Applicability of bacterial cellulose as an alternative to paper points in endodontic treatment

Modifications of cellulose-based biomaterials for biomedical applications

Cellulose is one of the most abundant organic compounds in nature and is available from diverse sources. Cellulose features tunable properties, making it a promising substrate for biomaterial development. In this review, we highlight advances in the physical processes and chemical modifications of cellulose that enhance its properties for use as a biomaterial. Three cellulosic products are discussed, including nanofibrillated, nanocrystalline, and bacterial cellulose, with a focus on how each may serve as a platform for the development of advanced cellulose-based biomaterials for Biomedical applications. In addition to associating mechanical and chemical properties of cellulosic materials to specific applications, a prospectus is offered for the future development of cellulose-based biomaterials for biomedicine.

The applications of polysaccharides in dentistry

Polysaccharides are natural polymers widely present in animals, plants, and several microorganisms. Polysaccharides have remarkable properties, including easy extractions, degradability, and renewability, and have no apparent toxicity, making them ideal for biomedical applications. Moreover, polysaccharides are suitable for repairing oral tissue defects and treating oral diseases due to their excellent biocompatibility, biosafety, anti-inflammatory, and antibacterial properties. The oral cavity is a relatively complex environment vulnerable to numerous conditions, including soft tissue diseases, hard tissue disorders, and as well as soft and hard tissue diseases, all of which are complex to treat. In this article, we reviewed different structures of natural polysaccharides with high commercial values and their applications in treating various oral disease, such as drug delivery, tissue regeneration, material modification, and tissue repair.

Cellulose-Based Nanomaterials Advance Biomedicine: A Review

There are various biomaterials, but none fulfills all requirements. Cellulose biopolymers have advanced biomedicine to satisfy high market demand and circumvent many ecological concerns. This review aims to present an overview of cellulose knowledge and technical biomedical applications such as antibacterial agents, antifouling, wound healing, drug delivery, tissue engineering, and bone regeneration. It includes an extensive bibliography of recent research findings from fundamental and applied investigations. Cellulose-based materials are tailorable to obtain suitable chemical, mechanical, and physical properties required for biomedical applications. The chemical structure of cellulose allows modifications and simple conjugation with several materials, including nanoparticles, without tedious efforts. They render the applications cheap, biocompatible, biodegradable, and easy to shape and process.

Fabrication strategies and biomedical applications of three-dimensional bacterial cellulose-based scaffolds: A review

Bacterial cellulose (BC), an extracellular polysaccharide, is a versatile biopolymer due to its intrinsic physicochemical properties, broad-spectrum applications, and remarkable achievements in different fields, especially in the biomedical field. Presently, the focus of BC-related research is on the development of scaffolds containing other materials for in-vitro and in-vivo biomedical applications. To this end, prime research objectives concern the biocompatibility of BC and the development of three-dimensional (3D) BC-based scaffolds. This review summarizes the techniques used to develop 3D BC scaffolds and discusses their potential merits and limitations. In addition, we discuss the various biomedical applications of BC-based scaffolds for which the 3D BC matrix confers desired structural and conformational features. Overall, this review provides comprehensive coverage of the idea, requirements, synthetic strategies, and current and prospective applications of 3D BC scaffolds, and thus, should be useful for researchers working with polysaccharides, biopolymers, or composite materials.

Antimicrobial Properties of Bacterial Cellulose Films Enriched with Bioactive Herbal Extracts Obtained by Microwave-Assisted Extraction

The use of bacterial cellulose (BC) as scaffold for active biofilms is one of the most interesting applications, especially for the biomedical and food industries. However, there are currently few studies evaluating the potential of incorporating herbal extracts into various biomaterials, including BC. Thus, the aim of this study is to report a screening of the total phenolic content and antioxidant and antimicrobial activity of ethanolic extracts of oregano, rosemary, parsley, and lovage. At the same time, the bioactive potential of BC enriched with the four ethanolic extracts is described. Microwave-assisted extraction was used to extract bioactive compounds from the four selected herbs. The physical, mechanical, structural, and chemical properties of BC were also assessed. Next, BC was enriched with the extracts, and their effect against Escherichia coli, Staphylococcus aureus, and Candida albicans was evaluated. The results showed that the bioactivity of the herbs varied significantly, with rosemary extract being the most bioactive. The BC films possessed good mechanical properties, and a three-dimensional network fibrillar structure appropriate for ethanolic-extract incorporation. The BC samples enriched with rosemary extracts had the highest antibacterial activity against S. aureus, while E. coli. and C. albicans seemed to be resistant to all extracts, regardless of herbs.

