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Moradi S, Moushekhian S, Najafi E, Sedigh HS, Navabi S. Efficacy of propolis and triple antibiotic paste as intra-canal medicaments for revascularisation of immature teeth in dogs: a comparative study. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00806-1. [PMID: 37314621 DOI: 10.1007/s40368-023-00806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/22/2023] [Indexed: 06/15/2023]
Abstract
AIM Revascularisation is a therapeutic approach for treatment of immature teeth with necrotic pulp. The conventional protocol includes application of triple antibiotic paste (TAP). The present study aimed to compare the efficacy of propolis and TAP as intra-canal medicaments for revascularisation of immature teeth in dogs. METHODOLOGY This study was conducted on 20 immature (open-apex) canine teeth in mixed breaded dogs. First, the teeth were exposed to oral environment, followed by intra-canal cleaning and shaping 2 weeks later.. The teeth were divided into two groups. The TAP group received paste comprising of ciprofloxacin, metronidazole, and minocycline (at a concentration of 100 µg/mL), while propolis (15% w/v) was used in the other group. The revascularisation procedure was done by means of sodium hypochlorite, EDTA and distilled water as final irrigant. After dehumidifying and induction of bleeding, mineral trioxide aggregate (MTA) was applied At 6-month follow-up, radiographs were evaluated by two observers regarding root length and thickness, intra-canal calcification, periapical lesions, and apex formation. Data were analysed by the Chi-square and Fisher's exact tests. RESULTS There was no significant difference between the TAP and propolis groups in root length or root thickness increase, calcification, related lesions, or apex formation (P > 0.05). CONCLUSION Findings of the present study in experimental animals revealed that the efficacy of propolis as an intra-canal medicament is comparable to that of triple antibiotic paste for revascularisation therapy.
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Affiliation(s)
- S Moradi
- Dental Materials Research Center and Department of Endodontics, Faculty of Dentisry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Moushekhian
- Dental Materials Research Center and Department of Endodontics, Faculty of Dentisry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - E Najafi
- Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - H S Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - S Navabi
- Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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2
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Durmazpinar PM, Recen D, Çeliksöz Ö, Yazkan B. Micro shear bond strength of mineral trioxide aggregate to different innovative dental restorative materials. Proc Inst Mech Eng H 2023; 237:762-769. [PMID: 37171056 DOI: 10.1177/09544119231173506] [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: 05/13/2023]
Abstract
The objective of this in vitro study was to investigate the micro shear bond strength (µSBS) of mineral trioxide aggregate to four different restorative materials. Sixty mineral trioxide aggregate (MTA) samples were randomly assigned into four experimental groups based on the restorative materials used: nanohybrid resin composite as a control, giomer, alkasite and ormocer. µSBS samples were prepared for each group (n = 15). These samples were then submitted to a µSBS test (crosshead speed, 0.5 mm/min). The resulting data were statistically analyzed by one-way analysis of variance (ANOVA), Levene, and Bonferroni tests (α = 0.05). The bond strength of the alkasite group was statistically significantly higher than all the tested groups (p<0.05), while there were no significant differences between the nanohybrid resin composite, giomer, or ormocer groups (p > 0.05). Within the limitations of this study, alkasite restorative material could be a promising material when placed over MTA.
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Affiliation(s)
| | - Duygu Recen
- Department of Restorative Dentistry, Faculty of Dentistry, Izmir Democracy University, Istanbul, Turkey
| | - Özge Çeliksöz
- Department of Restorative Dentistry, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Başak Yazkan
- Department of Restorative Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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3
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Dubey N, Ribeiro JS, Zhang Z, Xu J, Ferreira JA, Qu L, Mei L, Fenno JC, Schwendeman A, Schwendeman SP, Nör JE, Bottino MC. Gelatin methacryloyl hydrogel as an injectable scaffold with multi-therapeutic effects to promote antimicrobial disinfection and angiogenesis for regenerative endodontics. J Mater Chem B 2023; 11:3823-3835. [PMID: 36946228 PMCID: PMC10160005 DOI: 10.1039/d2tb02788g] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Regenerative endodontics represents a paradigm shift in dental pulp therapy for necrotic young permanent teeth. However, there are still challenges associated with attaining maximum root canal disinfection while supporting angiogenesis and preserving resident stem cells viability and differentiation capacity. Here, we developed a hydrogel system by incorporating antibiotic-eluting fiber-based microparticles in gelatin methacryloyl (GelMA) hydrogel to gather antimicrobial and angiogenic properties while prompting minimum cell toxicity. Minocycline (MINO) or clindamycin (CLIN) was introduced into a polymer solution and electrospun into fibers, which were further cryomilled to attain MINO- or CLIN-eluting fibrous microparticles. To obtain hydrogels with multi-therapeutic effects, MINO- or CLIN-eluting microparticles were suspended in GelMA at distinct concentrations. The engineered hydrogels demonstrated antibiotic-dependent swelling and degradability while inhibiting bacterial growth with minimum toxicity in dental-derived stem cells. Notably, compared to MINO, CLIN hydrogels enhanced the formation of capillary-like networks of endothelial cells in vitro and the presence of widespread vascularization with functioning blood vessels in vivo. Our data shed new light onto the clinical potential of antibiotic-eluting gelatin methacryloyl hydrogel as an injectable scaffold with multi-therapeutic effects to promote antimicrobial disinfection and angiogenesis for regenerative endodontics.
