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Silva ECA, Pradelli JA, da Silva GF, Cerri PS, Tanomaru-Filho M, Guerreiro-Tanomaru JM. Biocompatibility and bioactive potential of NeoPUTTY calcium silicate-based cement: An in vivo study in rats. Int Endod J 2024; 57:713-726. [PMID: 38467586 DOI: 10.1111/iej.14054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
AIM To evaluate the inflammatory reaction and the ability to induce mineralization activity of a new repair material, NeoPUTTY (NPutty; NuSmile, USA), in comparison with Bio-C Repair (BC; Angelus, Brazil) and MTA Repair HP (MTA HP; Angelus, Brazil). METHODOLOGY Polyethylene tubes were filled with materials or kept empty (control group, CG) and implanted in subcutaneous tissue of rats for 7, 15, 30, and 60 days (n = 6/group). Capsule thickness, number of inflammatory cells (ICs), fibroblasts, collagen content, and von Kossa analysis were performed. Unstained sections were evaluated under polarized light and by immunohistochemistry for osteocalcin (OCN). Data were submitted to two-way anova followed by Tukey's test (p ≤ .05), except for OCN. OCN data were submitted to Kruskal-Wallis and Dunn and Friedman post hoc tests followed by the Nemenyi test at a significance level of 5%. RESULTS At 7, 15, and 30 days, thick capsules containing numerous ICs were seen around the materials. At 60 days, a moderate inflammatory reaction was observed for NPutty, BC while MTA HP presented thin capsules with moderate inflammatory cells. In all periods, NPutty specimens contained the highest values of ICs (p < .05). From 7 to 60 days, the number of ICs reduced significantly while an increase in the number of fibroblasts and birefringent collagen content was observed. At 7 and 15 days, no significant difference was observed in the immunoexpression of OCN (p > .05). At 30 and 60 days, NPutty showed the lowest values of OCN (p < .05). At 60 days, a similar immunoexpression was observed for BC and MTA HP (p > .05). In all time intervals, capsules around NPutty, BC, and MTA HP showed von Kossa-positive and birefringent structures. CONCLUSIONS Despite the greater inflammatory reaction promoted by NeoPutty than BC and MTA HP, the reduction in the thickness of capsules, the increase in the number of fibroblasts, and the reduction in the number of ICs indicate that this bioceramic material is biocompatible Furthermore, NeoPutty presents the ability to induce mineralization activity.
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Affiliation(s)
- Evelin Carine Alves Silva
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Jéssica Arielli Pradelli
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Paulo Sérgio Cerri
- Department of Morphology, School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
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Tanomaru-Filho M, de Oliveira BV, Tavares KIMC, Rodrigues EM, Torres FFE, Guerreiro-Tanomaru JM. Effect of radiopacifier and liquid in the physicochemical and biological properties of calcium silicate clinker Angelus: A laboratory investigation. AUST ENDOD J 2024; 50:52-59. [PMID: 37902156 DOI: 10.1111/aej.12808] [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: 03/10/2023] [Revised: 09/27/2023] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
The aim of this study was to evaluate the effect of radiopacifier calcium tungstate and manipulation with distilled water (DW) or liquid with additives (LA) on calcium silicate clinker Angelus (CL) properties, compared with MTA (Angelus, Brazil) and MTA Repair HP (MTAHP, Angelus, Brazil). The physicochemical properties, cellular viability and bioactivity were evaluated. ANOVA/Tukey and Bonferroni tests were performed (α = 0.05). There was no difference in material setting time (p > 0.05). MTA and MTAHP were similar (p > 0.05) and had greater radiopacity than CL + DW and CL + LA (p < 0.05). All experimental materials showed mass increase, alkalinisation capacity, besides biocompatibility and bioactivity at 3 and 7 days. The different liquids had no influence in the biological properties and bioactivity of the calcium silicate clinker Angelus. Calcium tungstate provided radiopacity, without changing the setting time, maintaining the mass increase and alkalinisation ability of the calcium silicate materials.
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Affiliation(s)
- Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | | | - Elisandra Márcia Rodrigues
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Fernanda Ferrari Esteves Torres
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
- School of Dentistry, University Center - UNIFAE, São João da Boa Vista, Brazil
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Sanz JL, López-García S, García-Bernal D, Rodríguez-Lozano FJ, Forner L, Lozano A, Murcia L. Comparative bioactivity and immunomodulatory potential of the new Bioroot Flow and AH Plus Bioceramic sealer: An in vitro study on hPDLSCs. Clin Oral Investig 2024; 28:195. [PMID: 38441709 PMCID: PMC10914906 DOI: 10.1007/s00784-024-05593-7] [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: 02/03/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To evaluate the cytocompatibility, bioactivity, and anti-inflammatory potential of the new pre-mixed calcium silicate cement-based sealers Bioroot Flow (BrF) and AH Plus Bioceramic Sealer (AHPbcs) on human periodontal ligament stem cells (hPDLSCs) compared to the epoxy resin-based sealer AH Plus (AHP). MATERIALS AND METHODS Standardized discs and 1:1, 1:2, and 1:4 eluates of BrF, AHPbcs and AHP after setting were prepared. The following assays were performed: cell attachment and morphology via SEM, cell viability via a MTT assay, cell migration/proliferation via a wound-healing assay, cytoskeleton organization via immunofluorescence staining; cytokine release via ELISA; osteo/cemento/odontogenic marker expression via RT-qPCR, and cell mineralized nodule formation via Alizarin Red S staining. HPDLSCs were isolated from extracted third molars from healthy patients. Comparisons were made with hPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media. Statistical significance was established at p < 0.05. RESULTS Both BrF and AHPbcs showed significantly positive results in the cytocompatibility assays (cell metabolic activity, migration, attachment, morphology, and cytoskeleton organization) compared with a negative control group, while AHP showed significant negative results. BrF exhibited an upregulation of at least one osteo/cementogenic marker compared to the negative and positive control groups. BrF showed a significantly higher calcified nodule formation than AHPbcs, the negative and positive control groups, while AHPbcs was higher than the negative control group. Both were also significantly higher than AHP group. CONCLUSION BrF and AHPbcs exhibit adequate and comparable cytocompatibility on hPDLSCs. BrF also promoted the osteo/cementogenic differentiation of hPDLSCs. Both calcium silicate-based sealers favored the downregulation of the inflammatory cytokine IL-6 and the calcified nodule formation from hPDLSCs. BrF exerted a significantly higher influence on cell mineralization than AHPbcs. CLINICAL RELEVANCE This is the first study to elucidate the biological properties and immunomodulatory potential of Bioroot Flow and AH Plus Bioceramic Sealer. The results act as supporting evidence for their use in root canal treatment.
