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Bahammam LA, Alsharqawi W, Bahammam HA, Mounir M. Histological Evaluation of Pulpal Response and Dentin Bridge Formation After Direct Pulp Capping Using Recombinant Amelogenin and Mineral Trioxide Aggregate (MTA). Cureus 2024; 16:e54560. [PMID: 38516479 PMCID: PMC10957103 DOI: 10.7759/cureus.54560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
The purpose of the study was to compare and histologically investigate pulpal response and dentin bridge formation after direct pulp capping using recombinant amelogenin and mineral trioxide aggregate (MTA). Recombinant amelogenin protein and MTA were used as pulp capping materials in 120 teeth from eight mongrel dogs. Dogs were sacrificed at two different evaluation times. Regenerative changes were evaluated histologically. At two weeks, in contrast to the MTA group, most of the amelogenin group showed moderately formed hard tissue formation and the pulp tissue was completely filling the entire pulp chamber. These results were statistically significant. At two months, all the samples of the amelogenin group showed complete dentin bridge formation and the pulp chamber was filled entirely with tissue-mimicking the authentic pulp in all the specimens of the amelogenin group. These results were statistically significant. In conclusion, direct pulp capping by recombinant amelogenin protein resulted in significantly better regeneration of the dentin-pulp complex than MTA.
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Affiliation(s)
- Laila A Bahammam
- Department of Endodontics, King Abdulaziz University, Jeddah, SAU
| | | | - Hammam A Bahammam
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Maha Mounir
- Department of Oral Diagnostic Sciences, King Abdulaziz University, Jeddah, SAU
- Department of Oral Biology, Future University, Cairo, EGY
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Ataş O, Bılge K, Yıldız S, Dundar S, Calik I, Gezer Ataş A, Bozoglan A. Systemic effect of calcium silicate-based cements with different radiopacifiers-histopathological analysis in rats. PeerJ 2023; 11:e15376. [PMID: 37312877 PMCID: PMC10259441 DOI: 10.7717/peerj.15376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/18/2023] [Indexed: 06/15/2023] Open
Abstract
Aim This in vivo study aimed to examine the systemic effects of contemporary calcium silicate cements (CSC) contain different radiopacifiers in rats. Materials & Methods Polyethylene tubes filled with BIOfactor MTA (BIO), Neo MTA Plus (NEO), MTA Repair HP (REP), Biodentine (DENT) and empty tubes (control group) were implanted into the subcutaneous tissues of 80 male Spraque Dawley rats for 7 and 30 days (n = 8). After 7 and 30 day, samples of liver and kidney tissues were submitted to histopathological analysis. Blood samples were collected to evaluate changes in hepatic and renal functions of rats. Wilcoxon and post hoc Dunn Bonferroni tests were used to compare between the 7th and 30th days in order to evaluate the histopathological data. Paired-sample t-test was used to compare laboratory values between the 7th and 30th days, ANOVA analysis and a post hoc Tukey test were used to compare values between groups (p < 0.05). Results On the 7th day, REP, BIO and NEO groups were statistically similar in kidney tissue and the degree of inflammation was found to be significantly higher in these groups compared to the control and DENT groups. On the 30th day, the degree of inflammation of the REP and NEO groups in the kidney tissue was found to be significantly higher than the control, BIO and DENT groups. Although the inflammation in the liver was moderate and mild on the 7th and 30th days, no statistically significant difference was observed between the groups. Vascular congestion was evaluated as mild and moderate in kidney and liver in all groups, and no statistically significant difference was observed between the groups. While there was no statistically significant difference between the groups in the 7th day AST, ALT and urea values, when the creatinine values were compared, the DENT and NEO groups were found to be statistically similar and significantly lower than the control group. On the 30th day, ALT values were statistically similar between the groups. The AST values of the BIO group were found to be significantly higher than the DENT group. While BIO, DENT, NEO and control groups had statistically similar urea values, the REP group was found to be significantly higher than the other groups. The creatinine value of the REP group was significantly higher than the groups other than the control group (p < 0.05). Conclusion CSCs with different radiopacifiers had similar and acceptable effects on the histological examination of the kidneys and liver systemically, and serum ALT, AST, urea, creatinine levels.
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Affiliation(s)
- Osman Ataş
- Faculty of Dentistry, Department of Pediatric Dentistry, Firat (Euphrates) University, Elazig, Turkey
| | - Kubra Bılge
- Faculty of Dentistry, Department of Restorative Dentistry, Firat University, Elazig, Turkey
| | - Semsettin Yıldız
- Faculty of Dentistry, Department of Pediatric Dentistry, Firat (Euphrates) University, Elazig, Turkey
| | - Serkan Dundar
- Faculty of Dentistry, Department of Periodontology, Firat (Euphrates) University, Elazig, Turkey
| | - Ilknur Calik
- Faculty of Medicine, Department of Pathology, Firat (Euphrates) University, Elazig, Turkey
| | | | - Alihan Bozoglan
- Faculty of Dentistry, Department of Periodontology, Firat (Euphrates) University, Elazig, Turkey
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Pelepenko LE, Marciano MA, Francati TM, Bombarda G, Bessa Marconato Antunes T, Sorrentino F, Martin RA, Boanini E, Cooper PR, Shelton RM, Camilleri J. Can strontium replace calcium in bioactive materials for dental applications? J Biomed Mater Res A 2022; 110:1892-1911. [PMID: 35770805 PMCID: PMC9796236 DOI: 10.1002/jbm.a.37421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 01/01/2023]
Abstract
The substitution of calcium with strontium in bioactive materials has been promising but there has been some concern over the material instability and possible toxicity. The aim of this research was the synthesis and characterization of calcium and strontium substituted bioactive materials and assessment of interactions with local tissues and peripheral elemental migration in an animal model. A bioactive glass, hydroxyapatite and hydraulic calcium silicate with 50% or 100% calcium substitution with strontium were developed and the set materials were characterized immediately after setting and after 30 and 180-days in solution. Following subcutaneous implantation, the local (tissue histology, elemental migration) and systemic effects (elemental deposition after organ digestion) were assessed. The strontium-replaced silicate cements resulted in the synthesis of partially substituted phases and strontium leaching at all-time points. The strontium silicate implanted in the animal model could not be retrieved in over half of the specimens showing the high rate of material digestion. Tissue histology showed that all materials caused inflammation after 30 days of implantation however this subsided and angiogenesis occurred after 180 days. Strontium was not detected in the local tissues or the peripheral organs while all calcium containing materials caused calcium deposition in the kidneys. The tricalcium silicate caused elemental migration of calcium and silicon in the local tissues shown by the elemental mapping but no deposition of calcium was identified in the peripheral organs verified by the assessment of the digested tissues. Strontium can substitute calcium in bioactive materials without adverse local or systemic effects.
