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Justen M, Scheck D, Münchow EA, Jardim JJ. Is Cention-N comparable to other direct dental restorative materials? A systematic review with network meta-analysis of in vitro studies. Dent Mater 2024; 40:1341-1352. [PMID: 38880724 DOI: 10.1016/j.dental.2024.06.014] [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: 04/01/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC, bioactive resins, silver amalgam) via a systematic review study. METHODS The review followed the PRISMA-NMA recommendations, and the protocol of the review was published at osf.io/ybde8. The search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, Lilacs, and SciELO databases, as well as in the grey literature (Open Grey, Proquest, and Periódicos CAPES). Studies with an in vitro experimental design evaluating the characteristics and properties of Cention-N in comparison to other restorative materials were included. The risk of bias of included studies was assessed using the RoBDEMAT tool, and meta-analyses were conducted using Review Manager 5.4 and MetaInsight V3 tools. RESULTS A total of 85 studies were included in the review, from which 79 were meta-analyzed. Several characteristics of direct restorative materials were analyzed, including physical (color change, degree of conversion, hardness, microleakage, polymerization rate, roughness, water solubility, water sorption), mechanical (bond strength to dentin, compressive strength, diametral tensile strength, flexural modulus, flexural strength, load-to-fracture, wear), and biological (alkalinizing effect, antibacterial activity, calcium and fluoride release) properties. SIGNIFICANCE Cention-N presented similar physico-mechanical properties compared to RBCs, but a stronger behavior than GICs. Despite the Alkasite nature of Cention-N, GICs may still demonstrate the greatest fluoride releasing ability from all direct restorative materials. This review confirmed the adequate behavior of Cention-N when compared to several other more traditionally used materials, confirming its applicability for the permanent restoration of decayed or fractured teeth.
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Affiliation(s)
- Michelli Justen
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Débora Scheck
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Eliseu Aldrighi Münchow
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil; Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.
| | - Juliana Jobim Jardim
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil; Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
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François P, Benoit A, Slimani L, Dufresne A, Gouze H, Attal JP, Mangione F, Dursun E. In vitro remineralization by various ion-releasing materials of artificially demineralized dentin: A micro-CT study. Dent Mater 2024; 40:520-526. [PMID: 38212175 DOI: 10.1016/j.dental.2023.12.013] [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: 05/30/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the remineralizing properties of ion-releasing restorative materials on pH cycling-induced carious dentin. METHODS Fifty sound molars were freshly extracted. The occlusal surfaces were abraded using water-cooled sandpaper (800 grit). The residual crowns were embedded in self-cured acrylic resin with the flat dentin surface exposed. A mesio-distal trench was created using a calibrated 0.5 mm deep occlusal reduction burr, and artificial dentin caries were generated by pH cycling. Then, teeth were randomly assigned to five groups according to the ion-releasing material used. For each sample, micro-CT acquisitions were performed at various intervals. Remineralization was assessed by mean gray value (MGV) measurements after registration and segmentation of the region of interest with 3D Slicer software. One-way repeated-measures ANOVA followed by Tukey's post hoc test was used to investigate the difference in MGVs among the various groups. RESULTS Only Cention Forte showed significantly increased MGVs after 4 weeks compared to demineralized dentin. MGVs were higher, but not significantly, after placement of the restorative materials, including in the resin composite control group. These results can be explained by the radiopacity of the materials. SIGNIFICANCE Cention Forte, the material with the highest radiopacity, showed a significant increase in the MGVs of artificially carious dentin after 4 weeks. However, the study of dentin remineralization by micro-CT could be impacted by the radiopacity of the restorative materials used. The relevance of this examination for the study of dentinal remineralization should be investigated.
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Affiliation(s)
- Philippe François
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Aurélie Benoit
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Lotfi Slimani
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Ambre Dufresne
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Hélène Gouze
- CESP-INSERM, University Paris-Saclay, 16 avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Jean-Pierre Attal
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Francesca Mangione
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; Department of Imagery, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Elisabeth Dursun
- URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; Department of Pediatric Dentistry, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France.