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Affiliation(s)
- José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Sergio López-García
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - David García-Bernal
- Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Biomedical Research Institute (IMIB), 30120, Murcia, Spain
| | - Francisco Javier Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008, Murcia, Spain.
- School of Dentistry, Hospital Morales Meseguer2 Pl.Av. Marqués de los Vélez, S/NUniversity of Murcia, 30008, Murcia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Adrián Lozano
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, 30107, Murcia, Spain
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Chen CL, Chi CW, Lee CY, Tsai YL, Kasimayan U, K P O M, Lin HP, Chiang YC. Effects of surface treatments of bioactive tricalcium silicate-based restorative material on the bond strength to resin composite. Dent Mater 2024; 40:102-110. [PMID: 37919112 DOI: 10.1016/j.dental.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES This study aimed to enhance the bond strength between Biodentine™ (BD), a bioactive tricalcium silicate (C3S) based material, and resin composite through various surface treatments. METHODOLOGY BD samples were immersed in either double distilled water or Hank's Balanced Salt Solution and analyzed using X-ray Diffraction (XRD). Shear bond strength (SBS) evaluations of BD were performed using Prime & Bond™ NT (PNT), Single Bond Universal (SBU), Xeno V (Xeno), and glass ionomer cement (GIC) following various etching durations (0 s/ 15 s/ 30 s/ 60 s with 37.5% phosphoric acid). Two primers, RelyX™ Ceramic Primer (RCP) and Monobond ™ Plus (MBP), were chosen to prime BD for SBS enhancement. Fractography and bonding interfaces were examined with energy dispersive X-ray spectroscopy (EDS)/ scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR). RESULTS XRD confirmed BD's main compositions as C3S, Ca(OH)2, CaCO3 and ZrO2 after 14 days crystal maturation. Etched BD did not improve SBS. GIC exhibited the lowest SBS (p < 0.05) among all adhesives, regardless of the etching mode (all < 1 MPa). The highest SBS (17.5 ± 3.6 MPa, p < 0.05) was achieved when BD primed with MBP followed by SBU application. FTIR and EDS showed γ-MPTS and10-MDP within the MBP primer interacted with C3S and ZrO2 of BD, achieving enhanced SBS. Most specimens exhibited mixed or cohesive failure modes. Significance BD's subpar mechanical properties and texture may contribute to its poor adhesion to resin composite. Pretreating BD with MBP primer, followed by SBU adhesive is recommended for improving bond strength.
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Affiliation(s)
- Che-Lun Chen
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan
| | - Chih-Wen Chi
- Department of Dentistry, National Taiwan University Hospital, Hsin-Chu Branch, No. 25, Ln. 442, Section 1, Jingguo Rd., North Dist., Hsinchu City 300195, Taiwan
| | - Chen-Yi Lee
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan
| | - Yi-Ling Tsai
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Uma Kasimayan
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Mahesh K P O
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Hong-Ping Lin
- Department of Chemistry, National Cheng Kung University. No.1, Daxue Rd., Tainan City 701, Taiwan
| | - Yu-Chih Chiang
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei 10617, Taiwan; School of Dentistry, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
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Büker M, Sümbüllü M, Ali A, Ünal O, Arslan H. The Effects of Calcium Silicate- and Calcium Hydroxide-based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial. J Endod 2023; 49:1588-1594. [PMID: 37683888 DOI: 10.1016/j.joen.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION This study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide-based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. METHODS A total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). RESULTS The statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). CONCLUSIONS Patients treated with calcium silicate- and calcium hydroxide-based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.
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Affiliation(s)
- Mine Büker
- Department of Endodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
| | - Meltem Sümbüllü
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Türkiye.
| | - Afzal Ali
- Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Oğuzhan Ünal
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Türkiye
| | - Hakan Arslan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medeniyet University, Istanbul, Türkiye
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Kandemir Demirci G, Çöven FO, Güneri P, Karavana SY, Nalbantsoy A, Köse T, Kaval ME. The solubility, pH value, chemical structure, radiopacity, and cytotoxicity of four different root canal sealers: an in vitro study. Clin Oral Investig 2023; 27:5413-5425. [PMID: 37486382 DOI: 10.1007/s00784-023-05160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet sealers. MATERIALS AND METHODS Cytotoxicity analysis with direct and extraction tests at 3 different concentrations (1:1, 1:2, 1:4 v/v%) and time (24 h, 48 h, and 72 h) on Saos-2, PdLF, and THP-1 cell lines, chemical structure with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis, solubility, pH, and radiopacity values of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet were evaluated. For statistical analyses of the groups, repeated measures, factorial, and one-way ANOVA tests were used. The statistical significance level was set at p < .05. RESULTS Resin-based sealers showed higher cytotoxicity values than the bioceramic-based sealers (p < 0.05). Time and concentrations were effective on the cell viabilities for cell lines. Higher peaks of calcium were detected bioceramic-based sealers and higher amount of zirconium was detected in AH Plus BC (p < 0.05). AH Plus BC showed similar radiopacity value with AH Plus, AH Plus Jet, whereas TotalFill BC showed the lowest radiopacity (p < 0.05). Bioceramic-based sealers had higher pH values in all experiment periods, and the difference between resin- and bioceramic-based sealer groups was significant (p < 0.05). However, the solubility values of the tested root canal sealers revealed no differences (p > 0.05). CONCLUSIONS The newly produced AH Plus BC Sealer showed similar properties with TotalFill BC, and their biological properties were better than AH Plus and AH Plus Jet. CLINICAL RELEVANCE AH Plus BC could be a possible alternative to other bioceramic- or resin-based sealers.
