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Saghiri MA, Vakhnovetsky J, Samadi E, Napoli S, Samadi F, Conte M, Morgano SM. Effects of Diabetes on Elemental Levels and Nanostructure of Root Canal Dentin. J Endod 2023; 49:1169-1175. [PMID: 37429496 DOI: 10.1016/j.joen.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/26/2023] [Accepted: 07/02/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION This study evaluated the effects of diabetes mellitus (DM) on the nanostructure of root canal dentin using high-resolution transmission electron microscopy (HRTEM) and inductively coupled plasma mass spectrometry (ICP-MS). METHODS Twenty extracted human premolars from diabetic and nondiabetic patients (n = 10 in each group) were decoronated and sectioned horizontally into 40 2-mm-thick dentin discs, with each disc designated for a specific test. ICP-MS was used to determine the different elemental levels of copper, lithium, zinc, selenium, strontium, manganese, and magnesium in diabetic and nondiabetic specimens. HRTEM was used to analyze the shape and quantity of the apatite crystals in diabetic and nondiabetic dentin at the nanostructural level. Statistical analysis was performed using Kolmogorov-Smirnov and Student t test (P < .05). RESULTS ICP-MS revealed significant differences in trace element concentrations between the diabetic and nondiabetic specimens (P < .05), with lower levels of magnesium, zinc, strontium, lithium, manganese, and selenium (P < .05), and higher levels of copper in diabetic specimens (P < .05). HRTEM revealed that diabetic dentin exhibited a less compact structure with smaller crystallites and significantly more crystals in the 2500 nm2 area (P < .05). CONCLUSION Diabetic dentin exhibited smaller crystallites and altered elemental levels more than nondiabetic dentin, which could explain the higher root canal treatment failure rate in diabetic patients.
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Affiliation(s)
- Mohammad Ali Saghiri
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey; Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California.
| | - Julia Vakhnovetsky
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, New Jersey; Biomaterial and Prosthodontics Laboratory, Rutgers School of Dental Medicine, Newark, New Jersey; University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Elham Samadi
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, New Jersey; Biomaterial and Prosthodontics Laboratory, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Salvatore Napoli
- Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Fatereh Samadi
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, New Jersey; Biomaterial and Prosthodontics Laboratory, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Michael Conte
- Office of Clinical Affairs, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Steven M Morgano
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey
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Chen Q, Wang Y, Shuai J. Current status and future prospects of stomatology research. J Zhejiang Univ Sci B 2023; 24:853-867. [PMID: 37752088 PMCID: PMC10522564 DOI: 10.1631/jzus.b2200702] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/27/2023] [Indexed: 08/08/2023]
Abstract
Research in stomatology (dental medicine) continues to expand globally and is oriented towards solving clinical issues, focusing on clarifying the clinical relevance and potential mechanisms of oral-systemic connections via clinical epidemiology, oral microecological characterization, and the establishment of animal models. Interdisciplinary integration of materials science and tissue engineering with stomatology is expected to lead to the creation of innovative materials and technologies to better resolve the most prevalent and challenging clinical issues such as peri-implantitis, soft and hard tissue defects, and dentin hypersensitivity. With the rapid development of artificial intelligence (AI), 5th generation mobile communication technology (5G), and big data applications, "intelligent stomatology" is emerging to build models for better clinical diagnosis and management, accelerate the reform of education, and support the growth and advancement of scientific research. Here, we summarized the current research status, and listed the future prospects and limitations of these three aspects, aiming to provide a basis for more accurate etiological exploration, novel treatment methods, and abundant big data analysis in stomatology to promote the translation of research achievements into practical applications for both clinicians and the public.
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Affiliation(s)
- Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China.
