Root-end Filling Materials Alter Fibroblast Differentiation

Use of microarrays to find novel regulators of periodontal ligament fibroblast differentiation

Periodontal regeneration requires the coordinated movement and differentiation of several cell types in order to re-establish the cementum, periodontal ligament (PDL), and alveolar bone. Cells in culture are often used as model systems for mature tissues, although they may represent expanded progenitor cell populations. Comparison of transcript expression between fresh PDL tissue and PDL cell isolates by MicroArray analysis has revealed numerous molecular differences. Several transcripts (including alkaline phosphatase, bone sialoprotein, periostin, and fibromodulin) are expressed at higher levels in fresh PDL than in cultured PDL cells. In contrast, PDL cells in culture selectively express a variety of growth factors. Several of these growth factors alter PDL fibroblast behavior. Two members of the transforming growth factor beta family of growth factors, namely, bone morphogenic protein-7 (BMP7) and growth differentiation factor-5 (GDF5), reduce cell proliferation and Stro-1 expression (a bone marrow stromal stem cell marker), whereas only BMP7 induces alkaline phosphatase activity. In contrast, fibroblast growth factor-5 induces enhanced cell proliferation and Stro-1 expression, while repressing alkaline phosphatase activity. The stimulation of PDL cells to differentiate (either by BMP7 or GDF5) inhibits cell motility. Thus, PDL cells in culture are regulated by several factors that differentially stimulate a mineralized (cementoblast-like) fate, a non-mineralized fate (mature fibroblasts), or the propagation of a more naive phenotype (potential progenitors).

Human alveolar bone cells interact with ProRoot and tooth-colored MTA

The cellular response to mineral trioxide aggregate (MTA) is important for the repair and regeneration of periradicular tissues. The purpose of this study was to analyze the response of human alveolar bone cells to MTA. A human alveolar bone chip was obtained from an oral surgical procedure and explant cultures harvested after 3 to 4 weeks of outgrowth in alpha-minimum essential medium supplemented with fetal calf serum. Cells in early passage were seeded onto preset ProRoot (gray) MTA, tooth-colored (white) MTA, and MTA prepared with local anesthetic solution. Scanning electron microscopy showed cells were attached and spread out onto MTA within 24 hours, and proliferated to form a matrix-like layer within 7 days. Cell attachment and cell-surface interactions with the gray and white MTA, and with the MTA prepared with local anesthetic were comparably propagated for 14 days. The surgically derived human alveolar bone cells provided a clinically relevant model that demonstrated the capacity of both ProRoot and tooth-colored MTA to support cell attachment, proliferation, and matrix formation.

Responses of MC3T3-E1 cells to three dental resin-based restorative materials

This study aimed to examine the influences of three dental resin-based restorative materials on cells associated with hard tissue regeneration using osteoblastic MC3T3-E1 cells. A Bis-GMA-based resin composite [Clearfil AP-X (APX)], an MMA-based resin cement [Superbond C&B (SB)], and a resin-modified glass-ionomer [Fuji Ionomer Type II LC (LC)] were tested. A zinc oxide eugenol cement [Super EBA (EBA)] was included in the study for comparison. MC3T3-E1 cells were cultured on set materials for 3, 7, 14, or 21 days. Cell attachment and proliferation were observed by scanning electron microscopy, and mitochondrial dehydrogenase and alkaline phosphatase (ALP) activities of the cells were evaluated. Cell cultures on polystyrene tissue culture dishes served as controls. On APX and SB, cells demonstrated attachment, spreading, and proliferation similar to the controls. In contract, cells adhered and proliferated poorly on LC and EBA. The mitochondrial function and ALP activity of the cells were significantly suppressed (p < 0.05, Scheffe's F test) throughout the experimental period when cultured on LC or EBA, although APX and SB exhibited less inhibition. The results indicate that APX and SB are less toxic to proliferation and differentiation of MC3T3-E1, suggesting that a smaller influence on cementogenesis on these materials can be expected.

Effects of Gray and White Mineral Trioxide Aggregate on the Proliferation of Oral Keratinocytes and Cementoblasts

Mineral trioxide aggregate (MTA) is used as a repair material and may directly contact cells from different cell lineages. The purpose of this study was to assess cell proliferation of immortalized Murine cementoblasts (OCCM.30) and immortalized keratinocytes (OKF6/TERT1) on gray MTA (GMTA) and white MTA (WMTA) with the DNA intercalating dye Hoechst 33342. Cells were grown for 72 hours on GMTA or WMTA that had been cured for 24 hours or 12 days. WMTA significantly (p < 0.001) increased the proliferation of OCCM.30 cementoblasts compared to control and OKF6/TERT1 keratinocytes. Both cell types grew significantly (p < 0.001) better on the surface of WMTA compared to GMTA. In addition, both cell types showed significantly (p < 0.005) higher proliferation when grown on 12-day-cured GMTA compared to 24-hour-cured GMTA.

The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formation

AIM

To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA.

METHODOLOGY

Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide-propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%.

RESULTS

Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters.

CONCLUSIONS

Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls.

Chemical and physical surface and bulk material characterization of white ProRoot MTA and two Portland cements

OBJECTIVES

The chemical and physical properties of white ProRoot MTA were analyzed in the bulk and at the surface and compared with two common Portland cements types CEM1 and CEM2.

METHODS

The main components were analyzed by X-ray photoelectron spectroscopy (XPS) and energy-dispersive X-ray analysis (EDX), and the minor constituents were identified with inductively coupled plasma optical emission spectroscopy (ICP-OES). Moreover, the setting of the different cements was studied: the chemical composition of the surface of both powder and bound cement was investigated by XPS and the morphological changes were examined by scanning electron microscopy (SEM).

RESULTS

In ProRoot MTA, the amount of gypsum is approximately half of that of the Portland cements. ProRoot MTA consists of less toxic heavy metals (Cu, Mn, Sr), less chromophores (Fe3+), and less Al-species, but contains about 2 at % Bi. In contrast to Portland cements, ProRoot MTA contains about 2 at.% Bi. In all three products, the amount of sulfur at the surface in the bound cements was 3 times higher than in the powder, indicating that in terms of the kinetics of the hardening reaction, a sulfate action mechanism prolongs the setting time. The Portland cements are composed of particles with a wide range of size, whereas ProRoot MTA showed a uniform and smaller particle size.

SIGNIFICANCE

With regard to chemical and physical surface and bulk properties, ProRoot MTA cannot simply be substituted by the cheaper Portland cement. Both products are similar but not equal and exhibit marked differences.