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de Oliveira G, de Andrade Rodrigues L, Souza da Silva AA, Gouvea LC, Silva RCL, Sasso-Cerri E, Cerri PS. Reduction of osteoclast formation and survival following suppression of cytokines by diacerein in periodontitis. Biomed Pharmacother 2024; 177:117086. [PMID: 39013222 DOI: 10.1016/j.biopha.2024.117086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/29/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
Periodontitis causes an increase in several bioactive agents such as interleukins (IL), tumor necrosis factor (TNF)-α and receptor activator of NF-kB ligand (RANKL), which induce the osteoclast formation and activity. Since diacerein exerts anti-TNF-α and anti-IL-1 effects, alleviating bone destruction in osteoarthritis, we investigated whether this drug inhibits the formation and survival of osteoclast in the periodontitis. Rats were distributed into 3 groups: 1) group with periodontitis treated with 100 mg/kg diacerein (PDG), 2) group with periodontitis treated with saline (PSG) and group control (CG) without any treatment. After 7, 15 and 30 days, the maxillae were collected for light and transmission electron microscopy analyses. Gingiva samples were collected to evaluate the mRNA levels for Tnf, Il1b, Tnfsf11 and Tnfrsf11b by RT-qPCR. In PDG, the expression of Tnf and Il1b genes reduced significantly compared to PSG, except for Tnf expression at 7 days. The number of osteoclasts reduced significantly in the PDG in comparison with PSG at 7 and 15 days. In all periods, the IL-6 immunoexpression, RANKL/OPG immunoexpression and mRNA levels of Tnfsf11/Tnfrsf11b ratio were significantly lower in PDG than in PSG. PDG exhibited significantly higher frequency of TUNEL-positive osteoclasts than in PSG and CG at all time points. Osteoclasts with caspase-3-immunolabelled cytoplasm and nuclei with masses of condensed chromatin were observed in PDG, confirming osteoclast apoptosis. Diacerein inhibits osteoclastogenesis by decreasing Tnf and Il1b mRNA levels, resulting in decreased RANKL/OPG ratio, and induces apoptosis in osteoclasts of alveolar process of rat molars with periodontitis.
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Affiliation(s)
- Gabriella de Oliveira
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Lucas de Andrade Rodrigues
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | | | - Lays Cristina Gouvea
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Renata Cristina Lima Silva
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Estela Sasso-Cerri
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Paulo Sérgio Cerri
- São Paulo State University (UNESP), School of Dentistry, Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil.
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Ateş A, Kurt A, Mercantepe T. Effects of mineral trioxide aggregate and methyl sulfonyl methane on pulp exposure via RUNX2 and RANKL pathways. Odontology 2024; 112:895-905. [PMID: 38194042 DOI: 10.1007/s10266-023-00885-y] [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: 07/12/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
The aim of this study was to determine the therapeutic effects of mineral trioxide aggregate (MTA) and methyl sulfonyl methane (MSM) on pulp damage due to pulp exposure through the RUNX2 and RANKL pathways. Seventy-two male Sprague-Dawley rats aged 4-6 months and weighing 250-300 g were divided into healthy, control, MTA, and MSM groups. After experimental applications, all rats at 2, 4, and 8 weeks were killed anesthetically with xylazine hydrochloride (Rompun, Bayer) 30 mg/kg and ketamine hydrochloride (Ketalar, Pfizer) 50 mg/kg injections (i.p.). We observed that necrotic odontoblasts, edema, inflammation, and vascular congestion findings were reduced from week 2 to week 8 in the MSM treatment group after pulp capping compared to the control group and MTA group. Similarly, we found a decrease in RUNX2 and RANKL levels in the MSM application group compared to the control and MTA groups (p < 0.05). MSM material has shown therapeutic effects on pulp capping treatment-induced pulp injury via increased RUNX2 ve RANKL expression.
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Affiliation(s)
- Altar Ateş
- Department of Pediatric Dentistry, Faculty of Dentistry, Recep Tayyip Erdogan University, 53100, Rize, Turkey
| | - Ayca Kurt
- Department of Pediatric Dentistry, Faculty of Dentistry, Recep Tayyip Erdogan University, 53100, Rize, Turkey.
| | - Tolga Mercantepe
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, 53100, Rize, Turkey
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Silva ECA, Pradelli JA, da Silva GF, Cerri PS, Tanomaru-Filho M, Guerreiro-Tanomaru JM. Biocompatibility and bioactive potential of NeoPUTTY calcium silicate-based cement: An in vivo study in rats. Int Endod J 2024; 57:713-726. [PMID: 38467586 DOI: 10.1111/iej.14054] [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: 09/13/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
AIM To evaluate the inflammatory reaction and the ability to induce mineralization activity of a new repair material, NeoPUTTY (NPutty; NuSmile, USA), in comparison with Bio-C Repair (BC; Angelus, Brazil) and MTA Repair HP (MTA HP; Angelus, Brazil). METHODOLOGY Polyethylene tubes were filled with materials or kept empty (control group, CG) and implanted in subcutaneous tissue of rats for 7, 15, 30, and 60 days (n = 6/group). Capsule thickness, number of inflammatory cells (ICs), fibroblasts, collagen content, and von Kossa analysis were performed. Unstained sections were evaluated under polarized light and by immunohistochemistry for osteocalcin (OCN). Data were submitted to two-way anova followed by Tukey's test (p ≤ .05), except for OCN. OCN data were submitted to Kruskal-Wallis and Dunn and Friedman post hoc tests followed by the Nemenyi test at a significance level of 5%. RESULTS At 7, 15, and 30 days, thick capsules containing numerous ICs were seen around the materials. At 60 days, a moderate inflammatory reaction was observed for NPutty, BC while MTA HP presented thin capsules with moderate inflammatory cells. In all periods, NPutty specimens contained the highest values of ICs (p < .05). From 7 to 60 days, the number of ICs reduced significantly while an increase in the number of fibroblasts and birefringent collagen content was observed. At 7 and 15 days, no significant difference was observed in the immunoexpression of OCN (p > .05). At 30 and 60 days, NPutty showed the lowest values of OCN (p < .05). At 60 days, a similar immunoexpression was observed for BC and MTA HP (p > .05). In all time intervals, capsules around NPutty, BC, and MTA HP showed von Kossa-positive and birefringent structures. CONCLUSIONS Despite the greater inflammatory reaction promoted by NeoPutty than BC and MTA HP, the reduction in the thickness of capsules, the increase in the number of fibroblasts, and the reduction in the number of ICs indicate that this bioceramic material is biocompatible Furthermore, NeoPutty presents the ability to induce mineralization activity.