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Affiliation(s)
| | | | | | - Gabriela Bombarda
- School of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | | | | | | | - Elisa Boanini
- Department of Chemistry, “Giacomo Ciamician”University of BolognaBolognaItaly
| | - Paul Roy Cooper
- Department of Oral ScienceSir John Walsh Research Institute, University of OtagoDunedinNew Zealand
| | - Richard Michael Shelton
- School of Dentistry, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Josette Camilleri
- School of Dentistry, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
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4
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Hosseinpour S, Gaudin A, Peters OA. A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials. Int Endod J 2022; 55 Suppl 2:346-369. [PMID: 35124840 PMCID: PMC9315036 DOI: 10.1111/iej.13701] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.
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Affiliation(s)
- S Hosseinpour
- School of Dentistry The University of Queensland Herston QLD Australia
| | - A Gaudin
- Inserm UMR 1229 RMeS, Regenerative Medicine and Skeleton Université de Nantes ONIRIS Nantes France
- Université de Nantes UFR Odontologie Nantes France
| | - O A Peters
- School of Dentistry The University of Queensland Herston QLD Australia
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5
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Periodontal Tissue Reaction Consecutive Implantation of Endodontic Materials and Subsequent Integration of Complex Oral Rehabilitation Treatments. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Oral rehabilitation is a main branch of dentistry focused on diagnosing the patient’s problem and creating a treatment plan to restore aesthetics, recondition morphologically all components, and recover the functionality of the oral cavity. Biological compatibility of the materials used has a major importance, due to the direct contact with essential tissues, such as the soft and hard tissue of the periodontium and the potential influence on the outcome of the treatment. The present material aims to assess the inflammatory response after subcutaneous implantation of three materials frequently used in endodontics (Mineral Trioxide Aggregate—MTA, DiaRoot BioAggregate, and Sealapex). The evaluation of the reparative tissue reaction after 7, 30, and 60 days, respectively, subsequent to in vivo implantation, was carried out through electron microscopy imaging. Moreover, evaluation of the dynamics of the osteogenesis process was an indicator for the maintenance of internal homeostasis in the context of complex intraoral rehabilitation treatments that include fixed prosthodontics correlated with the particular periodontal-aesthetic aspects and completed by cranio-mandibular repositioning. Our study showed increased absolute values of alkaline phosphatase in all material-implanted cases (more pronounced in MTA and Bio Aggregate), highlighting that this enzyme could be an effective indicator of bone formation, which takes place after the material implantation, with the most significant elevated values at 30 days postoperatively.
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de Azevedo Queiroz ÍO, Machado T, Alves CC, Vasques AMV, Cury MTS, Vasconcelos BC, Gomes-Filho JE, Vivan RR, Braga T, Love RM, Duarte MAH. Tracing the toxic ions of an endodontic tricalcium silicate-based sealer in local tissues and body organs. J Trace Elem Med Biol 2021; 68:126856. [PMID: 34560425 DOI: 10.1016/j.jtemb.2021.126856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to track the toxic ions released by MTA Fillapex, BioRoot RCS, and an experimental tricalcium silicate-based sealer (CEO) into local and distant tissues as well as to investigate their potential adverse effects. In addition, the chemical constituents of the sealers were also evaluated. The main components of the dry powders, pastes, and mixed sealers were characterized. MATERIAL AND METHODS Dry powder and sealer discs were each set for 72 h and their main components were characterized by energy dispersive X-ray spectroscopy. Polyethylene tubes filled with sealers were used to measure silicon and calcium ions. Polyethylene tubes filled with sealers or empty tubes were implanted into the dorsal connective tissue of Wistar rats. On days 7, 15, 30, and 45, the animals were euthanized and their brains, livers, kidneys, and subcutaneous tissues were removed and processed to determine the concentrations of chromium, cobalt, copper, lead, iron, magnesium and nickel using an inductively coupled plasma optical emission spectrometer. RESULTS The main compounds in all sealers were carbon, oxygen, silicon, and calcium. MTA Fillapex release more Si while highest levels of Si were found in presence of BioRoot. The release of Si and Ca ions promoted by MTA Fillapex raise by time. No traces of cobalt, chromium, or magnesium were detected in any tissue. Irrespective of the sealer, no traces of copper and lead were found in the subcutaneous tissue; however, they were observed in the organs. The highest concentration of iron was identified in the liver. All sealers exhibited similar nickel traces in the brain, kidney, and liver except for MTA Fillapex, which demonstrated levels higher than CEO in the subcutaneous tissue on day 7. Tracing nickel ions over time revealed that lowest concentrations were found in subcutaneous tissue. CONCLUSION Taken together, our data demonstrate that CEOs have chemical compositions similar to those of other commercial sealers. Furthermore, none of them exhibited a threat to systemic health. Moreover, the minimal amounts of iron and nickel detected were not related to the sealers.