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Affiliation(s)
| | - Furkan Ozan Çöven
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, İzmir, Turkey
| | - Sinem Yaprak Karavana
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Ege University, İzmir, Turkey
| | - Ayşe Nalbantsoy
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Mehmet Emin Kaval
- Department of Endodontology, School of Dentistry, Ege University, 35100, İzmir, Turkey
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Inada RNH, Queiroz MB, Lopes CS, Silva ECA, Torres FFE, da Silva GF, Guerreiro-Tanomaru JM, Cerri PS, Tanomaru-Filho M. Biocompatibility, bioactive potential, porosity, and interface analysis calcium silicate repair cements in a dentin tube model. Clin Oral Investig 2023:10.1007/s00784-023-05002-5. [PMID: 37014506 DOI: 10.1007/s00784-023-05002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES This study is to evaluate biocompatibility, bioactive potential, porosity, and dentin/material interface of Bio-C Repair (BIOC-R), MTA Repair HP (MTAHP), and Intermediate Restorative Material (IRM). MATERIALS AND METHODS Dentin tubes were implanted into subcutaneous of rats for 7, 15, 30, and 60 days. Thickness of capsules, number of inflammatory cells (ICs), interleukin-6 (IL-6), osteocalcin (OCN), and von Kossa were evaluated. Porosity and material/dentin interface voids were also analyzed. Data were submitted to ANOVA and Tukey's tests (p < 0.05). RESULTS IRM capsules were thicker and contained greater ICs and IL-6-immunopositive cells at 7 and 15 days. BIOC-R capsules exhibited higher thickness and ICs at 7 days and greater IL-6 at 7 and 15 days than MTAHP (p < 0.05). At 30 and 60 days, no significant difference was observed among the groups. OCN-immunopositive cells, von Kossa-positive, and birefringent structures were observed in BIOC-R and MTAHP. MTAHP exhibited higher porosity and interface voids (p < 0.05). CONCLUSIONS BIOC-R, MTAHP, and IRM are biocompatible. Bioceramics materials demonstrate bioactive potential. MTAHP presented the highest porosity and presence of voids. CLINICAL RELEVANCE BIOC-R and MTAHP have adequate biological properties. BIOC-R demonstrated lower porosity and presence of voids, which may represent better sealing for its clinical applications.
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Affiliation(s)
- Rafaela Nanami Handa Inada
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Marcela Borsatto Queiroz
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Camila Soares Lopes
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Evelin Carine Alves Silva
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Fernanda Ferrari Esteves Torres
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Guilherme Ferreira da Silva
- Department of Dentistry, Centro Universitário Sagrado Coração (UNISAGRADO), Rua Irmã Armida, 10-50, Bauru, SP, CEP 17011-160, Brazil
| | - Juliane Maria Guerreiro-Tanomaru
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Paulo Sérgio Cerri
- Department of Morphology and Children Clinic, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil.
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Saber S, Raafat S, Elashiry M, El-Banna A, Schäfer E. Effect of Different Sealers on the Cytocompatibility and Osteogenic Potential of Human Periodontal Ligament Stem Cells: An In Vitro Study. J Clin Med 2023; 12:jcm12062344. [PMID: 36983344 PMCID: PMC10056919 DOI: 10.3390/jcm12062344] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
Background: There is tendency for unavoidable sealer extrusion in some clinical cases. This might adversely affect host stem cells and affect healing. This study aimed to investigate the effect of different sealers on the cytocompatibility and osteogenic potential of human periodontal ligament stem cells (hPDLSCs). Methods: The cytotoxic effect of the extracted elutes of VDW.1Seal (VDW.1), Endosequence BC Sealer HiFlow (ES), GuttaFlow-2 (GF), and ADSeal (AD-S) on the hPDLSCs was determined using the MTT assay. Cell proliferation and migration were assessed by the scratch wound healing assay. Osteogenic differentiation potential was assessed. Measurement of pH values and calcium ions release was performed. Results: GF had a significantly higher percentage of viable cells. The cell migration assay showed that GF demonstrated the lowest open wound area percentage. GF and AD-S showed the highest calcium nodule deposition. GF demonstrated higher ALP activity than ES. Expression of RUNX2 and OC genes was similar for all sealers, while OPG gene expression was significantly higher for VDW.1 and GF. ES and AD-S displayed the highest pH values on day 1. Calcium ion release of ES and VDW.1 was significantly the highest. Conclusions: GuttaFlow-2 and VDW.1Seal sealers have favorable behavior toward host stem cells.
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Affiliation(s)
- Shehabeldin Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt;
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
- Correspondence:
| | - Shereen Raafat
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt;
- Pharmacology Department, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt
| | - Mohamed Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
| | - Ahmed El-Banna
- Department of Biomaterials, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, 48149 Münster, Germany;
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Queiroz MB, Inada RNH, Jampani JLDA, Guerreiro-Tanomaru JM, Sasso-Cerri E, Tanomaru-Filho M, Cerri PS. Biocompatibility and bioactive potential of an experimental tricalcium silicate-based cement in comparison with Bio-C repair and MTA Repair HP materials. Int Endod J 2023; 56:259-277. [PMID: 36314136 DOI: 10.1111/iej.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
AIM To evaluate the tissue reaction of a tricalcium silicate-based repair material associated with 30% calcium tungstate (TCS + CaWO4 ) in comparison to Bio-C Repair (Bio-C; Angelus) and to MTA Repair HP (MTA HP; Angelus). METHODOLOGY Polyethylene tubes filled with one of the materials or left empty (control group, CG) were implanted into the subcutaneous tissues of rats for 7, 15, 30 and 60 days (n = 32/group). The capsule thickness, number of inflammatory cells, collagen content, interleukin-6 (IL-6), osteocalcin (OCN), von Kossa reaction and analysis under polarized light were evaluated. The data were subjected to generalized linear models for repeated measures, except the OCN. OCN data were submitted to Kruskal-Wallis and Dunn's post hoc test and Friedman followed by Nemenyi's test at significance level of 5%. RESULTS At all time points, significant differences in the number of inflammatory cells were not observed between TCS + CaWO4 and Bio-C, whereas, at 15, 30 and 60 days, no significant difference was detected between TCS + CaWO4 and MTA HP. At all periods, significant differences were not detected in the number of fibroblasts in TCS + CaWO4 versus MTA HP, and, at 60 days, no significant difference was demonstrated between these groups and CG. Significant differences in the immunoexpression of IL-6 were not detected amongst bioceramic materials at all periods. From 7 to 60 days, significant reduction in the number of inflammatory cells, number of IL-6-immunopositive cells and in the capsule thickness was accompanied by significant increase in the collagen in all groups. OCN-immunolabelled cells, von Kossa-positive structures and amorphous calcite deposits were observed around all materials, whereas, in the CG, these structures were not seen. CONCLUSIONS These findings indicate that the experimental material (TCS + CaWO4 ) is biocompatible and has a bioactive potential, similar to the MTA HP and Bio-C Repair, and suggest its use as a root repair material.
