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Zhang L, Yin L, Wu J, Wang X, Huang J, Li Q. Clinical influencing factors of vital pulp therapy on pulpitis permanent teeth with 2 calcium silicate-based materials: A randomized clinical trial. Medicine (Baltimore) 2024; 103:e38015. [PMID: 38701294 PMCID: PMC11062667 DOI: 10.1097/md.0000000000038015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Compared with traditional root canal therapy (RCT), vital pulp therapy (VPT) is a personalized and minimally invasive method for the treatment of pulpitis caused by dental caries. However, there are still no clear guidelines for VPT because high-quality randomized clinical trials are scarce. This prospective cohort study evaluated the clinical efficacy of VPT with the light-curable calcium silicate-based material TheraCal LC (TH) and bioceramic material iRoot BP Plus (BP) in reversible and irreversible pulpitis permanent teeth with carious exposures. METHODS 115 teeth with reversible or irreversible pulpitis caused by deep care were randomly divided into 2 groups. TheraCal LC and iRoot BP Plus were used for the pulp capping. Direct pulp capping (DPC), partial pulpotomy (PP) and full pulpotomy (FP) were performed based on observation of the exposed pulp. Postoperative discomforts were enquired and recorded via follow-up phone calls. Clinical and radiographic evaluations were performed 3, 6, and 12 months postoperatively. RESULTS The overall clinical success rate in the first year was 90.4% (47/52) in both groups. The TH group required less operating time, showed lower levels of pain, and had shorter pain duration post-operative (P < .001). According to the binary logistic regression model, preoperative pain duration was significantly correlated with the prognosis of VPT (P = .011). CONCLUSION VPT with TheraCal LC and iRoot BP Plus in pulpitis permanent carious teeth both achieved good clinical outcomes, and TheraCal LC can be easily operated for clinical use. Preoperative pain duration of the affected tooth might have a significant correlation with the prognosis of VPT.
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Affiliation(s)
- Linlin Zhang
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
| | - Li Yin
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
| | - Jianbo Wu
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
| | - Xiaoyan Wang
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
| | - Jiahui Huang
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
| | - Quanli Li
- Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China
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Shamszadeh S, Shirvani A, Torabzadeh H, Asgary S. Effects of Growth Factors on the Differentiation of Dental Stem Cells: A Systematic Review and Meta-analysis (Part I). Curr Stem Cell Res Ther 2024; 19:523-543. [PMID: 35762556 DOI: 10.2174/1574888x17666220628125048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION To evaluate the biological interaction between dental stem cells (DSCs) and different growth factors in the field of regenerative endodontics. METHODS A systematic search was conducted in the electronic databases up to October 2021. This study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Ex vivo studies evaluating the biological interactions of DSCs and growth factors were included. The meta-analysis was performed according to the type of growth factor. The outcomes were cell viability/ proliferation and mineralization. Standardized mean differences (SMDs) were estimated using the random-effect maximum-likelihood method (P < .05). Additional analysis was performed to find any potential source of heterogeneity. RESULTS Twenty articles were included in the systematic review; meta-analysis was performed for fibroblast growth factor-2 (FGF-2) and Transforming growth factor-ß1 (TGF-β1) (n = 5). Results showed that use of FGF-2 significantly increased cell proliferation on day 1-(SMD = 3.56, P = 0.00), 3-(SMD = 9.04, P = 0.00), 5-(SMD = 8.37, P = 0.01), and 7 (SMD=8.51, P=0.00) than the control group. TGF-ß1 increased alkaline phosphatase (ALP) activity more than control only on day 3 (SMD = 3.68, P = 0.02). TGF-β1 had no significant effect on cell proliferation on days 1 and 3 (P > 0.05) and on ALP activity on days 5 and 7 (P > 0.05). Meta-regression analysis showed that different covariates (i.e., cell type, passage number, and growth factors' concentration) could significantly influence the effect sizes at different follow- ups (P < 0.05). CONCLUSION Specific growth factors might enhance the proliferation and mineralization of DSCs; however, the obtained evidence was weak. Due to the high heterogeneity among the included studies, other growth factors' inhibitory/stimulatory effects on DSCs could not be evaluated.
