1
|
Elshahat S, Elgendy AA, Elsewify T. Osteogenic Differentiation and Proliferation of Apical Papilla Stem Cells Using Chitosan-Coated Nanohydroxyapatite and Bioactive Glass Nanoparticles. Eur J Dent 2024; 18:665-671. [PMID: 38442913 PMCID: PMC11132763 DOI: 10.1055/s-0043-1777044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells (SCAPs) using chitosan-coated nanohydroxyapatite and bioactive glass nanoparticles. MATERIALS AND METHODS Hydroxyapatite, chitosan-coated nanohydroxyapatite, and bioactive glass 45S5 nanoparticles were prepared and characterized using a transmission electron microscope and X-ray diffraction. SCAPs were harvested from freshly extracted impacted wisdom teeth, cultured, and characterized using flow cytometric analysis. Tested nanomaterials were mixed and samples were classified into five equal groups as follows: negative control group: SCAP with Dulbecco's modified eagle's medium, positive control group: SCAP with inductive media, first experimental group: nanohydroxyapatite with SCAP, second experimental group: chitosan-coated nanohydroxyapatite with SCAP, third experimental group: bioactive glass nanoparticles with SCAP. Osteoblastic differentiation was assessed using an alkaline phosphatase (ALP) assay. Receptor activator of nuclear factor kappa beta ligand (RANKL) expression was evaluated using specific polyclonal antibodies by fluorescence microscope. The proliferation of SCAP was assessed using cell count and viability of trypan blue in addition to an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. RESULTS Isolated SCAP showed a nonhematopoietic origin. Chitosan-coated nanohydroxyapatite showed the highest ALP concentration followed by nanobioactive glass, nanohydroxyapatite, and negative control. Chitosan-coated nanohydroxyapatite showed the highest H score followed by nanobioactive glass, nanohydroxyapatite, and negative control in RANKL expression. Chitosan-coated nanohydroxyapatite showed the highest viable cell count. CONCLUSION SCAP isolation is achievable from extracted fully impacted immature third molars. All tested biomaterials have the ability to induce osteogenic differentiation and proliferation of SCAP. Composite nanoparticle materials show better osteogenic differentiation and proliferation of SCAP than single nanoparticles.
Collapse
Affiliation(s)
- Sara Elshahat
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | - Tarek Elsewify
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Restorative Dental Sciences Department, College of Dentistry, Gulf Medical University, Ajman, UAE
| |
Collapse
|
2
|
Abdelaziz H, Mahran AH, Elsewify T. Osteogenic differentiation and proliferation of apical papilla stem cells using nanoparticles of Neo MTA and bioactive glass. Saudi Dent J 2024; 36:134-139. [PMID: 38375392 PMCID: PMC10874795 DOI: 10.1016/j.sdentj.2023.10.018] [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: 07/20/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 02/21/2024] Open
Abstract
Objective The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells using nanoparticles of Neo MTA and bioactive glass. Methods Neo MTA and bioactive glass 45S5 nanoparticles were prepared and characterized using a transmission electron microscope and X-ray diffraction. Apical papilla stem cells were harvested from freshly-extracted fully-impacted wisdom teeth, cultured, and characterized using flow cytometric analysis. Tested nanomaterials were mixed and samples were classified into four equal groups as follows; Negative control group: SCAP with Dulbecco's modified eagle's medium, Positive control group: SCAP with inductive media, First experimental group: Neo MTA nanoparticles with SCAP, Second experimental group: Bioactive glass nanoparticles with SCAP. Osteoblastic differentiation was assessed using an alkaline phosphatase assay and RANKL expression using specific polyclonal antibodies by fluorescence microscope. The proliferation of SCAP was assessed using cell count and viability of Trypan Blue in addition to an MTT assay. Results Isolated SCAP showed a non-hematopoietic origin. Neo MTA showed the highest ALP concentration followed by bioactive glass nanoparticles, and negative control. Bioactive glass nanoparticles showed the highest H score for RANKL protein expression followed by Neo MTA, and negative control. Bioactive glass nanoparticles showed the highest viable cell count. Conclusions SCAP isolation is achievable from extracted fully impacted immature third molars. Both tested nanobiomaterials have the ability to induce osteogenic differentiation and proliferation of SCAP.
Collapse
Affiliation(s)
- H. Abdelaziz
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Abeer H. Mahran
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - T. Elsewify
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Restorative Dental Sciences Department, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Liu Q, Gao Y, He J. Stem Cells from the Apical Papilla (SCAPs): Past, Present, Prospects, and Challenges. Biomedicines 2023; 11:2047. [PMID: 37509686 PMCID: PMC10377451 DOI: 10.3390/biomedicines11072047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Dental diseases occurring on young permanent teeth usually lead to the premature arrest of tooth root development. Sustained tooth root elongation is necessary to achieve the goal of long-term preservation of affected teeth. To this end, stem cell-based regenerative endodontic treatment has been regarded as one of the most promising strategies for treating young permanent teeth with pulp and periapical infections. Endogenous stem cells residing in the apical papilla, named stem cells from the apical papilla (SCAPs), have been intensively investigated due to their critical roles in pulp regeneration and root redevelopment. The present review summarizes advances in the field of SCAPs studies and discusses the challenges that need to be further addressed.