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Affiliation(s)
- Nileshkumar Dubey
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Juliana S Ribeiro
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Zhaocheng Zhang
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Jinping Xu
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Jessica A Ferreira
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Liu Qu
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
- Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Ling Mei
- Department of Pharmaceutical Sciences and the Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Anna Schwendeman
- Department of Pharmaceutical Sciences and the Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven P Schwendeman
- Department of Pharmaceutical Sciences and the Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacques E Nör
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
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4
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Ruiz-Linares M, Monroy-Rojas JF, Solana C, Baca P, Aguado B, Soriano-Lerma A, Arias-Moliz MT, Ferrer-Luque CM. Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study. Int Endod J 2023; 56:103-117. [PMID: 36169591 DOI: 10.1111/iej.13840] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 12/13/2022]
Abstract
AIM There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH]2 ). METHODOLOGY The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH)2 paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log10 of bacterial DNA copies in root canal samples before (S1) and the Log10 reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison. RESULTS Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log10 DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them. The results of FC showed that only 5% DCH proved significantly superior to the other treatments. CONCLUSIONS Sodium DC hydrogels demonstrate antimicrobial efficacy against endodontic biofilms.
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Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Javier F Monroy-Rojas
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Beatriz Aguado
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Ana Soriano-Lerma
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - María Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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5
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Effects of sodium hypochlorite and ethylenediaminetetraacetic acid on proliferation, osteogenic/odontogenic differentiation, and mechanosensitive gene expression of human dental pulp stem cells. Tissue Cell 2022; 79:101955. [DOI: 10.1016/j.tice.2022.101955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
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6
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Arhakis A, Cotti E, Kotsanos N. Pulp Therapy in Pediatric Dentistry. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Unpredictable Outcomes of a Regenerative Endodontic Treatment. Case Rep Dent 2021; 2021:2478310. [PMID: 34659840 PMCID: PMC8514905 DOI: 10.1155/2021/2478310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
Regenerative endodontic treatment (RET) is a valuable treatment for necrotic immature teeth with many advantages such as increasing root length and thickness of root wall. The success of RETs is based on healthy stem cells, suitable scaffolds, and growth factors and takes place when bacterial contamination is well controlled. The aim of this article is to address controversy in a case with multiple success criteria. This paper reports a 9-year-old boy with a complicated crown fracture of the maxillary left central incisor about three years prior to referral with a diagnosis of intrusive luxation with spontaneous reeruption. The tooth had an underdeveloped root and a well-defined periapical radiolucent lesion around the root apex. RET was considered according to the stage of root development. Upon the three-week recall session, the clinical examination indicated that the patient was asymptomatic in the affected site. However, the patient returned two weeks later with a sinus tract pertaining to the apex of tooth #9. Therefore, debridement of the root canal space was repeated and the RET redone. On the second trial, the patient was symptom-free, but no more evidence of root maturation was observed on 18-month follow-up. The tooth was asymptomatic (without swelling, drainage, and pain) during this time, and esthetics was provided for the patient.
