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Long Y, Xu X, Chen J, Liu S, Li J, Dong Y. An explainable predictive model of direct pulp capping in carious mature permanent teeth. J Dent 2024; 149:105269. [PMID: 39094974 DOI: 10.1016/j.jdent.2024.105269] [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: 07/10/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE To introduce a novel approach for predicting the personalized probability of success of DPC treatment in carious mature permanent teeth using explainable machine learning (ML) models. METHODS Clinical data were obtained from our previous single-center retrospective study, comprising 393 carious mature permanent teeth from 372 patients who underwent DPC and attended 1-year follow-up between January 2015 and February 2021. Six ML models were derived based on 80 % cases of the cohort, with the remaining 20 % cases used for validation. Shapley additive explanation (SHAP) values were utilized to assess feature importance and the clinical relevance of prediction models. RESULTS Within the cohort, 9.67 % (38 out of 393) of teeth experienced failure at the 1-year follow-up after DPC treatment. Among the six evaluated ML models, the XGBoost model exhibited the highest discriminative ability. By prioritizing features based on their importance, streamlined and interpretable XGBoost model with 11 features were developed for 1-year prognostication post-DPC. The model demonstrated predictive accuracy with area under the curve (AUC) scores of 0.86 for the 1-year prediction. The final model has been translated into a web application to facilitate clinical decision-making. CONCLUSION By incorporating demographic and clinical examination data, the XGBoost model offered a user-friendly tool for dentists to predict personalized probability of success, thereby improving personalized dental care and patient counseling. The utilization of SHAP for model interpretation provided transparent insights into the decision-making process.
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Affiliation(s)
- Yunzi Long
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, PR China; Department of General Dentistry II, Peking University School and Hospital of Stomatology, Beijing 100081, PR China
| | - Xiaowei Xu
- Institute of Medical Information/ Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China; College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310058, China
| | - Jiaqi Chen
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, PR China
| | - Siyi Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, PR China.
| | - Jiao Li
- Institute of Medical Information/ Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China.
| | - Yanmei Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, PR China
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Xie Z, Jiang W, Liu H, Chen L, Xuan C, Wang Z, Shi X, Lin Z, Gao X. Antimicrobial Peptide- and Dentin Matrix-Functionalized Hydrogel for Vital Pulp Therapy via Synergistic Bacteriostasis, Immunomodulation, and Dentinogenesis. Adv Healthc Mater 2024; 13:e2303709. [PMID: 38431770 DOI: 10.1002/adhm.202303709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/20/2024] [Indexed: 03/05/2024]
Abstract
The preservation of vital pulps is crucial for maintaining the physiological functions of teeth; however, vital pulp therapy (VPT) of pulpitis teeth remains a substantial challenge due to uncontrolled infection, excessive inflammation, and limited regenerative potential. Current pulp capping agents have restricted effects in the infectious and inflammatory microenvironment. To address this, a multifunctional hydrogel (TGH/DM) with antibacterial, immunomodulatory, and mineralization-promoting effects is designed. The antimicrobial peptide (AMP) and demineralized dentin matrix are incorporated into the hydrogel, achieving sustainable delivery of AMP and a cocktail of growth factors. In vitro results show that TGH/DM could kill endodontic microbiota, ameliorate inflammatory responses of human dental pulp stem cells (hDPSCs), and prompt odontogenic differentiation of inflammatory hDPSCs via activation of peroxisome proliferator-activated receptor gamma. In vivo results suggest that TGH/DM is capable of inducing M2 phenotype transformation of macrophages in mice and fostering the regeneration of the dentin-pulp complex in inflamed pulps of beagle dogs. Overall, this study first proposes the synergistic regulation of AMP and tissue-specific extracellular matrix for the treatment of pulpitis, and the advanced hydrogel provides a facile and effective way for VPT.
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Affiliation(s)
- Zhuo Xie
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Wentao Jiang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Hui Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Lingling Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Chengkai Xuan
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Zhenxing Wang
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Xuetao Shi
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Zhengmei Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Xianling Gao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
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Huang X, Ge X, Fu W, Zhang Z, Xiao K, Lv H. Effects of Novel Nanoparticulate Bioceramic Endodontic Material on Human Dental Pulp Stem Cells In Vitro. Int Dent J 2024; 74:482-491. [PMID: 38431469 PMCID: PMC11123531 DOI: 10.1016/j.identj.2023.12.008] [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: 05/22/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the in vitro effects of root canal filling and repair paste (nRoot BP) on human dental pulp stem cells (hDPSCs). METHODS The effects of nRoot BP and iRoot BP Plus on the adhesion, proliferation, migration, and differentiation of hDPSCs were examined in vitro for 72 hours. The adhesion of cells was observed using immunofluorescence rhodamine ghost pen cyclic peptide staining and scanning electron microscopy (SEM). Cell density and changes in migration area were measured under a fluorescence inverted microscope. Fluorescent quantitative PCR was performed to detect genes related to odontogenesis and osteogenesis. RESULTS Cells adhering to the surfaces of nRoot BP and iRoot BP Plus exhibited similar irregular polygonal morphologies, with cells extending irregular pseudopods to adhere to the materials. CCK-8 results indicated that the density of living cells for nRoot BP and iRoot BP Plus was lower than that of the blank control group at 3 and 5 days of culture. There was no significant difference in cell migration between the groups (P > .05). The migration ability of iRoot BP Plus and nRoot BP was similar to that of the control group. Both nRoot BP and iRoot BP Plus increased the expression of the RUNX2 gene, but there was no significant difference between the groups (P < .05). Furthermore, both nRoot BP and iRoot BP Plus downregulated the expression of the DSPP gene, with no significant difference between them (P > .05). CONCLUSIONS nRoot BP exhibited a slight inhibition of hDPSC proliferation but did not affect the adhesion and migration of hDPSCs. The impact of nRoot BP on the osteogenic and odontogenic differentiation of hDPSCs was similar to that of iRoot BP Plus.
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Affiliation(s)
- Xinhui Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Xinting Ge
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Weihao Fu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Zonghao Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Kuancheng Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Hongbing Lv
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; School and Hospital of Stomatology, Fujian Medical University, China.
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Wang L, Ren S, Sun X, Guo S. Six-year clinical evaluation of iRoot BP Plus as apical barrier in permanent teeth of periapical periodontitis. AUST ENDOD J 2024; 50:115-122. [PMID: 37994232 DOI: 10.1111/aej.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
The apical barrier technique in permanent teeth with extensive destruction of the periapical tissue and a long infection time is much more difficult to succeed, which is a clinical challenge. This study aimed to evaluate the long-term effects of iRoot BP Plus as an apical material in adult teeth. Fifty incisors and premolars were chosen for this study. All teeth were performed apical barrier with the same operator. After treatment, the teeth were clinically and radiographically evaluated at 1, 2 and 6 years. At the 1-year follow-up, 35 teeth had healed, and three patients developed an apical abscess due to root fracture at the 2-year follow-up. Six years postoperatively, one tooth showed root resorption, which was considered a failure. The long clinical evaluation confirmed that iRoot BP Plus is a suitable material for the apical barrier of mature teeth with open apices and periapical lesions.
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Affiliation(s)
- Lijun Wang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shuangshuang Ren
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xiujuan Sun
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shiliang Guo
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Zhao Y, Song L, Li M, Peng H, Qiu X, Li Y, Zhu B, Liu C, Ren S, Miao L. Injectable CNPs/DMP1-loaded self-assembly hydrogel regulating inflammation of dental pulp stem cells for dentin regeneration. Mater Today Bio 2024; 24:100907. [PMID: 38170028 PMCID: PMC10758968 DOI: 10.1016/j.mtbio.2023.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Vital pulp preservation, which is a clinical challenge of aseptic or iatrogenic accidental exposure of the pulp, in cases direct pulp capping is the main technology. Human dental pulp stem cells (hDPSCs) play a critical role in pulp tissue repair, but their differentiative ability could be inhibited by the potential infection and inflammatory response of the exposed pulp. Therefore, inflammatory regulation and differentiated promotion of hDPSCs are both essential for preserving living pulp teeth. In this study, we constructed a functional dental pulp-capping hydrogel by loading cerium oxide nanoparticles (CNPs) and dentin matrix protein-1 (DMP1) into an injectable Fmoc-triphenylalanine hydrogel (Fmoc-phe3 hydrogel) as CNPs/DMP1/Hydrogel for in situ drugs delivery. With a view to long-term storage and release of CNPs (anti-inflammatory and antioxidant) to regulate the local inflammatory environment and DMP1 to promote the regeneration of dentin. Results of CCK-8, LDH release, hemolysis, and Live/Dead assessment of cells demonstrated the good biocompatibility of CNPs/DMP1/Hydrogel. The levels of alkaline phosphatase activity, quantification of the mineralized nodules, expressions of osteogenic genes and proteins demonstrated CNPs/DMP1/Hydrogel could protect the activity of hDPSCs' osteogenic/dentinogenic differentiation by reducing the inflammation response via releasing CNPs. The therapy effects were further confirmed in rat models, CNPs/DMP1/Hydrogel reduced the necrosis rate of damaged pulp and promoted injured pulp repair and reparative dentin formation with preserved vital pulps. In summary, the CNPs/DMP1/Hydrogel composite is an up-and-coming pulp-capping material candidate to induce reparative dentin formation, as well as provide a theoretical and experimental basis for developing pulp-capping materials.