Bacterial Cellulose-A Remarkable Polymer as a Source for Biomaterials Tailoring

Nowadays, the development of new eco-friendly and biocompatible materials using ‘green’ technologies represents a significant challenge for the biomedical and pharmaceutical fields to reduce the destructive actions of scientific research on the human body and the environment. Thus, bacterial cellulose (BC) has a central place among these novel tailored biomaterials. BC is a non-pathogenic bacteria-produced polysaccharide with a 3D nanofibrous structure, chemically identical to plant cellulose, but exhibiting greater purity and crystallinity. Bacterial cellulose possesses excellent physicochemical and mechanical properties, adequate capacity to absorb a large quantity of water, non-toxicity, chemical inertness, biocompatibility, biodegradability, proper capacity to form films and to stabilize emulsions, high porosity, and a large surface area. Due to its suitable characteristics, this ecological material can combine with multiple polymers and diverse bioactive agents to develop new materials and composites. Bacterial cellulose alone, and with its mixtures, exhibits numerous applications, including in the food and electronic industries and in the biotechnological and biomedical areas (such as in wound dressing, tissue engineering, dental implants, drug delivery systems, and cell culture). This review presents an overview of the main properties and uses of bacterial cellulose and the latest promising future applications, such as in biological diagnosis, biosensors, personalized regenerative medicine, and nerve and ocular tissue engineering.

Bacterial Cellulose (BC) and BC Composites: Production and Properties

The synthesis of bacterial cellulose (BC) by Komagataeibacter xylinus strain B-12068 was investigated on various C-substrates, under submerged conditions with stirring and in static surface cultures. We implemented the synthesis of BC on glycerol, glucose, beet molasses, sprat oil, and a mixture of glucose with sunflower oil. The most productive process was obtained during the production of inoculum in submerged culture and subsequent growth of large BC films (up to 0.2 m2 and more) in a static surface culture. The highest productivity of the BC synthesis process was obtained with the growth of bacteria on molasses and glycerol, 1.20 and 1.45 g/L per day, respectively. We obtained BC composites with silver nanoparticles (BC/AgNPs) and antibacterial drugs (chlorhexidine, baneocin, cefotaxime, and doripenem), and investigated the structure, physicochemical, and mechanical properties of composites. The disc-diffusion method showed pronounced antibacterial activity of BC composites against E. coli ATCC 25922 and S. aureus ATCC 25923.

Optimization of Moist and Oven-Dried Bacterial Cellulose Production for Functional Properties

Bacterial cellulose (BC) is a natural polymer with properties suitable for tissue engineering and possible applications in scaffold production. However, current procedures have limitations in obtaining BC pellicles with the desired structural, physical, and mechanical properties. Thus, this study analyzed the optimal culture conditions of BC membranes and two types of processing: draining and oven-drying. The aim was to obtain BC membranes with properties suitable for a wound dressing material. Two studies were carried out. In the preliminary study, the medium (100 mL) was inoculated with varying volumes (1, 2, 3, 4, and 5 mL) and incubated statically for different periods (3, 6, 9, 12, and 18 days), using a full factorial experimental design. Thickness, uniformity, weight, and yield were evaluated. In the optimization study, a Box–Behnken design was used. Two independent variables were used: inoculum volume (X₁: 1, 3, and 5 mL) and fermentation period (X₂: 6, 12, and 18 d) to determine the target response variables: thickness, swelling ratio, drug release, fiber diameter, tensile strength, and Young’s modulus for both dry and moist BC membranes. The mathematical modelling of the effect of the two independent variables was performed by response surface methodology (RSM). The obtained models were validated with new experimental values and confirmed for all tested properties, except Young’s modulus of oven-dried BC. Thus, the optimal properties in terms of a scaffold material of the moist BC were obtained with an inoculum volume of 5% (v/v) and 16 d of fermentation. While, for the oven-dried membranes, optimal properties were obtained with a 4% (v/v) and 14 d of fermentation.