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8
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Sponchiado-Júnior EC, de Andrade Vieira W, Frozoni M, Herkrath FJ, de-Jesus-Soares A. CONSORT Compliance in Randomized Clinical Trials of Regenerative Endodontic treatments of Necrotic Immature Teeth. A Scoping Review. J Endod 2021; 47:1751-1766. [PMID: 34352304 DOI: 10.1016/j.joen.2021.07.017] [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: 05/28/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This study aimed to investigate methodological quality of clinical trials in regenerative endodontics and its compliance with the CONSORT statement. METHODS An electronic search was performed in eight electronic databases. Only clinical trials whose participants underwent regenerative endodontic treatment on necrotic permanent immature teeth were included. Quality assessment was performed using the Cochrane Collaboration's Risk of Bias Tool (RoB, version 2.0). Compliance of articles with the CONSORT guidelines was assessed by a tool with scales: 0 = no description, 1 = deficient, and 2 = adequate description, totaling a maximum score of 32 points. The Mann-Whitney and Kruskal-Wallis tests were used to compare the scores between journals, studies, country, income levels, and publication periods. Spearman correlation analyses were performed between CONSORT compliance scores and 2019 journal CiteScore values, publication year, and quality assessment. RESULTS Twenty studies were included. The average CONSORT compliance score was 20.95 (±6.19). The better reported items were the description of the interventions performed in the trials (100%), followed by the description of the number of patients analyzed, losses and exclusions (90%) and the hypothesis tested (85%). Within the 20 studies, 3 articles were classified as "low risk of bias," 8 studies were classified as "some concerns" and 9 studies were considered "high risk of bias". Studies carried out in countries with higher income levels presented higher CONSORT scores. Significant moderate correlations were found between the CONSORT score and the percentage of risk of bias in low-risk domains (rs = 0.63, 95%CI = 0.31 to 0.94, p = 0.003) and the overall risk of bias categories (rs = 0.76, 95%CI = 0.54 to 0.98, p = 0.001). CONCLUSIONS The adequacy of reporting based on the CONSORT checklist items of regenerative endodontic trials was low with a moderate to high risk of bias.
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Affiliation(s)
- Emílio Carlos Sponchiado-Júnior
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil; Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil.
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Marcos Frozoni
- São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| | | | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
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9
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Gunal E, Bezgin T, Ocak M, Bilecenoglu B. Effects of various thicknesses and levels of mineral trioxide aggregate coronal plugs on nanoleakage and fracture resistance in revascularization: An in vitro study. AUST ENDOD J 2021; 47:608-615. [PMID: 34062047 DOI: 10.1111/aej.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 05/14/2021] [Indexed: 01/26/2023]
Abstract
The aim of this study was to evaluate the effects of mineral trioxide aggregate (MTA) applied at varying levels and thickness in the cervical region of the root on the leakage and fracture resistance of the simulated immature teeth. 3 study groups (n = 16) (Group 1: 2 mm MTA, Group 2: 4 mm MTA, Group 3: 2 mm MTA+2 mm RMGIC below cementoenamel junction) and 2 control groups (Group 4: Complete canal obturation, Group 5: No coronal plug) were used for the study. Nanoleakage was measured using a micro-computed tomography system. For the fracture resistance test, a universal testing machine was used. The amount of silver nitrate penetration decreased while MTA thicknesses increased (P < 0.001). However, the placement of MTA as a thicker layer did not make any additional contribution on the fracture resistance (P > 0.05). The 4-mm coronal MTA plug can be suggested in RETs for its superior sealing and reinforcement abilities.
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Affiliation(s)
- Esin Gunal
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Tugba Bezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mert Ocak
- Department of Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Burak Bilecenoglu
- Department of Anatomy, Faculty of Medicine, Ankara Medipol University, Ankara, Turkey
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Bohns FR, Leitune VCB, Garcia IM, Genari B, Dornelles NB, Guterres SS, Ogliari FA, de Melo MAS, Collares FM. Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study. Restor Dent Endod 2020; 45:e50. [PMID: 33294415 PMCID: PMC7691264 DOI: 10.5395/rde.2020.45.e50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/11/2020] [Accepted: 05/26/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement. Materials and Methods Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy. Results The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05). Conclusions Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.