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Affiliation(s)
- Evelin Carine Alves Silva
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Jéssica Arielli Pradelli
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Paulo Sérgio Cerri
- Department of Morphology, School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
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Bueno CRE, Benetti F, Cury MTS, Vasques AMV, Cosme-Silva L, Queiroz ÍODA, da Silva ACR, Jacinto RDC, Cintra LTA, Dezan-Junior E. Biological investigation of resinous endodontic sealers containing calcium hydroxide. PLoS One 2023; 18:e0287890. [PMID: 37459336 PMCID: PMC10351732 DOI: 10.1371/journal.pone.0287890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
The purpose of this study was to evaluate, in vivo, the biocompatibility, biomineralization, collagen maturation and the in vitro antibacterial and cytotoxicity of resinous endodontic sealers containing calcium hydroxide. Forty rats were implanted with polyethylene tubes containing Sealer 26, Sealer Plus, Dia-ProSeal and an empty tube, examined after 7, 15, 30 and 60 days. Antimicrobial activity was evaluated against Enterococcus faecalis by Agar Diffusion Test (ADT) through inhibition zones. For cytotoxicity, undifferentiated pulp cells (OD-21) were cultured and assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, exposed to dilution of serial extracts at 6, 24, 48h. Cytotoxicity was analyzed by two-way ANOVA and Bonferroni correction. Kruskal-Wallis test followed by Dunn test was performed for nonparametric data (p<0.05). MTT assay revealed cell proliferation affected by sealers extract in all periods (p<0.0001), except for Dia-Proseal and Sealer Plus ⅛ dilution. Subcutaneous analysis showed at day 7th moderate inflammatory infiltration. After 30 days, Sealer 26 still showed moderate inflammatory infiltrate compared to mild inflammation from control and Dia-ProSeal (p = 0.006). At day 60th, all groups showed similar mild inflammatory infiltrate (p>0.05). Sealer 26 induced more biomineralization than other sealers in all periods. At 7 and 15 days, all sealers had significant percentage of immature collagen fibers. After 60 days Sealer 26 showed more mature fibers compared to other sealers (p<0.001). All sealers had a smaller zone of inhibition than chlorhexidine, but with no significant difference among any group (p>0.05). All sealers showed satisfactory biological responses with in vitro/in vivo biocompatibility and antimicrobial activity against planktonic bacteria. Sealer 26 induced more biomineralization than Sealer Plus and Dia-ProSeal.
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Affiliation(s)
- Carlos Roberto Emerenciano Bueno
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Marina Tolomei Sandoval Cury
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Ana Maria Veiga Vasques
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Leopoldo Cosme-Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Índia Olinta de Azevedo Queiroz
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Ana Cláudia Rodrigues da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Rogério de Castilho Jacinto
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Eloi Dezan-Junior
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Ezawa N, Akashi Y, Nakajima K, Kokubun K, Furusawa M, Matsuzaka K. The Effects of Tricalcium-Silicate-Nanoparticle-Containing Cement: In Vitro and In Vivo Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4451. [PMID: 37374634 DOI: 10.3390/ma16124451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
A tricalcium-silicate-nanoparticle-containing cement (Biodentine) was developed to overcome the disadvantages of existing mineral trioxide aggregate (MTA) dental materials. This study aimed at evaluating the effects of Biodentine on the osteogenic differentiation of human periodontal ligament fibroblasts (HPLFs) in vitro and the healing of furcal perforations created experimentally in rat molars in vivo, in comparison to MTA. The in vitro studies performed the following assays: pH measurement using a pH meter, the release of calcium ions using a calcium assay kit, cell attachment and morphology using SEM, cell proliferation using a coulter counter, marker expression using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and cell mineralized deposit formation using Alizarin Red S (ARS) staining. In the in vivo studies, MTA and Biodentine were used to fill the rat molar perforations. Rat molars were processed at 7, 14 and 28 days for analysis of inflammatory processes using hematoxylin and eosin (HE) staining, immunohistochemical staining of Runx2 and tartrate-resistant acid phosphate (TRAP) staining. The results demonstrate that the nanoparticle size distribution of Biodentine is critical for osteogenic potential at an earlier stage compared to MTA. Further studies are required to elucidate the mechanism of action of Biodentine in osteogenic differentiation.
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Affiliation(s)
- Naho Ezawa
- Department of Endodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, Tokyo 101-0061, Japan
| | | | - Masahiro Furusawa
- Department of Endodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, Tokyo 101-0061, Japan
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Küçükkaya Eren S. Clinical applications of calcium silicate-based materials: a narrative review. Aust Dent J 2023; 68 Suppl 1:S96-S109. [PMID: 37885314 DOI: 10.1111/adj.12986] [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] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.
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Affiliation(s)
- S Küçükkaya Eren
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
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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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de Souza GL, Freitas GAN, Ribeiro MTH, Lemus NXA, Soares CJ, Moura CCG. Effects of different calcium-silicate based materials on fracture resistance of immature permanent teeth with replacement root resorption and osteoclastogenesis. Restor Dent Endod 2023; 48:e21. [PMID: 37284344 PMCID: PMC10240096 DOI: 10.5395/rde.2023.48.e21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/26/2023] [Accepted: 03/26/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Results No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.
