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Rosa V, Silikas N, Yu B, Dubey N, Sriram G, Zinelis S, Lima AF, Bottino MC, Ferreira JN, Schmalz G, Watts DC. Guidance on the assessment of biocompatibility of biomaterials: Fundamentals and testing considerations. Dent Mater 2024:S0109-5641(24)00221-5. [PMID: 39129079 DOI: 10.1016/j.dental.2024.07.020] [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: 06/09/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Assessing the biocompatibility of materials is crucial for ensuring the safety and well-being of patients by preventing undesirable, toxic, immune, or allergic reactions, and ensuring that materials remain functional over time without triggering adverse reactions. To ensure a comprehensive assessment, planning tests that carefully consider the intended application and potential exposure scenarios for selecting relevant assays, cell types, and testing parameters is essential. Moreover, characterizing the composition and properties of biomaterials allows for a more accurate understanding of test outcomes and the identification of factors contributing to cytotoxicity. Precise reporting of methodology and results facilitates research reproducibility and understanding of the findings by the scientific community, regulatory agencies, healthcare providers, and the general public. AIMS This article aims to provide an overview of the key concepts associated with evaluating the biocompatibility of biomaterials while also offering practical guidance on cellular principles, testing methodologies, and biological assays that can support in the planning, execution, and reporting of biocompatibility testing.
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Affiliation(s)
- Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore.
| | - Nikolaos Silikas
- Dental Biomaterials, Dentistry, The University of Manchester, Manchester, United Kingdom.
| | - Baiqing Yu
- Faculty of Dentistry, National University of Singapore, Singapore.
| | - Nileshkumar Dubey
- ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore; Division of Cariology and Operative Dentistry, Department of Comprehensive Dentistry, University of Maryland School of Dentistry, Baltimore, United States.
| | - Gopu Sriram
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore.
| | - Spiros Zinelis
- School of Dentistry National and Kapodistrian University of Athens (NKUA), Greece.
| | - Adriano F Lima
- Dental Research Division, Paulista University, Sao Paulo, Brazil.
| | - Marco C Bottino
- School of Dentistry, University of Michigan, Ann Arbor, USA.
| | - Joao N Ferreira
- Center of Excellence for Innovation for Oral Health and Healthy Longevity, Faculty of Dentistry, Chulalongkorn University, Thailand.
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - David C Watts
- School of Medical Sciences and Photon Science Institute, University of Manchester, United Kingdom.
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Koutrouli A, Machla F, Arapostathis K, Kokoti M, Bakopoulou A. "Biological responses of two calcium-silicate-based cements on a tissue-engineered 3D organotypic deciduous pulp analogue". Dent Mater 2024; 40:e14-e25. [PMID: 38431482 DOI: 10.1016/j.dental.2024.02.024] [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: 09/25/2023] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES The biological responses of MTA and Biodentine™ has been assessed on a three-dimensional, tissue-engineered organotypic deciduous pulp analogue. METHODS Human endothelial (HUVEC) and dental mesenchymal stem cells (SHED) at a ratio of 3:1, were incorporated into a collagen I/fibrin hydrogel; succeeding Biodentine™ and MTA cylindrical specimens were placed in direct contact with the pulp analogue 48 h later. Cell viability/proliferation and morphology were evaluated through live/dead staining, MTT assay and Scanning Electron Microscopy (SEM), and expression of angiogenic, odontogenic markers through real time PCR. RESULTS Viable cells dominated at day 3 after treatment presenting typical morphology, firmly attached within the hydrogel structures, as shown by live/dead staining and SEM images. MTT assay at day 1 presented a significant increase of cell proliferation in Biodentine™ group. Real-time PCR showed significant upregulation of odontogenic markers DSPP, BMP-2 (day 3,6), RUNX2, ALP (day 3) in contact with Biodentine™ compared to MTA and the control, whereas MTA promoted significant upregulation of DSPP, BMP-2, RUNX2, Osterix (day 3) and ALP (day 6) compared to the control. MSX1 presented downregulation in both experimental groups. Expression of angiogenic markers VEGFa and ANGPT-1 at day 3 was significantly upregulated in contact with Biodentine™ and MTA respectively, while the receptors VEGFR1, VEGFR2 and Tie-2, as well as PECAM-1 were downregulated. SIGNIFICANCE Both calcium silicate-based materials are biocompatible and exert positive angiogenic and odontogenic effects, although Biodentine™ during the first days of culture, seems to induce higher cell proliferation and provoke a more profound odontogenic and angiogenic response from SHED.
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Affiliation(s)
- A Koutrouli
- Department of Paediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece
| | - F Machla
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece
| | - K Arapostathis
- Department of Paediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece
| | - M Kokoti
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece
| | - A Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece.
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Bilge K, Ataş O, Yildiz Ş, Çalik I, Dündar S, Gezer Ataş A. Histological evaluation of tissue reaction and new bone formation of different calcium silicate-based cements in rats. Aust Dent J 2024; 69:18-28. [PMID: 37715562 DOI: 10.1111/adj.12980] [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] [Accepted: 08/31/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the local reactions and new bone formation of rat subcutaneous and bone tissue to different calcium silicate cements. METHODS In this study, 80 rats were divided into five groups as control, BIOfactor MTA (BIO), NeoMTA Plus (NEO), MTA Repair Hp (REP), Biodentine (DENT) and then into two subgroups according to sacrification times (7, 30 days; n = 8). Polyethylene tubes filled with appropriate materials (test groups); empty tubes (control group) were implanted into the dorsum of each rat subcutaneously. For intraosseous implantation, materials were placed in the cavities created in tibia of rats. Subcutaneous tissue and tibia samples were stained with haematoxylin-eosin and subjected to histopathological analysis. A score (0-3) was used to grade inflammatory reaction and new bone formation. Data were analysed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). RESULTS Inflammatory reaction observed in subcutaneous and intraosseous tissues for 7 days decreased significantly in all groups over time (P < 0.05). It was determined that there was significant increase in new bone formation in REP, BIO, DENT groups over time (P < 0.05). CONCLUSION Four contemporary bioceramic materials induced local inflammation and tissues changes shortly after subcutaneous implantation, which were reduced over time. In ıntraosseous implantation, all materials induced new bone formation over time. REGISTRATION NUMBER ADJ-03-23-0134. © 2023 Australian Dental Association.
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Affiliation(s)
- K Bilge
- Department of Restorative Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - O Ataş
- Department of Pediatric Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - Ş Yildiz
- Department of Pediatric Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - I Çalik
- Department of Pathology, Faculty of Medicine, Firat University, Elazıg, Turkey
| | - S Dündar
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig, Turkey
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Islam R, Islam MRR, Tanaka T, Alam MK, Ahmed HMA, Sano H. Direct pulp capping procedures - Evidence and practice. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:48-61. [PMID: 36880059 PMCID: PMC9985044 DOI: 10.1016/j.jdsr.2023.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/15/2023] [Indexed: 02/27/2023] Open
Abstract
The aim of direct pulp capping (DPC) is to promote pulp healing and mineralized tissue barrier formation by placing a dental biomaterial directly over the exposed pulp. Successful application of this approach avoids the need for further and more extensive treatment. In order to ensure a complete pulp healing with the placement of restorative materials, a mineralized tissue barrier must form to protect the pulp from microbial invasion. The formation of mineralized tissue barrier can only be induced when there is a significant reduction in pulp inflammation and infection. Consequently, promoting the healing of pulp inflammation may provide a favorable therapeutic opportunity to maintain the sustainability of DPC treatment. Mineralized tissue formation was observed as the favorable reaction of exposed pulp tissue against a variety of dental biomaterials utilized for DPC. This observation reveals an intrinsic capacity of pulp tissue for healing. Therefore, this review focuses on the DPC and its healing procedure as well as the materials used for DPC treatment and their mechanisms of action to promote pulpal healing. In addition, the factors that can affect the healing process of DPC, clinical considerations and future perspective has been described.
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Affiliation(s)
- Rafiqul Islam
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Md Refat Readul Islam
- Department of Restorative Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Toru Tanaka
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, 72345 Sakaka, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
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Tran ATL, Sukajintanakarn C, Senawongse P, Sritanaudomchai H, Ruangsawasdi N, Lapthanasupkul P, Kitkumthorn N, Monmaturapoj N, Khamsut C, Naruphontjirakul P, Pongprueksa P. Influence of Lithium- and Zinc-Containing Bioactive Glasses on Pulpal Regeneration. Eur J Dent 2023; 17:1120-1128. [PMID: 36812931 PMCID: PMC10756789 DOI: 10.1055/s-0042-1758789] [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] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To evaluate the potential of modified bioactive glasses containing lithium and zinc as pulp capping materials by investigating the odontogenic differentiation and mineralization response in the tooth culture model. MATERIALS AND METHODS Lithium- and zinc-containing bioactive glasses (45S5.1Li, 45S5.5Li, 45S5.1Zn, 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel), fibrinogen-thrombin, and biodentine were prepared to assess Axin2 gene expression at 0, 30 minutes, 1 hour, 12 hours, and 1 day and DSPP gene expression at 0, 3, 7, and 14 days in stem cells from human exfoliated deciduous teeth (SHEDs) using qRT-PCR. The experimental bioactive glasses incorporated with fibrinogen-thrombin and biodentine were placed on the pulpal tissue in the tooth culture model. Histology and immunohistochemistry were analyzed at 2 weeks and 4 weeks. RESULTS Axin2 gene expression for all experimental groups was significantly higher than the control at 12 hours. The DSPP gene expression for all experimental groups was significantly higher than the control at 14 days. The presence of mineralization foci was significantly higher at 4 weeks for the modified bioactive glasses 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel as well as Biodentine compared with the fibrinogen-thrombin control. CONCLUSION Lithium- and zinc-containing bioactive glasses increased Axin2 and DSPP gene expression in SHEDs and can potentially enhance pulp mineralization and regeneration. Zinc-containing bioactive glasses are a promising candidate to be used as pulp capping materials.
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Affiliation(s)
- An Thi Loc Tran
- Dental Biomaterials Science Program, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Charnsak Sukajintanakarn
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Pisol Senawongse
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Nisarat Ruangsawasdi
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Puangwan Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nakarin Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Naruporn Monmaturapoj
- Assistive Technology and Medical Devices Research Center, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Chutikarn Khamsut
- Assistive Technology and Medical Devices Research Center, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Parichart Naruphontjirakul
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Pong Pongprueksa
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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EzEldeen M, Pedano De Piero MNS, Xu L, Driesen RB, Wyatt J, Van Gorp G, Meschi N, Van Meerbeek B, Lambrichts I, Jacobs R. Multimodal Imaging of Dental Pulp Healing Patterns following Tooth Autotransplantation And Regenerative Endodontic Treatment. J Endod 2023:S0099-2399(23)00324-2. [PMID: 37315781 DOI: 10.1016/j.joen.2023.06.003] [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: 03/21/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Understanding the healing process of dental pulp after tooth autotransplantation (TAT) and regenerative endodontic treatment (RET) of immature teeth is important both clinically and scientifically. This study aimed to characterize the pattern of dental pulp healing in human teeth that underwent TAT and RET using state-of-the-art imaging techniques. MATERIALS AND METHODS This study examined four human teeth, two premolars that underwent TAT and two central incisors that received RET. The premolars were extracted after one year (case 1) and two years (case 2) due to ankylosis, while the central incisors were extracted after three years (cases 3 and 4) for orthodontic reasons. Nanofocus x-ray computed tomography was used to image the samples before being processed for histological and immunohistochemical analysis. Laser scanning confocal second harmonic generation imaging (SHG) was used to examine the patterns of collagen deposition. A maturity-matched premolar was included as a negative control for the histological and SHG analysis. RESULTS Analysis of the four cases revealed different patterns of dental pulp healing. Similarities were observed in the progressive obliteration of the root canal space. However, a striking loss of typical pulpal architecture was observed in the TAT cases, while a pulp-like tissue was observed in one of the RET cases. Odontoblast-like cells were observed in cases 1 and 3. CONCLUSION This study provided insights into the patterns of dental pulp healing after TAT and RET. The SHG imaging sheds light on the patterns of collagen deposition during reparative dentin formation.
