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Jung K, Choi SM, Jung HI, Kim E, Kim S. Evaluation of residual dentin thickness using quantitative light-induced fluorescence technology. Odontology 2024; 112:1135-1141. [PMID: 38509319 DOI: 10.1007/s10266-024-00922-4] [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: 10/11/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
This study aimed to determine whether a correlation exists between residual dentin thickness and quantitative light-induced fluorescence (QLF) values and, if so, to analyze its tendencies. Forty extracted sound human molars were assigned to filled and unfilled groups. The teeth were submerged in a mold with clear acrylic resin. Red utility wax was inserted into the pulp chamber space in the filled group to simulate vital pulp. The specimen was sectioned longitudinally to observe the inside of the pulp space. The samples were cut horizontally from the highest point of the pulp space 2 mm apart. QLF images were then taken of 2 mm, 1 mm, and 0.5 mm samples using the QLF-D Biluminator™ 2 + system. Three operators independently evaluated the QLF images, and the statistical analysis was conducted using one-way analysis of variance, Pearson correlation coefficients, and intraclass correlation coefficients. In the filled group, the mean ΔF values for residual dentin thicknesses of 2 mm, 1 mm, and 0.5 mm were - 3.22, - 7.84, and - 11.52, respectively. In the unfilled group, the mean ΔF values were 0, - 6.90, and - 10.14, respectively. A positive correlation was found between residual dentin thickness and ΔF values (P < 0.05). The intraclass correlation coefficients for observations made by the three operators for the filled and unfilled groups were 0.831 and 0.917, respectively (P < 0.05). In conclusion, residual dentin thickness and ΔF values were significantly correlated and had a highly positive correlation regardless of the QLF device operator.
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Affiliation(s)
- Kiljoo Jung
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Stephanie Myeong Choi
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Hoi-In Jung
- Department of Preventive Dentistry & Public Oral Health, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Giudice CD, Spagnuolo G, Menale C, Chou YF, Martí JMN, Rengo C, Rengo S, Sauro S. Biocompatibility and osteogenic assessment of experimental fluoride-doped calcium-phosphate cements on human dental pulp stem cells. Dent Mater 2024:S0109-5641(24)00288-4. [PMID: 39358191 DOI: 10.1016/j.dental.2024.09.019] [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: 08/16/2024] [Revised: 09/26/2024] [Accepted: 09/26/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVES This study investigated the impact of some specific experimental calcium phosphate cements doped with different fluoride salts (FDCPCs) concentrations on the basal functions of human Dental Pulp Stem Cells (hDPSCs). Furthermore, this study also examined the migration, as well as the mineralisation through osteogenic differentiation. METHODS Experimental FDCPCs were formulated using different concentrations of calcium/sodium fluoride salts [(5 wt%: VS5F), (10 wt%: VS10F), (20 wt%: VS20F)]. A fluoride-free calcium phosphate (VS0F) was used as a control. The hDPSCs were assessed to evaluate their self-renewal and migration activity in the presence of eluates of the different FDCPCs. A viability assay in osteogenic conditions was carried out, along with the differentiation potential through Alkaline Phosphatase Activity (ALP), and Alizarin Red Staining (ARS). Moreover, the gene expression of specific markers (RUNX2, ALP, COL1α1, OCN, OPN, DSPP, MEPE, and DMP-1) was also evaluated. RESULTS All the tested FDCPD had no influence on cell migrations, but they caused a decrease in cell viability in osteogenic conditions when not diluted. Conversely, the eluants of VS20F showed a positive effect on stem cell differentiation. This result was corroborated through ALP activity, ARS assay. Moreover, upregulation of specific gene markers such as RUNX2, DMP-1, and DSPP was observed in hDPSCs, especially when treated with VS20F. SIGNIFICANCE The experimental FDCPC tested in this study exhibits a dose-dependent capacity to promote mineralisation in osteogenic environment. The FDCPC-VS20F seems to be the most promising experimental material suitable for developing of pulp-capping materials with osteogenic and bioactive properties.
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Affiliation(s)
- Carmela Del Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Ciro Menale
- Department of Clinical Medicine and Surgery, the University of Naples "Federico II", 80131 Naples, Italy
| | - Yu Fu Chou
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Faculty of Health Sciences, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Juan Manuel Núñez Martí
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Faculty of Health Sciences, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Carlo Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Sandro Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Faculty of Health Sciences, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain.