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Affiliation(s)
- Fábio Rocha Bohns
- Department of Dental Materials, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Isadora Martini Garcia
- Department of Dental Materials, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Genari
- Department of Dental Materials, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Orthodontics and Biomaterials, Centro Universitário UDF, Brasília, DF, Brazil
| | - Nélio Bairros Dornelles
- Department of Dental Materials, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Silvia Stanisçuaski Guterres
- Cosmetology Laboratory, School of Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Mary Anne Sampaio de Melo
- Program in Biomedical Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA.,Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Fabrício Mezzomo Collares
- Department of Dental Materials, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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11
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Demirel A, Bezgin T, Sarı Ş. Effects of Root Maturation and Thickness Variation in Coronal Mineral Trioxide Aggregate Plugs Under Traumatic Load on Stress Distribution in Regenerative Endodontic Procedures: A 3-dimensional Finite Element Analysis Study. J Endod 2020; 47:492-499.e4. [PMID: 33217468 DOI: 10.1016/j.joen.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Regenerative endodontic procedures (REPs) are the best biological-based treatment choice for managing necrotic immature permanent teeth. This study aimed to evaluate the stress distribution of immature maxillary permanent incisors and periodontal tissues under a traumatic load after root maturation achieved by REP with thickness variation in coronal mineral trioxide aggregate (MTA) plugs. METHODS Five different mathematical 3-dimensional finite element analysis models of an immature permanent maxillary incisor were created. These involved immediate postoperative models after REP with varying coronal MTA plug thickness (model 1: 3-mm MTA and model 2: 5-mm MTA), postoperative models after REP with varying coronal MTA plug thickness with 15% volumetric root maturation (model 3: 3-mm MTA and model 4: 5-mm MTA), and a control model (model 5: a mature, healthy maxillary incisor). After the modeling procedures, a traumatic horizontal force load of 400 N was applied, and 3-dimensional finite element analysis was performed. The minimum principal, maximum principal, and von Mises stress criteria were calculated for evaluation. RESULTS Regardless of the coronal MTA plug thickness, tensile stress in cervical root surfaces decreased with root maturation after REP. Using the 5-mm MTA plug reduced all types of stress in the middle third of the root. In bone tissue, the difference in MTA thickness did not affect stress values. However, stress decreased in most of the bony surfaces with root maturation after REP. CONCLUSIONS Using the 5-mm coronal MTA plug may help in providing biomechanical advantages regarding stress transmission. Also, because root maturation after REP provided a more favorable stress distribution as mentioned, regenerative treatments can be recommended for immature permanent maxillary incisors for a good prognosis.
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Affiliation(s)
- Akif Demirel
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Tuğba Bezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Şaziye Sarı
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
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12
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Clinical and Molecular Microbiological Evaluation of Regenerative Endodontic Procedures in Immature Permanent Teeth. J Endod 2020; 46:1448-1454. [DOI: 10.1016/j.joen.2020.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/17/2020] [Accepted: 07/04/2020] [Indexed: 11/17/2022]
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13
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Ayoub S, Cheayto A, Bassam S, Najar M, Berbéri A, Fayyad-Kazan M. The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update. Stem Cell Rev Rep 2020; 16:650-660. [PMID: 32394343 DOI: 10.1007/s12015-020-09982-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures.
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Affiliation(s)
- Sara Ayoub
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Ali Cheayto
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Sanaa Bassam
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mehdi Najar
- Genetics and Immune Cell Therapy Unit, Faculty of Sciences, University Mohammed Premier, Oujda, Morocco.,Osteoarthritis Research Unit, Department of Medicine, Research Center (CRCHUM), University of Montreal Hospital, University of Montreal, Montreal, QC, Canada
| | - Antoine Berbéri
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mohammad Fayyad-Kazan
- Laboratory of Cancer biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath, Beirut, Lebanon. .,Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
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14
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da Silva LB, Gabriel M, Marques MM, Carrer FC, Gonçalves F, Sarra G, Carvalho GL, Armas-Vega A, Moreira MS. Knowledge, attitudes, and practices of undergraduate students concerning Regenerative Endodontics. ACTA ACUST UNITED AC 2020; 69:223-234. [PMID: 32181614 DOI: 10.23736/s0026-4970.20.04317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Knowledge, attitudes, and beliefs of the students are important for the Tissue Engineering in Endodontic practice. The opinion of these future dentists would ultimately will decide the endurance of REPs as routine procedures in endodontic practice. The aim of this study was to perform a survey to identify the knowledge, attitudes, and practices of undergraduate students about regenerative endodontic procedures (REPs). METHODS The questionnaire was obtained after cross-cultural adaptation of a questionnaire previously applied in USA and was applied to two hundred forty-eight undergraduates. Data were statistically analyzed. RESULTS Most of the students (82.9%) agreed that regenerative therapy should be incorporated to dentistry and 87.5% of them believed that stem cells banks would be useful for the tissue regeneration. Most participants (58.1%) would like to obtain an internship/tutoring that addresses REPs and 80.8% of participants think that the major obstacle to a patient accepting a REP was the expected high cost of the treatment. The freshmen students were more optimistic about offering stem cell treatments to their patients (P≤0.05). CONCLUSIONS The undergraduates were very optimistic about the future of REPs, stem cell banking, and tissue engineering. Although seniors demonstrated less enthusiasm towards REPs than the freshman, most students are willing to recommend these treatments to their patients.