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Affiliation(s)
- Mostafa EzEldeen
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
| | - Mariano N Simon Pedano De Piero
- KU Leuven (University of Leuven), Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Lianyi Xu
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Ronald B Driesen
- Biomedical Research Institute, Hasselt University, Campus Diepenbeek, Agoralaan Building C, B-3590 Diepenbeek, Belgium
| | - Jan Wyatt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Gertrude Van Gorp
- KU Leuven (University of Leuven), Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Nastaran Meschi
- Section of Endodontology, Department of Oral Health Sciences, Ghent University, C. Heymanslaan 10/P8, 9000 Ghent, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven, University Hospitals Leuven, Dentistry, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Ivo Lambrichts
- Biomedical Research Institute, Hasselt University, Campus Diepenbeek, Agoralaan Building C, B-3590 Diepenbeek, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Mohamed M, Hashem AAR, Obeid MF, Abu-Seida A. Histopathological and immunohistochemical profiles of pulp tissues in immature dogs' teeth to two recently introduced pulpotomy materials. Clin Oral Investig 2023; 27:3095-3103. [PMID: 36781475 PMCID: PMC10264498 DOI: 10.1007/s00784-023-04915-5] [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: 09/28/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The pulpal response to Hoffmann's Pulpine mineral (PMIN) and Pulpine NE (PNE) was compared to mineral trioxide aggregate (MTA) when used as pulpotomy materials in immature permanent teeth in dogs. MATERIALS AND METHODS Immature premolars were randomly divided according to the observation period into three equal groups (n = 24) (10 days, 30 days, and 90 days) then furtherly subdivided into 3 subgroups according to the material used. Histopathological analysis regarding inflammatory cell infiltration and dentin bridge (DB) formation was done. Immunohistochemical analysis was performed using osteopontin marker. RESULTS The results showed that after 90 days, both MTA and PMIN subgroups had 100% complete thick DB without inflammation in 87.5% of the samples, while the PNE subgroup failed to form DB in 37.5% of the samples and 50% of samples showed thin initial DB with heavy inflammation in 62.5% of the samples. There was no significant difference between MTA and PMIN, while there was a statistically significant difference between PNE and the two other subgroups in DB formation and inflammatory cell infiltration (P > 0.05). After 90 days, MTA showed the highest mean value of osteopontin positive fraction area followed by PMIN without statistically significant differences, while the least value was recorded in PNE subgroup with statistically significant difference with the remaining subgroups (P < 0.05). CONCLUSION PMIN is a promising alternative to MTA when used for pulpotomy. CLINICAL RELEVANCE Vital pulp therapy in immature teeth can be done using PMIN as an alternative to MTA.
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Affiliation(s)
- Mai Mohamed
- Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Piglionico SS, Pons C, Romieu O, Cuisinier F, Levallois B, Panayotov IV. In vitro, ex vivo, and in vivo models for dental pulp regeneration. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:15. [PMID: 37004591 PMCID: PMC10067643 DOI: 10.1007/s10856-023-06718-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 03/13/2023] [Indexed: 05/03/2023]
Abstract
Based on the concept of tissue engineering (Cells-Scaffold-Bioactive molecules), regenerative endodontics appeared as a new notion for dental endodontic treatment. Its approaches aim to preserve dental pulp vitality (pulp capping) or to regenerate a vascularized pulp-like tissue inside necrotic root canals by cell homing. To improve the methods of tissue engineering for pulp regeneration, numerous studies using in vitro, ex vivo, and in vivo models have been performed. This review explores the evolution of laboratory models used in such studies and classifies them according to different criteria. It starts from the initial two-dimensional in vitro models that allowed characterization of stem cell behavior, through 3D culture matrices combined with dental tissue and finally arrives at the more challenging ex vivo and in vivo models. The travel which follows the elaboration of such models reveals the difficulty in establishing reproducible laboratory models for dental pulp regeneration. The development of well-established protocols and new laboratory ex vivo and in vivo models in the field of pulp regeneration would lead to consistent results, reduction of animal experimentation, and facilitation of the translation to clinical practice.
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Affiliation(s)
- Sofia Silvia Piglionico
- LBN, Univ. Montpellier, Montpellier, France.
- Centro de Investigaciones Odontológicas, National University of Cuyo, Mendoza, Argentina.
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Franca CM, Balbinot GDS, Cunha D, Saboia VDPA, Ferracane J, Bertassoni LE. In-vitro models of biocompatibility testing for restorative dental materials: From 2D cultures to organs on-a-chip. Acta Biomater 2022; 150:58-66. [PMID: 35933103 PMCID: PMC9814917 DOI: 10.1016/j.actbio.2022.07.060] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023]
Abstract
Dental caries is a biofilm-mediated, diet-modulated, multifactorial and dynamic disease that affects more than 90% of adults in Western countries. The current treatment for decayed tissue is based on using materials to replace the lost enamel or dentin. More than 500 million dental restorations are placed annually worldwide, and materials used for these purposes either directly or indirectly interact with dentin and pulp tissues. The development and understanding of the effects of restorative dental materials are based on different in-vitro and in-vivo tests, which have been evolving with time. In this review, we first discuss the characteristics of the tooth and the dentin-pulp interface that are unique for materials testing. Subsequently, we discuss frequently used in-vitro tests to evaluate the biocompatibility of dental materials commonly used for restorative procedures. Finally, we present our perspective on the future directions for biological research on dental materials using tissue engineering and organs on-a-chip approaches. STATEMENT OF SIGNIFICANCE: Dental caries is still the most prevalent infectious disease globally, requiring more than 500 million restorations to be placed every year. Regrettably, the failure rates of such restorations are still high. Those rates are partially based on the fact that current platforms to test dental materials are somewhat inaccurate in reproducing critical components of the complex oral microenvironment. Thus, there is a collective effort to develop new materials while evolving the platforms to test them. In this context, the present review critically discusses in-vitro models used to evaluate the biocompatibility of restorative dental materials and brings a perspective on future directions for tissue-engineered and organs-on-a-chip platforms for testing new dental materials.
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Affiliation(s)
- Cristiane Miranda Franca
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States
| | - Gabriela de Souza Balbinot
- Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diana Cunha
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Jack Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States
| | - Luiz E Bertassoni
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, United States; Center for Regenerative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, United States; Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, United States; Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Portland, OR, United States.
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Hosseinpour S, Gaudin A, Peters OA. A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials. Int Endod J 2022; 55 Suppl 2:346-369. [PMID: 35124840 PMCID: PMC9315036 DOI: 10.1111/iej.13701] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.
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Affiliation(s)
- S Hosseinpour
- School of Dentistry The University of Queensland Herston QLD Australia
| | - A Gaudin
- Inserm UMR 1229 RMeS, Regenerative Medicine and Skeleton Université de Nantes ONIRIS Nantes France
- Université de Nantes UFR Odontologie Nantes France
| | - O A Peters
- School of Dentistry The University of Queensland Herston QLD Australia
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Rodrigues MNM, Bruno KF, de Alencar AHG, Silva JDS, de Siqueira PC, Decurcio DDA, Estrela C. Comparative analysis of bond strength to root dentin and compression of bioceramic cements used in regenerative endodontic procedures. Restor Dent Endod 2021; 46:e59. [PMID: 34909423 PMCID: PMC8636073 DOI: 10.5395/rde.2021.46.e59] [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: 11/18/2020] [Revised: 01/19/2021] [Accepted: 02/08/2021] [Indexed: 11/12/2022] Open
Abstract
Objectives This study compared the Biodentine, MTA Repair HP, and Bio-C Repair bioceramics in terms of bond strength to dentin, failure mode, and compression. Materials and Methods Fifty-four slices obtained from the cervical third of 18 single-rooted human mandibular premolars were randomly distributed (n = 18). After insertion of the bioceramic materials, the push-out test was performed. The failure mode was analyzed using stereomicroscopy. Another set of cylindrically-shaped bioceramic samples (n = 10) was prepared for compressive strength testing. The normality of data distribution was analyzed using the Shapiro-Wilk test. The Kruskal-Wallis and Friedman tests were used for the push-out test data, while compressive strength was analyzed with analysis of variance and the Tukey test, considering a significance level of 0.05. Results Biodentine presented a higher median bond strength value (14.79 MPa) than MTA Repair HP (8.84 MPa) and Bio-C Repair (3.48 MPa), with a significant difference only between Biodentine and Bio-C Repair. In the Biodentine group, the most frequent failure mode was mixed (61%), while in the MTA Repair HP and Bio-C Repair groups, it was adhesive (94% and 72%, respectively). Biodentine showed greater resistance to compression (29.59 ± 8.47 MPa) than MTA Repair HP (18.68 ± 7.40 MPa) and Bio-C Repair (19.96 ± 3.96 MPa) (p < 0.05). Conclusions Biodentine showed greater compressive strength than MTA Repair HP and Bio-C Repair, and greater bond strength than Bio-C Repair. The most frequent failure mode of Biodentine was mixed, while that of MTA Repair HP and Bio-C Repair was adhesive.
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Affiliation(s)
| | - Kely Firmino Bruno
- Department of Endodontics, South American College, Goiânia, Goiás, Brazil
| | | | | | | | | | - Carlos Estrela
- Department of Endodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Yoshida S, Sugii H, Itoyama T, Kadowaki M, Hasegawa D, Tomokiyo A, Hamano S, Ipposhi K, Yamashita K, Maeda H. Development of a novel direct dental pulp-capping material using 4-META/MMA-TBB resin with nano hydroxyapatite. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 130:112426. [PMID: 34702511 DOI: 10.1016/j.msec.2021.112426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 01/09/2023]
Abstract
In the case of dental pulp exposure, direct pulp capping is often performed to preserve vital dental pulp tissue. Numerous studies regarding the development of direct pulp-capping materials have been conducted, but materials with an appropriate sealing ability, which induce dense reparative dentin formation, have not been developed. Although nano hydroxyapatite (naHAp) is a bone-filling material with bioactivity and biocompatibility, the inductive effects of naHAp on reparative dentin formation remain unclear. In the present study, the effects of dental adhesive material 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate tri-n-butylborane [4-META/MMA-TBB or Super-bond (SB)], which included 10%, 30%, and 50% naHAp (naHAp/SB) on odontoblastic differentiation of dental pulp stem cells (DPSCs) and reparative dentin formation were investigated. Scanning electron microscopy (SEM) and energy dispersive X-ray spectrometer analysis were performed to verify the existence of naHAp particles on the surface of naHAp/SB discs. The tensile adhesive strength of naHAp/SB was measured using a universal testing machine. As a result, 10% naHAp/SB and 30% naHAp/SB showed almost the same tensile adhesive strength as SB but 50% naHAp/SB showed significantly lower than the other experimental group. WST-1 proliferation assay and SEM analysis revealed that naHAp/SB did not affect the proliferation of DPSCs. Calcium release assay, quantitative RT-PCR, and western blotting analysis demonstrated that naHAp/SB did not release calcium ion but 30% naHAp/SB increased the expression of calcium-sensing receptor (CaSR) in DPSCs. Additionally, quantitative RT-PCR, western blotting analysis, Alizarin Red S- and von Kossa staining revealed that 30% naHAp/SB induced odontoblastic differentiation of DPSCs, which was inhibited by a MEK/ERK inhibitor and CaSR antagonist. Furthermore, 30% naHAp/SB promoted dense reparative dentin formation in an experimentally-formed rat dental pulp exposure model. These findings suggest that 30% naHAp/SB can be used as an ideal direct pulp capping material.