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Affiliation(s)
- Yue Zhao
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Lutong Song
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Mengchen Li
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Haoran Peng
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xinyi Qiu
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yuyang Li
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Bijun Zhu
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chao Liu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shuangshuang Ren
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Leiying Miao
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Yang N, Yang W, Shen R, Zhang S, Ma T, Liu Y. In vitro and in vivo evaluation of iRoot BP Plus as a coronal sealing material for regenerative endodontic procedures. Clin Oral Investig 2024; 28:70. [PMID: 38170260 PMCID: PMC10764398 DOI: 10.1007/s00784-023-05468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To investigate in vitro effects of a nanoparticle bioceramic material, iRoot BP Plus, on stem cells from apical papilla (SCAP) and in vivo capacity to induce pulp-dentin complex formation. MATERIALS AND METHODS The sealing ability of iRoot BP Plus was measured via scanning electron microscopy (SEM). SCAP were isolated and treated in vitro by iRoot BP Plus conditioned medium, with mineral trioxide aggregate (MTA) conditioned medium and regular medium used as controls, respectively. Cell proliferation was assessed by BrdU labeling and MTT assay and cell migration was evaluated with wound healing and transwell assays. Osteo/odontogenic potential was evaluated by Alizarin red S staining and qPCR. Pulp-dentin complex formation in vivo was assessed by a tooth slice subcutaneous implantation model. RESULTS iRoot BP Plus was more tightly bonded with the dentin. There was no difference in SCAP proliferation between iRoot BP Plus and control groups (P > 0.05). iRoot BP Plus had a greater capacity to elevated cell migration (P < 0.05) and osteo/odontogenic marker expression and mineralization nodule formation of SCAP compared with MTA groups (P < 0.05). Furthermore, the new continuous dentine layer and pulp-like tissue was observed in the iRoot BP Plus group in vivo. CONCLUSIONS iRoot BP Plus showed excellent sealing ability, promoted the migration and osteo/odontogenesis of SCAP and induced pulp-dentin complex formation without affecting the cell proliferation, which indicated iRoot BP Plus was a promising coronal sealing material in REPs. CLINICAL RELEVANCE The coronal sealing materials play crucial roles for the outcomes of REPs. This study showed that iRoot BP Plus has good coronal sealing and promote pulp-dentin complex formation compared with MTA, providing experimental evidences for the clinical application of iRoot BP Plus as a promising coronal seal material in REPs.
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Affiliation(s)
- Ning Yang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, 117 Nanjing North Street, Shenyang, 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Wenxiao Yang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, 117 Nanjing North Street, Shenyang, 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Rou Shen
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, 117 Nanjing North Street, Shenyang, 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Shengcai Zhang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, 117 Nanjing North Street, Shenyang, 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Tianchi Ma
- Department of Orthodontics, Shenyang Stomatology Hospital, 138 Zhongshan Road, Shenyang, 110004, China.
| | - Yao Liu
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, 117 Nanjing North Street, Shenyang, 110002, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
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Tang J, Wang H, Wu D, Wang Z. LAMA5-inspired adhesive dodecapeptide facilitates efficient dentine regeneration: An in vitro and in vivo study. Int Endod J 2023; 56:1385-1398. [PMID: 37632694 DOI: 10.1111/iej.13967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/12/2023] [Accepted: 08/13/2023] [Indexed: 08/28/2023]
Abstract
AIM The primary goal of this study was to investigate the potential effects of A5G81 in inducing reparative dentine (RD) formation both in vitro and in vivo. METHODOLOGY Cell adhesion was observed by crystal violet staining and quantified by Sodium Dodecyl Sulphate (SDS) extraction. Cell proliferation was investigated using Cell Counting Kit-8 (CCK-8) assay. Spreading of cytoskeleton was visualized using immunofluorescence staining. Protein expression level of Akt signalling pathway was compared in a human Akt pathway phosphorylation array. Genes that were up or downregulated by A5G81 were identified by RNA sequencing. The mRNA expression of odontoblastic markers was detected by quantitative real-time polymerase chain reaction (qPCR). Moreover, mineralization of human dental pulp cells (hDPCs) was visualized by alizarin red staining and quantified using cetylpyridinium chloride (CPC). A direct pulp-capping model was established in SD rats and the RD formation at 2 weeks after operation was observed using HE staining. RESULTS A5G81 (optimal coating concentration: 0.5 mg/mL) promoted hDPCs adhesion and proliferation to a level that was similar to Type I collagen (COL-1). Meanwhile, A5G81 activated Akt signalling pathway, albeit to a lesser extent than COL-1. An inhibition test indicated that A5G81 induced hDPCs adhesion by activating PI3K pathway. A5G81 induced the expression of ECM remodelling genes and odontoblastic genes, which were demonstrated by RNA-seq and qPCR, respectively. In addition, A5G81 efficiently accelerated the mineralization of hDPCs in both immobilized and soluble forms, a property that makes it more applicable in dental clinic. Finally, the pulp-capping study in rats suggested that use of A5G81 could successfully induce the formation of RD within 2 weeks. CONCLUSION Coating of A5G81 to non-tissue culture-treated polystyrene facilitates spreading, proliferation and differentiation of hDPCs, resulting in rapid RD formation in artificially exposed pulp.
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Affiliation(s)
- Jia Tang
- School and Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Haicheng Wang
- School and Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Di Wu
- School and Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Zuolin Wang
- School and Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
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Qiu Y, Tian J, Kong S, Feng Y, Lu Y, Su L, Cai Y, Li M, Chang J, Yang C, Wei X. SrCuSi 4 O 10 /GelMA Composite Hydrogel-Mediated Vital Pulp Therapy: Integrating Antibacterial Property and Enhanced Pulp Regeneration Activity. Adv Healthc Mater 2023; 12:e2300546. [PMID: 37260366 DOI: 10.1002/adhm.202300546] [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: 02/20/2023] [Revised: 04/11/2023] [Indexed: 06/02/2023]
Abstract
Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries-induced dental pulp infections. However, bacterial contamination negatively affects dentine-pulp complex repair. The common capping materials show limited antimicrobial effects against some microorganisms. To improve the VPT efficacy, capping materials with increased antibacterial properties and enhanced odontogenic and angiogenic activities are needed. Herein, a SrCuSi4 O10 /gelatin methacrylate(SC/Gel) composite hydrogel has been proposed for infected dental pulp treatment. SrCuSi4 O10 (SC) is a microscale bioceramic composed of assembled multilayered nanosheets that possesses good near-infrared photothermal conversion ability and multiple bioactivities due to sustained Sr2+ , Cu2+ , and SiO3 2- ion release. It is shown that the SC/Gel composite hydrogel efficiently eliminates Streptococcus mutans and Lactobacillus casei and inhibits biofilm formation under photothermal heating, while the ion extract from SC promotes odontogenesis of rat dental pulp stem cells and angiogenesis of human umbilical vein endothelial cells. The as-designed therapeutic effect of SC/Gel composite hydrogel-mediated VPT has been proven in a rat dental pulp infection model and yielded improved dentine-pulp complex repair compared with the commercially used iRoot® BP Plus. This study suggests that the SC/Gel composite hydrogel is a potential pulp-capping material with improved effects on dentine-pulp complex repair in infected pulp.
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Affiliation(s)
- Yu Qiu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Jun Tian
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Siyi Kong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Yanping Feng
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
| | - Yangyu Lu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Lefeng Su
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
| | - Yanling Cai
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Mengjie Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Jiang Chang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, P. R. China
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai, 200050, P. R. China
| | - Chen Yang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, P. R. China
| | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
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Küçükkaya Eren S. Clinical applications of calcium silicate-based materials: a narrative review. Aust Dent J 2023; 68 Suppl 1:S96-S109. [PMID: 37885314 DOI: 10.1111/adj.12986] [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] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.
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Affiliation(s)
- S Küçükkaya Eren
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
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Zeng Q, Zhou C, Li M, Qiu Y, Wei X, Liu H. Concentrated growth factor combined with iRoot BP Plus promotes inflamed pulp repair: an in vitro and in vivo study. BMC Oral Health 2023; 23:225. [PMID: 37076830 PMCID: PMC10114309 DOI: 10.1186/s12903-023-02903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/21/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Platelet concentrates combined with calcium silicate cements may promote reparative dentin formation. However, few studies have reported their effect on dental pulp inflammation. This study aimed to evaluate the effects of concentrated growth factor (CGF) combined with iRoot BP Plus on inflammatory human dental pulp stem cells (hDPSCs) in vitro and inflamed pulp in rats in vivo. METHODS The proliferation of LPS-stimulated hDPSCs treated with 50% CGF with/without 25% iRoot BP Plus was evaluated using Cell Counting Kit-8 on days 1, 4 and 7. The expression of genes associated with inflammation on day 1 and differentiation on day 14 was analysed by real-time polymerase chain reaction. The exposed pulp of rat maxillary molars was injected with 10 mg/mL LPS and directly capped with CGF membrane with/without iRoot BP Plus extract for 1, 7 and 28 days. The teeth were subjected to histologic analyses and immunohistochemistry. RESULTS The proliferation rates of the inflammatory hDPSCs after the combination treatment were significantly higher than those after the other treatments on days 4 and 7 (P < 0.05). IL-1β, IL-6, and TNF-α levels were increased in inflammatory hDPSCs but decreased after treatment with CGF combined with iRoot BP Plus extract, whereas IL-4 and IL-10 showed the opposite expression patterns. Expression of the odontogenesis-related genes OCN, Runx2, and ALP was dramatically enhanced by combined treatment with CGF and iRoot BP Plus extract. In rat pulp, the average inflammation scores of the CGF and CGF-iRoot BP Plus groups significantly decreased in comparison with those of the LPS group (P < 0.05), and the CGF-iRoot BP Plus group had more reparative dentin than the CGF and BP groups. Immunohistochemical staining showed fewer M1 macrophages on day 1 and more M2 macrophages on day 7 in the CGF-iRoot BP Plus group than in the other groups. CONCLUSIONS The combination of CGF and iRoot BP Plus showed a synergistic effect on anti-inflammatory potential and promoted greater pulp healing than CGF or iRoot BP Plus alone.
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Affiliation(s)
- Qian Zeng
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
| | - Can Zhou
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
| | - Mengjie Li
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
| | - Yu Qiu
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
| | - Xi Wei
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China.
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China.
| | - Hongyan Liu
- Hospital of Stomatology, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510055, China.
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China.
