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Tanvir MAH, Khaleque MA, Kim GH, Yoo WY, Kim YY. The Role of Bioceramics for Bone Regeneration: History, Mechanisms, and Future Perspectives. Biomimetics (Basel) 2024; 9:230. [PMID: 38667241 PMCID: PMC11048714 DOI: 10.3390/biomimetics9040230] [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: 03/15/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Osteoporosis is a skeletal disorder marked by compromised bone integrity, predisposing individuals, particularly older adults and postmenopausal women, to fractures. The advent of bioceramics for bone regeneration has opened up auspicious pathways for addressing osteoporosis. Research indicates that bioceramics can help bones grow back by activating bone morphogenetic protein (BMP), mitogen-activated protein kinase (MAPK), and wingless/integrated (Wnt)/β-catenin pathways in the body when combined with stem cells, drugs, and other supports. Still, bioceramics have some problems, such as not being flexible enough and prone to breaking, as well as difficulties in growing stem cells and discovering suitable supports for different bone types. While there have been improvements in making bioceramics better for healing bones, it is important to keep looking for new ideas from different areas of medicine to make them even better. By conducting a thorough scrutiny of the pivotal role bioceramics play in facilitating bone regeneration, this review aspires to propel forward the rapidly burgeoning domain of scientific exploration. In the end, this appreciation will contribute to the development of novel bioceramics that enhance bone regrowth and offer patients with bone disorders alternative treatments.
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Affiliation(s)
| | | | | | | | - Young-Yul Kim
- Department of Orthopedic Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, Republic of Korea; (M.A.H.T.); (M.A.K.); (G.-H.K.); (W.-Y.Y.)
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Fernandes BF, Silva N, Da Cruz MB, Garret G, Carvalho Ó, Silva F, Mata A, Francisco H, Marques JF. Cell Biological and Antibacterial Evaluation of a New Approach to Zirconia Implant Surfaces Modified with MTA. Biomimetics (Basel) 2024; 9:155. [PMID: 38534840 DOI: 10.3390/biomimetics9030155] [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: 01/18/2024] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Peri-implantitis continues to be one of the major reasons for implant failure. We propose a new approach to the incorporation of MTA into zirconia implant surfaces with Nd:YAG laser and investigate the biological and the microbiological responses of peri-implant cells. Discs of zirconia stabilized with yttria and titanium were produced according to the following four study groups: Nd:YAG laser-textured zirconia coated with MTA (Zr MTA), Nd:YAG laser-textured zirconia (Zr textured), polished zirconia discs, and polished titanium discs (Zr and Ti). Surface roughness was evaluated by contact profilometry. Human osteoblasts (hFOB), gingival fibroblasts (HGF hTERT) and S. oralis were cultured on discs. Cell adhesion and morphology, cell differentiation markers and bacterial growth were evaluated. Zr textured roughness was significantly higher than all other groups. SEM images reveal cellular adhesion at 1 day in all samples in both cell lines. Osteoblasts viability was lower in the Zr MTA group, unlike fibroblasts viability, which was shown to be higher in the Zr MTA group compared with the Zr textured group at 3 and 7 days. Osteocalcin and IL-8 secretion by osteoblasts were higher in Zr MTA. The Zr textured group showed higher IL-8 values released by fibroblasts. No differences in S. oralis CFUs were observed between groups. The present study suggests that zirconia implant surfaces coated with MTA induced fibroblast proliferation and osteoblast differentiation; however, they did not present antibacterial properties.
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Affiliation(s)
- Beatriz Ferreira Fernandes
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Neusa Silva
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Mariana Brito Da Cruz
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Gonçalo Garret
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - Óscar Carvalho
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - Filipe Silva
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - António Mata
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), LIBPhys-FCT UIDB/04559/2020, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
- CEMDBE-Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Helena Francisco
- Grupo de Investigação Implantologia e Regeneração Óssea (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Joana Faria Marques
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
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Lin H, Zhang L, Zhang Q, Wang Q, Wang X, Yan G. Mechanism and application of 3D-printed degradable bioceramic scaffolds for bone repair. Biomater Sci 2023; 11:7034-7050. [PMID: 37782081 DOI: 10.1039/d3bm01214j] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Bioceramics have attracted considerable attention in the field of bone repair because of their excellent osteogenic properties, degradability, and biocompatibility. To resolve issues regarding limited formability, recent studies have introduced 3D printing technology for the fabrication of bioceramic bone repair scaffolds. Nevertheless, the mechanisms by which bioceramics promote bone repair and clinical applications of 3D-printed bioceramic scaffolds remain elusive. This review provides an account of the fabrication methods of 3D-printed degradable bioceramic scaffolds. In addition, the types and characteristics of degradable bioceramics used in clinical and preclinical applications are summarized. We have also highlighted the osteogenic molecular mechanisms in biomaterials with the aim of providing a basis and support for future research on the clinical applications of degradable bioceramic scaffolds. Finally, new developments and potential applications of 3D-printed degradable bioceramic scaffolds are discussed with reference to experimental and theoretical studies.
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Affiliation(s)
- Hui Lin
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Liyun Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Qiyue Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Xue Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
| | - Guangqi Yan
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
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Yousefi-Koma AA, Assadian H, Mohaghegh S, Nokhbatolfoghahaei H. Comparative Biocompatibility and Odonto-/Osteogenesis Effects of Hydraulic Calcium Silicate-Based Cements in Simulated Direct and Indirect Approaches for Regenerative Endodontic Treatments: A Systematic Review. J Funct Biomater 2023; 14:446. [PMID: 37754860 PMCID: PMC10532331 DOI: 10.3390/jfb14090446] [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: 02/02/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Regenerative dentistry is the operation of restoring dental, oral and maxillofacial tissues. Currently, there are no guidelines for the ideal cement/material in regenerative endodontic treatments (RET). Hydraulic calcium silicate-based cements (hCSCs) are currently the material of choice for RET. OBJECTIVES This systematic review was conducted to gather all of the different direct and indirect approaches of using hCSCs in RET in vitro and in vivo, and to ascertain if there are any superiorities to indirect approaches. METHODS AND MATERIALS This systematic review was conducted according to the 2020 PRISMA guidelines. The study question according to the PICO format was as follows: Comparison of the biological behavior (O) of stem cells (P) exposed to hCSCs through direct and indirect methods (I) with untreated stem cells (C). An electronic search was executed in Scopus, Google Scholar, and PubMed. RESULTS A total of 78 studies were included. Studies were published between 2010 and 2022. Twenty-eight commercially available and eighteen modified hCSCs were used. Seven exposure methods (four direct and three indirect contacts) were assessed. ProRoot MTA and Biodentine were the most used hCSCs and had the most desirable results. hCSCs were either freshly mixed or set before application. Most studies allowed hCSCs to set in incubation for 24 h before application, which resulted in the most desirable biological outcomes. Freshly mixed hCSCs had the worst outcomes. Indirect methods had significantly better viability/proliferation and odonto-/osteogenesis outcomes. CONCLUSION Biodentine and ProRoot MTA used in indirect exposure methods result in desirable biological outcomes.
