1
|
Huang L, Chen X, Yang X, Zhang Y, Liang Y, Qiu X. Elucidating epigenetic mechanisms governing odontogenic differentiation in dental pulp stem cells: an in-depth exploration. Front Cell Dev Biol 2024; 12:1394582. [PMID: 38863943 PMCID: PMC11165363 DOI: 10.3389/fcell.2024.1394582] [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: 03/01/2024] [Accepted: 05/13/2024] [Indexed: 06/13/2024] Open
Abstract
Epigenetics refers to the mechanisms such as DNA methylation and histone modification that influence gene expression without altering the DNA sequence. These epigenetic modifications can regulate gene transcription, splicing, and stability, thereby impacting cell differentiation, development, and disease occurrence. The formation of dentin is intrinsically linked to the odontogenic differentiation of dental pulp stem cells (DPSCs), which are recognized as the optimal cell source for dentin-pulp regeneration due to their varied odontogenic potential, strong proliferative and angiogenic characteristics, and ready accessibility Numerous studies have demonstrated the critical role of epigenetic regulation in DPSCs differentiation into specific cell types. This review thus provides a comprehensive review of the mechanisms by which epigenetic regulation controls the odontogenesis fate of DPSCs.
Collapse
Affiliation(s)
| | | | | | | | | | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Mumcu AK, Kurnaz S, Kiraz G, Gündüz MK. Comparative effects of 17% ethylenediaminetetraacetic acid and 9% etidronic acid applied with different irrigant activation techniques on the release of growth factors from dentin: in vitro study. BMC Oral Health 2024; 24:612. [PMID: 38802852 PMCID: PMC11131224 DOI: 10.1186/s12903-024-04336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. METHODS Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov-Smirnov test, ANOVA, and the Tukey test (p < .05). RESULTS Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest. CONCLUSIONS IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments.
Collapse
Affiliation(s)
- Arzu Kaya Mumcu
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye.
| | - Safa Kurnaz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Gülsen Kiraz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Meliha Koldemir Gündüz
- Department of Basic Sciences of Engineering, Faculty of Engineering and Natural Sciences, Kutahya Health Sciences University, Kutahya, Türkiye
| |
Collapse
|
3
|
Khonglim K, Chuenjitkuntaworn B, Tamura Y, Fuangtharnthip P. Effects of Capsaicin on Migration and Alkaline Phosphatase Activity of Dental Pulp Cells. Eur J Dent 2024. [PMID: 38698615 DOI: 10.1055/s-0044-1782191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES Dental pulp, a specialized mesenchymal tissue within teeth, is pivotal in dental health and tissue repair. Capsaicin, the primary pungent component of chili peppers, is known for its diverse pharmacological properties. While capsaicin's effects on various cell types have been studied, its impact on dental pulp cells remains relatively unexplored. This study investigated the influence of pure capsaicin extract on dental pulp cell behavior, focusing on cell viability, proliferation, migration, and alkaline phosphatase (ALP) activity. MATERIALS AND METHODS Capsaicin solution was prepared and diluted to various concentrations (1 nM, 0.01 µM, 0.1 µM, 1 µM, 10 µM, and 100 µM), then was tested on rat dental pulp cells (RPC-C2A). Cell viability and proliferation were assessed using the MTT assay. Boyden chamber tests and wound healing were used for evaluating cell migration. The activity of ALP was determined to show cell function during dental pulp repair. STATISTICAL ANALYSIS The data were analyzed using a one-way analysis of variance or an independent-sample Kruskal-Wallis, followed by multiple comparison tests. RESULTS Capsaicin of 100 µM exhibited cytotoxicity, whereas those with lower concentrations stimulated cell proliferation. Wound healing assays revealed increased cell migration, particularly when cultured with 1 nM capsaicin (p = 0.002). Boyden chamber assays demonstrated enhanced cell invasion without statistical significance. ALP activity of dental pulp cells increased significantly at 1 nM (p < 0.001) and 1 µM (p = 0.021) capsaicin concentrations, indicating potential dentinogenesis and pulp repair. CONCLUSION Capsaicin of lower concentrations, less than 10 µM, is likely to promote proliferation, migration, and ALP activity of dental pulp cells. Our findings offer potential applications for capsaicin as a medication for dental pulp repair.
Collapse
Affiliation(s)
- Kittipot Khonglim
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok, Thailand
| | | | - Yukihiko Tamura
- Department of Cariology and Operative Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Pornpoj Fuangtharnthip
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok, Thailand
| |
Collapse
|
4
|
Anselmi C, Mendes Soares IP, Mota RLM, Leite ML, Ribeiro RADO, Fernandes LDO, Bottino MC, de Souza Costa CA, Hebling J. Functionalization of PCL-Based Fiber Scaffolds with Different Sources of Calcium and Phosphate and Odontogenic Potential on Human Dental Pulp Cells. J Funct Biomater 2024; 15:97. [PMID: 38667554 PMCID: PMC11051160 DOI: 10.3390/jfb15040097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
This study investigated the incorporation of sources of calcium, phosphate, or both into electrospun scaffolds and evaluated their bioactivity on human dental pulp cells (HDPCs). Additionally, scaffolds incorporated with calcium hydroxide (CH) were characterized for degradation, calcium release, and odontogenic differentiation by HDPCs. Polycaprolactone (PCL) was electrospun with or without 0.5% w/v of calcium hydroxide (PCL + CH), nano-hydroxyapatite (PCL + nHA), or β-glycerophosphate (PCL + βGP). SEM/EDS analysis confirmed fibrillar morphology and particle incorporation. HDPCs were cultured on the scaffolds to assess cell viability, adhesion, spreading, and mineralized matrix formation. PCL + CH was also evaluated for gene expression of odontogenic markers (RT-qPCR). Data were submitted to ANOVA and Student's t-test (α = 5%). Added CH increased fiber diameter and interfibrillar spacing, whereas βGP decreased both. PCL + CH and PCL + nHA improved HDPC viability, adhesion, and proliferation. Mineralization was increased eightfold with PCL + CH. Scaffolds containing CH gradually degraded over six months, with calcium release within the first 140 days. CH incorporation upregulated DSPP and DMP1 expression after 7 and 14 days. In conclusion, CH- and nHA-laden PCL fiber scaffolds were cytocompatible and promoted HDPC adhesion, proliferation, and mineralized matrix deposition. PCL + CH scaffolds exhibit a slow degradation profile, providing sustained calcium release and stimulating HDPCs to upregulate odontogenesis marker genes.
Collapse
Affiliation(s)
- Caroline Anselmi
- Department of Morphology, Orthodontics, and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil; (C.A.); (R.L.M.M.)
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA; (I.P.M.S.); (M.C.B.)
| | - Igor Paulino Mendes Soares
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA; (I.P.M.S.); (M.C.B.)
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil;
| | - Rafaella Lara Maia Mota
- Department of Morphology, Orthodontics, and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil; (C.A.); (R.L.M.M.)
| | - Maria Luísa Leite
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia (UBC), Vancouver, BC V6T 1Z4, Canada;
| | - Rafael Antonio de Oliveira Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil;
| | - Lídia de Oliveira Fernandes
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil;
| | - Marco C. Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA; (I.P.M.S.); (M.C.B.)
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil;
| | - Josimeri Hebling
- Department of Morphology, Orthodontics, and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, SP, Brazil; (C.A.); (R.L.M.M.)
| |
Collapse
|
5
|
Aye TA, Polkit S, Klaijan I, Nachanok K, Salil L, Pasutha T. Acemannan-containing bioactive resin modified glass ionomer demonstrates satisfactory physical and biological properties. J Dent Sci 2024; 19:1061-1069. [PMID: 38618108 PMCID: PMC11010605 DOI: 10.1016/j.jds.2023.06.009] [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: 04/17/2023] [Revised: 06/11/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Resin-modified glass ionomers (RMGIs) have been recommended as liner and cement to provide the teeth with mechanical support, a chemical barrier, and thermal insulation. Acemannan, the main polysaccharide extracted from Aloe vera, is a promising inductive material in vitro and in vivo. This study aimed to develop acemannan-containing bioactive resin-modified glass ionomers (RMGIs). Materials and methods Acemannan (3%, 5%, and 10%) was added to the three types of RMGIs (RU-HBM1/Fuji II LC/Vitrebond) to generate 3%, 5%, and 10% aceRMGIs (aceRU/aceFuji/aceVB). The materials were evaluated for depth of cure/flexural strength/cumulative fluoride ion release. Cell viability and vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) secretion were determined using MTT/apoptosis/necrosis assays, and ELISA kits, respectively. RMGI without acemannan were used as controls. Results The aceRMGIs met the ISO requirements for depth of cure and flexural strength. Adding 10% acemannan increased the cumulative fluoride release in the RU and FJ groups, but slightly decreased it in the VB group (P < 0.05). The MTT assay revealed 10% aceRU and all aceFJ groups significantly increased cell viability compared with each control group (P < 0.05). Apoptosis/necrosis assay showed the biocompatibility of all aceRMGIs. Adding acemannan to RMGIs significantly induced VEGF expression in a dose dependent manner while 5% and 10% aceRU significantly induced BMP-2 expression compared with RU group (P < 0.05). Conclusion We conclude that 5-10% acemannan in RMGI is the optimal concentration based on its physical properties and ability to induce pulp cell proliferation and growth factor secretion.
