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Bjørndal L, Simon S, Tomson PL, Duncan HF. Management of deep caries and the exposed pulp. Int Endod J 2019; 52:949-973. [PMID: 30985944 DOI: 10.1111/iej.13128] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/10/2019] [Indexed: 01/12/2023]
Abstract
Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one-visit as indirect pulp treatment or two-visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re-emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp-dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence-based management strategies and education in management of the exposed pulp are critical in the future.
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Affiliation(s)
- L Bjørndal
- Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Simon
- Paris Diderot University, Paris, France.,Hôpital de Rouen Normandie, Rouen, France.,Laboratoire IN SERM UMR 1138, Paris, France
| | - P L Tomson
- School of Dentistry, Institute of Clinical Sciences, Birmingham, UK
| | - H F Duncan
- Division of Restorative Dentistry & Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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52
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Medina-Fernandez I, Celiz AD. Acellular biomaterial strategies for endodontic regeneration. Biomater Sci 2019; 7:506-519. [PMID: 30569918 DOI: 10.1039/c8bm01296b] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Dental decay is treated by removing infected dental tissues such as dentine and restoring the tooth with a material. However, the vast majority of these materials have been designed to be mechanically robust and bioinert, whereas the potential regenerative properties of a biomaterial have not been considered. In endodontics for example, materials are used to seal the pulp cavity to avoid bacterial colonisation of the tooth and prevent further infection. While these treatments are effective in the short term, many of these materials have not been designed to interface with the pulp tissue in a biocompatible manner and are often cytotoxic. This can lead to less favourable long-term outcomes such as devitalisation of the tooth via root-canal therapy or extraction of the tooth. Clinical outcomes could be improved if regenerative approaches were followed whereby the biology of the tooth is engineered for repair and regeneration often with the support of a biomaterial. Within these, acellular or cell homing approaches are particularly interesting, as some regulatory hurdles associated with cellular therapies could be circumvented which may aid their clinical translation. In this review, we highlight progress in regenerative dentistry and focus on exciting developments using acellular biomaterials for regenerating dental tissues.
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53
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Shotgun Proteomics of Human Dentin with Different Prefractionation Methods. Sci Rep 2019; 9:4457. [PMID: 30872775 PMCID: PMC6418255 DOI: 10.1038/s41598-019-41144-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/28/2019] [Indexed: 01/08/2023] Open
Abstract
Human dentin is not only a composite material of a collagenous matrix and mineral to provide strength and elasticity to teeth, but also a precious reservoir full of bioactive proteins. They are released after demineralization caused by bacterial acids in carious lesions, by decalcifying irrigants or dental materials and they modulate tissue responses in the underlying dental pulp. This work describes a first-time analysis of the proteome of human dentin using a shotgun proteomic approach that combines three different protein fractionation methods. Dentin matrix proteins were extracted by EDTA and separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), OFFGEL isoelectric focusing (IEF) or strong cation exchange chromatography (SCX). Liquid chromatography tandem mass spectrometry (LC-MS/MS) identified 813 human proteins with high confidence, however, isoelectric focusing turned out to be the most beneficial prefractionation method. All Proteins were categorized based on the PANTHER system and representation analysis revealed 31 classes and subclasses to be overrepresented. The acquired knowledge provides a comprehensive insight into the number of proteins in human dentin as well as their physiological and pathological functions. Thus, the data presented paves the way to the analysis of specific functions of dentin matrix proteins in vivo and their potential in tissue engineering approaches to regenerate dental pulp.
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54
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Austah O, Widbiller M, Tomson PL, Diogenes A. Expression of Neurotrophic Factors in Human Dentin and Their Regulation of Trigeminal Neurite Outgrowth. J Endod 2019; 45:414-419. [PMID: 30771898 DOI: 10.1016/j.joen.2018.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Neurotrophic factors play a significant role in the innervation of the pulp-dentin complex during and after organogenesis. There have been numerous bioactive molecules identified in the dentin extracellular matrix; however, the expression of neurotrophic factors in the dentin matrix and their biological activity are largely unknown. The purpose of this study was to characterize the relative expression of neurotrophic factors in human dentin matrix proteins (DMPs) and their effect on neurite outgrowth of trigeminal (TG) neurons. METHODS Dentin was powdered in liquid nitrogen from noncarious human third molar teeth. DMPs were solubilized through an EDTA extraction method, dialyzed, and lyophilized until use. The relative expression of nerve growth factor, brain-derived neurotrophic factor, glial cell-line derived neurotrophic factor, neurotrophin 3, and neurotrophin 4/5 was determined by the enzyme-linked immunosorbent assay. Rat TG neurons were cultured and exposed to different concentrations of DMPs (1-105 ng/mL) or vehicle, and a quantitative neurite outgrowth assay was performed. RESULTS Human DMPs contained all of the tested neurotrophic factors, with glial cell-line derived neurotrophic factor and neurotrophin 4/5 found at the highest levels. DMPs were able to promote the neurite outgrowth of rat TG neurons at an optimum concentration of 10-102 ng/mL, whereas the effect was partially inhibited at higher concentrations (>103 ng/mL). CONCLUSIONS The human dentin extracellular matrix is a rich reservoir for neurotrophic factors that are key components for neuronal homeostasis, differentiation, and regeneration. These data suggest that neurotrophins in DMPs could play an important role as signaling molecules for the innervation of the pulp-dentin complex during the processes of tooth formation, repair, and regeneration.