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Affiliation(s)
| | - Thiago Machado
- Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Camila Carneiro Alves
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Ana Maria Veiga Vasques
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | | | - Bruno Carvalho Vasconcelos
- Departmento de Endodontia, Faculdade de Odontologia da Universidade Federal do Ceará - Campus de Sobral, UFC, Sobral, Brazil
| | - João Eduardo Gomes-Filho
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Rodrigo Ricci Vivan
- Departmento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, FOB/USP, Bauru, Brazil
| | - Tiago Braga
- School of Medicine and Dentistry Griffith University, Queensland, Australia
| | | | - Marco Antonio Hungaro Duarte
- Departmento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, FOB/USP, Bauru, Brazil
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7
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Bakir EP, Yildirim ZS, Bakir Ş, Ketani A. Are resin-containing pulp capping materials as reliable as traditional ones in terms of local and systemic biological effects? Dent Mater J 2021; 41:78-86. [PMID: 34483201 DOI: 10.4012/dmj.2021-065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to compare the local and systemic effects of current pulp capping materials containing resin with those of traditional materials in an animal study. A total of 48 rats were used: a control group (n=12) (sub-control and negative control), a resin-containing group (n=18) (Calcimol LC, Theracal LC, Activa-BioActive Base/Liner), and a traditional group (n=18) (Biodentine, ProRoot MTA, Dycal). The materials which had been placed in polyethylene tubes were implanted in subcutaneous pockets. The rats were sacrificed at 1, 2, or 4 weeks. Evaluations were made of subcutaneous connective tissue, the left kidney, liver, and blood samples. Of all the study groups, MTA demonstrated biocompatibility at a level close to that of the control groups. Inflammation was observed to be more severe in resin-containing materials, but Activa Base/Liner showed a more successful local and systemic tissue response.
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Affiliation(s)
- Elif Pinar Bakir
- Dicle University, Faculty of Dentistry, Restorative Dentistry Department
| | | | - Şeyhmus Bakir
- Dicle University, Faculty of Dentistry, Restorative Dentistry Department
| | - Aydin Ketani
- Dicle University, Faculty of Veterinary Medicine, Histology and Embryology Department
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8
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Dayi B, Bilecen DS, Eröksüz H, Yalcin M, Hasirci V. Evaluation of a collagen-bioaggregate composite scaffold in the repair of sheep pulp tissue. Eur Oral Res 2021; 55:152-161. [PMID: 34746787 PMCID: PMC8547756 DOI: 10.26650/eor.2021911441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/04/2021] [Accepted: 05/17/2021] [Indexed: 01/09/2023] Open
Abstract
Purpose: This study aimed to compare the effects of the collagen-BioAggregate mixture
(CBA-M) and collagen-BioAggregate composite (CBA-C) sponge as a scaffolding
material on the reparative dentin formation. Materials and methods: CBA-C sponge (10:1 w/w) was obtained and characterized by Scanning Electron
Microscopy (SEM) and Mercury Porosimetry. Cytotoxicity of the CBA-C sponge was
tested by using the L929 mouse fibroblast cell line. Dental pulp stem cells (DPSCs)
were isolated from the pulp tissue of sheep teeth and characterized by flow
cytometry for the presence of mesenchymal stem cell marker, CD44. The osteogenic
differentiation capability of isolated DPSCs was studied by Alizarin Red staining.
The cells were then used to study for the compatibility of CBA-C sponge with cell
proliferation and calcium phosphate deposition. The effect of CBA-C sponge and
CBA-M on the induction of dentin regeneration was studied in the perforated
teeth of sheep for the eight-week period. All the analyses were performed with
appropriate statistical hypothesis tests. Results: CBA-C sponge was found to be biocompatible for DPSCs. The DPSCs seeded on the
CBA-C sponge were able to differentiate into the osteoblastic lineage and deposit
calcium phosphate crystals in vitro. Reparative dentin formation was observed after
the second week in the CBA-C sponge applied group. At the end of eight weeks,
a complete reparative dentin structure was formed in the CBA-C sponge applied
group, whereas necrotic tissue residues were observed in groups treated with the
CBA-M. Conclusion: CBA-C sponge represents a better microenvironment for reparative dentin
formation probably due to maintaining DPSCs and allowing their osteogenic
differentiation and thus calcium phosphate deposition.