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Affiliation(s)
- Sayna Shamszadeh
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Torabzadeh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Saber SM, Gomaa SM, Elashiry MM, El-Banna A, Schäfer E. Comparative biological properties of resin-free and resin-based calcium silicate-based endodontic repair materials on human periodontal ligament stem cells. Clin Oral Investig 2023; 27:6757-6768. [PMID: 37796335 PMCID: PMC10630253 DOI: 10.1007/s00784-023-05288-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES To investigate the effect of three different calcium silicate-based materials (CSBM) on the biological behavior of human periodontal ligament stem cells (hPDLSCs). METHODS Eluates of Biodentine, NeoPutty and TheraCal PT prepared at 1:1, 1:2, and 1:4 ratios were extracted under sterile conditions. The cytotoxicity of the extracts to the hPDLSCs was assessed using the MTT assay. Scratch wound healing assay was utilized for assessing cell migration. Scanning electron microscopy was used to detect cell attachment and morphology. Calcium ion release was measured using inductively coupled plasma-optical emission spectrometry; the pH-value was evaluated with a pH-meter. ANOVA with post hoc Tukey test was used for statistical analysis. RESULTS Cell viability was significantly higher for Biodentine and NeoPutty at day 1 with all dilutions (p < 0.05), while at day 3 and day 7 with dilutions 1:2 and 1:4; all materials showed similar behavior (p > 0.05). Biodentine had the highest percentage of cell migration into the scratched area at day 1 for all dilutions (p < 0.05). Stem cells were attached favorably on Biodentine and NeoPutty with evident spreading, and intercellular communications; however, this was not shown for TheraCal PT. Biodentine showed the highest pH values and calcium ion release (p < 0.05). CONCLUSIONS The resin-free CSBM showed better performance and favorable biological effects on hPDLSCs and were therefore considered promising for usage as endodontic repair materials. CLINICAL SIGNIFICANCE Proper selection of materials with favorable impact on the host stem cells is crucial to ensure outcome in different clinical scenarios.
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Affiliation(s)
- Shehabeldin M Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt
- Dental Science Research Group, Health Research Centre of Excellence, The British University in Egypt (BUE), Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Egypt, Cairo, Egypt
| | - Shaimaa M Gomaa
- Dental Science Research Group, Health Research Centre of Excellence, The British University in Egypt (BUE), Cairo, Egypt
| | - Mohamed M Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Egypt, Cairo, Egypt
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Ahmed El-Banna
- Department of Biomaterials, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany.
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Qiu Y, Tian J, Kong S, Feng Y, Lu Y, Su L, Cai Y, Li M, Chang J, Yang C, Wei X. SrCuSi 4 O 10 /GelMA Composite Hydrogel-Mediated Vital Pulp Therapy: Integrating Antibacterial Property and Enhanced Pulp Regeneration Activity. Adv Healthc Mater 2023; 12:e2300546. [PMID: 37260366 DOI: 10.1002/adhm.202300546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/11/2023] [Indexed: 06/02/2023]
Abstract
Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries-induced dental pulp infections. However, bacterial contamination negatively affects dentine-pulp complex repair. The common capping materials show limited antimicrobial effects against some microorganisms. To improve the VPT efficacy, capping materials with increased antibacterial properties and enhanced odontogenic and angiogenic activities are needed. Herein, a SrCuSi4 O10 /gelatin methacrylate(SC/Gel) composite hydrogel has been proposed for infected dental pulp treatment. SrCuSi4 O10 (SC) is a microscale bioceramic composed of assembled multilayered nanosheets that possesses good near-infrared photothermal conversion ability and multiple bioactivities due to sustained Sr2+ , Cu2+ , and SiO3 2- ion release. It is shown that the SC/Gel composite hydrogel efficiently eliminates Streptococcus mutans and Lactobacillus casei and inhibits biofilm formation under photothermal heating, while the ion extract from SC promotes odontogenesis of rat dental pulp stem cells and angiogenesis of human umbilical vein endothelial cells. The as-designed therapeutic effect of SC/Gel composite hydrogel-mediated VPT has been proven in a rat dental pulp infection model and yielded improved dentine-pulp complex repair compared with the commercially used iRoot® BP Plus. This study suggests that the SC/Gel composite hydrogel is a potential pulp-capping material with improved effects on dentine-pulp complex repair in infected pulp.