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Novotná B, Holík P, Morozova Y, Rosa M, Galandáková A, Langová K. Evaluation of Cytotoxicity of the Dental Materials TheraCal LC, TheraCal PT, ApaCal ART and Biodentine Used in Vital Pulp Therapy: In Vitro Study. Dent J (Basel) 2024; 12:249. [PMID: 39195093 DOI: 10.3390/dj12080249] [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: 05/30/2024] [Revised: 07/05/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024] Open
Abstract
(1) Background: The aim of this study was to compare the cytotoxicity of selected resin-modified materials used in direct contact with the dental pulp (TheraCal LC, TheraCal PT, and ApaCal ART) with calcium silicate cement (Biodentine). (2) Methods: The mouse fibroblast Balb/3T3 cell line and the extracts of tested materials in four concentrations were used for the testing. An MTT assay was performed in three independent experiments with six replicates for each concentration of tested material. The cell viability (%) and cytotoxicity were expressed (cytotoxic effect is considered in cases where the cell viability is lower than 70%). The mean of the cell viability and the standard deviation were expressed for each material at all concentrations. ANOVA and Dunnet's post hoc tests were used for the statistical analysis. All of these tests were performed at the 0.05 significance level. (3) Results: At all concentrations, the cell viability was statistically significantly lower (p ≤ 0.002) for all tested materials compared to Biodentine. ApaCal ART showed a high level of cytotoxicity at all concentrations (cell viability lower than 47.71%, p < 0.0001). The same result was found for TheraCal LC at concentrations of 100%, 50% and 25% and TheraCal PT at concentrations of 100% and 50%. TheraCal LC at a 10% concentration (cell viability 68.18%) and TheraCal PT at a 25% concentration (cell viability 60.63%) indicated potential cytotoxicity. TheraCal PT at a 10% concentration was not found to be cytotoxic (cell viability 79.18%, p = 0.095). (4) Conclusion: The resin-modified calcium silicate and calcium phosphate materials showed higher cytotoxic potential, so they should be used with caution when in direct contact with the dental pulp.
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Affiliation(s)
- Barbora Novotná
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University and Faculty Hospital Olomouc, Palackého 12, 779 00 Olomouc, Czech Republic
| | - Pavel Holík
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University and Faculty Hospital Olomouc, Palackého 12, 779 00 Olomouc, Czech Republic
| | - Yuliya Morozova
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University and Faculty Hospital Olomouc, Palackého 12, 779 00 Olomouc, Czech Republic
| | - Matej Rosa
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University and Faculty Hospital Olomouc, Palackého 12, 779 00 Olomouc, Czech Republic
| | - Adéla Galandáková
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic
| | - Kateřina Langová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic
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Fasoulas A, Keratiotis G, Spineli L, Pandis N, De Bruyne MAA, De Moor RJ, Meire MA. Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth: A systematic review and meta-analysis. Clin Exp Dent Res 2023; 9:1129-1148. [PMID: 37710421 PMCID: PMC10728530 DOI: 10.1002/cre2.767] [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: 02/04/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Different materials have been used for capping the pulp after exposure during caries removal in permanent teeth. The purpose of this study was to collate and analyze all pertinent evidence from randomized controlled trials (RCTs) on different materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth. MATERIALS AND METHODS Trials comparing two or more capping agents used for direct pulp capping (DPC) or pulpotomy were considered eligible. An electronic search of four databases and two clinical trial registries was carried out up to February 28, 2021 using a search strategy properly adapted to the PICO framework. Screening, data extraction, and risk of bias (RoB) assessment of primary studies were performed in duplicate and independently. The primary outcome was clinical and radiological success; secondary outcomes included continued root formation, tooth discoloration, and dentin bridge formation. RESULTS 21 RCTs were included in the study. The RoB assessment indicated a moderate risk among the studies. Due to significant clinical and statistical heterogeneity among the studies, performing network meta-analysis (NMA) was not possible. An ad hoc subgroup analysis revealed strong evidence of a higher success of DPC with Mineral Trioxide Aggregate (MTA) compared to calcium hydroxide (CH) (odds ratio [OR] = 3.10, 95% confidence interval [CI]: 1.66-5.79). MTA performed better than CH in pulp capping (both DPC and pulpotomy) of mature compared to immature teeth (OR = 3.34, 95% CI: 1.81-6.17). The GRADE assessment revealed moderate strength of evidence for DPC and mature teeth, and low to very low strength of evidence for the remaining subgroups. CONCLUSIONS Considerable clinical and statistical heterogeneity among the trials did not allow NMA. The ad hoc subgroup analysis indicated that the clinical and radiographic success of MTA was higher than that of CH but only in mature teeth and DPC cases where the strength of evidence was moderate. PROSPERO Registration: number CRD42020127239.
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Affiliation(s)
- Athanasios Fasoulas
- Department of Oral Health Sciences, Section of EndodontologyGhent UniversityGhentBelgium
| | - Georgios Keratiotis
- Department of Oral Health Sciences, Section of EndodontologyGhent UniversityGhentBelgium
| | - Loukia Spineli
- Midwifery Research and Education UnitHannover Medical SchoolHannoverGermany
| | - Nikos Pandis
- Department of Orthodontics and Dentofacial OrthopaedicsUniversity of BernBernSwitzerland
| | - Mieke A. A. De Bruyne
- Department of Oral Health Sciences, Section of EndodontologyGhent UniversityGhentBelgium
| | - Roeland J.G. De Moor
- Department of Oral Health Sciences, Section of EndodontologyGhent UniversityGhentBelgium
| | - Maarten A. Meire
- Department of Oral Health Sciences, Section of EndodontologyGhent UniversityGhentBelgium
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Chung M, Lee S, Kim S, Kim E. Inflammatory response and odontogenic differentiation of inflamed dental pulp treated with different pulp capping materials: An in vivo study. Int Endod J 2023; 56:1118-1128. [PMID: 37350351 DOI: 10.1111/iej.13947] [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: 12/14/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
AIM Previous studies have evaluated the pulpal responses to calcium silicate cements (CSCs) on normal dental pulp, but investigations on the effects of CSCs on inflamed pulp are limited. This study aimed to test the inflammatory response and odontogenic differentiation of inflamed rat dental pulp after direct pulp capping with CSCs. METHODOLOGY Wistar rat molars pulps were exposed for 48 h to induce inflammation and then capped with ProRoot MTA (Dentsply), Biodentine (Septodont), RetroMTA (Bio MTA) and Dycal (Dentsply Caulk). The degree of pulpal inflammation and hard tissue formation was evaluated by histological analysis. Immunofluorescence staining for interleukin (IL)-6, osteocalcin (OCN) and runt-related transcription factor 2 (RUNX2) was also performed. RESULTS After 4 weeks, complete recovery from inflammation was evident in 22%, 37.5%, 10% and none of the ProRoot MTA, Biodentine, RetroMTA and Dycal samples, respectively. Heavy hard tissue deposition as a continuous hard tissue bridge was observed in 77.8%, 75%, 70% and 60% of the ProRoot MTA, Biodentine, RetroMTA and Dycal samples, respectively. IL-6, OCN and RUNX2 were detected in all materials, mainly adjacent to areas of inflammation and reparative dentine formation. At one, two and 4 weeks, significant differences were not observed between the inflammation and hard tissue formation scores of the four material groups (p > .05). CONCLUSIONS In this study, pulpal inflammation was still present in most specimens at 4 weeks after pulp capping and a significant number of samples showed incomplete and discontinuous dentine bridge formation. The results of this study suggest that initial inflammatory conditions of the pulp may risk the prognosis of teeth treated with CSCs.
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Affiliation(s)
- M Chung
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - S Lee
- Oral Science Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - S Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - E Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
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Nijakowski K, Ortarzewska M, Jankowski J, Lehmann A, Surdacka A. The Role of Cellular Metabolism in Maintaining the Function of the Dentine-Pulp Complex: A Narrative Review. Metabolites 2023; 13:metabo13040520. [PMID: 37110177 PMCID: PMC10143950 DOI: 10.3390/metabo13040520] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
The cellular metabolic processes ensure the physiological integrity of the dentine-pulp complex. Odontoblasts and odontoblast-like cells are responsible for the defence mechanisms in the form of tertiary dentine formation. In turn, the main defence reaction of the pulp is the development of inflammation, during which the metabolic and signalling pathways of the cells are significantly altered. The selected dental procedures, such as orthodontic treatment, resin infiltration, resin restorations or dental bleaching, can impact the cellular metabolism in the dental pulp. Among systemic metabolic diseases, diabetes mellitus causes the most consequences for the cellular metabolism of the dentine-pulp complex. Similarly, ageing processes present a proven effect on the metabolic functioning of the odontoblasts and the pulp cells. In the literature, several potential metabolic mediators demonstrating anti-inflammatory properties on inflamed dental pulp are mentioned. Moreover, the pulp stem cells exhibit the regenerative potential essential for maintaining the function of the dentine-pulp complex.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Martyna Ortarzewska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Jakub Jankowski
- Student's Scientific Group in the Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Lehmann
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Rao AC, Venkatesh KV, Nandini V, Sihivahanan D, Alamoudi A, Bahammam HA, Bahammam SA, Zidane B, Bahammam MA, Chohan H, Albar NH, Yadalam PK, Patil S. Evaluating the Effect of Tideglusib-Loaded Bioactive Glass Nanoparticles as a Potential Dentine Regenerative Material. MATERIALS 2022; 15:ma15134567. [PMID: 35806692 PMCID: PMC9267687 DOI: 10.3390/ma15134567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022]
Abstract
Dental pulp treatment is the least intrusive procedure currently available for preserving the vitality of the pulp. Several studies are underway to improve the bioactivity of pulp capping materials. Tideglusib isa potent anti-inflammatory, antioxidant, and a regenerative drug developed against Alzheimer’s disease and has been shown to be effective in the treatment of dental cavities. However, its bioactive properties encapsulated within the nanoparticles as a component of pulp capping material are largely unknown. In this study, tideglusib-loaded bioactive glass nanoparticles were synthesized (tideglusib-BgNPs) and mixed at various concentrations into the calcium silicate cement to testits physiomechanical and bioactivitiescompared with biodentine (control). The calcium silicate cement with 10wgt% tideglusib-BgNPs showed comparable physiomechanical properties to that of biodentine. Additionally, the assessment of cytotoxicity and bioactivity (cell proliferation, wound healing, and cell migration assays) showed increased bioactivity in terms of better wound healing, increased proliferation, and better migration of human dental pulp stem cells than biodentine. These findings suggest new opportunities to use tideglusib-BgNPs in pulp therapy.