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Affiliation(s)
- Shinichiro Yoshida
- Division of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hideki Sugii
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomohiro Itoyama
- Division of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masataka Kadowaki
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Daigaku Hasegawa
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Atsushi Tomokiyo
- Division of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Sayuri Hamano
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; OBT Research Center, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Keita Ipposhi
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kozue Yamashita
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidefumi Maeda
- Division of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Minic S, Florimond M, Sadoine J, Valot-Salengro A, Chaussain C, Renard E, Boukpessi T. Evaluation of Pulp Repair after Biodentine TM Full Pulpotomy in a Rat Molar Model of Pulpitis. Biomedicines 2021; 9:biomedicines9070784. [PMID: 34356848 PMCID: PMC8301331 DOI: 10.3390/biomedicines9070784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022] Open
Abstract
Dental pulp is a dynamic tissue able to heal after injury under moderate inflammatory conditions. Our study aimed to evaluate pulp repair under inflammatory conditions in rats. For this purpose, we developed a rat model of controlled pulpitis followed by pulpotomy with a tricalcium silicate-based cement. Fifty-four cavities were prepared on the occlusal face of the maxillary upper first molar of 27 eight-week-old male rats. E. coli lipopolysaccharides at 10 mg/mL or phosphate-buffered saline PBS was injected after pulp injury. Non-inflamed molars were used as controls. Levels of inflammation-related molecules were measured 6 and 24 h after induction by enzyme-linked immunosorbent assay of coronal pulp samples. Pulp capping and coronal obturation after pulpotomy were performed with tricalcium silicate-based cement. Four and fifteen days after pulpotomy, histological and immunohistochemical analysis was performed to assess pulp inflammation and repair processes. Our results showed significantly higher levels of innate inflammatory proteins (IL-1β, IL-6, TNF-α and CXCL-1) compared with those in controls. Moderate residual inflammation near the capping material was demonstrated by histology and immunohistochemistry, with the presence of few CD68-positive cells. We showed that, in this model of controlled pulpitis, pulpotomy with BiodentineTM allowed the synthesis at the injury site of a mineralized bridge formed from mineralized tissue secreted by cells displaying odontoblastic characteristics. Analysis of these data suggests overall that, with the limitations inherent to findings in animal models, pulpotomy with a silicate-based cement is a good treatment for controlling inflammation and enhancing repair in cases of controlled pulpitis.
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Affiliation(s)
- Sandra Minic
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
| | - Marion Florimond
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
| | - Jérémy Sadoine
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
| | | | - Catherine Chaussain
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
| | - Emmanuelle Renard
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 1 Place Alexis Ricordeau, 44000 Nantes, France
- CHU de Nantes, Service d’Odontologie Restauratrice et Chirurgicale, 1 Place Alexis Ricordeau, 44000 Nantes, France
- Correspondence: (E.R.); (T.B.); Tel.: +33-2-40-41-29-86 (E.R.); +33-1-58-07-67-24 (T.B.)
| | - Tchilalo Boukpessi
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d’excellence INFLAMEX, Université de Paris, URP 2496, 1 Rue Maurice Arnoux, 92120 Montrouge, France; (S.M.); (M.F.); (J.S.); (C.C.)
- AP-HP Department of Dental Medicine, Charles Foix and Bretonneau Hospitals, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, 7 Avenue de la République, 94200 Ivry-sur-Seine, France
- Correspondence: (E.R.); (T.B.); Tel.: +33-2-40-41-29-86 (E.R.); +33-1-58-07-67-24 (T.B.)
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Platform technologies for regenerative endodontics from multifunctional biomaterials to tooth-on-a-chip strategies. Clin Oral Investig 2021; 25:4749-4779. [PMID: 34181097 DOI: 10.1007/s00784-021-04013-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this review is to highlight recent progress in the field of biomaterials-mediated dental pulp tissue engineering. Specifically, we aim to underscore the critical design criteria of biomaterial platforms that are advantageous for pulp tissue engineering, discuss models for preclinical evaluation, and present new and innovative multifunctional strategies that hold promise for clinical translation. MATERIALS AND METHODS The current article is a comprehensive overview of recent progress over the last 5 years. In detail, we surveyed the literature in regenerative pulp biology, including novel biologic and biomaterials approaches, and those that combined multiple strategies, towards more clinically relevant models. PubMed searches were performed using the keywords: "regenerative dentistry," "dental pulp regeneration," "regenerative endodontics," and "dental pulp therapy." RESULTS Significant contributions to the field of regenerative dentistry have been made in the last 5 years, as evidenced by a significant body of publications. We chose exemplary studies that we believe are progressive towards clinically translatable solutions. We close this review with an outlook towards the future of pulp regeneration strategies and their clinical translation. CONCLUSIONS Current clinical treatments lack functional and predictable pulp regeneration and are more focused on the treatment of the consequences of pulp exposure, rather than the restoration of healthy dental pulp. CLINICAL RELEVANCE Clinically, there is great demand for bioinspired biomaterial strategies that are safe, efficacious, and easy to use, and clinicians are eager for their clinical translation. In particular, we place emphasis on strategies that combine favorable angiogenesis, mineralization, and functional tissue formation, while limiting immune reaction, risk of microbial infection, and pulp necrosis.
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Pedano MS, Yoshihara K, Li X, Camargo B, Van Landuyt K, Van Meerbeek B. Experimental resin-modified calcium-silicate cement containing N-(2-hydroxyethyl) acrylamide monomer for pulp tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 126:112105. [PMID: 34082929 DOI: 10.1016/j.msec.2021.112105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 04/08/2021] [Indexed: 01/06/2023]
Abstract
AIM Our study aimed to measure (1) the flexural strength, (2) shear bond strength to dentin, (3) pH, and (4) calcium (Ca) release of a series of innovative resin-modified calcium-silicate pulp-capping cements (Rm-CSCs). Using an ex-vivo human vital tooth-culture model, we additionally assessed (5) their pulp-healing initiation when brought in direct contact with human dental pulp tissue. METHODOLOGY Three experimental Rm-CSCs, being referred to 'Exp_HEAA', 'Exp_GDM' and 'Exp_HEAA/GDM', contained either 20 wt% N-(2-hydroxyethyl) acrylamide (HEAA), 20 wt% glycerol dimethacrylate (GDM) or 10 wt% HEAA plus 10 wt% GDM, added to a common base composition consisting of 25 wt% urethane dimethacrylate (UDMA), 10 wt% 4-methacryloxyethyl trimellitate anhydride (4-MET), and 5 wt% N,N'-{[(2-acrylamido-2-[(3-acrylamidopropoxy)methyl] propane-1,3-diyl)bis(oxy)]bis-(propane-1,3-diyl)}diacrylamide (FAM-401). As Ca source and radiopacifier, 37 wt% tricalcium silicate powder (TCS) and 3 wt% zirconium oxide (ZrO 2) were respectively added. RESULTS All three experimental Rm-CSCs revealed a significantly higher flexural strength and shear bond strength to dentin (p < 0.05) than the commercial reference Rm-CSC TheraCal LC (Bisco). Exp_HEAA presented with a significantly higher Ca release and pH at 24 h compared with the other Rm-CSCs (p < 0.05). At 1 week, the Ca release and pH of Exp_HEAA and Exp_HEAA/GDM was significantly higher than those of Exp_GDM and TheraCal LC (p < 0.05). Using the ex-vivo human vital tooth culture model, Exp_HEAA revealed pulp-healing initiation capacity as documented by nestin and collagen-I expression. CONCLUSIONS Depending on the formulation, the innovative Rm-CSCs performed favorably for primary properties of relevance regarding pulp capping, this more specifically in terms of flexural strength, bond strength to dentin, as well as alkaline pH and Ca release. However, only Exp_HEAA revealed pulp-healing initiation in direct contact with human dental pulp tissue in the ex-vivo human vital tooth-culture model. This promising outcome for Exp_HEAA should be attributed to the combined use of (1) a novel hydrophilic acrylamide monomer, enabling sufficient polymerization while maintaining adequate hydrophilicity, with (2) the functional monomer 4-MET, possessing chemical bonding potential to dentin, and (3) tricalcium silicate powder to achieve an alkaline pH and to release Ca in a sufficient and controlled way.
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Affiliation(s)
- Mariano S Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium.
| | - Kumiko Yoshihara
- National Institute of Advanced Industrial Science and Technology (AIST), Health Research Institute, 2217-14 Hayashi-Cho, Takamaysu, Kagawa 761-0395, Japan; Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Pathology & Experimental Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Bernardo Camargo
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
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Hadjichristou C, About I, Koidis P, Bakopoulou A. Advanced in Vitro Experimental Models for Tissue Engineering-based Reconstruction of a 3D Dentin/pulp Complex: a Literature Review. Stem Cell Rev Rep 2020; 17:785-802. [PMID: 33145672 DOI: 10.1007/s12015-020-10069-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Experimental procedures have been used to monitor cellular responses at the dentin/pulp interface. Aiming to divert from in vivo studies and oversimplified two-dimensional assays, three-dimensional (3D) models have been developed. This review provides an overview of existing literature, regarding 3D in vitro dentin/pulp reconstruction. MATERIAL & METHODS PubMed, Scopus, Cochrane Library and Web of Science- were systematically searched for attributes between 1998 and 2020. The search focused on articles on the development of three-dimensional tools for the reconstruction of a dentin/pulp complex under in vitro conditions, which were then screened and qualitatively assessed. Article grouping according to mode of implementation, resulted in five categories: the customised cell perfusion chamber (CPC) (n = 8), the tooth bud model (TBM) (n = 3), the 3D dentin/pulp complex manufactured by tissue engineering (DPC) (n = 6), the entire tooth culture (ETC) (n = 4) and the tooth slice culture model (TSC) (n = 5). RESULTS A total of 26 publications, applying nine and eight substances for pulp and dentin representation respectively, were included. Natural materials and dentin components were the most widely utilized. The most diverse category was the DPC, while the CPC group was the test with the highest longevity. The most consistent categories were the ETC and TSC models, while the TBM presented as the most complete de novo approach. CONCLUSIONS All studies presented with experimental protocols with potential upgrades. Solving the limitations of each category will provide a complete in vitro testing and monitoring tool of dental responses to exogenous inputs. CLINICAL RELEVANCE The 3D dentin/pulp complexes are valid supplementary tools for in vivo studies and clinical testing. Graphical Abstract.