| | - Yahui Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Jing Shuai
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
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Saghiri MA, Saghiri AM, Samadi E, Nath D, Vakhnovetsky J, Morgano SM. Neural network approach to evaluate the physical properties of dentin. Odontology 2023; 111:68-77. [PMID: 35819652 DOI: 10.1007/s10266-022-00726-4] [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: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 01/06/2023]
Abstract
This study intended to evaluate the effects of inorganic trace elements such as magnesium (Mg), strontium (Sr), and zinc (Zn) on root canal dentin using an Artificial Neural Network (ANN). The authors obtained three hundred extracted human premolars from type II diabetic individuals and divided them into three groups according to the solutions used (Mg, Sr, or Zn). The authors subdivided the specimens for each experimental group into five subgroups according to the duration for which the authors soaked the teeth in the solution: 0 (control group), 1, 2, 5, and 10 min (n = 20). The authors then tested the specimens for root fracture resistance (RFR), surface microhardness (SμH), and tubular density (TD). The authors used the data obtained from half of the specimens in each subgroup (10 specimens) for the training of ANN. The authors then used the trained ANN to evaluate the remaining data. The authors analyzed the data by Kolmogorov-Smirnov, one-way ANOVA, post hoc Tukey, and linear regression analysis (P < 0.05). Treatment with Mg, Sr, and Zn significantly increased the values of RFR and SμH (P < 0.05), and decreased the values of TD in dentin specimens (P < 0.05). The authors did not notice any significant differences between evaluations by manual or ANN methods (P > 0.05). The authors concluded that Mg, Sr, and Zn may improve the RFR and SμH, and decrease the TD of root canal dentin in diabetic individuals. ANN may be used as a reliable method to evaluate the physical properties of dentin.
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Affiliation(s)
- Mohammad Ali Saghiri
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, 185 South Orange Avenue, Newark, NJ, 07103, USA. .,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | - Ali Mohammad Saghiri
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Elham Samadi
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Devyani Nath
- Biomaterial Research Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Julia Vakhnovetsky
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA.,Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Steven M Morgano
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
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Saghiri MA, Sheibani N, Kawai T, Nath D, Dadvand S, Amini S, Vakhnovetsky J, Morgano SM. Diabetes Negatively Affects Tooth Enamel and Dentine Microhardness: An In-vivo Study. Arch Oral Biol 2022; 139:105434. [DOI: 10.1016/j.archoralbio.2022.105434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/25/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022]
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Alsamahi S, Milne TM, Hussaini H, Rich AM, Friedlander LT. Type 2 diabetes and the clinically normal pulp - An in-vitro study. Int Endod J 2022; 55:660-671. [PMID: 35322881 PMCID: PMC9324782 DOI: 10.1111/iej.13732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/15/2022]
Abstract
Aim The aim of this study was to investigate the effect of type 2 diabetes (T2D) on clinically normal dental pulp tissue by using special stains and immunohistochemistry (IHC) to determine the morphology of the coronal pulp and distribution of immune markers in non‐T2D and T2D groups. Methodology Ethics approval for this in vitro pilot study was obtained from the University of Otago Human Ethics Committee (16/069). Twenty extracted permanent molar teeth diagnosed as having clinically normal pulp status were collected. Ten teeth were from participants with well‐controlled T2D and ten from participants without diabetes (non‐T2D). Each tooth was sectioned transversely at the cemento‐enamel junction before the crowns were decalcified and embedded in paraffin. Sections were stained with haematoxylin and eosin, Massons trichrome, and van Gieson stains for histological and morphological evaluation. IHC using anti‐CD4, anti‐CD68 and anti‐CD83 and anti‐IL1β, anti‐IL6, anti‐IL17, anti‐TNF‐α, anti‐TLR2, anti‐TLR4 and anti‐FOXP3 identified proteins of interest. Qualitative and semi‐quantitative analyses evaluated the morphology of the dental pulp and protein expression. Data analyses were performed with GraphPad Prism, using Student's t‐test and multiple regression using SPSS at p < .05. Results Special stains demonstrated morphological differences in the T2D dental pulp compared with non‐T2D. Qualitative analysis indicated that the pulp in the T2D samples was consistently less cellular, less vascular, showed evidence of thickened blood vessel walls, increased pulp calcification and collagen deposition. Semi‐quantitative analysis of IHC samples showed the T2D pulp had significantly increased expression of macrophage and dendritic cell markers CD68 (p < .001) and CD83 (p = .04), and there was significantly greater expression of inflammatory cytokines IL1β (p = .01), IL6 (p < .0001), IL17 (p < .0001) and TNF‐α (p = .01). T2D samples showed a significant increase in markers of innate inflammation, TLR2 (p < .001) and TLR4 (p < .001) and decreased expression of regulatory T‐cell marker, FOXP3 (p = .01). Multiple regression showed that age‐corrected differences were statistically significant. Conclusion Preliminary findings suggest that T2D may exert a similar response in the pulp to complications in other body sites. Hyperglycaemia is associated with changes in the morphology of the clinically normal dental pulp with altered immune cell and cytokine expression.
