1
|
Safy RK, Ragab MH, Abdel-Maksoud HB. Histopathological Evaluation of Human Placental Extract as a Direct Pulp-Capping Material in Dogs' Teeth. Eur J Dent 2024. [PMID: 38942055 DOI: 10.1055/s-0044-1786841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVE The current research aimed to evaluate the histopathological pulpal alterations in dogs' teeth following direct pulp capping using either mineral trioxide aggregate (MTA) or human placenta extract (HPE). MATERIALS AND METHODS Forty-eight incisors with mature apices from four dogs were involved. The teeth were randomly allocated to three groups (n = 16) based on the material utilized for direct pulp capping: MTA, HPE, and Teflon as the negative control group. All involved teeth were capped and restored at the same session. Each group was subsequently divided into two subgroups (n = 8) based on the post treatment evaluation period: 2 and 4 weeks. The histopathologic changes in each specimen's pulp tissues, including pulp inflammation, hyperemia, necrosis, and dentin bridge development, were assessed. Then, all the data were statistically analyzed using chi-square, t-test, and one-way analysis of variance (p < 0.05). RESULTS At 2 weeks, chronic inflammation was observed in 100% of MTA and 50% of HPE subgroups with a significant difference between them whereas the remaining 50% exhibited no inflammation. In contrast to Teflon that showed acute inflammation, remission of inflammation was time-dependent at both MTA and HPE subgroups as there was a substantial difference between the 2- and 4-weeks evaluation periods within the same group. However, throughout the initially observed 2 weeks, all subgroups exhibited essentially no complete calcified bridge; at 4 weeks, all MTA and HPE subgroups developed dentin bridge formation, with a significant difference between them regarding its thickness. CONCLUSION HPE is a promising pulp-capping material inducing less intense chronic inflammation accompanied with thicker dentine bridge formation in comparison to MTA.
Collapse
Affiliation(s)
- Rehab Khalil Safy
- Department of Conservative Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia Governorate, Egypt
| | - Mai Hamdy Ragab
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, Ismailia Governorate, Egypt
- King Salman International University, Eltor, South Sinai, Egypt
| | - Heba Bahgat Abdel-Maksoud
- Department of Conservative Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia Governorate, Egypt
- Restorative Dentistry Department, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
2
|
Elkady DM, Helaly YR, El Fayoumy HW, AbuBakr HO, Yassin AM, AbdElkader NA, Farag DBE, El Aziz PMA, Scarano A, Khater AGA. An animal study on the effectiveness of platelet-rich plasma as a direct pulp capping agent. Sci Rep 2024; 14:3699. [PMID: 38355945 PMCID: PMC10867036 DOI: 10.1038/s41598-024-54162-1] [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: 11/26/2023] [Accepted: 02/09/2024] [Indexed: 02/16/2024] Open
Abstract
Direct pulp capping (DPC) is a conservative approach for preserving tooth vitality without requiring more invasive procedures by enhancing pulp healing and mineralized tissue barrier formation. We investigated the effectiveness of Platelet Rich Plasma (PRP) vs. Mineral Trioxide Aggregate (MTA) as a DPC agent. Forty-two teeth from three mongrel dogs were divided into two equal groups. After three months, the animals were sacrificed to evaluate teeth radiographically using cone-beam computerized tomography, histopathologically, and real-time PCR for dentin sialophosphoprotein (DSPP), matrix extracellular phosphoglycoprotein (MEPE), and nestin (NES) mRNA expression. Radiographically, hard tissue formation was evident in both groups without significant differences (p = 0.440). Histopathologic findings confirmed the dentin bridge formation in both groups; however, such mineralized tissues were homogenous without cellular inclusions in the PRP group, while was osteodentin type in the MTA group. There was no significant difference in dentin bridge thickness between the PRP-capped and MTA-capped teeth (p = 0.732). The PRP group had significantly higher DSPP, MEPE, and NES mRNA gene expression than the MTA group (p < 0.05). In conclusion, PRP enables mineralized tissue formation following DPC similar to MTA, and could generate better cellular dentinogenic responses and restore dentin with homogenous architecture than MTA, making PRP a promising alternative DPC agent.
Collapse
Affiliation(s)
- Dina M Elkady
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Yara R Helaly
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Hala W El Fayoumy
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Huda O AbuBakr
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Aya M Yassin
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Naglaa A AbdElkader
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Dina B E Farag
- Oral Biology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Possy M Abd El Aziz
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Giza, Egypt
- Faculty of Oral and Dental Medicine, Egyptian Russian University, Badr City, Cairo, Egypt
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Chieti, Italy
| | - Ahmad G A Khater
- Faculty of Oral and Dental Medicine, Egyptian Russian University, Badr City, Cairo, Egypt.