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Affiliation(s)
- Ligia B da Silva
- School of Dentistry, Department of Endodontics, Ibirapuera University (UNIB), São Paulo, Brazil
| | - Mariana Gabriel
- School of Dentistry, Department of Community Dentistry, University of Sao Paulo (USP), São Paulo, Brazil
| | - Márcia M Marques
- School of Dentistry, Department of Endodontics, Ibirapuera University (UNIB), São Paulo, Brazil
| | - Fernanda C Carrer
- School of Dentistry, Department of Community Dentistry, University of Sao Paulo (USP), São Paulo, Brazil
| | - Flávia Gonçalves
- School of Dentistry, Department of Endodontics, Ibirapuera University (UNIB), São Paulo, Brazil
| | - Giovanna Sarra
- School of Dentistry, Department of Restorative Dentistry, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Giovanna L Carvalho
- School of Dentistry, Department of Restorative Dentistry, University of Sao Paulo (USP), Sao Paulo, Brazil.,Stomatology Department, A.C. Carrargo Covicer Center, São Paulo, Brazil
| | | | - Maria S Moreira
- School of Dentistry, Department of Endodontics, Ibirapuera University (UNIB), São Paulo, Brazil - .,Stomatology Department, A.C. Carrargo Covicer Center, São Paulo, Brazil.,Instituto do Coraçao (InCor), Hospital das Clínicas (+CFMUSP, School of Medicine, University of São Paulo (USP), São Paulo, Brazil
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15
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Regenerative Endodontic Management of an Immature Molar Using Calcium Hydroxide and Triple Antibiotic Paste: a Two-Year Follow-Up. Case Rep Dent 2020; 2020:9025847. [PMID: 32095292 PMCID: PMC7035542 DOI: 10.1155/2020/9025847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/22/2020] [Indexed: 01/01/2023] Open
Abstract
The regenerative endodontic procedure (REP) is considered a viable treatment option for immature teeth with necrotic pulp and periapical radiolucency which can facilitate continued root formation. In this report, an immature necrotic mandibular molar received REP in three appointments wherein chemomechanical debridement was performed with a sequential application of nonsetting calcium hydroxide (in the whole canal) and triple antibiotics paste (in the root's middle third) dressings in the first and second appointments, respectively. In the third appointment, blood clots were created in the root canals. MTA was placed over the blood clots and the tooth was restored with a composite filling and stainless-steel crown. Recall appointments were performed for two years where the tooth was deemed asymptomatic clinically and a complete root formation with significant periapical healing was evident radiographically. More cases are required to warrant the feasibility of this disinfection protocol.
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16
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Interventions to reduce bruxism in children and adolescents: a systematic scoping review and critical reflection. Eur J Pediatr 2020; 179:177-189. [PMID: 31858254 DOI: 10.1007/s00431-019-03549-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/20/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022]
Abstract
The aim of the present study was to perform a critical reflection about intervention options for bruxism reduction in children and adolescents. Search was conducted based on the PICO-structured question: "What are the intervention options to reduce bruxism in children/adolescents?". No language, year, or study design restrictions were imposed. Studies reporting interventions to reduce bruxism in children (< 10) and adolescents (10 to 19 years old) were included. Reviews and letters to editors were not included. From 2723 records, 17 papers were included. Included studies were primarily randomized clinical trials performed in Brazil (35.3%) and using different criteria for the diagnosis of bruxism. Reduction in self-reported bruxism and headaches associated with bruxism were observed in studies that used medications (hydroxyzine/trazodone/flurazepam), occlusal splints, orthodontic interventions, and psychological and physical therapy interventions. Reduction in Rhythmic Masticatory Muscle Activity was observed with the use of the occlusal splint and in orthodontic interventions. Alternative treatments (medicinal extracts such as Melissa officinalis-L) have shown inconclusive results.Conclusions: Several intervention options are available to inhibit or reduce bruxism activity. The respective indication, contraindications, and side effects of each treatment option must be assessed individually and carefully, taking into account that bruxism is not considered a disorder in otherwise healthy individuals.What is known• Biological and psychological factors have been strongly correlated to the development of bruxism• Bruxism prevalence ranging from 6 to 50% in childrenWhat is new• Reduction in self-reported bruxism and headaches associated with bruxism were observed in studies that used medication (Hydroxyzine/ Trazodone/ Flurazepam), occlusal splints, orthodontic interventions, psychological, and physical therapy interventions• A reduction in Rhythmic Masticatory Muscle Activity was observed with the use of the occlusal splint and orthodontic interventions. Alternative treatments (medicinal extracts such as Melissa officinalis L) show inconclusive results in respect of the reduction in bruxism.