Collapse
Affiliation(s)
- Qi Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jinzhi He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
5
|
Stanley E, Strother KK, Kirkpatrick T, Jeong JW. Calcium Silicate-based Sealer Extrusion into the Mandibular Canal: Three Different Recovery Outcomes: A Report of Three Cases. J Endod 2023:S0099-2399(23)00216-9. [PMID: 37098401 DOI: 10.1016/j.joen.2023.04.006] [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: 02/01/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
The use of calcium silicate-based sealers (CSS) is increasing in dentistry as result of their favorable properties. The inadvertent extrusion of these sealers into the mandibular canal (MC) can result in temporary or permanent neurosensory alterations. Three different recovery outcomes of CSS extrusion into the MC after endodontic treatment of mandibular molars, confirmed by cone beam computed tomography (CBCT) imaging, are described. In Case 1, CSS from the mesiolingual canal of #31 was extruded into the MC during obturation. The patient reported paresthesia. The symptoms of paresthesia were completely resolved by nine months. In Case 2, CSS from the mesial canals of #30 was extruded into the MC during obturation. "Plasma-like spreading pattern" of the extruded sealer was observed on the radiographs. The patient reported paresthesia and dysesthesia. In addition, the patient complained of hyperalgesia with heat and mechanical allodynia. The symptoms continued to persist during follow up. At 22 months, the patient still reported persistent paresthesia, hyperalgesia and mechanical allodynia, affecting the ability to eat. In Case 3, CSS from the distal canal of #31 was extruded into the MC during obturation. The patient did not report any paresthesia or dysesthesia. All three patients elected a follow up approach and monitoring rather than surgical intervention. These cases illustrate the need for the development of guidelines for the management of iatrogenic CSS extrusion into the MC because such an occurrence may not necessarily result in permanent, temporary or no neurosensory alterations.
Collapse
Affiliation(s)
- Eva Stanley
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Kortnie K Strother
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Timothy Kirkpatrick
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Ji Wook Jeong
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry.
| |
Collapse
|
6
|
Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering (Basel) 2023; 10:bioengineering10030354. [PMID: 36978746 PMCID: PMC10045528 DOI: 10.3390/bioengineering10030354] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Bioceramics, with excellent bioactivity and biocompatibility, have been widely used in dentistry, particularly in endodontics. Mineral trioxide aggregate (MTA) is the most widely used bioceramic in endodontics. Recently, many new bioceramics have been developed, showing good potential for the treatment of endodontic diseases. This paper reviews the characteristics of bioceramics and their applications in various clinical endodontic situations, including root-end filling, root canal therapy, vital pulp therapy, apexification/regenerative endodontic treatment, perforation repair, and root defect repair. Relevant literature published from 1993 to 2023 was searched by keywords in PubMed and Web of Science. Current evidence supports the predictable outcome of MTA in the treatment of endodontic diseases. Although novel bioceramics such as Biodentine, EndoSequence, and calcium-enriched mixtures have shown promising clinical outcomes, more well-controlled clinical trials are still needed to provide high-level evidence for their application in endodontics. In addition, to better tackle the clinical challenges in endodontics, efforts are needed to improve the bioactivity of bioceramics, particularly to enhance their antimicrobial activity and mechanical properties and reduce their setting time and solubility.
Collapse
Affiliation(s)
- Xu Dong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: ; Tel.: +86-028-85503494
| |
Collapse
|
7
|
Wang MC, Chang KW, Lin SC, Hung PS. Biodentine but not MTA induce DSPP expression of dental pulp cells with different severity of LPS-induced inflammation. Clin Oral Investig 2023; 27:1207-1214. [PMID: 36208328 DOI: 10.1007/s00784-022-04734-0] [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: 06/03/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To explore the inflammatory and differentiation response in inflamed dental pulp cells (DPCs) induced by lipopolysaccharide (LPS) under different conditions with Biodentine and mineral trioxide aggregate (MTA) treatment. MATERIALS AND METHODS DPCs were treated with 0.001-1 µg/mL LPS for different periods to induce inflammation. Normal and inflamed DPCs were further treated with 0.14 mg/mL Biodentine or 0.13 mg/mL MTA for different periods. mRNA expression level of IL-6, IL-8 and ALP were analysed by qPCR. DSPP protein expression was detected by western blot. The data were analysed by the Mann-Whitney test, unpaired t test or two-way ANOVA. RESULTS After treatment for different times and with different concentrations of LPS, different severity of pulp inflammation was revealed by the expressions of IL-6 and IL-8. Higher concentrations of LPS induced higher IL-6 and IL-8 expressions, and these expressions first increased and then decreased (p < 0.0001). At 96 and 192 h, Biodentine significantly suppressed IL-6 expression in both normal and inflamed DPCs (p < 0.05). At 48 and 96 h, Biodentine suppressed ALP expression in both normal and inflamed DPCs (p < 0.05). At 48 and 96 h, Biodentine induced DSPP expressions in both normal and inflamed DPCs (p < 0.05). CONCLUSION Biodentine enhanced more DSPP differentiation of both normal and inflamed DPCs under different treatment durations than MTA. CLINICAL RELEVANCE The prognosis of vital pulp therapy may depend on the severity of pulp inflammation which is difficult to be determined in clinical settings. Therefore, Biodentine may enhance odontogenic differentiation in different severity of pulp inflammation imply its clinical indications.
Collapse
Affiliation(s)
- Min-Ching Wang
- Division of Dentistry, Taipei Municipal Hospital, WanFang Branch, Taipei, Taiwan.,Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuo-Wei Chang
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Chun Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Shih Hung
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Medical Research, National Yang Ming Chiao Tung University Hospital, Siaoshe Road, No.169, Yilan, 26058, Taiwan.