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Affiliation(s)
- Amir-Ali Yousefi-Koma
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hadi Assadian
- Department of Endodontics, Tehran University of Medical Sciences, Tehran 1417614418, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
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Kim M, Lee SH, Shin DH. In Vitro Study of the Biological and Physical Properties of Dual-Cure Resin-Modified Calcium Silicate-Based Cement. Dent J (Basel) 2023; 11:dj11050120. [PMID: 37232772 DOI: 10.3390/dj11050120] [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: 02/15/2023] [Revised: 04/14/2023] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The aim of the present study was to compare the biological and mechanical properties of a novel dual-cure, resin-modified calcium silicate material, Theracal PT® (TP), with those of Theracal LC® (TL) and BiodentineTM (BD). METHODS The cell counting kit-8 was used on human dental pulp cells to test cell the viability of the three materials. Antibacterial activity of TP, TL, and BD against Enterococcus faecalis was investigated under anaerobic conditions. The ability of the materials to support odontogenic differentiation was studied by examining the relative gene expression of osteocalcin (OCN), osteopontin (OPN), and Collagen I (ColI) using real-time polymerase chain reaction. For mechanical property tests, microhardness was evaluated using the Vickers microhardness (VHN) test, and the bond strength to the resin was evaluated using a shear bond test machine. RESULTS There was no significant difference in cell viability between TL and TP after 48 h, and BD showed the highest cell viability, while TP showed the highest antibacterial effect. At the 12-h time point, there was no significant difference in ColI and OCN expression between BD and TP, but TP showed a higher expression of OPN than BD. However, at the 48-h time point, ColI and OCN showed higher levels of expression for BD than for TP and TL. At the same time point, only OPN had a higher diffusion for TP than for BD. TP demonstrated a VHN of approximately 30-35. This value was higher than that of TL and lower than that of BD. In contrast to VHN, the shear bond strength to resin was significantly higher for TL and TP than for BD. CONCLUSION TP showed lower biocompatibility than BD but higher OPN expression and antibacterial effects than BD and TL. TP showed higher shear bond strength than BD and higher VHN than TL and BD at the 24-h time point.
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Affiliation(s)
- Minjung Kim
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
| | - Sung-Hoon Lee
- Department of Oral Microbiology and Immunology, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
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Rathinam E, Rajasekharan S, Declercq H, Vanhove C, De Coster P, Martens L. Effect of Intracoronal Sealing Biomaterials on the Histological Outcome of Endodontic Revitalisation in Immature Sheep Teeth-A Pilot Study. J Funct Biomater 2023; 14:jfb14040214. [PMID: 37103304 PMCID: PMC10144940 DOI: 10.3390/jfb14040214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/28/2023] Open
Abstract
The influence of intracoronal sealing biomaterials on the newly formed regenerative tissue after endodontic revitalisation therapy remains unexplored. The objective of this study was to compare the gene expression profiles of two different tricalcium silicate-based biomaterials alongside the histological outcomes of endodontic revitalisation therapy in immature sheep teeth. The messenger RNA expression of TGF-β, BMP2, BGLAP, VEGFA, WNT5A, MMP1, TNF-α and SMAD6 was evaluated after 1 day with qRT-PCR. For evaluation of histological outcomes, revitalisation therapy was performed using Biodentine (n = 4) or ProRoot white mineral trioxide aggregate (WMTA) (n = 4) in immature sheep according to the European Society of Endodontology position statement. After 6 months' follow-up, one tooth in the Biodentine group was lost to avulsion. Histologically, extent of inflammation, presence or absence of tissue with cellularity and vascularity inside the pulp space, area of tissue with cellularity and vascularity, length of odontoblast lining attached to the dentinal wall, number and area of blood vessels and area of empty root canal space were measured by two independent investigators. All continuous data were subjected to statistical analysis using Wilcoxon matched-pairs signed rank test at a significance level of p < 0.05. Biodentine and ProRoot WMTA upregulated the genes responsible for odontoblast differentiation, mineralisation and angiogenesis. Biodentine induced the formation of a significantly larger area of neoformed tissue with cellularity, vascularity and increased length of odontoblast lining attached to the dentinal walls compared to ProRoot WMTA (p < 0.05), but future studies with larger sample size and adequate power as estimated by the results of this pilot study would confirm the effect of intracoronal sealing biomaterials on the histological outcome of endodontic revitalisation.