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Ibrahim H, Aziz AA, Yahya NA, Yap AU. Surface Degradation of Ion-releasing Restorative Materials With Cariogenic Challenge. Oper Dent 2024; 49:178-188. [PMID: 38196082 DOI: 10.2341/23-038-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 01/11/2024]
Abstract
This study examined the influence of cariogenic environments on the surface roughness of ion-releasing restorative materials (IRMs). Custom-made stainless steel molds with holes of 5 mm × 2mm were used to fabricate 60 disc-shaped specimens of each of the following materials: Activa Bioactive (AV), Beautifil Bulk Restorative (BB), Cention N (Bulk-fill) (CN), and Filtek Z350XT (FZ) (Control). Baseline surface roughness (Ra) measurements were obtained using an optical 3D measurement machine (Alicona Imaging GmbH, Graz, Austria). The specimens were then randomly divided into five subgroups (n=12) and exposed to 10 ml of the following mediums at 37°C: distilled water (DW), demineralization solution (DM), remineralization solution (RM), pH cycling (PC) and air (AR) (control). Ra measurements were again recorded after one week and one month, followed by statistical evaluations with two-way analysis of variance (ANOVA) to determine interactions between materials and mediums. One-way ANOVA and post hoc Games Howell tests were performed for intergroup comparisons at a significance level of 0.05. Mean Ra values ranged from 0.085 ± 0.004 (µm) to 0.198 ± 0.001 µm for the various material-medium combinations. All IRMs showed significant differences in Ra values after exposure to the aqueous mediums. The smoothest surfaces were observed in the AR for all materials. When comparing materials, AV presented the roughest surfaces for all mediums. All IRM materials showed increased surface roughness over time in all cariogenic environments but were below the threshold value for bacterial adhesion, except for AV 1-month post immersion with pH cycling. Therefore, besides AV, the surface roughness of IRMs did not deteriorate to an extent that it is clinically relevant.
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Affiliation(s)
- H Ibrahim
- Hafizah Ibrahim, DDS, MClinDent, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - A Abdul Aziz
- *Azwatee Abdul Aziz, BDS, MClinDent, PhD, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N A Yahya
- Noor Azlin Yahya, DipTrans, BDS, MDentSci, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - A U Yap
- Adrian U-Jin Yap, BDS, MSc, PhD, Grad Dip Psychotherapy, Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore; National Dental Research Institute Singapore, National Dental Centre and Duke-NUS Medical School, Singapore Health Services, Singapore
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Ai X, Liu Z, Wang T, Xie Q, Xie W. POSS hybrid bioactive glass dental composite resin materials: Synthesis and analysis. J Dent 2024; 142:104860. [PMID: 38281618 DOI: 10.1016/j.jdent.2024.104860] [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: 10/04/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION This study create a dental composite by hybirding polyhedral oligo-sesquioxide nano monomers and bioactive glass BG 45S5. METHODS Make an experimental composite resin material with a 60 % filler content overall by substituting 20 % of the filler with BG 45S5. The experimental resins are grouped and named P0, P2, P4, P6 and P8 based on the reactive nanomonomer methacrylic acid-based multifaceted oligomeric sesquisiloxane (POSS) added by 2 %-8 % in the resin matrix portion of each group. Utilize a universal testing machine to analyze and compare the mechanical properties of these, then perform Fourier infrared spectrum analysis, double bond conversion analysis, and scanning electron microscope analysis. Based on this, after soaking the experimental materials artificial saliva solution or lactic acid solution for a while, the pH changes of the solution, the release of Ca2+ and PO43- ions, and the precipitation of apatite on the resin material's surface were tested and analyzed. Cell viability tests were used to assess sample cell viability and quantify the cytotoxicity of biological cells. The independent sample t-test was used to examine the group comparisons, and a difference was considered statistically significant at P<0.05. RESULTS Outstanding mechanical and the double bond conversion are demonstrated by the nanocomposites when the POSS concentration hits 4 wt%. Agglomeration will cause the performance to deteriorate if the concentration beyond this threshold. In the P4 group, the double bond conversion, CS, and FS rose by a large margin, respectively, in comparison to the blank control group P0. Thankfully, the data demonstrate that adding POSS increases adhesive ability when compared to the blank group P0, however, there is no discernible difference between the other experimental groups. The acid neutralization capacity of the P4 group is essentially the same as that of the control group (P0). Ca2+ and PO43- ions are released in significant amounts following treatment with lactic acid solution, although this tendency is clearly less pronounced in artificial saliva. SEM and EDX data indicate that when the experimental resin is soaked in lactic acid solution and artificial saliva, apatite precipitation will happen on its surface. The results of the cell viability test indicated that there was no statistically significant difference between the experimental groups, and the viability of the cells increased after 24hours and 48 hours. CONCLUSIONS POSS was included into the composite resin along with 20% bioactive glass as a filler. When the proportion of POSS is less than 4%, the indices of composite resin materials rise in a dose-dependent way. When this value is surpassed, performance begins to deteriorate. The inclusion of POSS has no influence on the biological activity of the composites, which means that the hybrid composite resin is capable of acid neutralization, ion release, and apatite precipitation. CLINICAL SIGNIFICANCE The experimental composite resin can be used as an intelligent material in clinical treatment. It has the clinical application potential of preventing demineralization of tooth hard tissue, promoting remineralization, and improving edge sealing through apatite precipitation.
