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Pelepenko LE, Marciano MA, Francati TM, Bombarda G, Bessa Marconato Antunes T, Sorrentino F, Martin RA, Boanini E, Cooper PR, Shelton RM, Camilleri J. Can strontium replace calcium in bioactive materials for dental applications? J Biomed Mater Res A 2022; 110:1892-1911. [PMID: 35770805 PMCID: PMC9796236 DOI: 10.1002/jbm.a.37421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 01/01/2023]
Abstract
The substitution of calcium with strontium in bioactive materials has been promising but there has been some concern over the material instability and possible toxicity. The aim of this research was the synthesis and characterization of calcium and strontium substituted bioactive materials and assessment of interactions with local tissues and peripheral elemental migration in an animal model. A bioactive glass, hydroxyapatite and hydraulic calcium silicate with 50% or 100% calcium substitution with strontium were developed and the set materials were characterized immediately after setting and after 30 and 180-days in solution. Following subcutaneous implantation, the local (tissue histology, elemental migration) and systemic effects (elemental deposition after organ digestion) were assessed. The strontium-replaced silicate cements resulted in the synthesis of partially substituted phases and strontium leaching at all-time points. The strontium silicate implanted in the animal model could not be retrieved in over half of the specimens showing the high rate of material digestion. Tissue histology showed that all materials caused inflammation after 30 days of implantation however this subsided and angiogenesis occurred after 180 days. Strontium was not detected in the local tissues or the peripheral organs while all calcium containing materials caused calcium deposition in the kidneys. The tricalcium silicate caused elemental migration of calcium and silicon in the local tissues shown by the elemental mapping but no deposition of calcium was identified in the peripheral organs verified by the assessment of the digested tissues. Strontium can substitute calcium in bioactive materials without adverse local or systemic effects.
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Affiliation(s)
| | | | | | - Gabriela Bombarda
- School of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | | | | | | | - Elisa Boanini
- Department of Chemistry, “Giacomo Ciamician”University of BolognaBolognaItaly
| | - Paul Roy Cooper
- Department of Oral ScienceSir John Walsh Research Institute, University of OtagoDunedinNew Zealand
| | - Richard Michael Shelton
- School of Dentistry, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Josette Camilleri
- School of Dentistry, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
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de Azevedo Queiroz ÍO, Machado T, Alves CC, Vasques AMV, Cury MTS, Vasconcelos BC, Gomes-Filho JE, Vivan RR, Braga T, Love RM, Duarte MAH. Tracing the toxic ions of an endodontic tricalcium silicate-based sealer in local tissues and body organs. J Trace Elem Med Biol 2021; 68:126856. [PMID: 34560425 DOI: 10.1016/j.jtemb.2021.126856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to track the toxic ions released by MTA Fillapex, BioRoot RCS, and an experimental tricalcium silicate-based sealer (CEO) into local and distant tissues as well as to investigate their potential adverse effects. In addition, the chemical constituents of the sealers were also evaluated. The main components of the dry powders, pastes, and mixed sealers were characterized. MATERIAL AND METHODS Dry powder and sealer discs were each set for 72 h and their main components were characterized by energy dispersive X-ray spectroscopy. Polyethylene tubes filled with sealers were used to measure silicon and calcium ions. Polyethylene tubes filled with sealers or empty tubes were implanted into the dorsal connective tissue of Wistar rats. On days 7, 15, 30, and 45, the animals were euthanized and their brains, livers, kidneys, and subcutaneous tissues were removed and processed to determine the concentrations of chromium, cobalt, copper, lead, iron, magnesium and nickel using an inductively coupled plasma optical emission spectrometer. RESULTS The main compounds in all sealers were carbon, oxygen, silicon, and calcium. MTA Fillapex release more Si while highest levels of Si were found in presence of BioRoot. The release of Si and Ca ions promoted by MTA Fillapex raise by time. No traces of cobalt, chromium, or magnesium were detected in any tissue. Irrespective of the sealer, no traces of copper and lead were found in the subcutaneous tissue; however, they were observed in the organs. The highest concentration of iron was identified in the liver. All sealers exhibited similar nickel traces in the brain, kidney, and liver except for MTA Fillapex, which demonstrated levels higher than CEO in the subcutaneous tissue on day 7. Tracing nickel ions over time revealed that lowest concentrations were found in subcutaneous tissue. CONCLUSION Taken together, our data demonstrate that CEOs have chemical compositions similar to those of other commercial sealers. Furthermore, none of them exhibited a threat to systemic health. Moreover, the minimal amounts of iron and nickel detected were not related to the sealers.