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17
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Hursh KA, Kirkpatrick TC, Cardon JW, Brewster JA, Black SW, Himel VT, Sabey KA. Shear Bond Comparison between 4 Bioceramic Materials and Dual-cure Composite Resin. J Endod 2019; 45:1378-1383. [DOI: 10.1016/j.joen.2019.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/08/2019] [Accepted: 07/12/2019] [Indexed: 12/18/2022]
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18
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Bottino MC, Albuquerque MTP, Azabi A, Münchow EA, Spolnik KJ, Nör JE, Edwards PC. A novel patient-specific three-dimensional drug delivery construct for regenerative endodontics. J Biomed Mater Res B Appl Biomater 2019; 107:1576-1586. [PMID: 30281899 PMCID: PMC6447484 DOI: 10.1002/jbm.b.34250] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/15/2018] [Accepted: 09/09/2018] [Indexed: 12/13/2022]
Abstract
Evoked bleeding (EB) clinical procedure, comprising a disinfection step followed by periapical tissue laceration to induce the ingrowth of undifferentiated stem cells from the periodontal ligament and alveolar bone, is currently the only regenerative-based therapeutic approach to treating pulp tissue necrosis in undeveloped (immature) permanent teeth approved in the United States. Yet, the disinfection step using antibiotic-based pastes leads to cytotoxic, warranting a biocompatible strategy to promote root canal disinfection with no or minimal side-effects to maximize the regenerative outcomes. The purpose of this investigation was to develop a tubular three-dimensional (3D) triple antibiotic-eluting construct for intracanal drug delivery. Morphological (scanning electron microscopy), chemical (Fourier transform infrared spectroscopy), and mechanical (tensile testing) characteristics of the polydioxanone-based triple antibiotic-eluting fibers were assessed. The antimicrobial properties of the tubular 3D constructs were determined in vitro and in vivo using an infected (Actinomyces naeslundii) dentin tooth slice model and a canine method of periapical disease, respectively. The in vitro data indicated significant antimicrobial activity and the ability to eliminate bacterial biofilm inside dentinal tubules. In vivo histological findings demonstrated that, using the EB procedure, the tubular 3D triple antibiotic-eluting construct allowed the formation of an appropriate environment that led to apex closure and the ingrowth of a thin layer of osteodentin-like tissue into the root canal. Taken together, these findings indicate that our novel drug delivery construct is a promising biocompatible disinfection strategy for immature permanent teeth with necrotic pulps. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1576-1586, 2019.
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Affiliation(s)
- Marco C. Bottino
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI - 48109, USA
| | - Maria T. P. Albuquerque
- Department of Clinical Dentistry (Endodontics), Federal University of Bahia, Salvador, BA - 40110, Brazil
| | - Asma Azabi
- Department of Biomedical & Applied Sciences, Indiana University School of Dentistry (IUSD), Indianapolis, IN - 46202, USA
| | - Eliseu A. Münchow
- Department of Dentistry, Health Science Institute, Federal University of Juiz de Fora, Governador Valadares, MG - 35010, Brazil
| | | | - Jacques E. Nör
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI - 48109, USA
| | - Paul C. Edwards
- Department of Oral Pathology, Medicine, and Radiology, IUSD, Indianapolis, IN - 46202, USA
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19
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Chisini LA, Conde MCM, Grazioli G, Martin ASS, Carvalho RVD, Sartori LRM, Demarco FF. Bone, Periodontal and Dental Pulp Regeneration in Dentistry: A Systematic Scoping Review. Braz Dent J 2019; 30:77-95. [DOI: 10.1590/0103-6440201902053] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 07/02/2018] [Indexed: 02/07/2023] Open
Abstract
Abstract The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate bone, periodontal and pulp with histological confirmation of the nature of formed tissue. Electronic search was conducted using a combination between Keywords and MeSH terms in PubMed, Scopus, ISI-Web of Science and Cochrane library databases up to January 2016. Two reviewers conducted independently the papers judgment. Screened studies were read following the predetermined inclusion criteria. The included studies were evaluated in accordance with Arksey and O’Malley’s modified framework. From 1349 papers, 168 completed inclusion criteria. Several characterized and uncharacterized cells used in Cell Therapy have provided bone regeneration, demonstrating bone gain in quantity and quality, even as accelerators for bone and periodontal regeneration. Synthetic and natural scaffolds presented good cell maintenance, however polyglycolid-polylactid presented faster resorption and consequently poor bone gain. The Growth Factor-Mediated Therapy was able to regenerate bone and all features of a periodontal tissue in bone defects. Teeth submitted to Revascularization presented an increase of length and width of root canal. However, formed tissues not seem able to deposit dentin, characterizing a repaired tissue. Both PRP and PRF presented benefits when applied in regenerative therapies as natural scaffolds. Therefore, most studies that applied regenerative therapies have provided promising results being possible to regenerate bone and periodontal tissue with histological confirmation. However, pulp regeneration was not reported. These results should be interpreted with caution due to the short follow-up periods.