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Affiliation(s)
- Obadah Austah
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Matthias Widbiller
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Conservative Dentistry and Periodontology, University Hospital, Regensburg, Germany
| | - Phillip L Tomson
- Department of Oral Biology, Institute of Clinical Sciences, The University of Birmingham School of Dentistry, Birmingham, UK
| | - Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
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55
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Petridis X, Beems BP, Tomson PL, Scheven B, Giepmans BNG, Kuipers J, van der Sluis LWM, Harmsen MC. Effect of Dentin Matrix Components on the Mineralization of Human Mesenchymal Stromal Cells. Tissue Eng Part A 2018; 25:1104-1115. [PMID: 30444193 DOI: 10.1089/ten.tea.2018.0192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPACT STATEMENT This research has been conducted with the aim to contribute to the development of treatment modalities for the reconstruction of lost/damaged mineralized tissues. Currently, determining the most appropriate stromal cell population and signaling cues stands at the core of developing effective treatments. We provide new insights into the effect of innate inductive cues found in human dentin matrix components, on the osteogenic differentiation of various human stromal cell types. The effects of dentin extracellular matrix components on umbilical cord mesenchymal stromal cells have not been investigated before. The findings of this study could underpin translational research based on the development of techniques for mineralized tissue engineering and will be of great interest for the readership of Tissue Engineering Part A.
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Affiliation(s)
- Xenos Petridis
- 1Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bas P Beems
- 1Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Phillip L Tomson
- 2School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ben Scheven
- 2School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ben N G Giepmans
- 3Department of Cell Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jeroen Kuipers
- 3Department of Cell Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Luc W M van der Sluis
- 1Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin C Harmsen
- 4Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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56
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Braga RR. Calcium phosphates as ion-releasing fillers in restorative resin-based materials. Dent Mater 2018; 35:3-14. [PMID: 30139530 DOI: 10.1016/j.dental.2018.08.288] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 01/30/2023]
Abstract
Calcium phosphates (CaP) are the main constituents of the mineral phase in bones and teeth and, along with calcium silicates and bioactive glasses, have been extensively investigated in remineralization of enamel and dentin. When used as ion-releasing fillers in resin-based materials, they could contribute to extend the service life of adhesive restorations, remineralize caries-affected dentin or prevent caries lesions under sealants and orthodontic brackets. However, the development of resin-based bioactive materials is not straightforward because of the several compositional variables involved in ion release. Also, CaP particles do not reinforce the material; therefore, if high mechanical properties are required, the ratio between CaP particles and reinforcing fillers must be observed. Several research groups have investigated how CaP phase, particle size and content, as well as resin matrix formulation affect remineralization, ion release kinetics and mechanical properties of these materials. This review presents an overview of the main findings reported in the literature.
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Affiliation(s)
- Roberto Ruggiero Braga
- Department of Biomaterials and Oral Biology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227 São Paulo, SP 05508-000, Brazil.