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11
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Li G, Xu Z, Yang M, Ning Y, Ye L, Jiang H, Du Y. Topographic Cues of a PLGA Scaffold Promote Odontogenic Differentiation of Dental Pulp Stem Cells through the YAP/β-Catenin Signaling Axis. ACS Biomater Sci Eng 2023; 9:1598-1607. [PMID: 36861954 DOI: 10.1021/acsbiomaterials.2c01497] [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] [Indexed: 03/03/2023]
Abstract
PURPOSE The underlying mechanism of how topographic cues of artificial scaffolds regulate cell function remains poorly understood. Yes-associated protein (YAP) and β-catenin signaling have both been reported to play important roles in mechano-transduction and dental pulp stem cells (DPSCs) differentiation. We investigated the effects of YAP and β-catenin in spontaneous odontogenic differentiation of DPSCs induced by topographic cues of a poly(lactic-co-glycolic acid) (PLGA) membrane. METHODS The topographic cues and function of a fabricated PLGA scaffold were explored via scanning electron microscopy (SEM), alizarin red staining (ARS), reverse transcription-polymerase chain reaction (RT-PCR), and pulp capping. Immunohistochemistry (IF), RT-PCR, and western blotting (WB) were used to observe the activation of YAP and β-catenin when DPSCs were cultured on the scaffolds. Further, YAP was inhibited or overexpressed on either side of the PLGA membrane, and YAP, β-catenin, and odontogenic marker expression were analyzed using IF, ARS, and WB. RESULTS The closed side of the PLGA scaffold promoted spontaneous odontogenic differentiation and nuclear translocation of YAP and β-catenin in vitro and in vivo compared to the open side. The YAP antagonist verteporfin inhibited β-catenin expression, nuclear translocation, and odontogenic differentiation on the closed side, but the effects were rescued by LiCl. YAP overexpressing DPSCs on the open side activated β-catenin signaling and promoted odontogenic differentiation. CONCLUSION The topographic cue of our PLGA scaffold promotes odontogenic differentiation of DPSCs and pulp tissue through the YAP/β-catenin signaling axis.
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Affiliation(s)
- Guixian Li
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
| | - Zhiqing Xu
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
| | - Maobin Yang
- Regenerative Health Research Laboratory, Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
| | - Yang Ning
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
| | - Li Ye
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
| | - Hongwei Jiang
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
| | - Yu Du
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, Guangdong, China
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12
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Zhang D, Zheng C, Zhu T, Yang F, Zhou Y. Identification of key module and hub genes in pulpitis using weighted gene co-expression network analysis. BMC Oral Health 2023; 23:2. [PMID: 36593446 PMCID: PMC9808982 DOI: 10.1186/s12903-022-02638-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/30/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pulpitis is a common disease mainly caused by bacteria. Conventional approaches of diagnosing the state of dental pulp are mainly based on clinical symptoms, thereby harbor deficiencies. The accurate and rapid diagnosis of pulpitis is important for choosing the suitable therapy. The study aimed to identify pulpits related key genes by integrating micro-array data analysis and systems biology network-based methods such as weighted gene co-expression network analysis (WGCNA). METHODS The micro-array data of 13 inflamed pulp and 11 normal pulp were acquired from Gene Expression Omnibus (GEO). WGCNA was utilized to establish a genetic network and categorize genes into diverse modules. Hub genes in the most associated module to pulpitis were screened out using high module group members (MM) methods. Pulpitis model in rat was constructed and iRoot BP plus was applied to cap pulp. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used for validation of hub genes. RESULTS WGCNA was established and genes were categorized into 22 modules. The darkgrey module had the highest correlation with pulpitis among them. A total of 5 hub genes (HMOX1, LOX, ACTG1, STAT3, GNB5) were identified. RT-qPCR proved the differences in expression levels of HMOX1, LOX, ACTG1, STAT3, GNB5 in inflamed dental pulp. Pulp capping reversed the expression level of HMOX1, LOX, ACTG1. CONCLUSION The study was the first to produce a holistic view of pulpitis, screen out and validate hub genes involved in pulpitis using WGCNA method. Pulp capping using iRoot BP plus could reverse partial hub genes.
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Affiliation(s)
- Denghui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Chen Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Tianer Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Fan Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Yiqun Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
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Alharbi H, Khalil W, Alsofi L, Binmadi N, Elnahas A. The effect of low-level laser on the quality of dentin barrier after capping with bioceramic material: A histomorphometric analysis. AUST ENDOD J 2022; 49:27-37. [PMID: 35229961 DOI: 10.1111/aej.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/24/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
Abstract
The study aims to investigate the quality of dentin barriers and pulp reaction to EndoSequence Root Repair Material (ERRM) combined with low-level laser application. In eight dogs, pulps were exposed via class V, half of the samples received low-level diode laser at 870 nm. Thereafter, cavities were capped with fast-set or regular-set ERRM. The specimens were processed for histomorphological and immunohistochemical examination after 2 weeks and 2 months. Dentin bridges were observed in all samples, and 87.5% were complete. The low-level laser group had significantly more reparative dentin area than the non-lased group (p < 0.05). The dentin bridges were found to have an unprecedented tubularity of 43%-89%. Tiny dentin island formation was observed within the material particles. Initial mild-to-moderate inflammatory reactions were observed, which subsided after 2 months. RUNX2 and osteocalcin staining were evident for all samples at both time intervals. Low-level laser combined with bioactive ERRM is effective in inducing reparative dentin formation.
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Affiliation(s)
- Hanan Alharbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Conservative Sciences, Division of Endodontics, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Wafaa Khalil
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Loai Alsofi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada Binmadi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Elnahas
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al Hofuf, Saudi Arabia
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[Evaluation of bioceramic putty repairmen iRoot and mineral trioxide aggregate in mature permanent teeth pulpotomy]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022. [PMID: 35165477 PMCID: PMC8860637 DOI: 10.19723/j.issn.1671-167x.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot and mineral trioxide aggregate (MTA). METHODS Pulpotomy was performed on mature permanent premolars and molars with carious exposures at the Department of General Dentistry of Peking University School and Hospital of Stomatology, from November 2017 to September 2019. The patients were randomly divided into 2 groups, Group iRoot (n=22) and Group MTA (n=21). In Group iRoot, bioceramic putty repairmen iRoot was used as pulp capping agent, while in Group MTA, mineral trioxide aggregate was used as pulp capping agent. All the patients had signed informed consent forms. The clinical efficacy was evaluated by clinical examinations (temperature and electrical activity test) and imaging examinations 3, 6, and 12 months after surgery. Blinding was used for the patients and evaluators, but due to the obvious differences in the properties of the two pulp capping agents, the blinding method was not used for the treatment provider (the attending physician). RESULTS There was no significant difference in gender, average age, dentition and tooth position distribution between the two groups (P>0.05). In the study, 7 cases were lost to follow-up 12 months after operation (4 cases in Group iRoot, and 3 cases in Group MTA). One case in each of the two groups had transient sensitivity at the end of the 3-month follow-up, and the pulp vitality was normal at the end of the 6-month follow-up. One case in Group iRoot showed sensitivity at the end of the 12-month follow-up. The success rates of the two groups at the end of 12-month follow-up were 100%, and the cure rates were 94.4% (Group iRoot) and 100% (Group MTA), respectively, and the difference was not statistically significant (P>0.05). No cases in Group iRoot had obvious crown discoloration, while 3 cases in Group MTA had. CONCLUSION The clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot were similar with MTA. Bioceramic putty repairmen iRoot is an acceptable material when used in pulpotomy of mature permanent teeth. Because it is not easy to cause tooth discoloration after treatment and is convenient to operate, bioceramic putty repairmen iRoot has a better clinical application prospect.
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Effectiveness of Direct Pulp Capping Bioactive Materials in Dentin Regeneration: A Systematic Review. MATERIALS 2021; 14:ma14226811. [PMID: 34832214 PMCID: PMC8621741 DOI: 10.3390/ma14226811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022]
Abstract
Background: Regenerative endodontics aims to restore normal pulp function in necrotic and infected teeth, restoring protective functions, such as innate pulp immunity, pulp repair through mineralization, and pulp sensibility. The aim of this systematic review was to assess the dentin regeneration efficacy of direct pulp capping (DPC) biomaterials. Methods: The literature published between 2005 and 2021 was searched by using PubMed, Web of Science, Science Direct, Google Scholar, and Scopus databases. Clinical controlled trials, randomized controlled trials, and animal studies investigating DPC outcomes or comparing different capping materials after pulp exposure were included in this systematic review. Three independent authors performed the searches, and information was extracted by using a structured data format. Results: A total of forty studies (21 from humans and 19 from animals) were included in this systemic review. Histological examinations showed complete/partial/incomplete dentin bridge/reparative dentin formation during the pulp healing process at different follow-up periods, using different capping materials. Conclusions: Mineral trioxide aggregate (MTA) and Biodentine can induce dentin regeneration when applied over exposed pulp. This systematic review can conclude that MTA and its variants have better efficacy in the DPC procedure for dentin regeneration.
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Guan X, Zhou Y, Yang Q, Zhu T, Chen X, Deng S, Zhang D. Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study. J Pers Med 2021; 11:jpm11111125. [PMID: 34834477 PMCID: PMC8620894 DOI: 10.3390/jpm11111125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/30/2021] [Indexed: 01/09/2023] Open
Abstract
Background: When a tooth is diagnosed with irreversible pulpitis, root canal therapy (RCT) is generally performed to completely remove pulp tissue, which might lead to a higher risk of loss of vascularity, and teeth being more prone to fracture. Vital pulp therapy (VPT) is a personalized method of treating irreversible pulpitis, which conforms to the trend of minimally invasive endodontics. The remaining vital pulp could promote the physiological development of the roots of young permanent teeth with incomplete apical foramen. However, clear guidelines for VPT indication are still missing. Objective: This prospective cohort study evaluated the outcomes of vital pulp therapy (VPT) using iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, BC, Canada) in permanent teeth of 6- to 20-year-old patients with irreversible pulpitis caused by caries and analyzed the preoperative factors affecting VPT prognosis. Methods: Fifty-nine permanent teeth in 59 patients with irreversible pulpitis caused by caries were treated with VPT using iRoot BP Plus. All patients received VPT under a standardized protocol. After informed consent, teeth were isolated with a dental dam, then operators performed VPT with iRoot BP Plus and restored the teeth with composite resin or stainless steel crown. Patients were postoperatively recalled after 3, 6 and 12 months and then recalled annually. Successful cases were defined as successful in both clinical and radiographic evaluations. A statistical analysis was performed using the Fisher exact test, and the level of significant difference was p < 0.05. Results: After 6–36 months of follow-up, a total of 57 teeth from 57 patients were accessible for evaluation. The mean age of subjects was 11.75 ± 3.81 years. The overall clinical and radiographic success rate of VPT was 91.2% (52/57). With an observation time of one year or more, the success rate was 90.5% (38/42). All the symptoms and physical examination findings showed no significant effect on VPT prognosis (p > 0.05) using a binary logistic regression model. Conclusions: Permanent teeth in 6- to 20-year-old patients diagnosed as irreversible pulpitis caused by caries can be successfully treated with VPT using iRoot BP Plus.