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Affiliation(s)
- Akhil C. Rao
- Department of Conservative Dentistry and Endodontics, SRM Dental College and Hospital, Kattankulathur, Kanchipuram, Chennai 603203, India; (A.C.R.); (K.V.V.); (D.S.)
| | - K. Vijay Venkatesh
- Department of Conservative Dentistry and Endodontics, SRM Dental College and Hospital, Kattankulathur, Kanchipuram, Chennai 603203, India; (A.C.R.); (K.V.V.); (D.S.)
| | - Vidyashree Nandini
- Department of Prosthodontics and Implantology, SRM Dental College and Hospital, Kattankulathur, Kanchipuram, Chennai 603203, India;
| | - Dhanasekaran Sihivahanan
- Department of Conservative Dentistry and Endodontics, SRM Dental College and Hospital, Kattankulathur, Kanchipuram, Chennai 603203, India; (A.C.R.); (K.V.V.); (D.S.)
| | - Ahmed Alamoudi
- Oral Biology Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia;
| | - Hammam Ahmed Bahammam
- Department of Pediatric Dentistry, College of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia;
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Medina 42353, Saudi Arabia; or
| | - Bassam Zidane
- Restorative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Maha A. Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia;
- Executive Presidency of Academic Affairs, Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
| | - Hitesh Chohan
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.C.); (N.H.A.)
| | - Nassreen H. Albar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.C.); (N.H.A.)
| | - Pradeep Kumar Yadalam
- Department of Periodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai 602117, India;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Correspondence:
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Cushley S, Duncan HF, Lundy FT, Nagendrababu V, Clarke M, El Karim I. Outcomes reporting in systematic reviews on vital pulp treatment: A scoping review for the development of a core outcome set. Int Endod J 2022; 55:891-909. [PMID: 35704241 PMCID: PMC9545459 DOI: 10.1111/iej.13785] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/18/2022] [Accepted: 06/03/2022] [Indexed: 11/30/2022]
Abstract
Background A large number of research reports on vital pulp treatment (VPT) has been published over the last two decades. However, heterogeneity in reporting outcomes of VPT is a significant challenge for evidence synthesis and clinical decision‐making. Objectives To identify outcomes assessed in VPT studies and to evaluate how and when outcomes are measured. A subsidiary aim was to assess evidence for selective reporting bias in the included studies. The results of this review will be used to inform the development of a core outcome set (COS) for endodontic treatments. Methods Multiple healthcare bibliographic databases, including PubMed/MEDLINE, Ovid EMBASE, Scopus, Cochrane Database of Systematic Reviews and Web of Science were searched for systematic reviews published between 1990 and 2020, reporting on VPT. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Outcomes' information was extracted and aligned with a healthcare taxonomy into five core areas: survival, clinical/physiological changes, life impact, resource use and adverse events. Results Thirty‐six systematic reviews were included, 10 reporting on indirect pulp capping or selective caries removal, nine on direct pulp capping, eight on pulpotomy and nine on combined VPTs. There was considerable variation in the outcomes reported in these reviews and their included studies. Clinician‐reported outcomes were used considerably more often than patient‐reported outcomes. A range of instruments and time points were used for measuring outcomes. Several of the reviews were assessed as having low risk of selective reporting bias, but many did not specifically report this domain, whilst others did not provide risk of bias assessment at all. Discussion Considerable variation in selection of outcomes and how and when they are measured and reported was evident, and this heterogeneity has implications for evidence synthesis and clinical decision‐making. Conclusions Whilst there is a lack of consistency, several potentially important outcomes for VPT, including pulp survival, incidence of post‐operative pain and need for further intervention, have been identified which could inform the development of a COS for endodontic treatment. Registration Core Outcome Measures in Effectiveness Trials (COMET) (No. 1879).
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Affiliation(s)
- Siobhan Cushley
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland
| | - Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin, Ireland
| | - Fionnuala T Lundy
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland
| | - Ikhlas El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland
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9
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Dental Pulp Response to Different Types of Calcium-Based Materials Applied in Deep Carious Lesion Treatment—A Clinical Study. J Funct Biomater 2022; 13:jfb13020051. [PMID: 35645259 PMCID: PMC9149999 DOI: 10.3390/jfb13020051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/15/2022] [Accepted: 04/28/2022] [Indexed: 12/16/2022] Open
Abstract
Dental pulp vitality preservation in dental caries treatment is a major goal in odontotherapy. The main objective of this study was to compare dental pulp tissue responses to vital therapies in deep carious lesions, using different calcium-based materials. An ambispective study was conducted on 47 patients. Ninety-five teeth with deep carious lesions were treated. Among them, 25 (26.32%) were diagnosed with pulpal exposures and treated by direct pulp capping. Indirect pulp capping was applied when pulp exposure was absent (n = 70; 73.68%). Fifty teeth (52.63%) were treated with TheraCal LC (prospective study), 31 teeth (32.63%) with Calcimol LC, and 14 teeth (14.74%) with Life Kerr AC (retrospective study). The results show that the survival rate for dental pulp was 100% for Life Kerr AC, 92% for TheraCal LC, and 83.87% for Calcimol LC, without significant differences. Apparently, self-setting calcium hydroxide material provided better dental pulp response than the two light-cured materials, regardless of their composition, that is, either calcium -hydroxide or calcium silicate-based. We will need a significant number of long-term clinical studies with the highest levels of evidence to determine the most adequate biomaterials for vital pulp therapies.