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif, Egypt.
| |
Collapse
|
3
|
Islam R, Islam MRR, Tanaka T, Alam MK, Ahmed HMA, Sano H. Direct pulp capping procedures - Evidence and practice. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:48-61. [PMID: 36880059 PMCID: PMC9985044 DOI: 10.1016/j.jdsr.2023.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/15/2023] [Indexed: 02/27/2023] Open
Abstract
The aim of direct pulp capping (DPC) is to promote pulp healing and mineralized tissue barrier formation by placing a dental biomaterial directly over the exposed pulp. Successful application of this approach avoids the need for further and more extensive treatment. In order to ensure a complete pulp healing with the placement of restorative materials, a mineralized tissue barrier must form to protect the pulp from microbial invasion. The formation of mineralized tissue barrier can only be induced when there is a significant reduction in pulp inflammation and infection. Consequently, promoting the healing of pulp inflammation may provide a favorable therapeutic opportunity to maintain the sustainability of DPC treatment. Mineralized tissue formation was observed as the favorable reaction of exposed pulp tissue against a variety of dental biomaterials utilized for DPC. This observation reveals an intrinsic capacity of pulp tissue for healing. Therefore, this review focuses on the DPC and its healing procedure as well as the materials used for DPC treatment and their mechanisms of action to promote pulpal healing. In addition, the factors that can affect the healing process of DPC, clinical considerations and future perspective has been described.
Collapse
Affiliation(s)
- Rafiqul Islam
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Md Refat Readul Islam
- Department of Restorative Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Toru Tanaka
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| | - Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, 72345 Sakaka, Saudi Arabia
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo 060-8586, Japan
| |
Collapse
|
4
|
Wang X, Xiao Y, Song W, Ye L, Yang C, Xing Y, Yuan Z. Clinical application of calcium silicate-based bioceramics in endodontics. J Transl Med 2023; 21:853. [PMID: 38007432 PMCID: PMC10676601 DOI: 10.1186/s12967-023-04550-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/21/2023] [Indexed: 11/27/2023] Open
Abstract
Pulp treatment is extremely common in endodontics, with the main purpose of eliminating clinical symptoms and preserving tooth physiological function. However, the effect of dental pulp treatment is closely related to the methods and materials used in the process of treatment. Plenty of studies about calcium silicate-based bioceramics which are widely applied in various endodontic operations have been reported because of their significant biocompatibility and bioactivity. Although most of these materials have superior physical and chemical properties, the differences between them can also have an impact on the success rate of different clinical practices. Therefore, this review is focused on the applications of several common calcium silicate-based bioceramics, including Mineral trioxide aggregate (MTA), Biodentine, Bioaggregate, iRoot BP Plus in usual endodontic treatment, such as dental pulp capping, root perforation repair, regenerative endodontic procedures (REPs), apexification, root-end filling and root canal treatment (RCT). Besides, the efficacy of these bioceramics mentioned above in human trials is also compared, which aims to provide clinical guidance for their clinical application in endodontics.
Collapse
Affiliation(s)
- Xinyuan Wang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Yizhi Xiao
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Lanxiang Ye
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Chen Yang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Yuzhen Xing
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China.
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China.
| |
Collapse
|
5
|
Candan M, Altinay Karaca FK, Öznurhan F. Evaluation of the Shear Bond Strength of Immediate and Delayed Restorations of Various Calcium Silicate-Based Materials with Fiber-Reinforced Composite Resin Materials. Polymers (Basel) 2023; 15:3971. [PMID: 37836020 PMCID: PMC10575331 DOI: 10.3390/polym15193971] [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: 08/24/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Due to significant tissue loss in teeth requiring pulp treatments, hermetic restoration of the remaining dental tissues is one of the most crucial factors in determining the treatment's success. The adhesion of composite resins to calcium silicate cements (CSCs) is considered challenging. Consequently, it is crucial to identify the optimal method for obtaining optimal adhesion. The aim of the present study is to evaluate the shear bond strength (SBS) values of immediate and delayed restorations with fiber-reinforced composites on powder-liquid, premixed, and resin-containing flowable CSCs. In the present study, the SBS values obtained after immediate (14 min) and delayed (7 days) restorations of three different CSCs (NeoMTA2, NeoPutty, and TheraCal PT) with three different resin composite materials (EverX FlowTM, EverX PosteriorTM, and Filtek Z550) were compared. The fracture types were evaluated using a stereomicroscope and SEM. TheraCal PT had the highest SBS values for both immediate and delayed restorations, and the comparison with other materials showed a statistically significant difference (p = 0.001). In contrast, there was no statistically significant difference between the SBS values of NeoMTA and NeoPutty (p > 0.05). In both immediate and delayed restorations, there was no statistically significant difference between nanohybrid and fiber-reinforced composites (p > 0.05). The simple use and strong bonding ability of TheraCal PT with composite resins may provide support for the idea that it is suitable for pulpal interventions. Nevertheless, due to the in vitro nature of this study, additional in vitro and clinical studies are required to investigate the material's physical, mechanical, and biological properties for use in clinical applications.