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Affiliation(s)
- XuanMei Ai
- The First Affiliated Hospital Of Harbin Medical Uhiversity, School of Stomatology, Harbin Medical University, Harbin 150001, China.
| | - ZhaoNan Liu
- The First Affiliated Hospital Of Harbin Medical Uhiversity, School of Stomatology, Harbin Medical University, Harbin 150001, China.
| | - TianQi Wang
- The First Affiliated Hospital Of Harbin Medical Uhiversity, School of Stomatology, Harbin Medical University, Harbin 150001, China.
| | - Qi Xie
- Department of Stomatology, Harbin Medical University, Harbin 150001, China.
| | - WeiLi Xie
- The First Affiliated Hospital Of Harbin Medical Uhiversity, School of Stomatology, Harbin Medical University, Harbin 150001, China.
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Nabil Sulyiman S, El-Rashidy AA, El Moshy S, Abbas MMS, Waly G. Nano eggshell-based slurry as a direct pulp-capping material: In vitro characterization and histopathological assessment in an experimental animal model. Int Endod J 2023; 56:1129-1146. [PMID: 37358385 DOI: 10.1111/iej.13949] [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: 11/21/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023]
Abstract
AIM Pulp vitality is essential for tooth integrity. Following pulp exposure, choosing a suitable pulp-capping material is crucial to maintain pulp vitality. However, the reparative dentine bridge created by calcium hydroxide (Ca(OH)2 ) is generally porous and incomplete. The aim of the current study is to assess the in vitro and in vivo bioactivities of nano eggshell-based slurry (NES), using NES as a direct pulp-capping material, compared with Ca(OH)2 in rabbit animal model. METHODOLOGY Nano eggshell powder (NE) was characterized for particle morphology, chemical composition and ion release. In vitro bioactivity was tested by immersion in simulated body fluid (SBF) for 7 days. For histopathological evaluation, 36 adult New Zealand rabbits (72 pulp exposures) were divided into nine groups (n = 8) according to the pulp-capping material (NES, Ca(OH)2 and no capping as negative control group) and the animals were sacrificed after 7, 14 or 28 days. The pulps of the two lower central incisors were exposed and then directly capped by Ca(OH)2 or NES or left untreated. The cavities were then sealed with glass ionomer cement. Teeth were collected for histopathological evaluation using an optical microscope. Pulp haemorrhage, inflammation, fibrosis and calcific bridge formation were assessed. Results were statistically analysed using anova and Tukey's tests. RESULTS Nano eggshell particles were spherical with a 20 nm diameter and were composed mainly of calcite. Statistical analysis showed that there was a significant increase in the release of all investigated ions between days 1 and 28, except for copper. NES group showed a significantly higher release of all elements as compared to Ca(OH)2 . Environmental scanning electron microscope micrographs of NES incubated for 7 days in SBF showed the formation of HAp with a Ca/P ratio (1.686). For histopathological evaluation, the difference between groups was statistically significant. At day 28, 75% of the pulps of the Ca(OH)2 group showed mild calcific bridge in comparison with 100% moderate calcific bridge in the NES group. The NES group showed significantly less inflammation at days 7 and 28, and higher fibrosis at day 7 compared with Ca(OH)2 . CONCLUSIONS Nano eggshell-based slurry represents a promising novel direct pulp-capping material with favourable pulp tissue response.