Cellulose-Based Fibrous Materials From Bacteria to Repair Tympanic Membrane Perforations

Perforation is the most common illness of the tympanic membrane (TM), which is commonly treated with surgical procedures. The success rate of the treatment could be improved by novel bioengineering approaches. In fact, a successful restoration of a damaged TM needs a supporting biomaterial or scaffold able to meet mechano-acoustic properties similar to those of the native TM, along with optimal biocompatibility. Traditionally, a large number of biological-based materials, including paper, silk, Gelfoam®, hyaluronic acid, collagen, and chitosan, have been used for TM repair. A novel biopolymer with promising features for tissue engineering applications is cellulose. It is a highly biocompatible, mechanically and chemically strong polysaccharide, abundant in the environment, with the ability to promote cellular growth and differentiation. Bacterial cellulose (BC), in particular, is produced by microorganisms as a nanofibrous three-dimensional structure of highly pure cellulose, which has thus become a popular graft material for wound healing due to a number of remarkable properties, such as water retention, elasticity, mechanical strength, thermal stability, and transparency. This review paper provides a comprehensive overview of the current experimental studies of BC, focusing on the application of BC patches in the treatment of TM perforations. In addition, computational approaches to model cellulose and TM are summarized, with the aim to synergize the available tools toward the best design and exploitation of BC patches and scaffolds for TM repair and regeneration.

PVA based nanofiber containing CQDs modified with silica NPs and silk fibroin accelerates wound healing in a rat model

In recent years, applying various wound dressings with antibacterial activities to expedite tissue repair stages has gained remarkable attention. The intertwined three-dimensional structure of nanofibers provides unique spaces for carrying drugs and repair agents during the wound healing process. In this research, a carbon quantum dot (CQD)/silica nanoparticle (Si NP)/silk fibroin (SF) nanocomposite was synthesized, and two novel wound dressings, a BC-CQD/Si NP/SF nanocomposite and a PVA-CQD/Si NP/SF nanofiber, were prepared by Spray Printing and Electrospinning methods and successfully characterized. The water-uptake capacity of the BC-CQD/Si NP/SF nanocomposite has been optimized to evaluate its swelling behavior. To determine the antibacterial effects of the synthesized materials both MIC and Optical Density (OD) methods were performed, and the results imply that materials have high antibacterial activity and could successfully inhibit the growth of both S. aureus and E. coli bacteria. Cell toxicity, viability, and proliferation on NIH 3T3 fibroblast cells with the MTT assay have proved that the CQD/Si NP/SF nanocomposite not only has no toxicity but also can accelerate cell viability and proliferation. To assess the effect of the CQD/Si NP/SF nanocomposite on cell migration and in vitro wound healing scratch, a wound assay was performed, and the nanocomposite exhibits the ability to promote wound healing. The PVA-CQD/Si NP/SF nanofiber was used to investigate wound healing in an animal model. The results show that the PVA-CQD/Si NP/SF nanofiber effectively accelerates the skin and hair follicle regeneration. Therefore, the PVA-CQD/Si NP/SF nanofiber is a promising wound dressing for inhibiting bacterial growth and promoting skin wound repair and hair regeneration.

Biomedical Applications of Bacterial Exopolysaccharides: A Review

Bacterial exopolysaccharides (EPSs) are an essential group of compounds secreted by bacteria. These versatile EPSs are utilized individually or in combination with different materials for a broad range of biomedical field functions. The various applications can be explained by the vast number of derivatives with useful properties that can be controlled. This review offers insight on the current research trend of nine commonly used EPSs, their biosynthesis pathways, their characteristics, and the biomedical applications of these relevant bioproducts.