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Affiliation(s)
| | - Rafaela N H Inada
- Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - José Leandro de Abreu Jampani
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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10
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Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111853. [PMID: 36430988 PMCID: PMC9697500 DOI: 10.3390/life12111853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
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11
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Ashi T, Mancino D, Hardan L, Bourgi R, Zghal J, Macaluso V, Al-Ashkar S, Alkhouri S, Haikel Y, Kharouf N. Physicochemical and Antibacterial Properties of Bioactive Retrograde Filling Materials. Bioengineering (Basel) 2022; 9:bioengineering9110624. [PMID: 36354535 PMCID: PMC9687475 DOI: 10.3390/bioengineering9110624] [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: 10/08/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 12/02/2022] Open
Abstract
The purpose of the present study was to evaluate the physicochemical properties and antibacterial activity of three calcium silicate cements. Mineral trioxide aggregate (MTA Biorep “BR”), Biodentine (BD) and Well-Root PT (WR) materials were investigated using scanning electron microscopy (SEM) at 24, 72 and 168 h of immersion in phosphate buffered saline (PBS). The antibacterial activity against Enterococcus faecalis (E. faecalis), the solubility, roughness, pH changes and water contact angle were also analyzed. All results were statistically analyzed using a one-way analysis of variance test. Statistically significant lower pH was detected for BD than WR and BR (p < 0.05). No statistical difference was found among the three materials for the efficacy of kill against E. faecalis (p > 0.05). Good antibacterial activity was observed (kill 50% of bacteria) after 24 h of contact. The wettability and the roughness of BR were higher than for the other cements (p < 0.05). BD was more soluble than WR and BR (p < 0.05). In conclusion, the use of bioceramic cements as retrograde materials may play an important role in controlling bacterial growth and in the development of calcium phosphate surface layer to support healing. Moreover, the premixed cement was easier to use than powder−liquid cement.
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Affiliation(s)
- Tarek Ashi
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Jihed Zghal
- Laboratoire Energetique Mecanique Electromagnetisme, University of Paris Ouest, 50 Rue de Sèvres, 92410 Ville d’Avray, France
- ICube Laboratory, UMR 7357 CNRS, Mechanics Department, University of Strasbourg, 67000 Strasbourg, France
| | | | - Sharif Al-Ashkar
- Faculty of Dentistry, Al Sham Private University (ASPU), Damascus 0100, Syria
| | - Sleman Alkhouri
- Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.: +33-667522841
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12
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An in vitro evaluation of antimicrobial activity of a fast-setting endodontic material. Sci Rep 2022; 12:16021. [PMID: 36163407 PMCID: PMC9513078 DOI: 10.1038/s41598-022-20454-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/13/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study is to evaluate the antimicrobial activity of the fast-setting iRoot Fast Set Root Repair Material (iRoot FS), Mineral trioxide aggregate (MTA) and Biodentine. The materials were freshly mixed or set for 1 and 7 days to conduct the agar diffusion test, direct contact test and carry-over effect test against E. faecalis and P. gingivalis, and the pH values were also measured. The data were analyzed by an analysis of variance and one-way ANOVA or Dunnett's T3 test, and the Tukey's post hoc test for multiple comparisons (α = 0.05). In the direct contact test, all three materials showed good antibacterial activity after setting for 20 min. The antibacterial properties of the three materials decreased with the increase of setting time (p < 0.05). The suspension of all the three materials showed high pH values (11-12) and no significant difference was observed (p > 0.05). With the extension of setting time, the pH of iRoot FS and Biodentine slightly decreased (p < 0.05). Fresh iRoot FS, Biodentine, and MTA killed E. faecalis and P. gingivalis effectively, but their antimicrobial effect decreased after 24 h, and distinctly decreased after 7 days after mixing. iRoot FS, Biodentine, and MTA showed a tendency of alkalinity during this 7-day experiment.
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13
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Abu Hasna A, de Paula Ramos L, Campos TMB, de Castro Lopes SLP, Rachi MA, de Oliveira LD, Carvalho CAT. Biological and chemical properties of five mineral oxides and of mineral trioxide aggregate repair high plasticity: an in vitro study. Sci Rep 2022; 12:14123. [PMID: 35986029 PMCID: PMC9391469 DOI: 10.1038/s41598-022-17854-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/02/2022] [Indexed: 12/31/2022] Open
Abstract
Calcium silicate-based cements have diverse applications in endodontics. This study aimed to evaluate the antibiofilm action, biocompatibility, morphological structure, chemical composition and radiopacity of Five Mineral Oxides (5MO), Mineral Trioxide Aggregate Repair High Plasticity (MTA Repair HP), and Mineral Trioxide Aggregate (MTA) cements. MTT analysis was used to test the antibiofilm action of these cements against five anaerobic microorganisms, and test their biocompatibility with mouse macrophage (RAW 264.7) and osteoblasts (MG-63) cultures. Their morphological structure and chemical composition were evaluated by scanning electron microscopy (SEM) coupled to energy dispersion X-ray spectroscopy (EDX), and the phase analysis was performed by X-ray diffraction (XRD). Conventional radiography was used to assess the radiopacity of the cements. 5MO, MTA Repair HP and MTA were effective against Porphyromonas gingivalis, Parvimonas micra, Fusobacterium nucleatum and Prevotella intermedia, they were biocompatible with macrophages and osteoblasts after 5 min of contact, and they had adequate radiopacity to be used clinically. Bismuth oxide (Bi2O3) is used as a radiopacifier in MTA and 5MO, and calcium tungstate, in MTA Repair HP. Titanium dioxide (TiO2) (ANATASE) is responsible for the antimicrobial action and biocompatibility of 5MO.
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Affiliation(s)
- Amjad Abu Hasna
- grid.410543.70000 0001 2188 478XDepartment of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University – UNESP, Av. Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000 Brazil
| | - Lucas de Paula Ramos
- grid.410543.70000 0001 2188 478XDepartment of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University – UNESP, São José dos Campos, São Paulo Brazil
| | - Tiago Moreira Bastos Campos
- grid.419270.90000 0004 0643 8732Physics Department, Aeronautics Technological Institute (ITA), São José dos Campos, São Paulo Brazil
| | - Sergio Lucio Pereira de Castro Lopes
- grid.410543.70000 0001 2188 478XDepartment of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University – UNESP, São José dos Campos, São Paulo Brazil
| | - Maisour Ala Rachi
- grid.449576.d0000 0004 5895 8692Department of Operative Dentistry, Syrian Private University (S.P.U), Damascus, Syria
| | - Luciane Dias de Oliveira
- grid.410543.70000 0001 2188 478XDepartment of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University – UNESP, São José dos Campos, São Paulo Brazil
| | - Cláudio Antonio Talge Carvalho
- grid.410543.70000 0001 2188 478XDepartment of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University – UNESP, Av. Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000 Brazil
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14
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Sanz JL, López‐García S, Rodríguez‐Lozano FJ, Melo M, Lozano A, Llena C, Forner L. Cytocompatibility and bioactive potential of AH Plus Bioceramic Sealer: an
in vitro
study. Int Endod J 2022; 55:1066-1080. [PMID: 35950780 PMCID: PMC9541143 DOI: 10.1111/iej.13805] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Abstract
Aim To assess the cytocompatibility and bioactive potential of the new calcium silicate cement‐based sealer AH Plus Bioceramic Sealer (AHPbcs) on human periodontal ligament stem cells (hPDLSCs) compared with the epoxy resin‐based sealer AH Plus (AHP) and the calcium silicate cement‐based sealer Endosequence BC Sealer (ESbcs). Methodology Standardized sample discs and 1:1, 1:2 and 1:4 eluates of the tested materials were prepared. The following assays were performed: surface element distribution via SEM–EDX, cell attachment and morphology via SEM, cell viability via a MTT assay, cell migration/proliferation via a wound‐healing assay, osteo/cemento/odontogenic marker expression via RT‐qPCR and cell mineralized nodule formation via Alizarin Red S staining. HPDLSCs were isolated from extracted third molars. Comparisons were made with hPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media. Statistical significance was established at p < .05. Results A higher peak of Ca2+ was detected from ESbcs compared with AHPbcs and AHP in SEM–EDX. Both AHPbcs and ESbcs showed significantly positive results in the cytocompatibility assays (cell viability, migration/proliferation, attachment and morphology) compared with a negative control group, whilst AHP showed significant negative results. Both AHPbcs and ESbcs exhibited an upregulation of at least one osteo/odonto/cementogenic marker compared with the negative and positive control groups. Both ESbcs and AHPbcs showed a significantly higher calcified nodule formation than the negative and positive control groups, indicative of their biomineralization potential and were also significantly higher than AHP group. Conclusion AH Plus Bioceramic Sealer exhibited a significantly higher cytocompatibility and bioactive potential than AH Plus and a similar cytocompatibility to that of Endosequence BC Sealer. Endosequence BC Sealer exhibited a significantly higher mineralization potential than the other tested sealers. The results from this in vitro study act as supporting evidence for the use of AH Plus Bioceramic Sealer in root canal treatment.
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Affiliation(s)
- José Luis Sanz
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
| | - Sergio López‐García
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
| | - Francisco Javier Rodríguez‐Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine University of Murcia Murcia Spain
| | - María Melo
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
| | - Adrián Lozano
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
| | - Carmen Llena
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
| | - Leopoldo Forner
- Departament d’Estomatologia, Facultat de Medicina I Odontologia Universitat de València Valencia Spain
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15
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Effect of root perforation repair with mineral aggregate-based cements on the retention of customized fiberglass posts. Odontology 2022; 110:535-544. [PMID: 35044577 DOI: 10.1007/s10266-022-00686-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/03/2022] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to investigate whether the root perforation repair with mineral aggregate-based cements affects the retention of customized fiberglass posts to bovine intraradicular dentin. Sixty-four bovine mandibular incisors had their root canals endodontically treated and prepared for fiberglass posts luting. Teeth were randomly distributed into four groups (n = 16), according to the cement used for the perforations repair (MTA HP; calcium aluminate cement-CAC; and CAC + calcium carbonate nanoparticles-nano-CaCO3) and control group (no perforation). The groups were redistributed according to the fiberglass posts luting protocol (n = 8): total-etching (TE) (MTA HP/TE; CAC/TE; CAC + CaCO3/TE and control/TE) and self-etching (SE) (MTA HP/SE; CAC/SE; CAC + CaCO3/SE and control/SE). Roots were sectioned into 1.3 mm-thick dentin slices obtaining samples that were submitted to the push-out test in Universal Testing Machine (Instron, Model 4444-0.5 mm/min). The fractured samples were analyzed under stereomicroscope and Scanning Electron Microscope (SEM). CAC/TE and CAC/SE groups had significant difference between the cervical and middle thirds (p < 0.05). When the root thirds were not considered, CAC/SE had the lowest bond strength and differed statistically from CAC/TE and CAC + CaCO3/TE groups, which had the highest mean bond strength values (p < 0.05). The root perforations repair did not affect the bond strength of resin cement/customized fiberglass posts to bovine dentin. The increase in bond strength is luting protocol dependent.