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Affiliation(s)
- Burak Dayi
- Department of Restorative Dentistry, Faculty of Dentistry, Inonu University, Malatya,Turkey
| | - Deniz Sezlev Bilecen
- Department of Molecular Biology and Genetics, Faculty of Agriculture and Natural Sciences, Konya Food and Agriculture University, Konya,Turkey.,BIOMATEN, METU Center of Excellence in Biomaterials and Tissue Engineering, Ankara,Turkey
| | - Hatice Eröksüz
- Department of Pathology, Faculty of Veterinary Medicine, Firat University, Elazığ,Turkey
| | | | - Vasif Hasirci
- BIOMATEN, METU Center of Excellence in Biomaterials and Tissue Engineering, Ankara,Turkey.,Department of Medical Engineering, Faculty of Engineering, Acibadem University, İstanbul,Turkey
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Delfino MM, de Abreu Jampani JL, Lopes CS, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Sasso-Cerri E, Cerri PS. Comparison of Bio-C Pulpo and MTA Repair HP with White MTA: effect on liver parameters and evaluation of biocompatibility and bioactivity in rats. Int Endod J 2021; 54:1597-1613. [PMID: 33999424 DOI: 10.1111/iej.13567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/31/2022]
Abstract
AIM To evaluate the tissue response promoted by Bio-C Pulpo (Bio), MTA Repair HP (MTA-HP) and White MTA (WMTA) and whether these materials cause liver changes in a rat experimental model. METHODOLOGY Polyethylene tubes filled with Bio, MTA-HP and WMTA, and empty tubes (control group, CG) were implanted into the subcutaneous tissues of rats for 7, 15, 30 and 60 days. Inflammatory reaction score (IRS), capsule thickness, number of inflammatory cells (IC), von Kossa reaction, interleukin-6 (IL-6) and alkaline phosphatase (ALP) immunohistochemistry reactions were performed. Combined methods, von Kossa followed by immunohistochemistry for detection of ALP, were performed. At 60 days, the serum glutamic-oxaloacetic transaminase (GOT) and glutamic-pyruvic transaminase (GPT) levels were measured and liver fragments were collected for histological analysis; the data were assessed by one-way ANOVA analysis followed by Sidak's post-test. The biocompatibility and bioactivity data were subjected to the two-way ANOVA analysis followed by Tukey post hoc test, except the IRS. The IRS data were subjected to the Kruskal-Wallis ANOVA non-parametric test followed by Dunn's test (p ≤ .05). RESULTS No significant difference was detected in serum GOT and GPT concentrations and in the number of hepatocytes among the experimental and CG samples. Although Bio-C Pulpo had the highest IC and IL-6-immunolabelled cells (p < 0.0001) at all periods, no significant difference was observed in the IRS among the materials, except at 60 days. In this period, the WMTA had lower IRS. All groups had a significant reduction in the capsule thickness and in the number of IC and IL-6-immunolabelled cells over time. Bio-C Pulpo, MTA-HP and WMTA specimens had greater immunoexpression of ALP than CG (p < .0001). At all periods, von Kossa-positive and birefringent structures were observed in the capsules around the materials. ALP-immunolabelled cells were also seen near von Kossa-positive structures. CONCLUSIONS Bio-C Pulpo, MTA-HP and WMTA materials did not cause morphological changes in the liver and no significant alteration in the serum GOT and GPT levels. Moreover, these bioceramic materials were biocompatible and exhibited bioactive potential. However, Bio-C Pulpo induced greater inflammatory infiltrate than MTA-HP and WMTA at all periods.
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Affiliation(s)
- Mateus Machado Delfino
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - José Leandro de Abreu Jampani
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Camila Soares Lopes
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Paulo S Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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11
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Biocompatibility Study of a New Dental Cement Based on Hydroxyapatite and Calcium Silicates: Focus on Liver, Kidney, and Spleen Tissue Effects. Int J Mol Sci 2021; 22:ijms22115468. [PMID: 34067318 PMCID: PMC8196841 DOI: 10.3390/ijms22115468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The effects of a new material based on hydroxyapatite and calcium silicates, named ALBO-MPCA, were investigated on the liver, kidney and spleen. The material was administrated orally for 120 days in an in vivo model in Wistar rats, and untreated animals served as a control. Hematological and biochemical blood parameters were analyzed. Qualitative histological analysis of tissues, change in mitotic activity of cells, and histological characteristics was conducted, as well as quantitative stereological analysis of parenchymal cells, blood sinusoids, and connective tissues. Additionally, the protein expressions of Ki67 and CD68 markers were evaluated. Histological analysis revealed no pathological changes after the tested period. It showed the preservation of the architecture of blood sinusoids and epithelial cells and the presence of mitosis. Additionally, the significantly increased number of the Ki67 in the presence of ALBO-MPCA confirmed the proliferative effect of the material noticed by stereological analysis, while immunoreactive CD68 positive cells did not differ between groups. The study showed non-toxicity of the tested material based on the effects on the hematological, biochemical, and observed histological parameters; in addition, it showed evidence of its biocompatibility. These results could be the basis for further steps toward the application of tested materials in endodontics.
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Histological Evaluation of Periradicular Tissue Inflammatory Reactions and Calcified Tissue Formations After Implantation of Experimental Calcium Silicate and Hydroxyapatite Based Nanostructural Cements Into Root Canals of Rabbits Teeth. ACTA VET-BEOGRAD 2021. [DOI: 10.2478/acve-2021-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The aim of the study was to evaluate inflammatory tissue reactions and the formation of calcified tissue after implantation of experimental nanostructured calcium silicate cement (CS) and hydroxyapatite with calcium silicate cement (HA-CS) into root canals of rabbits’ teeth. The study was conducted on four rabbits of the genus Oryctolagus cuniculus. After instrumentation and irrigation, the root canals of the central incisors were dried and filled with CS, HA-CS and control material (MTA Angelus). The animals were sacrificed after 28 days. After histological preparation and hematoxylin-eosin staining, tissue samples were evaluated for the intensity and extension of inflammatory tissue reaction; continuity, morphology and thickness of the newly formed calcified tissue; and presence of giant cells, materials particles and microorganisms. Kruskal Wallis and Dunn’s post hoc test were used for data analysis (α=0.05). There were no significant differences in the intensity of inflammatory reactions between CS, HA-CS and MTA control. HA-CS showed significantly better results than MTA and CS with respect to continuity of the newly formed calcified tissue (P=0.003 and P=0.010, respectively). Significant differences in thickness of the calcified tissue existed between CS and MTA (P=0.004) and between HA-CS and MTA (P=0.012). Application of CS and HA-CS resulted in minimal inflammatory tissue response, similar to the MTA control. CS and HA-CS were more efficient than MTA in supporting hard tissue formation. The best organized newly formed calcified tissue was seen after HA-CS application.
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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.