Collapse
Affiliation(s)
- Thant Aye Aye
- Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Herbal Medicine, Biomaterial, and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sangvanich Polkit
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Inchudech Klaijan
- Research Unit of Herbal Medicine, Biomaterial, and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Kuvieng Nachanok
- Research Unit of Herbal Medicine, Biomaterial, and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lalitkanjanakul Salil
- Research Unit of Herbal Medicine, Biomaterial, and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Thunyakitpisal Pasutha
- Research Unit of Herbal Medicine, Biomaterial, and Material for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| |
Collapse
|
6
|
Phang V, Malhotra R, Chen NN, Min KS, Yu VSH, Rosa V, Dubey N. Specimen Shape and Elution Time Affect the Mineralization and Differentiation Potential of Dental Pulp Stem Cells to Biodentine. J Funct Biomater 2023; 15:1. [PMID: 38276474 PMCID: PMC10816296 DOI: 10.3390/jfb15010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
The liquid extract method is commonly used to evaluate the cytotoxicity and bioactivity of materials. Although ISO has recommended guidelines for test methods, variations in elution period, and shape of samples can influence the biological outcomes. The aim of this study was to investigate the influence of material form and elution period of Biodentine on dental pulp stem cells (DPSCs)' proliferation and mineralization. Biodentine (0.2 g) discs or powder were immersed in culture media (10 mL) for 1, 3 or 7 days (D1, D3 and D7). The eluents were filtered and used to treat DPSC. The calcium release profile and pH were determined. Cell proliferation was evaluated by MTS for 3 days, and mineralization and differentiation were assessed by alizarin red S staining (Ca2+/ng of DNA) and qRT-PCR (MEPE, DSPP, DMP-1, RUNX2, COL-I and OCN) for 14 days. Statistical analysis was performed with a one or two-way ANOVA and post hoc Tukey's test (pH, calcium release and proliferation) or Mann-Whitney test (α = 0.05). pH and calcium ion release of powdered eluents were significantly higher than disc eluents. Powdered eluent promoted extensive cell death, while the disc form was cytocompatible. All disc eluents significantly increased the gene expression and mineralization after 14 days compared to the untreated control. D7 induced less mineralization and differentiation compared to D1 and D3. Thus, the materials' form and elution time are critical aspects to be considered when evaluating the bioactivity of materials, since this binomial can affect positively and negatively the biological outcomes.
Collapse
Affiliation(s)
- Valene Phang
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore; (V.P.); (R.M.); (V.S.H.Y.)
- National Dental Centre Singapore, 5 Second Hospital Ave., Singapore 168938, Singapore;
| | - Ritika Malhotra
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore; (V.P.); (R.M.); (V.S.H.Y.)
| | - Nah Nah Chen
- National Dental Centre Singapore, 5 Second Hospital Ave., Singapore 168938, Singapore;
| | - Kyung-San Min
- Department of Conservative Dentistry, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea;
| | - Victoria Soo Hoon Yu
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore; (V.P.); (R.M.); (V.S.H.Y.)
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore; (V.P.); (R.M.); (V.S.H.Y.)
| | - Nileshkumar Dubey
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore; (V.P.); (R.M.); (V.S.H.Y.)
| |
Collapse
|
7
|
Duncan HF, Kobayashi Y, Kearney M, Shimizu E. Epigenetic therapeutics in dental pulp treatment: Hopes, challenges and concerns for the development of next-generation biomaterials. Bioact Mater 2023; 27:574-593. [PMID: 37213443 PMCID: PMC10199232 DOI: 10.1016/j.bioactmat.2023.04.013] [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: 03/14/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
This opinion-led review paper highlights the need for novel translational research in vital-pulp-treatment (VPT), but also discusses the challenges in translating evidence to clinics. Traditional dentistry is expensive, invasive and relies on an outmoded mechanical understanding of dental disease, rather than employing a biological perspective that harnesses cell activity and the regenerative-capacity. Recent research has focussed on developing minimally-invasive biologically-based 'fillings' that preserve the dental pulp; research that is shifting the paradigm from expensive high-technology dentistry, with high failure rates, to smart restorations targeted at biological processes. Current VPTs promote repair by recruiting odontoblast-like cells in a material-dependent process. Therefore, exciting opportunities exist for development of next-generation biomaterials targeted at regenerative processes in the dentin-pulp complex. This article analyses recent research using pharmacological-inhibitors to therapeutically-target histone-deacetylase (HDAC) enzymes in dental-pulp-cells (DPCs) that stimulate pro-regenerative effects with limited loss of viability. Consequently, HDAC-inhibitors have the potential to enhance biomaterial-driven tissue responses at low concentration by influencing the cellular processes with minimal side-effects, providing an opportunity to develop a topically-placed, inexpensive bio-inductive pulp-capping material. Despite positive results, clinical translation of these innovations requires enterprise to counteract regulatory obstacles, dental-industry priorities and to develop strong academic/industry partnerships. The aim of this opinion-led review paper is to discuss the potential role of therapeutically-targeting epigenetic modifications as part of a topical VPT strategy in the treatment of the damaged dental pulp, while considering the next steps, material considerations, challenges and future for the clinical development of epigenetic therapeutics or other 'smart' restorations in VPT.
Collapse
Affiliation(s)
- Henry F. Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Lincoln Place, Dublin, Ireland
| | - Yoshifumi Kobayashi
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Michaela Kearney
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Lincoln Place, Dublin, Ireland
| | - Emi Shimizu
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ, USA
| |
Collapse
|
8
|
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.
Collapse
Affiliation(s)
- Mai Mohamed
- Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | | | | |
Collapse
|
9
|
Cunha D, Souza N, Moreira M, Rodrigues N, Silva P, Franca C, Horsophonphong S, Sercia A, Subbiah R, Tahayeri A, Ferracane J, Yelick P, Saboia V, Bertassoni L. 3D-printed microgels supplemented with dentin matrix molecules as a novel biomaterial for direct pulp capping. Clin Oral Investig 2023; 27:1215-1225. [PMID: 36287273 PMCID: PMC10171721 DOI: 10.1007/s00784-022-04735-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To develop a 3D-printed, microparticulate hydrogel supplemented with dentin matrix molecules (DMM) as a novel regenerative strategy for dental pulp capping. MATERIALS AND METHODS Gelatin methacryloyl microgels (7% w/v) mixed with varying concentrations of DMM were printed using a digital light projection 3D printer and lyophilized for 2 days. The release profile of the DMM-loaded microgels was measured using a bicinchoninic acid assay. Next, dental pulp exposure defects were created in maxillary first molars of Wistar rats. The exposures were randomly capped with (1) inert material - negative control, (2) microgels, (3) microgels + DMM 500 µg/ml, (4) microgels + DMM 1000 µg/ml, (5) microgels + platelet-derived growth factor (PDGF 10 ng/ml), or (6) MTA (n = 15/group). After 4 weeks, animals were euthanized, and treated molars were harvested and then processed to evaluate hard tissue deposition, pulp tissue organization, and blood vessel density. RESULTS All the specimens from groups treated with microgel + 500 µg/ml, microgel + 1000 µg/ml, microgel + PDGF, and MTA showed the formation of organized pulp tissue, tertiary dentin, newly formed tubular and atubular dentin, and new blood vessel formation. Dentin bridge formation was greater and pulp necrosis was less in the microgel + DMM groups compared to MTA. CONCLUSIONS The 3D-printed photocurable microgels doped with DMM exhibited favorable cellular and inflammatory pulp responses, and significantly more tertiary dentin deposition. CLINICAL RELEVANCE 3D-printed microgel with DMM is a promising biomaterial for dentin and dental pulp regeneration in pulp capping procedures.
Collapse
Affiliation(s)
- Diana Cunha
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Nayara Souza
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Manuela Moreira
- School of Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Nara Rodrigues
- School of Dentistry, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Paulo Silva
- School of Dentistry, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Cristiane Franca
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Sivaporn Horsophonphong
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Salaya, Thailand
| | - Ashley Sercia
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Ramesh Subbiah
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Anthony Tahayeri
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Jack Ferracane
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Pamela Yelick
- Department of Orthodontics, School of Medicine, School of Engineering, Tufts University, Boston, MA, 02111, USA
| | - Vicente Saboia
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Luiz Bertassoni
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
- Center for Regenerative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
- Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Portland, OR, USA.
| |
Collapse
|
10
|
Direct pulp capping in asymptomatic carious primary molars using three different pulp capping materials: a prospective clinical trial. Eur Arch Paediatr Dent 2022; 23:803-811. [PMID: 35780237 DOI: 10.1007/s40368-022-00720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/11/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Τo assess the outcome of direct pulp capping in asymptomatic carious primary molars using three pulp capping materials. METHODS In this prospective clinical trial, carious primary molars free of irreversible pulp inflammation signs and symptoms, with negative pain history and pulp exposure following caries removal were included. Teeth were divided into groups: A: Ca(OH)2, B: Pure Portland cement®, C: Biodentine™. Following anaesthesia, isolation, caries removal, pulp exposure, hemorrhage control, pulp capping, additional lining in groups A, B, teeth were restored with composite resin. Descriptive statistics, Chi-squared and Fisher's exact tests, Kaplan-Meier survival curves, multivariable random effects Cox regression model were performed. RESULTS Sixty-six patients (25 girls, 41 boys) with mean age 7.2 (± 1.7) years participated. The mean follow-up time was 13 months. Seventy-nine primary molars were assigned to groups A (n = 27), B (29), C (n = 23). The overall failure was 16% and the distribution by group was: A: 5 teeth, B: 5 teeth, C: 3 teeth. No significant differences in failure rates between capping materials, tooth types, age bands and genders were identified. CONCLUSIONS Direct pulp capping in asymptomatic carious primary molars may be an acceptable option, when treating an exposed pulp with bioceramic materials as pulp capping agents.
Collapse
|
11
|
Anselmi C, Mendes Soares IP, Leite ML, Kitagawa FA, de Souza Costa CA, Hebling J. Cytocompatibility and bioactivity of calcium hydroxide-containing nanofiber scaffolds loaded with fibronectin for dentin tissue engineering. Clin Oral Investig 2022; 26:4031-4047. [PMID: 35029747 DOI: 10.1007/s00784-022-04372-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/31/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to characterize polycaprolactone-based nanofiber scaffolds (PCL) incorporated with calcium hydroxide (CH) and evaluate their bioactivity on human dental pulp cells (HDPCs) when loaded with fibronectin (FN). MATERIALS AND METHODS CH (0.1%; 0.2%; 0.4% w/v; or 0%) was incorporated into PCL (10% w/v) scaffolds prepared by electrospinning. Morphology and composition were characterized using SEM/EDS. HDPCs were seeded on the scaffolds and evaluated for viability (alamarBlue; Live/Dead), and adhesion/spreading (F-actin). Next, scaffolds containing 0.4% CH were loaded with FN (20 µg/mL). HDPCs were evaluated for viability, adhesion/spreading, migration (Trans-well), gene expression (RT-qPCR), alkaline phosphatase activity (ALP), and mineralization nodules (Alizarin Red). Data were submitted to ANOVA and post-hoc tests (α = 5%). RESULTS Nanofibers with larger diameter were seen as CH concentration increased, while there was no effect on interfibrillar spaces. An increase in cell viability was seen for 0.4% CH, in all periods. Incorporation of CH and FN into the scaffolds increased cellular migration, spread, and viability, all intensified when CH and FN were combined. ALPL and DSPP expression, and ALP activity were not affected by CH and FN. COL1A1 was downregulated in all groups, while DMP1 was upregulated in the presence of CH, with no differences for the groups loaded with FN. CH increased the formation of mineralized matrix, which was not influenced by FN. CONCLUSIONS In conclusion, the incorporation of CH enhanced the odontogenic potential of HDPCs, irrespective of the presence of FN. The PCL + 0.4% CH formulation may be a useful strategy for use in dentin tissue engineering. CLINICAL RELEVANCE A change in the form of presentation of calcium hydroxide-based materials used for direct pulp capping can increase biocompatibility and prolong the vitality of dental pulp.
Collapse
Affiliation(s)
- Caroline Anselmi
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Maria Luísa Leite
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Fernanda Ali Kitagawa
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Josimeri Hebling
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.
| |
Collapse
|
12
|
In Vitro and In Vivo Efficacy of New Composite for Direct Pulp Capping. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8414577. [PMID: 34869772 PMCID: PMC8639243 DOI: 10.1155/2021/8414577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/29/2021] [Indexed: 11/18/2022]
Abstract
Objectives To investigate physicochemical properties, dentin bonding, cytotoxicity, and in vivo pulp response of experimental self-adhesive composites tailored to direct pulp capping. Materials and Methods Experimental composites were prepared with beta-tricalcium phosphate and hydroxyapatite nanoparticles adsorbed with simvastatin and glutathione added at 0% (control resin), 1 wt% (Res 1%), and 10 wt% (Res 10%). A commercial light-curable calcium hydroxide (Ca(OH)2) (Ultra-Blend Plus) was used as control material. The physicochemical properties investigated were flexural strength and modulus, calcium release, and degree of conversion. Dentin bonding was assessed by the push-out test. Proliferation and cell counting assays were performed to evaluate in vitro cytotoxicity using fluorescence microscopy. In vivo pulp capping was performed on molars of Wistar rats, which were euthanized after 14 days and evaluated by histological analysis. Results No statistical difference was observed in flexural strength and cell viability (p > 0.05). Res 10% presented higher modulus than control resin and Ca(OH)2. Also, Res 10% attained statistically higher degree of conversion when compared to other experimental composites. Ca(OH)2 showed higher calcium release after 28 and 45 days of storage, with no statistical difference at 45 days to Res 10%. All experimental composites achieved significantly higher bond strength when compared to Ca(OH)2. While no significant difference was observed in the cell proliferation rates, resins at lower concentrations showed higher cell viability. In vivo evaluation of pulp response demonstrated no pulp damage with experimental composites. Conclusions The experimental composite investigated in this study achieved adequate physicochemical properties with minor in vivo pulpal inflammation and proved to be a valuable alternative for direct pulp capping.
Collapse
|
13
|
Biocompatibility of a HA/β-TCP/C Scaffold as a Pulp-Capping Agent for Vital Pulp Treatment: An In Vivo Study in Rat Molars. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083936. [PMID: 33918101 PMCID: PMC8068992 DOI: 10.3390/ijerph18083936] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023]
Abstract
Bioceramic materials possess desirable biological properties, highlighting their non-reactivity and osteoconductivity. Their use has been extended in vital pulp treatment. The purpose of this study was to evaluate and compare the effects of beta-tricalcium phosphate (β-TCP), hydroxyapatite (HA), and collagen (C) scaffold with mineral trioxide aggregate (MTA) on the vital pulp of rat molars. Thirty-two molars of Sprague–Dawley rats underwent direct pulp capping with β-TCP/HA/C (n = 16) and MTA (n = 16). After 30 days, the following parameters were evaluated in the tested samples: the degree of pulp inflammation and pulp vitality, the presence of reparative dentin, the homogeneity of the odontoblastic layer, and the presence of pulp fibrosis. No statistically significant differences were observed between HA/β-TCP/C and MTA in terms of the degree of inflammation (p = 0.124). Significant differences were found in reparative dentin formation between the treatment groups (p = 0.0005). Dentin bridge formation was observed in the MTA-treated group. The local action of HA/β-TCP/C is similar to that of MTA when used as an agent for pulp vital treatment in terms of absence of inflammation and maintenance of pulp vitality, although there are significant differences between both materials regarding the formation of dentin bridges.
Collapse
|
14
|
Arandi NZ, Thabet M. Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5569313. [PMID: 33884264 PMCID: PMC8041541 DOI: 10.1155/2021/5569313] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/03/2021] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Abstract
Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.
Collapse
Affiliation(s)
- Naji Ziad Arandi
- Department of Conservative Dentistry and Prosthodontics, Arab American University, Jenin, State of Palestine
| | - Mohammad Thabet
- Department of Orthodontics and Pediatric Dentistry, Arab American University, Jenin, State of Palestine
| |
Collapse
|
15
|
Cunha NNDO, Junqueira MA, Cosme-Silva L, Santos LDST, Oliveira GAVD, Moretti Neto RT, Nogueira DA, Brigagão MRPL, Moretti ABDS. Expression of Matrix Metalloproteinases-8 and Myeloperoxidase in Pulp Tissue after Pulpotomy with Calcium Silicate Cements. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
16
|
|
17
|
Effect of Naturally Occurring Biogenic Materials on Human Dental Pulp Stem Cells (hDPSC): an In Vitro Study. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00170-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
18
|
Carrillo-Cotto R, Etges A, Jardim PS, Torre E, Kaizer MR, Ferrúa CP, Nedel F, Cuevas-Suárez CE, Moraes RR. Cytotoxicity of contemporary resin-based dental materials in contact with dentin. Eur J Oral Sci 2020; 128:436-443. [PMID: 32741041 DOI: 10.1111/eos.12723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 01/09/2023]
Abstract
In this study, the cytotoxicity of different combinations of contemporary resin-based restoratives (adhesives, composites, luting agents) against human keratinocytes (HaCaT) was evaluated under two conditions, whether materials were applied to dentin or not. Adhesives (3-step etch-and-rinse/3ER: OptiBond FL; 2-step self-etch/2SE Clearfil SE Bond; Single Bond Universal/UNI), composites (conventional composite resin/CCR: Filtek Z350XT; flowable/FCR: Filtek Z350XT Flow; self-adhesive composite resin/SACR: Dyad Flow), and luting agents (conventional luting agent/CLA: Variolink-II; self-adhesive luting agent/SLA: RelyXU200) were combined according to their clinical use. Eluates from polymerized specimens applied to dentin were placed in contact with cells grown for 1 and 7 d. The controls were defined by cells without material contact. Cell viability was determined using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)] assay. C=C conversion was investigated using Fourier-transform infrared spectroscopy. After 1 d of incubation, when dentin was not present, 2SE yielded the highest cell viability, whereas 3ER, UNI, and SACR showed higher cell viability in the presence of dentin. After 7 d, when dentin was absent, 2SE and CLA achieved significantly higher cell viability. The presence of dentin resulted in a drastically higher cell viability for all materials, except 2SE and CLA. UNI had the lowest C=C conversion. The presence of dentin was a significant factor, which resulted in higher cell viability than what was seen for the material specimens per se. All materials resulted in a lower viability of HaCaT than what was seen under the no-material control conditions, with effects mainly limited to the first 24 h.
Collapse
Affiliation(s)
- Ricardo Carrillo-Cotto
- Department of Restorative Dentistry and Dental Biomaterials, School of Dentistry, University of San Carlos of Guatemala, Guatemala city, Guatemala.,Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Adriana Etges
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Eliana Torre
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marina R Kaizer
- Graduate Program in Dentistry, Positivo University, Curitiba, Brazil
| | - Camila P Ferrúa
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Fernanda Nedel
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Rafael R Moraes
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
19
|
Couto RSD, Rodrigues MFSD, Ferreira LS, Diniz IMA, Silva FDS, Lopez TCC, Lima RR, Marques MM. Evaluation of Resin-Based Material Containing Copaiba Oleoresin ( Copaifera Reticulata Ducke): Biological Effects on the Human Dental Pulp Stem Cells. Biomolecules 2020; 10:biom10070972. [PMID: 32605172 PMCID: PMC7407412 DOI: 10.3390/biom10070972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study was to analyze in vitro the biological effects on human dental pulp stem cells triggered in response to substances leached or dissolved from two experimental cements for dental pulp capping. The experimental materials, based on extracts from Copaifera reticulata Ducke (COP), were compared to calcium hydroxide [Ca(OH)2] and mineral trioxide aggregate (MTA), materials commonly used for direct dental pulp capping in restorative dentistry. For this, human dental pulp stem cells were exposed to COP associated or not with Ca(OH)2 or MTA. Cell cytocompatibility, migration, and differentiation (mineralized nodule formation (Alizarin red assay) and gene expression (RT-qPCR) of OCN, DSPP, and HSP-27 (genes regulated in biomineralization events)) were evaluated. The results showed that the association of COP reduced the cytotoxicity of Ca(OH)2. Upregulations of the OCN, DSPP, and HSP-27 genes were observed in response to the association of COP to MTA, and the DSPP and HSP-27 genes were upregulated in the Ca(OH)2 + COP group. In up to 24 h, cell migration was significantly enhanced in the MTA + COP and Ca(OH)2 + COP groups. In conclusion, the combination of COP with the currently used materials for dental pulp capping [Ca(OH)2 and MTA] improved the cell activities related to pulp repair (i.e., cytocompatibility, differentiation, mineralization, and migration) including a protective effect against the cytotoxicity of Ca(OH)2.
Collapse
Affiliation(s)
- Roberta Souza D’Almeida Couto
- Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP 05508-060, Brazil; (L.S.F.); (M.M.M.)