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Affiliation(s)
- Elanagai Rathinam
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Sivaprakash Rajasekharan
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Human Structure and Repair, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Tissue Engineering Laboratory, Department of Development and Regeneration, KU Leuven, 8500 Kortrijk, Belgium
| | - Christian Vanhove
- Medical Imaging & Signal Processing, Infinity Laboratory, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Dental School, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Luc Martens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
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Li D, Zhu Y, Zhang L, Shi L, Deng L, Ding Z, Ai R, Zhang X, He Y. MZB1 targeted by miR-185-5p inhibits the migration of human periodontal ligament cells through NF-κB signaling and promotes alveolar bone loss. J Periodontal Res 2022; 57:811-823. [PMID: 35653494 DOI: 10.1111/jre.13014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the role of Marginal Zone B and B-1 Cell-Specific Protein (MZB1), a novel molecule associated with periodontitis, in migration of human periodontal ligament cells (hPDLCs) and alveolar bone orchestration. BACKGROUND MZB1 is an ER-localized protein and its upregulation has been found to be associated with a variety of human diseases. However, few studies have investigated the effect and mechanism of MZB1 on hPDLCs in periodontitis. METHODS Gene expression profiles in human gingival tissues were acquired from the Gene Expression Omnibus (GEO) database, and candidate molecules were then selected through bioinformatic analysis. Subsequently, we identified the localization and expression of MZB1 in human gingival tissues, mice, and hPDLCs by immunofluorescence, RT-qPCR, and Western blot. Dual-luciferase reporter assay was applied to assess the binding of miR-185-5p to MZB1. Furthermore, the effects of MZB1 on cell migration, proliferation, and apoptosis in vitro were investigated by wound-healing assay, transwell assay, CCK-8 assay, and flow cytometry analysis. Finally, Micro-CT analysis and H&E staining were performed to examine the effects of MZB1 on alveolar bone loss in vivo. RESULTS Bioinformatic analysis discovered that MZB1 was one of the most significantly increased genes in periodontitis patients. MZB1 was markedly increased in the gingival tissues of periodontitis patients, in the mouse models, and in the hPDLCs treated with lipopolysaccharide of Porphyromonas gingivalis (LPS-PG). Furthermore, in vitro experiments showed that MZB1, as a target gene of miR-185-5p, inhibited migration of hPDLCs. Overexpression of MZB1 specifically upregulated the phosphorylation of p65, while pretreatment of MZB1-overexpressed hPDLCs with PDTC (NF-κB inhibitor) notably reduced the p-p65 level and promoted cell migration. In addition, the mRNA expression levels of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (Runx2) were inhibited in MZB1-overexpressed hPDLCs and miR-185-5p inhibitor treated hPDLCs, respectively. In vivo experiments showed that knockdown of MZB1 alleviated the loss of alveolar bone. CONCLUSION As a target gene of miR-185-5p, MZB1 plays a crucial role in inhibiting the migration of hPDLCs through NF-κB signaling pathway and deteriorating alveolar bone loss.
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Affiliation(s)
- Dingyi Li
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Yiting Zhu
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China.,Department of Laboratory Medicine, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Lu Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Luyao Shi
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Li Deng
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Zhiqiang Ding
- School of Computer Science, Chongqing Institute of Engineering, Chongqing, China
| | - Rongshuang Ai
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Xiaonan Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yujuan He
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
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Touya N, Devun M, Handschin C, Casenave S, Omar NA, Gaubert A, Dusserre N, De Oliveira H, Kérourédan O, Devillard R. In vitroand in vivocharacterization of a novel tricalcium silicate-based ink for bone regeneration using laser-assisted bioprinting. Biofabrication 2022; 14. [PMID: 35203068 DOI: 10.1088/1758-5090/ac584b] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/24/2022] [Indexed: 11/11/2022]
Abstract
Grafts aside, current strategies employed to overcome bone loss still fail to reproduce native tissue physiology. Among the emerging bioprinting strategies, Laser-Assisted Bioprinting (LAB) offers very high resolution, allowing designing micrometric patterns in a contactless manner, providing a reproducible tool to test ink formulation. To this date, no LAB associated ink succeeded to provide a reproducible ad integrum bone regeneration on a murine calvaria critical size defect model. Using the CE approved BioRoot RCS® as a mineral addition to a collagen-enriched ink compatible with LAB, the present study describes the process of the development of a solidifying tricalcium silicate-based ink as a new bone repair promoting substrates in a LAB model. This ink formulation was mechanically characterized by rheology to adjust it for LAB. Printed aside Stromal Cells from Apical Papilla (SCAPs), this ink demonstrated a great cytocompatibility, with significant in vitro positive impact upon cell motility, and an early osteogenic differentiation response in the absence of another stimulus. Results indicated that the in vivo application of this new ink formulation to regenerate critical size bone defect tends to promote the formation of bone volume fraction without affecting the vascularization of the neo-formed tissue. The use of LAB techniques with this ink failed to demonstrate a complete bone repair, whether SCAPs were printed or not of at its direct proximity. The relevance of the properties of this specific ink formulation would therefore rely on the quantity applied in situ as a defect filler rather than its cell modulation properties observed in vitro. For the first time, a tricalcium silicate-based printed ink, based on rheological analysis, was characterized in vitro and in vivo, giving valuable information to reach complete bone regeneration through formulation updates. This LAB-based process could be generalized to normalize the characterization of candidate ink for bone regeneration.
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Affiliation(s)
- Nicolas Touya
- University of Bordeaux, 146 rue leo saignat, Bordeaux, 33067, FRANCE
| | - Mathilde Devun
- University of Bordeaux, 146 rue leo saignat, Talence, 33405, FRANCE
| | - Charles Handschin
- Inserm U1026, Tissue Bioengineering: Bordeaux, FR, 146 rue leo saignat, Bordeaux, 33067, FRANCE
| | - Sophia Casenave
- University of Bordeaux, 146 rue leo saignat, Talence, 33405, FRANCE
| | - Naïma Ahmed Omar
- University of Bordeaux, 146 rue leo saignat, Talence, 33405, FRANCE
| | - Alexandra Gaubert
- University of Bordeaux, 146 rue leo saignat, Bordeaux, 33067, FRANCE
| | - Nathalie Dusserre
- ART Bioprint, INSERM U1026, 146 rue leo saignat, BORDEAUX, 33067, FRANCE
| | - Hugo De Oliveira
- , Université de Bordeaux, Bioingénierie tissulaire, rue Léo Saignat, 33076 Bordeaux, Bordeaux, 33067, FRANCE
| | - Olivia Kérourédan
- Bioingénierie Tissulaire, INSERM U1026, 146 rue Léo Saignat, BORDEAUX, 33067, FRANCE
| | - Raphael Devillard
- Bioingenierie tissulaire, INSERM U1026, 146 rue leo Saignat, Bordeaux, 33067, FRANCE
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Odonto/Osteogenic Differentiation of Dental Pulp Stem Cells of Type 1 Diabetic Patients with Mineral Trioxide Aggregate/1α,25-Dihydroxyvitamin D3 Combination. J Endod 2022; 48:516-526. [DOI: 10.1016/j.joen.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/20/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022]
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Calabrese EJ. Human periodontal ligament stem cells and hormesis: Enhancing cell renewal and cell differentiation. Pharmacol Res 2021; 173:105914. [PMID: 34563662 DOI: 10.1016/j.phrs.2021.105914] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
This paper provides a detailed assessment of hormetic dose responses by human periodontal ligament stem cells (hPDLSCs). Hormetic dose responses were induced by a broad range of chemicals, including dietary supplements (e.g., curcumin, ginsenoside Rg1), pharmaceutical/commercial substances (e.g., metformin) and endogenous agents (e.g., periostin, TNF-α) for cell proliferation/viability and osteogenic/adipocyte differentiation. This paper clarifies underlying mechanistic foundations of the hPLDSC hormetic dose responses and explores their therapeutic implications. Emerging evidence based on assessments of multiple types of stem cells shows hormetic dose responses to be widespread, reflecting considerable generality and a highly conserved evolutionary trait.