Bacterial Nanocellulose in Dentistry: Perspectives and Challenges

Bacterial cellulose (BC) is a natural polymer that has fascinating attributes, such as biocompatibility, low cost, and ease of processing, being considered a very interesting biomaterial due to its options for moldability and combination. Thus, BC-based compounds (for example, BC/collagen, BC/gelatin, BC/fibroin, BC/chitosan, etc.) have improved properties and/or functionality, allowing for various biomedical applications, such as artificial blood vessels and microvessels, artificial skin, and wounds dressing among others. Despite the wide applicability in biomedicine and tissue engineering, there is a lack of updated scientific reports on applications related to dentistry, since BC has great potential for this. It has been used mainly in the regeneration of periodontal tissue, surgical dressings, intraoral wounds, and also in the regeneration of pulp tissue. This review describes the properties and advantages of some BC studies focused on dental and oral applications, including the design of implants, scaffolds, and wound-dressing materials, as well as carriers for drug delivery in dentistry. Aligned to the current trends and biotechnology evolutions, BC-based nanocomposites offer a great field to be explored and other novel features can be expected in relation to oral and bone tissue repair in the near future.

Is the Bacterial Cellulose Membrane Feasible for Osteopromotive Property?

Guided bone regeneration was studied to establish protocols and develop new biomaterials that revealed satisfactory results. The present study aimed to comparatively evaluate the efficiency of the bacterial cellulose membrane (Nanoskin^®) and collagen membrane Bio-Gide^® in the bone repair of 8-mm critical size defects in rat calvaria. Seventy-two adult male rats were divided into three experimental groups (n = 24): the CG—membrane-free control group (only blood clot, negative control), BG—porcine collagen membrane group (Bio-Guide^®, positive control), and BC—bacterial cellulose membrane group (experimental group). The comparison periods were 7, 15, 30, and 60 days postoperatively. Histological, histometric, and immunohistochemical analyses were performed. The quantitative data were subjected to 2-way ANOVA and Tukey’s post-test, and p < 0.05 was considered significant. At 30 and 60 days postoperatively, the BG group showed more healing of the surgical wound than the other groups, with a high amount of newly formed bone (p < 0.001), while the BC group showed mature connective tissue filling the defect. The inflammatory cell count at postoperative days 7 and 15 was higher in the BC group than in the BG group (Tukey’s test, p = 0.006). At postoperative days 30 and 60, the area of new bone formed was greater in the BG group than in the other groups (p < 0.001). Immunohistochemical analysis showed moderate and intense immunolabeling of osteocalcin and osteopontin at postoperative day 60 in the BG and BC groups. Thus, despite the promising application of the BC membrane in soft-tissue repair, it did not induce bone repair in rat calvaria.

Applications of bacterial-synthesized cellulose in veterinary medicine – a review

Tissue engineering promotes tissue regeneration through biomaterials that have excellent properties and have the potential to replace tissues. Many studies show that bacterial cellulose (BC) might ensure tissue regeneration and substitution, being used for the bioengineering of hard, cartilaginous and soft tissues. Bacterial cellulose is extensively used as wound dressing material and results show that BC is a promising tissue scaffold (bone, cardiovascular, urinary tissue). It can be combined with polymeric and non-polymeric compounds to acquire antimicrobial, cell-adhesion and proliferation properties. To ensure proper tissue regeneration, the material has to be: biocompatible, with minimum tissue reaction and biodegradability; bio-absorbable, to promote tissue development, cellular interaction and grow; resistant to support the weight of the newly formed tissue. Its versatile structure, physical and biochemical properties can be adjusted by adapting the bacteria culturing conditions. The main biomedical applications seem to be as hard (bone, dental), fibrocartilaginous (meniscal) and soft tissue (skin, cardiovascular, urinary) substituents. This paper reviews the current state of knowledge, challenges and future applications of BC and its biomedical potential in veterinary medicine. It was focused on the main uses in regeneration and scaffold tissue replacement and, although BC showed promising results, there is a lack of successful results of BC use in clinical practice. Most studies were performed only at experimental level and further research is needed for BC to enter clinical veterinary practice.