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Affiliation(s)
| | - Thiago Machado
- Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Camila Carneiro Alves
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Ana Maria Veiga Vasques
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | | | - Bruno Carvalho Vasconcelos
- Departmento de Endodontia, Faculdade de Odontologia da Universidade Federal do Ceará - Campus de Sobral, UFC, Sobral, Brazil
| | - João Eduardo Gomes-Filho
- Departmento de Odontologia Restauradora, Faculdade de Odontologia de Araçatuba, FOA/UNESP, Araçatuba, Brazil
| | - Rodrigo Ricci Vivan
- Departmento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, FOB/USP, Bauru, Brazil
| | - Tiago Braga
- School of Medicine and Dentistry Griffith University, Queensland, Australia
| | | | - Marco Antonio Hungaro Duarte
- Departmento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, FOB/USP, Bauru, Brazil
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Biocompatibility Study of a New Dental Cement Based on Hydroxyapatite and Calcium Silicates: Focus on Liver, Kidney, and Spleen Tissue Effects. Int J Mol Sci 2021; 22:ijms22115468. [PMID: 34067318 PMCID: PMC8196841 DOI: 10.3390/ijms22115468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The effects of a new material based on hydroxyapatite and calcium silicates, named ALBO-MPCA, were investigated on the liver, kidney and spleen. The material was administrated orally for 120 days in an in vivo model in Wistar rats, and untreated animals served as a control. Hematological and biochemical blood parameters were analyzed. Qualitative histological analysis of tissues, change in mitotic activity of cells, and histological characteristics was conducted, as well as quantitative stereological analysis of parenchymal cells, blood sinusoids, and connective tissues. Additionally, the protein expressions of Ki67 and CD68 markers were evaluated. Histological analysis revealed no pathological changes after the tested period. It showed the preservation of the architecture of blood sinusoids and epithelial cells and the presence of mitosis. Additionally, the significantly increased number of the Ki67 in the presence of ALBO-MPCA confirmed the proliferative effect of the material noticed by stereological analysis, while immunoreactive CD68 positive cells did not differ between groups. The study showed non-toxicity of the tested material based on the effects on the hematological, biochemical, and observed histological parameters; in addition, it showed evidence of its biocompatibility. These results could be the basis for further steps toward the application of tested materials in endodontics.
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Benetti F, Gomes-Filho JE, de Azevedo-Queiroz IO, Carminatti M, Conti LC, Dos Reis-Prado AH, de Oliveira SHP, Ervolino E, Dezan-Júnior E, Cintra LTA. Biological assessment of a new ready-to-use hydraulic sealer. Restor Dent Endod 2021; 46:e21. [PMID: 34123757 PMCID: PMC8170373 DOI: 10.5395/rde.2021.46.e21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/09/2020] [Accepted: 05/29/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives This study compared the cytotoxicity, biocompatibility, and tenascin immunolabeling of a new ready-to-use hydraulic sealer (Bio-C Sealer) with MTA-Fillapex and white MTA-Angelus. Materials and Methods L929 fibroblasts were cultivated and exposed to undiluted and diluted material extracts. Polyethylene tubes with or without (the control) the materials were implanted into the dorsa of rats. At 7 days and 30 days, the rats were euthanized, and the specimens were prepared for analysis; inflammation and immunolabeling were measured, and statistical analysis was performed (p < 0.05). Results MTA-Fillapex exhibited greater cytotoxicity than the other materials at all time points (p < 0.05). The undiluted Bio-C Sealer exhibited greater cytocompatibility at 6 and 48 hours than white MTA-Angelus, with higher cell viability than in the control (p < 0.05). White MTA-Angelus displayed higher cell viability than the control at 24 hours, and the one-half dilution displayed similar results at both 6 and 48 hours (p < 0.05). At 7 days and 30 days, the groups exhibited moderate inflammation with thick fibrous capsules and mild inflammation with thin fibrous capsules, respectively (p > 0.05). At 7 days, moderate to strong immunolabeling was observed (p > 0.05). After 30 days, the control and MTA-Fillapex groups exhibited strong immunolabeling, the white MTA-Angelus group exhibited moderate immunolabeling (p > 0.05), and the Bio-C Sealer group exhibited low-to-moderate immunolabeling, differing significantly from the control (p < 0.05). Conclusions Bio-C Sealer and white MTA-Angelus exhibited greater cytocompatibility than MTA-Fillapex; all materials displayed adequate biocompatibility and induced tenascin immunolabeling.