| |
Collapse
|
8
|
Khoshbin E, Ghasemi L, Najafi R, Karkehabadi H. Effects of CEM cement and emdogain on proliferation and differentiation of human stem cells from the apical papilla: a comparative in vitro study. Biotechnol Lett 2023; 45:69-81. [PMID: 36550335 DOI: 10.1007/s10529-022-03329-9] [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: 06/03/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study compared the effects of calcium-enriched mixture (CEM) cement, Emdogain (EMD), and their combination (CEM/Emdogain) on the differentiation and proliferation of stem cells from the apical papilla (SCAPs). METHODS In this in vitro, experimental study, SCAPs were isolated from two sound immature impacted third molars and cultured. After ensuring their stemness by detecting cell surface markers they were exposed to CEM cement, Emdogain, and CEM cement coated with Emdogain for 24 and 72 h. The control cells did not undergo any intervention. Cell viability [by methyl thiazolyl tetrazolium (MTT) assay], expression of odontogenic differentiation genes [by quantitative reverse-transcription polymerase chain reaction (qRT-PCR)], and alkaline phosphatase (ALP) activity (by ALP staining kit) were evaluated. Data were analyzed by one-way ANOVA, t-test, and Mann-Whitney test (α = 0.05). RESULTS Cell viability in the CEM cement and CEM/Emdogain groups decreased compared with the control group at 72 h (P < 0.05). Expression of dentin sialophosphoprotein (DSPP), dentin matrix protein 1 (DMP1), bone sialoprotein (BSP) genes, and ALP activity significantly increased in all three experimental groups compared with the control group at both 24 and 72 h. This increase was substantially more significant in CEM/Emdogain group (P > 0.05). The number of mineralized nodules significantly increased in all groups at 72 h, with a higher rate in the CEM/Emdogain group. CONCLUSION All biomaterials increased the differentiation of SCAPs, expression of odontogenic differentiation genes, and ALP activity, but CEM/Emdogain was considerably more effective for this purpose.
Collapse
Affiliation(s)
- Elham Khoshbin
- Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Ghasemi
- Department of Endodontics, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Rezvan Najafi
- Department of Molecular Medicine and Genetics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Karkehabadi
- Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
| |
Collapse
|
9
|
Castro-Jara S, Antilef B, Osbén C, Alcántara R, Fraga M, Nova-Lamperti E, Sánchez-Sanhueza G. Bioactivity analysis of calcium silicate-based sealers and repair cements on the phenotype and cytokine secretion profile of CD14 + monocytes: An ex vivo study. Int Endod J 2023; 56:80-91. [PMID: 36226465 DOI: 10.1111/iej.13847] [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: 01/05/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 12/13/2022]
Abstract
AIM This study evaluated the immune bioactivity of testing media (TM) obtained from different calcium silicate-based sealers and cements on monocyte morphology, activation, differentiation and cytokine secretion. METHODS Blood-derived CD14+ monocytes were isolated and cultured for 5 days with 25% TM from the following calcium silicate-based materials: TotalFill BC RRM Fast-Set Putty, Biodentine, TotalFill BC Sealer and BioRoot-Root-Canal-Sealer (RCS). A resin-based endodontic cement was used as a control. The expression of surface markers such as CD86, HLA-DR, CD16, CD309 and CD209, and cytokine secretion were analysed by flow cytometry. Data were analysed using the one-way repeated measures analysis of variance (anova) multiple comparison test and a Holm-Sidak multiple comparison post-hoc test (p < .05). RESULTS This comparative analysis revealed that monocytes co-cultured with calcium silicate-based materials showed a spindle-shaped morphology compared with the round shape observed in the control. Regarding activation markers, BioRoot-RCS and Biodentine significantly increased CD86 expression compared with the control sample, whereas no significant differences (p > .05) were observed in HLA-DR expression. In addition, no differences were observed among the differentiation markers. When the inflammatory cytokines were analysed, BioRoot-RCS increased the secretion of IL-1β, IL-6, IL-10 and TNF-α, whereas BioRoot-RCS and Biodentine significantly decreased IL-8 production (p < .05). CONCLUSIONS These data showed that the calcium silicate-based materials tested changed the morphology of CD14+ monocytes; however, only BioRoot-RCS and Biodentine significantly upregulated CD86. In addition, BioRoot-RCS was the sealer with the highest immunomodulatory properties for cytokine production which means that it can contribute with the in vivo healing process and regeneration of periapical lesions.
Collapse
Affiliation(s)
- Silvia Castro-Jara
- Department of Restorative Dentistry, Endodontic Discipline, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Bárbara Antilef
- Molecular & Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, School of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Carolina Osbén
- Department of Restorative Dentistry, Endodontic Discipline, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Raúl Alcántara
- Department of Restorative Dentistry, Endodontic Discipline, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Marco Fraga
- Molecular & Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, School of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Estefanía Nova-Lamperti
- Molecular & Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, School of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Gabriela Sánchez-Sanhueza
- Department of Restorative Dentistry, Endodontic Discipline, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| |
Collapse
|
10
|
Estrela C, Cintra LTA, Duarte MAH, Rossi-Fedele G, Gavini G, Sousa-Neto MD. Mechanism of action of Bioactive Endodontic Materials. Braz Dent J 2023; 34:1-11. [PMID: 36888836 PMCID: PMC10027099 DOI: 10.1590/0103-6440202305278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/06/2023] [Indexed: 03/08/2023] Open
Abstract
A continuous search for bioactive materials capable of supporting the replacement of damaged pulp tissue, with effective sealing potential and biocompatibility, has represented the attention of studies over the last decades. This study involves a narrative review of the literature developed by searching representative research in PUBMED/MEDLINE and searches in textbooks associated with the mechanism of action of bioactive materials (calcium hydroxide, mineral trioxide aggregate (MTA), and calcium silicate cements). The reflective analysis of the particularities of the chemical elements of these materials, considering the tissue and antibacterial mechanism of action, allows a better understanding of the characteristics and similarities in their tissue responses. Calcium hydroxide paste remains the antibacterial substance of choice as intracanal dressing for the treatment of root canal system infections. Calcium silicate cements, including MTA, show a favorable biological response with the stimulation of mineralized tissue deposition in sealed areas when in contact with connective tissue. This is due to the similarity between the chemical elements, especially ionic dissociation, the potential stimulation of enzymes in tissues, and the contribution towards an alkaline environment due to the pH of these materials. The behavior of bioactive materials, especially MTA and the new calcium silicate cements in the biological sealing activity, has been shown to be effective. Contemporary endodontics has access to bioactive materials with similar properties, which can stimulate a biological seal in lateral and furcation root perforations, root-end fillings and root fillings, pulp capping, pulpotomy, apexification, and regenerative endodontic procedures, in addition to other clinical conditions.