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Affiliation(s)
- Gabriela Leite de Souza
- Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Maria Tereza Hordones Ribeiro
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Delfino MM, Jampani JLDA, Lopes CS, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Sasso-Cerri E, Cerri PS. Participation of fibroblast growth factor-1 and interleukin-10 in connective tissue repair following subcutaneous implantation of bioceramic materials in rats. Int Endod J 2023; 56:385-401. [PMID: 36353742 DOI: 10.1111/iej.13867] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
AIM To evaluate whether the bioceramic materials Bio-C Pulpo (Bio-C, Angelus) and mineral trioxide aggregate (MTA) Repair HP (MTA-HP, Angelus) induce fibroblast proliferation and release of interleukin-10 (IL-10), an anti-inflammatory cytokine, stimulating connective tissue remodelling. The tissue response of Bio-C and MTA-HP was compared with the White MTA (WMTA; Angelus) since studies have demonstrated that WMTA induces tissue repair. METHODOLOGY Bio-C, MTA-HP and WMTA were inserted into polyethylene tubes and implanted in the subcutaneous tissue of Holtzman rats for 7, 15, 30 and 60 days. As a control group (CG), empty tubes were implanted subcutaneously. The number of fibroblasts (FB), Ki-67-, fibroblast growth factor-1- (FGF-1) and IL-10-immunolabelled cells and collagen content in the capsules was obtained. The data were subjected to two-way anova followed by Tukey's test (p ≤ .05). RESULTS At 7 days, significant differences in the number of FB were not detected amongst Bio-C, MTA-HP and WMTA groups (p ˃ .05). The capsules of all groups exhibited a significant increase in the number of FB and content of collagen over time. From 7 to 60 days, a significant reduction in the number of FGF-1- and Ki-67-immunolabelled cells was seen in the capsules of all specimens. In all periods, no significant difference in the number of FGF-1-immunolabelled cells was detected between Bio-C and CG specimens. At 60 days, significant differences in the immunoexpression of FGF-1 were not observed amongst the groups. At 7 and 15 days, the highest immunoexpression for Ki-67 was present in Bio-C specimens whilst, after 30 and 60 days, no significant difference was observed amongst the bioceramic materials. At 7 days, few IL-10 immunolabelled cells were present in the capsules of all specimens whereas, at 60 days, a significant increase in the IL-10-immunostaining was present in all groups. At 60 days, the Bio-C, MTA-HP and WMTA groups showed a greater number of IL-10-immunolabelled cells than in the CG specimens (p < .0001). CONCLUSIONS Bio-C, MTA-HP and WMTA stimulate fibroblast proliferation, leading to the formation of collagen-rich capsules. FGF-1 and IL-10 may mediate the remodelling of capsules around Bio-C, MTA-HP and WMTA bioceramic materials.
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Affiliation(s)
- Mateus Machado Delfino
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - José Leandro de Abreu Jampani
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Camila Soares Lopes
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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Al-Nazhan S, El Mansy I, Al-Nazhan N, Al-Rowais N, Al-Awad G. Outcomes of furcal perforation management using Mineral Trioxide Aggregate and Biodentine: a systematic review. J Appl Oral Sci 2022; 30:e20220330. [PMID: 36477558 PMCID: PMC9724492 DOI: 10.1590/1678-7757-2022-0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
Furcal perforation is an iatrogenic or pathologic communication between the pulp chamber floor and the alveolar bone. The outcome of perforation sealing depends greatly on the tissue compatibility and bioactivity and sealing properties of the repair materials. Mineral trioxide aggregate (MTA) and Biodentine are currently the most used materials to treat this condition. The present systematic review aimed to report the treatment outcome of repaired furcal perforation using MTA and Biodentine and identify which material would yield a better outcome. METHODOLOGY A comprehensive search was conducted using the PubMed database to identify experimental studies and case reports that describe treatment of furcal perforation. Studies and case reports that evaluated the outcome of repaired furcal perforations using MTA and Biodentine, published in English from 2018 to April 2022, were identified. Unavailable full texts were excluded. RESULTS Initial screening of 724 articles (670 studies and 54 case reports). After discarding the duplicated studies, we reviewed 50 studies, selecting 13 for abstract analysis. We retrieved and evaluated full texts of eight studies and five case reports. Both materials had an equivalent success rate in the first three months but by 12 months Biodentine performed better than MTA clinically and radiographically. CONCLUSIONS Repair of furcal perforation with Biodentine yields a better outcome compared to MTA.
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Affiliation(s)
- Saad Al-Nazhan
- Riyadh Elm UniversityCollege of DentistryRestorative Dentistry DepartmentRiyadhSaudi ArabiaRiyadh Elm University, College of Dentistry, Restorative Dentistry Department, Riyadh, Saudi Arabia.,Corresponding address: Saad A. Al-Nazhan, Riyadh Elm University - College of Dentistry - Restorative Dentistry Department - Endodontics - P.O. Box 84891 - Riyadh - Saudi Arabia 11681. e-mail:
| | - Iman El Mansy
- Riyadh Elm UniversityCollege of DentistryRestorative Dentistry DepartmentRiyadhSaudi ArabiaRiyadh Elm University, College of Dentistry, Restorative Dentistry Department, Riyadh, Saudi Arabia.
| | - Nada Al-Nazhan
- Riyadh Elm UniversityCollege of DentistryRestorative Dentistry DepartmentRiyadhSaudi ArabiaRiyadh Elm University, College of Dentistry, Restorative Dentistry Department, Riyadh, Saudi Arabia.
| | - Nbras Al-Rowais
- Riyadh Elm UniversityCollege of DentistryRestorative Dentistry DepartmentRiyadhSaudi ArabiaRiyadh Elm University, College of Dentistry, Restorative Dentistry Department, Riyadh, Saudi Arabia.
| | - Ghalia Al-Awad
- Riyadh Elm UniversityCollege of DentistryRestorative Dentistry DepartmentRiyadhSaudi ArabiaRiyadh Elm University, College of Dentistry, Restorative Dentistry Department, Riyadh, Saudi Arabia.
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ASSADIAN H, KHOJASTEH A, EBRAHIMIAN Z, AHMADINEJAD F, BOROOJENI HSH, BOHLOULI M, NEKOOFAR MH, MH DUMMER P, NOKHBATOLFOGHAHAEI H. Comparative evaluation of the effects of three hydraulic calcium silicate cements on odontoblastic differentiation of human dental pulp stem cells: an in vitro study. J Appl Oral Sci 2022; 30:e20220203. [PMID: 36350874 PMCID: PMC9651926 DOI: 10.1590/1678-7757-2022-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/02/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The study aimed to compare the response of human dental pulp stem cells (hDPSCs) towards three hydraulic calcium silicate cements (HCSCs) by measuring cytotoxicity and expression of dentinogenic genes. METHODOLOGY Dental pulps of five impacted mandibular third molars were extirpated as a source for hDPSCs. Next to culturing, hDPSCs were subjected to fluorescence-activated cell sorting after the third passage to validate stemness of the cells. Human DPSCs were exposed to diluted supernatants of OrthoMTA (OMTA), Biodentine (BD) and Calcium-Enriched Mixture (CEM) at concentrations 10, 25, 50 and 100% at the first, third and fifth day of culture. Then, cells were exposed to 10% concentrations supernatant of HCSCs to determine DSPP and DMP1 gene expression, using a quantitative polymerase-chain reaction. Data were analyzed using one-way and three-way ANOVA, followed by Tukey post hoc statistical tests. RESULTS Optimal cell proliferation was observed in all groups, regardless of concentration and time-point. HCSC supernatants were non-cytotoxic to hDPSCs at all three time-points, except for 100% Biodentine on day five. On day seven, OMTA group significantly upregulated the expression of DSPP and DMP1 genes. On day 14, expression of DMP1 and DSPP genes were significantly higher in BD and OMTA groups, respectively. CONCLUSION Biodentine significantly upregulated DMP1 gene expression over 14 days, whereas CEM was associated with only minimal expression of DSPP and DMP1 .