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Affiliation(s)
- Edward J Calabrese
- School of Public Health and Health Sciences, Department of Environmental Health Sciences, Morrill I, N344, University of Massachusetts, Amherst, MA 01003, Unites States.
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Pinheiro LS, Kopper PMP, Quintana RM, Scarparo RK, Grecca FS. Does MTA provide a more favourable histological response than other materials in the repair of furcal perforations? A systematic review. Int Endod J 2021; 54:2195-2218. [PMID: 34418122 DOI: 10.1111/iej.13617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/20/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND There is no consensus on which furcal perforation repair material induces a more favourable histological response. This systematic review of laboratory studies provides an overview of the studies comparing repair materials in animal models. OBJECTIVES To evaluate whether mineral trioxide aggregate (MTA) yields a more favourable histological response than other materials when used to repair furcal perforations in animal experimental models. METHODS This review followed the PRISMA checklist. The studies included various materials used to repair furcal perforations and compared the histological responses with MTA. An electronic search was conducted in EMBASE, PubMed, Scopus and Web of Science up to 2 September 2020, with no language or publication date restrictions. Studies whose full text was unavailable were excluded. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. RESULTS The studies included in the qualitative synthesis were conducted in rat (n = 3) and dog (n = 17) models. They were classified as having a low quality, high methodological heterogeneity and high RoB. MTA and Biodentine, the materials most often compared, reduced the inflammatory reaction to mild over time. In addition, a mineralized tissue was formed in all studies. The response yielded by MTA was better than or equivalent to that of the other tested materials. DISCUSSION This review confirmed that MTA is the reference standard material for furcal perforation repair. However, research using animal models has inherent limitations, and the substantial methodological heterogeneity across the studies included should be considered. Therefore, the knowledge generated by this systematic review should be translated into clinical practice cautiously. CONCLUSIONS Features described in the report and quality assessment guidelines, such as PRIASE, ARRIVE and SYRCLE, should guide researchers. Despite the high RoB and the low methodological quality of the studies included, findings indicated that MTA yields a more favourable histological response than other materials in the repair of furcal perforations. REGISTRATION PROSPERO (CRD42020181297).
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Affiliation(s)
- Lucas Siqueira Pinheiro
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Maria Poli Kopper
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro Martins Quintana
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Fabiana Soares Grecca
- Postgraduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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12
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Lin Q, Zhang X, Liang D, Li J, Wang W, Wang Z, Wong CP. The in vivo dissolution of tricalcium silicate bone cement. J Biomed Mater Res A 2021; 109:2527-2535. [PMID: 34185370 DOI: 10.1002/jbm.a.37247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 11/12/2022]
Abstract
This study aimed to investigate the in vivo dissolution of tricalcium silicate (Ca3 SiO5 , C3 S) bone cement in the rabbit femoral defect. Results indicated that C3 S paste directly integrated with the bone tissue without the protection of the bone-like apatite. Calcium silicate hydrate gel (C-S-H gel) and Ca(OH)2 were the main components of C3 S paste. The dissolution model of C3 S paste was a mass loss rather than a decrease in volume. The initial dissolution of C3 S paste (0 ~ 6 weeks) was greatly attributed to the release of Ca(OH)2 , and the later dissolution (>6 weeks) was attributed to the decalcification of C-S-H gel. Although the mass of C3 S paste could decrease by more than 19 wt % after 6 weeks of implantation, the created pores (<1 μm) were not large enough for the bone tissue to migrate into C3 S paste. The loss of Ca ions also resulted in the transformation of SiO4 tetrahedrons from Q1 and Q2 to Q0 , Q3 , and Q4 in C-S-H gel. Because only isolated SiO4 tetrahedrons (Q0 ) and Ca ions could be absorbed by the bone tissue, C3 S paste gradually transformed into a silica-rich gel. The fundamental reason for no decrease in volume of C3 S paste was that the SiO4 tetrahedron network still maintained the frame structure of C3 S paste during the implantation.
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Affiliation(s)
- Qing Lin
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China.,School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Xiaojuan Zhang
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China
| | - Dong Liang
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China
| | - Junlin Li
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China
| | - Wei Wang
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China
| | - Zhao Wang
- School of Materials Engineering, Jinling Institute of Technology, Nanjing, China
| | - Ching-Ping Wong
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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Gomes PS, Pinheiro B, Colaço B, Fernandes MH. The Osteogenic Assessment of Mineral Trioxide Aggregate-based Endodontic Sealers in an Organotypic Ex Vivo Bone Development Model. J Endod 2021; 47:1461-1466. [PMID: 34126159 DOI: 10.1016/j.joen.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/27/2021] [Accepted: 06/05/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Mineral trioxide aggregate (MTA)-based sealers are endodontic materials with widespread success in distinct clinical applications, potentially embracing direct contact with the bone tissue. Bone response to these materials has been traditionally addressed in vitro. Nonetheless, translational data are limited by the absence of native cell-to-cell and cell-to-matrix interactions that hinder the representativeness of the analysis. Ex vivo organotypic systems, relying on the culture of explanted biological tissues, preserve the cell/tissue composition, reproducing the spatial and organizational in situ complexity. This study was grounded on an innovative research approach, relying on the assessment of an ex vivo organotypic bone tissue culture system to address the osteogenic response to 3 distinct MTA-based sealers. METHODS Embryonic chick femurs were isolated and grown ex vivo for 11 days in the presence of MTA Plus (Avalon Biomed Inc, Bradenton, FL), ProRoot MTA (Dentsply Tulsa Dental, Hohnson City, Germany), Biodentine (Septodont, Saint Maurdes Fosses, France), or AH Plus (Dentsply Sirona, Konstanz, Germany); the latter was used as a control material. Femurs were characterized by histologic, histochemical, and histomorphometric analysis. Gene expression assessment of relevant osteogenic markers was conducted by quantitative polymerase chain reaction. RESULTS All MTA-based sealers presented an enhanced osteogenic performance compared with AH Plus. Histochemical and histomorphometric analyses support the increased activation of the osteogenic program by MTA-based sealers, with enhanced collagenous matrix deposition and tissue mineralization. Gene expression analysis supported the enhanced activation of the osteogenic program. Comparatively, ProRoot MTA induced the highest osteogenic functionality on the characterized femurs. CONCLUSIONS MTA-based sealers enhanced the osteogenic activity within the assayed organotypic bone model, which was found to be a sensitive system for the assessment of osteogenic modulation mediated by endodontic sealers.