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Toida Y, Kawano S, Islam R, Jiale F, Chowdhury AA, Hoshika S, Shimada Y, Tagami J, Yoshiyama M, Inoue S, Carvalho RM, Yoshida Y, Sano H. Pulpal response to mineral trioxide aggregate containing phosphorylated pullulan-based capping material. Dent Mater J 2021; 41:126-133. [PMID: 34602588 DOI: 10.4012/dmj.2021-153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aimed to evaluate the pulpal responses of monkey's pulp after direct pulp capping (DPC) with the novel mineral trioxide aggregate containing phosphorylated pullulan-based material (MTAPPL). Seventy-two teeth were randomly divided into four groups: MTAPPL; Nex-Cem MTA (NX); TheraCal LC (TH); and Dycal (DY). Histopathological changes in the pulps were observed at days 3, 7 and 70. On day 3, mild inflammatory responses were observed in the MTAPPL, no to moderate inflammatory responses in the TH, whereas moderate inflammatory responses in the NX and DY. No mineralized tissue formation (MTF) was observed in all groups. On day 7, no or mild inflammatory responses were observed in all groups. Initial MTF was observed except for DY. No inflammation with complete MTF including presence of odontoblast-like cells was observed in the MTAPPL, NX and TH groups at day 70. These findings indicate that MTAPPL could be an efficient DPC material.
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Affiliation(s)
- Yu Toida
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University
| | - Shimpei Kawano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University.,Sapporo Prison, Sapporo Regional Correction Headquarters, Correction Bureau, Ministry of Justice, Government of Japan
| | - Rafiqul Islam
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University
| | - Fu Jiale
- Department of Dental Materials, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Disease
| | - Afm A Chowdhury
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University.,Department of Conservative Dentistry and Endodontics, Sapporo Dental College and Hospital
| | - Shuhei Hoshika
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University
| | - Yasushi Shimada
- Department of Operative Dentistry, Field of Study of Biofunctional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Junji Tagami
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Masahiro Yoshiyama
- Department of Operative Dentistry, Field of Study of Biofunctional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Satoshi Inoue
- Section for Clinical Education, Faculty of Dental Medicine, Hokkaido University
| | - Ricardo M Carvalho
- Division of Biomaterials, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia
| | - Yasuhiro Yoshida
- Department of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido University
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University
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Xu X, Li Z, Ai X, Tang Y, Yang D, Dou L. Human three-dimensional dental pulp organoid model for toxicity screening of dental materials on dental pulp cells and tissue. Int Endod J 2021; 55:79-88. [PMID: 34587308 DOI: 10.1111/iej.13641] [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] [Received: 02/10/2021] [Accepted: 09/28/2021] [Indexed: 01/15/2023]
Abstract
AIM To establish a 3D model for screening the biocompatibility of dental materials/drugs on dental pulp cells and tissue. METHODOLOGY Human dental pulp cells (hDPC) and endothelial cells (EC) were mixed with or without human dental pulp derived extracellular matrix (hDP-ECM) according to several protocols and cultured in 3D plates to fabricate 3D organoids. Cell viability and proliferation in organoids were evaluated using Live/Dead cell viability assay and ATPase assay. Organoids were fixed, cut and stained with a H&E staining kit. The expressions of DSPP, DMP-1, CD31, vWF and COL1A in 3D organoids were evaluated using immunofluorescence. To assess the feasibility of 3D organoids on drug/material toxicity screening, the organoids were treated with lipopolysaccharides (LPS) or iRoot BP. Then, cell viability and apoptosis were assessed. The expressions of IL-6, TNF-α, and IL-1β were compared in LPS-treated and non-treated organoids. Alizarin Red S staining was used to evaluate calcium deposit formation in organoids. Data were analysed using one-way anova followed by Tukey's post hoc comparison. RESULTS The 3D spheres/organoids were formed at day 1 or day 2. Cells in 3D organoids maintained a high viability rate and low proliferation activity. The level of CD31 increased significantly (p < .05) when EC were added to coculture with hDPC. The expressions of odontogenesis-associated proteins (DSPP, COL1A) upregulated (p < .05) with the addition of hDP-ECM. Level of IL-6 expression and rates of dead and apoptotic cells in 3D organoids were increased significantly (p < .05) in response to LPS. Calcium deposit formation was observed in iRoot BP-treated organoids. CONCLUSIONS Coculture of hDPC and EC in the presence of hDP-ECM formed functional dental pulp organoids. The experimental model provides an alternative tool for toxicity screening of dental pulp capping agents and dental pulp regeneration research.
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Affiliation(s)
- Xiaoqi Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zheng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiaoqing Ai
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yin Tang
- University of Southern California Herman Ostrow School of Dentistry, Los Angeles, California, USA
| | - Deqin Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lei Dou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Yeh CL, Bhorade R, Hsu TT, Chen CY, Lin CP. Mechanical assessment and odontogenic behavior of a 3D-printed mesoporous calcium silicate/calcium sulfate/poly-ε-caprolactone composite scaffold. J Formos Med Assoc 2021; 121:510-518. [PMID: 34266707 DOI: 10.1016/j.jfma.2021.06.025] [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: 06/08/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/PURPOSE Tissue engineering in dentistry has fundamentally changed the way endodontists assess treatment options. Our previous study found that quercetin-contained mesoporous calcium silicate/calcium sulfate (MSCSQ) could induce hard tissue defect region regeneration. This study focused on whether the MSCSQ scaffold could also be effective in regulating odontogenesis and dentin regeneration. METHODS In this study, we fabricated MSCSQ composite scaffolds using the 3D printing technique. The characteristics of the MSCSQ scaffold were examined by scanning electron microscope (SEM), and mechanical properties were also assessed. In addition, we evaluated the cell viability, cell proliferation, odontogenic-related protein expression, and mineralization behavior of human dental pulp stem cells (hDPSCs) cultured on different scaffolds. RESULTS We found the precipitation of spherical-apatite on the scaffold surface rapidly in short periods. The in-vitro results for cell behavior revealed that hDPSCs with an MSCSQ scaffold were significantly higher in cell viability as followed time points. In addition, the specific makers of odontogenesis, such as DSPP and DMP-1 proteins, were induced obviously after culturing the hDPSCs on the MSCSQ scaffold. CONCLUSION Our results demonstrated that MSCSQ scaffolds could enhance physicochemical and biological behaviors compared to mesoporous calcium silicate/calcium sulfate (MSCS) scaffolds. In addition, MSCSQ scaffolds also enhanced odontogenic and immuno-suppressive properties compared to MSCS scaffolds. These results indicated that MSCSQ scaffolds could be considered a potential bioscaffold for clinical applications and dentin regeneration.
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Affiliation(s)
- Chun-Liang Yeh
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Rupali Bhorade
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Tuan-Ti Hsu
- X-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yu Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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20
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Tucker RL, Ha WN. A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs. J Vet Dent 2021; 38:34-45. [PMID: 34192968 DOI: 10.1177/08987564211024905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vital pulp therapy (VPT) and direct pulp capping (DPC) are procedures regularly performed in dogs for the management of acute tooth fractures and as part of management for traumatic malocclusions. The purpose of this review is to apply an evidence-based medicine approach to systematically review and evaluate the scientific literature evaluating the efficacy of mineral trioxide aggregate (MTA) to other commercially available materials used for VPT in the permanent teeth of dogs. The 9 studies meeting inclusion criteria were reviewed and each studies evidence was classified using a grading system modified from the Oxford Centre for Evidence-Based Medicine. For the studies meeting inclusion criteria, MTA consistently performed as well or better than other commercially available products in terms of calcific barrier formation and biocompatibility. This review found a lack of consistency between the studies making a direct comparison of the results unreliable. Future studies would benefit from the implementation of a standard scoring system for histology, equivalent and longer study duration times and the correlation of histological and radiographic data.
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Affiliation(s)
- Rebecca Lee Tucker
- Advanced Animal Dentistry, Veterinary Specialist Services, Underwood, Queensland, Australia
| | - William Nguyen Ha
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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21
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Islam R, Toida Y, Chen F, Tanaka T, Inoue S, Kitamura T, Yoshida Y, Chowdhury AFMA, Ahmed HMA, Sano H. Histological evaluation of a novel phosphorylated pullulan-based pulp capping material: An in vivo study on rat molars. Int Endod J 2021; 54:1902-1914. [PMID: 34096634 DOI: 10.1111/iej.13587] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the dental pulp response to a novel mineral trioxide aggregate containing phosphorylated pullulan (MTAPPL) in rats after direct pulp capping. METHODS Ninety-six cavities were prepared in the maxillary first molars of 56 male Wistar rats. The dental pulps were intentionally exposed and randomly divided into four groups according to the application of pulp capping materials: MTAPPL; phosphorylated pullulan (PPL); a conventional MTA (Nex-Cem MTA, NCMTA; positive control); and Super-Bond (SB; negative control). All cavities were restored with SB and observed for pulpal responses at 1-, 3-, 7- and 28-day intervals using a histological scoring system. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-test with Bonferroni's correction, and the level of significance was set at 0.05. DMP1 and CD34 antigen were used to evaluate odontoblast differentiation and pulpal vascularization, respectively. RESULTS On day 1, mild inflammatory cells were present in MTAPPL and NCMTA groups; fewer inflammatory cells were present in the PPL, whereas SB was associated with a mild-to-moderate inflammatory response. A significant difference was observed between PPL and SB (p < .05). No mineralized tissue deposition was observed. On day 3, moderate-to-severe inflammatory cells were present in PPL and SB, whereas MTAPPL and NCMTA had a mild inflammatory response. Initial mineralized tissue deposition was observed in the NCMTA, MTAPPL and SB. A significant difference was observed between MTAPPL and PPL (p < .05). On day 7, a thin layer of mineralized tissue was observed in all tested groups with no or mild inflammatory response. On day 28, no inflammatory response was observed in MTAPPL, whereas NCMTA, PPL and SB had mild inflammatory responses. A significant difference was observed between MTAPPL and SB (p < .05). Complete mineralized tissue barrier formation was observed in MTAPPL, NCMTA and PPL with no significant difference (p > .05). SB exhibited incomplete mineralized tissue barriers, significantly different from NCMTA, MTAPPL and PPL (p < .05). The staining with CD34 was positive in all the groups on all observation days. CONCLUSION The favourable pulpal responses and induction of mineralized tissue formation associated with MTAPPL indicate its potential application as a direct pulp capping material.
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Affiliation(s)
- Rafiqul Islam
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Yu Toida
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Fei Chen
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Toru Tanaka
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Satoshi Inoue
- Section for Clinical Education, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Tetsuya Kitamura
- Department of Vascular Biology and Molecular Pathology, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Yasuhiro Yoshida
- Department of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Abu Faem Mohammad Almas Chowdhury
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan.,Department of Conservative Dentistry and Endodontics, Sapporo Dental College and Hospital, Dhaka, Bangladesh
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
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22
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Andrei M, Vacaru RP, Coricovac A, Ilinca R, Didilescu AC, Demetrescu I. The Effect of Calcium-Silicate Cements on Reparative Dentinogenesis Following Direct Pulp Capping on Animal Models. Molecules 2021; 26:molecules26092725. [PMID: 34066444 PMCID: PMC8125639 DOI: 10.3390/molecules26092725] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022] Open
Abstract
Dental pulp vitality is a desideratum for preserving the health and functionality of the tooth. In certain clinical situations that lead to pulp exposure, bioactive agents are used in direct pulp-capping procedures to stimulate the dentin-pulp complex and activate reparative dentinogenesis. Hydraulic calcium-silicate cements, derived from Portland cement, can induce the formation of a new dentin bridge at the interface between the biomaterial and the dental pulp. Odontoblasts are molecularly activated, and, if necessary, undifferentiated stem cells in the dental pulp can differentiate into odontoblasts. An extensive review of literature was conducted on MedLine/PubMed database to evaluate the histological outcomes of direct pulp capping with hydraulic calcium-silicate cements performed on animal models. Overall, irrespective of their physico-chemical properties and the molecular mechanisms involved in pulp healing, the effects of cements on tertiary dentin formation and pulp vitality preservation were positive. Histological examinations showed different degrees of dental pulp inflammatory response and complete/incomplete dentin bridge formation during the pulp healing process at different follow-up periods. Calcium silicate materials have the ability to induce reparative dentinogenesis when applied over exposed pulps, with different behaviors, as related to the animal model used, pulpal inflammatory responses, and quality of dentin bridges.
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Affiliation(s)
- Mihai Andrei
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Raluca Paula Vacaru
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Anca Coricovac
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
| | - Radu Ilinca
- Division of Biophysics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania;
| | - Andreea Cristiana Didilescu
- Division of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania; (M.A.); (R.P.V.); (A.C.)
- Correspondence: ; Tel.: +40-722536798
| | - Ioana Demetrescu
- Department of General Chemistry, University Politehnica Bucharest, Spl. Independentei 313, 060042 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov, 050044 Bucharest, Romania
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23
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Motwani N, Ikhar A, Nikhade P, Chandak M, Rathi S, Dugar M, Rajnekar R. Premixed bioceramics: A novel pulp capping agent. J Conserv Dent 2021; 24:124-129. [PMID: 34759576 PMCID: PMC8562841 DOI: 10.4103/jcd.jcd_202_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/28/2020] [Accepted: 02/22/2021] [Indexed: 01/26/2023] Open
Abstract
The main aim of restorative dentistry is to protect the vitality of the Pulp tissue. The pin point carious expoure and iatrogenic errors warrant the need for various pulp capping procedures like Indirect Pulp Capping and Direct Pulp Capping. Pulp Capping is dressing of the dental pulp exposed due to mechanical procedure, carious lesion or traumatic injury to preserve its vitality and function. There has been constant evolution and research on materials used to cap the Pulp tissue. The different kind of chemical and biological materials has been used with varying degree of success. The prognosis based on the pulp capping material has dramatically improved with the introduction of bioactive cement. Though MTA and biodentine have shown a high success rate, their properties can be adversely affected with error in powder/liquid ratio and may present with difficulty in the handling characteristic. Premixed bioceramics have been introduced in the market and present with desirable properties as a pulp capping agent. Owing to good handling characteristics, biocompatibility, odontogenic property, and antibacterial action it is a potent pulp capping agent for clinical application. This review is aimed to discuss the introduction of premixed bioceramics, forms of premixed bioceramics available, and its physical, chemical, and biocompatible properties.
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Affiliation(s)
- Nidhi Motwani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Pradnya Nikhade
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Saurabh Rathi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Meghna Dugar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| | - Rutuja Rajnekar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
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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: 15] [Impact Index Per Article: 3.8] [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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25
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Chen X, Zhang H, Zhong J, Yan W, Lin B, Ding M, Xue S, Xia B. Comparison of indirect pulp treatment and iRoot BP Plus pulpotomy in primary teeth with extremely deep caries: a prospective randomized trial. Clin Oral Investig 2020; 25:3067-3076. [PMID: 33063220 DOI: 10.1007/s00784-020-03627-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/07/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this randomized controlled trial was to compare the 24-month success rates of indirect pulp treatment (IPT) and iRoot BP Plus pulpotomy of primary molars with extremely deep caries. MATERIALS AND METHODS Generally healthy children aged 3-7 years requiring general anesthesia for treating primary molars with extremely deep caries or reversible pulpitis were recruited. Patients with systemic disease, mental health problems, or manifestations of irreversible pulpitis were excluded. In total, 175 molars were randomized and blinded for either IPT (n = 87) or iRoot BP Plus pulpotomy (n = 88). All teeth were restored with stainless steel crowns and evaluated after 6, 12, 18, and 24 months by two blinded calibrated investigators. Kaplan-Meier survival curves were used to compare the survival rates between the groups. The correlations between success rate and patient characteristics were explored with the Cox proportional hazards model. RESULTS A total of 168 primary molars in 67 patients (average age: 3.83 years) were evaluated. The cumulative survival probability at 24 months was not significantly different between the IPT (93.8%) and pulpotomy (97.7%) groups (P = 0.238). IPT treatment success was significantly associated with age (odds ratio = 2.347; 95% CI: 1.068-5.156; P = 0.034) and preoperative sensitivity (odds ratio = 9.742; 95% CI: 1.079-87.970; P = 0.043). CONCLUSIONS The 24-month success rates of IPT and iRoot BP Plus pulpotomy performed in primary molars with extremely deep caries were not significantly different. Increasing age and preoperative sensitivity were found to be associated with the cumulative survival probability in IPT-treated primary molars with extremely deep caries. Primary teeth with extremely deep carious lesions without signs of irreversible pulpitis can be treated successfully by either indirect pulp capping or iRoot BP Plus pulpotomy. TRIAL REGISTRATION ChiCTR2000032462.
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Affiliation(s)
- Xiaoxian Chen
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Hongmei Zhang
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jie Zhong
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Wenjuan Yan
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Bichen Lin
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Meili Ding
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Shihua Xue
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Bin Xia
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Zhongguancun South Avenue 22, Haidian District, Beijing, 100081, China.
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Zhai Y, Yuan X, Zhao Y, Ge L, Wang Y. Potential Application of Human β-Defensin 4 in Dental Pulp Repair. Front Physiol 2020; 11:1077. [PMID: 32973567 PMCID: PMC7472722 DOI: 10.3389/fphys.2020.01077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/05/2020] [Indexed: 01/02/2023] Open
Abstract
When pulp tissue is damaged by caries or trauma, vital pulp therapy (VPT) can help preserve the pulp tissue for long-term retention of teeth. However, the choice of pulp capping agent used in VPT is important for the successful preservation of the pulp tissue. Here we investigated the expression and biological function of human β-defensin 4 (HBD4) in dental pulp stem cells (DPSC) and explored its potential as a pulp capping agent. We examined the expression of HBD4 in DPSC in vitro using qPCR and immunofluorescence staining. We also looked at the effect of HBD4 on inflammatory factors in lipopolysaccharide (LPS)-stimulated DPSC, and its effects on mineralizing cell phenotype differentiation, via qPCR and western blot. Finally, we examined the ability of HBD4 to promote the restoration of the pulp-dentin complex in vivo, using male Wistar rats with reversible pulpitis. We found HBD4 was highly expressed in DPSC stimulated by TNF-α and IL-1α. HBD4 down-regulated the expression of inflammatory mediators (i.e., IL-1α, IL-1β, IL-6, TNF-α) in LPS-stimulated DPSC, and suppressed MAPK activity and the NF-κB pathway. HBD4 also enhanced the differentiation of DPSC into osteoblasts or odontoblasts, potentially by modulating the Notch pathway. Furthermore, HBD4 controlled the degree of pulp inflammation in a rat model of reversible pulpitis and induced the formation of restorative dentin. Together our findings indicate HBD4 may be a useful pulp capping agent for use in VPT.
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Affiliation(s)
| | | | | | | | - Yuanyuan Wang
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
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Lee S, Park YT, Setzer FC. Combined Regenerative and Vital Pulp Therapies in an Immature Mandibular Molar: A Case Report. J Endod 2020; 46:1085-1090. [PMID: 32553418 DOI: 10.1016/j.joen.2020.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/09/2020] [Accepted: 04/19/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This report describes the treatment of an immature mandibular molar by combining vital pulp therapy (VPT) and regenerative endodontic procedures (REPs). It details the use of REP to regain functionality and continued root development of an immature root with pulp necrosis and VPT for an immature root containing vital pulpal tissues. METHODS An 8-year old male presented for evaluation of a mandibular first right molar with mild buccal swelling and a nontraceable sinus tract. He recently had received a restoration. After intraoral and radiographic examination, a diagnosis of pulp necrosis and chronic apical abscess was made. After access, pulp necrosis was confirmed in the distal root; however, vital pulp tissues were present in the mesial canals. It was decided on pulpotomy (VPT) in the mesial and REP in the distal root. At the initial visit, pulpotomy was completed in the mesial root, and REP was initiated in the distal root. Three weeks later, the patient was asymptomatic and the sinus tract absent. REP was completed in the distal root, and the tooth was restored. RESULTS At the 6-, 12-, and 18-month follow-up, the patient presented without symptoms, and the tooth responded positively to pulp sensibility tests. Radiographic examinations showed resolution of the apical radiolucency and completed root development. CONCLUSIONS Combined treatment using both VPT and REP for immature molars with different pulpal status in individual roots may be a preferable treatment option because preservation of vital pulp tissues and regeneration of new vital tissues allow for continued root development and functionality.