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Affiliation(s)
- Hadi ASSADIAN
- Tehran University of Medical SciencesSchool of DentistryDepartment of EndodonticsTehranIranTehran University of Medical Sciences, School of Dentistry, Department of Endodontics, Tehran, Iran.
| | - Arash KHOJASTEH
- Shahid Beheshti University of Medical SciencesResearch Institute of Dental SciencesDental Research CenterTehranIranShahid Beheshti University of Medical Sciences, Research Institute of Dental Sciences, Dental Research Center, Tehran, Iran.
| | | | - Fereshteh AHMADINEJAD
- Shahrekord University of Medical ScienceCellular and Molecular Research CenterShahrekordIranShahrekord University of Medical Science, Cellular and Molecular Research Center, Shahrekord, Iran.
| | - Helia Sadat Haeri BOROOJENI
- Shahid Beheshti University of Medical SciencesResearch Institute of Dental SciencesDental Research CenterTehranIranShahid Beheshti University of Medical Sciences, Research Institute of Dental Sciences, Dental Research Center, Tehran, Iran.
| | - Mahboubeh BOHLOULI
- Shahid Beheshti University of Medical SciencesSchool of Advanced Technologies in MedicineDepartment of Tissue Engineering and Applied Cell SciencesTehranIranShahid Beheshti University of Medical Sciences, School of Advanced Technologies in Medicine, Department of Tissue Engineering and Applied Cell Sciences, Tehran, Iran.
| | - Mohammad Hossein NEKOOFAR
- Tehran University of Medical SciencesSchool of DentistryDepartment of EndodonticsTehranIranTehran University of Medical Sciences, School of Dentistry, Department of Endodontics, Tehran, Iran.
| | - Paul MH DUMMER
- Cardiff UniversityCollege of Biomedical and Life SciencesSchool of DentistryCardiffUKCardiff University, College of Biomedical and Life Sciences, School of Dentistry, Cardiff, UK.
| | - Hanieh NOKHBATOLFOGHAHAEI
- Shahid Beheshti University of Medical SciencesResearch Institute of Dental SciencesDental Research CenterTehranIranShahid Beheshti University of Medical Sciences, Research Institute of Dental Sciences, Dental Research Center, Tehran, Iran.
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12
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The Immunomodulatory and Regenerative Effect of Biodentine™ on Human THP-1 Cells and Dental Pulp Stem Cells: In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2656784. [PMID: 36093401 PMCID: PMC9462999 DOI: 10.1155/2022/2656784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/09/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022]
Abstract
Background Pulp tissue affected by deep caries and trauma can be protected by vital pulp therapies in which pulp regeneration success depends on the degree of pulp inflammation and the presence of regenerative signals. Reparative dentinogenesis requires dental pulp stem cell (DPSC) activity which can be stimulated by many bioactive molecules to repair the dentine, mediating a balance between the inflammatory response and the reparative events. Therefore, this study was performed in order to investigate the immune-inflammatory effect of Biodentine capping material on DPSCs and macrophages. Method THP-1, a human monocytic cell line, was differentiated to macrophages, and flow cytometry was used to analyze the expressions of specific macrophage markers. LPS-mediated infection was created for macrophages and DPSCs followed by treatment with Biodentine. CBA array was used to investigate the cytokine secretion followed by qPCR. Migration potential of treated DPSCs was also determined. Results Our results showed that THP-1 cell line was successfully differentiated into macrophages as shown by surface marker expression. CBA array and qPCR results showed that Biodentine-treated DPSCs and macrophages upregulated anti-inflammatory cytokines and downregulated proinflammatory cytokines. Also, Biodentine enhances the migration potential of treated DPSCs. Conclusion Biodentine capping material mediated the polarization of M1 to M2 macrophages suggestive of tissue repair properties of macrophages and enhanced the anti-inflammatory cytokines of DPSCs responsible for dentine-pulp regeneration.
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de Oliveira MCG, Queiroz ÍODA, Machado T, Garrido LDMA, de Oliveira SHP, Duarte MAH. Effect of nonsteroidal anti-inflammatory drugs (NSAIDs) association on physicochemical and biological properties of tricalcium silicate-based cement. Braz Dent J 2022; 33:47-54. [PMID: 35766716 PMCID: PMC9645202 DOI: 10.1590/0103-6440202204644] [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: 08/10/2021] [Accepted: 03/08/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to investigate the physicochemical and biological properties of an experimental tricalcium silicate-based repair cement containing diclofenac sodium (CERD). For the physicochemical test, MTA, Biodentine and CERD were mixed and cement disc were prepared to evaluate the setting time and radiopacity. Root-end cavity were performed in acrylic teeth and filled with cements to analyze the solubility up to 7 days. Polyethylene tubes containing cements were prepared and calcium ions and pH were measured at 3h, 24h, 72h and 15 days. For the biological test, SAOS-2 were cultivated, exposed to cements extracts and cell proliferation were investigated by MTT assay at 6h, 24h and 48h. Polyethylene tubes containing cements were implanted into Wistar rats. After 7 and 30 days, the tubes were removed and processed for histological analyses. Parametric and nonparametric data were performed. No difference was identified in relation to setting time, radiopacity and solubility. Biodentine released more calcium ion than MTA and CERD; however, no difference between MTA and CERD were detected. Alkaline pH was observed for all cements and Biodentine exhibited highest pH. All cements promoted a raise on cell proliferation at 24h and 48h, except CERD at 48h. Biodentine stimulated cell metabolism in relation to MTA and CERD while CERD was more cytotoxic than MTA at 48h. Besides, no difference on both inflammatory response and mineralization ability for all cement were found. CERD demonstrated similar proprieties to others endodontic cements available.