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Affiliation(s)
- Pedro S Gomes
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Associated Laboratory for Green Chemistry/Network of Chemistry and Technology (LAQV/REQUIMTE), University of Porto, Porto, Portugal.
| | - Bruna Pinheiro
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Bruno Colaço
- Department of Zootechnics, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal; Center for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Maria H Fernandes
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Associated Laboratory for Green Chemistry/Network of Chemistry and Technology (LAQV/REQUIMTE), University of Porto, Porto, Portugal
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14
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Liu M, He L, Wang H, Su W, Li H. Comparison of in vitro biocompatibility and antibacterial activity of two calcium silicate-based materials. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:52. [PMID: 33900464 PMCID: PMC8076131 DOI: 10.1007/s10856-021-06523-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
This study is aimed at comparing and evaluating the biocompatibility and antibacterial activities of mineral trioxide aggregate (MTA) and iRoot BP Plus as novel retro-filling materials. Discs of both materials were prepared and incubated for 72 h to obtain material extracts in medium. Flow cytometry and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay were used to assess the rate of apoptosis and proliferation of human periodontal ligament stem cells (hPDLSCs) when exposed to eluates of both materials. The expression levels of alkaline phosphatase, collagen type I, osteocalcin, Runt-related transcription factor-2, and Osterix were tested for evaluating the osteogenic differentiation of hPDLSCs. The antibacterial activities of both materials were compared by the direct contact test. The hPDLSCs stimulated by MTA or iRoot BP Plus eluates showed significantly higher cell viability than that of the control group with no eluates. No significant differences were observed among the percentages of necrotic and apoptotic cells stimulated by MTA and iRoot BP Plus eluates and the control group. The expression of all osteogenic differentiation markers of hPDLSCs in both experimental groups were significantly higher than those of the control group, while the increment values in MTA group were significantly higher than those of the iRoot BP Plus group. The antibacterial activity against Enterococcus faecalis showed no significant difference between MTA and iRoot BP Plus. Therefore, both materials may be suitable for retro-filling applications.
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Affiliation(s)
- Mingxiang Liu
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Lu He
- Affiliated Stomatology Hospital of Guangzhou Medical University, School of Stomatology, Guangzhou Medical University, Guangdong, 510140, China
| | - Hongyuan Wang
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Wenpei Su
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Hong Li
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China.
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15
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Garrido M, Morales D, Saldías MP, Fernández C, Villalobos V, Cerda O, Cáceres M. Cellular response of human apical papilla cells to calcium hydroxide and tricalcium silicate-based cements. BMC Oral Health 2021; 21:106. [PMID: 33750358 PMCID: PMC7941877 DOI: 10.1186/s12903-021-01467-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/24/2021] [Indexed: 01/09/2023] Open
Abstract
Background This study aimed to evaluate the biological response of human apical papilla cells to different calcium hydroxide formulations and three tricalcium silicate-based materials. Methods Primary cells were obtained from explants of young immature premolars. 20,000 cells adhered for 24 h over discs of Biodentine™, ProRoot®MTA, BioRoot®RCS and calcium hydroxide mixed either with sodium chloride 0.9%w/v or polyethylene glycol and UltraCal® were used to evaluate cell adhesion by scanning electron microscopy and cell viability by MTT assay. Results Cells adhered to ProRoot®MTA showed an increase of F-actin like protrusions, suggesting bioactivity. Cells adhered to UltraCal® show protrusion such as filopodia. On the contrary, cells adhered to BioRoot®RCS showed no signs of any cellular protrusion. Regarding viability between the materials, we found a higher percentage of viability in cells cultured over discs of Biodentine™ and ProRoot®MTA. Conclusion ProRoot®MTA and Biodentine™ exhibit a better cellular response of human apical papilla cells in vitro conditions compared to BioRoot® and calcium hydroxide diluted in sodium chloride.
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Affiliation(s)
- Mauricio Garrido
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Diego Morales
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile.,Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - María Paz Saldías
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile.,Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Christian Fernández
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile.,Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Veronica Villalobos
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile.,Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Oscar Cerda
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile.,Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Mónica Cáceres
- Program of Molecular and Cell Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile. .,Millenium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Santiago, Chile. .,Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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16
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Sanz JL, Rodríguez-Lozano FJ, Lopez-Gines C, Monleon D, Llena C, Forner L. Dental stem cell signaling pathway activation in response to hydraulic calcium silicate-based endodontic cements: A systematic review of in vitro studies. Dent Mater 2021; 37:e256-e268. [PMID: 33573840 DOI: 10.1016/j.dental.2021.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/16/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To present a qualitative synthesis of in vitro studies which analyzed human dental stem cell (DSC) molecular signaling pathway activation in response to hydraulic calcium silicate-based cements (HCSCs). METHODS A systematic electronic search was performed in Medline, Scopus, Embase, Web of Science and SciELO databases on January 20 and last updated on March 20, 2020. In vitro studies assessing the implication of signaling pathways in activity related marker (gene/protein) expression and mineralization induced by HCSCs in contact with human DSCs were included. RESULTS The search identified 277 preliminary results. After discarding duplicates, and screening of titles, abstracts, and full texts, 13 articles were considered eligible. All of the materials assessed by the included studies showed positive results in cytocompatibility and/or bioactivity assays. ProRoot MTA and Biodentine were the modal HCSCs studied, hDPSCs were the modal cell variant used, and the most studied signaling pathway was MAPK. In vitro assays measuring the expression of activity-related markers and mineralized nodule formation evidenced the involvement of MAPK (and its subfamilies ERK, JNK and P38), NF-κB, Wnt/β-catenin, BMP/Smad and CAMKII pathways in the biological response of DSCs to HCSCs. SIGNIFICANCE HCSCs considered in the present review elicited a favorable biological response from a variety of DSCs in vitro, thus supporting their use in biologically-based endodontic procedures. MAPK, NF-κβ, Wnt/β-catenin, BMP/Smad and CAMKII signaling pathways have been proposed as potential mediators in the biological interaction between DSCs and HCSCs. Understanding the signaling processes involved in tissue repair could lead to the development of new biomaterial compositions targeted at enhancing these mechanisms through biologically-based procedures.