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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
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Toxicological Profile of Nanostructured Bone Substitute Based on Hydroxyapatite and Poly(lactide-co-glycolide) after Subchronic Oral Exposure of Rats. NANOMATERIALS 2020; 10:nano10050918. [PMID: 32397466 PMCID: PMC7279500 DOI: 10.3390/nano10050918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 01/18/2023]
Abstract
Novel three-dimensional (3D) nanohydroxyapatite-PLGA scaffolds with high porosity was developed to better mimic mineral component and microstructure of natural bone. To perform a final assessment of this nanomaterial as a potential bone substitute, its toxicological profile was particularly investigated. Therefore, we performed a comet assay on human monocytes for in vitro genotoxicity investigation, and the systemic subchronic toxicity investigation on rats being per oral feed with exactly administrated extract quantities of the nano calcium hydroxyapatite covered with tiny layers of PLGA (ALBO-OS) for 120 days. Histological and stereological parameters of the liver, kidney, and spleen tissue were analyzed. Comet assay revealed low genotoxic potential, while histological analysis and stereological investigation revealed no significant changes in exposed animals when compared to controls, although the volume density of blood sinusoids and connective tissue, as well as numerical density and number of mitosis were slightly increased. Additionally, despite the significantly increased average number of the Ki67 and slightly increased number of CD68 positive cells in the presence of ALBO-OS, immunoreactive cells proliferation was almost neglected. Blood analyses showed that all of the blood parameters in rats fed with extract nanomaterial are comparable with corresponding parameters of no feed rats, taken as blind probe. This study contributes to the toxicological profiling of ALBO-OS scaffold for potential future application in bone tissue engineering.
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Paraš S, Janković O, Trišić D, Čolović B, Mitrović-Ajtić O, Dekić R, Soldatović I, Živković Sandić M, Živković S, Jokanović V. Influence of nanostructured calcium aluminate and calcium silicate on the liver: histological and unbiased stereological analysis. Int Endod J 2019; 52:1162-1172. [PMID: 30802977 DOI: 10.1111/iej.13105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 02/22/2019] [Indexed: 12/11/2022]
Abstract
AIM To examine the potential systemic toxicity of nanostructured materials based on calcium silicate and calcium aluminate, for potential application in Dentistry. METHODOLOGY Twenty-four Albino Wistar rats aged 2 months were used as an in vivo animal model for subcutaneous implantation of the investigated materials, placed in polyethylene tubes. Thirty days after implantation, the livers of the rats were analysed and following histological and stereological parameters were evaluated for volume density of hepatocytes and blood sinusoids, number and numerical density of hepatocytes, surface of hepatocytes and their nucleuses, nucleocytoplasmic ratio and mitotic index of hepatocytes. Stereological measurements were achieved using Cavalieri's principle, with grid P2 and unbiased analysis. Additionally, immunohistochemistry studies were performed to further analyse changes in liver tissue. Several haematological and biochemical parameters of blood of experimental animals were also analysed, as well as local tissue reactions around the implants. Statistical analysis was performed using parametric (anova and t-test) and nonparametric tests (Kruskal-Wallis and Mann-Whitney U-test) depending on data distribution. RESULTS Implanted dental cements led to an increase in stereological and histological parameters in liver tissue compared to control rats. Although the investigated parameters mostly showed significant differences between control and experimental animals, the liver tissue of the experimental animals did not have visible signs of pathological changes. This was supported by the analysis of blood parameters which were not significantly different between control and experimental animals. Also, the subcutaneous tissues had minimal inflammatory reactions. Immunohistochemistry studies revealed that nanostructured materials induced proliferation of hepatocytes, but that the immunological response to the materials was not strong enough to induce proliferation of immunoreactive cells in liver in the observed time period. CONCLUSIONS This study was performed as a contribution to the attestation of the biocompatibility of dental cements based on calcium silicate and calcium aluminate. Although these materials induced several changes in the liver structure, they were not clinically relevant and represent a normal and reversible response of the liver to the presence of biocompatible materials in the body. Blood and immunohistochemistry analyses and local tissue reactions further confirmed that these materials possess good biocompatible potential.
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Affiliation(s)
- S Paraš
- Department of Zoology, Faculty of Science and Mathematics, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - O Janković
- Department of Stomatology, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - D Trišić
- Faculty of Stomatology, University of Belgrade, Belgrade, Serbia
| | - B Čolović
- Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - O Mitrović-Ajtić
- Department for Molecular Oncology, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - R Dekić
- Department of Zoology, Faculty of Science and Mathematics, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - I Soldatović
- Institute for Biostatistics, University of Belgrade, Belgrade, Serbia
| | | | - S Živković
- Faculty of Stomatology, University of Belgrade, Belgrade, Serbia
| | - V Jokanović
- Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia.,ALBOS LLC, Belgrade, Serbia
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Cintra LTA, Estrela C, Azuma MM, Queiroz ÍODA, Kawai T, Gomes-Filho JE. Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials. Braz Oral Res 2018; 32:e68. [DOI: 10.1590/1807-3107bor-2018.vol32.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
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Demirkaya K, Can Demirdöğen B, Öncel Torun Z, Erdem O, Tunca YM. The effects of hydraulic calcium silicate containing endodontic materials on oxidative stress in erythrocytes and liver. TURKISH JOURNAL OF BIOCHEMISTRY-TURK BIYOKIMYA DERGISI 2018. [DOI: 10.1515/tjb-2016-0263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
Objective:
The aim of this study was to evaluate the effects of hydraulic calcium silicate endodontic cements, MTA Angelus, MTA Fillapex, and Theracal LC, on erythrocyte and liver oxidative stress parameters of rats.
Methods:
Right upper incisor of each rat was extracted and polyethylene tubes containing the dental cements, or left empty for the control group, were inserted into the extraction socket. Blood and liver samples of each animal were obtained after 7, 30, or 60 days. Thiobarbituric acid reactive substances (TBARS) levels and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities were determined by spectrophotometry.
Results:
Erythrocyte and liver TBARS levels, and CAT and SOD enzymatic activities were significantly increased in dental cement applied groups compared with controls on day 7. The highest erythrocyte and liver TBARS concentrations were observed in the MTA Angelus group on day 7 of exposure. On day 30, erythrocyte CAT activity remained markedly high, but the other parameters returned to almost normal levels. On day 60, all parameters were similar between the control and the experimental groups.