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Affiliation(s)
- Yu Qiu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Jun Tian
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Siyi Kong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Yanping Feng
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
| | - Yangyu Lu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Lefeng Su
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
| | - Yanling Cai
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Mengjie Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Jiang Chang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, P. R. China
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai, 200050, P. R. China
| | - Chen Yang
- Joint Centre of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, P. R. China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, P. R. China
| | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, 510055, P. R. China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
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Yousefi-Koma AA, Assadian H, Mohaghegh S, Nokhbatolfoghahaei H. Comparative Biocompatibility and Odonto-/Osteogenesis Effects of Hydraulic Calcium Silicate-Based Cements in Simulated Direct and Indirect Approaches for Regenerative Endodontic Treatments: A Systematic Review. J Funct Biomater 2023; 14:446. [PMID: 37754860 PMCID: PMC10532331 DOI: 10.3390/jfb14090446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Regenerative dentistry is the operation of restoring dental, oral and maxillofacial tissues. Currently, there are no guidelines for the ideal cement/material in regenerative endodontic treatments (RET). Hydraulic calcium silicate-based cements (hCSCs) are currently the material of choice for RET. OBJECTIVES This systematic review was conducted to gather all of the different direct and indirect approaches of using hCSCs in RET in vitro and in vivo, and to ascertain if there are any superiorities to indirect approaches. METHODS AND MATERIALS This systematic review was conducted according to the 2020 PRISMA guidelines. The study question according to the PICO format was as follows: Comparison of the biological behavior (O) of stem cells (P) exposed to hCSCs through direct and indirect methods (I) with untreated stem cells (C). An electronic search was executed in Scopus, Google Scholar, and PubMed. RESULTS A total of 78 studies were included. Studies were published between 2010 and 2022. Twenty-eight commercially available and eighteen modified hCSCs were used. Seven exposure methods (four direct and three indirect contacts) were assessed. ProRoot MTA and Biodentine were the most used hCSCs and had the most desirable results. hCSCs were either freshly mixed or set before application. Most studies allowed hCSCs to set in incubation for 24 h before application, which resulted in the most desirable biological outcomes. Freshly mixed hCSCs had the worst outcomes. Indirect methods had significantly better viability/proliferation and odonto-/osteogenesis outcomes. CONCLUSION Biodentine and ProRoot MTA used in indirect exposure methods result in desirable biological outcomes.
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Affiliation(s)
- Amir-Ali Yousefi-Koma
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hadi Assadian
- Department of Endodontics, Tehran University of Medical Sciences, Tehran 1417614418, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
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Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering (Basel) 2023; 10:bioengineering10030354. [PMID: 36978746 PMCID: PMC10045528 DOI: 10.3390/bioengineering10030354] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Bioceramics, with excellent bioactivity and biocompatibility, have been widely used in dentistry, particularly in endodontics. Mineral trioxide aggregate (MTA) is the most widely used bioceramic in endodontics. Recently, many new bioceramics have been developed, showing good potential for the treatment of endodontic diseases. This paper reviews the characteristics of bioceramics and their applications in various clinical endodontic situations, including root-end filling, root canal therapy, vital pulp therapy, apexification/regenerative endodontic treatment, perforation repair, and root defect repair. Relevant literature published from 1993 to 2023 was searched by keywords in PubMed and Web of Science. Current evidence supports the predictable outcome of MTA in the treatment of endodontic diseases. Although novel bioceramics such as Biodentine, EndoSequence, and calcium-enriched mixtures have shown promising clinical outcomes, more well-controlled clinical trials are still needed to provide high-level evidence for their application in endodontics. In addition, to better tackle the clinical challenges in endodontics, efforts are needed to improve the bioactivity of bioceramics, particularly to enhance their antimicrobial activity and mechanical properties and reduce their setting time and solubility.