- School of Dentistry, Federal University of Pará, Belém, PA 66075-110, Brazil
- Correspondence: ; Tel.: +55-091-3201-7637
| | | | - Leila Soares Ferreira
- Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP 05508-060, Brazil; (L.S.F.); (M.M.M.)
| | - Ivana Márcia Alves Diniz
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizionte, MG 31270-901, Brazil;
| | - Fernando de Sá Silva
- Departamento de Ciências da Vida, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil;
| | - Talita Christine Camilo Lopez
- Postgraduation Program in Biophotonics Applied to Health Sciences, Nove de Julho University, São Paulo, SP 02112-000, Brazil; (M.F.S.D.R.); (T.C.C.L.)
| | - Rafael Rodrigues Lima
- Institute of Biological Sciences, Federal University of Pará, Belém, PA 66075-110, Brazil;
| | - Márcia Martins Marques
- Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP 05508-060, Brazil; (L.S.F.); (M.M.M.)
- Post graduation course in Dentistry, Ibirapuera University, São Paulo, SP 04661-100, Brazil
| |
Collapse
|
20
|
Bioactivity and Physicochemical Properties of Three Calcium Silicate-Based Cements: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9576930. [PMID: 32596400 PMCID: PMC7273418 DOI: 10.1155/2020/9576930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 12/16/2022]
Abstract
Objective This study evaluated the bioactivity and physicochemical properties of three commercial calcium silicate-based endodontic materials (MTA, EndoSequence Root Repair Material putty, and Biodentine™). Material and Methods. Horizontal sections of 3 mm thickness from 18 root canals of human teeth were subjected to biomechanical preparation with WaveOne Gold large rotary instruments. The twelve specimens were filled with three tested materials (MM-MTA, EndoSequence Root Repair Material putty, and Biodentine™) and immersed in phosphate-buffered saline for 7 and 30 days. After this period of time, each specimen of each material was processed for morphological observation, surface precipitates, and interfacial dentin using SEM. In addition, the surface morphology of the set materials, without soaking in phosphate-buffered solution after one day and after 28 days stored in phosphate-buffered saline, was evaluated using SEM; also, the pH of the soaking water and the amount of calcium ions released from the test materials were measured by using an inductively coupled plasma-optical emission spectroscopy test. Data obtained were analyzed using one-way analysis of variance and Tukey's honest significant difference test with a significance level of 5%. Result The formation of precipitates was observed on the surfaces of all materials at 1 week and increased substantially over time. Interfacial layers in some areas of the dentin-cement interface were found from one week of immersion. All the analyzed materials showed alkaline pH and capacity to release calcium ions; however, the concentrations of released calcium ions were significantly more in Biodentine and ESRRM putty than MM-MTA (P < 0.05). ESRRM putty maintained a pH of around 11 after 28 days. Conclusion Compared with MM-MTA, Biodentine and ESRRM putty showed significantly more calcium ion release. However, exposure of three tested cements to phosphate-buffered solution resulted in precipitation of apatite crystalline structures over both cement and dentin that increased over time. This suggests that the tested materials are bioactive.
Collapse
|
21
|
Melatonin as an Agent for Direct Pulp-Capping Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031043. [PMID: 32041360 PMCID: PMC7037898 DOI: 10.3390/ijerph17031043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 12/15/2022]
Abstract
Melatonin plays an essential role in the regulation of bone growth. The actions that melatonin exerts on odontoblasts may be similar to its action on osteoblasts. This research aimed to evaluate the pulp response to melatonin used for direct pulp capping to evaluate the antioxidant effect of melatonin administered orally and its influence on dental pulp. Direct pulp capping was performed on the upper molars of Sprague Dawley rats using melatonin or Mineral Trioxide Aggregate (MTA). The study groups were: MTA; Melatonin; MTA + Melatonin administered orally; and Melatonin + Melatonin administered orally. In the latter two groups, the animals drank water dosed with melatonin ad libitum (10 mg/100 mL). After 30 days, the animals were sacrificed, and 5 ml of blood, the kidneys, and the liver were extracted in order to evaluate oxidative stress using thiobarbituric acid reactive substances testing (TBARS). Fragments of the maxilla containing the study molars were prepared for histological evaluation. The degree of pulp inflammation and pulp necrosis, the presence of reparative dentin and dentin bridging the pulp chamber, the presence and regularity of the odontoblastic layer, and the presence of pulp fibrosis were evaluated. No significant differences were found between the four study groups for any of the studied histological variables. The oral administration of melatonin did not modify the local effects of MTA or melatonin on dental pulp, or reduce basal-level oxidative stress. The effect of melatonin on pulp is similar to that of MTA and may be used as an agent for direct pulp capping.
Collapse
|
22
|
Petta TDM, Pedroni ACF, Saavedra DF, Faial KDCF, Marques MM, Couto RSD. The effect of three different pulp capping cements on mineralization of dental pulp stem cells. Dent Mater J 2019; 39:222-228. [PMID: 31827054 DOI: 10.4012/dmj.2018-349] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated the osteogenic differentiation of human dental pulp stem cells in response to substances released by the pulp capping agents, Biodentine (BD), mineral trioxide aggregate (MTA) and two-paste calcium hydroxide cement (CHC), along with their physicochemical characteristics. The dimensional stability test showed that of the materials studied, only BD met the standards recommended by the International Organization for Standardization (ISO) for pulp capping materials and thus can be used safely. In the chemical tests, BD was the most stable material. In the Alizarin red S test, BD formed the higher amount of mineralized nodules in the mineralizing medium and also formed mineralized nodules in a non-mineralizing medium. BD releases substances that can significantly induce formation of the human dental pulp stem cell-mineralized extracellular matrix, with physicochemical characteristics that are more conducive to pulp repair than those of MTA and CHC.
Collapse
|
23
|
Paula AB, Laranjo M, Marto CM, Paulo S, Abrantes AM, Fernandes B, Casalta-Lopes J, Marques-Ferreira M, Botelho MF, Carrilho E. Evaluation of dentinogenesis inducer biomaterials: an in vivo study. J Appl Oral Sci 2019; 28:e20190023. [PMID: 31800871 PMCID: PMC6886398 DOI: 10.1590/1678-7757-2019-0023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 06/29/2019] [Indexed: 12/16/2022] Open
Abstract
When exposure of the pulp to external environment occurs, reparative dentinogenesis can be induced by direct pulp capping to maintain pulp tissue vitality and function. These clinical situations require the use of materials that induce dentin repair and, subsequently, formation of a mineralized tissue. Objective: This work aims to assess the effect of tricalcium silicate cements and mineral trioxide aggregate cements, including repairing dentin formation and inflammatory reactions over time after pulp exposure in Wistar rats. Methodology: These two biomaterials were compared with positive control groups (open cavity with pulp tissue exposure) and negative control groups (no intervention). The evaluations were performed in three stages; three, seven and twenty-one days, and consisted of an imaging (nuclear medicine) and histological evaluation (H&E staining, immunohistochemistry and Alizarin Red S). Results: The therapeutic effect of these biomaterials was confirmed. Nuclear medicine evaluation demonstrated that the uptake of 99mTc-Hydroxymethylene diphosphonate (HMDP) showed no significant differences between the different experimental groups and the control, revealing the non-occurrence of differences in the phosphocalcium metabolism. The histological study demonstrated that in mineral trioxide aggregate therapies, the presence of moderate inflammatory infiltration was found after three days, decreasing during follow-ups. The formation of mineralized tissue was only verified at 21 days of follow-up. The tricalcium silicate therapies demonstrated the presence of a slight inflammatory infiltration on the third day, increasing throughout the follow-up. The formation of mineralized tissue was observed in the seventh follow-up day, increasing over time. Conclusions: The mineral trioxide aggregate (WhiteProRoot®MTA) and tricalcium silicate (Biodentine™) present slight and reversible inflammatory signs in the pulp tissue, with the formation of mineralized tissue. However, the exacerbated induction of mineralized tissue formation with the tricalcium silicate biomaterial may lead to the formation of pulp calcifications
Collapse
Affiliation(s)
- Anabela B Paula
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Prática Clínica Integrada, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Mafalda Laranjo
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Carlos-Miguel Marto
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Prática Clínica Integrada, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Patologia Experimental, Coimbra, Portugal
| | - Siri Paulo
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Prática Clínica Integrada, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Ana M Abrantes
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Bruno Fernandes
- Centro Hospitalar e Universitário do Porto, Departamento de Patologia, Porto, Portugal
| | - João Casalta-Lopes
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Coimbra University Hospital Center, Radiation Oncology Department, Coimbra, Portugal
| | - Manuel Marques-Ferreira
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Prática Clínica Integrada, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Maria Filomena Botelho
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| | - Eunice Carrilho
- Universidade de Coimbra, Faculdade de Medicina, Instituto de Prática Clínica Integrada, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Biofísica, Coimbra, Portugal.,Universidade de Coimbra, Faculdade de Medicina, Instituto de Pesquisa Clínica e Biomédica, area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal.,Universidade de Coimbra, CNC.IBILI, Coimbra, Portugal
| |
Collapse
|
24
|
Wang F, Yang G, Xiao Y, He C, Cai G, Song E, Li Y. Effect of SDF-1 with biphasic ceramic-like bone graft on the repair of rabbit radial defect. J Orthop Surg Res 2019; 14:231. [PMID: 31331380 PMCID: PMC6647097 DOI: 10.1186/s13018-019-1277-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/11/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effects of stromal cell-derived factor-1 (SDF-1) on biphasic ceramic-like biologic bone (BCBB) in vivo on the repair of large segment bone defect in rabbits. METHODS A large-segment radius defect model of the rabbits was constructed. In the experimental group, BCBB with SDF-1 sustained-release system were implanted into the bone defect site. Other three groups including normal control, autologous bone graft, and BCBB implantation without SDF-1 were set. After surgery, general observation, X-ray radiography and scoring, and tissue section staining were performed at 2, 4, 8, 12, and 24 weeks post-implantation. RESULTS By general observation, X-ray radiography and grading and tissue section staining observation, we found that the BCBB carrying SDF-1 was better than those in the group of BCBB without SDF-1 (P < 0.05). BCBB scaffold had certain bone conduction capacity, and the BCBB scaffold carrying SDF-1 had improved bone conduction ability and possessed bone induction ability. In the case of carrying SDF-1, it can be used to repair large bone defects in a shorter time than simply using BCBB, which is equivalent to the effect of autologous bone. CONCLUSION BCBB scaffold carrying SDF-1 can promote the repair effect on a large bone defect, which is equivalent to the effect of autologous bone.