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Affiliation(s)
| | | | - Thiago Machado
- Department of Oral and Maxillofacial Surgery and Integrated Clinic,
Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil
| | | | | | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru
School of Dentistry, USP, Bauru, São Paulo, Brazil
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14
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Córdova-Malca F, Coaguila-Llerena H, Garré-Arnillas L, Rayo-Iparraguirre J, Faria G. Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e35. [DOI: 10.5395/rde.2022.47.e35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/08/2022] [Accepted: 05/22/2022] [Indexed: 11/11/2022]
Affiliation(s)
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Lucía Garré-Arnillas
- Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, Peru
| | - Jorge Rayo-Iparraguirre
- Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, Peru
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Reis MDS, Scarparo RK, Signor B, Bolzan JT, Steier L, Figueiredo JAPD. Pulp capping with mineral trioxide aggregate or Biodentine: a comparison of mineralized barrier formation and inflammatory and degenerative events. Braz Oral Res 2021; 35:e118. [PMID: 34878073 DOI: 10.1590/1807-3107bor-2021.vol35.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Biodentine in endodontic practice has been widely investigated, but comprehensive histological descriptions of degenerative and inflammatory responses are not covered in most of the studies that compare pulp capping materials. This study aimed to evaluate pulpal responses to mineral trioxide aggregate (MTA Angelus) and Biodentine, focusing on mineralized barrier formation and on inflammatory and degenerative events. 80 male Wistar rats were assigned to 5 groups, according to the materials used for pulp capping and coronal sealing (n=8 per group/period). The lower first molars were mechanically exposed, capped with either MTA or Biodentine, and restored with silver amalgam. In an additional test group, the teeth were capped and sealed with Biodentine. The teeth capped with gutta-percha and restored with silver amalgam served as positive control, whereas untreated teeth served as negative control. Pulpal responses and coronal sealing were evaluated after 14 or 21 days. Data was statistically analyzed by the Kruskal-Wallis and Dunn's post hoc tests (p<0.05). Biodentine and MTA presented satisfactory results, showing a milder inflammatory response (p<0.0001) and more pronounced formation of mineralized barrier (p<0.0001) compared to the teeth capped with gutta-percha. As a restorative material, Biodentine kept coronal sealing in only 37.5% of the samples. Biodentine showed favorable properties in vital pulp therapy, being similar to MTA. However, it was not effective in protecting dental pulp from microleakage during the experimental period.
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Affiliation(s)
- Magda de Sousa Reis
- Universidade de Santa Cruz do Sul - Unisc, Department of Health Sciences, Santa Cruz do Sul, RS, Brazil
| | - Roberta Kochenborger Scarparo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Bruna Signor
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Juliana Troglio Bolzan
- Pontifícia Universidade Católica do Riio Grande do Sul - PUCRS, Clinical Department, Porto Alegre, RS, Brazil
| | - Liviu Steier
- University of Pennsylvania, School of Dental Medicine, Division of Restorative Dentistry, Philadelphia, PA, USA
| | - José Antonio Poli de Figueiredo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
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Delfino MM, de Abreu Jampani JL, Lopes CS, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Sasso-Cerri E, Cerri PS. Comparison of Bio-C Pulpo and MTA Repair HP with White MTA: effect on liver parameters and evaluation of biocompatibility and bioactivity in rats. Int Endod J 2021; 54:1597-1613. [PMID: 33999424 DOI: 10.1111/iej.13567] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/31/2022]
Abstract
AIM To evaluate the tissue response promoted by Bio-C Pulpo (Bio), MTA Repair HP (MTA-HP) and White MTA (WMTA) and whether these materials cause liver changes in a rat experimental model. METHODOLOGY Polyethylene tubes filled with Bio, MTA-HP and WMTA, and empty tubes (control group, CG) were implanted into the subcutaneous tissues of rats for 7, 15, 30 and 60 days. Inflammatory reaction score (IRS), capsule thickness, number of inflammatory cells (IC), von Kossa reaction, interleukin-6 (IL-6) and alkaline phosphatase (ALP) immunohistochemistry reactions were performed. Combined methods, von Kossa followed by immunohistochemistry for detection of ALP, were performed. At 60 days, the serum glutamic-oxaloacetic transaminase (GOT) and glutamic-pyruvic transaminase (GPT) levels were measured and liver fragments were collected for histological analysis; the data were assessed by one-way ANOVA analysis followed by Sidak's post-test. The biocompatibility and bioactivity data were subjected to the two-way ANOVA analysis followed by Tukey post hoc test, except the IRS. The IRS data were subjected to the Kruskal-Wallis ANOVA non-parametric test followed by Dunn's test (p ≤ .05). RESULTS No significant difference was detected in serum GOT and GPT concentrations and in the number of hepatocytes among the experimental and CG samples. Although Bio-C Pulpo had the highest IC and IL-6-immunolabelled cells (p < 0.0001) at all periods, no significant difference was observed in the IRS among the materials, except at 60 days. In this period, the WMTA had lower IRS. All groups had a significant reduction in the capsule thickness and in the number of IC and IL-6-immunolabelled cells over time. Bio-C Pulpo, MTA-HP and WMTA specimens had greater immunoexpression of ALP than CG (p < .0001). At all periods, von Kossa-positive and birefringent structures were observed in the capsules around the materials. ALP-immunolabelled cells were also seen near von Kossa-positive structures. CONCLUSIONS Bio-C Pulpo, MTA-HP and WMTA materials did not cause morphological changes in the liver and no significant alteration in the serum GOT and GPT levels. Moreover, these bioceramic materials were biocompatible and exhibited bioactive potential. However, Bio-C Pulpo induced greater inflammatory infiltrate than MTA-HP and WMTA at all periods.