Collapse
Affiliation(s)
- Carlos Estrela
- School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | | | - Giulio Gavini
- School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
11
|
Expert consensus on regenerative endodontic procedures. Int J Oral Sci 2022; 14:55. [PMID: 36450715 PMCID: PMC9712432 DOI: 10.1038/s41368-022-00206-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 12/05/2022] Open
Abstract
Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
Collapse
|
12
|
Kim Y, Lee D, Kye M, Ha YJ, Kim SY. Biocompatible Properties and Mineralization Potential of Premixed Calcium Silicate-Based Cements and Fast-Set Calcium Silicate-Based Cements on Human Bone Marrow-Derived Mesenchymal Stem Cells. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7595. [PMID: 36363187 PMCID: PMC9654067 DOI: 10.3390/ma15217595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Premixed calcium silicate-based cements (CSCs) and fast-set CSCs were developed for the convenience of retrograde filling during endodontic microsurgery. The aim of this study was to analyze the biocompatible properties and mineralization potential of premixed CSCs, such as Endocem MTA Premixed (EM Premixed) and EndoSequence BC RRM putty (EndoSequence), and fast-set RetroMTA on human bone marrow-derived mesenchymal stem cells (BMSCs) compared to ProRoot MTA. Using CCK-8, a significantly higher proliferation of BMSCs occurred only in the EM Premixed group on days 2 and 4 (p < 0.05). On day 6, the ProRoot MTA group had significantly higher cell proliferation than the control group (p < 0.05). Regardless of the experimental materials, all groups had complete cell migration by day 4. Alizarin Red-S staining and alkaline phosphatase assay demonstrated higher mineralization potential of all CSCs similar to ProRoot MTA (p < 0.05). The EndoSequence group showed more upregulation of SMAD1 and OSX gene expression than the other experimental groups (p < 0.05), and all experimental cements upregulated osteogenic gene expression more than the control group (p < 0.05). Therefore, using premixed CSCs and fast-set CSCs as retrograde filling cements may facilitate satisfactory biological responses and comparable osteogenic potential to ProRoot MTA.
Collapse
Affiliation(s)
- Yemi Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul 07986, Korea
| | - Donghee Lee
- Department of Dentistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Minjoo Kye
- Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Yun-Jae Ha
- Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| |
Collapse
|
13
|
Comparison of MTA versus Biodentine in Apexification Procedure for Nonvital Immature First Permanent Molars: A Randomized Clinical Trial. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030410. [PMID: 35327782 PMCID: PMC8946907 DOI: 10.3390/children9030410] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/06/2022] [Accepted: 03/10/2022] [Indexed: 11/23/2022]
Abstract
This study aimed to evaluate the radiological and clinical outcomes of Biodentine apical plugs compared to mineral trioxide aggregate (MTA) in treating immature molars with apical lesions in children. Materials and Methods: Thirty immature roots of 24 permanent lower first molars with apical lesions were randomly divided into two groups: group 1 (15 roots) treated with MTA apical plugs and group 2 (15 roots) treated with Biodentine apical plugs. Treatment radiological outcomes were assessed using the periapical index (PAI) scale after 6 and 12 months of treatment. The presence or absence of apical calcified barrier (ACB) was assessed after 12 months of treatment. The visual analog scale (VAS) was used to compare the postoperative pain between the two groups after 1, 3, 7, and 14 days of treatment. PAI scores between the two groups were compared using the Mann–Whitney U test, the presence or absence of the ACB was compared using the chi-square test, and the VAS scores were compared using the t-test. The statistical significance threshold was set at 0.05. Results: There were no statistically significant differences in the PAI between the two groups at 6 and 12 months postoperatively. After 12 months, four cases in the Biodentine group showed ACB formation, whereas ACB was not found in any case treated with MTA. The VAS scores were statistically lower in the MTA group on the first day after treatment. Nevertheless, these scores were not statistically significantly different after 3, 7, and 14 days of treatment between the two groups. Conclusions: Biodentine can be used as an apical plug to treat immature permanent molars with apical lesions in a single visit in children. Biodentine showed favorable outcomes in apical lesions healing, which was comparable to MTA but with a decreased treatment time associated with its use.
Collapse
|
14
|
Alharbi H, Khalil W, Alsofi L, Binmadi N, Elnahas A. The effect of low-level laser on the quality of dentin barrier after capping with bioceramic material: A histomorphometric analysis. AUST ENDOD J 2022; 49:27-37. [PMID: 35229961 DOI: 10.1111/aej.12610] [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: 10/14/2021] [Revised: 12/24/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
Abstract
The study aims to investigate the quality of dentin barriers and pulp reaction to EndoSequence Root Repair Material (ERRM) combined with low-level laser application. In eight dogs, pulps were exposed via class V, half of the samples received low-level diode laser at 870 nm. Thereafter, cavities were capped with fast-set or regular-set ERRM. The specimens were processed for histomorphological and immunohistochemical examination after 2 weeks and 2 months. Dentin bridges were observed in all samples, and 87.5% were complete. The low-level laser group had significantly more reparative dentin area than the non-lased group (p < 0.05). The dentin bridges were found to have an unprecedented tubularity of 43%-89%. Tiny dentin island formation was observed within the material particles. Initial mild-to-moderate inflammatory reactions were observed, which subsided after 2 months. RUNX2 and osteocalcin staining were evident for all samples at both time intervals. Low-level laser combined with bioactive ERRM is effective in inducing reparative dentin formation.