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Affiliation(s)
- Christina Hadjichristou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124, Thessaloniki, Greece.
| | - Imad About
- Centre National de la Recherche Scientifique, Institute of Movement Sciences, Aix Marseille University, Marseille, France
| | - Petros Koidis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124, Thessaloniki, Greece
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Use of in vitro bone models to screen for altered bone metabolism, osteopathies, and fracture healing: challenges of complex models. Arch Toxicol 2020; 94:3937-3958. [PMID: 32910238 PMCID: PMC7655582 DOI: 10.1007/s00204-020-02906-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023]
Abstract
Approx. every third hospitalized patient in Europe suffers from musculoskeletal injuries or diseases. Up to 20% of these patients need costly surgical revisions after delayed or impaired fracture healing. Reasons for this are the severity of the trauma, individual factors, e.g, the patients’ age, individual lifestyle, chronic diseases, medication, and, over 70 diseases that negatively affect the bone quality. To investigate the various disease constellations and/or develop new treatment strategies, many in vivo, ex vivo, and in vitro models can be applied. Analyzing these various models more closely, it is obvious that many of them have limits and/or restrictions. Undoubtedly, in vivo models most completely represent the biological situation. Besides possible species-specific differences, ethical concerns may question the use of in vivo models especially for large screening approaches. Challenging whether ex vivo or in vitro bone models can be used as an adequate replacement for such screenings, we here summarize the advantages and challenges of frequently used ex vivo and in vitro bone models to study disturbed bone metabolism and fracture healing. Using own examples, we discuss the common challenge of cell-specific normalization of data obtained from more complex in vitro models as one example of the analytical limits which lower the full potential of these complex model systems.
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Li X, Pedano MS, Li S, Sun Z, Jeanneau C, About I, Hauben E, Chen Z, Van Landuyt K, Van Meerbeek B. Preclinical effectiveness of an experimental tricalcium silicate cement on pulpal repair. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 116:111167. [PMID: 32806325 DOI: 10.1016/j.msec.2020.111167] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/18/2020] [Accepted: 06/05/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To investigate the pulpal repair potential of an experimental zirconium-oxide containing tricalcium-silicate cement, referred to as 'TCS 50'. MATERIALS AND METHODS The effect of TCS 50 on viability, proliferation, migration, and odontoblastic differentiation of human dental pulp cells (HDPCs) was assessed using XTT assay, in-vitro wound healing assay and RT-PCR, respectively. Additionally, the pulp-capping potential was evaluated using a vital human tooth model. Statistical analysis was performed using non-parametric Kruskal-Wallis test and post-hoc test (Mann-Whitney U test). The tests were performed at a significance level of α = 0.05. RESULTS The effect of TCS 50 towards HDPCs was dose dependent. Undiluted TCS 50 extract showed no immediate adverse impact on cell viability (p > .05); however, it significantly inhibited proliferation and migration of HDPCs (p < .05). A 25% diluted TCS 50 extract showed no significant effect on cell viability, proliferation or migration (p > .05), and it significantly enhanced odontoblastic differentiation of HDPCs (p < .05). In pulps capped with TCS 50 for both 2 and 4 weeks, H&E staining revealed a normal morphology of pulp tissue; mineralized foci with cellular components entrapped in the matrix were formed underneath the exposure site. Collagen I expression was weak within the matrix of mineralized foci, while the expression of nestin was positive for entrapped cellular components within the mineralized foci, indicating that the formed mineralized foci corresponded to an initial form of reparative dentin formation. CONCLUSION TCS 50 is capable of generating an early pulp-healing reaction and therefore could serve as a promising pulp-capping agent.
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Affiliation(s)
- Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Mariano Simón Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Shuchen Li
- Wuhan University, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine of Ministry of Education, Wuhan, PR China
| | - Zheyi Sun
- Wuhan University, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine of Ministry of Education, Wuhan, PR China
| | - Charlotte Jeanneau
- Wuhan University, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine of Ministry of Education, Wuhan, PR China
| | - Imad About
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Esther Hauben
- Laboratory for Pathology, UZ Leuven & Department of Imaging and Pathology, Translational Cell and Tissue Research, KU, Leuven, Belgium
| | - Zhi Chen
- Wuhan University, School and Hospital of Stomatology, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine of Ministry of Education, Wuhan, PR China
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium.
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Application of BMP-2/FGF-2 gene-activated scaffolds for dental pulp capping. Clin Oral Investig 2020; 24:4427-4437. [PMID: 32415397 DOI: 10.1007/s00784-020-03308-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/23/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the effect of non-viral gene therapy on human dental pulp stem cells (DPSCs) in an in vitro and an ex vivo model. MATERIALS AND METHODS Nanoplexes comprising polyethyleneimine (PEI) and plasmid DNA (pDNA) encoding for fibroblast growth factor-2 (pFGF-2) and bone morphogenic protein-2 (pBMP-2) were cultured with DPSCs to evaluate cytotoxicity, protein expression, and mineralization activity. Collagen scaffolds loaded with these nanoplexes or mineral trioxide aggregate (MTA) were utilized in an ex vivo tooth culture model to assess pulp response, over a period of 14 days. All nanoplex formulations were characterized for size and zeta potential by measuring dynamic light scattering and electrophoretic mobility, respectively. RESULTS DPSCs treated with the nanoplexes showed increased cell proliferation and enhanced expression of BMP-2 and FGF-2 proteins. Collagen scaffolds containing PEI-pBMP-2 and/or pFGF-2 nanoplexes significantly increased cell proliferation, BMP-2 and FGF-2 expression, and mineralization when compared to MTA. Ex vivo histology showed a well-preserved pulp and healthy tissue in both the MTA and scaffold groups. Connective tissue in contact with the scaffold was dense and homogeneous, with some cells present in contact and within the scaffold. CONCLUSION Transfection of DPSCs with pBMP-2/pFGF-2 nanoplexes resulted in increased expression of BMP-2 and FGF-2, enhanced proliferation, and mineralization properties compared to MTA. These findings were supported by the ex vivo observations. CLINICAL RELEVANCE This biological approach in pulp capping brings new insights into the effective management of engineered pulp tissues, mainly those generated by the transplantation of DPSCs in empty root canals.
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Pedano MS, Li X, Camargo B, Hauben E, De Vleeschauwer S, Yoshihara K, Van Landuyt K, Yoshida Y, Van Meerbeek B. Injectable phosphopullulan-functionalized calcium-silicate cement for pulp-tissue engineering: An in-vivo and ex-vivo study. Dent Mater 2020; 36:512-526. [PMID: 32061443 DOI: 10.1016/j.dental.2020.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/04/2019] [Accepted: 01/14/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate, by means of an ex-vivo human tooth-culture model and in-vivo minipig animal study, the pulpal inflammatory reaction and reparative dentin-formation capacity of an injectable phosphopullulan-based calcium-silicate cement (GC, Tokyo, Japan) upon pulp capping, this in comparison with the commercial reference material Biodentine (Septodont). METHODS For the ex-vivo tooth model, 9 freshly-extracted teeth from 3 different patients were pulp-capped with the experimental biomaterial (n = 3), Biodentine (n = 3) or left uncapped (control; n = 3). The teeth were kept in fresh culture medium for 4 weeks and, upon fixation three-dimensional Micro-CT and histology were performed. For the in-vivo animal study, 40 teeth from 3 minipigs were exposed and pulp capped with the experimental biomaterial containing phosphopullulan (n = 24) or Biodentine (n = 16) for 7 or 70 days. The inflammatory reaction and the tissue-regenerative potential was qualitatively and semi-quantitatively characterized using three-dimensional micro-CT and histology. RESULTS Ex vivo, the treatment with the experimental phosphopullulan-based calcium-silicate cement and Biodentine stimulated the formation of fibrous tissue and mineralized foci. In vivo, early inflammatory reaction and regeneration of the pulp-tissue interface was promoted by both bioceramic materials after 7 and 70 days, respectively. SIGNIFICANCE Our findings bring new insights into calcium-silicate-mediated dental pulp repair and regeneration. The novel ready-to-use and self-adhering functionalized calcium-silicate cement revealed effective pulpal repair potential.
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Affiliation(s)
- Mariano Simón Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium; Wuhan University, School and Hospital of Stomatology, Ministry of Education, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Wuhan, PR China
| | - Bernardo Camargo
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium; Federal University of Rio de Janeiro, Nuclear Engineering Program, Rio de Janeiro, Brazil
| | - Esther Hauben
- UZ Leuven (University Hospitals Leuven), Laboratory for Pathology & KU Leuven (University of Leuven), Department of Imaging and Pathology, Translational Cell and Tissue Research, Leuven, Belgium
| | | | - Kumiko Yoshihara
- Okayama University Hospital, Center for Innovative Clinical Medicine, Okayama, Japan; National Institute of Advanced Industrial Science and Technology (AIST), Health Research Institute, Takamatsu, Japan
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Yasuhiro Yoshida
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium.
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Tran XV, Salehi H, Truong MT, Sandra M, Sadoine J, Jacquot B, Cuisinier F, Chaussain C, Boukpessi T. Reparative Mineralized Tissue Characterization after Direct Pulp Capping with Calcium-Silicate-Based Cements. MATERIALS 2019; 12:ma12132102. [PMID: 31261905 PMCID: PMC6650868 DOI: 10.3390/ma12132102] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/26/2019] [Accepted: 06/26/2019] [Indexed: 12/30/2022]
Abstract
Nowadays, the preservation of dental pulp vitality is an integral part of our daily therapies. The success of these treatments depends on the clinical situation as well as the biomaterials used. Mineral Trioxide aggregate and BiodentineTM are commonly used as pulp capping materials. One objective of vital pulp therapy is the repair/regeneration of the pulp. In addition to the initial inflammatory status of the pulp, the nature and quality of the new mineralized tissue obtained after pulp capping directly influence the success of the treatment. In order to characterize the reparative dentin, in the current study, the chemical composition and microstructure of the dentin bridge after direct pulp capping using Biodentine™ and mineral trioxide aggregate (MTA) was studied by using Raman microspectroscopy and scanning electron microscopy, respectively. The results showed that the reparative dentin bridge observed in both groups presented dentin tubules and chemical composition similar to primary dentin. With the limitations of this study, the calcium-silicate-based cements used as pulp capping materials provide an optimal environment for pulp healing, resulting in a reparative dentin resembling on certain points of the primary dentin and the regeneration of the pulp.
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Affiliation(s)
- Xuan Vinh Tran
- EA 2496, Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Dental School, Paris Descartes University, Sorbonne Paris Cite, 1 rue Maurice Arnoux, 92120 Montrouge, France.
- Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City (UMP), 217 Hong Bang street, Ward 11, Dist 5, Ho Chi Minh City, Viet Nam.
| | - Hamideh Salehi
- EA4203, Laboratory BioHealth and Nanosciences, Dental school, Montpellier University, avenue du Pr Jean-Louis Viala, CEDEX 5, 34193 Montpellier, France
| | - Minh Tam Truong
- Thanh Vu Medic Bac Lieu Hospital; Highway 1 bypass, Ward 7, Bac Lieu City, Bac Lieu province, Viet Nam
| | - Minic Sandra
- EA 2496, Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Dental School, Paris Descartes University, Sorbonne Paris Cite, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Jeremy Sadoine
- EA 2496, Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Dental School, Paris Descartes University, Sorbonne Paris Cite, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Bruno Jacquot
- EA4203, Laboratory BioHealth and Nanosciences, Dental school, Montpellier University, avenue du Pr Jean-Louis Viala, CEDEX 5, 34193 Montpellier, France
| | - Frédéric Cuisinier
- EA4203, Laboratory BioHealth and Nanosciences, Dental school, Montpellier University, avenue du Pr Jean-Louis Viala, CEDEX 5, 34193 Montpellier, France
| | - Catherine Chaussain
- EA 2496, Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Dental School, Paris Descartes University, Sorbonne Paris Cite, 1 rue Maurice Arnoux, 92120 Montrouge, France
- AP-HP Department of odontology, Charles Foix and Bretonneau Hospitals, 12 avenue de la République, 94200, Ivry-sur-Seine, France and 12 rue Carpeaux, 75018 Paris, France
| | - Tchilalo Boukpessi
- EA 2496, Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Dental School, Paris Descartes University, Sorbonne Paris Cite, 1 rue Maurice Arnoux, 92120 Montrouge, France.
- AP-HP Department of odontology, Charles Foix and Bretonneau Hospitals, 12 avenue de la République, 94200, Ivry-sur-Seine, France and 12 rue Carpeaux, 75018 Paris, France.
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Al-Saudi KW, Nabih SM, Farghaly AM, AboHager EAA. Pulpal repair after direct pulp capping with new bioceramic materials: A comparative histological study. Saudi Dent J 2019; 31:469-475. [PMID: 31695296 PMCID: PMC6823775 DOI: 10.1016/j.sdentj.2019.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/08/2019] [Accepted: 05/13/2019] [Indexed: 12/22/2022] Open
Abstract
Aim To histopathologically evaluate the pulpal healing after direct pulp capping with TotalFill and compared it with Neo MTA Plus in human tooth cultures. Methods Forty sound human premolars freshly extracted for orthodontic reasons were randomly assigned to two experimental groups; group I: TotalFill and group II: Neo MTA Plus. Standardized Class V cavities were prepared on the buccal surface of each tooth where the pulp exposure was performed with a dental explorer. The pulp-exposed teeth were immediately capped with one of the tested materials. The prepared cavities were then finally restored with glass-ionomer cement. Teeth were cultured for three weeks and three months. Then, the cultured teeth were demineralized, sectioned and stained for histopathological evaluation. Data collected and statistically analyzed by using Fisher's exact test. The significance level was set at P ≤ 0.05. Results Histopathological analysis showed complete dentin bridge formation and an absence of inflammatory pulp response. Statistical analysis showed no significant differences between the TotalFill and Neo MTA Plus groups during the observation periods. However, a significantly higher thickness of the dentin bridge was found in the group of teeth treated with TotalFill at three months. Conclusions TotalFill produced similar favorable pulp healing and repair, and were comparable to Neo MTA Plus. Furthermore, TotalFill can form a thicker dentin bridge compared with Neo MTA Plus.
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Affiliation(s)
- Khaled Wagih Al-Saudi
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Misr University for Science and Technology, Cairo, Egypt
| | - Sameh Mahmoud Nabih
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mustafa Farghaly
- Department of Endodontics, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Eman Abdul-Aziz AboHager
- Oral Pathology Department, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
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24
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Pedano MS, Li X, Jeanneau C, Ghosh M, Yoshihara K, Van Landuyt K, About I, Van Meerbeek B. Survival of human dental pulp cells after 4-week culture in human tooth model. J Dent 2019; 86:33-40. [PMID: 31121243 DOI: 10.1016/j.jdent.2019.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/04/2019] [Accepted: 05/18/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aimed to validate the human tooth model by investigating the growth efficiency, expression of mesenchymal stem cell (MSC) markers and differentiation ability of human dental pulp cells (hDPCs) harvested from extracted immature third molars and cultured for different periods. Moreover, the effect of exposure and capping with a hydraulic calcium-silicate cement on pulp tissue after 4-week culture in the tooth model was investigated. METHODS Primary hDPCs were collected from 18 molars from six individuals (15-19 years). One tooth of each patient was immediately cultured (control), while the other teeth were exposed to culture medium for 1, 2 or 4 weeks. After different culture periods, cells were harvested using the explant method, upon which cells were evaluated for cell-doubling time, colony-forming efficiency and expression of cell surface markers. The osteogenic, adipogenic and chondrogenic differentiation efficacy was also determined. Two teeth from three different patients (n = 6) were used for the pulp-capping assay. Three teeth were capped with ProRoot MTA (Dentsply Sirona), while three other exposed teeth remained uncapped (control). RESULTS Cells were found to grow, express MSC markers and showed osteogenic, adipogenic and chondrogenic differentiation potential at all time periods. Histology of the teeth subjected to the pulp-capping assay showed the formation of mineralized tissue after 4-week exposure to ProRoot MTA (Dentsply Sirona) and normal histological features in the control teeth. CONCLUSIONS This study confirmed that hDPCs of teeth cultured for up to 4 weeks in a human tooth model are viable, express MSC markers and show differentiation ability. CLINICAL SIGNIFICANCE The human tooth model can be seen as an advanced cell-culture model that makes use of the original 3D pulp-chamber structure. It can serve as a screening tool to evaluate new pulp-capping formulations in a relatively cheap and fast manner.
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Affiliation(s)
- Mariano S Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | | | - Manosij Ghosh
- KU Leuven, Department of Public Health and Primary Care, Centre Environment and Health, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Kumiko Yoshihara
- Okayama University Hospital, Center for Innovative Clinical Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; National Institute of Advanced Industrial Science and Technology (AIST), Health Research Institute2217-14 Hayashi-cho Takamatsu Kagawa 761-0395 JAPAN
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Imad About
- Aix Marseille Univ, CNRS, IMS, Inst Movement Sci, Marseille, France
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7, 3000 Leuven, Belgium.
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25
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Regenerative Endodontic Procedures Using Contemporary Endodontic Materials. MATERIALS 2019; 12:ma12060908. [PMID: 30893790 PMCID: PMC6471897 DOI: 10.3390/ma12060908] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/28/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022]
Abstract
Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application.
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Widbiller M, Bucchi C, Rosendahl A, Spanier G, Buchalla W, Galler KM. Isolation of primary odontoblasts: Expectations and limitations. AUST ENDOD J 2019; 45:378-387. [DOI: 10.1111/aej.12335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Matthias Widbiller
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Cristina Bucchi
- Department of Pathology and Experimental Therapy Universitat de Barcelona Barcelona Spain
- Department of Integral Adult Dentistry Research Centre for Dental Sciences Universidad de La Frontera Temuco Chile
| | - Andreas Rosendahl
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Gerrit Spanier
- Department of Oral‐ and Maxillofacial Surgery University Hospital Regensburg Regensburg Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Kerstin M. Galler
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
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27
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Di Foggia M, Prati C, Gandolfi MG, Taddei P. An in vitro study on dentin demineralization and remineralization: Collagen rearrangements and influence on the enucleated phase. J Inorg Biochem 2019; 193:84-93. [PMID: 30685550 DOI: 10.1016/j.jinorgbio.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/24/2018] [Accepted: 01/10/2019] [Indexed: 01/17/2023]
Abstract
Dentin remineralization is of clinical relevance in the therapy of caries and dentin hypersensitivity. This study is aimed at gaining more insights on a molecular scale, through IR spectroscopy, into dentin demineralization and remineralization. The dentin demineralization by ethylenediaminetetraacetic acid, EDTA (17%, 2 h) significantly altered the secondary structure distribution of collagen, upon loss of interaction with calcium ions. To investigate dentin remineralization, previously demineralized human dentin slices were soaked in Dulbecco's Phosphate Buffered Saline (DPBS) or Hank's Balanced Salt Solution HBSS, in close contact with three commercial cements used as sustained releasing sources of Ca2+ and OH- ions (i.e. calcium hydroxide- and calcium silicate-based cements). IR spectroscopy showed the occurrence of remineralization under these conditions. Collagen did not lose its ability to chelate Ca2+, and these interactions allowed collagen to rearrange into a conformation similar to that of sound dentin. This process appeared slower in HBSS than DPBS, as also shown by the lower degree of maturation of the inorganic phase enucleated in the former medium (amorphous calcium phosphate versus B-type carbonated apatite). Collagen appeared to act as a spatial constraint to crystal deposition, affecting crystallinity and carbonate content of the enucleated phase. Remineralization was found to strongly depend on the calcium releasing ability of the cements. The fast formation of a rough apatite biocoating may represent a favorable clinical condition in the context of mineralized tissue regeneration.
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Affiliation(s)
- Michele Di Foggia
- Biochemistry Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Belmeloro 8/2, 40126 Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, Unit of Odontostomatological Sciences, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40136 Bologna, Italy
| | - Maria Giovanna Gandolfi
- Laboratory of Biomaterials and Oral Pathology, Unit of Odontostomatological Sciences, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40136 Bologna, Italy
| | - Paola Taddei
- Biochemistry Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Belmeloro 8/2, 40126 Bologna, Italy.
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Giraud T, Jeanneau C, Rombouts C, Bakhtiar H, Laurent P, About I. Pulp capping materials modulate the balance between inflammation and regeneration. Dent Mater 2018; 35:24-35. [PMID: 30269862 DOI: 10.1016/j.dental.2018.09.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 01/05/2023]
Abstract
The interrelations between inflammation and regeneration are of particular significance within the dental pulp tissue inextensible environment. Recent data have demonstrated the pulp capacity to respond to insults by initiating an inflammatory reaction and dentin pulp regeneration. Different study models have been developed in vitro and in vivo to investigate the initial steps of pulp inflammation and regeneration. These include endothelial cell interaction with inflammatory cells, stem cell interaction with pulp fibroblasts, migration chambers to study cell recruitment and entire human tooth culture model. Using these models, the pulp has been shown to possess an inherent anti-inflammatory potential and a high regeneration capacity in all teeth and at all ages. The same models were used to investigate the effects of tricalcium silicate-based pulp capping materials, which were found to modulate the pulp anti-inflammatory potential and regeneration capacity. Among these, resin-containing materials such as TheraCal® shift the pulp response towards the inflammatory reaction while altering the regeneration process. On the opposite, resin-free materials such as Biodentine™ have an anti-inflammatory potential and induce the pulp regeneration capacity. This knowledge contradicts the new tendency of developing resin-based calcium silicate hybrid materials for direct pulp capping. Additionally, it would allow investigating the modulatory effects of newly released pulp capping materials on the balance between tissue inflammation and regeneration. It would also set the basis for developing future capping materials targeting these processes.
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Affiliation(s)
- Thomas Giraud
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Timone, Service d'Odontologie, Marseille, 13005, France.
| | | | | | - Hengameh Bakhtiar
- Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
| | - Patrick Laurent
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Timone, Service d'Odontologie, Marseille, 13005, France.
| | - Imad About
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France.
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Giraud T, Jeanneau C, Bergmann M, Laurent P, About I. Tricalcium Silicate Capping Materials Modulate Pulp Healing and Inflammatory Activity In Vitro. J Endod 2018; 44:1686-1691. [PMID: 30217466 DOI: 10.1016/j.joen.2018.06.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION On stimulation by lipoteichoic acid or by a physical injury, fibroblasts have been shown to play a major role in the initiation of the pulp inflammatory reaction and healing through secretion of complement proteins and growth factors. The application of direct pulp-capping materials on these cells may interfere with the inflammatory and the healing processes within the pulp's inextensible environment. This work was designed to study in vitro the effects of silicate-based materials on pulp fibroblast modulation of the initial steps of pulp inflammation and healing. METHODS The effects of Biodentine, TheraCal, and Xeno III eluates were studied on lipoteichoic acid-stimulated and physically injured fibroblasts. Cytokine secretion (interleukin 6, vascular endothelial growth factor, fibroblast growth factor-2, and transforming growth factor-β1) was quantified by enzyme-linked immunosorbent assay. Inflammatory THP-1 adhesion to endothelial cells and their migration and activation were studied in vitro. Human pulp fibroblast proliferation was investigated with the MTT test, and their migration to the injury site was studied with the scratch healing assay. RESULTS Interleukin 6 and vascular endothelial growth factor secretion increased with all materials but to a lesser extent with Biodentine. Fibroblast growth factor-2 and transforming growth factor-β1 secretion was significantly higher with Biodentine than with all other materials. THP-1 cell adhesion to endothelial cells and their activation were reduced by Biodentine and TheraCal. However, their migration decreased only with Biodentine. Fibroblast proliferation significantly increased with Biodentine but significantly decreased with Xeno III after day 6. Finally, only Biodentine induced fibroblast migration to the injury site in the scratch assay. CONCLUSIONS These results confirm that pulp-capping materials affect the early steps of pulp inflammation and healing. They show that Biodentine had the highest pulp healing and anti-inflammatory potential when compared with the resin-containing materials. This highlights the interest of the material choice for direct pulp-capping.