Conclusions:
This is the first study to show that TBARS levels and antioxidant enzyme activities are transiently increased as a result of dental cement application.
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de Azevedo Queiroz IO, Mello WG, Martins CM, Dal Fabbro R, Narciso LG, Massunari L, Cintra LTA, Ervolino E, Gomes-Filho JE. Systemic bone marker expression induced by grey and white mineral trioxide aggregate in normal and diabetic conditions. Int Endod J 2018; 51:889-900. [PMID: 29377189 DOI: 10.1111/iej.12900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/22/2018] [Indexed: 01/28/2023]
Abstract
AIM To investigate the relationship between diabetes mellitus and local/systemic effects of both grey and white mineral trioxide aggregate (MTA) Angelus on bone marker expression. METHODOLOGY Wistar rats were divided into two groups: healthy and diabetic (Alloxan induced), which were further divided into three subgroups (control, GMTA Angelus and WMTA Angelus). Polyethylene tubes filled with MTA materials or empty tubes were implanted in dorsal connective tissue. On days 7 and 30, blood samples were collected for calcium, phosphorus and ALP measurement. The animals were euthanized; implanted tubes were removed and processed for immunohistochemical analysis of osteocalcin (OCN) and osteopontin (OPN). Kruskal-Wallis followed by Dunn's multiple comparison test was performed for nonparametric data, and anova followed by Tukey's test for parametric data. RESULTS No difference in systemic serum calcium levels between both groups was observed. On day 7, serum phosphorus levels within the WMTA healthy group were higher than that of the diabetic group. On day 30, healthy rats exhibited lower phosphorus levels than diabetic ones. At both time points, the diabetic group was associated with more ALP activity than the healthy group. Immunohistochemical analyses of the healthy group revealed OCN- and OPN-positive cells in the presence of both MTA materials. However, under diabetic conditions, both OCN and OPN were absent. CONCLUSION Both MTA materials were associated with an increase in serum calcium, phosphorus and ALP, suggesting a potential systemic effect, along with triggered differentiation of OCN- and OPN-positive cells. Moreover, in diabetic conditions, an inhibitory effect on MTA-induced differentiation of OCN- and OPN-positive cells was detected.
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Affiliation(s)
- I O de Azevedo Queiroz
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - W G Mello
- Department of Basic Science, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil.,Centro Universitário Toledo - UNITOLEDO, Araçatuba, São Paulo, Brazil
| | - C M Martins
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - R Dal Fabbro
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - L G Narciso
- Department of Clinic and Surgery and Animal Reproduction, Araçatuba School of Veterinary Medicine, São Paulo State University (UNESP), São Paulo, Brazil
| | - L Massunari
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - L T A Cintra
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - E Ervolino
- Department of Basic Science, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - J E Gomes-Filho
- Department of Endodontics, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
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Garcia LDFR, Huck C, Magalhães FAC, Souza PPCD, Souza Costa CAD. Systemic effect of mineral aggregate-based cements: histopathological analysis in rats. J Appl Oral Sci 2018; 25:620-630. [PMID: 29211283 PMCID: PMC5701532 DOI: 10.1590/1678-7757-2016-0634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 04/19/2017] [Indexed: 11/29/2022] Open
Abstract
Objective: Several studies reported the local tissue reaction caused by mineral aggregate-based cements. However, few studies have investigated the systemic effects promoted by these cements on liver and kidney when directly applied to connective tissue. The purpose of this in vivo study was to investigate the systemic effect of mineral aggregate-based cements on the livers and kidneys of rats. Material and Methods: Samples of Mineral Trioxide Aggregate (MTA) and a calcium aluminate-based cement (EndoBinder) containing different radiopacifiers were implanted into the dorsum of 40 rats. After 7 and 30 d, samples of subcutaneous, liver and kidney tissues were submitted to histopathological analysis. A score (0-3) was used to grade the inflammatory reaction. Blood samples were collected to evaluate changes in hepatic and renal functions of animals. Results: The moderate inflammatory reaction (2) observed for 7 d in the subcutaneous tissue decreased with time for all cements. The thickness of inflammatory capsules also presented a significant decrease with time (P<.05). Systemically, all cements caused adverse inflammatory reactions in the liver and kidney, being more evident for MTA, persisting until the end of the analysis. Liver functions increased significantly for MTA during 30 d (P<.05). Conclusion: The different cements induced to a locally limited inflammatory reaction. However, from the systemic point of view, the cements promoted significant inflammatory reactions in the liver and kidney. For MTA, the reactions were more accentuated.
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Affiliation(s)
- Lucas da Fonseca Roberti Garcia
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Odontologia, Área de Endodontia, Florianópolis, SC, Brasil
| | - Claudia Huck
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Odontologia Restauradora, Araraquara, SP, Brasil
| | | | - Pedro Paulo Chaves de Souza
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, SP, Brasil
| | - Carlos Alberto de Souza Costa
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, SP, Brasil
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Yoldaş SE, Bani M, Atabek D, Bodur H. Comparison of the Potential Discoloration Effect of Bioaggregate, Biodentine, and White Mineral Trioxide Aggregate on Bovine Teeth: In Vitro Research. J Endod 2016; 42:1815-1818. [PMID: 27776876 DOI: 10.1016/j.joen.2016.08.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/26/2016] [Accepted: 08/30/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Tricalcium silicate cements can be used for pulp capping, pulpotomies, apical barrier formation in teeth with open apices, repair of root perforations, regenerative endodontics, and root canal filling. The aim of this study was to evaluate and compare the discoloration potential of 3 different tricalcium cements using a bovine tooth model. METHODS Forty bovine anterior teeth have been used for the study. Crowns separated from the roots were randomly divided into 4 groups: the BioAggregate (IBC, Vancouver, Canada) group, the Biodentine (Septodont, Saint Maur des Fosses, France) group, the mineral trioxide aggregate Angelus (Angelus, Londrina, PR, Brazil) group, and the only blood group. Materials have been placed to the standardized cavities on the lingual surfaces of the crowns, and their contact with blood has been provided. The color values of the samples were measured with a digital tooth shade determinator (VITA Easyshade; VITA Zahnfabrik, Bad Sackingen, Germany) before the placement of the materials, after the placement of the materials, in the 24th hour, in the first week, in the first month, in the third month, and in the first year. The mean value of all groups was compared using the Tukey multiple comparison test (α = 0.05). RESULTS All groups displayed increasing discoloration during a period of the first year. The "only blood group" showed the highest color change values, and it was followed as BioAggregate, mineral trioxide aggregate Angelus, and Biodentine, respectively. Statistically significant differences were found for Biodentine when compared with the only blood and BioAggregate groups (P < .05). CONCLUSIONS Considering the results of the study, Biodentine is found to have the least discoloration potential among the tested materials.