Collapse
Affiliation(s)
- Merve Candan
- Department of Pedodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir 26040, Turkey
| | | | - Fatih Öznurhan
- Department of Pedodontics, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas 58140, Turkey
| |
Collapse
|
6
|
Kato G, Gomes PS, Neppelenbroek KH, Rodrigues C, Fernandes MH, Grenho L. Fast-Setting Calcium Silicate-Based Pulp Capping Cements-Integrated Antibacterial, Irritation and Cytocompatibility Assessment. MATERIALS (BASEL, SWITZERLAND) 2023; 16:450. [PMID: 36614788 PMCID: PMC9822223 DOI: 10.3390/ma16010450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Calcium silicate-based cements (CSCs) are endodontic materials widely used in vital pulp-capping approaches. Concerning the clinical application, the reduced set time and pre-mixed formulations are relevant characteristics during the operative management of pulpal exposure, aiming to optimise the work time and improve cross-infection/asepsis control. Additionally, clinical success seems to be greatly dependent on the biological performance of the materials that directly contact the living pulp. As such, this work approaches an integrative biological characterisation (i.e., antibacterial, irritation, and cytocompatibility assays) of three fast-setting CSCs-BiodentineTM, TotalFill® BC RRM™ Fast Putty, and Theracal LC®. These cements, after setting for 24 h, presented the expected topography and elemental composition (assessed by scanning electron microscopy, coupled with EDS analysis), in accordance with the information of the manufacturer. The set cements displayed a significant and similar antibiofilm activity against S. mutans, in a direct contact assay. Twenty-four-hour eluates were not irritant in the standardised CAM assay, but elicited distinct dose- and time-dependent cytotoxicity profiles on fibroblastic cells-i.e., Biodentine was devoid of toxicity, TotalFill presented a slight dose-dependent initial toxicity that was easily overcome, and Theracal LC was deleterious at high concentrations. When compared to long-setting ProRoot MTA cement, which highlighted the pursued integrative approach, Biodentine presented a similar profile, but TotalFill and Theracal LC displayed a poorer performance regarding antibiofilm activity/cytocompatibility features, and Theracal LC suggested eventual safety concerns.
Collapse
Affiliation(s)
- Gabriel Kato
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Pedro Sousa Gomes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Karin Hermana Neppelenbroek
- Department of Periodontics and Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru 17012-901, SP, Brazil
| | - Cláudia Rodrigues
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Maria Helena Fernandes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Liliana Grenho
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| |
Collapse
|
7
|
Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111853. [PMID: 36430988 PMCID: PMC9697500 DOI: 10.3390/life12111853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
Collapse
|
8
|
MTA-Based Cements: Biocompatibility and Effects on the Gene Expression of Collagen Type 1 and TGF- β1. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2204698. [PMID: 35402617 PMCID: PMC8989590 DOI: 10.1155/2022/2204698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/31/2022]
Abstract
Objective This study sought to evaluate the biocompatibility of Neomineral Trioxide Aggregate (Neo-MTA), MTA Repair High Plasticity (MTA-HP), and Mineral Trioxide Aggregate-Angelus white (MTA-Ang) in fibroblasts of human dental pulp. Materials and Methods Morphology was evaluated after 24 h of incubation. LIVE/DEAD assay and cell adhesion tests were performed at 24 h of treatment. Cell proliferation assays (MTSs) and Annexin V were performed at 48 h incubation with different treatments. The expression of Col-1 and TGF-β1 was tested by endpoint PCR at 5 days of treatment. Results Morphological changes were observed in all groups. Neo-MTA and MTA-Ang were associated with increased cell viability, and all materials induced apoptosis, with a higher percentage in the MTA-HP group than in the other groups. In the LIVE/DEAD assay, there was more damage to the cell membrane in the group of cells treated with MTA-HP than in the other groups. Conclusion Neo-MTA and MTA-Ang presented similar biocompatibility, and both showed greater biocompatibility than MTA-HP. MTA-HP and MTA-Ang increased Col-1A gene expression, and Neo-MTA and MTA-Ang increased TGF-β1 gene expression in a similar way.
Collapse
|