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Affiliation(s)
- Thomas Giraud
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Timone, Service d'Odontologie, Marseille, France
| | | | - Madison Bergmann
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Patrick Laurent
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Timone, Service d'Odontologie, Marseille, France
| | - Imad About
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France.
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30
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Pedano MS, Li X, Li S, Sun Z, Cokic SM, Putzeys E, Yoshihara K, Yoshida Y, Chen Z, Van Landuyt K, Van Meerbeek B. Freshly-mixed and setting calcium-silicate cements stimulate human dental pulp cells. Dent Mater 2018. [PMID: 29525357 DOI: 10.1016/j.dental.2018.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To evaluate the effect of the eluates from 3 freshly-mixed and setting hydraulic calcium-silicate cements (hCSCs) on human dental pulp cells (HDPCs) and to examine the effect of a newly developed hCSC containing phosphopullulan (PPL) on HDPCs. METHODS Human dental pulp cells, previously characterized as mesenchymal stem cells, were used. To collect the eluates, disks occupying the whole surface of a 12-well plate were prepared using an experimental hCSC containing phosphopullulan (GC), Nex-Cem MTA (GC), Biodentine (Septodont) or a zinc-oxide (ZnO) eugenol cement (material-related negative control). Immediately after preparing the disks (non-set), 3ml of Dulbecco's Modified Eagle Medium (DMEM) with 10% fetal bovine serum (FBS) were added. The medium was left in contact with the disks for 24h before being collected. Four different dilutions were prepared (100%, 50%, 25% and 10%) and cell-cytotoxicity, cell-proliferation, cell-migration and odontogenic differentiation were tested. The cell-cytotoxicity and cell-proliferation assays were performed by XTT-colorimetric assay at different time points. The cell-migration ability was tested with the wound-healing assay and the odontogenic differentiation capacity of hCSCs on HDPCs was tested with RT-PCR. RESULTS Considering all experimental data together, the eluates from 3 freshly-mixed and setting hCSCs appeared not cytotoxic toward HDPCs. Moreover, all three cements stimulated proliferation, migration and odontogenic differentiation of HDPCs. SIGNIFICANCE The use of freshly-mixed and setting hCSCs is an appropriate approach to test the effect of the materials on human dental pulp cells. The experimental material containing PPL is non-cytotoxic and positively stimulates HDPCs.
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Affiliation(s)
- Mariano S Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Shuchen Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Zeyi Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Stevan M Cokic
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Eveline Putzeys
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Kumiko Yoshihara
- Okayama University Hospital, Center for Innovative Clinical Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yashuhiro Yoshida
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium; University Hospitals Leuven (UZ Leuven), Dentistry, Campus Sint-Raphaël, block A - box 7001, Kapucijnenvoer 7, 3000 Leuven, Belgium
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Jeanneau C, Laurent P, Rombouts C, Giraud T, About I. Light-cured Tricalcium Silicate Toxicity to the Dental Pulp. J Endod 2017; 43:2074-2080. [PMID: 29032813 DOI: 10.1016/j.joen.2017.07.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/11/2017] [Accepted: 07/13/2017] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Numerous studies reported dentin bridge formation after pulp capping with tricalcium silicates. By contrast, pulp capping with resins leads to pulp toxicity and inflammation. Hybrid materials made up of tricalcium silicates and resins have also been developed to be used in direct pulp capping. This work was designed to study the consequences of adding resins to tricalcium silicates by investigating TheraCal (BISCO, Lançon De Provence, France) and Biodentine (Septodont, Saint Maur des Fosses, France) interactions with the dental pulp. METHODS Media conditioned with the biomaterials were used to analyze pulp fibroblast proliferation using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) test and proinflammatory cytokine interleukin 8 (IL-8) secretion using the enzyme-linked immunosorbent assay. The effects of conditioned media on dentin sialoprotein (DSP) and nestin expression by dental pulp stem cells (DPSCs) were investigated by immunofluorescence. The materials' interactions with the vital pulp were investigated using the entire tooth culture model. RESULTS TheraCal-conditioned media significantly decreased pulp fibroblast proliferation, whereas no effect was observed with Biodentine. When DPSCs were cultured with Biodentine-conditioned media, immunofluorescence showed an increased expression of DSP and nestin. This expression was lower with TheraCal, which significantly induced proinflammatory IL-8 release both in cultured fibroblasts and entire tooth cultures. This IL-8 secretion increase was not observed with Biodentine. Entire tooth culture histology showed a higher mineralization with Biodentine, whereas significant tissue disorganization was observed with TheraCal. CONCLUSIONS Within the limits of these preclinical results, resin-containing TheraCal cannot be recommended for direct pulp capping.
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Affiliation(s)
| | - Patrick Laurent
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; Assistance Publique-Hôpitaux de Marseille (APHM), Hôpital Timone, Service d'Odontologie, Marseille, France
| | | | - Thomas Giraud
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; Assistance Publique-Hôpitaux de Marseille (APHM), Hôpital Timone, Service d'Odontologie, Marseille, France
| | - Imad About
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France.
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Abstract
Immature teeth are at risk for pulp necrosis, resulting in arrested root development and poor long-term prognosis. There is growing evidence that regenerative endodontic procedures promote desirable clinical outcomes. Despite significant advances in the field of regenerative endodontics and acceptable clinical outcomes, current evidence suggests that the tissues formed following currently used procedures do not completely recapitulate the former pulp-dentin complex. Further research is needed to identify prognostic factors and predictors of successful outcomes and to develop different treatment strategies to better predictably achieve all identified clinical outcomes, while favoring tissue formation that more closely resembles the pulp-dentin complex.
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Affiliation(s)
- Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Nikita B Ruparel
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Jalan AL, Warhadpande MM, Dakshindas DM. A comparison of human dental pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents. J Conserv Dent 2017; 20:129-133. [PMID: 28855762 PMCID: PMC5564240 DOI: 10.4103/0972-0707.212247] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Context: Direct pulp capping involves the placement of a biocompatible agent on pulp tissue that has been inadvertently exposed from traumatic injury or by iatrogenic means. Aim: To compare the human pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents. Materials and Methods: Pulp exposures were performed on the pulpal floor of forty human permanent premolars. The exposure sites were dressed with either Dycal or Biodentine as pulp-capping materials. After 45 days, teeth were extracted and processed for histological examination. Statistical Analysis: The histological data were subjected to Wilcoxon rank-sum test. Results: The dentinal bridges in teeth that were capped with Biodentine were significantly thicker (P < 0.0001) and more continuous (P = 0.0001) with less pulpal inflammation (P = 0.0044) in comparison to Dycal. Conclusion: Based on the result of this study, Biodentine can be suggested as the material of choice for direct pulp capping procedure instead of Dycal. However, further long-term follow-up in vivo human studies using Biodentine on cariously exposed pulpal teeth are warranted to derive a definite conclusion.
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Affiliation(s)
- Anushka Lalit Jalan
- Department of Conservative Dentistry and Endodontics, Government Dental College, Nagpur, Maharashtra, India
| | - Manjusha M Warhadpande
- Department of Conservative Dentistry and Endodontics, Government Dental College, Nagpur, Maharashtra, India
| | - Darshan M Dakshindas
- Department of Conservative Dentistry and Endodontics, Government Dental College, Nagpur, Maharashtra, India
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Yoshida S, Wada N, Hasegawa D, Miyaji H, Mitarai H, Tomokiyo A, Hamano S, Maeda H. Semaphorin 3A Induces Odontoblastic Phenotype in Dental Pulp Stem Cells. J Dent Res 2016; 95:1282-90. [DOI: 10.1177/0022034516653085] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In cases of pulp exposure due to deep dental caries or severe traumatic injuries, existing pulp-capping materials have a limited ability to reconstruct dentin-pulp complexes and can result in pulpectomy because of their low potentials to accelerate dental pulp cell activities, such as migration, proliferation, and differentiation. Therefore, the development of more effective therapeutic agents has been anticipated for direct pulp capping. Dental pulp tissues are enriched with dental pulp stem cells (DPSCs). Here, the authors investigated the effects of semaphorin 3A (Sema3A) on various functions of human DPSCs in vitro and reparative dentin formation in vivo in a rat dental pulp exposure model. Immunofluorescence staining revealed expression of Sema3A and its receptor Nrp1 (neuropilin 1) in rat dental pulp tissue and human DPSC clones. Sema3A induced cell migration, chemotaxis, proliferation, and odontoblastic differentiation of DPSC clones. In addition, Sema3A treatment of DPSC clones increased β-catenin nuclear accumulation, upregulated expression of the FARP2 gene (FERM, RhoGEF, and pleckstrin domain protein 2), and activated Rac1 in DPSC clones. Furthermore, in the rat dental pulp exposure model, Sema3A promoted reparative dentin formation with dentin tubules and a well-aligned odontoblast-like cell layer at the dental pulp exposure site and with novel reparative dentin almost completely covering pulp tissue at 4 wk after direct pulp capping. These findings suggest that Sema3A could play an important role in dentin regeneration via canonical Wnt/β-catenin signaling. Sema3A might be an alternative agent for direct pulp capping, which requires further study.
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Affiliation(s)
- S. Yoshida
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - N. Wada
- Division of General Dentistry, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - D. Hasegawa
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - H. Miyaji
- Department of Periodontology and Endodontology, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - H. Mitarai
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - A. Tomokiyo
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - S. Hamano
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - H. Maeda
- Division of Endodontology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Hirose Y, Yamaguchi M, Kawabata S, Murakami M, Nakashima M, Gotoh M, Yamamoto T. Effects of Extracellular pH on Dental Pulp Cells In Vitro. J Endod 2016; 42:735-41. [PMID: 26951958 DOI: 10.1016/j.joen.2016.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 01/15/2016] [Accepted: 01/27/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The proliferation and migration of dental pulp stem cells (DPSCs), a population comprised of dental pulp cells (DPCs), are important processes for pulp tissue repair. Dental pulp is exposed to changes in extracellular pH under various conditions, such as acidosis and exposure to caries-associated bacteria or a pulp capping agent. The objective of this study was to investigate the effects of extracellular pH on DPC proliferation and migration in vitro. METHODS To evaluate the proliferation potency of DPCs in various extracellular pH conditions, 2 × 10(4) cells were seeded into 35-mm dishes. The following day, we changed to NaHCO3-free medium, which was adjusted to different extracellular pH levels. RESULTS After 120 hours, DPCs cultured in media from a pH of 3.5 to 5.5 showed cell death, those cultured in conditions from a pH of 6.5 to 7.5 showed growth arrest or cell death, and those grown at a pH of 9.5 showed mild proliferation. The migratory activity of living DPCs was not affected by extracellular pH. For histologic analysis, human teeth possessing a small abscess in the coronal pulp chamber were sliced for histologic analysis. Proliferating cell nuclear antigen (PCNA) immunolocalization was used as an index of cell proliferation for the sections and cultured cells. Acidic extracellular pH conditions resulted in reduced numbers of PCNA-positive DPCs in the dishes. As for pulp tissue affected by a small abscess, a PCNA-negative pulp cell layer was observed in close proximity to the infectious lesion. CONCLUSIONS Together, these results suggest that an acidic extracellular pH condition is associated with DPC growth arrest or cell death.