Bioactive bacterial cellulose membrane with prolonged release of chlorhexidine for dental medical application

Bioabsorbable barrier membrane is desired in dental medicine for treatment of periodontal diseases caused by different types of bacteria. Bioactive and bioabsorbable bacterial cellulose (BC) is a promising material for such application. However, a key challenge to implement this approach is produce BC membranes selectively oxidized and loaded with a bactericide, in order to modulate bioabsortion time and bactericide effect, respectively. In the present study, the drug model chlorhexidine (CHX) was chosen and NaIO₄ was used as oxidizing agent. To modulate CHX release and efficacy, inclusion complexes of CHX with β-cyclodextrin (CHX:βCD) were synthesized. A linear dependence between degree of oxidation (DO) and oxidant concentration was found (DO = 2.07 + 45 [NaIO₄]). CHX has strong chemical interaction with cellulose structure, contributing for its significant retention. The association of membrane oxidation and formation of the inclusion complex with βCD causes a 10-fold increase in CHX release rate compared to unmodified cellulose. Thus, validating the concept that CHX release can be modulated using these two strategies. All membranes loaded with CHX inhibited S. aureus, E. coli and C. albicans growth, but DABC+CHX:βCD showed greater inhibition zone (p < 0.05). That, associated with other results, indicates potential application as bioactive and bioabsorbable membrane.

Functionalized Bacterial Cellulose Microparticles for Drug Delivery in Biomedical Applications

Background:

Bacterial cellulose (BC) has recently attained greater interest in various research fields, including drug delivery for biomedical applications. BC has been studied in the field of drug delivery, such as tablet coating, controlled release systems and prodrug design.

Objective:

In the current work, we tested the feasibility of BC as a drug carrier in microparticulate form for potential pharmaceutical and biomedical applications.

Method :

For this purpose, drug-loaded BC microparticles were prepared by simple grinding and injection moulding method through regeneration. Model drugs, i.e., cloxacillin (CLX) and cefuroxime (CEF) sodium salts were loaded in these microparticles to assess their drug loading and release properties. The prepared microparticles were evaluated in terms of particle shapes, drug loading efficiency, physical state of the loaded drug, drug release behaviour and antibacterial properties.

Results:

The BC microparticles were converted to partially amorphous state after regeneration. Moreover, the loaded drug was transformed into the amorphous state. The results of scanning electron microscopy (SEM) showed that microparticles had almost spherical shape with a size of ca. 350-400 μm. The microparticles treated with higher drug concentration (3%) exhibited higher drug loading. Keeping drug concertation constant, i.e., 1%, the regenerated BC (RBC) microparticles showed higher drug loading (i.e., 37.57±0.22% for CEF and 33.36±3.03% for CLX) as compared to as-synthesized BC (ABC) microparticles (i.e., 9.46±1.30% for CEF and 9.84±1.26% for CLX). All formulations showed immediate drug release, wherein more than 85% drug was released in the initial 30 min. Moreover, such microparticles exhibited good antibacterial activity with larger zones of inhibition for drug loaded RBC microparticles as compared to corresponding ABC microparticles.

Conclusion :

Drug loaded BC microparticles with immediate release behaviour and antibacterial activity were fabricated. Such functionalized microparticles may find potential biomedical and pharmaceutical applications.

Efficacy of Bacterial Cellulose as a Carrier of BMP-2 for Bone Regeneration in a Rabbit Frontal Sinus Model

If the alveolar bone height of patients requiring dental implants in the maxillary molar region is inadequate, it is difficult to achieve satisfactory outcomes using existing bone graft materials. We previously reported the possible utility of bacterial cellulose (BC) as a new dental treatment material. BC has a high absorptive capacity, good mechanical strength, and good volume retention. BC loaded with bone morphogenetic protein-2 (BMP-2) might allow effective alveolar bone augmentation. We created critical frontal bone defect models in 12 male Japanese white rabbits and divided them into four groups: sham; BC (BC grafting only); BMP-2 (treated with BMP-2 solution only); and BC+BMP-2 (grafted with BC loaded with BMP-2). Newly formed bone volume was calculated via hematoxylin-eosin staining evaluation. The proliferating cell nuclear antigen and osteocalcin levels were determined by the immunohistochemical staining analysis. All measured indices of the BC+BMP-2 group were significantly superior to those of the other groups (all p < 0.05). BC maintained the graft space and released BMP-2 in a sustained manner, promoting optimal bone formation. The BC+BMP-2 combination enhanced bone regeneration and shows promise as a useful means of clinical pre-dental implant bone augmentation in the maxillary sinus.