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Affiliation(s)
- Sumin Lee
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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Tu MG, Lee AKX, Lin YH, Huang TH, Ho CC, Shie MY. Caffeic Acid-coated Nanolayer on Mineral Trioxide Aggregate Potentiates the Host Immune Responses, Angiogenesis, and Odontogenesis. J Endod 2020; 46:1455-1464. [PMID: 32668309 DOI: 10.1016/j.joen.2020.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/08/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The aim of this study was to investigate whether mineral trioxide aggregate (MTA) can be modified with caffeic acid (CA) to form caffeic acid/mineral trioxide aggregate (CAMTA) cement and to evaluate its physicochemical and biological properties as well as its capability in immune suppression and angiogenesis. METHODS MTA was immersed in trishydroxymethyl aminomethane buffer with CA to allow coating onto MTA powders. X-ray diffractometry and tensile stress-strain tests were conducted to assess for physical characteristics of CAMTA and to evaluate for successful modification of MTA. Then, the CAMTA cement was immersed in simulated body fluid to evaluate its hydroxyapatite formation capabilities and Si release profiles. In addition, RAW 264.7 cells and human dental pulp stem cells were used to evaluate CAMTA's immunosuppressive capabilities and cell responses, respectively. hDPSCs were also used to assess CAMTA's angiogenic capabilities. RESULTS The X-ray diffractometry results showed that CA can be successfully coated onto MTA without disrupting or losing MTA's original structural properties, thus allowing us to retain the initial advantages of MTA. CAMTA was shown to have higher mechanical properties compared with MTA and had rougher pitted surfaces, which were hypothesized to lead to enhanced adhesion, proliferation, and secretion of angiogenic- and odontogenic-related proteins. In addition, it was found that CAMTA was able to enhance hydroxyapatite formation and immunosuppressive capabilities compared with MTA. CONCLUSIONS CAMTA cements were found to have improved physicochemical and biological characteristics compared with their counterpart. In addition, CAMTA cements had enhanced odontogenic, angiogenic, and immunosuppressive properties compared with MTA. All of the results of this study proved that CAMTA cements could be a biomaterial for future clinical applications and tissue engineering use.
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Affiliation(s)
- Ming-Gene Tu
- School of Dentistry, China Medical University, Taichung City, Taiwan; Department of Dentistry, China Medical University Hospital, Taichung City, Taiwan
| | - Alvin Kai-Xing Lee
- School of Medicine, China Medical University, Taichung City, Taiwan; x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung City, Taiwan
| | - Yen-Hong Lin
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung City, Taiwan; The PhD Program for Medical Engineering and Rehabilitation Science, China Medical University, Taichung City, Taiwan
| | - Tsui-Hsien Huang
- School of Dentistry, Chung Shan Medical University Hospital, Taichung City, Taiwan; Department of Stomatology, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Chia-Che Ho
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan; 3D Printing Medical Research Institute, Asia University, Taichung City, Taiwan
| | - Ming-You Shie
- School of Dentistry, China Medical University, Taichung City, Taiwan; x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung City, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan.
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29
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Yang Y, Xia B, Xu Z, Dou G, Lei Y, Yong W. The effect of partial pulpotomy with iRoot BP Plus in traumatized immature permanent teeth: A randomized prospective controlled trial. Dent Traumatol 2020; 36:518-525. [PMID: 32348009 DOI: 10.1111/edt.12563] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022]
Affiliation(s)
- YingTing Yang
- The Third Clinical Division of Peking University School and Hospital of Stomatology Beijing China
| | - Bin Xia
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Beijing China
| | - Zheng Xu
- Department of Pediatric Dentistry The Center for Pediatric Dentistry University of Washington Seattle WA USA
| | - Guili Dou
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Beijing China
| | - Yue Lei
- The Third Clinical Division of Peking University School and Hospital of Stomatology Beijing China
| | - Wei Yong
- Department of General Dentistry Peking University School and Hospital of Stomatology Beijing China
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Zaen El-Din AM, Hamama HH, Abo El-Elaa MA, Grawish ME, Mahmoud SH, Neelakantan P. The effect of four materials on direct pulp capping: An animal study. AUST ENDOD J 2020; 46:249-256. [PMID: 32129919 DOI: 10.1111/aej.12400] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 01/08/2023]
Abstract
The aim of this study was to investigate the outcomes of direct pulp capping performed with two types of tricalcium silicate-based materials (mineral trioxide aggregate/MTA and Biodentine/BD); nano-hydroxyapatite (nHAP) crystals or calcium hydroxide (CH) in dogs. Following mechanical exposure, the pulps were randomly capped with one of the four materials. Histological analyses were performed to examine the outcomes after 7 days or 3 months. At 7 days, BD and nHAP showed significantly less inflammatory cell response than MTA and CH. At 3 months, the inflammatory cell response and tissue necrosis were significantly higher in the CH group. There was no significant difference between the tested materials in the calcific bridge formation after 7 days; however, a significant difference was noticed at the 3-month period. Tricalcium silicate-based cements and nHAP are potential alternatives to CH in vital pulp therapy following accidental pulp exposure.
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Affiliation(s)
- Ahmed M Zaen El-Din
- Faculty of Dentistry, Delta University for Science and Technology, Gamasa, Egypt
| | - Hamdi H Hamama
- Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | | | - Mohammed E Grawish
- Faculty of Dentistry, Mansoura University, Mansoura, Egypt.,Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Egypt
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Vital Pulp Therapy an Insight Over the Available Literature and Future Expectations. Eur Endod J 2020; 5:46-53. [PMID: 32342038 PMCID: PMC7183799 DOI: 10.14744/eej.2019.44154] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/29/2019] [Indexed: 12/16/2022] Open
Abstract
Vital pulp therapy (VPT) defined as “treatment which aims at preserving and maintaining the pulp tissue that has been compromised but not destroyed by extensive dental caries, dental trauma, and restorative procedures or for iatrogenic reasons”, offers some beneficial advantages over the conventional root canal treatment such as protective resistance for mastication forces or to prevent the loss of environmental changes sensation ability, which can lead to unnoticeable progression of caries and later fracture. A wide range of materials are suggested in the literature to be used as pulp capping protective dressing materials that varies from ready-made synthetic materials to biological based scaffolds and composites. The aim of the present review is to provide a full understanding of currently used materials to clinicians in order to help in their decision-making process delivering the best available evidence-based treatments to their patients. An extensive search for recent available data regarding direct pulp capping materials and potential suggestions for future use have been made. Newly developed biological based scaffolds showed promising results in dentine regeneration therefore strengthening the tooth structure and overcoming potential drawbacks of use of currently available recommended materials.
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Dou L, Yan Q, Yang D. Effect of five dental pulp capping agents on cell proliferation, viability, apoptosis and mineralization of human dental pulp cells. Exp Ther Med 2020; 19:2377-2383. [PMID: 32104306 DOI: 10.3892/etm.2020.8444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/19/2019] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the effect of calcium hydroxide [Ca(OH)2], mineral trioxide aggregate (MTA), iRoot BP, platelet-rich fibrin (PRF) and concentrated growth factors (CGF) on the proliferation, viability, apoptosis and mineralization of human dental pulp cells (HDPCs). HDPCs were treated with Ca(OH)2, MTA, iRoot BP, PRF and CGF exudates. Cell viability, apoptosis, proliferation, cell cycle and alkaline phosphatase (ALP) activity were evaluated in vitro. PRF significantly increased the cell proliferation as compared with that in the MTA and iRoot BP groups on day 3. The CGF group displayed higher proliferation rates as compared with that in the MTA group on days 3 and 7. The MTA group displayed the highest ALP activity on days 1 and 3, and the CGF group on day 7. Ca(OH)2 inhibited cell proliferation and the percentages of dead and apoptotic cells were relatively higher in the Ca(OH)2 group on days 1, 3 and 7 compared with those in the other groups. In conclusion, PRF and CGF may be potential pulp-capping materials for vital pulp therapy. Future in vivo studies are required to confirm this.
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Affiliation(s)
- Lei Dou
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P.R. China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P.R. China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P.R. China
| | - Qifang Yan
- Department of Endodontics, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Deqin Yang
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P.R. China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P.R. China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P.R. China
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Ricucci D, Grande NM, Plotino G, Tay FR. Histologic Response of Human Pulp and Periapical Tissues to Tricalcium Silicate-based Materials: A Series of Successfully Treated Cases. J Endod 2019; 46:307-317. [PMID: 31836137 DOI: 10.1016/j.joen.2019.10.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 12/12/2022]
Abstract
Pulpal/periapical responses of human teeth that are treated successfully with tricalcium silicate-based materials are extremely difficult to obtain because of the typical unavailability of these teeth for histologic examination. The present case series reports histologic and histobacteriologic findings of 3 human teeth that had undergone pulpotomy, orthograde retreatment, and apicoectomy/root-end filling using tricalcium silicate-based endodontic materials. The teeth were extracted after 34 days, 7 weeks, and 20 months, respectively, because of unusual circumstances. The extracted teeth were processed, paraffin embedded, sectioned, stained with hematoxylin-eosin or the modified Brown and Brenn technique, and examined with light microscopy. The recurrent observation for the 3 cases presented was the absence of inflammatory or foreign body reactions of the host tissues in contact with tricalcium silicate-based materials after different observation periods despite the identification of bacteria in dentinal tubules close to the site of operation. Wound healing was rapid with repair/regeneration of lost tissues with cementum and new bone trabeculae. Although the level of evidence for a case series is low because of the anecdotal nature of the reported episodes, the histologic results reported in the present case series illustrate the highly biocompatible and bioactive nature of the tricalcium silicate-based materials used in treating these cases.