Collapse
Affiliation(s)
- Fuke Wang
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - Guiran Yang
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - Yu Xiao
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - Chuan He
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - Guofeng Cai
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - En Song
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China
| | - Yanlin Li
- Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, No. 4 Building, Xichang Road, Wuhua District, Kunming, 650032, Yunnan Province, China.
| |
Collapse
|
25
|
Biodentine ™ Boosts, WhiteProRoot ®MTA Increases and Life ® Suppresses Odontoblast Activity. MATERIALS 2019; 12:ma12071184. [PMID: 30978943 PMCID: PMC6479701 DOI: 10.3390/ma12071184] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/06/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022]
Abstract
(1) Background: When pulp exposure occurs, reparative dentinogenesis can be induced by direct pulp capping to maintain the vitality and function of the tissue. The aim of this work was to assess the cytotoxicity and bioactivity of three different direct pulp capping materials, calcium hydroxide (Life®), mineral trioxide aggregate (WhiteProRoot®MTA) and calcium silicate (Biodentine™), in an odontoblast-like mouse cell line (MDPC-23). (2) Methods: Metabolic activity was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test (MTT)assay, viability by the sulforhodamine B (SRB) assay, and the type of death and cell cycle analysis by flow cytometry. Alkaline phosphatase was evaluated by polymerase chain reaction (PCR), and dentin sialoprotein expression was assessed by immunocytochemistry. Mineralization was determined by the Alizarin Red S colorimetric assay and quantified by spectrophotometry. (3) Results: Life® induced a decrease in metabolic activity and viability, which is associated with an increase cell death. WhiteProRoot®MTA and Biodentine™ induced similar effects in cytotoxicity assays, with an increase in the expression of dentin sialoprotein (DSP) and formation of mineralized deposits, especially with Biodentine™. (4) Conclusions: The results of WhiteProRoot®MTA confirm its indication for these therapies, justifying its recognition as the “gold standard”. Biodentine™ may be an alternative, since they promote the same cellular response that mineral trioxide aggregate (MTA) does.
Collapse
|
26
|
Yani RWE, Palupi R, Bramantoro T, Setijanto D. Analysis of Calcium Levels in Groundwater and Dental Caries in the Coastal Population of an Archipelago Country. Open Access Maced J Med Sci 2019; 7:134-138. [PMID: 30740177 PMCID: PMC6352460 DOI: 10.3889/oamjms.2019.013] [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: 09/13/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND: The coastal region is the largest region in Indonesia as a country of the archipelago. Characteristics of groundwater content in coastal areas are very influential on dental health, especially dental caries. The main elements contained in 1-1000 mg/litre groundwater are calcium, magnesium, sodium, potassium, chlorine, bicarbonate, and sulfate groups. Calcium is an essential ingredient for living organisms that play a role in the formation of bone and tooth along with permeability of cell walls. AIM: This study aimed to analyse the relationship between calcium in groundwater with dental caries. METHOD: Analytical observational study with cross-sectional approach was implemented was coastal communities in Watu Ulo Jember Regency in February 2018 (3,686 inhabitants), with sample criteria of the minimum age of 12 years and consumed groundwater as drinking water at least 2 years by purposive side. The variables in this study were calcium levels as the independent variable and dental caries as the dependent variable. Calcium was measured using the spectrophotometric method. Caries measurements were performed using the DMF-T index. Data were presented descriptively in the table and analysed by Spearman Correlation test to analyze the relationship between groundwater calcium with dental caries. RESULTS: Average groundwater calcium content was 126.75 mg/litre (high category), and average dental caries was 2.2 (low category). Spearman correlation analysis showed p = 0.029 (p < 0.000), which means there was a correlation between groundwater calcium level with dental caries. CONCLUSION: There is a positive relationship between the calcium content of groundwater with dental caries.
Collapse
Affiliation(s)
- Ristya Widi Endah Yani
- Department of Dental Public Health, Faculty of Dental Medicine, University of Jember, Jalan Borneo No. 37, Campus Tegalboto, Jember, East Java, 68121, Indonesia
| | - Retno Palupi
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airalangga, Jl. Mayjend Prof Dr Moestopo 47, 60132, Surabaya, Indonesia
| | - Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airalangga, Jl. Mayjend Prof Dr Moestopo 47, 60132, Surabaya, Indonesia
| | - Darmawan Setijanto
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airalangga, Jl. Mayjend Prof Dr Moestopo 47, 60132, Surabaya, Indonesia
| |
Collapse
|
27
|
Fuks AB, Kupietzky A, Guelmann M. Pulp Therapy for the Primary Dentition. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
28
|
Leite ML, Soares DG, de Oliveira Duque CC, Bordini EAF, Anovazzi G, Basso FG, Spolidorio DMP, Hebling J, de Souza Costa CA. Positive influence of simvastatin used as adjuvant agent for cavity lining. Clin Oral Investig 2018; 23:3457-3469. [DOI: 10.1007/s00784-018-2757-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
|
29
|
Careddu R, Duncan HF. How does the pulpal response to Biodentine and ProRoot mineral trioxide aggregate compare in the laboratory and clinic? Br Dent J 2018; 225:sj.bdj.2018.864. [PMID: 30337724 DOI: 10.1038/sj.bdj.2018.864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Affiliation(s)
- R Careddu
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
| | - H F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
| |
Collapse
|
30
|
Boutsiouki C, Frankenberger R, Krämer N. Relative effectiveness of direct and indirect pulp capping in the primary dentition. Eur Arch Paediatr Dent 2018; 19:297-309. [PMID: 30187263 DOI: 10.1007/s40368-018-0360-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Carious or traumatised teeth with a normal pulp status or with reversible pulpitis need an indirect or direct pulp capping procedure to keep the pulp vital. AIM To evaluate the clinical outcome of both interventions for treating vital primary teeth. STUDY DESIGN Two reviewers on Pubmed and ISI Web of Science performed a comprehensive literature review of publications from 1966 until December 2017. Among PubMed abstracts, publications were selected according to the following criteria: prospective clinical study, correct indication for the performed treatment, and clear definition of clinical and/or radiographic success criteria. The strict selection criteria limited the amount of randomised controlled trials (RCT) or controlled clinical trials (CT); especially for "indirect pulp therapy", "direct pulp capping" and the number of RCTs was limited. CONCLUSIONS Based on a systematic review (20 controlled clinical studies or randomised controlled clinical studies), the following statements can be given: Due to the opportunity of tissue repair, indirect pulp treatment can be an acceptable procedure for reversible pulp inflammation. The use of adhesives for indirect pulp capping in a single-visit procedure after gentle caries removal can be recommended. Successful pulp capping is possible under defined conditions (symptom-free tooth, disinfection of pulp exposures, Class-I cavity) and appropriate sealing of the cavity with an effective dentine seal being a conditio sine qua non. There is maximum evidence for the use of disinfecting solutions prior to pulp capping and Dycal as pulp capping material. Longer follow-up periods, more clinical studies, comparable conditions, and clear definitions of evaluation criteria are needed to confirm the results of endodontic treatment in primary teeth.
Collapse
Affiliation(s)
- C Boutsiouki
- Department of Paediatric Dentistry, Medical Centre for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - R Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Strasse 3, 35039, Marburg, Germany.
| | - N Krämer
- Department of Paediatric Dentistry, Medical Centre for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| |
Collapse
|
31
|
Kearney M, Cooper PR, Smith AJ, Duncan HF. Epigenetic Approaches to the Treatment of Dental Pulp Inflammation and Repair: Opportunities and Obstacles. Front Genet 2018; 9:311. [PMID: 30131827 PMCID: PMC6090030 DOI: 10.3389/fgene.2018.00311] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/23/2018] [Indexed: 12/12/2022] Open
Abstract
Concerns over the cost and destructive nature of dental treatment have led to the call for novel minimally invasive, biologically based restorative solutions. For patients with toothache, this has resulted in a shift from invasive root-canal-treatment (RCT) toward more conservative vital-pulp-treatment (VPT) procedures, aimed to protect the pulp and harness its natural regenerative capacity. If the dental pulp is exposed, as long as the infection and inflammation can be controlled, conservative therapies can promote the formation of new tertiary dentine in a stem cell-led reparative process. Crucially, the volume and quality of new dentine is dependent on the material applied; however, currently available dental-materials are limited by non-specific action, cytotoxicity and poor clinical handling. Looking to the future, an improved understanding of the cellular regulators of pulpal inflammation and associated repair mechanisms is critical to predict pulpal responses and devise novel treatment strategies. Epigenetic modifications of DNA-associated proteins and the influences of non-coding RNAs have been demonstrated to control the self-renewal of stem cell populations as well as regulate mineralised tissue development and repair. Notably, the stability of microRNAs and their relative ease of sampling from pulpal blood highlight their potential for application as diagnostic inflammatory biomarkers, while increased understanding of their actions will not only enhance our knowledge of pulpal disease and repair, but also identify novel molecular targets. The potential therapeutic application of epigenetic modifying agents, DNA-methyltransferase-inhibitors (DNMTi) and histone-deacetylase-inhibitors (HDACi), have been shown to promote mineralisation and repair processes in dental-pulp-cell (DPC) populations as well as induce the release of bioactive dentine-matrix-components. Consequently, HDACis and DNMTis have the potential to enhance tertiary dentinogenesis by influencing the cellular and tissue processes at low concentrations with minimal side effects, providing an opportunity to develop a topically placed, inexpensive bio-inductive restorative material. The aim of this review is to highlight the potential role of epigenetic approaches in the treatment of the damaged dental pulp, considering the opportunities and obstacles, such as off-target effects, delivery mechanisms, for the therapeutic use of miRNA as an inflammatory biomarker or molecular target, before discussing the application of HDACi and DNMTi to the damaged pulp to stimulate repair.