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20
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Santos LGPD, Chisini LA, Springmann CG, Souza BDMD, Pappen FG, Demarco FF, Felippe MCS, Felippe WT. Alternative to Avoid Tooth Discoloration after Regenerative Endodontic Procedure: A Systematic Review. Braz Dent J 2018; 29:409-418. [DOI: 10.1590/0103-6440201802132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/11/2018] [Indexed: 12/18/2022] Open
Abstract
Abstract This systematic review aimed to evaluate whether alternative materials to conventional triple antibiotic paste (TAP - metronidazole, ciprofloxacin, and minocycline) and grey mineral trioxide aggregate (GMTA) could avoid tooth discoloration in teeth submitted to Regenerative Endodontic Procedure (REP). It was also investigated if dental bleaching is able to reverse the color of darkened teeth due to REP. The search was conducted in four databases (Medline via PubMed, Scopus, ISI Web of Science and BVS - Virtual health library), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The retrieved papers were uploaded in the software EndNoteTM and two reviewers independently selected the studies and extracted the data. Only studies in humans (case reports, case series, clinical trials) were included in the review. From 1,122 potentially eligible studies, 83 were selected for full-text analysis, and 38 were included in the review. The included studies were mainly case reports (76.3 %). The studies described a total of 189 teeth submitted to REP. From these, about 54% of teeth presented some degree of discoloration. Most teeth presenting color alteration were treated with TAP, especially when combined with GMTA. Only three studies performed dental bleaching to restore the color of teeth and neither bleaching technique was able to restore the original color of the crowns. The use of alternative materials to TAP and GMTA, such as double antibiotic paste or Ca(OH)2 pastes and white mineral trioxide aggregate or BiodentineTM, reduces the occurrence of tooth discoloration.
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21
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Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J 2018; 51:1367-1388. [PMID: 29777616 DOI: 10.1111/iej.12954] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
Abstract
The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.
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Affiliation(s)
- S G Kim
- Division of Endodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - M Malek
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - A Sigurdsson
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - L M Lin
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - B Kahler
- The University of Queensland School of Dentistry, Brisbane, Australia
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22
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Lin LM, Kim SG, Martin G, Kahler B. Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy. AUST ENDOD J 2018; 44:292-299. [DOI: 10.1111/aej.12252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Louis M. Lin
- Department of Endodontics; College of Dentistry; New York University; New York New York USA
| | - Sahng G. Kim
- Division of Endodontics; College of Dental Medicine; Columbia University; New York New York USA
| | - Gabriela Martin
- Department of Endodontics; School of Health Sciences; Catholic University of Cordoba; Cordoba Argentina
| | - Bill Kahler
- School of Dentistry; University of Queensland; Brisbane Australia
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23
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Chisini LA, Conde MCM, Grazioli G, Martin ASS, Carvalho RVD, Nör JE, Demarco FF. Venous Blood Derivatives as FBS-Substitutes for Mesenchymal Stem Cells: A Systematic Scoping Review. Braz Dent J 2017; 28:657-668. [PMID: 29211118 DOI: 10.1590/0103-6440201701646] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022] Open
Abstract
Although the biological properties of mesenchymal stem cells (MSC) are well-characterized in vitro, MSC clinical application is still far away to be achieved, mainly due to the need of xenogeneic substances for cell expansion, such as fetal bovine serum (FBS). FBS presents risks regarding pathogens transmissions and internalization of animal's proteins, which can unleash antigenic responses in patients after MSC implantation. A wide range of venous blood derivatives (VBD) has been reported as FBS substitutes showing promising results. Thus, the aim of this study was to conduct a systematic scoping review to analyze whether VBD are effective FBS substitutes for MSC ex vivo expansion. The search was performed in SciVerse ScopusTM, PubMed, Web of ScienceTM, BIREME, Cochrane library up to January 2016. The keywords were selected using MeSH and entry terms. Two independent reviewers scrutinized the records obtained considering specific inclusion criteria. The included studies were evaluated in accordance with a modified Arksey and O' Malley's framework. From 184 found studies, 90 were included. Bone marrow mesenchymal stem cells (BMMSC) were presented in most of these studies. Overall, VBD allowed for either, maintenance of MCS's fibroblast-like morphology, high proliferation, high colony-formation ability and maintenance of multipotency. Besides. MSC expanded in VBD supplements presented higher mitogen activity than FBS. VBD seems to be excellent xeno-free serum for ex vivo expansion of mesenchymal stem cells. However, an accentuated heterogeneity was observed between the carried out protocols for VBD isolation did not allowing for direct comparisons between the included studies.