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Treatment and Outcomes of Tusk Fractures in Managed African Savanna and Asian Elephants ( Loxodonta africana and Elephas maximus) across Five Continents. Animals (Basel) 2022; 12:ani12091125. [PMID: 35565551 PMCID: PMC9100196 DOI: 10.3390/ani12091125] [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: 02/15/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023] Open
Abstract
Elephant tusk fractures are a clinical challenge that can impact the overall health of the animal, particularly when they result in pulp exposure. An international survey was sent to veterinarians to understand individual fracture characteristics and management strategies as they relate to outcomes, with the goal of better informing treatment procedures. The data set consisted of 79 fractures from 64 elephants (including Asian and African males and females), 44.3% of which were Class III fractures with pulpal involvement. Of this subset, pulp canal exposures of >0.5 cm were 23.8-fold more likely to develop pulpitis than fractures with <0.5 cm exposed, though canal size did not impact healing versus extraction outcome. Odds ratios showed that treatments including endodontics were 12.0-fold more likely to heal than tusks treated exclusively with medical management, though no association was observed in reducing the risk of pulpitis. Further, pulpitis was 7.58-fold more likely to develop when tap water was used to rinse exposed pulpal tissue; a finding that merits further investigation. The use of endodontic treatment versus medical management alone was significantly associated with improved recovery outcomes (i.e., reduced risk of extraction) in tusk fractures with pulpal involvement.
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Franzin NRS, Sostena MMDS, Santos ADD, Moura MR, Camargo ERD, Hosida TY, Delbem ACB, Moraes JCS. Novel pulp capping material based on sodium trimetaphosphate: synthesis, characterization, and antimicrobial properties. J Appl Oral Sci 2022; 30:e20210483. [PMID: 35352770 PMCID: PMC8963389 DOI: 10.1590/1678-7757-2021-0483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To evaluate the mechanical, physicochemical, and antimicrobial properties of four different formulations containing micro- or nanoparticles of sodium trimetaphosphate (mTMP and nTMP, respectively). METHODOLOGY Four experimental groups were used in this investigation: two mTMP groups and two nTMP groups, each containing zirconium oxide (ZrO2), and solution containing either chitosan or titanium oxide (TiO2) nanoparticles (NPs). Setting time, compression resistance, and radiopacity were estimated. The agar diffusion test was used to assess the antimicrobial activity of the formulations against five different microbial strains: Streptococcus mutans, Lactobacillus casei, Actinomyces israelii, Candida albicans, and Enterococcus faecalis. Parametric and nonparametric tests were performed after evaluating homoscedasticity data (p<0.05). RESULTS From the properties evaluated, nTMP cements required less setting time and showed greater resistance to compression. Cements containing TiO2 showed greater radiopacity for both nTMP and mTMP. All four cement formulations showed antimicrobial activity against S. mutans and L. casei. CONCLUSION Formulations containing nTMP have shorter setting times and higher compressive strength, and those with TiO2 nanoparticles showed antimicrobial activities. Clinical relevance: The cement containing nTMP, ZrO2, and TiO2 could be an alternative material for protecting the pulp complex.
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Affiliation(s)
| | | | | | - Marcia Regina Moura
- Universidade Estadual Paulista (UNESP), Faculdade de Engenharia, Ilha Solteira, SP, Brasil
| | | | - Thayse Yumi Hosida
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Araçatuba, SP, Brasil
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Biocompatibility and pro-mineralization effect of tristrontium aluminate cement for endodontic use. J Dent Sci 2022; 17:1193-1200. [PMID: 35784112 PMCID: PMC9236952 DOI: 10.1016/j.jds.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/25/2021] [Indexed: 11/23/2022] Open
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Effectiveness of Direct Pulp Capping Bioactive Materials in Dentin Regeneration: A Systematic Review. MATERIALS 2021; 14:ma14226811. [PMID: 34832214 PMCID: PMC8621741 DOI: 10.3390/ma14226811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022]
Abstract
Background: Regenerative endodontics aims to restore normal pulp function in necrotic and infected teeth, restoring protective functions, such as innate pulp immunity, pulp repair through mineralization, and pulp sensibility. The aim of this systematic review was to assess the dentin regeneration efficacy of direct pulp capping (DPC) biomaterials. Methods: The literature published between 2005 and 2021 was searched by using PubMed, Web of Science, Science Direct, Google Scholar, and Scopus databases. Clinical controlled trials, randomized controlled trials, and animal studies investigating DPC outcomes or comparing different capping materials after pulp exposure were included in this systematic review. Three independent authors performed the searches, and information was extracted by using a structured data format. Results: A total of forty studies (21 from humans and 19 from animals) were included in this systemic review. Histological examinations showed complete/partial/incomplete dentin bridge/reparative dentin formation during the pulp healing process at different follow-up periods, using different capping materials. Conclusions: Mineral trioxide aggregate (MTA) and Biodentine can induce dentin regeneration when applied over exposed pulp. This systematic review can conclude that MTA and its variants have better efficacy in the DPC procedure for dentin regeneration.