Collapse
Affiliation(s)
- Michaela Kearney
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paul R. Cooper
- Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Anthony J. Smith
- Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Henry F. Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| |
Collapse
|
32
|
Chae Y, Yang M, Kim J. Release of TGF-β1 into root canals with various final irrigants in regenerative endodontics: an in vitro
analysis. Int Endod J 2018; 51:1389-1397. [DOI: 10.1111/iej.12951] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 05/12/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Y. Chae
- Private Practice; Baltimore MD USA
| | - M. Yang
- Regenerative Health Research Laboratory; Philadelphia PA USA
- Department of Endodontology; Maurice H. Kornberg School of Dentistry; Temple University; Philadelphia PA USA
| | - J. Kim
- Department of Endodontology; Maurice H. Kornberg School of Dentistry; Temple University; Philadelphia PA USA
| |
Collapse
|
33
|
Paula AB, Laranjo M, Marto CM, Paulo S, Abrantes AM, Casalta-Lopes J, Marques-Ferreira M, Botelho MF, Carrilho E. Direct Pulp Capping: What is the Most Effective Therapy?-Systematic Review and Meta-Analysis. J Evid Based Dent Pract 2018; 18:298-314. [PMID: 30514444 DOI: 10.1016/j.jebdp.2018.02.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/05/2018] [Accepted: 02/05/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was to compare the effectiveness of biomaterials and techniques by means of a systematic review and meta-analysis. METHODS The PubMed, Cochrane, and Embase databases were used to search the literature published from January 1, 1980 until August 31, 2017. Studies that met inclusion criteria were screened by 2 authors individually. The meta-analysis was performed on mineral trioxide aggregate (MTA) cement vs calcium hydroxide cement, tricalcium silicate cement vs MTA cement, and adhesive systems vs CaOH cement and evaluated the success rate, inflammatory response, and dentin bridge formation. RESULTS Forty-six studies were included in the systematic review, while 22 studies were included in the meta-analysis. There was no significant heterogeneity between the studies. MTA cements showed a significantly higher success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 2.72; 95% confidence interval [CI] = 1.90-3.90; P = 0.000). However, when compared with the tricalcium silicate cements, there were no statistically significant differences (odds ratio = 1.18; 95% CI = 0.53-2.65; P = 0.672). Adhesive systems showed a significantly lower success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 0.062; 95% CI = 0.024-0.157; P = 0.000). CONCLUSIONS MTA cements have a higher success rate, with a lower inflammatory response and a more predictable hard dentin barrier formation than calcium hydroxide cements. However, there were no differences, in these parameters, when MTA cement was compared with tricalcium silicate cements. Dental adhesives systems showed the lowest success rates.
Collapse
Affiliation(s)
- Anabela B Paula
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal.
| | - Mafalda Laranjo
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Carlos-Miguel Marto
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal; Experimental Pathology Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Siri Paulo
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Ana M Abrantes
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - João Casalta-Lopes
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Radiation Oncology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - Manuel Marques-Ferreira
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Maria Filomena Botelho
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Eunice Carrilho
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC.IBILI, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
34
|
Ali A, Almaroof A, Festy F, Banerjee A, Mannocci F. In vitro Remineralization of Caries-affected Dentin after Selective Carious Tissue Removal. ACTA ACUST UNITED AC 2018. [DOI: 10.5005/jp-journals-10015-1529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
35
|
Leite MLDAES, Soares DG, Basso FG, Hebling J, Costa CADS. Biostimulatory effects of simvastatin on MDPC-23 odontoblast-like cells. Braz Oral Res 2017; 31:e104. [DOI: 10.1590/1807-3107bor-2017.vol31.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 11/10/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Josimeri Hebling
- Universidade Estadual Paulista “Júlio de Mesquita Filho” – Unesp, Brazil
| | | |
Collapse
|
36
|
Huang XQ, Camba J, Gu LS, Bergeron BE, Ricucci D, Pashley DH, Tay FR, Niu LN. Mechanism of bioactive molecular extraction from mineralized dentin by calcium hydroxide and tricalcium silicate cement. Dent Mater 2017; 34:317-330. [PMID: 29179973 DOI: 10.1016/j.dental.2017.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/10/2017] [Accepted: 11/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of the present study was to elucidate the mechanism of bioactive molecule extraction from mineralized dentin by calcium hydroxide (Ca(OH)2) and tricalcium silicate cements (TSC). METHODS AND RESULTS Transmission electron microscopy was used to provide evidence for collagen degradation in dentin surfaces covered with Ca(OH)2 or a set, hydrated TSC for 1-3 months. A one micron thick collagen degradation zone was observed on the dentin surface. Fourier transform-infrared spectroscopy was used to identify increases in apatite/collagen ratio in dentin exposed to Ca(OH)2. Using three-point bending, dentin exposed to Ca(OH)2 exhibited significant reduction in flexural strength. Using size exclusion chromatography, it was found that the small size of the hydroxyl ions derived from Ca(OH)2 enabled those ions to infiltrate the intrafibrillar compartment of mineralized collagen and degrade the collagen fibrils without affecting the apatite minerals. Using ELISA, TGF-β1 was found to be extracted from dentin covered with Ca(OH)2 for 3 months. Unlike acids that dissolve the mineral component of dentin to release bioactive molecules, alkaline materials such as Ca(OH)2 or TSC released growth factors such as TGF-β1 via collagen degradation. SIGNIFICANCE The bioactive molecule extraction capacities of Ca(OH)2 and TSC render these dental materials excellent for pulp capping and endodontic regeneration. These highly desirable properties, however, appear to be intertwined with the untoward effect of degradation of the collagen matrix within mineralized dentin, resulting in reduced flexural strength.
Collapse
Affiliation(s)
- Xue-Qing Huang
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - John Camba
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Li-Sha Gu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Brian E Bergeron
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - David H Pashley
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China.
| |
Collapse
|
37
|
Abstract
OBJECTIVE This review integrates the literature on cavity liners and current concepts of pulp protection with the aim of establishing a better understanding of the role of calcium hydroxide as a cavity liner. MATERIALS AND METHODS A search was conducted through PubMed, MEDLINE, and Ovid for articles with the criteria for the following terms: cavity liners and bases, pulp protection, and calcium hydroxide liners. No specific inclusion or exclusion criteria were applied as to what articles would be included in this review. It was hoped that the extent of the literature reviewed would be as comprehensive as possible. CONCLUSION This review underlines the fact that calcium hydroxide liners should only be used in the deepest spots in the cavity where the remaining dentine thickness is ≤0.5 mm. A protective layer of resin-modified glass ionomer should always follow the application of calcium hydroxide liners.
Collapse
Affiliation(s)
- Naji Ziad Arandi
- Faculty of Dentistry, The Arab American University, Jenin, Palestine
| |
Collapse
|
38
|
Chen J, Cui C, Qiao X, Yang B, Yu M, Guo W, Tian W. Treated dentin matrix paste as a novel pulp capping agent for dentin regeneration. J Tissue Eng Regen Med 2017; 11:3428-3436. [PMID: 28198096 DOI: 10.1002/term.2256] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 06/03/2016] [Accepted: 07/03/2016] [Indexed: 02/05/2023]
Abstract
Regenerating dentin and preserving pulp vitality are the two key targets for the treatment of dental pulp exposure. Calcium hydroxide (CH), the widely used capping agent, may induce potential tunnel defect in reparative dentin and cause inflammation or even necrosis in pulp tissues. This study aimed to produce a novel pulp capping agent with better bioactivities. Treated dentin matrix (TDM) paste (TDMP) was fabricated consisting of TDM powder and aqueous TDM extract. The chemical and biological characteristics of TDMP were investigated, and its effect on the odontogenic differentiation of dental pulp stem cells explored at gene and protein level; the therapeutic effect for pulp exposure in miniature swine was further verified. TDMP possessed better biocompatibility with neutral pH value, significantly promoted the proliferation of dental pulp stem cells, and enhanced the gene and protein expressions of alkaline phosphatase, bone sialoprotein, dentin sialoprotein etc., compared with CH. In vivo pulp capping using TDMP presented the formation of continuous reparative dentin bridge thicker and denser than CH group. Moreover, pulp tissues under TDMP capping sites showed relatively slight angiectasis than those induced by CH. TDMP could achieve both dentin regeneration and vital pulp conservation, and might serve as a feasible substitute for CH in dental pulp repair procedure. Copyright © 2017 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Jinlong Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Departments of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Caiyun Cui
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiangchen Qiao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bo Yang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Departments of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Mei Yu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weihua Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Departments of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Departments of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
39
|
Luiz de Oliveira da Rosa W, Machado da Silva T, Fernando Demarco F, Piva E, Fernandes da Silva A. Could the application of bioactive molecules improve vital pulp therapy success? A systematic review. J Biomed Mater Res A 2017; 105:941-956. [PMID: 27998031 DOI: 10.1002/jbm.a.35968] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 12/26/2022]
Abstract
This study aimed to systematically review the literature of animal studies to evaluate whether bioactive dentin proteins could improve vital pulp therapy success. The review is reported in accordance with the PRISMA Statement. Two reviewers independently conducted a literature search of seven databases: PubMed (Medline), Lilacs, IBECS, BBO, Web of Science, Scopus, and SciELO. Animal experiments in which bioactive dentin proteins were applied directly or indirectly to the pulp tissue were included. Data regarding the characteristics of the proteins evaluated, the delivery systems used and the main findings from each study were tabulated to assess the outcomes of interest (tertiary dentin formation, inflammatory response, intratubular mineralization). After screening, 32 papers were subjected to qualitative analysis. In 75% of the studies, direct pulp capping was performed. Additionally, the most studied proteins were BMP-7, TGF-β1, and extracted soluble dentin matrix proteins. In conclusion, there is evidence in the literature suggesting that bioactive dentin molecules could enhance tertiary dentin formation with fewer initial inflammatory responses in direct and indirect pulp therapy in animal models. There are potential areas to be explored for novel therapeutic approaches for dental tissue repair and regeneration with bioactive materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 941-956, 2017.
Collapse
Affiliation(s)
| | - Tiago Machado da Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Evandro Piva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Adriana Fernandes da Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
40
|
Cui CY, Wang SN, Ren HH, Li AL, Qiu D, Gan YH, Dong YM. Regeneration of dental–pulp complex-like tissue using phytic acid derived bioactive glasses. RSC Adv 2017. [DOI: 10.1039/c7ra01480e] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Phytic acid derived bioactive calcium phosphosilicate (PSC) glasses were synthesised by using phytic acid as a phosphorus precursor. PSC have superior biocompatibility for dental pulp cells and ability to regenerate dentin–pulp complex to 45S5.
Collapse
Affiliation(s)
- Cai-Yun Cui
- Department of Cariology and Endodontology
- Peking University School and Hospital of Stomatology
- Beijing 100081
- P. R. China
- National Engineering Laboratory for Digital and Material Technology of Stomatology
| | - Sai-Nan Wang
- Department of Cariology and Endodontology
- Peking University School and Hospital of Stomatology
- Beijing 100081
- P. R. China
- National Engineering Laboratory for Digital and Material Technology of Stomatology
| | - Hui-Hui Ren
- Beijing National Laboratory for Molecular Sciences
- State Key Laboratory of Polymer Physics and Chemistry
- Institute of Chemistry
- Chinese Academy of Sciences
- Beijing 100190
| | - Ai-Ling Li
- Beijing National Laboratory for Molecular Sciences
- State Key Laboratory of Polymer Physics and Chemistry
- Institute of Chemistry
- Chinese Academy of Sciences
- Beijing 100190
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences
- State Key Laboratory of Polymer Physics and Chemistry
- Institute of Chemistry
- Chinese Academy of Sciences
- Beijing 100190
| | - Ye-Hua Gan
- National Engineering Laboratory for Digital and Material Technology of Stomatology
- Beijing Key Laboratory of Digital Stomatology
- Beijing 100081
- P. R. China
- Central Laboratory
| | - Yan-Mei Dong
- Department of Cariology and Endodontology
- Peking University School and Hospital of Stomatology
- Beijing 100081
- P. R. China
- National Engineering Laboratory for Digital and Material Technology of Stomatology
| |
Collapse
|
41
|
Kuhn E, Reis A, Chibinski ACR, Wambier DS. The influence of the lining material on the repair of the infected dentin in young permanent molars after restoration: A randomized clinical trial. J Conserv Dent 2016; 19:516-521. [PMID: 27994311 PMCID: PMC5146765 DOI: 10.4103/0972-0707.194026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: This study evaluated the impact of liner material on the fluorescence, morphological and mineral characteristics of permanent carious dentin after cavity sealing. Methods: Thirty children (11.0 ± 2.7 years old) presenting at least one active deep carious lesion in permanent molars were selected. Fragments of carious dentin were removed from teeth before lining the cavity (baseline samples) with high-viscosity glass ionomer cement (G1) or an inert material (wax - G2). Cavities were restored with composite resin and reopened 60 days later, and other fragments were removed (60-day sample). The laser fluorescence (LF) readings and morphological and mineral changes of both groups were compared. Results: After 60 days, forty teeth were available for evaluation. Lower LF means were obtained (Wilcoxon signed-rank test; P < 0.05), and enhanced calcium and phosphorus levels were detected for both groups (t-test, P < 0.05). An uptake of fluorine was observed only in G1 (t-test; P < 0.05). Regardless of the group, baseline samples exhibited clear signs of bacterial invasion, and the collagen fibers were exposed; the 60-day samples showed a better-organized tissue with a more compact intertubular dentin. Conclusion: Caries arrestment with dentin reorganization occurs regardless of the lining material placed in contact with the infected dentin.
Collapse
Affiliation(s)
- Eunice Kuhn
- Department of Dentistry, State University of Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Paraná, Brazil
| | | | | |
Collapse
|
42
|
Espir CG, Guerreiro-Tanomaru JM, Spin-Neto R, Chávez-Andrade GM, Berbert FLCV, Tanomaru-Filho M. Solubility and bacterial sealing ability of MTA and root-end filling materials. J Appl Oral Sci 2016; 24:121-5. [PMID: 27119759 PMCID: PMC4836918 DOI: 10.1590/1678-775720150437] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/18/2016] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate solubility and sealing ability of Mineral Trioxide Aggregate (MTA) and root-end filling materials. Material and Methods The materials evaluated were: MTA, Calcium Silicate Cement with zirconium oxide (CSC/ZrO2), and zinc oxide/eugenol (ZOE). Solubility test was performed according to ANSI/ADA. The difference between initial and final mass of the materials was analyzed after immersion in distilled water for 7 and 30 days. Retrograde cavities in human teeth with single straight root canal were performed by using ultrasonic tip CVD 9.5107-8. The cavities were filled with the evaluated materials to evaluate sealing ability using the bacterial leakage test with Enterococcus faecalis. Bacterial leakage was evaluated every 24 hours for six weeks observing the turbidity of Brain Heart infusion (BHI) medium in contact with root apex. Data were submitted to ANOVA followed by Tukey tests (solubility), and Kruskal-Wallis and Dunn tests (sealing ability) at a 5% significance level. Results For the 7-day period, ZOE presented highest solubility when compared with the other groups (p<0.05). For the 30-day period, no difference was observed among the materials. Lower bacterial leakage was observed for MTA and CSC/ZrO2, and both presented better results than ZOE (p<0.05). Conclusion MTA and CSC/ZrO2 presented better bacterial sealing capacity, which may be related to lower initial solubility observed for these materials in relation to ZOE.
Collapse
Affiliation(s)
- Camila Galletti Espir
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Juliane Maria Guerreiro-Tanomaru
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Rubens Spin-Neto
- Department of Dentistry, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Gisselle Moraima Chávez-Andrade
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Fabio Luiz Camargo Villela Berbert
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Mario Tanomaru-Filho
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brasil
| |
Collapse
|
43
|
Schweikl H, Widbiller M, Krifka S, Klement J, Petzel C, Bolay C, Hiller KA, Buchalla W. Interaction between LPS and a dental resin monomer on cell viability in mouse macrophages. Dent Mater 2016; 32:1492-1503. [PMID: 27671463 DOI: 10.1016/j.dental.2016.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/26/2016] [Accepted: 09/03/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Lipopolysaccharide (LPS) from cariogenic microorganisms and resin monomers like HEMA (2-hydroxyethyl methacrylate) included in dentin adhesive are present in a clinical situation in deep dentinal cavity preparations. Here, cell survival, expression of proteins related to redox homeostasis, and viability of mouse macrophages exposed to LPS and HEMA were analyzed with respect to the influence of oxidative stress. METHODS Cell survival of RAW264.7 mouse macrophages was determined using a crystal violet assay, protein expression was detected by Western blotting, and HEMA- or LPS-induced apoptosis (cell viability) was analyzed by flow cytometry. Cells were exposed to HEMA (0-8mM), LPS (0.1μg/ml) or combinations of both substances for 24h. The influence of mitogen-activated protein kinases (MAPK) was analyzed using the specific inhibitors PD98059 (ERK1/2), SB203580 (p38) or SP600125 (JNK), and oxidative stress was identified by the antioxidant N-acetylcysteine (NAC). RESULTS Cell survival was reduced by HEMA. LPS, however, increased cell survival from 29% in cultures exposed to 8mM HEMA, to 46% in cultures co-exposed to 8mM HEMA/LPS. Notably, LPS-induced apoptosis was neutralized by 4-6mM HEMA but apoptosis caused by 8mM HEMA was counteracted by LPS. Expression of NOS (nitric oxide synthase), p47phox and p67phox subunits of NADPH oxidase, catalase or heme oxygenase (HO-1) was associated with HEMA- or LPS-induced apoptosis. While no influence of MAPK was detected, NAC inhibited cytotoxic effects of HEMA. SIGNIFICANCE HEMA- and LPS-triggered pathways may induce apoptosis and interfere with physiological tissue responses as a result of the differential formation of oxidative stress.
Collapse
Affiliation(s)
- Helmut Schweikl
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany.
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Stephanie Krifka
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Johannes Klement
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Christine Petzel
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Carola Bolay
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital, University of Regensburg, D-93042 Regensburg, Germany
| |
Collapse
|
44
|
Yu CY, Abbott PV. Responses of the pulp, periradicular and soft tissues following trauma to the permanent teeth. Aust Dent J 2016; 61 Suppl 1:39-58. [DOI: 10.1111/adj.12397] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- CY Yu
- School of Dentistry; The University of Western Australia; Western Australia Australia
| | - PV Abbott
- School of Dentistry; The University of Western Australia; Western Australia Australia
| |
Collapse
|
45
|
Chibinski ACR, Wambier L, Reis A, Wambier DS. Clinical, mineral and ultrastructural changes in carious dentin of primary molars after restoration. Int Dent J 2016; 66:150-7. [PMID: 26846944 DOI: 10.1111/idj.12219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Partial caries removal has been shown to be an effective method to treat deep carious lesions in deciduous teeth. Nevertheless, the possibility of keeping infected dentin in the cavity still requires additional investigation. The objective of this research was to describe changes in primary infected dentin after restoration with glass ionomer cement. METHODS Dentin from 45 primary molars with deep and active carious lesions was evaluated using clinical and laboratory criteria, before and 60 days after restoration. The clinical analysis evaluated dentin colour (CO), dentin consistency (COS) and laser fluorescence (LF). The laboratory procedures assessed bacterial contamination and mineral content (MC), and evaluated the dentin ultrastructure and collagen content. Data on CO, COS, LF and colony forming units were analysed using the Wilcoxon signed-rank test; MC, bacterial counts and collagen evaluations were evaluated using the Student's t-test. RESULTS After 60 days, lower values of LF were observed, together with a lower bacterial count, and a higher COS was found, with an increase in calcium, phosphorus and collagen contents. Differences were not detected for CO or for fluorine content. Baseline samples showed enlarged tubules with bacterial invasion; 60-day samples showed better organised tissue, with a more compact intertubular dentin and narrower tubules. CONCLUSION It is concluded that appropriate cavity sealing can promote beneficial changes in deep carious lesions of primary teeth, even in the presence of infected dentin.