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Affiliation(s)
- Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil.,Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - India Olinta de Azevedo-Queiroz
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Marina Carminatti
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Letícia Citelli Conti
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | | | - Edilson Ervolino
- Department of Basic Science, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Elói Dezan-Júnior
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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Camilleri J, Borg J, Damidot D, Salvadori E, Pilecki P, Zaslansky P, Darvell BW. Colour and chemical stability of bismuth oxide in dental materials with solutions used in routine clinical practice. PLoS One 2020; 15:e0240634. [PMID: 33176336 PMCID: PMC7657490 DOI: 10.1371/journal.pone.0240634] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/29/2020] [Indexed: 11/19/2022] Open
Abstract
Bismuth(III) oxide is included as a radio-opacifier in dental materials, including hydraulic silicate cements, the material of choice for several endodontic procedures. It has been implicated in tooth discoloration after contact with endodontic irrigants, in particular NaOCl solution, To date, there has been no work on the chemistry: all reports have been of clinical findings only. The purpose now was to report the reactions leading to colour change from Bi2O3 in contact with solutions used in routine endodontic practice. Ten-gram portions of Bi2O3 were immersed in either water, NaOH, NaCl, NaOCl or HCl solution, either in the dark or exposed to visible light, and samples retrieved at 1, 4, 12 and 24 weeks. After washing, these were exposed to either added CO2 or not, for 1 week while drying, and under the same dark or light conditions. Changes in appearance were monitored by photography and colour measurement, and chemically by X-ray diffraction and Fourier-transform infrared spectroscopy. 24-week material was studied using electron paramagnetic resonance and Raman spectroscopy; NaOCl-treated material was also examined by scanning electron microscopy. With water, NaCl and NaOH, bismuth subcarbonate was formed. With or without added carbon dioxide, discoloration occurred from pale yellow to light brown when exposed to light, and to a lesser extent in the dark, intensifying with time. In contrast, exposure to NaOCl rapidly formed a dark brown-black sodium bismuthate. With HCl, white BiOCl was formed. Bi2O3 is not at all inert in this context as is commonly believed, denying its principle of use. Previously unreported solution-mediated reaction occurs readily even in water and NaCl solution, forming new compounds that discolour. In contact with NaOCl sodium bismuthate is formed; severe darkening occurs rapidly. The reactivity is such that Bi2O3 is not indicated for dental materials and should be withdrawn from use.
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Affiliation(s)
- Josette Camilleri
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Joseph Borg
- Systems Engineer, Triq L-Uqija Ta L-Ibrag, Is-Swieqi, Malta
| | - Denis Damidot
- Department of Civil and Structural Engineering, Faculty of Civil Engineering, Ecole de Mines, LGCgE-GCE, Douai, France
| | | | - Peter Pilecki
- Imaging and Microscopy, King’s College London, London, United Kingdom
| | - Paul Zaslansky
- Department for Operative and Preventive Dentistry, Centrum für Zahn-, Mund- und Kieferheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Brian W. Darvell
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
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de Miguel R, Asín J, Rodríguez-Largo A, Molín J, Echeverría I, de Andrés D, Pérez M, de Blas I, Mold M, Reina R, Luján L. Detection of aluminum in lumbar spinal cord of sheep subcutaneously inoculated with aluminum-hydroxide containing products. J Inorg Biochem 2019; 204:110871. [PMID: 31901536 DOI: 10.1016/j.jinorgbio.2019.110871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/13/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
The use of vaccines containing aluminum (Al) adjuvants is widespread in ovine production. Al adjuvants induce an effective immune-response but lead to the formation of post-vaccination granulomas from which Al can disseminate. This work aims to study the accumulation of Al in the central nervous system of sheep subcutaneously inoculated with Al-hydroxide containing products. Lumbar spinal cord and parietal lobe from 21 animals inoculated with 19 doses of Vaccine (n = 7), Adjuvant-only (n = 7) or phosphate-buffered saline as Control (n = 7) were analyzed with transversely heated graphite furnace atomic absorption spectroscopy and lumogallion staining for Al analytical measurements and Al tisular localization respectively. In the lumbar spinal cord, Al median content was higher in both the Adjuvant-only and Vaccine group (p = .001) compared with the Control group. Animals of the Adjuvant-only group showed the higher individual measurements in the lumbar spinal cord (14.36 μg/g and 7.83 μg/g). In the parietal lobe, Al median content tended to be higher in the Adjuvant-only group compared with Control group (p = .074). Except for three replicates of the Adjuvant-only group, Al content was always below 1 μg/g. In the lumbar spinal cord, lumogallion-reactive Al deposits were more abundant in the gray matter than in the white matter in both Vaccine (p = .034) and Adjuvant-only groups (p = .017) and Al deposits were mostly associated with glial-like cells (p = .042). In the parietal lobe, few Al deposits, which were sometimes related to blood vessels, were found. In sheep, Al-hydroxide adjuvants inoculated in the subcutaneous tissue selectively accumulate in the lumbar spinal cord.