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Andrei M, Vacaru RP, Coricovac A, Ilinca R, Didilescu AC, Demetrescu I. The Effect of Calcium-Silicate Cements on Reparative Dentinogenesis Following Direct Pulp Capping on Animal Models. Molecules 2021; 26:molecules26092725. [PMID: 34066444 PMCID: PMC8125639 DOI: 10.3390/molecules26092725] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022] Open
Abstract
Dental pulp vitality is a desideratum for preserving the health and functionality of the tooth. In certain clinical situations that lead to pulp exposure, bioactive agents are used in direct pulp-capping procedures to stimulate the dentin-pulp complex and activate reparative dentinogenesis. Hydraulic calcium-silicate cements, derived from Portland cement, can induce the formation of a new dentin bridge at the interface between the biomaterial and the dental pulp. Odontoblasts are molecularly activated, and, if necessary, undifferentiated stem cells in the dental pulp can differentiate into odontoblasts. An extensive review of literature was conducted on MedLine/PubMed database to evaluate the histological outcomes of direct pulp capping with hydraulic calcium-silicate cements performed on animal models. Overall, irrespective of their physico-chemical properties and the molecular mechanisms involved in pulp healing, the effects of cements on tertiary dentin formation and pulp vitality preservation were positive. Histological examinations showed different degrees of dental pulp inflammatory response and complete/incomplete dentin bridge formation during the pulp healing process at different follow-up periods. Calcium silicate materials have the ability to induce reparative dentinogenesis when applied over exposed pulps, with different behaviors, as related to the animal model used, pulpal inflammatory responses, and quality of dentin bridges.
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Affiliation(s)
- Mihai Andrei
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Raluca Paula Vacaru
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Anca Coricovac
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Radu Ilinca
- Division of Biophysics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania;
| | - Andreea Cristiana Didilescu
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
- Correspondence: ; Tel.: +40-722536798
| | - Ioana Demetrescu
- Department of General Chemistry, University Politehnica Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov, 050044 Bucharest, Romania
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Potential of tailored amorphous multiporous calcium silicate glass for pulp capping regenerative endodontics-A preliminary assessment. J Dent 2021; 109:103655. [PMID: 33798640 DOI: 10.1016/j.jdent.2021.103655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION/OBJECTIVE The tailored amorphous multi-porous (TAMP) material fabrication technology has led to a new class of bioactive materials possessing versatile characteristics. It has not been tested for dental applications. Thus, we aimed to assess its biocompatibility and ability to regenerate dental mineral tissue. METHODS 30CaO-70SiO2 model TAMP discs were fabricated by a sol-gel method followed by in vitro biocompatibility testing with isolated human or mini-swine dental pulp stem cells (DPSCs). TAMP scaffolds were tested in vivo as a pulp exposure (pin-point, 1 mm, 2 mm, and entire pulp chamber roof) capping material in the molar teeth of mini-swine. RESULTS The in vitro assays showed that DPSCs attached well onto the TAMP discs with comparable viability to those attached to culture plates. Pulp capping tests on mini-swine showed that after 4.5 months TAMP material was still present at the capping site, and mineral tissue (dentin bridge) had formed in all sizes of pulp exposure underneath the TAMP material. CONCLUSIONS TAMP calcium silicate is biocompatible with both human and swine DPSCs in vitro and with pulp in vivo, it may help regenerate the dentin bridge after pulp exposure.
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Comparison of Four Dental Pulp-Capping Agents by Cone-Beam Computed Tomography and Histological Techniques—A Split-Mouth Design Ex Vivo Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11073045] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Dental pulp-capping is done to preserve vital teeth when the pulp is exposed due to caries, trauma or instrumentation. Various materials are used as pulp-capping agents. The introduction of newer materials requires scientific studies to assess their clinical efficacy. The study was designed as a split-mouth randomized analysis of four pulp-capping agents (calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine and EndoSequence root repair material (ERRM)). Based on selection criteria, 15 orthodontic patients requiring the extraction of four premolars (60 teeth total) were included in the study. After pulp-capping, the teeth were extracted after 8 weeks. We analyzed the extracted teeth using cone-beam computed tomography (CBCT) and histological sections to determine the quality of the dentinal bridge and the pulpal response. Ordinal scores were given based on the completeness of the dentinal bridge, the type of bridge and the degree of pulpal inflammation. Results were analyzed using a Kruskal–Wallis test (p < 0.05) with post hoc Conover values being used when applicable. All four pulp-capping materials elicited dentinal bridge formation (60/60). MTA had the highest scores (10/15) in dentinal bridge formation followed by ERRM (8/15). Both materials showed more samples with complete dentinal bridges (9/15 each) and a favorable pulpal response (15/15). Teeth capped with calcium hydroxide showed more cases of incomplete bridge formation (9/15) and pulpal inflammation. These differences in dentinal bridge formation and pulpal inflammation were statistically significant (p 0.001 and p 0.00005, respectively), with post hoc tests revealing no significant differences between MTA and ERRM (p 0.49 and p 0.71, respectively). MTA and ERRM performed better than the other pulp-capping materials but did not differ significantly from each other. The individual preference for a pulp-capping material may be based on clinical efficacy and handling characteristics.