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Affiliation(s)
- Yujiro Hirose
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaya Yamaguchi
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shigetada Kawabata
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masashi Murakami
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Misako Nakashima
- Department of Dental Regenerative Medicine, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tokunori Yamamoto
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Li Z, Cao L, Fan M, Xu Q. Direct Pulp Capping with Calcium Hydroxide or Mineral Trioxide Aggregate: A Meta-analysis. J Endod 2015; 41:1412-7. [DOI: 10.1016/j.joen.2015.04.012] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/17/2015] [Accepted: 04/12/2015] [Indexed: 11/30/2022]
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Calcium silicate bioactive cements: Biological perspectives and clinical applications. Dent Mater 2015; 31:351-70. [DOI: 10.1016/j.dental.2015.01.004] [Citation(s) in RCA: 272] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/23/2014] [Accepted: 01/07/2015] [Indexed: 01/25/2023]
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Shigetani Y, Yoshiba K, Kuratate M, Takei E, Yoshiba N, Yamanaka Y, Ohshima H, Okiji T. Temporospatial localization of dentine matrix protein 1 following direct pulp capping with calcium hydroxide in rat molars. Int Endod J 2014; 48:573-81. [PMID: 25074651 DOI: 10.1111/iej.12351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/28/2014] [Indexed: 11/29/2022]
Abstract
AIM To examine the temporospatial expression of dentine matrix protein 1 (DMP1; a noncollagenous protein involved in mineralized tissue formation), osteopontin (another noncollagenous protein detected during reparative dentinogenesis) and nestin (a marker of differentiating/differentiated odontoblasts), following direct pulp capping with calcium hydroxide in rat molars. METHODOLOGY The maxillary first molars of 8-week-old Wistar rats had their pulps exposed and capped with calcium hydroxide. The pulp-capped teeth were collected from 6 h to 14 days postoperatively and processed for immunohistochemistry for DMP1, osteopontin and nestin. Cell proliferation was monitored using 5-bromo-2'-deoxyuridine (BrdU) labelling. RESULTS The capped pulps initially exhibited superficial necrotic changes followed by the formation of new matrix and its mineralization. DMP1 immunoreactivity was observed in the matrix beneath the necrotic layer from 6 h onwards and present in the outer portion of the newly formed mineralized matrix from 7 days onwards. Osteopontin displayed a similar expression pattern, although it occupied a narrower area than DMP1 at 6 and 12 h. Nestin-immunoreactive cells appeared beneath the DMP1-immunoreactive area at 1 day, were distributed beneath the newly formed matrix at 5 days and exhibited odontoblast-like morphology by 14 days. BrdU-positive cells significantly increased at 2 and 3 days (P < 0.05) and then decreased. CONCLUSIONS The deposition of DMP1 at exposed pulp sites preceded the appearance of nestin-immunoreactive cells, active cell proliferation and new matrix formation after pulp capping with calcium hydroxide in rat molars, suggesting that DMP1 acts as a trigger of pulp repair. The colocalization of DMP1 and osteopontin suggests that these two proteins play complementary roles.
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Affiliation(s)
- Y Shigetani
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Yoshiba
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Kuratate
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - E Takei
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - N Yoshiba
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Y Yamanaka
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - H Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Okiji
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Chang KC, Chang CC, Chen WT, Hsu CK, Lin FH, Lin CP. Development of calcium phosphate/sulfate biphasic cement for vital pulp therapy. Dent Mater 2014; 30:e362-70. [PMID: 25189109 DOI: 10.1016/j.dental.2014.08.368] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 07/28/2014] [Accepted: 08/08/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Bioactive calcium phosphate cement (CPC) has been used widely to repair bone defects because of its excellent biocompatibility and bioactivity. However, the poor handling properties, low initial mechanical strength, and long setting time of CPC limit its application in vital pulp therapy (VPT). The aim of this study was to synthesize biphasic calcium phosphate/sulfate cements and evaluate the feasibility of applying these cements in VPT. METHODS The physical, chemical, and mechanical properties of CPC were improved by mixing the cement with various amounts of α-calcium sulfate hemihydrate (CSH). The hydration products and crystalline phases of the materials were characterized using scanning electron microscopy and X-ray diffraction analysis. In addition, the physical properties, such as the setting time, compressive strength, viscosity, and pH were determined. Water-soluble tetrazolium salt-1 and lactase dehydrogenase were used to evaluate cell viability and cytotoxicity. RESULTS The developed CPC (CPC/CSH cement), which contains 50wt% CSH cement, exhibited no obvious temperature increase or pH change during setting when it was used as a paste. The initial setting time of the CPC/CSH biphasic cement was substantially shorter than that of CPC, and the initial mechanical strength was 23.7±5.6MPa. The CPC/CSH cement exhibited higher viscosity than CPC and, thus, featured acceptable handling properties. X-ray diffraction analysis revealed that the relative peak intensity for hydroxyapatite increased, and the intensity for calcium sulfate dehydrate decreased as the amount of CPC was increased. The cell viability and cytotoxicity test results indicated that the CPC/CSH cement did not harm dental pulp cells. SIGNIFICANCE The developed CPC/CSH biphasic cement exhibits substantial potential for application in VPT.
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Affiliation(s)
- Kai-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, No. 1, Chang-De St., Jhong-Jheng District, Taipei City 100, Taiwan, ROC.
| | - Chia-Chieh Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, No. 1, Chang-De St., Jhong-Jheng District, Taipei City 100, Taiwan, ROC
| | - Wei-Tang Chen
- Institute of Materials Science and Engineering, National Taipei University of Technology, No. 1, Sec. 3 Chung-Hsiao E. Rd., Da-an District, Taipei City 106, Taiwan, ROC
| | - Chung-King Hsu
- Institute of Materials Science and Engineering, National Taipei University of Technology, No. 1, Sec. 3 Chung-Hsiao E. Rd., Da-an District, Taipei City 106, Taiwan, ROC
| | - Feng-Huei Lin
- Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Ren-Ai Rd., Jhong-Jheng District, Taipei City 100, Taiwan, ROC
| | - Chun-Pin Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, No. 1, Chang-De St., Jhong-Jheng District, Taipei City 100, Taiwan, ROC; National Taiwan University Hospital, National Taiwan University, No. 1, Chang-De St., Taipei City 100, Taiwan, ROC.
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Camilleri J, Laurent P, About I. Hydration of Biodentine, Theracal LC, and a prototype tricalcium silicate-based dentin replacement material after pulp capping in entire tooth cultures. J Endod 2014; 40:1846-54. [PMID: 25154317 DOI: 10.1016/j.joen.2014.06.018] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 06/02/2014] [Accepted: 06/14/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The calcium-releasing ability of pulp-capping materials induces pulp tissue regeneration. Tricalcium silicate-based materials produce calcium hydroxide as a by-product of hydration. Assessment of hydration and calcium ion leaching is usually performed on samples that have been aged in physiological solution for a predetermined period of time. The hydration and activity of the materials in vivo may not be similar to those displayed in vitro because of insufficient fluid available in contact with dentin. The aim of this research was the assessment of hydration of Biodentine, Theracal LC, and a prototype radiopacified tricalcium silicate-based material after pulp capping and to compare it with direct hydration in an aqueous solution. METHODS The extent of hydration of Biodentine, Theracal LC, and a prototype radiopacified tricalcium silicate-based material with a similar composition to Biodentine but not incorporating the additives was assessed by scanning electron microscopy and energy dispersive spectroscopy of polished specimens after being allowed to hydrate in Hank's balanced salt solution for 14 days. The extent of hydration was compared with material hydration when used as direct pulp capping materials by using a tooth culture model. Material activity was also assessed by x-ray diffraction analysis to investigate the deposition of calcium hydroxide by the materials, and calcium ion leaching in Hank's balanced salt solution was assessed by ion chromatography. RESULTS Biodentine and the prototype tricalcium silicate cement hydrated and reaction by-products were deposited in the cement matrix both after pulp capping and when incubated in an aqueous solution. Calcium hydroxide was formed, and calcium ions were leached in solution. Theracal LC hydration was incomplete because of the limited moisture diffusion within the material. Thus, no calcium hydroxide was produced, and a lower calcium ion leaching was recorded. CONCLUSIONS Theracal LC had a heterogeneous structure with large unhydrated particles because not enough moisture was present to allow hydration to proceed. Biodentine composition was shown to be optimized, and the environmental conditions did not affect material microstructure. Biodentine exhibited formation of calcium hydroxide and calcium ion leaching, which are beneficial to the dental pulp.
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Affiliation(s)
- Josette Camilleri
- Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, Msida, Malta
| | - Patrick Laurent
- Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France
| | - Imad About
- Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France.
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Abou Neel EA, Chrzanowski W, Salih VM, Kim HW, Knowles JC. Tissue engineering in dentistry. J Dent 2014; 42:915-28. [PMID: 24880036 DOI: 10.1016/j.jdent.2014.05.008] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 05/15/2014] [Accepted: 05/17/2014] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES of this review is to inform practitioners with the most updated information on tissue engineering and its potential applications in dentistry. DATA The authors used "PUBMED" to find relevant literature written in English and published from the beginning of tissue engineering until today. A combination of keywords was used as the search terms e.g., "tissue engineering", "approaches", "strategies" "dentistry", "dental stem cells", "dentino-pulp complex", "guided tissue regeneration", "whole tooth", "TMJ", "condyle", "salivary glands", and "oral mucosa". SOURCES Abstracts and full text articles were used to identify causes of craniofacial tissue loss, different approaches for craniofacial reconstructions, how the tissue engineering emerges, different strategies of tissue engineering, biomaterials employed for this purpose, the major attempts to engineer different dental structures, finally challenges and future of tissue engineering in dentistry. STUDY SELECTION Only those articles that dealt with the tissue engineering in dentistry were selected. CONCLUSIONS There have been a recent surge in guided tissue engineering methods to manage periodontal diseases beyond the traditional approaches. However, the predictable reconstruction of the innate organisation and function of whole teeth as well as their periodontal structures remains challenging. Despite some limited progress and minor successes, there remain distinct and important challenges in the development of reproducible and clinically safe approaches for oral tissue repair and regeneration. Clearly, there is a convincing body of evidence which confirms the need for this type of treatment, and public health data worldwide indicates a more than adequate patient resource. The future of these therapies involving more biological approaches and the use of dental tissue stem cells is promising and advancing. Also there may be a significant interest of their application and wider potential to treat disorders beyond the craniofacial region. CLINICAL SIGNIFICANCE Considering the interests of the patients who could possibly be helped by applying stem cell-based therapies should be carefully assessed against current ethical concerns regarding the moral status of the early embryo.
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Affiliation(s)
- Ensanya Ali Abou Neel
- Division of Biomaterials, Operative and Aesthetic Department Biomaterials Division, King Abdulaziz University, Jeddah, Saudi Arabia; Biomaterials Department, Faculty of Dentistry, Tanta University, Tanta, Egypt; UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK.
| | - Wojciech Chrzanowski
- The University of Sydney, The Faculty of Pharmacy, NSW 2006 Sydney, Australia; Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea
| | - Vehid M Salih
- UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK; Plymouth University Peninsula School of Medicine & Dentistry, Drake's Circus, Plymouth PL4 8AA, Devon, UK
| | - Hae-Won Kim
- Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea; Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea; Department of Biomaterials Science, College of Dentistry, Dankook, University, Cheonan 330-714, Republic of Korea
| | - Jonathan C Knowles
- UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK; Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea
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Cytocompatibility and antibacterial properties of capping materials. ScientificWorldJournal 2014; 2014:181945. [PMID: 24959601 PMCID: PMC4052471 DOI: 10.1155/2014/181945] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/24/2014] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to evaluate and compare the antimicrobial activity and cytocompatibility of six different pulp-capping materials: Dycal (Dentsply), Calcicur (Voco), Calcimol LC (Voco), TheraCal LC (Bisco), MTA Angelus (Angelus), and Biodentine (Septodont). To evaluate antimicrobial activity, materials were challenged in vitro with Streptococcus mutans, Streptococcus salivarius, and Streptococcus sanguis in the agar disc diffusion test. Cytocompatibility of the assayed materials towards rat MDPC-23 cells was evaluated at different times by both MTT and apoptosis assays. Results significantly differed among the different materials tested. Both bacterial growth inhibition halos and cytocompatibility performances were significantly different among materials with different composition. MTA-based products showed lower cytotoxicity and valuable antibacterial activity, different from calcium hydroxide-based materials, which exhibited not only higher antibacterial activity but also higher cytotoxicity.