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Affiliation(s)
- Mateus Machado Delfino
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - José Leandro de Abreu Jampani
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Camila Soares Lopes
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Paulo S Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Pinheiro LS, Kopper PMP, Quintana RM, Scarparo RK, Grecca FS. Does MTA provide a more favourable histological response than other materials in the repair of furcal perforations? A systematic review. Int Endod J 2021; 54:2195-2218. [PMID: 34418122 DOI: 10.1111/iej.13617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/20/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND There is no consensus on which furcal perforation repair material induces a more favourable histological response. This systematic review of laboratory studies provides an overview of the studies comparing repair materials in animal models. OBJECTIVES To evaluate whether mineral trioxide aggregate (MTA) yields a more favourable histological response than other materials when used to repair furcal perforations in animal experimental models. METHODS This review followed the PRISMA checklist. The studies included various materials used to repair furcal perforations and compared the histological responses with MTA. An electronic search was conducted in EMBASE, PubMed, Scopus and Web of Science up to 2 September 2020, with no language or publication date restrictions. Studies whose full text was unavailable were excluded. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. RESULTS The studies included in the qualitative synthesis were conducted in rat (n = 3) and dog (n = 17) models. They were classified as having a low quality, high methodological heterogeneity and high RoB. MTA and Biodentine, the materials most often compared, reduced the inflammatory reaction to mild over time. In addition, a mineralized tissue was formed in all studies. The response yielded by MTA was better than or equivalent to that of the other tested materials. DISCUSSION This review confirmed that MTA is the reference standard material for furcal perforation repair. However, research using animal models has inherent limitations, and the substantial methodological heterogeneity across the studies included should be considered. Therefore, the knowledge generated by this systematic review should be translated into clinical practice cautiously. CONCLUSIONS Features described in the report and quality assessment guidelines, such as PRIASE, ARRIVE and SYRCLE, should guide researchers. Despite the high RoB and the low methodological quality of the studies included, findings indicated that MTA yields a more favourable histological response than other materials in the repair of furcal perforations. REGISTRATION PROSPERO (CRD42020181297).
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Affiliation(s)
- Lucas Siqueira Pinheiro
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Maria Poli Kopper
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro Martins Quintana
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Fabiana Soares Grecca
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Calcium silicate-based cements cause environmental stiffness and show diverse potential to induce osteogenesis in human osteoblastic cells. Sci Rep 2021; 11:16784. [PMID: 34408247 PMCID: PMC8373887 DOI: 10.1038/s41598-021-96353-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/09/2021] [Indexed: 01/12/2023] Open
Abstract
Calcium silicate-based cements differ markedly in their radiopacifiers and the presence of calcium sulfate, aluminates, carbonates and other components that can affect their biological properties. This study aimed to compare the biological properties of six calcium silicate cements in human osteoblastic cell culture (Saos-2 cells): Bio-C Repair (Bio-C), PBS HP (PBS-HP), Biodentine (Biodentine), MTA Repair HP (MTA-HP), NeoMTA Plus (NeoMTA-P), and ProRoot MTA (ProRoot). After exposure to these materials, the cells were analyzed by MTT, wound healing, cell migration, and alkaline phosphatase activity (ALP) assays, real-time PCR (qPCR) analysis of the osteogenesis markers (osteocalcin or bone gamma-carboxyglutamate protein, BGLAP; alkaline phosphatase, ALPL; bone sialoprotein or secreted phosphoprotein 1, BNSP), and alizarin red staining (ARS). Curiously, the migration rates were low 24-48 h after exposure to the materials, despite the cells showing ideal rates of viability. The advanced and intermediate cell differentiation markers BGLAP and BNSP were overexpressed in the Bio-C, MTA-HP, and ProRoot groups. Only the Biodentine group showed ALPL overexpression, a marker of initial differentiation. However, the enzymatic activity was high in all groups except Biodentine. The mineralization area was significantly large in the NeoMTA-P, ProRoot, PBS-HP, MTA-HP, and Bio-C groups. The results showed that cellular environmental stiffness, which impairs cell mobility and diverse patterns of osteogenesis marker expression, is a consequence of cement exposure. Environmental stiffness indicates chemical and physical stimuli in the microenvironment; for instance, the release of cement compounds contributes to calcium phosphate matrix formation with diverse stiffnesses, which could be essential or detrimental for the migration and differentiation of osteoblastic cells. Cells exposed to Bio-C, PBS-HP, ProRoot, NeoMTA-P, and MTA-HP seemed to enter the advanced or intermediate differentiation phases early, which is indicative of the diverse potential of cements to induce osteogenesis. Cements that quickly stimulate osteoblast differentiation may be ideal for reparative and regenerative purposes since they promptly lead to dentin or bone deposition.
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ORHAN AI, TUFENKCİ P, ONCU A, SEVGI S, CELİKTEN B, ORHAN K. CBCT Visualization of Furcation Perforation Repair Materials Using Different Voxel Sizes. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.954463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Biocompatibility Study of a New Dental Cement Based on Hydroxyapatite and Calcium Silicates: Focus on Liver, Kidney, and Spleen Tissue Effects. Int J Mol Sci 2021; 22:ijms22115468. [PMID: 34067318 PMCID: PMC8196841 DOI: 10.3390/ijms22115468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The effects of a new material based on hydroxyapatite and calcium silicates, named ALBO-MPCA, were investigated on the liver, kidney and spleen. The material was administrated orally for 120 days in an in vivo model in Wistar rats, and untreated animals served as a control. Hematological and biochemical blood parameters were analyzed. Qualitative histological analysis of tissues, change in mitotic activity of cells, and histological characteristics was conducted, as well as quantitative stereological analysis of parenchymal cells, blood sinusoids, and connective tissues. Additionally, the protein expressions of Ki67 and CD68 markers were evaluated. Histological analysis revealed no pathological changes after the tested period. It showed the preservation of the architecture of blood sinusoids and epithelial cells and the presence of mitosis. Additionally, the significantly increased number of the Ki67 in the presence of ALBO-MPCA confirmed the proliferative effect of the material noticed by stereological analysis, while immunoreactive CD68 positive cells did not differ between groups. The study showed non-toxicity of the tested material based on the effects on the hematological, biochemical, and observed histological parameters; in addition, it showed evidence of its biocompatibility. These results could be the basis for further steps toward the application of tested materials in endodontics.
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Nagendrababu V, Kishen A, Murray PE, Nekoofar MH, de Figueiredo JAP, Priya E, Jayaraman J, Pulikkotil SJ, Jakovljevic A, Dummer PMH. PRIASE 2021 guidelines for reporting animal studies in Endodontology: explanation and elaboration. Int Endod J 2021; 54:858-886. [PMID: 33492704 DOI: 10.1111/iej.13481] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022]
Abstract
Laws and ethics require that before conducting human clinical trials, a new material, device or drug may have to undergo testing in animals in order to minimize health risks to humans, unless suitable supporting grandfather data already exist. The Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) 2021 guidelines were developed exclusively for the specialty of Endodontology by integrating and adapting the ARRIVE (Animals in Research: Reporting In Vivo Experiments) guidelines and the Clinical and Laboratory Images in Publications (CLIP) principles using a validated consensus-based methodology. Implementation of the PRIASE 2021 guidelines will reduce potential sources of bias and thus improve the quality, accuracy, reproducibility, completeness and transparency of reports describing animal studies in Endodontology. The PRIASE 2021 guidelines consist of a checklist with 11 domains and 43 individual items and a flowchart. The aim of the current document is to provide an explanation for each item in the PRIASE 2021 checklist and flowchart and is supplemented with examples from the literature in order for readers to understand their significance and to provide usage guidance. A link to the PRIASE 2021 explanation and elaboration document and PRIASE 2021 checklist and flowchart is available on the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org/priase/).