Collapse
Affiliation(s)
| | - Letícia Wambier
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, Paraná, Brazil
| | - Denise Stadler Wambier
- Department of Pediatric Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, Paraná, Brazil
| |
Collapse
|
46
|
Salehi S, Cooper P, Smith A, Ferracane J. Dentin matrix components extracted with phosphoric acid enhance cell proliferation and mineralization. Dent Mater 2016; 32:334-42. [PMID: 26777093 DOI: 10.1016/j.dental.2015.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/07/2015] [Accepted: 11/20/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Acids, such as those used in adhesive dentistry, have been shown to solubilize bioactive molecules from dentin. These dentin matrix components (DMC) may promote cell proliferation and differentiation, and ultimately contribute to dentin regeneration. The objective of this study was to evaluate the potential for varying concentrations of DMC extracted from human dentin by phosphoric acid of a range of pHs to stimulate proliferation and mineralization of two different cultured pulp cell populations. METHODS DMC were solubilized from powdered human dentin (7 days - 4°C) by phosphoric acid of pH 1, 3, and 5 and also, EDTA. Extracts were dialyzed for 7 days against distilled water and lyophilized. Undifferentiated mouse dental pulp cells (OD-21) and cells of the odontoblast-like cell line (MDPC-23) were seeded in six-well plates (1×10(5)) and cultured for 24h in DMEM (Dulbecco's modified Eagle's medium) containing 10% (v/v) FBS (fetal bovine serum). The cells were washed with serum-free medium and then treated with different concentrations of DMC (0.01, 0.1, 1.0 and 10.0μg/ml) daily in serum free medium for 7 days. After 3, 5 (MDPC-23 only), and 7 days of treatment, cell proliferation was measured using 10vol% Alamar blue solution, which was added to each well for 1h. Cell numbers were first measured by cell counting (Trypan blue; n=5) and Alamar blue fluorescence to validate the assay, which was then used for the subsequent assessments of proliferation. Mineralization was assessed by Alizarin Red S assay after 12 days exposure to DMC (n=5). Controls were media-only (DMEM) and dexamethasone (DEX; positive control). Results were analysed by ANOVA/Tukey's (p≤0.05). RESULTS There was a linear correlation between cell counts and Alamar blue fluorescence (R(2)>0.96 for both cell types) , verifying the validity of the Alamar blue assay for these cell types. In general, there was a dose-dependent trend for enhanced cell proliferation with higher concentration of DMC for both cell lines, especially at 10.0μg/ml. DEX exposure resulted in significantly higher mineralization, but did not affect cell proliferation. DMC exposure demonstrated significantly greater mineralization than media-only control for 10μg/ml for all extracts, and at lower concentrations for EDTA and pH 5 extracts. SIGNIFICANCE Human dentin matrix components solubilized by acids at pH levels found in commercial dentin adhesives enhanced cell proliferation and mineralization of mouse and rat undifferentiated dental pulp cells when presented in adequate concentration.
Collapse
Affiliation(s)
- Satin Salehi
- Department of Restorative Dentistry, Division of Biomaterials and Biomechanics, Oregon Health & Science University, Portland, OR 97201, USA
| | - Paul Cooper
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham B4 6NN, United Kingdom
| | - Anthony Smith
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham B4 6NN, United Kingdom
| | - Jack Ferracane
- Department of Restorative Dentistry, Division of Biomaterials and Biomechanics, Oregon Health & Science University, Portland, OR 97201, USA.
| |
Collapse
|
47
|
Duncan HF, Smith AJ, Fleming GJP, Reid C, Smith G, Cooper PR. Release of bio-active dentine extracellular matrix components by histone deacetylase inhibitors (HDACi). Int Endod J 2016; 50:24-38. [PMID: 26609946 DOI: 10.1111/iej.12588] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/19/2015] [Indexed: 01/24/2023]
Abstract
AIM To characterize dentine matrix component (DMC) release and smear layer removal by histone deacetylase inhibitors (HDACis). METHODOLOGY DMCs were extracted from powdered human dentine over 14 days using three HDACis, valproic acid (VPA), trichostatin A (TSA) and suberoylanilide hydroxamic acid (SAHA) and compared with a control extractant, 10% (w/v) EDTA. Protein compositions of the resultant extracts were analysed by 1D-polyacrylamide gel electrophoresis (1D-PAGE), TGF-β-1 and MMP-9 ELISAs and a high-throughput growth factor antibody array. Dentine discs with a standardized smear layer were prepared from human molars and treated with EDTA (17% w/v), polyacrylic acid (PA) (20% v/v) and the experimental HDACis prior to analysis by scanning electron microscopy. Parametric ELISA data were analysed using one-way anova and Tukey's post hoc test, whilst nonparametric smear layer data were analysed by Kruskal-Wallis test and Mann-Whitney U-test (P < 0.05). RESULTS HDACis did not remove smear layer in the presence or absence of PA pre-treatment (P ≥ 0.478). 1D-PAGE analysis demonstrated different protein profiles for EDTA and HDACi extracts. All HDACi solutions released TGF-β-1 although less effectively than EDTA (P < 0.001), whilst MMP-9 was extracted in significantly higher concentration by EDTA and VPA compared with TSA (P < 0.012). Antibody array analysis demonstrated the ability of HDACis to extract a complex cocktail of established/novel growth factors from dentine, albeit significantly less efficiently than EDTA for certain cytokines (TGF-β-1, PDGF-AA, VEGF-A) and significantly more effectively for others (GDF-15, IGF-1, EGRF-1, NGFR, BDNF, SCF-R). CONCLUSIONS HDACi release a range of bioactive DMCs that could promote dentine repair processes in vivo; however, they are ineffective at removing smear layer.
Collapse
Affiliation(s)
- H F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - A J Smith
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
| | - G J P Fleming
- Material Science Unit, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - C Reid
- Centre for Microscopy and Analysis, Trinity College Dublin, Dublin, Ireland
| | - G Smith
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
| | - P R Cooper
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
| |
Collapse
|
48
|
Schmalz G, Widbiller M, Galler KM. Material Tissue Interaction--From Toxicity to Tissue Regeneration. Oper Dent 2015; 41:117-31. [PMID: 26645359 DOI: 10.2341/15-249-bl] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The topic of material tissue interaction has gained increasing interest over recent decades from both the dental profession and the public. The primary goal initially was to avoid adverse reactions after the application of dental materials. New laboratory test methods have been developed, and currently premarket testing programs, which attempt to guarantee a basic level of patient safety, are legally required worldwide. The dentist is responsible for selecting the correct indication as well as the proper handling of any newly emerging risk. Apart from this phenomenon-oriented "inert materials concept," the "analytical concept" focuses primarily on analyzing the reasons for adverse reactions, and identifying their associated modifying factors, in order to prevent them or to develop new and more biocompatible materials. The "concept of bioactivity" involves addressing the possibility of positively influencing tissue by materials application, such as the generation of tertiary dentin or antibacterial effects. Finally, tissue regeneration may be supported and promoted by the use of various suitable materials (matrices/scaffolds) into which stem cells can migrate or be seeded, leading to cell differentiation and the generation of new tissue. These new dental materials must also fulfill additional requirements such as controlled degradability in order to be suitable for clinical use. Clearly, the field of material tissue interaction is complex and comprises a wide range of issues. To be successful as dentists in the future, practitioners should remain informed of these important new developments and have the argumentative competence to both properly advise and treat their patients.
Collapse
|
49
|
Sohn S, Park Y, Srikanth S, Arai A, Song M, Yu B, Shin KH, Kang MK, Wang C, Gwack Y, Park NH, Kim RH. The Role of ORAI1 in the Odontogenic Differentiation of Human Dental Pulp Stem Cells. J Dent Res 2015; 94:1560-7. [PMID: 26403672 DOI: 10.1177/0022034515608128] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Pulp capping, or placing dental materials directly onto the vital pulp tissues of affected teeth, is a dental procedure that aims to regenerate reparative dentin. Several pulp capping materials are clinically being used, and calcium ion (Ca(2+)) released from these materials is known to mediate reparative dentin formation. ORAI1 is an essential pore subunit of store-operated Ca(2+) entry (SOCE), which is a major Ca(2+) influx pathway in most nonexcitable cells. Here, we evaluated the role of ORAI1 in mediating the odontogenic differentiation and mineralization of dental pulp stem cells (DPSCs). During the odontogenic differentiation of DPSCs, the expression of ORAI1 increased in a time-dependent manner. DPSCs knocked down with ORAI1 shRNA (DPSC/ORAI1sh) or overexpressed with dominant negative mutant ORAI1(E106Q) (DPSC/E106Q) exhibited the inhibition of Ca(2+) influx and suppression of odontogenic differentiation and mineralization as demonstrated by alkaline phosphatase (ALP) activity/staining as well as alizarin red S staining when compared with DPSCs of their respective control groups (DPSC/CTLsh and DPSC/CTL). The gene expression for odontogenic differentiation markers such as osteocalcin, bone sialoprotein, and dentin matrix protein 1 (DMP1) was also suppressed. When DPSC/CTL or DPSC/E106Q cells were subcutaneously transplanted into nude mice, DPSC/CTL cells induced mineralized tissue formation with significant increases in ALP and DMP1 staining in vivo, whereas DPSC/E106Q cells did not. Collectively, our data showed that ORAI1 plays critical roles in the odontogenic differentiation and mineralization of DPSCs by regulating Ca(2+) influx and that ORAI1 may be a therapeutic target to enhance reparative dentin formation.
Collapse
Affiliation(s)
- S Sohn
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Y Park
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - S Srikanth
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - A Arai
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - M Song
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - B Yu
- UCLA School of Dentistry, Los Angeles, CA, USA
| | - K-H Shin
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - M K Kang
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - C Wang
- UCLA School of Dentistry, Los Angeles, CA, USA UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Y Gwack
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - N-H Park
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - R H Kim
- UCLA School of Dentistry, Los Angeles, CA, USA Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| |
Collapse
|
50
|
Songsiripradubboon S, Banlunara W, Sangvanich P, Trairatvorakul C, Thunyakitpisal P. Clinical, radiographic, and histologic analysis of the effects of acemannan used in direct pulp capping of human primary teeth: short-term outcomes. Odontology 2015; 104:329-37. [DOI: 10.1007/s10266-015-0215-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 07/22/2015] [Indexed: 01/28/2023]
|