Collapse
Affiliation(s)
- Hanan Alharbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Conservative Sciences, Division of Endodontics, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Wafaa Khalil
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Loai Alsofi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada Binmadi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Elnahas
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al Hofuf, Saudi Arabia
| |
Collapse
|
15
|
Effect of biodentine coated with emdogain on proliferation and differentiation of human stem cells from the apical papilla. Mol Biol Rep 2022; 49:3685-3692. [PMID: 35107735 DOI: 10.1007/s11033-022-07208-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study assessed the effect of Biodentine coated with Emdogain (Biodentine/Emdogain) on proliferation and differentiation of human stem cells from the apical papilla (SCAPs). METHODS AND RESULTS: In this in vitro, experimental study, SCAPs were isolated from two immature impacted third molars and cultured. After ensuring the stemness of the cells by assessing the cell surface markers, they were exposed to Biodentine, Emdogain, and Biodentine/Emdogain for 24 and 72 h. The control cells did not receive any intervention. Cell viability was evaluated by the methyl thiazolyl tetrazolium assay. Expression of odontogenic differentiation genes was analyzed by the quantitative reverse transcription polymerase chain reaction. Alkaline phosphatase (ALP) activity was quantified by the respective kit. Data were analyzed by one-way ANOVA, t-test, and Mann-Whitney test (α = 0.05). Cell viability did not change after 24 h of exposure to biomaterials. At 72 h, the viability of the cells exposed to Biodentine and Biodentine/Emdogain decreased compared with the control group. The expression of dentin sialophosphoprotein, dentin matrix protein 1, and bone sialoprotein genes, and ALP activity significantly increased in all three experimental groups, compared with the control group at both 24 and 72 h; this increase was significantly greater in Biodentine/Emdogain group. The number of mineralized nodules significantly increased in all groups after 72 h with a greater rate in Biodentine/Emdogain group. CONCLUSIONS All biomaterials increased the differentiation of SCAPs, expression of odontogenic genes, and ALP activity, but Biodentine/Emdogain was significantly more effective for this purpose.
Collapse
|
16
|
The additive effect of iloprost on the biological properties of Mineral trioxide aggregate on mesenchymal stem cells. J Dent Sci 2022; 17:225-232. [PMID: 35028042 PMCID: PMC8739256 DOI: 10.1016/j.jds.2021.03.018] [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: 02/19/2021] [Revised: 03/28/2021] [Indexed: 12/30/2022] Open
Abstract
Background/purpose Iloprost has been proposed as a potential biomaterial owing to angiogenic and odontogenic properties. However, the liquid form can limit its use during clinical applications. Mineral trioxide aggregate (MTA) has been used for various dental applications in which cell–material interaction is essential. This study aimed to investigate additive effects of iloprost on the biological properties of MTA on the viability, attachment, migration and differentiation of human mesenchymal stem cells (hMSCs). Materials and methods Standardized human dentin disks were prepared. MTA was prepared by mixing distilled water or iloprost solution, and the lumen of the disks was filled with MTA or MTA-iloprost. hMSCs on disk alone and hMSCs on culture plates were used as controls. Cell viability and attachment were measured after 1, 7 and 14 days using AlamarBlue assay and scanning electron microscopy (SEM). Cell migration in MTA or MTA-iloprost extracts was determined using a wound-healing model. Osteogenic differentiation was evaluated by real-time reverse transcriptase polymerase chain reaction for alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OCN), and osteopontin (OSP) gene expressions after 7 and 14 days of osteogenic induction. Results Cells on MTA-iloprost surface showed similar viability with MTA at 1 and 14 days but enhanced cellular viability and cell spreading compared to MTA at 7 days (p < 0.05). Cell migration was similar by MTA-iloprost and MTA extracts (p > 0.05). MTAiloprost significantly upregulated BSP, OCN and OSP expressions compared to MTA (p < 0.05). Conclusion The addition of iloprost to MTA improved the initial cell viability and osteogenic potential of hMSCs.
Collapse
|
17
|
Pedrosa MDS, Nogueira FN, Sipert CR. Calcium silicate-based cements affect the cell viability and the release of TGF-β1 from apical papilla cells. Braz Dent J 2022; 32:1-7. [PMID: 35019013 DOI: 10.1590/0103-6440202104598] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/05/2021] [Indexed: 12/23/2022] Open
Abstract
This study investigated the cytotoxicity and release of Transforming Growth Factor Beta 1 (TGF-β1) from cultured human apical papilla cells (APCs) after application of four bioactive materials. Culture of APCs was established and used for cytotoxic and quantitative assays. Extracts of Biodentine, Bio-C Repair, MTA Repair and White MTA were prepared and diluted (1, 1:4 and 1:16) and used for MTT assays up to 72 h. Total TGF-β1 was quantified by ELISA. Data were analyzed by ANOVA and Tukey's test (α = 0.05). For Biodentine, at 24 h and 48 h, cell viability was lower than control (p < 0.05). At 72 h, only undiluted extract of Biodentine were cytotoxic (p < 0.05). At 24 h, a cytotoxic effect was found for undiluted and 1:4 dilution of Bio-C Repair (p < 0.05). At 48 h, however, Bio-C Repair at 1:4 and 1:8 dilution showed higher cell viability (p < 0.05). At 24 and 48 h, the cell viability for undiluted MTA Repair were higher than control (p < 0.05). For White MTA, at 24 and 48 h, all dilutions were cytotoxic (p < 0.05). All cements led to reduced release of total TGF-β1 from the APCs (p < 0.05). In conclusion, cell viability varied depending on the material and dilution. Only Bio-C repair and MTA repair led to higher cell viability of APCs. All materials induced a decrease in the release of total TGF-β1 from the APCs.
