Graphene-Based Nanomaterials for Tissue Engineering in the Dental Field

Nanomaterials: innovative approaches for addressing key objectives in periodontitis treatment

Periodontitis is a chronic inflammatory disease primarily caused by dental plaque, which is a significant global public health concern due to its high prevalence and severe impact on oral, and even systemic diseases. The current therapeutic plan focuses on three objectives: pathogenic bacteria inhibition, inflammation control, and osteogenic differentiation induction. Existing treatments still have plenty of drawbacks, thus, there is a pressing need for novel methods to achieve more effective treatment effects. Nanomaterials, as emerging materials, have been proven to exert their inherent biological properties or serve as stable drug delivery platforms, which may offer innovative solutions in periodontitis treatment. Nanomaterials utilized in periodontitis treatment fall into two categories, organic and inorganic nanomaterials. Organic nanomaterials are known for their biocompatibility and their potential to promote tissue regeneration and cell functions, including natural and synthetic polymers. Inorganic nanomaterials, such as metal, oxides, and mesoporous silica nanoparticles, exhibit unique physicochemical properties that make them suitable as antibacterial agents and drug delivery platforms. The inorganic nanosurface provides terrain induction for cell migration and osteogenic regeneration at defect sites by introducing different surface morphologies. Inorganic nanomaterials also play a role in antibacterial photodynamic therapy (aPDT) for eliminating pathogenic bacteria in the oral cavity. In this review, we will introduce multiple forms and applications of nanomaterials in periodontitis treatment and focus on their roles in addressing the key therapeutic objectives, to emphasize their promising future in achieving more effective and patient-friendly approaches toward periodontal tissue regeneration and overall health.

Properties of a Dental Adhesive Containing Graphene and DOPA-Modified Graphene

Graphene is a promising biomaterial. However, its dispersion in aqueous medium is challenging. This study aimed to modify graphene nanoparticles with L-dopa to improve the properties of experimental dental adhesives. Adhesives were formulated with 0% (control), 0.25%, 0.5%, and 0.75% of graphene, modified or not. Particle modification and dispersion were microscopically assessed. Degree of conversion was tested by Fourier-transform infrared spectroscopy. Flexural strength and modulus of elasticity were evaluated by a 3-point flexural test. Bond strength was tested by shear. To test water sorption/solubility, samples were weighed during hydration and dehydration. