiff 3D printing porous metal scaffold and soft multifunctional, self-healable, injectable, and biodegradable supramolecular polysaccharide hydrogel. Apart from mimicking the bone extracellular matrix, the bioactive interface could also encapsulate bioactive substances, namely bone marrow mesenchymal stem cells (BMSCs) and bone morphogenetic protein-2 (BMP-2). A series of in vitro characterizations, such as topography and mechanical characterization, in vitro release of BMP-2, biocompatibility analysis, and osteogenic induction of BMSCs were carried out. After that, the in vivo osseointegration effect of the bioactive interface was investigated in detail using an osteoporotic model. Results: The administration of injectable supramolecular hydrogel into the inner pores of 3D printing porous metal scaffold could obviously change the morphology of BMSCs and facilitate its cell proliferation. Meanwhile, BMP-2 was capable of being sustained released from supramolecular hydrogel, and subsequently induced osteogenic differentiation of BMSCs and promoted the integration of the metal microspores-bone interface in vitro and in vivo. Moreover, the osteoporosis condition of bone around the bioactive interface was significantly ameliorated. Conclusion: This study demonstrates that the 3D inorganic-organic supramolecular bioactive interface can serve as a novel artificial prosthesis interface for various osteogenesis-deficient patients, such as osteoporosis and rheumatoid arthritis.
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Affiliation(s)
- Haotian Bai
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Orthopaedic Research Institute of Jilin Province, Changchun 130041, P. R. China
| | - Yue Zhao
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, P. R. China
| | - Chenyu Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Department of Plastic and Reconstruct Surgery, The First Bethune Hospital of Jilin University, Changchun 130021, P. R. China
| | - Zhonghan Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Orthopaedic Research Institute of Jilin Province, Changchun 130041, P. R. China
| | - Jincheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Orthopaedic Research Institute of Jilin Province, Changchun 130041, P. R. China
| | - Hou Liu
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, P. R. China
| | - Yubin Feng
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, P. R. China
| | - Quan Lin
- State Key Lab of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun 130012, P. R. China
| | - Zuhao Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Orthopaedic Research Institute of Jilin Province, Changchun 130041, P. R. China
- Department of Pain, Renji Hospital, South Campus, Shanghai Jiaotong University, Shanghai 201112, P. R. China
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
- Orthopaedic Research Institute of Jilin Province, Changchun 130041, P. R. China
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In Vitro Effect of Putty Calcium Silicate Materials on Human Periodontal Ligament Stem Cells. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10010325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
New bioactive materials have been developed for retrograde root filling. These materials come into contact with vital tissues and facilitate biomineralization and apical repair. The objective of this study was to evaluate the cytocompatibility and bioactivity of two bioactive cements, Bio-C Repair (Angelus, Londrina, Pr, Brazil) and TotalFill BC RRM putty (FGK, Dentaire SA, La-Chaux-de-fonds, Switzerland). The biological properties in human periodontal ligament stem cells (hPDLSCs) that were exposed to Bio-C Repair and TotalFill BC RRM putty were studied. Cell viability, migration, and cell adhesion were analyzed. Moreover, qPCR and mineralization assay were performed to evaluate the bioactivity potential of these cements. The results were statistically analyzed using ANOVA and the Tukey test (p < 0.05). It was observed that cell viability and cell migration in Bio-C Repair and TotalFill BC RRM putty were similar to the control without statistically significant differences, except at 72 h when TotalFill BC RRM putty was slightly lower (p < 0.05). Excellent cell adhesion and morphology were observed with both Bio-C Repair and TotalFill BC RRM putty. Both cements promoted the osteo- and cementogenic differentiation of hPDLSCs. These results suggest that Bio-C Repair and TotalFill BC RRM putty are biologically appropriate materials to be used as retrograde obturation material.
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