Collapse
Affiliation(s)
- Marlus da Silva Pedrosa
- University of São Paulo- USP, School of Dentistry, Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Fernando Neves Nogueira
- University of São Paulo- USP, School of Dentistry, Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Carla Renata Sipert
- University of São Paulo - USP, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
18
|
Song W, Li S, Tang Q, Chen L, Yuan Z. In vitro biocompatibility and bioactivity of calcium silicate‑based bioceramics in endodontics (Review). Int J Mol Med 2021; 48:128. [PMID: 34013376 PMCID: PMC8136140 DOI: 10.3892/ijmm.2021.4961] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/19/2021] [Indexed: 12/26/2022] Open
Abstract
Calcium silicate-based bioceramics have been applied in endodontics as advantageous materials for years. In addition to excellent physical and chemical properties, the biocompatibility and bioactivity of calcium silicate-based bioceramics also serve an important role in endodontics according to previous research reports. Firstly, bioceramics affect cellular behavior of cells such as stem cells, osteoblasts, osteoclasts, fibroblasts and immune cells. On the other hand, cell reaction to bioceramics determines the effect of wound healing and tissue repair following bioceramics implantation. The aim of the present review was to provide an overview of calcium silicate-based bioceramics currently applied in endodontics, including mineral trioxide aggregate, Bioaggregate, Biodentine and iRoot, focusing on their in vitro biocompatibility and bioactivity. Understanding their underlying mechanism may help to ensure these materials are applied appropriately in endodontics.
Collapse
Affiliation(s)
- Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Shue Li
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Qingming Tang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| |
Collapse
|
19
|
Wang MC, Tu HF, Chang KW, Lin SC, Yeh LY, Hung PS. The molecular functions of Biodentine and mineral trioxide aggregate in lipopolysaccharide-induced inflamed dental pulp cells. Int Endod J 2021; 54:1317-1327. [PMID: 33711171 DOI: 10.1111/iej.13513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
AIM To explore the proliferation, adhesion and differentiation response and the underlying mechanisms that occur in lipopolysaccharide (LPS)-induced inflamed dental pulp cells (DPCs) in contact with Biodentine and mineral trioxide aggregate (MTA). METHODOLOGY The DPCs were isolated from three healthy donors and named DPC-H1 to DPC-H3. The DPCs were pre-cultured with 2 or 5 μg mL-1 LPS for 24 h to induce inflammation. The expression of inflammation marker miR-146a was detected by q-PCR. The normal and LPS-induced DPCs were further treated with 0.14 mg mL-1 Biodentine or 0.13 mg mL-1 MTA for 24 h. MTT assay and adhesion assay were used to analyse the changes of cell phenotypes. DSPP, AKT and ERK expressions were detected by Western blotting. The data were analysed by Mann-Whitney test or two-way anova. Differences were considered statistically significant when P < 0.05. RESULTS In LPS-induced DPCs, Biodentine and MTA treatment neither induced nor aggravated LPS-induced inflammation, but their presence did increase the expression of the odontogenic differentiation marker DSPP. Under 2 or 5 μg mL-1 LPS-induced inflammation, Biodentine and MTA promoted the proliferation of DPC cells, and significantly in DPC-H2 (P < 0.0001 for both reagents). With the treatment of 2 μg mL-1 LPS, the cell adhesion of DPCs on the fibronectin-coated culture plates was increased significantly by Biodentine (P = 0.0413) and MTA (P < 0.0001). Biodentine and MTA regulated cell adhesion on the fibronectin-coated culture plates (P < 0.0001 for both reagents) and proliferation (P < 0.0001 for both reagents) via the AKT pathway. However, the AKT pathway was not involved in the expression of DSPP induced by Biodentine and MTA. CONCLUSION Biodentine and MTA enhanced the proliferation, adhesion and differentiation of LPS-induced DPCs. The proliferation and adhesion process induced by Biodentine and MTA was via the AKT pathway. However, the cellular differentiation process might not use the same pathway, and this needs to be explored in future studies.
Collapse
Affiliation(s)
- M C Wang
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Dentistry, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan.,Taipei Municipal WanFang Hospital, Taipei, Taiwan
| | - H F Tu
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Dentistry, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - K W Chang
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - S C Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - L Y Yeh
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - P S Hung
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Medical Research, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| |
Collapse
|
20
|
Babaki D, Yaghoubi S, Matin MM. The effects of mineral trioxide aggregate on osteo/odontogenic potential of mesenchymal stem cells: a comprehensive and systematic literature review. Biomater Investig Dent 2020; 7:175-185. [PMID: 33313519 PMCID: PMC7717865 DOI: 10.1080/26415275.2020.1848432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/07/2020] [Indexed: 12/12/2022] Open
Abstract
The significance of dental materials in dentin-pulp complex tissue engineering is undeniable. The mechanical properties and bioactivity of mineral trioxide aggregate (MTA) make it a promising biomaterial for future stem cell-based endodontic therapies. There are numerous in vitro studies suggesting the low cytotoxicity of MTA towards various types of cells. Moreover, it has been shown that MTA can enhance mesenchymal stem cells' (MSCs) osteo/odontogenic ability. According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA), a literature review was conducted in the Medline, PubMed, and Scopus databases. Among the identified records, the cytotoxicity and osteo/odontoblastic potential of MTA or its extract on stem cells were investigated. Previous studies have discovered the differentiation-inducing potential of MTA on MSCs, providing a background for dentin-pulp complex cell therapies using the MTA, however, animal trials are needed before moving into clinical trials. In conclusion, MTA can be a promising candidate dental biomaterial for futuristic stem cell-based endodontic therapies.