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Affiliation(s)
- Xu Dong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: ; Tel.: +86-028-85503494
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7
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Parisay I, Qeidari A, Sabouri E, Khorakian F, Bagheri H. Cytotoxicity and induced apoptosis of a new bioceramic cement containing simvastatin on stem cells from human exfoliated deciduous teeth. Dent Res J (Isfahan) 2022; 19:79. [PMID: 36407772 PMCID: PMC9667492] [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: 11/12/2021] [Revised: 12/11/2021] [Accepted: 01/10/2021] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND This study aims to compare cytotoxicity and induced apoptosis of a new bioceramic cement containing different concentrations of simvastatin on stem cells from human exfoliated deciduous teeth (SHED). MATERIALS AND METHODS This research was an in vitro study. To evaluate the cytotoxicity and induced apoptosis of the bioceramic cement containing different concentrations of simvastatin, the SHED were exposed to the cement during 1, 3, and 7 days. Pure bioceramic cement and pure simvastatin with concentrations of 1, 0.1, and 0.01 μM were also tested to evaluate the possible synergic effect. Mineral trioxide aggregate (MTA) as the gold standard of pulp dressing materials was compared. MTT assay and Annexin V assay were used to evaluate cytotoxicity and induced apoptosis, respectively. The data were analyzed using ANOVA and Tukey post hoc tests at the significance level of 0.05. RESULTS During 7 days, MTA, bioceramic cement, simvastatin 0.1 and 0.01 μM, and bioceramic cement containing 0.1 and 0.01 μM simvastatin increased (P < 0.05) and simvastatin with concentration of 1 μM decreased the cell viability (P < 0.05). Except for MTA and bioceramic cement containing 0.1 and 0.01 μM simvastatin, all other compounds induced apoptosis within 7 days (P < 0.05). CONCLUSION After 7 days, the viability of the SHED in the presence of a new bioceramic cement containing 0.1 and 0.01 μM simvastatin was not compromised. Moreover, this cement showed superior results than MTA and provided an environment for cell proliferation. This finding appears to be due to the pharmacological effects of low concentrations of simvastatin.
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Affiliation(s)
- Iman Parisay
- Department of Pediatric Dentistry, Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Qeidari
- Department of Pediatric Dentistry, Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Sabouri
- Department of Pediatric Dentistry, Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Khorakian
- Department of Pediatric Dentistry, Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Bagheri
- Department of Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Bulajić DV, Drljača J, Čapo I, Savić SM, Vojisavljević K, Hodžić A, Sekulić S, Bajkin BV. Biocompatibility of mesoporous SBA-16/hydroxyapatite nanocomposite and dentin demineralized particles on human dental pulp stem cells. Microsc Res Tech 2021; 85:1557-1567. [PMID: 34888993 DOI: 10.1002/jemt.24017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/11/2022]
Abstract
In the present work, a biomaterial (SBA-16/HA) based on the growth of hydroxyapatite (HA) particles within an organized silica structure SBA-16 (Santa Barbara Amorphous-16) was developed to evaluate its application to act as a porous microenvironment promoting attachment and viability of human dental pulp stem cells of healthy deciduous teeth (SHED). First, SHED were isolated and their phenotypes were evaluated by flow cytometry. The samples of SBA-16/HA were characterized by X-ray diffraction (XRD), small and wide angle X-ray scattering (SWAXS), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) equipped with energy dispersive spectra detector (EDS). Afterward, cells were cultured in the eluates of the above-mentioned biomaterial aged for 24 hr, 7. and 14 days. Bio-Oss® and dentin particles are involved for comparison and cells are cultured in the eluates of these two materials also. Thiazolyl Blue Tetrazolium bromide assay-MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide assay) was used for the determination of cell viability. The results obtained by all aforementioned characterization methods of SBA-16/HA, revealed a uniform spherical mesoporous structure, an intrinsic characteristic of this material. This material displayed excellent biocompatibility on SHEDs, and even proliferative potential, indicating that SBA-16/HA could potentially serve as a suitable substrate for bone regeneration. Contrary to SBA-16/HA, dentin particles showed low cytotoxicity at all time points, compared to control and Bio-Oss®groups. Our results substantiate the idea that SBA-16/HA has a beneficial effect on SHEDs, thus paving the way toward developing new material for bone replacement.