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Affiliation(s)
| | - Aiah A El-Rashidy
- Biomaterials Department, Faculty of Dentistry, Cairo university, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo university, Cairo, Egypt
| | - Marwa M S Abbas
- Oral Biology Department, Faculty of Dentistry, Cairo university, Cairo, Egypt
| | - Gihan Waly
- Biomaterials Department, Faculty of Dentistry, Cairo university, Cairo, Egypt
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Oz FD, Meral E, Gurgan S. Clinical performance of an alkasite-based bioactive restorative in class II cavities: a randomized clinical trial. J Appl Oral Sci 2023; 31:e20230025. [PMID: 37377309 DOI: 10.1590/1678-7757-2023-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/18/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This clinical study aimed to evaluate the clinical performance of an alkasite-based bioactive material by comparing it with a resin composite (RC) in the restoration of Class II cavities over a year. METHODOLOGY A hundred Class II cavities were restored at 31 participants. Groups were as follows: Cention N (CN) (Ivoclar Vivadent, Schaan, Liechtenstein) and G-ænial Posterior (GP) (GC, Tokyo, Japan) in combination with G-Premio Bond (etch&rinse). Restorative systems were applied following manufacturers' instructions. They were finished and polished immediately after placement and scored based on retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified USPHS criteria after 1 week (baseline), 6 months, and 12 months. Statistical analyses were performed using chi-square, McNemar's, and Kaplan Meier tests. RESULTS After 12 months, the recall rate was 87%. Survival rates of CN and GP restorations were 92.5% and 97.7%, respectively. Three CN and one GP restorations lost retention. Seven CN (17.9%) and five (11.6%) GP restorations were scored as bravo for marginal adaptation and no significant difference was seen between groups (p=0.363). One (2.7%) CN and two GP (4.7%) restorations were scored as bravo for marginal discoloration, but no significant difference was observed between groups(p=1.00). For surface texture, three (8.1%) CN and three (7%) GP restorations were scored as bravo (p=1.00). None of the restorations demonstrated post-operative sensitivity or secondary caries at any examinations. CONCLUSION The tested restorative materials performed similar successful clinical performances after 12 months. ClinicalTrials.gov (NTC04825379).
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Affiliation(s)
- Fatma Dilsad Oz
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
| | - Ece Meral
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
| | - Sevil Gurgan
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
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Burrer P, Par M, Fürer L, Stübi M, Marovic D, Tarle Z, Attin T, Tauböck TT. Effect of polymerization mode on shrinkage kinetics and degree of conversion of dual-curing bulk-fill resin composites. Clin Oral Investig 2023; 27:3169-3180. [PMID: 36869923 PMCID: PMC10264464 DOI: 10.1007/s00784-023-04928-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVES To assess the behavior of dual-cure and conventional bulk-fill composite materials on real-time linear shrinkage, shrinkage stress, and degree of conversion. MATERIALS AND METHODS Two dual-cure bulk-fill materials (Cention, Ivoclar Vivadent (with ion-releasing properties) and Fill-Up!, Coltene) and two conventional bulk-fill composites (Tetric PowerFill, Ivoclar Vivadent; SDR flow + , Dentsply Sirona) were compared to conventional reference materials (Ceram.x Spectra ST (HV), Dentsply Sirona; X-flow; Dentsply Sirona). Light curing was performed for 20 s, or specimens were left to self-cure only. Linear shrinkage, shrinkage stress, and degree of conversion were measured in real time for 4 h (n = 8 per group), and kinetic parameters were determined for shrinkage stress and degree of conversion. Data were statistically analyzed by ANOVA followed by post hoc tests (α = 0.05). Pearson's analysis was used for correlating linear shrinkage and shrinkage force. RESULTS Significantly higher linear shrinkage and shrinkage stress were found for the low-viscosity materials compared to the high-viscosity materials. No significant difference in degree of conversion was revealed between the polymerization modes of the dual-cure bulk-fill composite Fill-Up!, but the time to achieve maximum polymerization rate was significantly longer for the self-cure mode. Significant differences in degree of conversion were however found between the polymerization modes of the ion-releasing bulk-fill material Cention, which also exhibited the significantly slowest polymerization rate of all materials when chemically cured. CONCLUSIONS While some of the parameters tested were found to be consistent across all materials studied, heterogeneity increased for others. CLINICAL RELEVANCE With the introduction of new classes of composite materials, predicting the effects of individual parameters on final clinically relevant properties becomes more difficult.