Collapse
Affiliation(s)
- Danial Babaki
- Department of Biomedical Engineering, Tagliatela College of Engineering, University of New Haven, West Haven, CT, USA
| | - Sanam Yaghoubi
- Visiting Scholar at Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Maryam M. Matin
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
- Novel Diagnostics and Therapeutics Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| |
Collapse
|
21
|
Matichescu A, Ardelean LC, Rusu LC, Craciun D, Bratu EA, Babucea M, Leretter M. Advanced Biomaterials and Techniques for Oral Tissue Engineering and Regeneration-A Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5303. [PMID: 33238625 PMCID: PMC7700200 DOI: 10.3390/ma13225303] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
The reconstruction or repair of oral and maxillofacial functionalities and aesthetics is a priority for patients affected by tooth loss, congenital defects, trauma deformities, or various dental diseases. Therefore, in dental medicine, tissue reconstruction represents a major interest in oral and maxillofacial surgery, periodontics, orthodontics, endodontics, and even daily clinical practice. The current clinical approaches involve a vast array of techniques ranging from the traditional use of tissue grafts to the most innovative regenerative procedures, such as tissue engineering. In recent decades, a wide range of both artificial and natural biomaterials and scaffolds, genes, stem cells isolated from the mouth area (dental follicle, deciduous teeth, periodontal ligament, dental pulp, salivary glands, and adipose tissue), and various growth factors have been tested in tissue engineering approaches in dentistry, with many being proven successful. However, to fully eliminate the problems of traditional bone and tissue reconstruction in dentistry, continuous research is needed. Based on a recent literature review, this paper creates a picture of current innovative strategies applying dental stem cells for tissue regeneration in different dental fields and maxillofacial surgery, and offers detailed information regarding the available scientific data and practical applications.
Collapse
Affiliation(s)
- Anamaria Matichescu
- Department of Preventive Dentistry, Community and Oral Health, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Dragos Craciun
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Emanuel Adrian Bratu
- Department of Implant Supported Restorations, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Marius Babucea
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Marius Leretter
- Department of Prosthodontics, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
| |
Collapse
|
22
|
Song W, Sun W, Chen L, Yuan Z. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Front Bioeng Biotechnol 2020; 8:580954. [PMID: 33195142 PMCID: PMC7658386 DOI: 10.3389/fbioe.2020.580954] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Endodontic therapy aims to preserve or repair the activity and function of pulp and periapical tissues. Due to their excellent biological features, a substantial number of calcium silicate-based bioceramics have been introduced into endodontics and simultaneously increased the success rate of endodontic treatment. The present manuscript describes the in vivo biocompatibility and bioactivity of four types of calcium silicate-based bioceramics in endodontics.
Collapse
Affiliation(s)
- Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Wei Sun
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| |
Collapse
|
23
|
Abstract
Two increasingly common endodontic procedures, vital pulp therapy (VPT) and regenerative endodontic procedures, rely on dental tissue regeneration/repair mechanisms with the aid of biomaterials. These materials are applied in close contact to the pulpal tissue and are required to be biocompatible, form an antimicrobial seal, not induce staining, and be easy to manipulate. Historically, calcium hydroxide played an important role in VPT. However, over the last 3 decades, significant efforts in research and industry have been made to develop various biomaterials, including hydraulic tricalcium silicate cements. The present review summarized various hydraulic tricalcium silicate cements and their biological properties in clinical procedures, namely VPT and regenerative endodontic procedures.
Collapse
|
24
|
Sanz JL, Forner L, Almudéver A, Guerrero-Gironés J, Llena C. Viability and Stimulation of Human Stem Cells from the Apical Papilla (hSCAPs) Induced by Silicate-Based Materials for Their Potential Use in Regenerative Endodontics: A Systematic Review. MATERIALS 2020; 13:ma13040974. [PMID: 32098171 PMCID: PMC7078727 DOI: 10.3390/ma13040974] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/13/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022]
Abstract
Blood clot formation in the apical third of the root canal system has been shown to promote further root development and reinforcement of dentinal walls by the deposition of mineralized tissue, resulting in an advancement from traditional apexification procedures to a regenerative endodontic treatment (RET) for non-vital immature permanent teeth. Silicate-based hydraulic biomaterials, categorized as bioactive endodontic cements, emerged as bright candidates for their use in RET as coronal barriers, sealing the previously induced blood clot scaffold. Human stem cells from the apical papilla (hSCAPs) surviving the infection may induce or at least be partially responsible for the regeneration or repair shown in RET. The aim of this study is to present a qualitative synthesis of available literature consisting of in vitro assays which analyzed the viability and stimulation of hSCAPs induced by silicate-based hydraulic biomaterials. A systematic electronic search was carried out in Medline, Scopus, Embase, Web of Science, Cochrane and SciELO databases, followed by a study selection, data extraction, and quality assessment following the PRISMA protocol. In vitro studies assessing the viability, proliferation, and/or differentiation of hSCAPs as well as their mineralization potential and/or osteogenic, odontogenic, cementogenic and/or angiogenic marker expression in contact with commercially available silicate-based materials were included in the present review. The search identified 73 preliminary references, of which 10 resulted to be eligible for qualitative synthesis. The modal materials studied were ProRoot MTA and Biodentine. Both bioceramic materials showed significant positive results when compared to a control for hSCAP cell viability, migration, and proliferation assays; a significant up-regulation of hSCAP odontogenic/osteogenic marker (ALP, DSPP, BSP, Runx2, OCN, OSX), angiogenic growth factor (VEGFA, FIGF) and pro-inflammatory cytokine (IL-1α, IL-1β, IL-6, TNF-α) expression; and a significant increase in hSCAP mineralized nodule formation assessed by Alizarin Red staining. Commercially available silicate-based materials considered in the present review can potentially induce mineralization and odontogenic/osteogenic differentiation of hSCAPs, thus prompting their use in regenerative endodontic procedures.