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57
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da Rosa WLO, Piva E, da Silva AF. Disclosing the physiology of pulp tissue for vital pulp therapy. Int Endod J 2018; 51:829-846. [DOI: 10.1111/iej.12906] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 01/30/2018] [Indexed: 12/23/2022]
Affiliation(s)
- W. L. O. da Rosa
- Department of Restorative Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - E. Piva
- Department of Restorative Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - A. F. da Silva
- Department of Restorative Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
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58
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Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J 2018; 51:819-828. [DOI: 10.1111/iej.12903] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/29/2018] [Indexed: 12/20/2022]
Affiliation(s)
- N. A. Taha
- Department of Conservative Dentistry; Jordan University of Science and Technology; Irbid Jordan
| | - S. Z. Abdelkhader
- Department of Conservative Dentistry; Jordan University of Science and Technology; Irbid Jordan
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59
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Widbiller M, Eidt A, Wölflick M, Lindner SR, Schweikl H, Hiller KA, Buchalla W, Galler KM. Interactive effects of LPS and dentine matrix proteins on human dental pulp stem cells. Int Endod J 2018; 51:877-888. [PMID: 29377169 DOI: 10.1111/iej.12897] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/20/2018] [Indexed: 12/14/2022]
Abstract
AIM To investigate the combinatorial effects of lipopolysaccharide (LPS) and extracted dentine matrix proteins (eDMP) on regenerative and inflammatory responses in human dental pulp stem cells (DPSCs). METHODOLOGY Culture media were supplemented with several concentrations of LPS, eDMP and combinations of both. Cell viability was assessed over 1 week by MTT assay; cell survival was evaluated after 24 h and 7 days by flow cytometry. The expression of mineralization-associated marker genes was determined by real-time quantitative polymerase chain reaction (RT-qPCR). To analyse the inflammatory response, secretion of interleukin 6 (IL-6) was quantified in the initial and the late phase of cell culture by enzyme-linked immunosorbent assay (ELISA). Data were treated nonparametrically and Mann-Whitney U-tests were performed to compare all experimental groups (α = 0.05). RESULTS Whereas LPS had no impact on viability, eDMP led to a concentration-dependent decrease, which was significant after 7 days (P ≤ 0.024). A moderate decline of cell survival induced by LPS was detected after 48 h (P ≤ 0.026), whereas eDMP was able to reverse this effect. eDMP alone caused increased expression of tested marker genes, LPS had no regulatory effect. Combined eDMP and LPS induced an upregulation of collagen type I and osteocalcin, whereas expression levels of dentine matrix acidic phosphoprotein and dentine sialophosphoprotein were similar to the control. IL-6-secretion was increased by LPS over time. eDMP markedly elevated initial production of IL-6 (P ≤ 0.002), but suppressed LPS-induced cytokine production in the later phase. CONCLUSIONS Lipopolysaccharide did not affect cell viability but interfered with odontoblast-like cell differentiation of DPSCs. Proteins from the dentine matrix may have a protective effect, attenuate the detrimental impact of LPS and thus play an important role during pulp repair.
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Affiliation(s)
- M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - A Eidt
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - M Wölflick
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - S R Lindner
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - H Schweikl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K M Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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60
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Biological response to self-etch adhesive after partial caries removal in rats. Clin Oral Investig 2018; 22:2161-2173. [PMID: 29380132 DOI: 10.1007/s00784-017-2303-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 12/07/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The purposes of this study were to evaluate a model of slow caries progression and to investigate the performance of a self-etch adhesive system for partial caries removal. MATERIALS AND METHODS Rat molars were infected with Streptococcus sobrinus 6715 culture. Different time points were analyzed: days 78, 85, and 95 (± 2). After this, the samples were processed for morphological analysis. Additionally, the first molars were restored with zinc oxide and eugenol (IRM™; Dentsply; Brazil) or adhesive system (Clearfil SE Bond™; Kuraray Medical; Japan) 78 days after caries induction. After, 3 or 15 days post-treatment, the animals were euthanized, and their mandibles were processed for morphological analysis, classified by means of scores, and submitted to statistical analysis. Subsequently, immunohistochemical analysis was performed for osteonectin (OSN) and transforming growth factor-ß1 (TGF-ß1) expression. RESULTS According to the caries induction model used, on day 95 greater inflammatory infiltration (p < 0.001), and more extensive degradation of secondary/primary dentin were demonstrated than on day 78 (p < 0.05). Furthermore, the restorative materials presented similar performance (p > 0.05) and proved to be fundamental to control the carious lesion. The TGF-ß1 and OSN were shown to be active during the caries process. CONCLUSIONS The slow caries lesion model was feasible for morphological analysis of the dentin-pulp complex. The self-etch adhesive system triggered no acute inflammatory infiltration or pulp necrosis, instead it seemed to stimulate early pulp repair. CLINICAL RELEVANCE Clearfil SE Bond™ applied directly on caries-affected dentin did not predispose to pulp inflammation; instead, it appeared to provide early biological benefits.