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Affiliation(s)
| | - Javier Asín
- Department of Animal Pathology, University of Zaragoza, Spain
| | | | - Jéssica Molín
- Department of Animal Pathology, University of Zaragoza, Spain
| | - Irache Echeverría
- Institute of Agrobiotechnology, CSIC- Government of Navarra, Mutilva Baja, Navarra, Spain
| | - Damián de Andrés
- Institute of Agrobiotechnology, CSIC- Government of Navarra, Mutilva Baja, Navarra, Spain
| | - Marta Pérez
- Department of Animal Anatomy, Embryology and Genetics, University of Zaragoza, Spain; Instituto Universitario de Investigación Mixto Agroalimentario de Aragón (IA2), University of Zaragoza, Spain
| | - Ignacio de Blas
- Department of Animal Pathology, University of Zaragoza, Spain; Instituto Universitario de Investigación Mixto Agroalimentario de Aragón (IA2), University of Zaragoza, Spain
| | - Matthew Mold
- The Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire ST5 5BG, UK
| | - Ramsés Reina
- Institute of Agrobiotechnology, CSIC- Government of Navarra, Mutilva Baja, Navarra, Spain
| | - Lluís Luján
- Department of Animal Pathology, University of Zaragoza, Spain; Instituto Universitario de Investigación Mixto Agroalimentario de Aragón (IA2), University of Zaragoza, Spain.
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Primus CM, Tay FR, Niu LN. Bioactive tri/dicalcium silicate cements for treatment of pulpal and periapical tissues. Acta Biomater 2019; 96:35-54. [PMID: 31146033 PMCID: PMC6717675 DOI: 10.1016/j.actbio.2019.05.050] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 12/11/2022]
Abstract
Over 2500 articles and 200 reviews have been published on the bioactive tri/dicalcium silicate dental materials. The indications have expanded since their introduction in the 1990s from endodontic restorative and pulpal treatments to endodontic sealing and obturation. Bioactive ceramics, based on tri/dicalcium silicate cements, are now an indispensable part of the contemporary dental armamentarium for specialists including endodontists, pediatric dentists, oral surgeons andfor general dentists. This review emphasizes research on how these materials have conformed to international standards for dental materials ranging from biocompatibility (ISO 7405) to conformance as root canal sealers (ISO 6876). Potential future developments of alternative hydraulic materials were included. This review provides accurate materials science information on these important materials. STATEMENT OF SIGNIFICANCE: The broadening indications and the proliferation of tri/dicalcium silicate-based products make this relatively new dental material important for all dentists and biomaterials scientists. Presenting the variations in compositions, properties, indications and clinical performance enable clinicians to choose the material most suitable for their cases. Researchers may expand their bioactive investigations to further validate and improve materials and outcomes.
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Affiliation(s)
- Carolyn M Primus
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA.
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA
| | - Li-Na Niu
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Hena, China
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Cintra LTA, Estrela C, Azuma MM, Queiroz ÍODA, Kawai T, Gomes-Filho JE. Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials. Braz Oral Res 2018; 32:e68. [DOI: 10.1590/1807-3107bor-2018.vol32.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
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Demirkaya K, Can Demirdöğen B, Öncel Torun Z, Erdem O, Tunca YM. The effects of hydraulic calcium silicate containing endodontic materials on oxidative stress in erythrocytes and liver. TURKISH JOURNAL OF BIOCHEMISTRY-TURK BIYOKIMYA DERGISI 2018. [DOI: 10.1515/tjb-2016-0263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
Objective:
The aim of this study was to evaluate the effects of hydraulic calcium silicate endodontic cements, MTA Angelus, MTA Fillapex, and Theracal LC, on erythrocyte and liver oxidative stress parameters of rats.
Methods:
Right upper incisor of each rat was extracted and polyethylene tubes containing the dental cements, or left empty for the control group, were inserted into the extraction socket. Blood and liver samples of each animal were obtained after 7, 30, or 60 days. Thiobarbituric acid reactive substances (TBARS) levels and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities were determined by spectrophotometry.
Results:
Erythrocyte and liver TBARS levels, and CAT and SOD enzymatic activities were significantly increased in dental cement applied groups compared with controls on day 7. The highest erythrocyte and liver TBARS concentrations were observed in the MTA Angelus group on day 7 of exposure. On day 30, erythrocyte CAT activity remained markedly high, but the other parameters returned to almost normal levels. On day 60, all parameters were similar between the control and the experimental groups.