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Affiliation(s)
- V Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - A Kishen
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - P E Murray
- Private Consultant, Fort Lauderdale, FL, USA
| | - M H Nekoofar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - E Priya
- Division of Children and Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - J Jayaraman
- Department of Developmental Dentistry, University of Texas Health School of Dentistry, San Antonio, TX, USA
| | - S J Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - A Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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22
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Barbosa DD, Delfino MM, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Sasso-Cerri E, Silva GF, Cerri PS. Histomorphometric and immunohistochemical study shows that tricalcium silicate cement associated with zirconium oxide or niobium oxide is a promising material in the periodontal tissue repair of rat molars with perforated pulp chamber floors. Int Endod J 2021; 54:736-752. [PMID: 33277697 DOI: 10.1111/iej.13459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023]
Abstract
AIM To evaluate the periodontium response to tricalcium silicate (TCS) with zirconium oxide (ZrO2 ) or niobium oxide (Nb2 O5 ) used in the sealing of perforated pulp chamber floors in rat maxillary molars. METHODOLOGY In eighty rats, the perforations in right maxillary molars were filled with either TCS + ZrO2 , TCS + Nb2 O5 , White MTA (used as a gold standard material) or no repair material was placed (Sham Group, SG); the left molars of SG, were used as controls (CG). Sections of maxillary fragments following 7, 15, 30 and 60 days were used to evaluate the volume densities of inflammatory cells (VvIC) and fibroblasts (VvFb), width of the periodontal space, amount of collagen, number of osteoclasts and number of IL-6-immunostained cells. The data were subjected to two-way ANOVA followed by Tukey's test (P ≤ 0.05). RESULTS At all periods, significant differences in VvIC were not detected among TCS + ZrO2, TCS + Nb2 O5 and MTA groups, which had values significantly lower (P < 0.05) than the SG. Significant differences in the number of IL-6-immunolabelled cells were not observed among TCS + ZrO2 , TCS + Nb2 O5 and MTA groups (P > 0.05) at 15, 30 and 60 days. At 7, 15 and 30 days, the number of osteoclast was significantly greater in TCS + ZrO2, TCS + Nb2 O5 and MTA (P < 0.05) than in the CG; no significant difference was detected after 60 days (P > 0.05). The width of the periodontal space and amount of collagen in TCS + ZrO2 and TCS + Nb2 O5 groups were similar to the CG at 30 and 60 days while SG specimens had a significant reduction (P < 0.05) in the amount of collagen and significant increase (P < 0.05) in the width of the periodontal space. CONCLUSIONS TCS + ZrO2 and TCS + Nb2 O5 were associated with periodontium repair since these materials allowed the reestablishment of periodontal space width and collagen formation when used in the filling of uninfected perforations in the pulp chamber floor of maxillary rat molars. Furthermore, the significant reduction in the periodontal space of TCS + ZrO2 and TCS + Nb2 O5 specimens after 60 days confirmed that the experimental materials were associated with a more rapid recovery of the injured tissues than MTA.
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Affiliation(s)
- D D Barbosa
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - M M Delfino
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - M Tanomaru-Filho
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - E Sasso-Cerri
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Laboratory of Histology and Embryology, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - G F Silva
- Pro-Rectory of Research and Graduation, School of Dentistry, Universidade Sagrado Coração (USC), Bauru, São Paulo, Brazil
| | - P S Cerri
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Laboratory of Histology and Embryology, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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The Influence of New Silicate Cement Mineral Trioxide Aggregate (MTA Repair HP) on Metalloproteinase MMP-2 and MMP-9 Expression in Cultured THP-1 Macrophages. Int J Mol Sci 2020; 22:ijms22010295. [PMID: 33396675 PMCID: PMC7795909 DOI: 10.3390/ijms22010295] [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: 11/17/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to investigate the new silicate cement mineral trioxide aggregate (MTA Repair HP) with respect to its effect on the inflammation process involving the tooth and periodontal tissues. The composition of MTA Repair HP was supplemented with plasticizer agents which can have a negative effect on the modulation of tooth inflammation. The silicate-based material in question is widely used in regeneration of the pulp-dentin complex, treatment of perforations of various locations in the tooth, as well as in surgical treatment of the complications of periapical tissue. The improved bioceramic restorative cement can affect the expression of metalloproteinases MMP-2 and MMP-9 in monocytes/macrophages involved in modulation of inflammation and regenerative processes of the tooth and periodontal tissues. The novel aspect of the present study lies in the application of the model of THP-1 monocyte/macrophage and applying the biomaterial in direct contact with the cells. Hence, it provides a representation of clinical conditions with respect to regenerative pulp and periodontal treatment with the use of MTA Repair HP. A lack of macrophage activation (as measured with flow cytometry) was found. Moreover, the study identified a lack of expression stimulation of the studied metalloproteinases (with the use of Western blotting and fluorescent microscopy). Similarly, no increase in MMP-2 and MMP-9 concentration was found (measured by ELISA method) in vitro when incubated with MTA Repair HP. Based on the results it can be concluded that new MTA Repair HP does not increase the inflammatory response in monocytes/macrophages associated with the activity of the described enzymes. It can also be speculated that they do not affect the process of dentin regeneration in which MMP-2 and MMP-9 play significant roles.