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Affiliation(s)
- Selen Esin Yoldaş
- Department of Pediatric Dentistry, Gazi University Faculty of Dentistry, Emek, Ankara, Turkey
| | - Mehmet Bani
- Department of Pediatric Dentistry, Gazi University Faculty of Dentistry, Emek, Ankara, Turkey.
| | - Didem Atabek
- Department of Pediatric Dentistry, Gazi University Faculty of Dentistry, Emek, Ankara, Turkey
| | - Haluk Bodur
- Department of Pediatric Dentistry, Gazi University Faculty of Dentistry, Emek, Ankara, Turkey
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Basak V, Bahar TE, Emine K, Yelda K, Mine K, Figen S, Rustem N. Evaluation of cytotoxicity and gelatinases activity in 3T3 fibroblast cell by root repair materials. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2016.1192960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Varol Basak
- Faculty of Medicine, Department of Biophysics, Istanbul University, Istanbul, Turkey
| | - Tuna Elif Bahar
- Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Karsli Emine
- Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Kasimoglu Yelda
- Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Koruyucu Mine
- Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Seymen Figen
- Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Nurten Rustem
- Faculty of Medicine, Department of Biophysics, Istanbul University, Istanbul, Turkey
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Simsek N, Bulut ET, Ahmetoğlu F, Alan H. Determination of trace elements in rat organs implanted with endodontic repair materials by ICP-MS. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:46. [PMID: 26758893 DOI: 10.1007/s10856-015-5663-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023]
Abstract
To investigate the levels of seven elements using an inductively coupled plasma-mass spectrometry (ICP-MS) method in rat organs after the implantation of Micro Mega Mineral Trioxide Aggregate (MM-MTA), Bioaggregate (BA) and Biodentine (BD) materials. MM-MTA, BA and BD were implanted into the subcutaneous tissue of 15 Wistar albino rats; three control animals had no operation. After 45 days, the rats were sacrificed and their brains, kidneys and livers were removed. The ICP-MS analysis was used to determine trace elements. Data were analysed using the Kruskal-Wallis and Connover post hoc tests. There was no significant difference between the control groups and the MM-MTA, BA and BD groups according to the concentration of aluminum, calcium, arsenic and lead in the rats' organs. Beryllium was not detected in all tissue samples. Chromium levels of these materials were higher than the control group in brain and kidney samples (P = 0.038 and P = 0.037); magnesium levels were higher than the control group in kidney and liver samples (P = 0.030 and P = 0.008). MM-MTA, BA and BD were nontoxic according to trace element levels in brain, kidney and liver samples of rats. Further investigation is required to understand the systemic effects of these materials.
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Affiliation(s)
- Neslihan Simsek
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Elçin Tekin Bulut
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Fuat Ahmetoğlu
- Department of Endodontics, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Hilal Alan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Zand V, Lotfi M, Aghbali A, Mesgariabbasi M, Janani M, Mokhtari H, Tehranchi P, Pakdel SMV. Tissue Reaction and Biocompatibility of Implanted Mineral Trioxide Aggregate with Silver Nanoparticles in a Rat Model. IRANIAN ENDODONTIC JOURNAL 2015; 11:13-6. [PMID: 26843871 PMCID: PMC4731527 DOI: 10.7508/iej.2016.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/16/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Abstract
Introduction: Biocompatibility and antimicrobial activity of endodontic materials are of utmost importance. Considering the extensive applications of mineral trioxide aggregate (MTA) in dentistry and antimicrobial properties of silver nanoparticles, this study aimed to evaluate the subcutaneous inflammatory reaction of rat connective tissues to white MTA with and without nanosilver (NS) particles. Methods and Materials: Polyethylene tubes (1.1×8 mm) containing experimental materials (MTA and MTA+NS and empty control tubes) were implanted in subcutaneous tissues of seventy-five male rats. Animals were divided into five groups (n=15) according to the time of evaluation: group 1; after 7 days, group 2; after 15 days, group 3; after 30 days, group 4; after 60 days and group 5; after 90 days. The inflammatory reaction was graded and data was analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Statistical significance was defined at 0.05. Results: Comparison of cumulative inflammatory reaction at all intervals revealed that the mean grade of inflammatory reaction to MTA, MTA+NS and control samples were 3, 2 and 2, respectively. According to the Mann-Whitney analysis there were no significant differences between MTA+NS and MTA (P=0.42). Conclusion: Incorporation of 1% nanosilver to MTA does not affect the inflammatory reaction of subcutaneous tissue in rat models.