Collapse
Affiliation(s)
- José Luis Sanz
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
| | - Leopoldo Forner
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
- Correspondence: ; Tel.: +34-96386-4175
| | - Alicia Almudéver
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
| | - Julia Guerrero-Gironés
- Special Care and Gerodontology Unit, Department of Stomatology, University of Murcia, 30100 Murcia, Spain;
| | - Carmen Llena
- Dental Pathology and Therapeutics Unit, Department of Stomatology, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (A.A.); (C.L.)
| |
Collapse
|
25
|
França CM, Tahayeri A, Rodrigues NS, Ferdosian S, Puppin Rontani RM, Sereda G, Ferracane JL, Bertassoni LE. The tooth on-a-chip: a microphysiologic model system mimicking the biologic interface of the tooth with biomaterials. LAB ON A CHIP 2020; 20:405-413. [PMID: 31854401 PMCID: PMC7395925 DOI: 10.1039/c9lc00915a] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The tooth has a unique configuration with respect to biomaterials that are used for its treatment. Cells inside of the dental pulp interface indirectly with biomaterials via a calcified permeable membrane, formed by the dentin matrix and several thousands of dentinal tubules (∼2 μm in diameter). Although the cytotoxic response of the dental pulp to biomaterials has been extensively studied, there is a shortage of in vitro model systems that mimic the dentin-pulp interface and enable an improved understanding of the morphologic, metabolic and functional influence of biomaterials on live dental pulp cells. To address this shortage, here we developed an organ-on-a-chip model system which integrates cells cultured directly on a dentin wall within a microfluidic device that replicates some of the architecture and dynamics of the dentin-pulp interface. The tooth-on-a-chip is made out of molded polydimethylsiloxane (PDMS) with a design consisting of two chambers separated by a dentin fragment. To characterize pulp cell responses to dental materials on-chip, stem cells from the apical papilla (SCAPs) were cultured in odontogenic medium and seeded onto the dentin surface, and observed using live-cell microscopy. Next, to evaluate the tooth-on-a-chip as a platform for materials testing, standard dental materials used clinically (2-hydroxyethylmethacrylate - HEMA, phosphoric acid - PA, and Adper-Scotchbond - SB) were tested for cytotoxicity, cell morphology, and metabolic activity on-chip, and compared against standardized off-chip controls. All dental materials had cytotoxic effects in both on-chip and off-chip systems in the following order: HEMA > SB > PA (p < 0.05), and cells presented consistently higher metabolic activity on-chip than off-chip (p < 0.05). Furthermore, the tooth-on-a-chip enabled real-time tracking of gelatinolytic activity in a model hybrid layer (HL) formed in the microdevice, which suggests that dental pulp cells may contribute to the proteolytic activity in the HL more than endogenous proteases. In conclusion, the tooth-on-a-chip is a novel platform that replicates near-physiologic conditions of the pulp-dentin interface and enables live-cell imaging to study dental pulp cell response to biomaterials.
Collapse
Affiliation(s)
- Cristiane Miranda França
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
| | - Anthony Tahayeri
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
| | - Nara Sousa Rodrigues
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Shirin Ferdosian
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
| | | | - Grigoriy Sereda
- Department of Chemistry, University of South Dakota, Vermillion, SD, USA
| | - Jack L Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
| | - Luiz E Bertassoni
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA. and Center for Regenerative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA and Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA and Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Portland, OR, USA
| |
Collapse
|
26
|
Cymerman JJ, Nosrat A. Regenerative Endodontic Treatment as a Biologically Based Approach for Non-Surgical Retreatment of Immature Teeth. J Endod 2020; 46:44-50. [DOI: 10.1016/j.joen.2019.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/07/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022]
|
27
|
Wattanapakkavong K, Srisuwan T. Release of Transforming Growth Factor Beta 1 from Human Tooth Dentin after Application of Either ProRoot MTA or Biodentine as a Coronal Barrier. J Endod 2019; 45:701-705. [DOI: 10.1016/j.joen.2019.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/08/2019] [Accepted: 03/16/2019] [Indexed: 12/28/2022]
|
28
|
Influence of ultrasonic agitation on bond strength, marginal adaptation, and tooth discoloration provided by three coronary barrier endodontic materials. Clin Oral Investig 2019; 23:4113-4122. [DOI: 10.1007/s00784-019-02850-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
|
29
|
Giacomino CM, Wealleans JA, Kuhn N, Diogenes A. Comparative Biocompatibility and Osteogenic Potential of Two Bioceramic Sealers. J Endod 2019; 45:51-56. [DOI: 10.1016/j.joen.2018.08.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/04/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022]
|
30
|
Torabinejad M, Alexander A, Vahdati SA, Grandhi A, Baylink D, Shabahang S. Effect of Residual Dental Pulp Tissue on Regeneration of Dentin-pulp Complex: An In Vivo Investigation. J Endod 2018; 44:1796-1801. [DOI: 10.1016/j.joen.2018.09.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/29/2018] [Accepted: 09/09/2018] [Indexed: 12/19/2022]
|
31
|
Estrela C, Decurcio DDA, Rossi-Fedele G, Silva JA, Guedes OA, Borges ÁH. Root perforations: a review of diagnosis, prognosis and materials. Braz Oral Res 2018; 32:e73. [DOI: 10.1590/1807-3107bor-2018.vol32.0073] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/22/2022] Open
|
32
|
Nagas E, Uyanik MO, Cehreli ZC. Revitalization of necrotic mature permanent incisors with apical periodontitis: a case report. Restor Dent Endod 2018; 43:e31. [PMID: 30135850 PMCID: PMC6103546 DOI: 10.5395/rde.2018.43.e31] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023] Open
Abstract
Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.
Collapse
Affiliation(s)
- Emre Nagas
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - M Ozgur Uyanik
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| |
Collapse
|