Functional cellulose-based hydrogels as extracellular matrices for tissue engineering

Cellulose-based hydrogels are immensely important for tissue engineering. In this review, we attempt to document the source, nature, and application of cellulose-based hydrogels as an extracellular matrix for tissue growth and regeneration. Hydrogels can be prepared either from native cellulose, including both bacterial and plant sources or from cellulose derivatives, such as methyl cellulose, carboxymethylcellulose, and hydroxypropylmethylcellulose or even metal ions such as silver. Cellulose-polymer composite (polymers that include natural sources including chitosan, starch, alginates, collagen, hyaluronic acid, and chitin) are an attractive, inexpensive, and advantageous structural material that is easy to use. Cellulose-based scaffolding materials are widely used in the regeneration of various tissues, such as bone, cartilage, heart, blood vessel, nerve, and liver, among others. In this review, we discuss the most important applications of cellulosic hydrogels in tissue engineering based on their structural compositions.

Bacterial nanocellulose: the future of controlled drug delivery?

Although bacterial nanocellulose (BNC), a natural nanostructured biopolymer network, offers unique material characteristics, the number of drug-loaded BNC-based carriers in clinical trials or on the market is still low. This report provides an overview of aspects still limiting the broad application of BNC as drug-delivery system and the challenges for its future applications. Continuous large-scale production, storability, the loading and controlled release of critical drugs, for example, with high molar mass or highly lipophilic character as well as the formulation of long-term release systems will be highlighted. Recent achievements toward promoting the application of BNC as drug-delivery system and overcoming these obstacles will be discussed. [Formula: see text].

Advances in polymeric materials for dental applications

This review focuses on the relationship between the structures and properties of various polymers for different applications in dentistry.

In situ and ex situ modifications of bacterial cellulose for applications in tissue engineering

Bacterial cellulose (BC) is secreted by a few strains of bacteria and consists of a cellulose nanofiber network with unique characteristics. Because of its excellent mechanical properties, outstanding biocompatibilities, and abilities to form porous structures, BC has been studied for a variety of applications in different fields, including the use as a biomaterial for scaffolds in tissue engineering. To extend its applications in tissue engineering, native BC is normally modified to enhance its properties. Generally, BC modifications can be made by either in situ modification during cell culture or ex situ modification of existing BC microfibers. In this review we will first provide a brief introduction of BC and its attributes; this will set the stage for in-depth and up-to-date discussions on modified BC. Finally, the review will focus on in situ and ex situ modifications of BC and its applications in tissue engineering, particularly in bone regeneration and wound dressing.

Advances in biomedical and pharmaceutical applications of functional bacterial cellulose-based nanocomposites

Bacterial cellulose (BC) synthesized by certain species of bacteria, is a fascinating biopolymer with unique physical and mechanical properties. BC's applications range from traditional dessert, gelling, stabilizing and thickening agent in the food industry to advanced high-tech applications, such as immobilization of enzymes, bacteria and fungi, tissue engineering, heart valve prosthesis, artificial blood vessels, bone, cartilage, cornea and skin, and dental root treatment. Various BC-composites have been designed and investigated in order to enhance its biological applicability. This review focuses on the application of BC-based composites for microbial control, wound dressing, cardiovascular, ophthalmic, skeletal, and endodontics systems. Moreover, applications in controlled drug delivery, biosensors/bioanalysis, immobilization of enzymes and cells, stem cell therapy and skin tissue repair are also highlighted. This review will provide new insights for academia and industry to further assess the BC-based composites in terms of practical applications and future commercialization for biomedical and pharmaceutical purposes.