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16
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Ruiz-Linares M, de Oliveira Fagundes J, Solana C, Baca P, Ferrer-Luque CM. Current status on antimicrobial activity of a tricalcium silicate cement. J Oral Sci 2022; 64:113-117. [PMID: 35197418 DOI: 10.2334/josnusd.21-0439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Biodentine (BD) is a bioactive material with many indications in endodontic therapy. The purpose of this study was to compile and review the outcomes of in vitro and in vivo studies of BD in terms of antimicrobial effectiveness. An electronic search was carried out in PubMed, from January 2009-April 2021 using the keywords: (Biodentine or dentine substitute or "Ca3SiO5" or tricalcium silicate cement or bioceramic cement) and (antimicrobial activity or antimicrobial effect or antimicrobial effectiveness or antibacterial activity or antibacterial effect or antibacterial effectiveness or antibiofilm activity or antibiofilm effectiveness). Two independent reviewers evaluated the studies for eligibility. All studies that did not include BD or its antimicrobial properties, as well as abstracts not written in English, were excluded. This review identified the need to develop standardized methods to evaluate antimicrobial activity in vitro. Most of the studies were against planktonic bacteria and gave conflicting results. Studies ex vivo and in vivo against biofilm are required to elucidate the antimicrobial activity of BD.
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Affiliation(s)
| | | | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada
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17
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Huang G, Liu SY, Wu JL, Qiu D, Dong YM. A novel bioactive glass-based root canal sealer in endodontics. J Dent Sci 2022; 17:217-224. [PMID: 35028041 PMCID: PMC8739251 DOI: 10.1016/j.jds.2021.04.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background/purpose Bioactive glass (BG), one type of bioceramics, shows similar or better characteristics to calcium silicate which has been regarded as a promising root filling material in endodontics. This study aimed to develop a novel BG-based root canal sealer for endodontics. Materials and methods The novel BG-based root canal sealer was composed of phytic acid derived bioactive calcium phosphosilicate glass named PSC mixed with zirconium oxide (ZrO2) as powder, and phosphate solution (PS) dissolved with sodium alginate (SA) named PS-SA as liquid. Moreover, the physicochemical properties, mineralization, sealing ability and biocompatibility of the novel BG-based root canal sealer were evaluated. Results This study developed a novel BG-based sealer named BGS-SA-Zr which contained the powder of PSC and ZrO2 and the liquid of PS-SA. Results indicated that the flow, film thickness and radiopacity of BGS-SA-Zr conformed to ISO 6876:2012. The setting time and solubility of BGS-SA-Zr were 53.7 ± 1.5 min and 21.46 ± 0.54%, respectively. The pH value of the simulated body fluid (SBF) immersed with BGS-SA-Zr raised slightly up to 7.70. The CCK-8 assay indicated that BGS-SA-Zr had no cytotoxic effects on MG-63 cells. After immersion in SBF for 4 weeks, dense hydroxyapatite crystals were observed on the surface of BGS-SA-Zr. Furthermore, there was no difference in the sealing ability between BGS-SA-Zr and the bioceramic sealer iRoot SP whether setting at 1 day or immersed in SBF for 4 weeks (P > 0.05). Conclusion Our results suggest that the novel BG-based sealer may be a promising sealer for endodontic treatment.
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Affiliation(s)
- Gang Huang
- Department of Cardiology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Si-Yi Liu
- Department of Cardiology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ji-Lin Wu
- Department of Cardiology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences, CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, PR China
| | - Yan-Mei Dong
- Department of Cardiology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
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18
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Lozano-Guillén A, López-García S, Rodríguez-Lozano FJ, Sanz JL, Lozano A, Llena C, Forner L. Comparative cytocompatibility of the new calcium silicate-based cement NeoPutty versus NeoMTA Plus and MTA on human dental pulp cells: an in vitro study. Clin Oral Investig 2022; 26:7219-7228. [PMID: 36053352 PMCID: PMC9708762 DOI: 10.1007/s00784-022-04682-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/10/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of the present in vitro study is to determine the cytocompatibility of the recently introduced NeoPutty in contact with human dental pulp cells compared with its precursor NeoMTA Plus and the classic gold standard MTA Angelus. MATERIALS AND METHODS Sample disks were obtained for each of the tested materials (5 mm diameter; 2 mm thickness; n = 30), along with 1:1, 1:2, and 1:4 material eluents. HDPCs were extracted and cultured with the tested materials (test groups) or in unconditioned medium (control group), and the following biocompatibility assays were performed: MTT assay, scratch wound assay, cell cytoskeleton staining assays, and cell attachment assessment via SEM. Additionally, material ion release and surface element composition were evaluated via ICP-MS and SEM-EDX, respectively. Each experimental condition was carried out three times and assessed in three independent experiments. Statistical significance was established at p < 0.05. RESULTS 1:2 dilutions of all the tested materials exhibited a comparable cell viability to that of the control group at 48 and 72 h of culture (p < 0.05). The same was observed for 1:4 dilutions of the tested materials at 24, 48, and 72 h of culture (p > 0.05). All the tested materials exhibited adequate cytocompatibility in the remaining biocompatibility assays. MTA exhibited a significantly higher calcium ion release compared to NeoPutty and NeoMTA Plus (p < 0.05). CONCLUSION The results from the present work elucidate the adequate cytocompatibility of NeoPutty, NeoMTA Plus, and MTA Angelus towards human dental pulp cells. CLINICAL RELEVANCE Within the limitations of the present in vitro study, our results may act as preliminary evidence for its use in vital pulp therapy as a pulp capper. However, results need to be interpreted with caution until further clinical supporting evidence is reported.