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Affiliation(s)
- Phoebe Burrer
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Leo Fürer
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Michelle Stübi
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Danijela Marovic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Zrinka Tarle
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Thomas Attin
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Tobias T Tauböck
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Maher YA, Rajeh MT, Hamooda FA, Zerain GO, Habis RM, Sulaimani RH, Albar ST, H Ali FM, Abdelaleem NA. Evaluation of the clinical impact and In Vitro antibacterial activities of two bioactive restoratives against S. mutans ATCC 25175 in class II carious restorations. Niger J Clin Pract 2023; 26:404-411. [PMID: 37203103 DOI: 10.4103/njcp.njcp_406_22] [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: 05/20/2023]
Abstract
Background Streptococcus mutans is a Gram-positive opportunistic bacterial pathogen and that causes dental caries and then restorative treatment remains the best clinical practice approach to repair and prevent dental caries. Aims This study compared the antimicrobial performance of resin modified glass ionomer cement (RM-GIC) and ACTIVA restoratives by evaluating the S. mutans count, pH levels, and plaque index (PI) scores before and on the 7th day of restoration, and then determined the antimicrobial activities against S. mutans ATCC 25175 in both restoratives in vitro. Materials and Methods Seventy-eight eligible Saudi female participants, with class II carious lesions, were randomly distributed into RM-GIC and ACTIVA restorative groups. We evaluated the S. mutans count by the serial dilution technique and salivary pH by using a portable pH meter. The PI scores were determined by Silness-Löe method and the antibacterial activity by the agar well diffusion method. Statistical analysis of normality distribution was performed with the Kolmogorov-Smirnov and the difference between groups was an analysis by paired t-test. In addition, the independent sample was compared with the independent samples t-test. Results Both groups reduced the S. mutans count, pH acidity, and PI scores, and this reduction was statistically significant on the 7th day of restoration (P < 0.05), preference for ACTIVA. The in vitro antibacterial activity against S. mutans ATCC 25175 showed a non-significant difference between both bioactive restorative materials (P < 0.05). Conclusion The novel application of ACTIVA restorative material is a promising option for patients at risk of caries.
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Affiliation(s)
- Y A Maher
- Department of Basic Oral Sciences, College of Dentistry - Umm Al-Qura University, Makkah, Saudi Arabia; Department of Microbiology, Faculty of Science, Al-Azhar University, Cairo, Egypt
| | - M T Rajeh
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
| | - F A Hamooda
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - G O Zerain
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R M Habis
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R H Sulaimani
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - S T Albar
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - F M H Ali
- Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - N A Abdelaleem
- Department of Conservative and Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Wuersching SN, Högg C, Kohl L, Reichl FX, Hickel R, Kollmuss M. Leaching components and initial biocompatibility of novel bioactive restorative materials. Dent Mater 2023; 39:293-304. [PMID: 36754734 DOI: 10.1016/j.dental.2023.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Bioactive restorative materials were developed on the premise that direct restorations should not only serve the purpose of reconstructing dental hard tissue defects but also exhibit biological features that prevent secondary caries development, without having adverse effects on the host cells. This study focuses on assessing the in vitro biocompatibility of two novel bioactive restorative materials. METHODS Specimens of the bioactive restorative materials, Cention Forte (CF) and ACTIVA BioACTIVE RESTORATIVE (AB), a glass ionomer cement/glass hybrid (EQUIA Forte HT, EF) and an established nanohybrid composite (Venus Diamond, VD) were produced and finished. The specimens were eluted in water and methanol and the resulting eluates were analyzed via gas chromatography-mass spectrometry. hGF-1 cells were exposed to eluates prepared in cell culture medium. Cellular ATP levels, oxidized glutathione concentration, caspase-3/7 activity and the inflammatory response (IL-6 and PGE2 levels) were determined. Microscopic images were taken to examine the cell morphology. RESULTS Methyl methacrylate and 2-Hydroxyethyl methacrylate were the main monomers detected in CF and AB eluates. All materials inhibited cell proliferation and led to significantly reduced ATP-levels. The cells exhibited a healthy morphology in the presence of CF and AB. Cells exposed to VD showed increased oxidized glutathione levels. Only EF led to enhanced caspase-3/7 activity. CF and AB caused IL-6 levels to increase, while EF and AB led to enhanced PGE2 levels. SIGNIFICANCE CF and AB are promising materials from a biological point of view and seem to have improved bioactive properties compared to glass ionomer cements.