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Affiliation(s)
- Vahid Zand
- Dental and Periodontal Research Center, Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrdad Lotfi
- Research Center for Pharmaceutical Nano-Technology, Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirala Aghbali
- Department of Oral and Maxillofacial Pathology, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehran Mesgariabbasi
- Researcher, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Janani
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Mokhtari
- Department of Endodontics, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pardis Tehranchi
- Department of Restorative Dentistry, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyyed Mahdi Vahid Pakdel
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Dawood AE, Parashos P, Wong RHK, Reynolds EC, Manton DJ. Calcium silicate-based cements: composition, properties, and clinical applications. ACTA ACUST UNITED AC 2015; 8. [PMID: 26434562 DOI: 10.1111/jicd.12195] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/19/2015] [Indexed: 01/02/2023]
Abstract
Mineral trioxide aggregate (MTA) is a calcium silicate-based cement (CSC) commonly used in endodontic procedures involving pulpal regeneration and hard tissue repair, such as pulp capping, pulpotomy, apexogenesis, apexification, perforation repair, and root-end filling. Despite the superior laboratory and clinical performance of MTA in comparison with previous endodontic repair cements, such as Ca(OH)2 , MTA has poor handling properties and a long setting time. New CSC have been commercially launched and marketed to overcome the limitations of MTA. The aim of the present review was to explore the available literature on new CSC products, and to give evidence-based recommendations for the clinical use of these materials. Within the limitations of the available data in the literature regarding the properties and performance of the new CSC, the newer products could be promising alternatives to MTA; however, further research is required to support this assumption.
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Affiliation(s)
- Alaa E Dawood
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Vic., Australia
| | - Peter Parashos
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Vic., Australia
| | - Rebecca H K Wong
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Vic., Australia
| | - Eric C Reynolds
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Vic., Australia
| | - David J Manton
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Vic., Australia
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Melo TAFD, Gründling GSL, Montagner F, Scarparo RK, Figueiredo JAPD, Vier-Pelisser FV. Are bovine teeth a suitable substitute for human teeth in in vitro studies to assess endotoxin load in root canals? Braz Oral Res 2015; 29:S1806-83242015000100282. [PMID: 26154374 DOI: 10.1590/1807-3107bor-2015.vol29.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/27/2015] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to determine the feasibility of using bovine teeth as a suitable alternative for human teeth, in experiments involving in vitro endotoxin contamination. Twenty bovine central incisors and 20 human single-root premolars had their dental crowns removed and root lengths set at 16 mm. Root canals were prepared up to #60 K-file size and sterilized with cobalt-60 gamma irradiation (20 kGy, 6 h). The teeth were randomly divided into four groups: G1-bovine teeth (bovine negative control, n = 10), G2-human teeth (human negative control, n = 10), G3-bovine teeth, inoculated with Escherichia coli (055:B55) LPS, and G4-human teeth inoculated with E. coli LPS. The G1 and G2 groups were exposed to apyrogenic water. After the teeth had been incubated at 37 °C and atmospheric humidity for 24 h, the samples of solutions in the main canals were collected with apyrogenic absorbent paper tips. LPS levels were quantified using Limulus Amebocyte Lysate assay. The data obtained were statistically analyzed using one-way ANOVA, with a significance level of 5%. A high amount of endotoxin was detected in the inoculated human teeth (G4) when compared to the sterilized teeth (G2), as well as in the inoculated bovine teeth (G3) when compared to the inoculated human teeth (G4). However, there was no statistical difference between bovine teeth before and after the E. coli endotoxin inoculation. Therefore, under the mentioned experimental conditions, the use of bovine teeth should not be a choice for laboratory research on endotoxin contamination.
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Affiliation(s)
- Tiago André Fontoura de Melo
- Clinical Department, Dental School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Francisco Montagner
- Endodontics Division, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Fabiana Vieira Vier-Pelisser
- Clinical Department, Dental School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Can Mineral Trioxide Aggregate and Nanoparticulate EndoSequence Root Repair Material Produce Injurious Effects to Rat Subcutaneous Tissues? J Endod 2015; 41:1151-6. [PMID: 25887808 DOI: 10.1016/j.joen.2015.02.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 02/03/2015] [Accepted: 02/15/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the injurious effects of mineral trioxide Aggregate (MTA) and EndoSequence Bioceramic Root Repair Material (ERRM; Brassler USA, Savannah, GA) 7 and 30 days after their implantation into rat subcutaneous tissues. METHODS Twelve Wistar rats were selected for the present study. Each animal received 3 implants: one contained MTA, one contained ERRM, and one was an empty tube that served as a control. Half of the animals were killed after 7 days, and the remaining animals were killed 30 days after implantation. Histologic sections prepared from the skin specimens were stained with H&E, toluidine blue, Masson trichrome, and Congo red. The data were statistically analyzed with 1-way analysis of variance and paired t tests. The P value for significance was set at .05. RESULTS After 7 days, MTA produced a significantly greater inflammatory reaction that involved the deposition of amyloidlike protein and an increase in the mast cell population compared with ERRM (P < .05). After 30 days, the ERRM group exhibited significantly reduced inflammatory reactions compared to the MTA groups (P < .05). Areas of mononuclear cell aggregation, abscess formation, and necrosis were observed more frequently in the MTA group. The thickness of the fibrous capsule was significantly increased in the MTA compared with the ERRM groups (P < .05). Amyloidlike proteins were more frequently observed around the fibrous capsule and subdermal blood vessels and were more frequently deposited in the MTA than the ERRM specimens. CONCLUSIONS The findings of the present study suggest that both ERRM and MTA cause an injurious effect when implanted in rat subcutaneous tissues after 7 and 30 days. ERRM is significantly less injurious to tissues than MTA.
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Zhu L, Yang J, Zhang J, Peng B. A Comparative Study of BioAggregate and ProRoot MTA on Adhesion, Migration, and Attachment of Human Dental Pulp Cells. J Endod 2014; 40:1118-23. [DOI: 10.1016/j.joen.2013.12.028] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/24/2013] [Accepted: 12/27/2013] [Indexed: 01/08/2023]
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