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Affiliation(s)
- José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Francisco Javier Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
| | - Concha Lopez-Gines
- Department of Pathology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Daniel Monleon
- Department of Pathology, 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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17
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Sun Q, Meng M, Steed JN, Sidow SJ, Bergeron BE, Niu LN, Ma JZ, Tay FR. Manoeuvrability and biocompatibility of endodontic tricalcium silicate-based putties. J Dent 2020; 104:103530. [PMID: 33220332 DOI: 10.1016/j.jdent.2020.103530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The present study evaluated the indentation depth, storage modulus and biocompatibility of an experimental endodontic putty designed for endodontic perforation repair and direct pulp-capping (NeoPutty). The results were compared with the properties associated with the commercially available EndoSequence BC RRM Putty (ES Putty). METHODS Indentation depth was measured by a profilometer following indentation with the 1/4 lb Gilmore needle. Elastic modulus was evaluated using a strain-controlled rheometer. The effects of eluents derived from these two putties were examined on the viability and proliferation of human dental pulp stem cells (hDPSCs) and human periodontal ligament fibroblasts (hPDLFs), before (1 st testing cycle) and after complete setting (2nd testing cycle). RESULTS The ES Putty became more difficult to ident and acquired a larger storage modulus after exposure to atmospheric moisture. Biocompatibility results indicated that both putties were relatively more cytotoxic than the bioinert Teflon negative control, but much less cytotoxic than the zinc oxide-eugenol cement negative control. NeoPutty was less cytotoxic than ES putty in the 1st testing cycle, particularly with hDPSCs. Both putties exhibited more favourable cytotoxicity profiles after complete setting. CONCLUSIONS NeoPutty has a better window of maneuverability after exposure to atmospheric moisture. From an in vitro cytotoxicity perspective, the NeoPutty may be considered more biocompatible than ES putty. CLINICAL SIGNIFICANCE The experimental NeoPutty is biocompatible and is capable of reducing the frustration of shortened shelf life when jar-stored endodontic putties are exposed to atmospheric moisture during repeated opening of the lid for clinical retrieval.
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Affiliation(s)
- Qin Sun
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jeffrey N Steed
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie J Sidow
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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18
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Rathinam E, Govindarajan S, Rajasekharan S, Declercq H, Elewaut D, De Coster P, Martens L. Transcriptomic profiling of human dental pulp cells treated with tricalcium silicate-based cements by RNA sequencing. Clin Oral Investig 2020; 25:3181-3195. [PMID: 33108483 DOI: 10.1007/s00784-020-03647-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Tricalcium silicate (TCS)-based biomaterials induce differentiation of human dental pulp cells (hDPCs) into odontoblasts/osteoblasts, which is regulated by the interplay between various intracellular pathways and their resultant secretome. The aim of this study was to compare the transcriptome-wide effects by next-generation RNA sequencing of custom-prepared hDPCs stimulated with TCS-based biomaterials: ProRoot white MTA (WMTA) (Dentsply, Tulsa; Tulsa, OK) and Biodentine (Septodont, Saint Maur des Fosses, France). METHODS Self-isolated hDPCs were seeded in a 6-well plate at a density of 5 × 105 cells per well. ProRoot white MTA and Biodentine were then placed in transwell inserts with a pore size of 0.4 μm and inserted in the well plate. RNA sequencing was performed after 3 and 7 days treatment. For post-validation, RT-PCR analyses were done on some of the RNA samples used for RNA sequencing. RESULTS Our RNA sequencing results for the first time identified 7533 differentially expressed genes (DEGs) between different treatments and the number of DEGs in Biodentine was higher than ProRoot WMTA at both 3 and 7 days. Despite their differential gene expression, both the TCS-based biomaterial treatments showed gene expressions mainly involved in odontoblast differentiation, angiogenesis, neurogenesis, dentinogenesis, and tooth mineralization. CONCLUSIONS The results of the present study illustrate that several important signalling pathways are induced by hDPCs stimulated with TCS-based biomaterials. CLINICAL RELEVANCE The differential expression of the genes associated with odontogenesis, angiogenesis, neurogenesis, dentinogenesis, and mineralization may affect the prognosis of teeth treated with Biodentine or ProRoot white MTA.
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Affiliation(s)
- Elanagai Rathinam
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.