Conclusions:
This is the first study to show that TBARS levels and antioxidant enzyme activities are transiently increased as a result of dental cement application.
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Garcia LDFR, Huck C, Magalhães FAC, Souza PPCD, Souza Costa CAD. Systemic effect of mineral aggregate-based cements: histopathological analysis in rats. J Appl Oral Sci 2018; 25:620-630. [PMID: 29211283 PMCID: PMC5701532 DOI: 10.1590/1678-7757-2016-0634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 04/19/2017] [Indexed: 11/29/2022] Open
Abstract
Objective: Several studies reported the local tissue reaction caused by mineral aggregate-based cements. However, few studies have investigated the systemic effects promoted by these cements on liver and kidney when directly applied to connective tissue. The purpose of this in vivo study was to investigate the systemic effect of mineral aggregate-based cements on the livers and kidneys of rats. Material and Methods: Samples of Mineral Trioxide Aggregate (MTA) and a calcium aluminate-based cement (EndoBinder) containing different radiopacifiers were implanted into the dorsum of 40 rats. After 7 and 30 d, samples of subcutaneous, liver and kidney tissues were submitted to histopathological analysis. A score (0-3) was used to grade the inflammatory reaction. Blood samples were collected to evaluate changes in hepatic and renal functions of animals. Results: The moderate inflammatory reaction (2) observed for 7 d in the subcutaneous tissue decreased with time for all cements. The thickness of inflammatory capsules also presented a significant decrease with time (P<.05). Systemically, all cements caused adverse inflammatory reactions in the liver and kidney, being more evident for MTA, persisting until the end of the analysis. Liver functions increased significantly for MTA during 30 d (P<.05). Conclusion: The different cements induced to a locally limited inflammatory reaction. However, from the systemic point of view, the cements promoted significant inflammatory reactions in the liver and kidney. For MTA, the reactions were more accentuated.
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Affiliation(s)
- Lucas da Fonseca Roberti Garcia
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Odontologia, Área de Endodontia, Florianópolis, SC, Brasil
| | - Claudia Huck
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Odontologia Restauradora, Araraquara, SP, Brasil
| | | | - Pedro Paulo Chaves de Souza
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, SP, Brasil
| | - Carlos Alberto de Souza Costa
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, SP, Brasil
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Kebudi Benezra M, Schembri Wismayer P, Camilleri J. Interfacial Characteristics and Cytocompatibility of Hydraulic Sealer Cements. J Endod 2018; 44:1007-1017. [PMID: 29398087 DOI: 10.1016/j.joen.2017.11.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/21/2017] [Accepted: 11/15/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The stability and long-term success of root canal obturation depends on the choice of sealer because the sealer bonds to the dentin and stabilizes the solid cone. Furthermore, the sealer needs to be nontoxic because sealer toxicity will certainly lead to treatment failure. The aim of this study was to assess the sealer-dentin interface of 3 hydraulic root canal sealers and to evaluate their cytocompatibility compared with AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany). METHODS Four dental root canal sealers were assessed. AH Plus, MTA Fillapex (Angelus, Londrina, Brazil), BioRoot RCS (Septodont, Saint-Maur-des-Fossés, France), and Endoseal (Maruchi, Wonju-si, Gangwon-do, South Korea) were characterized using scanning electron microscopy and energy-dispersive spectroscopy. The sealer-tooth interface was assessed by confocal microscopy and scanning electron microscopy, and biocompatibility was measured by assessing the cell metabolic function using direct contact assays and alkaline phosphatase activity. RESULTS The tricalcium silicate-based sealers presented a different microstructure and elemental composition despite their similar chemistry and classification. BioRoot RCS was free of aluminum, and all sealers presented different radiopacifying elements. The sealer penetration in the dentinal tubules and interfacial characteristics were different. The migration of silicon was evident from sealer to tooth for all sealers containing tricalcium silicate. MTA Fillapex and BioRoot RCS exhibited the best cytocompatibility in both the direct contact test and alkaline phosphatase activity. CONCLUSIONS The use of hydraulic calcium silicate-based sealers has introduced a different material type to endodontics. These materials are different than other sealers mostly because of their hydraulic nature and their interaction with the environment. Although the sealers tested had a similar chemistry, their cytocompatibility and bonding mechanisms were diverse.
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Affiliation(s)
- Mira Kebudi Benezra
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Josette Camilleri
- Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, Msida, Malta; School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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