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Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany. .-muenchen.de
| | - Christof Högg
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Lisa Kohl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
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Maciel Pires P, Ionescu AC, Pérez-Gracia MT, Vezzoli E, Soares IPM, Brambilla E, de Almeida Neves A, Sauro S. Assessment of the remineralisation induced by contemporary ion-releasing materials in mineral-depleted dentine. Clin Oral Investig 2022; 26:6195-6207. [PMID: 35670863 DOI: 10.1007/s00784-022-04569-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/29/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Evaluate the ability of current ion-releasing materials to remineralise bacteria-driven artificial caries lesions. MATERIALS AND METHODS Standardised class I cavities were obtained in 60 extracted human molars. Specimens underwent a microbiological cariogenic protocol (28 days) to generate artificial caries lesions and then were randomly divided into four restorative groups: adhesive + composite (negative control); glass ionomer cement (GIC); calcium silicate cement (MTA); and resin-modified calcium silicate cement (RMTA). Microhardness analysis (ΔKHN) was performed on 40 specimens (10/group, t = 30 days, 45 days, 60 days in artificial saliva, AS). Micro-CT scans were acquired (3/group, t = 0 days, 30 days, and 90 days in AS). Confocal microscopy was employed for interfacial ultra-morphology analysis (2/group, t = 0 days and 60 days in AS). Additional specimens were prepared and processed for scanning electron microscopy (SEM) and FTIR (n = 3/group + control) to analyse the ability of the tested materials to induce apatite formation on totally demineralised dentine discs (60 days in AS). Statistical analyses were performed with a significance level of 5%. RESULTS Adhesive + composite specimens showed the lowest ΔKHN values and the presence of gaps at the interface when assessed through micro-CT even after storage in AS. Conversely, all the tested ion-releasing materials presented an increase in ΔKHN after storage (p < 0.05), while MTA best reduced the demineralised artificial carious lesions gap at the interface. MTA and RMTA also showed apatite deposition on totally demineralised dentine surfaces (SEM and FTIR). CONCLUSIONS All tested ion-releasing materials expressed mineral precipitation in demineralised dentine. Additionally, calcium silicate-based materials induced apatite precipitation and hardness recovery of artificial carious dentine lesions over time. CLINICAL RELEVANCE Current ion-releasing materials can induce remineralisation of carious dentine. MTA shows enhanced ability of nucleation/precipitation of hydroxyapatite compared to RMTA and GIC, which may be more appropriate to recover severe mineral-depleted dentine.
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Affiliation(s)
- Paula Maciel Pires
- Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.,Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Andrei Cristian Ionescu
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Maria Teresa Pérez-Gracia
- Microbiology, Departamento de Farmacia, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Elena Vezzoli
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University UNESP, Araraquara, Brazil
| | - Eugenio Brambilla
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain.
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11
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Abstract
Bioactive materials for dental resin restorations are a rising field of investigation exploring treatment strategies for reducing the recurrence of carious lesions. The current effort has been directed toward developing dental materials that can inhibit biofilms and prevent tooth mineral loss. Bioactive resin materials have shown the potential to interfere with polymicrobial consortia in vivo and help maintain the lifespan of restorations.
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Affiliation(s)
- Mary Anne S Melo
- Program in Dental Biomedical Sciences, University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD 21201, USA; Division of Operative Dentistry, Department of General Dentistry, University of Maryland Dental School, 650 West Baltimore Street, Baltimore, MD 21201, USA.
| | - Lamia Mokeem
- Program in Dental Biomedical Sciences, University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Jirun Sun
- The Forsyth Institute, Harvard School of Dental Medicine Affiliate, 245 First Street, Cambridge, MA 02142, USA
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12
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Garoushi S, Vallittu P, Lassila L. Development and characterization of ion-releasing fiber-reinforced flowable composite. Dent Mater 2022; 38:1598-1609. [PMID: 36041943 DOI: 10.1016/j.dental.2022.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aimed to develop and characterize an ion-releasing experimental fiber-reinforced flowable composite (Bio-SFRC) and dentin treatment solution made of poly(acrylic acid) (PAA) with a high molecular weight. In addition we also evaluated the interface structure and mineralization potential between the Bio-SFRC and dentin. METHODS Some mechanical properties (flexural properties and fracture toughness) of Bio-SFRC in comparison with commercial inert (G-aenial Flo X) and ion-releasing materials (ACTIVA-BioActive Base/Liner and Fuji II LC) were assessed (n = 8/group). Calcium-release at different time-points was measured during the first six weeks by using a calcium-ion selective electrode. Surface analysis of composites after being stored in simulated body fluid (SBF) was investigated by using SEM/EDS. Dentin disks (n = 50) were prepared from extracted sound teeth and demineralization was simulated by acid etching. SEM/EDS was used to evaluate the microstructure of dentin on the top surface and at interface with composites after being stored in SBF. RESULTS Bio-SFRC showed higher fracture toughness (1.6 MPa m1/2) (p < 0.05) compared to Flo X (1.2 MPa m1/2), ACTIVA (1 MPa m1/2) and Fuji II LC (0.8 MPa m1/2). Accumulative calcium release after six weeks from Bio-SFRC (15 mg/l) was higher than other tested ion-releasing materials (≈ 6 mg/l). Mineralization was clearly seen at the interface between treated dentin and Bio-SFRC. None of the commercial tested materials showed signs of mineralization at the interface and dentinal tubules remained open. SIGNIFICANCE Developing such reinforced ion-releasing flowable composite and PAA solution might offer the potential for mineralization at the interface and inside the organic matrix of demineralized dentin.