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Affiliation(s)
- Dragica V Bulajić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Center for Medical and Pharmaceutical Investigations and Quality Control, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Jovana Drljača
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Center for Medical and Pharmaceutical Investigations and Quality Control, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Ivan Čapo
- Center for Medical and Pharmaceutical Investigations and Quality Control, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia.,Faculty of Medicine, Department of Histology and Embryology, University of Novi Sad, Novi Sad, Serbia
| | - Slavica M Savić
- BioSense Institute, University of Novi Sad, Novi Sad, Serbia
| | | | - Aden Hodžić
- Central European Research Infrastructure Consortium, Basovizza, Italy
| | - Slobodan Sekulić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Department of Neurology, University Hospital, Clinical Center of Vojvodina, Hajduk Veljkova 1-7, Novi Sad, 21000, Serbia
| | - Branislav V Bajkin
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Dental Clinic of Vojvodina, Novi Sad, Serbia
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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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10
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Biocompatibility and Antibiofilm Properties of Calcium Silicate-Based Cements: An In Vitro Evaluation and Report of Two Clinical Cases. BIOLOGY 2021; 10:biology10060470. [PMID: 34073519 PMCID: PMC8226987 DOI: 10.3390/biology10060470] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary Calcium silicate-based cements are successfully applied in the different fields of endodontics and vital pulp therapy. To better assess the properties of these bioactive materials, the present in vitro and in vivo study aimed to compare the biocompatibility and antibiofilm properties of ProRoot MTA and Biodentine. Human osteogenic sarcoma (Saos-2) cells were cultured in the presence of both materials and evaluated. Moreover, the bioactive cements were in vivo applied to perform vital pulp therapy on immature permanent teeth affected by reversible pulpitis. Saos-2 cells’ viability was slightly greater in the presence of ProRootMTA than Biodentine and cells would grow in a better way on ProRootMTA disks than on Biodentine ones. Moreover, ProRootMTA showed a powerful antibiofilm effect towards Streptococcus mutans. The in vitro results were clinically supported by a 100% success rate after 2 years of follow-up. Abstract Calcium silicate-based cements have reached excellent levels of performance in endodontics, providing predictable and successful results. To better assess the properties of these bioactive materials, the present study aimed to compare the biocompatibility and antibiofilm properties of ProRoot MTA and Biodentine. Human osteogenic sarcoma (Saos-2) cells were cultured on ProRoot MTA and Biodentine samples or in the presence of both cement extracts. Cell viability assay, measurement of reactive oxygen species (ROS), immunofluorescence analysis, as well as morphological evaluations were conducted. Moreover, Streptococcus mutans was used to assess the biofilm forming ability on ProRoot MTA and Biodentine disks. Finally, both cements were applied in vivo to treat immature permanent teeth affected by reversible pulpitis. Results: Cell viability assay demonstrated that Saos-2 cells had a dose- and time-dependent cytotoxicity to both analyzed cements, although cells exposed to ProRoot MTA showed a better cell vitality than those exposed to Biodentine (p < 0.001). Both cements demonstrated ROS production while this was greater in the case of Biodentine than ProRoot MTA (p < 0.001). Immunofluorescence images of the cytoskeleton and focal adhesions showed no differences in Saos-2 cells grown in the presence of ProRoot MTA eluate; whereas in the Biodentine groups, cells showed a morphology and focal adhesions more similar to that of the control sample, as the eluate concentration decreased. Morphological analysis revealed that Saos-2 cells were more flattened and exhibited better spreading when attached to ProRoot MTA disks than to Biodentine ones. The antibiofilm properties showed a time-dependent powerful inhibition of S. mutans superficial colonization and an antibiofilm effect of both cements. Clinically, complete root formation of the treated elements was achieved using the two studied cements, showing stable results over time. ProRoot MTA and Biodentine was demonstrated to be biocompatible and to possess antibiofilm properties. Their clinical application in vital pulp therapy provided successful outcomes after 2 years of follow-up.