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Călin C, Sajin M, Moldovan VT, Coman C, Stratul SI, Didilescu AC. Immunohistochemical expression of non-collagenous extracellular matrix molecules involved in tertiary dentinogenesis following direct pulp capping: a systematic review. Ann Anat 2021; 235:151674. [PMID: 33400977 DOI: 10.1016/j.aanat.2020.151674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/21/2020] [Accepted: 12/07/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Extracellular matrix molecules (ECMM) expression during tertiary dentinogenesis provides useful information for regenerative applications and efficacy of pulp capping materials. AIM To identify and review the expression and roles of non-collagenous ECMM after successful direct pulp capping (DPC), following mechanical pulp exposures, via immunohistochemistry (IHC). The study addressed the question of where will successful DPC impact the IHC expression of these molecules. DATA SOURCES In vivo animal and human original clinical studies reporting on ECMM in relation to different follow-up periods were screened and evaluated via descriptive analysis. The electronic literature search was carried out in three databases (MEDLINE/PubMed, Web of Science, Scopus), followed by manual screening of relevant journals and cross-referencing, up to December 2018. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Randomized and non-randomized controlled trials, conducted in humans and animals, were selected. Histological evidence for tertiary dentine formation was a prerequisite for IHC evaluation. STUDY APPRAISAL AND SYNTHESIS METHODS The methodological quality of the included articles was independently assessed using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) and the Cochrane risk of bias tool (RoB 1), respectively. RESULTS From a total of 1534 identified studies, 18 were included. Thirteen papers evaluated animal subjects and five studies were carried out on humans. In animals and humans, fibronectin and tenascin expressions were detected in pulp and odontoblast-like cells (OLC); dentine sialoprotein was expressed in both soft and newly-formed mineralized tissue. In animals, bone sialoprotein was early expressed, in association with OLC and predentin; the immunoreactivity for dentine sialophosphoprotein and dentine matrix protein-1 was associated with the OLC and dentine bridge; osteopontin was expressed in OLC, predentine and reparative dentine. A considerable heterogeneity was found in the methodologies of the included studies, as well as interspecies variability of results in terms of time. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Within the limited scientific evidence, all non-collagenous ECMM expressions during tertiary dentinogenesis are active and related to soft and hard tissues. There is a shortage of human studies, and future research directions should focus more on them. PROSPERO Protocol: CRD42019121304.
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Affiliation(s)
- C Călin
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Romania
| | - M Sajin
- Chair of Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Romania
| | - V T Moldovan
- Department of Pathology, Victor Babes National Institute of Pathology, Bucharest, Romania
| | - C Coman
- Preclinical Testing Unit, Cantacuzino National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - S I Stratul
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - A C Didilescu
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Romania.
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The effect of topical application of meloxicam on inflamed dental pulp. J Dent Sci 2020; 16:915-921. [PMID: 34141105 PMCID: PMC8189887 DOI: 10.1016/j.jds.2020.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/15/2020] [Indexed: 11/21/2022] Open
Abstract
Background/purpose Effective regulation of the inflammatory process is essential for pulp repair and regeneration. Meloxicam has anti-inflammatory activity in systemic administration. The purpose of this study is to observe effects of topically applied meloxicam on inflamed pulp and to explore its potential value in the treatment of pulpitis. Materials and methods The coronal pulp tissues of rat molars were stimulated with 10 mg/mL lipopolysaccharide (LPS group) and then treated with 500 μmol/L meloxicam (meloxicam group). The untreated pulp tissues were used as the control group. After 3 h of incubation in vitro, the gene expression of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in each group was detected by real-time RT-PCR. The pulp tissues of each group were randomly subcutaneously implanted into nude mice, and 500 μmol/L meloxicam was injected into the subcutaneous pocket of the meloxicam group. Haematoxylin eosin staining, Masson staining and immunohistochemical staining were performed on samples after 3 days and 4 weeks retrieval, respectively. Results Compared with the LPS group, the mRNA expression levels of TNF-α and IL-6 of the meloxicam group were significantly reduced in vitro. The inflammatory response and cyclooxygenase-2 expression of the meloxicam group were decreased, and osteodentin-like tissue was generated in the pulp cross section of the meloxicam group in vivo. Conclusion The topical application of meloxicam inhibits the inflammatory response of inflamed pulp and further promotes the formation of osteodentin-like tissues but fails to induce the formation of the pulp–dentin complex. Topically applied meloxicam has the potential to regulate pulp inflammation.