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Affiliation(s)
- Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland; City of Turku Welfare Division, Oral Health Care, Turku, Finland
| | - Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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13
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Comparative Evaluation of Bond Strength and Microleakage of Three Ion-Releasing Restorative Materials at Various pH Levels. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was a comparison of the micro-tensile bond strength (μTBS) to dentin and microleakage of in vitro class V restorations of three different ion-releasing restorative materials under various pH conditions: giomer, a resin-modified glass ionomer (RMGI), and a new alkasite material. A μTBS test was performed using a universal testing machine, immediately and after storage at different pH (4, 7, and 10) buffer solutions (n = 15) over 24 h, and the failure mode was analyzed. For microleakage analysis, class V restorations were performed on extracted premolars, which were sectioned and stored in pH 4-, 7-, and 10-buffered fluorescent 0.02% rhodamine B dye. The specimens were observed under a confocal laser scanning microscope (CLSM) and scored using the acquired images. There were no significant differences in the μTBS according to the type of material (p = 0.518). The giomer showed a decreased bond strength under the pH 4 condition compared with the immediately tested or pH 7-stored specimens (p ≤ 0.043). In the microleakage analysis, the class V restoration with giomer showed a higher microleakage than RMGI or alkasite (p = 0.001). For RMGI and alkasite, the specimens stored at pH 4 showed a significantly lower microleakage than those stored at pH 7 (p = 0.028). RMGI and alkasite can be adopted as restorative materials in generalized or localized low-pH conditions.
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14
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ÇINAR B, EREN D. EVALUATİON OF ALKALİZİNG POTENTİAL OF ALKASİTE RESTORATİONS PREPARED İN DİFFERENT SİZES. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1061216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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15
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Theerarath T, Sriarj W. An alkasite restorative material effectively remineralized artificial interproximal enamel caries in vitro. Clin Oral Investig 2022; 26:4437-4445. [PMID: 35190884 DOI: 10.1007/s00784-022-04407-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the remineralization of artificial interproximal enamel caries (AIEC) adjacent to alkasite, high viscous glass ionomer cement (HVGIC), and resin composite in class II restorations. MATERIALS AND METHODS Human enamel specimens were randomly assigned to 3 groups (n = 22): Filtek™ Z350, EQUIA Forte®, and Cention N®. The baseline hardness was determined using a Knoop microhardness assay. AIEC was formed in the specimens, and they were placed in contact with the proximal restorative materials then subjected to a 7-day pH cycling. Microhardness was determined post-artificial caries formation and post-pH cycling. The differences in the percentage of surface hardness recovery (%SHR) between the groups were compared using the Kruskal-Wallis test. The Dunn's test was used for between-group comparisons (p < 0.05). Specimen surface morphology was evaluated using scanning electron microscopy (SEM), and the calcium, phosphorus, and fluoride contents were analyzed by energy-dispersive spectroscopy (EDS). ANOVA with the post hoc Tukey multiple comparison test was used to evaluate the differences between groups (p < 0.05). RESULTS The Cention N® %SHR was the highest, followed by EQUIA Forte®, and Filtek™ Z350. There was a significant difference in the %SHR between Cention N® and Filtek™ Z350 (p < 0.05). In contrast, there were no significant difference between Cention N® and EQUIA Forte®. Significantly increased enamel surface fluoride content was observed in the Cention N® compared with Filtek™ Z350 specimens (p < 0.05). The SEM image of the Cention N® specimens demonstrated the greatest mineral deposition. CONCLUSIONS Cention N® markedly increased the surface hardness and fluoride content of adjacent AIEC compared with Filtek™ Z350 restorations. CLINICAL RELEVANCE Cention N® is a promising alternative restorative material to remineralize initial enamel lesions in approximal adjacent surfaces, especially in high-risk caries patients.
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Affiliation(s)
- Thipthida Theerarath
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Wannakorn Sriarj
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand.