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Pedano MS, Yoshihara K, Li X, Camargo B, Van Landuyt K, Van Meerbeek B. Experimental resin-modified calcium-silicate cement containing N-(2-hydroxyethyl) acrylamide monomer for pulp tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 126:112105. [PMID: 34082929 DOI: 10.1016/j.msec.2021.112105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 04/08/2021] [Indexed: 01/06/2023]
Abstract
AIM Our study aimed to measure (1) the flexural strength, (2) shear bond strength to dentin, (3) pH, and (4) calcium (Ca) release of a series of innovative resin-modified calcium-silicate pulp-capping cements (Rm-CSCs). Using an ex-vivo human vital tooth-culture model, we additionally assessed (5) their pulp-healing initiation when brought in direct contact with human dental pulp tissue. METHODOLOGY Three experimental Rm-CSCs, being referred to 'Exp_HEAA', 'Exp_GDM' and 'Exp_HEAA/GDM', contained either 20 wt% N-(2-hydroxyethyl) acrylamide (HEAA), 20 wt% glycerol dimethacrylate (GDM) or 10 wt% HEAA plus 10 wt% GDM, added to a common base composition consisting of 25 wt% urethane dimethacrylate (UDMA), 10 wt% 4-methacryloxyethyl trimellitate anhydride (4-MET), and 5 wt% N,N'-{[(2-acrylamido-2-[(3-acrylamidopropoxy)methyl] propane-1,3-diyl)bis(oxy)]bis-(propane-1,3-diyl)}diacrylamide (FAM-401). As Ca source and radiopacifier, 37 wt% tricalcium silicate powder (TCS) and 3 wt% zirconium oxide (ZrO 2) were respectively added. RESULTS All three experimental Rm-CSCs revealed a significantly higher flexural strength and shear bond strength to dentin (p < 0.05) than the commercial reference Rm-CSC TheraCal LC (Bisco). Exp_HEAA presented with a significantly higher Ca release and pH at 24 h compared with the other Rm-CSCs (p < 0.05). At 1 week, the Ca release and pH of Exp_HEAA and Exp_HEAA/GDM was significantly higher than those of Exp_GDM and TheraCal LC (p < 0.05). Using the ex-vivo human vital tooth culture model, Exp_HEAA revealed pulp-healing initiation capacity as documented by nestin and collagen-I expression. CONCLUSIONS Depending on the formulation, the innovative Rm-CSCs performed favorably for primary properties of relevance regarding pulp capping, this more specifically in terms of flexural strength, bond strength to dentin, as well as alkaline pH and Ca release. However, only Exp_HEAA revealed pulp-healing initiation in direct contact with human dental pulp tissue in the ex-vivo human vital tooth-culture model. This promising outcome for Exp_HEAA should be attributed to the combined use of (1) a novel hydrophilic acrylamide monomer, enabling sufficient polymerization while maintaining adequate hydrophilicity, with (2) the functional monomer 4-MET, possessing chemical bonding potential to dentin, and (3) tricalcium silicate powder to achieve an alkaline pH and to release Ca in a sufficient and controlled way.
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Affiliation(s)
- Mariano S Pedano
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium.
| | - Kumiko Yoshihara
- National Institute of Advanced Industrial Science and Technology (AIST), Health Research Institute, 2217-14 Hayashi-Cho, Takamaysu, Kagawa 761-0395, Japan; Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Pathology & Experimental Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Xin Li
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Bernardo Camargo
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Kirsten Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
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