A multipurpose natural and renewable polymer in medical applications: Bacterial cellulose

Bacterial cellulose (BC) produced by some bacteria, among them Gluconacetobacter xylinum, which secrets an abundant 3D networks fibrils, represents an interesting emerging biocompatible nanomaterial. Since its discovery BC has shown tremendous potential in a wide range of biomedical applications, such as artificial skin, artificial blood vessels and microvessels, wound dressing, among others. BC can be easily manipulated to improve its properties and/or functionalities resulting in several BC based nanocomposites. As example BC/collagen, BC/gelatin, BC/Fibroin, BC/Chitosan, etc. Thus, the aim of this review is to discuss about the applicability in biomedicine by demonstrating a variety of forms of this biopolymer highlighting in detail some qualities of bacterial cellulose. Therefore, various biomedical applications ranging from implants and scaffolds, carriers for drug delivery, wound-dressing materials, etc. that were reported until date will be presented.

Paper points revisited: risk of cellulose fibre shedding during canal length confirmation

AIM

To compare the degree of fibre shedding by six brands of endodontic paper point when used for the paper point technique (PPT) of working length confirmation.

METHODOLOGY

An in vitro model simulating the clinical use of paper points in PPT was used to assess the degree of fibre shedding of six brands of size 20, .02 taper paper point. Whilst observing the artificial terminal foramen with polarized light microscopy, the number of fibres shed directly (point inserted 1 mm beyond the terminal foramen) and indirectly (point inserted to length then a gutta-percha point inserted) was assessed. The degree of direct fibre shedding as a function of brand was analysed with Fisher's exact test and multiple pairwise comparisons. Indirect fibre shedding was analysed with Kruskal-Wallis and Wilcoxon rank-sum tests.

RESULTS

All brands shed fibres both directly and indirectly, with a significant influence of brand on the proportion of fibres shed directly (P < 0.0306) and on the mean number of fibres shed indirectly (P < 0.0001). Post hoc analysis demonstrated a similar hierarchy of point integrity for both tests with Classic (UnoDent, Witham, UK) shedding significantly more than other brands and SS White (Gloucester, UK) and Antaeos^® (VDW, Munich, Germany) shedding the least.

CONCLUSION

All brands of paper point may shed cellulose fibres both directly and indirectly with a significant influence of brand on the degree of fibre shedding. Further work should be undertaken to develop biocompatible absorbent dental points.

Structural modification and characterization of bacterial cellulose-alginate composite scaffolds for tissue engineering

A novel bacterial cellulose-alginate composite scaffold (N-BCA) was fabricated by freeze drying and subsequent crosslinking with Ca(2+). The N-BCA then underwent a second freeze drying step to remove water without altering the physical structure. A stable structure of N-BCA with open and highly interconnected pores in the range of 90-160 μm was constructed. The N-BCA was stable in both water and PBS. The swelling ability of N-BCA in water was approximately 50 times its weight, which was about 6.5 times that of the freeze dried bacterial cellulose pellicles. N-BCA demonstrated no cytotoxicity against L929 mouse fibroblast cells. For long-term culture, N-BCA supported attachment, spreading, and proliferation of human gingival fibroblast (GF) on the surface. However, under static conditions, the cell migration and growth inside the scaffold were limited. Because of its biocompatibility and open macroporous structure, N-BCA could potentially be used as a scaffold for tissue engineering.

Applications of bacterial cellulose and its composites in biomedicine

Bacterial cellulose produced by few but specific microbial genera is an extremely pure natural exopolysaccharide. Besides providing adhesive properties and a competitive advantage to the cellulose over-producer, bacterial cellulose confers UV protection, ensures maintenance of an aerobic environment, retains moisture, protects against heavy metal stress, etc. This unique nanostructured matrix is being widely explored for various medical and nonmedical applications. It can be produced in various shapes and forms because of which it finds varied uses in biomedicine. The attributes of bacterial cellulose such as biocompatibility, haemocompatibility, mechanical strength, microporosity and biodegradability with its unique surface chemistry make it ideally suited for a plethora of biomedical applications. This review highlights these qualities of bacterial cellulose in detail with emphasis on reports that prove its utility in biomedicine. It also gives an in-depth account of various biomedical applications ranging from implants and scaffolds for tissue engineering, carriers for drug delivery, wound-dressing materials, etc. that are reported until date. Besides, perspectives on limitations of commercialisation of bacterial cellulose have been presented. This review is also an update on the variety of low-cost substrates used for production of bacterial cellulose and its nonmedical applications and includes patents and commercial products based on bacterial cellulose.