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Affiliation(s)
- Ana Lozano-Guillén
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Sergio López-García
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca, IMIB-Arrixaca, University of Murcia, 30120 Murcia, Spain ,Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008 Murcia, Spain
| | - Francisco Javier Rodríguez-Lozano
- Hematopoietic Transplant and Cellular Therapy Unit, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca, IMIB-Arrixaca, University of Murcia, 30120 Murcia, Spain ,Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008 Murcia, Spain
| | - José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Adrián Lozano
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Carmen Llena
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Leopoldo Forner
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
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Wang Z, Shen Y, Haapasalo M. Antimicrobial and Antibiofilm Properties of Bioceramic Materials in Endodontics. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7594. [PMID: 34947188 PMCID: PMC8706218 DOI: 10.3390/ma14247594] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
Microbes are prevalent in the root canals of necrotic teeth, and they are the cause of primary and post-treatment apical periodontitis. Bacteria can dwell within the infected root canal system as surface-adherent biofilm structures, which exhibit high resistance to antimicrobial agents. Bioceramic materials, with their biocompatible nature and excellent physico-chemical properties, have been widely used in dental applications, including endodontics. This review focuses on the application of bioceramic technology in endodontic disinfection and the antibiofilm effects of endodontic bioceramic materials. Different bioceramic materials have shown different levels of antibiofilm effects. New supplements have emerged to potentially enhance the antibiofilm properties of bioceramics aiming to achieve the goal of microbial elimination in the root canal system.
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Affiliation(s)
| | | | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Z.W.); (Y.S.)
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20
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Wang X, Li Z, Wang Z, Liu H, Cui Y, Liu Y, Ren M, Zhan H, Li Z, Wu M, Wang J. Incorporation of Bone Morphogenetic Protein-2 and Osteoprotegerin in 3D-Printed Ti6Al4V Scaffolds Enhances Osseointegration Under Osteoporotic Conditions. Front Bioeng Biotechnol 2021; 9:754205. [PMID: 34805113 PMCID: PMC8600075 DOI: 10.3389/fbioe.2021.754205] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 01/23/2023] Open
Abstract
Osteoporosis is an age-related metabolic disease that results in limited bone regeneration capacity and excessive osteoclast activity. After arthroplasty in patients with osteoporosis, poor interface osseointegration resulting from insufficient bone regeneration ability often leads to catastrophic complications such as prosthesis displacement and loosening and periprosthetic fractures. In this study, we prepared a thermosensitive hydrogel loaded with bone morphogenetic protein-2 (BMP-2) to promote osteogenesis and osteoprotegerin (OPG) to inhibit excessive osteoclast activity. To construct three-dimensional (3D)-printed composite scaffolds for implantation, a hydrogel loaded with drugs was injected into porous Ti6Al4V scaffolds. The 3D-printed composite scaffolds showed good biocompatibility and sustained release of BMP-2 and OPG for more than 20 days. In vitro experiments indicated that composite scaffolds promoted osteogenic differentiation and reduced the osteoclastic activation simultaneously. Remarkably, immunofluorescence staining, micro-CT, histological, and biomechanical tests demonstrated that the sustained release of both BMP-2 and OPG from composite scaffolds significantly improved bone ingrowth and osseointegration in osteoporotic defects. In conclusion, this study demonstrated that the BMP-2- and OPG-loaded 3D-printed composite scaffolds can potentially promote osseointegration for osteoporotic patients after joint replacement.
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Affiliation(s)
- Xianggang Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Zhengyan Li
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Institute of Traumatology, Shanghai Academy of TCM, Shanghai, China
| | - Zhonghan Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yutao Cui
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yuzhe Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Ming Ren
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Hongsheng Zhan
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Institute of Traumatology, Shanghai Academy of TCM, Shanghai, China
| | - Zuhao Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Minfei Wu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
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21
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Silva PAO, Lima SMDF, Martins DCM, Amorim IA, Lacorte C, de Almeida JA, Franco OL, Rezende TMB. Concentrated MTA Repair HP reduced biofilm and can cause reparative action at a distance. Int Endod J 2021; 54:1925-1936. [PMID: 34164821 DOI: 10.1111/iej.13592] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/31/2022]
Abstract
AIM To evaluate in vitro whether MTA Repair HP can induce repair processes at a distance, including its effects on biofilm, cell viability, migration, production of TGF-β, phosphate and ALP, evaluated through MTA diluted extracts. METHODOLOGY Initially, antibacterial tests were performed with the bacterium Streptococcus mutans (ATCC 25175) in the presence of MTA extracts (dilutions of 1:1, 1:2 and 1:4). Growth inhibition assay by microdilution in broth, antibiofilm plate assay of young biofilm and antibiofilm assay in confocal microscopy of mature biofilm were carried out. Then, pulp cells were stimulated in the presence of several MTA dilutions, and cell viability (MTT assay), proliferation and migration capacity (scratch assay) were evaluated. To evaluate the capacity of 1:1, 1:2 and 1:4 dilutions of MTA Repair HP to promote the production of important agents of odontogenic differentiation and mineralization, ALP activity, TGF-β secretion and phosphate quantification were measured. Statistical differences were verified using one-way and two-way anova and Tukey's post-tests. RESULTS The test dilutions of MTA Repair HP did not inhibit planktonic S. mutans growth but were able to reduce young and mature S. mutans biofilm (p < 0.001). In addition, none of the MTA Repair HP dilutions was cytotoxic for pulp cells. The 1:2 and 1:4 dilutions of MTA Repair HP induced migration and proliferation of pulp cells (p < 0.05). ALP activity and TGF-β secretion were independent of the tested dilution (p < 0.001). Diluted 1:4 MTA Repair HP produced less phosphate than the more concentrated 1:1 and 1:2 MTA dilutions (p < 0.001). CONCLUSIONS Undiluted MTA Repair HP reduced S. mutans biofilm, when compared to 1:2 and 1:4 MTA dilutions. Furthermore, none of the tested dilutions was cytotoxic to pulp cells. MTA Repair HP promoted cell migration and proliferation at a distance, assessed through the dilution of the MTA. Even from a distance, MTA Repair HP has the ability to participate in some events related to repair, such as migration, proliferation and TGF production.