| | - Srinath Govindarajan
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, Zwijnaarde, 9052, Ghent, Belgium
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Human Structure and Repair, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Tissue Engineering Lab, Department of Development and Regeneration, KU Leuven, 8500, Kortrijk, Belgium
| | - Dirk Elewaut
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, Zwijnaarde, 9052, Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Dental School, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
| | - Luc Martens
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
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Alves Silva EC, Tanomaru-Filho M, da Silva GF, Delfino MM, Cerri PS, Guerreiro-Tanomaru JM. Biocompatibility and Bioactive Potential of New Calcium Silicate–based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC. J Endod 2020; 46:1470-1477. [DOI: 10.1016/j.joen.2020.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
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20
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Silva RAB, Borges ATN, Hernandéz-Gatón P, de Queiroz AM, Arzate H, Romualdo PC, Nelson-Filho P, Silva LAB. Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation. Int Endod J 2019; 52:1489-1500. [PMID: 31099018 DOI: 10.1111/iej.13145] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 05/14/2019] [Indexed: 12/12/2022]
Abstract
AIM To evaluate in vivo tissue responses after sealing furcation perforations in dog's teeth with either Biodentine™, mineral trioxide aggregate (MTA) or gutta-percha, by means of histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis. METHODOLOGY After root canal treatment, perforations were created in the central region of the pulp chamber floor using a round diamond bur and filled with one or other of the materials. The animals were euthanized after 120 days, and the teeth (n = 30) were processed for histopathological analysis of new mineralized tissue formation and collagen fibre reinsertion, immunohistochemical analysis of osteopontin (OPN) and alkaline phosphatase (ALP) and immunofluorescence analysis for bone morphogenetic protein (BMP-2), cementum attachment protein (CAP), bone sialoprotein (BSP), osteocalcin (OCN) and cementum protein1 (CEMP1). Histoenzymology was performed for TRAP activity and osteoclast count. Data were analysed statistically (α = 0.05) using chi-square and Kruskal-Wallis tests. RESULTS Gutta-percha did not induce mineralized tissue formation. MTA and BiodentineTM formed mineralized tissue in 88% and 92% of specimens, respectively, with no significant difference (P > 0.05). Gutta-percha was associated with scattered collagen fibres parallel to the perforations. Groups treated with MTA or BiodentineTM had partial fibre reinsertion perpendicular to the newly formed mineralized tissue. All materials induced OPN and ALP expression, weakest for gutta-percha and strongest for MTA (P < 0.05). Only MTA induced BMP-2, BSP, OCN, CAP and CEMP1 expression. Osteoclast counts were similar in all groups (P = 0.97). CONCLUSIONS Mineral trioxide aggregate and BiodentineTM were biocompatible, with formation of mineralized tissue and partial reinsertion of collagen fibres. In addition, the participation of several molecules by which calcium silicate-based materials induce the formation of mineralized tissue were noted, with expression of ALP and OPN mineralization markers, without interference in the number of osteoclasts. Only MTA stimulated the expression of proteins associated with the formation of a cementum-like mineralized tissue.
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Affiliation(s)
- R A B Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - A T N Borges
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Faculty of Amazonas, Manaus, Amazonas, Brazil
| | - P Hernandéz-Gatón
- Department of Integrated Paediatric Dentistry, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - A M de Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - H Arzate
- Laboratorio de Biología Periodontal, División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, México City, México
| | - P C Romualdo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - P Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - L A B Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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21
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Biodentine ™ Boosts, WhiteProRoot ®MTA Increases and Life ® Suppresses Odontoblast Activity. MATERIALS 2019; 12:ma12071184. [PMID: 30978943 PMCID: PMC6479701 DOI: 10.3390/ma12071184] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/06/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022]
Abstract
(1) Background: When pulp exposure occurs, reparative dentinogenesis can be induced by direct pulp capping to maintain the vitality and function of the tissue. The aim of this work was to assess the cytotoxicity and bioactivity of three different direct pulp capping materials, calcium hydroxide (Life®), mineral trioxide aggregate (WhiteProRoot®MTA) and calcium silicate (Biodentine™), in an odontoblast-like mouse cell line (MDPC-23). (2) Methods: Metabolic activity was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test (MTT)assay, viability by the sulforhodamine B (SRB) assay, and the type of death and cell cycle analysis by flow cytometry. Alkaline phosphatase was evaluated by polymerase chain reaction (PCR), and dentin sialoprotein expression was assessed by immunocytochemistry. Mineralization was determined by the Alizarin Red S colorimetric assay and quantified by spectrophotometry. (3) Results: Life® induced a decrease in metabolic activity and viability, which is associated with an increase cell death. WhiteProRoot®MTA and Biodentine™ induced similar effects in cytotoxicity assays, with an increase in the expression of dentin sialoprotein (DSP) and formation of mineralized deposits, especially with Biodentine™. (4) Conclusions: The results of WhiteProRoot®MTA confirm its indication for these therapies, justifying its recognition as the “gold standard”. Biodentine™ may be an alternative, since they promote the same cellular response that mineral trioxide aggregate (MTA) does.
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Wu YHA, Chiu YC, Lin YH, Ho CC, Shie MY, Chen YW. 3D-Printed Bioactive Calcium Silicate/Poly-ε-Caprolactone Bioscaffolds Modified with Biomimetic Extracellular Matrices for Bone Regeneration. Int J Mol Sci 2019; 20:E942. [PMID: 30795573 PMCID: PMC6413038 DOI: 10.3390/ijms20040942] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 12/28/2022] Open
Abstract
Currently, clinically available orthopedic implants are extremely biocompatible but they lack specific biological characteristics that allow for further interaction with surrounding tissues. The extracellular matrix (ECM)-coated scaffolds have received considerable interest for bone regeneration due to their ability in upregulating regenerative cellular behaviors. This study delves into the designing and fabrication of three-dimensional (3D)-printed scaffolds that were made out of calcium silicate (CS), polycaprolactone (PCL), and decellularized ECM (dECM) from MG63 cells, generating a promising bone tissue engineering strategy that revolves around the concept of enhancing osteogenesis by creating an osteoinductive microenvironment with osteogenesis-promoting dECM. We cultured MG63 on scaffolds to obtain a dECM-coated CS/PCL scaffold and further studied the biological performance of the dECM hybrid scaffolds. The results indicated that the dECM-coated CS/PCL scaffolds exhibited excellent biocompatibility and effectively enhanced cellular adhesion, proliferation, and differentiation of human Wharton's Jelly mesenchymal stem cells by increasing the expression of osteogenic-related genes. They also presented anti-inflammatory characteristics by showing a decrease in the expression of tumor necrosis factor-alpha (TNF-α) and interleukin-1 (IL-1). Histological analysis of in vivo experiments presented excellent bone regenerative capabilities of the dECM-coated scaffold. Overall, our work presented a promising technique for producing bioscaffolds that can augment bone tissue regeneration in numerous aspects.
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Affiliation(s)
- Yuan-Haw Andrew Wu
- School of Medicine, China Medical University, Taichung 40447, Taiwan.
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung 40447, Taiwan.
| | - Yung-Cheng Chiu
- School of Medicine, China Medical University, Taichung 40447, Taiwan.
- Department of Orthopedics, China Medical University Hospital, Taichung 40447, Taiwan.
| | - Yen-Hong Lin
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung 40447, Taiwan.
- The Ph.D. Program for Medical Engineering and Rehabilitation Science, China Medical University, Taichung 40447, Taiwan.
| | - Chia-Che Ho
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung 40447, Taiwan.
| | - Ming-You Shie
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung 40447, Taiwan.
- School of Dentistry, China Medical University, Taichung 40447, Taiwan.