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Alves Silva EC, Tanomaru-Filho M, da Silva GF, Delfino MM, Cerri PS, Guerreiro-Tanomaru JM. Biocompatibility and Bioactive Potential of New Calcium Silicate–based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC. J Endod 2020; 46:1470-1477. [DOI: 10.1016/j.joen.2020.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
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Rezende TMB, Ribeiro Sobrinho AP, Vieira LQ, Sousa MGDC, Kawai T. Mineral trioxide aggregate (MTA) inhibits osteoclastogenesis and osteoclast activation through calcium and aluminum activities. Clin Oral Investig 2020; 25:1805-1814. [PMID: 32789653 DOI: 10.1007/s00784-020-03483-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/29/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effect(s) of mineral trioxide aggregate (MTA) on in vitro RANKL-mediated osteoclast-dependent bone resorption events and the influence of Ca2+ and Al3+ on the osteoclastogenesis inhibition by MTA. MATERIALS AND METHODS Two types of osteoclast precursors, RAW 264.7 (RAW) cell line or bone marrow cells (obtained from BALB/c mice and stimulated with recombinant (r) macrophage colony stimulation factor (M-CSF), were stimulated with or without recombinant (r) activator of nuclear kappa B ligand (RANKL), in the presence or absence of MTA for 6 to 8 days. White Angelus MTA and Bios MTA (Angelus, Londrina, Paraná, Brazil) were prepared and inserted into capillary tubes (direct contact surface = 0.50 mm2 and 0.01 mm2). Influence of MTA on these types of osteoclast precursors was measured by the number of differentiated tartrate-resistant acid phosphatase (TRAP)-positive multinuclear cells (RAW and bone marrow cells), TRAP enzyme activity (RAW cells), cathepsin K gene expression (RAW cells), and resorptive pit formation (RAW cells) by mature osteoclasts. Besides, RAW cells were also stimulated with Ca2+ and Al3+ to evaluate the influence of these ions on MTA anti-osteoclastogenic potential. RESULTS In bone marrow and RAW cells, the number of TRAP-positive mature osteoclast cells induced by rRANKL was significantly inhibited by the presence of MTA compared with control rRANKL stimulation without MTA (p < 0.05), along with the reduction of TRAP enzyme activity (p < 0.05) and the low expression of cathepsin K gene (p < 0.05). In contrast, to control mature osteoclasts, the resorption area on dentin was significantly decreased for mature osteoclasts incubated with MTA (p < 0.05). rRANKL-stimulated RAW cells treated with Ca2+ and Al3+ decreased the number of osteoclasts cells. Besides, the aluminum oxide was the dominant suppressor of the osteoclastogenesis process. CONCLUSIONS MTA significantly suppressed RANKL-mediated osteoclastogenesis and osteoclast activity and, therefore, appears able to suppress bone resorption events in periapical lesions. This process might be related to Ca2+ and Al3+ activities. CLINICAL RELEVANCE MTA is an important worldwidely acknowleged biomaterial. The knowledge about its molecular activities on osteoclasts might contribute to improving the understanding of its clinical efficacy.
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Affiliation(s)
- Taia Maria Berto Rezende
- Programa de Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil. .,Curso de Odontologia, Universidade Católica de Brasília, Brasília, DF, Brazil. .,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, DF, Brazil.
| | - Antônio Paulino Ribeiro Sobrinho
- Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leda Quercia Vieira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Toshihisa Kawai
- Department of Oral Science and Translational Research, College of Dental Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA.,Cell Therapy Institute, Center for Collaborative Research, NOVA Southeastern University, Fort Lauderdale, FL, USA
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Eraković M, Duka M, Bekić M, Tomić S, Ismaili B, Vučević D, Čolić M. Anti‐inflammatory and immunomodulatory effects of Biodentine on human periapical lesion cells in culture. Int Endod J 2020; 53:1398-1412. [DOI: 10.1111/iej.13351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/19/2022]
Affiliation(s)
- M. Eraković
- Clinic for Stomatology Military Medical Academy BelgradeSerbia
| | - M. Duka
- Clinic for Stomatology Military Medical Academy BelgradeSerbia
| | - M. Bekić
- Institute for the Application of Nuclear Energy Zemun Serbia
| | - S. Tomić
- Institute for the Application of Nuclear Energy Zemun Serbia
| | - B. Ismaili
- Polyclinic, Ismaili Gostivar North Macedonia
| | - D. Vučević
- Medical Faculty of the Military Medical Academy University of Defense Belgrade Serbia
| | - M. Čolić
- Institute for the Application of Nuclear Energy Zemun Serbia
- Medical Faculty of the Military Medical Academy University of Defense Belgrade Serbia
- Medical Faculty Foča University of East Sarajevo R.Srpska Bosnia and Herzegovina
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Barczak K, Palczewska-Komsa M, Nowicka A, Chlubek D, Buczkowska-Radlińska J. Analysis of the Activity and Expression of Cyclooxygenases COX1 and COX2 in THP-1 Monocytes and Macrophages Cultured with Biodentine TM Silicate Cement. Int J Mol Sci 2020; 21:ijms21062237. [PMID: 32213831 PMCID: PMC7139705 DOI: 10.3390/ijms21062237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 12/17/2022] Open
Abstract
BiodentineTM is a material based on hydrated calcium silicate with odontotropic properties. However, from the clinician’s perspective, every material used to fill a tooth—even those showing the optimal biochemical parameters—is in fact a foreign body introduced to the organism of the host. Therefore, apart from the chemical parameters of such materials, equally important is the so-called biocompatibility of such materials. The aim of the study was to investigate whether BiodentineTM, used in the regeneration of the pulp-dentine complex, may affect the expression of the enzymes cyclooxygenase 1 (COX1) and cyclooxygenase 2 (COX2) in THP-1 monocytes/macrophages and the amount of prostanoids synthesized by these enzymes-precursors of biologically active prostanoids such as prostaglandin E2 (PGE2) and thromboxane (TXB2) which are mediators of inflammation. An original aspect of this research is the use of the THP-1 monocyte/macrophage cell model and the use of biomaterial in direct contact with cells. In this way we tried to reflect the clinical conditions of regenerative pulp and periodontal tissue treatment using BiodentineTM. The results of our study showed a lack of macrophage activation (measured by flow cytometry) and a lack of stimulation of the expression of the studied cyclooxygenase enzymes (measured by Western blotting and fluorescent microscopy), as well as a lack of increase in the concentration (measured by ELISA method) of their inflammatory mediators (PGE2 and TXB2) in vitro incubated with BiodentineTM.
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Affiliation(s)
- Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland; (M.P.-K.); (A.N.); (J.B.-R.)
- Correspondence: ; Tel.: +48-914-661-648
| | - Mirona Palczewska-Komsa
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland; (M.P.-K.); (A.N.); (J.B.-R.)
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland; (M.P.-K.); (A.N.); (J.B.-R.)
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp, 70-111 Szczecin, Poland;
| | - Jadwiga Buczkowska-Radlińska
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp 72, 70-111 Szczecin, Poland; (M.P.-K.); (A.N.); (J.B.-R.)
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