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Affiliation(s)
| | | | | | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia
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Liu Y, Liu XM, Bi J, Yu S, Yang N, Song B, Chen X. Cell migration and osteo/odontogenesis stimulation of iRoot FS as a potential apical barrier material in apexification. Int Endod J 2019; 53:467-477. [PMID: 31622505 DOI: 10.1111/iej.13237] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/06/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022]
Abstract
AIM To investigate the in vitro biological effects of a nanoparticle bioceramic material, iRoot Fast Set root repair material (iRoot FS), on the proliferation, migration and osteo/odontogenic differentiation of human stem cells from the apical papilla (hSCAP), and to further explore the mechanism involved in osteo/odontogenic induction of iRoot FS. METHODOLOGY hSCAP were isolated and characterized in vitro. iRoot FS conditioned medium were prepared and used to treat hSCAP, while using mineral trioxide aggregate (MTA) conditioned medium as the positive control and regular medium as the negative control. MTT assay and BrdU labelling assay were performed to determine cell proliferation. Wound healing assay and transwell assay were conducted to evaluate cell migration. The osteo/odontogenic differentiation of hSCAP was evaluated by qPCR, Western blot and Alizarin red S staining. Wnt inhibitor was used for downregulating the expression level of β-catenin of hSCAP. RESULTS The cell proliferation of hSACP in the iRoot FS group was not significantly different compared with the control groups. The cell migration of hSCAP in the iRoot FS group was significantly increased than the MTA and negative control groups (P < 0.01). The expression levels of osteo/odontogenic markers and mineralization nodule formation of hSCAP in the iRoot FS group were significantly elevated (P < 0.01). Furthermore, iRoot FS enhanced the osteo/odontogenic differentiation of hSCAP by activating Wnt/β-catenin signalling. CONCLUSIONS iRoot FS promoted the cell migration of hSCAP and enhanced their oseto/odontogenesis potential via the Wnt/β-catenin pathway without cytotoxicity. iRoot FS had satisfactory biological properties and has potential to be used as an apical barrier in apexification or as a coronal sealing material in regenerative endodontic treatment.
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Affiliation(s)
- Y Liu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - X M Liu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - J Bi
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - S Yu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - N Yang
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - B Song
- School of Dentistry, Cardiff University, Cardiff, UK
| | - X Chen
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
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Mahgoub N, Alqadasi B, Aldhorae K, Assiry A, Altawili ZM, Tao Hong. Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review. J Int Soc Prev Community Dent 2019; 9:542-552. [PMID: 32039073 PMCID: PMC6905310 DOI: 10.4103/jispcd.jispcd_249_19] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent. MATERIALS AND METHODS A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected. RESULTS A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate. CONCLUSION iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation.
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Affiliation(s)
- Nasrin Mahgoub
- Department of General Dentistry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Basema Alqadasi
- Orthodontic Department Hospital of Stomatology Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Khalid Aldhorae
- Department of Orthodontics, College of Dentistry, Thamar University, Thamar, Yemen, China
| | - Ali Assiry
- Department of Preventive Dental Sciences, Najran University, Najran, Kingdom of Saudi Arabia
| | | | - Tao Hong
- Department of General Dentistry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Lu J, Li Z, Wu X, Chen Y, Yan M, Ge X, Yu J. iRoot BP Plus promotes osteo/odontogenic differentiation of bone marrow mesenchymal stem cells via MAPK pathways and autophagy. Stem Cell Res Ther 2019; 10:222. [PMID: 31358050 PMCID: PMC6664598 DOI: 10.1186/s13287-019-1345-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/30/2019] [Accepted: 07/15/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND iRoot BP Plus is a novel bioceramic endodontic material. Recently, it has been considered as an alternative to MTA which is the most popular scaffold cover during regenerative endodontic therapy. This study aimed to evaluate the effects of iRoot BP Plus on the osteo/odontogenic capacity of bone marrow mesenchymal stem cells (BMMSCs), including the underlying mechanisms. METHODS BMMSCs were collected by a whole marrow method and treated with iRoot BP Plus-conditioned medium (BP-CM). The proliferation ability was evaluated by cell counting kit 8 and flow cytometry. Complete medium was used as a blank control, and 2 mg/ml MTA-conditioned medium was served as a positive control. Alkaline phosphatase (ALP) activity assay, ALP staining, western blot, real-time RT-PCR, Alizarin Red S staining, and immunofluorescence staining were performed to explore the osteo/odontogenic potential and the involvement of MAPK pathways. Besides, autophagy was investigated by western blot, immunofluorescence staining, and transmission electron microscopy. RESULTS
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Affiliation(s)
- Jiamin Lu
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China
| | - Zehan Li
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China
| | - Xiao Wu
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China
| | - Yan Chen
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, Jiangsu, China
| | - Ming Yan
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China.,Endodontic Department, School of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China
| | - Xingyun Ge
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China
| | - Jinhua Yu
- Key Laboratory of Oral Diseases of Jiangsu Province, Institute of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China. .,Endodontic Department, School of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu, China.
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Tu MG, Sun KT, Wang TH, He YZ, Hsia SM, Tsai BH, Shih YH, Shieh TM. Effects of mineral trioxide aggregate and bioceramics on macrophage differentiation and polarization in vitro. J Formos Med Assoc 2019; 118:1458-1465. [PMID: 31358435 DOI: 10.1016/j.jfma.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/04/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/PURPOSE Mineral trioxide aggregate (Pro-Root MTA, PR-MTA) and bioceramics (iRoot® SP Injectable Root Canal Sealer, iR-BC) are used for making apical plugs used in apexification, repairing root perforations during root canal therapy, and treating internal root resorption. The purpose of the present in vitro study was to compare the biological effects of PR-MTA- and iR-BC-based dental sealers in the mouse macrophage cell line RAW 264.7. METHODS Cytotoxicity and cell proliferation were analyzed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and cell hemocytometer, respectively. Protein expression of biomarkers of cell proliferation, autophagy, and osteoclast differentiation was determined by western blotting. Pro-inflammatory gene expression was examined using quantitative reverse transcription-PCR. RESULTS PR-MTA induced cytotoxicity in RAW 264.7 cells in a dose-dependent manner, and iR-BC was more cytotoxic than PR-MTA. Low-dose and short-term treatments of both PR-MTA and iR-BC induced RAW 264.7 cell proliferation. PR-MTA induced autophagy, whereas iR-BC did not. Neither PR-MTA nor iR-BC induced osteoclastogenesis. Pro-inflammatory genes were activated by both materials. However, the expression of inducible nitric oxide synthase (iNOS) mRNA was upregulated by iR-BC treatment, but not by PR-MTA treatment. CONCLUSION Overall, dental PR-MTA and iR-BC induced pro-inflammatory genes but did not induce osteoclastogenesis in macrophages. PR-MTA and iR-BC induced M2 and M1 polarization, respectively, of RAW 264.7 cells.
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Affiliation(s)
- Ming-Gene Tu
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Kuo-Ting Sun
- School of Dentistry, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Pediatric Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Tong-Hong Wang
- Tissue Bank, Chang Gung Memorial Hospital, Linko, Taiwan
| | - Yun-Zhen He
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Bi-He Tsai
- Department of Dental Hygiene, China Medical University, Taichung, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.
| | - Tzong-Ming Shieh
- Department of Dental Hygiene, China Medical University, Taichung, Taiwan.
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Tziafas D. Characterization of Odontoblast-like Cell Phenotype and Reparative Dentin Formation In Vivo: A Comprehensive Literature Review. J Endod 2019; 45:241-249. [PMID: 30803530 DOI: 10.1016/j.joen.2018.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The primary aim was to explore the criteria used in characterization of reparative cells and mineralized matrices formed after treatment of pulp exposures, and the sequence of relative events. The secondary aim was to evaluate whether the reparative events depend on the experimental model species, age, and therapeutic intervention. METHODS A literature search of databases using different combinations of the key words was undertaken. Data analysis was based only on studies having histological or histochemical assessment of the pulp tissue responses. The search yielded 86 studies, 47 capping material-based and 39 bioactive application-based experiments, which provided data on morphological or functional characterization of the mineralized matrices and the associated cells. RESULTS In 64% of capping material-based and 72% of bioactive application-based experiments, a 2-zone mineralized matrix formation (atubular followed by tubular) was detected, whereas characterization of odontoblastic differentiation is provided in only 25.5% and 46.1% of the studies, respectively. In 93.3% of the studies showing odontoblast-like cells, differentiated cells were in association with tubular mineralized matrix formation. Analyses further showed that cell- and matrix-related outcomes do not depend on experimental model species, age, and therapeutic intervention. CONCLUSIONS The evidence of the reviewed scientific literature is that dental pulp cells secrete a dentin-like matrix of tubular morphology in relation to primitive forms of atubular or osteotypic mineralized matrix. Furthermore, data analysis showed that dental pulp cells express in vivo the odontoblastic phenotype, and secrete matrix in a predentin-like pattern, regardless of the model species, age, and therapeutic intervention used.
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Affiliation(s)
- Dimitrios Tziafas
- Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, Dubai, UAE.
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雷 玥, 杨 颖, 战 园. [Evaluation of bioceramic putty repairment in primary molars pulpotomy]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:70-74. [PMID: 30773547 PMCID: PMC7433541 DOI: 10.19723/j.issn.1671-167x.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the clinical characteristics and effectiveness of bioceramic putty repairment (iroot BP Plus) used as pulp capping agents on pulpotomy in primary molars. METHODS Forty primary molars were treated by pulpotomy with bioceramic putty repairmen as the pulp capping agents at the Third Clinical Division of Peking University School and Hospital of Stomatology, from September 2016 to September 2017. The children who were followed up over one year were selected as the subjects of this study. The teeth were checked clinically and radiographically during fixed intervals, and classified into one of five outcomes: N, H, P0, PX, PY. N, absence of clinical symptoms, and absence of apical radiolucency; H, absence of clinical symptoms, and nonpathologic radiographic change present; P0, absence of clinical symptoms, and pathologic change present, no need for treatment; PX, present or absence of clinical symptoms, pathologic change present treatment or extract immediately; PY, premature loss of deciduous tooth. Molars classified into N and H were regarded as successful, classified into P0, PX and PY were regarded as failed. RESULTS Followed up for 12-24 months (the average follow up time was 16months), thirty four children were finally included, aged from 3.1 years to 8.5 yaers (the average age was 4.3 years), forty primary molars were included. Thirty four primary molars were included into N group, with absence of clinical symptoms, absence of apical radiolucency. Two molars were included into H group with physiological root absorption. One molar was included into P0group with absence of clinical symptoms butinternal absorption of the root. Three molars were included into PX group, with gingival fistula and apical radiolucency. None was included into PY group. Thirty six teeth got successful treatment, four molars failed. One year success rate of pulpotomy of primary molars using bioceramic putty repairment was 95%. CONCLUSION Current evidence suggests that bioceramic putty repairment as a pulpotomy medicament showed satisfied clinical and radiographic result in pulpotomy of primary molars. Bioceramic putty repairment is an acceptable material when used in pulpotomy of primary molars.