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Affiliation(s)
- S Alsamahi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - T M Milne
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - H Hussaini
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - A M Rich
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - L T Friedlander
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
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Saghiri MA, Freag P, Nath D, Morgano SM. The effect of diabetes on the tensile bond strength of a restorative dental composite to dentin. Odontology 2022; 110:648-654. [PMID: 35246807 DOI: 10.1007/s10266-022-00697-6] [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: 09/02/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
This study was performed to evaluate the effect of diabetes mellitus (DM) on the tensile bond strength (TBS) of dental composite resin bonding to enamel and dentin of extracted human teeth. Thirty caries-free human premolar teeth (10 from type 1 DM (D1), 10 from type 2 DM (D2), and 10 from non-diabetic individuals (control)) were wet ground and polished to obtain flat surfaces of dentin (n = 10). 37% phosphoric acid was used to etch dentin specimens for 15 s. After the application of the adhesive system, the composite resins were applied and cured for 20 s. Then, specimens were subjected to TBS testing by Universal Testing Machine (1 mm/min). One specimen from each group was prepared and observed under a scanning electron microscope (SEM) and a dot map was generated. Data were analyzed by ANOVA and post hoc Tukey tests (α = 0.05). The TBS values were significantly higher in the control group compared to the D1 and D2 groups (P < 0.05). Between DM groups, D2 values were significantly higher than those in the D1 group. Unlike DM groups, the zigzag fracture pattern was only noticed in the control group. DM adversely affected the TBS of dental composite resins to dentin; this negative effect is more exaggerated by type 1 DM than type 2 DM.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, MSB C639A-Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ, 07103, USA. .,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | | | - Devyani Nath
- Biomaterial and Prosthodontic Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Steven M Morgano
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
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The effect of diabetes mellitus on the shear bond strength of composite resin to dentin and enamel. Odontology 2021; 110:92-98. [PMID: 34318336 DOI: 10.1007/s10266-021-00641-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Diabetes mellitus might be linked to the deterioration of certain physical properties of dentin and enamel. This study aimed to determine the effect of two types of diabetes on the shear bond strength of enamel and dentin, by using the single bond universal bonding system. Sixty specimens [from 15 teeth; 5 from each group-non-diabetic (ND), Diabetic type I (D1), and Diabetic type II (D2)], were prepared with equal amounts of dentin (n = 5) and enamel (n = 5). Enamel specimens (E20) were etched with 37% phosphoric acid, for 20 s, and dentin specimens (D15) were etched for 15 s. A standard shear bond strength test was performed on all specimens. Their failure modes were also studied under a scanning electron microscope, and the data were analyzed by using ANOVA and Post Hoc Tukey's test (a = 0.050). For the enamel groups, significant differences were only noticed between the ND and D1 (P < 0.050) groups, and between the ND and D2 (P < 0.050) groups. In the dentin groups, there was a significant difference only between the ND and D1 (P < 0.050) groups. The micrographs showed that the ND group had the highest number of specimens with cohesive failure and D1 had the highest number of specimens with adhesive failure. It can be concluded that both types of diabetes reduce the shear bond strength of composite resin on dentin and enamel. However, it seems that the negative effect of diabetes on shear bond strength of dental composite resin is more drastic in individuals with type I diabetes as compared with type II.
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Saghiri MA, Nath D, Rahmani B, Amini S, Karamifar K, Peters OA. The effect of diabetes on Fracture Resistance of Teeth: An in vitro study. AUST ENDOD J 2021; 47:499-505. [PMID: 33813800 DOI: 10.1111/aej.12512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
The root fracture resistance (RFR) of premolars extracted from diabetic patients and the effect of biomaterials: white mineral trioxide aggregate (WMTA) and WMTA+Na2 HPO4 as an additive, on enhancing RFR were evaluated. Diabetic and non-diabetic teeth were divided into 4 subgroups (n = 5): root canals were obturated with WMTA, WMTA+Na2 HPO4 , gutta-percha and one unfilled (control). A plunger (1 mm diameter) applied a downward compressive load with crosshead speed of 1 mm min-1 on the specimens mounted on resin blocks, and the ultimate force to fracture was measured. The mean RFR values of diabetic specimens were significantly lower. The lowest and highest means of RFR were recorded in the control and WMTA, in normal group and the control and WMTA+Na2 HPO4 in the diabetic group, respectively. The RFR in diabetic patients was significantly lower, indicating their higher susceptibility to fracture under vertical forces. The use of WMTA (with or without Na2 HPO4 ) for obturation enhances the RFR.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA.,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Devyani Nath
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, NJ, USA
| | - Behnam Rahmani
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Saied Amini
- Statistics Department, George Washington University, Washington, DC, USA
| | - Kasra Karamifar
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Ove A Peters
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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