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 40447, Taiwan.
| | - Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40447, Taiwan.
- 3D Printing Medical Research Institute, Asia University, Taichung 40447, Taiwan.
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Tu MG, Ho CC, Hsu TT, Huang TH, Lin MJ, Shie MY. Mineral Trioxide Aggregate with Mussel-inspired Surface Nanolayers for Stimulating Odontogenic Differentiation of Dental Pulp Cells. J Endod 2018; 44:963-970. [DOI: 10.1016/j.joen.2018.02.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 12/17/2022]
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24
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Miller AA, Takimoto K, Wealleans J, Diogenes A. Effect of 3 Bioceramic Materials on Stem Cells of the Apical Papilla Proliferation and Differentiation Using a Dentin Disk Model. J Endod 2018; 44:599-603. [DOI: 10.1016/j.joen.2017.12.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/20/2017] [Accepted: 12/19/2017] [Indexed: 12/23/2022]
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25
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Nagendrababu V, Pulikkotil SJ, Sultan OS, Jayaraman J, Peters OA. Methodological and Reporting Quality of Systematic Reviews and Meta-analyses in Endodontics. J Endod 2018; 44:903-913. [PMID: 29602531 DOI: 10.1016/j.joen.2018.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/07/2017] [Accepted: 02/10/2018] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this systematic review (SR) was to evaluate the quality of SRs and meta-analyses (MAs) in endodontics. METHODS A comprehensive literature search was conducted to identify relevant articles in the electronic databases from January 2000 to June 2017. Two reviewers independently assessed the articles for eligibility and data extraction. SRs and MAs on interventional studies with a minimum of 2 therapeutic strategies in endodontics were included in this SR. Methodologic and reporting quality were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), respectively. The interobserver reliability was calculated using the Cohen kappa statistic. Statistical analysis with the level of significance at P < .05 was performed using Kruskal-Wallis tests and simple linear regression analysis. RESULTS A total of 30 articles were selected for the current SR. Using AMSTAR, the item related to the scientific quality of studies used in conclusion was adhered by less than 40% of studies. Using PRISMA, 3 items were reported by less than 40% of studies, which were on objectives, protocol registration, and funding. No association was evident comparing the number of authors and country with quality. Statistical significance was observed when quality was compared among journals, with studies published as Cochrane reviews superior to those published in other journals. AMSTAR and PRISMA scores were significantly related. CONCLUSIONS SRs in endodontics showed variability in both methodologic and reporting quality.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Shaju Jacob Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Omer Sheriff Sultan
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Jayakumar Jayaraman
- Division of Community and Children Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Ove A Peters
- Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California; The University of Queensland Dental School, UQ Oral Health Centre, Herston, Queensland, Australia
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26
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Lin YH, Chiu YC, Shen YF, Wu YHA, Shie MY. Bioactive calcium silicate/poly-ε-caprolactone composite scaffolds 3D printed under mild conditions for bone tissue engineering. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 29:11. [PMID: 29282550 DOI: 10.1007/s10856-017-6020-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 12/05/2017] [Indexed: 06/07/2023]
Abstract
The present study provides a solvent-free processing method for establishing the ideal porous 3-dimension (3D) scaffold filled with different ratios of calcium silicate-based (CS) powder and polycaprolactone (PCL) for 3D bone substitute application. Characterization of hybrid scaffolds developed underwent assessments for physicochemical properties and biodegradation. Adhesion and growth of human Wharton's Jelly mesenchymal stem cells (WJMSCs) on the CS/PCL blended scaffold were investigated in vitro. Cell attachment and morphology were examined by scanning electron microscope (SEM) and confocal microscope observations. Colorimetric assay was tested for assessing cell metabolic activity. In addition, RT-qPCR was also performed for the osteogenic-related and angiogenesis-related gene expression. As a result, the hydrophilicity of the scaffolds was further significantly improved after we additive CS into PCL, as well as the compressive strength up to 5.8 MPa. SEM showed that a great amount of precipitated bone-like apatite formed on the scaffold surface after immersed in the simulated body fluid. The 3D-printed scaffolds were found to enhance cell adhesion, proliferation and differentiation. Additionally, results of osteogenesis and angiogenesis proteins were expressed obviously greater in the response of WJMSCs. These results indicate the CS/PCL composite exhibited a favorable bioactivity and osteoconductive properties that could be served as a promising biomaterial for bone tissue engineering scaffolds.
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Affiliation(s)
- Yen-Hong Lin
- The Ph.D. program for Medical Engineering and Rehabilitation Science, China Medical University, Taichung, Taiwan
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Cheng Chiu
- School of Medicine, China Medical University, Taichung City, Taiwan
- Department of Orthopedics, China Medical University Hospital, Taichung City, Taiwan
| | - Yu-Fang Shen
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- 3D Printing Research Center, Asia University, Taichung, Taiwan
| | - Yuan-Haw Andrew Wu
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Ming-You Shie
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan.
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
- School of Dentistry, China Medical University, Taichung, Taiwan.
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27
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Wang Y, Zhou Y, Jin L, Pang X, Lu Y, Wang Z, Yu Y, Yu J. Mineral trioxide aggregate enhances the osteogenic capacity of periodontal ligament stem cells via NF-κB and MAPK signaling pathways. J Cell Physiol 2017; 233:2386-2397. [DOI: 10.1002/jcp.26110] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/20/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Yanqiu Wang
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- Endodontic Department, School of Stomatology; Nanjing Medical University; Nanjing Jiangsu China
| | - Yixiang Zhou
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- IVY Dental Clinic; Hangzhou Zhejiang China
| | - Lin Jin
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- Endodontic Department, School of Stomatology; Nanjing Medical University; Nanjing Jiangsu China
| | - Xiyao Pang
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- Endodontic Department, School of Stomatology; Nanjing Medical University; Nanjing Jiangsu China
| | - Yadie Lu
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
| | - Zilu Wang
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
| | - Yan Yu
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- Endodontic Department, School of Stomatology; Nanjing Medical University; Nanjing Jiangsu China
| | - Jinhua Yu
- Key Laboratory of Oral Diseases of Jiangsu Province and Stomatological Institute of Nanjing Medical University; Nanjing Jiangsu China
- Endodontic Department, School of Stomatology; Nanjing Medical University; Nanjing Jiangsu China
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