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Affiliation(s)
- 玥 雷
- />北京大学口腔医学院·口腔医院,第三门诊部 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100083Third Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100083, China
| | - 颖婷 杨
- />北京大学口腔医学院·口腔医院,第三门诊部 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100083Third Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100083, China
| | - 园 战
- />北京大学口腔医学院·口腔医院,第三门诊部 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100083Third Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100083, China
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Emara R, Elhennawy K, Schwendicke F. Effects of calcium silicate cements on dental pulp cells: A systematic review. J Dent 2018; 77:18-36. [DOI: 10.1016/j.jdent.2018.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 02/03/2023] Open
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41
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Kim DH, Jang JH, Lee BN, Chang HS, Hwang IN, Oh WM, Kim SH, Min KS, Koh JT, Hwang YC. Anti-inflammatory and Mineralization Effects of ProRoot MTA and Endocem MTA in Studies of Human and Rat Dental Pulps In Vitro and In Vivo. J Endod 2018; 44:1534-1541. [PMID: 30174104 DOI: 10.1016/j.joen.2018.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Few studies have reported direct pulp capping in inflamed pulp conditions. The purpose of this study was to investigate the in vitro and in vivo responses of dental pulp during direct pulp capping using various pulp capping materials in inflamed conditions. METHODS Human dental pulp cells were treated with lipopolysaccharide (LPS) and cultured with Dycal (Dentsply Caulk, Milford, DE), ProRoot MTA (Dentsply Maillefer, Ballaigues, Switzerland), and Endocem MTA (Maruchi, Wonju, South Korea). The expressions of interleukin (IL)-1β, IL-6, dentin matrix protein 1, and dentin sialophosphoprotein were analyzed through real-time polymerase chain reaction. The maxillary molars of Sprague-Dawley rats were exposed for 2 days. The exposed pulps were capped with Dycal, ProRoot MTA, and Endocem MTA and sealed with resin-modified glass ionomer followed by histologic and immunohistochemical analyses. RESULTS The expression of IL-1β and IL-6 was increased with LPS and decreased by Dycal, ProRoot MTA, and Endocem MTA. Dentin matrix protein 1 and dentin sialophosphoprotein levels were decreased with LPS and increased after treatment with pulp capping materials.In the in vivo study, inflammation associated with Dycal was higher than that associated with ProRoot MTA and Endocem MTA at week 1, without any significant difference between the 2. At 4 weeks, inflammation was decreased, and mineralization was increased compared with week 1 in all 3 of the materials. At week 1, IL-6 immunoreactivity was strongly expressed. Dycal exhibited stronger immunoreactivity than ProRoot MTA and Endocem MTA. However, the immunoreactivity was decreased in all groups at week 4. CONCLUSIONS Successful direct pulp capping requires more effective pulp capping materials for the treatment of inflamed pulps.
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Affiliation(s)
- Do-Hee Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Ji-Hyun Jang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Hoon-Sang Chang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - In-Nam Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Won-Mann Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Sun-Hun Kim
- Department of Oral Anatomy, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Kyung-San Min
- Department of Conservative Dentistry, School of Dentistry, Chonbuk National University, Jeonju, Korea
| | - Jeong-Tae Koh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea; Research Center for Biomineralization Disorders, Chonnam National University, Gwangju, Korea.
| | - Yun-Chan Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea; Research Center for Biomineralization Disorders, Chonnam National University, Gwangju, Korea.
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Dentinogenic effects of extracted dentin matrix components digested with matrix metalloproteinases. Sci Rep 2018; 8:10690. [PMID: 30013085 PMCID: PMC6048071 DOI: 10.1038/s41598-018-29112-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/05/2018] [Indexed: 01/28/2023] Open
Abstract
Dentin is primarily composed of hydroxyapatite crystals within a rich organic matrix. The organic matrix comprises collagenous structural components, within which a variety of bioactive molecules are sequestered. During caries progression, dentin is degraded by acids and enzymes derived from various sources, which can release bioactive molecules with potential reparative activity towards the dentin-pulp complex. While these molecules’ repair activities in other tissues are already known, their biological effects are unclear in relation to degradation events during disease in the dentin-pulp complex. This study was undertaken to investigate the effects of dentin matrix components (DMCs) that are partially digested by matrix metalloproteinases (MMPs) in vitro and in vivo during wound healing of the dentin-pulp complex. DMCs were initially isolated from healthy dentin and treated with recombinant MMPs. Subsequently, their effects on the behaviour of primary pulp cells were investigated in vitro and in vivo. Digested DMCs modulated a range of pulp cell functions in vitro. In addition, DMCs partially digested with MMP-20 stimulated tertiary dentin formation in vivo, which exhibited a more regular tubular structure than that induced by treatment with other MMPs. Our results indicate that MMP-20 may be especially effective in stimulating wound healing of the dentin-pulp complex.
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Lee LW, Hsiao SH, Lin YH, Chen PY, Lee YL, Hung WC. Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier. J Formos Med Assoc 2018; 118:362-370. [PMID: 29937322 DOI: 10.1016/j.jfma.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/PURPOSE Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth. METHODS Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm-3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8-10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure. RESULTS All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6-7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1-3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2-4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1-2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5-3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months. CONCLUSION PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors.
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Affiliation(s)
- Li-Wan Lee
- Department of Dentistry, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Sheng-Huang Hsiao
- Department of Neurosurgery, Taipei City Hospital, Renai Branch, Taipei, Taiwan; Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Yun-Ho Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Po-Yu Chen
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan
| | - Ya-Ling Lee
- Department of Dentistry, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chiang Hung
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
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Sun Y, Luo T, Shen Y, Haapasalo M, Zou L, Liu J. Effect of iRoot Fast Set root repair material on the proliferation, migration and differentiation of human dental pulp stem cells in vitro. PLoS One 2017; 12:e0186848. [PMID: 29059236 PMCID: PMC5653327 DOI: 10.1371/journal.pone.0186848] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023] Open
Abstract
The present study investigated the effect of iRoot Fast Set root repair material (iRoot FS) on the proliferation, migration and differentiation of human dental pulp stem cells (hDPSCs). The hDPSCs were treated with eluates of iRoot FS at concentrations of 0.2 and 2 mg/mL, referred to as FS0.2 and FS2, respectively, and Biodentine (BD; Septodont, Saint Maur des Faussés, France) eluates at the corresponding concentrations as positive controls. A CCK8 assay was performed to determine cell proliferation. Wound healing and transwell assays were conducted to examine cell migration. Osteogenic differentiation was evaluated based on alkaline phosphatase activity, Alizarin Red S staining and quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) to analyze the mRNA expression of differentiation gene markers. Cell proliferation was higher in the FS and BD groups than in the blank controls at 3 and 7 days. Moreover, FS0.2 enhanced cell migration and significantly promoted the osteogenic differentiation of hDPSCs. These findings suggested that iRoot FS is a bioactive material that promotes the proliferation, migration and osteogenic differentiation of hDPSCs.
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Affiliation(s)
- Yan Sun
- State Key Laboratory of Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Luo
- State Key Laboratory of Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ling Zou
- State Key Laboratory of Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail: (JL); ) (LZ)
| | - Jun Liu
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail: (JL); ) (LZ)
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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: 214] [Impact Index Per Article: 30.6] [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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Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J 2017; 51:177-205. [PMID: 28836288 DOI: 10.1111/iej.12841] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/21/2017] [Indexed: 01/09/2023]
Abstract
Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new BECs have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, NeoMTA Plus, OrthoMTA, Quick-Set, RetroMTA, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, the chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and VPT applications of BECs had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term 'bioactive endodontic cements (BECs)', which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used MTA for VPT. In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.
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Affiliation(s)
- M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Evaluation of Pulp Response to Novel Bioactive Glass Pulp Capping Materials. J Endod 2017; 43:1647-1650. [PMID: 28864220 DOI: 10.1016/j.joen.2017.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/27/2017] [Accepted: 03/06/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to investigate dental pulp responses to novel bioactive glass (BG) pulp capping materials after direct pulp capping in vivo. METHODS Novel BG pulp capping materials are composed of powder and fluid. The powder is BG (82.36% SiO2, 15.36% CaO, and 2.28% P2O5), and the fluid is provided in 2 kinds: (1) phosphate buffer solution (BG-PB) and (2) phosphate buffer solution with the addition of 1 wt% sodium alginate (BG-PB-SA). After mixing the powder and fluid, BG-PB and BG-PB-SA were prepared. Cavities with mechanical pulp exposure were prepared on maxillary first molars of Wistar rats. The exposures were randomly capped with BG-PB, BG-PB-SA, or mineral trioxide aggregate (MTA). After 1 (n = 6) and 4 weeks (n = 8), maxillary segments were obtained and prepared for histologic analysis with a scoring system. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests with the significance set at .05. RESULTS After 1 week, few inflammatory cells were present in the BG-PB, BG-PB-SA, and MTA groups. Moreover, a thin layer of newly generated matrix was observed in most specimens. After 4 weeks, all specimens from the 3 groups formed a heavy dentin bridge. BG-PB and BG-PB-SA groups exhibited no or slight inflammatory response, whereas the MTA group exhibited a slight to moderate inflammatory response. No significant difference was observed in pulp inflammation and dentin formation among the 3 groups at either time point (P > .05). CONCLUSIONS When used as a pulp capping agent, BG-PB and BG-PB-SA had similar favorable cellular and inflammatory pulp responses to those of MTA. Therefore, BG is a promising pulp capping material.
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Komabayashi T, Zhu Q, Eberhart R, Imai Y. Current status of direct pulp-capping materials for permanent teeth. Dent Mater J 2017; 35:1-12. [PMID: 26830819 DOI: 10.4012/dmj.2015-013] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Direct pulp-capping is a method for treating exposed vital pulp with dental material to facilitate the formation of reparative dentin and to maintain vital pulp. Two types of pulp-capping materials, calcium hydroxide and mineral trioxide aggregate, have been most commonly used in clinics, and an adhesive resin has been considered a promising capping material. However, until now, there has been no comprehensive review of these materials. Therefore, in this paper, the composition, working mechanisms and clinical outcome of these types of pulp-capping materials are reviewed.
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The Characteristics of Mineral Trioxide Aggregate/Polycaprolactone 3-dimensional Scaffold with Osteogenesis Properties for Tissue Regeneration. J Endod 2017; 43:923-929. [DOI: 10.1016/j.joen.2017.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/03/2017] [Accepted: 01/09/2017] [Indexed: 12/11/2022]
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