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Affiliation(s)
| | - Stella Maris de Freitas Lima
- Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil.,Curso de Odontologia, Universidade Católica de Brasília, Brasília, Brazil
| | - Danilo César Mota Martins
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.,Curso de Odontologia, Centro Universitário ICESP, Brasília, Brazil
| | - Ingrid Aquino Amorim
- Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil.,Curso de Odontologia, Centro Universitário UNIEURO, Brasília, Brazil
| | - Cristiano Lacorte
- Laboratório de Biologia Sintética, Embrapa Recursos Genéticos e Biotecnologia, Brasília, Brazil
| | - Jeesser Alves de Almeida
- Curso de Educação Física, Universidade Federal de Mato Grosso do Sul, UFMS, Campo Grande, Brazil
| | - Octávio Luiz Franco
- Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil.,S-Inova Biotech, Pós-graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, Brazil.,Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
| | - Taia Maria Berto Rezende
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.,Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, Brazil.,Curso de Odontologia, Universidade Católica de Brasília, Brasília, Brazil
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22
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Palczewska-Komsa M, Kaczor-Wiankowska K, Nowicka A. New Bioactive Calcium Silicate Cement Mineral Trioxide Aggregate Repair High Plasticity (MTA HP)-A Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4573. [PMID: 34443098 PMCID: PMC8398617 DOI: 10.3390/ma14164573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
Bioactive calcium silicate cement Mineral Trioxide Aggregate (MTA) has been used for years as a gold standard in intravital pulp treatment and specialist endodontic procedures. Owing to flaws of the material, the manufacturers have been trying to enhance and produce materials showing improved physical, chemical and biological parameters. One of the new calcium-silicate cements based on mineral trioxide aggregate, however without some flaws exhibited by the cement, is Mineral Trioxide Aggregate Repair High Plasticity (MTA HP). The aim of the present paper was a systematic literature review concerning the MTA HP material used nowadays in dentistry, as a review of its specific features. The present paper is the first article providing a systematic literature review on MTA HP. The aim of the present article is the better understanding of MTA HP properties, which can aid the decision-making process in endodontic treatment.
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Affiliation(s)
| | - Kinga Kaczor-Wiankowska
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland; (M.P.-K.); (A.N.)
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23
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Sanz JL, Guerrero-Gironés J, Pecci-Lloret MP, Pecci-Lloret MR, Melo M. Biological interactions between calcium silicate-based endodontic biomaterials and periodontal ligament stem cells: A systematic review of in vitro studies. Int Endod J 2021; 54:2025-2043. [PMID: 34338339 DOI: 10.1111/iej.13600] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/16/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Most recently, the biological interactions, that is cytocompatibility, cell differentiation and mineralization potential, between calcium silicate-based biomaterials and periodontal ligament stem cells (PDLSCs) have been studied at an in vitro level, in order to predict their clinical behaviour during endodontic procedures involving direct contact with periodontal tissues, namely root canal treatment, endodontic surgery and regenerative endodontic treatment. OBJECTIVE The aim of the present systematic review was to present a qualitative synthesis of available in vitro studies assessing the biological interaction of PDLSCs and calcium silicate-based biomaterials. METHODOLOGY The present review followed PRISMA 2020 guidelines. An advanced database search was performed in Medline, Scopus, Embase, Web of Science and SciELO on 1 July 2020 and last updated on 22 April 2021. Studies assessing the biological interactions of PDLSCs with calcium silicate-based sealers (CSSs) and/or cements (CSCs) at an in vitro level were considered for inclusion. The evaluation of the 'biological interaction' was defined as any assay or test on the cytotoxicity, cytocompatibility, cell plasticity or differentiation potential, and bioactive properties of PDLSCs cultured in CSC or CSS-conditioned media. Quality (risk of bias) was assessed using a modified CONSORT checklist for in vitro studies of dental materials. RESULTS A total of 20 studies were included for the qualitative synthesis. CSCs and CSSs, as a group of endodontic materials, exhibit adequate cytocompatibility and favour the osteo/cementogenic differentiation and mineralization potential of PDLSCs, as evidenced from the in vitro studies included in the present systematic review. DISCUSSION The influence of the compositional differences, inclusion of additives, sample preparation, and varying conditions and manipulations on the biological properties of calcium silicate-based materials remain a subject for future research. CONCLUSIONS Within the limitations of the in vitro nature of the included studies, this work supports the potential use of calcium silicate-based endodontic materials in stem cell therapy and biologically based regenerative endodontic procedures. REGISTRATION OSF Registries; https://doi.org/10.17605/OSF.IO/SQ9UY.
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Affiliation(s)
- José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - Julia Guerrero-Gironés
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - María P Pecci-Lloret
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - Miguel R Pecci-Lloret
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
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24
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Antimicrobial Activity of Calcium Silicate-Based Dental Materials: A Literature Review. Antibiotics (Basel) 2021; 10:antibiotics10070865. [PMID: 34356786 PMCID: PMC8300656 DOI: 10.3390/antibiotics10070865] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022] Open
Abstract
Endodontic biomaterials have significantly improved dental treatment techniques in several aspects now that they can be used for vital pulp treatments, as temporary intracanal medication, in definitive fillings, in apical surgeries, and for regenerative procedures. Calcium silicate-based cement is a class of dental material that is used in endodontics in direct contact with the dental structures, connective tissue, and bone. Because the material interacts with biological tissues and stimulates biomineralization processes, its properties are of major importance. The main challenge in endodontic treatments is the elimination of biofilms that are present in the root canal system anatomical complexities, as it remains even after chemical-mechanical preparation and disinfection procedures. Thus, an additional challenge for these biomaterials is to exert antimicrobial activity while maintaining their biological properties in parallel. This article reviews the literature for studies considering the antimicrobial properties of calcium silicate-based dental biomaterials used in endodontic practice. Considering the reviewed studies, it can be affirmed that the reduced antimicrobial effect exhibited by calcium silicate-based endodontic materials clearly emphasizes that all clinical procedures prior to their use must be carefully performed. Future studies for the evaluation of these materials, and especially newly proposed materials, under poly-microbial biofilms associated with endodontic diseases will be necessary.
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