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Comparative Evaluation of Platelet-rich Fibrin and Mineral Trioxide Aggregate as Pulpotomy Agents in Permanent Teeth with Incomplete Root Development: A Randomized Controlled Trial. J Endod 2014; 40:599-605. [DOI: 10.1016/j.joen.2014.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/26/2013] [Accepted: 01/09/2014] [Indexed: 11/19/2022]
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Xie X, Ma S, Li C, Liu P, Wang H, Chen L, Qin C. Expression of Small Integrin-Binding LIgand N-linked Glycoproteins (SIBLINGs) in the reparative dentin of rat molars. Dent Traumatol 2014; 30:285-95. [PMID: 24502800 DOI: 10.1111/edt.12093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2013] [Indexed: 12/27/2022]
Abstract
AIM To analyze the expression and distribution of Small Integrin-Binding LIgand N-linked Glycoproteins (SIBLINGs) in reparative dentin (RepD). METHODOLOGY Cavities on the mesial surfaces of rat molars were prepared to expose the pulp, and a calcium hydroxide agent was applied to cap the exposed pulp. The molars with pulp capping were extracted at postoperative 1, 2, and 4 weeks. The immunolocalization of four SIBLINGs, dentin matrix protein 1 (DMP1), dentin sialoprotein (DSP), bone sialoprotein (BSP), and osteopontin (OPN) in RepD, was analyzed in comparison with reactionary dentin (ReaD) and primary dentin (PD). RESULTS At two weeks after operation, the region of the exposed pulp formed a layer of reparative dentin bridge sealing the communication between the cavity and pulp chamber. Dentinal tubules in RepD were more irregular in shape and fewer in number than PD. At postoperative 2 and 4 weeks, RepD had lower levels of DMP1 and DSP than PD. BSP and OPN were present in RepD, but not in PD. RepD showed certain similarities to ReaD in the expression of SIBLINGs. CONCLUSIONS The reduced levels of DMP1 and DSP may be associated with the decreased number of dentinal tubules in RepD. The expression of BSP and OPN in RepD indicates that the odontoblast-like cells were attempting to produce a hard tissue at a very rapid pace. These findings suggest that in response to the surgical injury, the newly differentiated odontoblast-like cells altered their synthesis of the dentinogenesis-related proteins and produced a hard tissue that is an intermediate between dentin and bone.
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Affiliation(s)
- Xiaohua Xie
- Longjiang Scholar Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Department of Endodontics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Mathieu S, Jeanneau C, Sheibat-Othman N, Kalaji N, Fessi H, About I. Usefulness of controlled release of growth factors in investigating the early events of dentin-pulp regeneration. J Endod 2014; 39:228-35. [PMID: 23321236 DOI: 10.1016/j.joen.2012.11.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/26/2012] [Accepted: 11/06/2012] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Little information is yet available on the signals involved in progenitor cell migration that precede reparative dentin synthesis. Our aim was to investigate the effect of the controlled release of fibroblast growth factor (FGF)-2 and transforming growth factor β1 (TGF-β1) on permanent teeth pulp cell proliferation and progenitor cell migration. METHODS FGF-2 and TGF-β1 were encapsulated into a biodegradable polymer matrix of lactide and glycolide. Human pulp cells were prepared from third molars, and progenitor cells were sorted by STRO-1. The synthesized microsphere toxicity was checked with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test. The growth factor release kinetics were checked by an enzyme-linked immunosorbent assay while maintaining their biological activity and were evaluated by investigating their effects on pulp cell proliferation. Their chemotactic potential was investigated on STRO-1-sorted cells in a migration chamber on Matrigel (Cambrex Bio Science, Walkersville, MD). RESULTS The cell viability was unaffected by the presence of microspheres. The released amount of FGF-2 and TGF-β1 from the microspheres was maintained after 21 days. Increasing the FGF-2-loaded microsphere concentration or the release period significantly increased dental pulp cell proliferation. TGF-β1 acted as a potent chemotactic factor of STRO-1-sorted cells. CONCLUSIONS Encapsulating TGF-β1 and FGF-2 in a biodegradable polymer of lactide and glycolide microsphere allowed a sustained release of growth factors and provided a protection to their biological activities. Our results clearly show the usefulness of growth factor controlled release in investigating the early events of pulp/dentin regeneration. It provides additional data on the signals required for vital pulp therapy and future tissue engineering.
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Affiliation(s)
- Sylvie Mathieu
- Centre de Recherche en Oncologie et Oncopharmacologie, Aix-Marseille University, Marseille, France
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About I. Dentin-pulp regeneration: the primordial role of the microenvironment and its modification by traumatic injuries and bioactive materials. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Chmilewsky F, Jeanneau C, Laurent P, Kirschfink M, About I. Pulp progenitor cell recruitment is selectively guided by a C5a gradient. J Dent Res 2013; 92:532-9. [PMID: 23603337 DOI: 10.1177/0022034513487377] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
It recently became evident that activation of the complement system also contributes to tissue regeneration after infection/injury. The complement-derived fragment C5a induces vascular modifications and attracts cells expressing its receptor (C5aR/CD88) to the site of infection and tissue injury. Besides inflammatory cells, various tissue cells express this receptor. We hypothesized that pulp progenitor cells, being exposed to local complement activation in caries lesions, may respond to C5a via the C5aR. Our work aimed at evaluating the ability of C5a to induce pulp progenitor cell migration that may link complement activation to dentin regeneration. Immunofluorescence analysis of third molar pulp sections showed perivascular localization of the mesenchymal stem cell markers STRO-1 and C5aR. RT-PCR on STRO-1-sorted pulp progenitor cells, co-expressing both STRO-1 and C5aR, revealed high C5aR mRNA levels. Experiments with the C5aR antagonist W54011 revealed that C5a specifically bound to progenitor cells via C5aR, inducing their selective migration toward the C5a gradient. Since we could also demonstrate C5b-9 formation by immunohistochemistry in carious teeth, our findings suggest that, upon local complement activation, C5a induces pulp progenitor cell migration, which may be critical in initiating the regenerative process after dentin/pulp injury.
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Affiliation(s)
- F Chmilewsky
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France
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Masuda YM, Yamada Y, Kimura Y. In vitro guidance of dental pulp cells by Nd:YAG laser-irradiated endothelial cells. Photomed Laser Surg 2012; 30:315-9. [PMID: 22506550 DOI: 10.1089/pho.2011.3173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE After endothelial cells were ablated by neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation, we investigated the response of pulp cells by examining the expression of transforming growth factor beta-1 (TGF-β1). BACKGROUND DATA The reaction of stimulated blood vessels is related to the initiation of dentinogenesis. After artificial injury of endothelial cells, pulp cells migrate to the site of the injured endothelial cells. MATERIALS AND METHODS Rat aortic endothelial cells were cultured in the lower compartment of the experimental assembly, and a pulsed Nd:YAG laser was used to ablate these cells. Pulp cells were fluorescence labeled and cultured in the upper compartment. After 7-14 days of laser irradiation, total RNA was extracted from the cells in the lower chamber, and RT-PCR was performed to examine the expression of TGF-β1 and osteocalcin mRNA. TGF-β1 was also examined with immunohistochemistry. RESULTS Seven days after laser irradiation, migrating pulp cells that expressed TGF-β1 were observed in the lower compartment, and the expression of TGF-β1 mRNA and osteocalcin mRNA was altered. Without laser irradiation, few migrating pulp cells were observed, and the expression of TGF-β1 mRNA and osteocalcin mRNA was weak. These results suggested that TGF-β1 mRNA expression is detected earlier in pulp cells rather than in endothelial cells following injury to endothelial cells. CONCLUSIONS Using the Nd:YAG laser as an ablative stimulant, this study model was useful for investigating pulp-endothelial cell interactions in reparative dentinogenesis.
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Affiliation(s)
- Yoshiko Murakami Masuda
- Department of Endodontology, Showa University School of Dentistry, Kitasenzoku, Ohta-ku, Tokyo, Japan.
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Laurent P, Camps J, About I. Biodentine(TM) induces TGF-β1 release from human pulp cells and early dental pulp mineralization. Int Endod J 2011; 45:439-48. [PMID: 22188368 DOI: 10.1111/j.1365-2591.2011.01995.x] [Citation(s) in RCA: 248] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM To assess the ability of a recently developed tricalcium silicate-based cement (Biodentine™) to induce reparative dentine synthesis and to investigate its capacity to modulate pulp cells TGF-β1 secretion. METHODOLOGY Biodentine™ was directly applied onto the dental pulp in an entire human tooth culture model. After various culture periods, the interaction of the material with dental pulp tissue was analysed on tissue sections. The effect of increasing surface area of this material on TGF-β1 secretion was investigated on pulp cell cultures and compared with that of MTA, calcium hydroxide and Xeno(®) III adhesive resin. After performing artificial injuries on pulp cell cultures, the materials eluates were added for 24 h and then TGF-β1 secretion was quantified by ELISA. Controls were performed by incubating intact cells with the culture medium, while injured cells TGF-β1 level was used as the baseline value. RESULTS Biodentine™ induced mineralized foci formation early after its application. The mineralization appeared under the form of osteodentine and expressed markers of odontoblasts. Biodentine™ significantly increased TGF-β1 secretion from pulp cells (P < 0.03) independently of the contact surface increase. This increase was also observed with calcium hydroxide and MTA, but not with the resinous Xeno(®) III. The statistical analysis showed statistically significant differences between capping materials and the resinous Xeno(®) III (P < 0.001). CONCLUSIONS When Biodentine™ was applied directly onto the pulp, it induced an early form of reparative dentine synthesis, probably due to a modulation of pulp cell TGF-β1 secretion.
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Affiliation(s)
- P Laurent
- Laboratoire Interface Matrice Extracellulaire-Biomateriaux (IMEB), Faculté D'Odontologie, Université de la Méditerranée, Marseille, France
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Abstract
The elaboration of dentin-pulp engineering strategies requires the investigation of not only progenitor cell potentials but also their interactions with other non-progenitor "supportive" cells. Under severe caries lesions, progenitor cells may be activated by growth factors released after the acidic dissolution of carious dentin. However, dentin regeneration has also been observed after traumatic injuries without any significant dentin dissolution. This raises questions about the origin of signals involved in progenitor cell activation, migration, and differentiation. Study models such as the entire tooth culture and co-cultures of pulp and endothelial cells highlighted the role of interactions between the different pulp cell types and the pivotal role they play in dentin regeneration. Injured pulp fibroblasts secrete growth factors involved in progenitor cell activation and differentiation as well as neoangiogenesis which may pave the pathways for progenitor cell migration. This appears to be the first paper to focus on this very important field in dental pulp biology.
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Affiliation(s)
- I About
- Laboratoire Interface Matrice Extracellulaire-Biomatériaux, Faculté d'Odontologie, Université de la Méditerranée, Marseille, France.
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