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16
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Tohidkhah S, Kermanshah H, Ahmadi E, Jalalian B, Ranjbar Omrani L. Marginal microleakage and modified microtensile bond strength of Activa Bioactive, in comparison with conventional restorative materials. Clin Exp Dent Res 2022; 8:329-335. [PMID: 35037730 DOI: 10.1002/cre2.534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 09/27/2021] [Accepted: 12/14/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to assess the enamel and dentin marginal microleakage and dentin microtensile bond strength (μTBS) of ACTIVA BioACTIVE Restorative with and without a bonding agent compared with conventional restorative materials. MATERIAL AND METHODS For enamel and dentin microleakage, Class II boxes were prepared in the mesial (1 mm under the cementoenamel junction) and distal (1 mm above the cementoenamel junction) surfaces of 90 extracted human third molars. The teeth were randomly divided into five groups (n = 18): Group Z (G-Premio Bond + Filtek Z250 XT), Group X (G-Premio Bond + X-tra fil bulk-fill), Group AA (G-Premio Bond + Activa Bioactive restorative), Group A (Activa Bioactive restorative), and Group G (dentin conditioner + Fuji II LC Improve). The teeth were thermocycled, and their microleakage was quantified using the dye penetration test under a stereomicroscope. For dentin μTBS measurement, 12 specimens were fabricated in metal molds (1 × 1 × 12 mm³) for each group mentioned above, and a universal testing machine measured their μTBS. Data were analyzed using one-way analysis of variance (ANOVA), the Kruskal-Wallis test, and multiple comparisons tests. RESULTS Significant differences were noted among the groups in marginal microleakage and μTBS (p < .001). The highest mean microleakage scores at the enamel and dentin margins were noted in Group A, which had significant differences with other groups (p < .001). The highest μTBS was found in Group X, with significant differences with Group G and Group A (p < .05). The lowest µTBS was noted in Group A, with significant differences with Groups X, Group AA, and Group Z (p < .001). CONCLUSIONS Activa Bioactive without a bonding agent showed significantly lower µTBS to dentin, and higher microleakage at the enamel and dentin margins. Application of adhesive resin with Activa Bioactive provided a dentine bond strength and marginal seal comparable to other restorative materials.
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Affiliation(s)
- Saba Tohidkhah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Kermanshah
- Department of Restorative Dentistry, Dental Research Center, Dentistry Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ahmadi
- Department of Restorative Dentistry, Dental Research Center, Dentistry Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnous Jalalian
- Department of Restorative Dentistry, Faculty of Dentistry, Qom University of Medical Sciences, Tehran, Iran
| | - Ladan Ranjbar Omrani
- Department of Restorative Dentistry, Dental Research Center, Dentistry Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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17
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Sanz JL, Guerrero-Gironés J, Pecci-Lloret MP, Pecci-Lloret MR, Melo M. Biological interactions between calcium silicate-based endodontic biomaterials and periodontal ligament stem cells: A systematic review of in vitro studies. Int Endod J 2021; 54:2025-2043. [PMID: 34338339 DOI: 10.1111/iej.13600] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/16/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Most recently, the biological interactions, that is cytocompatibility, cell differentiation and mineralization potential, between calcium silicate-based biomaterials and periodontal ligament stem cells (PDLSCs) have been studied at an in vitro level, in order to predict their clinical behaviour during endodontic procedures involving direct contact with periodontal tissues, namely root canal treatment, endodontic surgery and regenerative endodontic treatment. OBJECTIVE The aim of the present systematic review was to present a qualitative synthesis of available in vitro studies assessing the biological interaction of PDLSCs and calcium silicate-based biomaterials. METHODOLOGY The present review followed PRISMA 2020 guidelines. An advanced database search was performed in Medline, Scopus, Embase, Web of Science and SciELO on 1 July 2020 and last updated on 22 April 2021. Studies assessing the biological interactions of PDLSCs with calcium silicate-based sealers (CSSs) and/or cements (CSCs) at an in vitro level were considered for inclusion. The evaluation of the 'biological interaction' was defined as any assay or test on the cytotoxicity, cytocompatibility, cell plasticity or differentiation potential, and bioactive properties of PDLSCs cultured in CSC or CSS-conditioned media. Quality (risk of bias) was assessed using a modified CONSORT checklist for in vitro studies of dental materials. RESULTS A total of 20 studies were included for the qualitative synthesis. CSCs and CSSs, as a group of endodontic materials, exhibit adequate cytocompatibility and favour the osteo/cementogenic differentiation and mineralization potential of PDLSCs, as evidenced from the in vitro studies included in the present systematic review. DISCUSSION The influence of the compositional differences, inclusion of additives, sample preparation, and varying conditions and manipulations on the biological properties of calcium silicate-based materials remain a subject for future research. CONCLUSIONS Within the limitations of the in vitro nature of the included studies, this work supports the potential use of calcium silicate-based endodontic materials in stem cell therapy and biologically based regenerative endodontic procedures. REGISTRATION OSF Registries; https://doi.org/10.17605/OSF.IO/SQ9UY.
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Affiliation(s)
- José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - Julia Guerrero-Gironés
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - María P Pecci-Lloret
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - Miguel R Pecci-Lloret
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, Morales Meseguer Hospital, University of Murcia, Murcia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
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