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Mineral Trioxide Aggregate Could Have a Better Success Rate Than Calcium Hydroxide for Partial Pulpotomy of Symptomatic Mature Permanent Molars. J Evid Based Dent Pract 2020; 20:101341. [DOI: 10.1016/j.jebdp.2019.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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20
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Sanz JL, Forner L, Almudéver A, Guerrero-Gironés J, Llena C. Viability and Stimulation of Human Stem Cells from the Apical Papilla (hSCAPs) Induced by Silicate-Based Materials for Their Potential Use in Regenerative Endodontics: A Systematic Review. MATERIALS 2020; 13:ma13040974. [PMID: 32098171 PMCID: PMC7078727 DOI: 10.3390/ma13040974] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/13/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022]
Abstract
Blood clot formation in the apical third of the root canal system has been shown to promote further root development and reinforcement of dentinal walls by the deposition of mineralized tissue, resulting in an advancement from traditional apexification procedures to a regenerative endodontic treatment (RET) for non-vital immature permanent teeth. Silicate-based hydraulic biomaterials, categorized as bioactive endodontic cements, emerged as bright candidates for their use in RET as coronal barriers, sealing the previously induced blood clot scaffold. Human stem cells from the apical papilla (hSCAPs) surviving the infection may induce or at least be partially responsible for the regeneration or repair shown in RET. The aim of this study is to present a qualitative synthesis of available literature consisting of in vitro assays which analyzed the viability and stimulation of hSCAPs induced by silicate-based hydraulic biomaterials. A systematic electronic search was carried out in Medline, Scopus, Embase, Web of Science, Cochrane and SciELO databases, followed by a study selection, data extraction, and quality assessment following the PRISMA protocol. In vitro studies assessing the viability, proliferation, and/or differentiation of hSCAPs as well as their mineralization potential and/or osteogenic, odontogenic, cementogenic and/or angiogenic marker expression in contact with commercially available silicate-based materials were included in the present review. The search identified 73 preliminary references, of which 10 resulted to be eligible for qualitative synthesis. The modal materials studied were ProRoot MTA and Biodentine. Both bioceramic materials showed significant positive results when compared to a control for hSCAP cell viability, migration, and proliferation assays; a significant up-regulation of hSCAP odontogenic/osteogenic marker (ALP, DSPP, BSP, Runx2, OCN, OSX), angiogenic growth factor (VEGFA, FIGF) and pro-inflammatory cytokine (IL-1α, IL-1β, IL-6, TNF-α) expression; and a significant increase in hSCAP mineralized nodule formation assessed by Alizarin Red staining. Commercially available silicate-based materials considered in the present review can potentially induce mineralization and odontogenic/osteogenic differentiation of hSCAPs, thus prompting their use in regenerative endodontic procedures.
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Affiliation(s)
- José Luis Sanz
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
| | - Leopoldo Forner
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
- Correspondence: ; Tel.: +34-96386-4175
| | - Alicia Almudéver
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
| | - Julia Guerrero-Gironés
- Special Care and Gerodontology Unit, Department of Stomatology, University of Murcia, 30100 Murcia, Spain;
| | - Carmen Llena
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
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Chen Y, Gao Y, Tao Y, Lin D, An S. Identification of a Calcium-sensing Receptor in Human Dental Pulp Cells That Regulates Mineral Trioxide Aggregate–induced Mineralization. J Endod 2019; 45:907-916. [DOI: 10.1016/j.joen.2019.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/28/2019] [Accepted: 03/28/2019] [Indexed: 12/23/2022]
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Shenkin J, Wilson L. Mineral Trioxide Aggregate May Be the Most Effective Direct Pulp Capping Material. J Evid Based Dent Pract 2019; 19:183-185. [PMID: 31326051 DOI: 10.1016/j.jebdp.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION The effect of dental pulp capping materials on hard-tissue barrier formation. Didilescu AC, Cristache CM, Andrei M, Voicu G, Perlea P. J Am Dent Assoc 2018; 149 (10):903 - 17. SOURCE OF FUNDING None. TYPE OF STUDY/DESIGN Systematic review and meta-analysis of data.
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Voicu G, Didilescu AC, Stoian AB, Dumitriu C, Greabu M, Andrei M. Mineralogical and Microstructural Characteristics of Two Dental Pulp Capping Materials. MATERIALS 2019; 12:ma12111772. [PMID: 31159182 PMCID: PMC6600720 DOI: 10.3390/ma12111772] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/26/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
This paper aims to investigate the composition, surface, and microstructural characteristics, and bioactivity of two commercially available pulp capping materials known as TheraCal LC and BIO MTA+. The materials were prepared as cylindrical samples and assessed by X-ray diffraction (XRD) and complex thermal analysis for mineralogical characterization, and by scanning electron microscopy (SEM) coupled with energy dispersive of X-ray (EDX), Fourier-Transformed Infrared Spectroscopy (FT-IR), and atomic force microscopy (AFM) for microstructural and surface characteristics. The in vitro bioactivity was highlighted by surface mineralization throughout SEM coupled with EDX and FT-IR analysis. XRD analysis performed on both materials showed calcium silicate phases and different radiopacifying compounds. AFM measurements indicated a smoother and more homogenous surface with a lower average roughness for TheraCal LC due to the resin matrix from its composition. FT-IR analysis displayed bands for several compounds in both materials. Both materials exhibited bioactive properties showing surface mineralization after being immersed in solution similar to the human physiological environment. However, the MTA cement showed a better mineralization due to the anhydrous and hydrated phases.
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Affiliation(s)
- Georgeta Voicu
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, University Politehnica of Bucharest, 1-7 Polizu, 011061 Bucharest, Romania.
| | - Andreea C Didilescu
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania.
| | - Andrei B Stoian
- Department of General Chemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, University Politehnica of Bucharest, 1-7 Polizu, 011061 Bucharest, Romania.
| | - Cristina Dumitriu
- Department of General Chemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, University Politehnica of Bucharest, 1-7 Polizu, 011061 Bucharest, Romania.
| | - Maria Greabu
- Division of Biochemistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania.
| | - Mihai Andrei
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania.
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