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61
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Huang XQ, Camba J, Gu LS, Bergeron BE, Ricucci D, Pashley DH, Tay FR, Niu LN. Mechanism of bioactive molecular extraction from mineralized dentin by calcium hydroxide and tricalcium silicate cement. Dent Mater 2017; 34:317-330. [PMID: 29179973 DOI: 10.1016/j.dental.2017.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/10/2017] [Accepted: 11/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of the present study was to elucidate the mechanism of bioactive molecule extraction from mineralized dentin by calcium hydroxide (Ca(OH)2) and tricalcium silicate cements (TSC). METHODS AND RESULTS Transmission electron microscopy was used to provide evidence for collagen degradation in dentin surfaces covered with Ca(OH)2 or a set, hydrated TSC for 1-3 months. A one micron thick collagen degradation zone was observed on the dentin surface. Fourier transform-infrared spectroscopy was used to identify increases in apatite/collagen ratio in dentin exposed to Ca(OH)2. Using three-point bending, dentin exposed to Ca(OH)2 exhibited significant reduction in flexural strength. Using size exclusion chromatography, it was found that the small size of the hydroxyl ions derived from Ca(OH)2 enabled those ions to infiltrate the intrafibrillar compartment of mineralized collagen and degrade the collagen fibrils without affecting the apatite minerals. Using ELISA, TGF-β1 was found to be extracted from dentin covered with Ca(OH)2 for 3 months. Unlike acids that dissolve the mineral component of dentin to release bioactive molecules, alkaline materials such as Ca(OH)2 or TSC released growth factors such as TGF-β1 via collagen degradation. SIGNIFICANCE The bioactive molecule extraction capacities of Ca(OH)2 and TSC render these dental materials excellent for pulp capping and endodontic regeneration. These highly desirable properties, however, appear to be intertwined with the untoward effect of degradation of the collagen matrix within mineralized dentin, resulting in reduced flexural strength.
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Affiliation(s)
- Xue-Qing Huang
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - John Camba
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Li-Sha Gu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Brian E Bergeron
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - David H Pashley
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
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62
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Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M, Stangvaltaite L, van der Sluis LWM. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J 2017; 50:825-829. [DOI: 10.1111/iej.12793] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- W. J. Wolters
- Center of Dentistry and Oral Hygiene; University Medical Center Groningen; Groningen The Netherlands
| | - H. F. Duncan
- Division of Restorative Dentistry & Periodontology; Dublin Dental University Hospital; Trinity College Dublin; Dublin Ireland
| | - P. L. Tomson
- College of Medical & Dental Sciences; The University of Birmingham School of Dentistry; Birmingham UK
| | - I. E. Karim
- Centre for Dentistry; School of Medicine; Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| | - G. McKenna
- Centre for Public Health; Queens University Belfast; Belfast UK
| | - M. Dorri
- School of Oral and Dental Sciences; Bristol Dental School; Bristol UK
| | - L. Stangvaltaite
- Department of Clinical Dentistry; Faculty of Health Sciences; UiT The Arctic University of Norway; Tromsø Norway
| | - L. W. M. van der Sluis
- Center of Dentistry and Oral Hygiene; University Medical Center Groningen; Groningen The Netherlands
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63
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Nikfarjam F, Beyer K, König A, Hofmann M, Butting M, Valesky E, Kippenberger S, Kaufmann R, Heidemann D, Bernd A, Zöller NN. Influence of Biodentine® - A Dentine Substitute - On Collagen Type I Synthesis in Pulp Fibroblasts In Vitro. PLoS One 2016; 11:e0167633. [PMID: 27936042 PMCID: PMC5147936 DOI: 10.1371/journal.pone.0167633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/17/2016] [Indexed: 12/15/2022] Open
Abstract
Preserving a patient’s own teeth—even in a difficult situation—is nowadays preferable to surgical intervention and therefore promotes development of suitable dental repair materials. Biodentine®, a mineral trioxide aggregate substitute, has been used to replace dentine in a bioactive and biocompatible manner in both the dental crown and the root. The aim of our study was to evaluate the influence of Biodentine® on pulp fibroblasts in vitro. For this study, one to five Biodentine® discs with a diameter of 5.1mm were incubated in DMEM. To obtain Biodentine® suspensions the media were collected and replaced with fresh medium every 24h for 4 days. Primary pulp cells were isolated from freshly extracted wisdom teeth of 20–23 year old patients and incubated with the Biodentine® suspensions. Proliferation, cell morphology, cell integrity and cell viability were monitored. To evaluate the effect of Biodentine® on collagen type I synthesis, the secretion of the N-terminal domain of pro-collagen type I (P1NP) and the release of transforming growth factor-β1 (TGF-β1) were quantified. None of the Biodentine® suspensions tested influenced cell morphology, proliferation or cell integrity. The cell viability varied slightly depending on the suspension used. However, the concentrations of P1NP of all pulp fibroblast cultures treated for 24h with the moderate to high Biodentine® concentration containing suspensions of day 1 were reduced to 5% of the control. Furthermore, a significant TGF-β1 reduction was observed after treatment with these suspensions. It could be shown that Biodentine® is biocompatible. However, dissolved particles of the moderate to high concentrated Biodentine® suspensions 24h after mixing induce a significant reduction of TGF-β1 release and reduce the secretion of collagen type I of primary pulp fibroblasts.
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Affiliation(s)
- Frangis Nikfarjam
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Kim Beyer
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Anke König
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Matthias Hofmann
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Manuel Butting
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Eva Valesky
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Stefan Kippenberger
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Detlef Heidemann
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - August Bernd
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Nadja Nicole Zöller
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
- * E-mail:
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