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Affiliation(s)
- Luiz A Chisini
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Marcus C M Conde
- Graduate Program in Dentistry, School of Dentistry, UNIVATES - Universidade do Vale do Taquari, Lajeado, Brazil
| | | | - Alissa S San Martin
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Jacques E Nör
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Flávio F Demarco
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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24
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Abstract
No current therapy promotes root canal disinfection and regeneration of the pulp-dentin complex in cases of pulp necrosis. Antibiotic pastes used to eradicate canal infection negatively affect stem cell survival. Three-dimensional easy-to-fit antibiotic-eluting nanofibers, combined with injectable scaffolds, enriched or not with stem cells and/or growth factors, may increase the likelihood of achieving predictable dental pulp regeneration. Periodontitis is an aggressive disease that impairs the integrity of tooth-supporting structures and may lead to tooth loss. The latest advances in membrane biomodification to endow needed functionalities and technologies to engineer patient-specific membranes/constructs to amplify periodontal regeneration are presented.
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Affiliation(s)
- Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA.
| | - Divya Pankajakshan
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Jacques E Nör
- Department of Biomedical and Applied Sciences, Indiana, University School of Dentistry, Indianapolis, IN 46202, USA
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25
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Chisini LA, Karam SA, Noronha TG, Sartori LRM, San Martin AS, Demarco FF, Conde MCM. Platelet-Poor Plasma as a Supplement for Fibroblasts Cultured in Platelet-Rich Fibrin. Acta Stomatol Croat 2017; 51:133-140. [PMID: 28827850 PMCID: PMC5548224 DOI: 10.15644/asc51/2/6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to evaluate the proliferation and adhesion of mesenchymal cells (3T3/NIH) in Dulbecco’s Modified Eagle Medium(DMEM) supplemented with Platelet-Poor Plasma (PPP) in aPlatelet-Rich Fibrin (PRF) scaffold. Human blood was obtained and processed in a centrifuge considering the equation G=1.12xRx(RPM/1000)2 to obtain PRF and PPP.Cell adhesion and maintenance analyses were performed by MTTassays in a 96 well plate withsupplemented DMEM: PPP (90:10) for 24 hours. Besides, the PRF was deposited in a 48 well plate and 10x104 cells were seeded above each PRF (n=3) with 800µl of DMEM: PPP (90:10) and cultured for 7 days. Histological analysis and the immunohistochemical staining for Vimentin were performed. Results were analyzed by one-way ANOVA in Stata12®. A significant decrease (p<0.05) of cells adhesion in relationship to FBSwas observed. However, a similar ability of cell-maintenance for PPP 10% was observed (P>0.05). Fibroblasts culture for 7 days in PRF supplemented with PPP 10% was possible, showing positive staining for Vimentin. Therefore, PPP cell supplementation decreased the initial adhesion of cells but was able to maintain the proliferation of adhered cells and able to support their viability in PRF.It seems that this method has many clinical advantagessince it provides an autologous and natural scaffold with their respective supplement for cell culture by only one process, without using xenogeneic compounds. This could improve the potential of clinical translational therapies based on the use of PRF cultured cells, promoting the regenerative potential for future use in medicine and dentistry.
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Affiliation(s)
| | | | - Thaís Gioda Noronha
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas-RS, Brazil
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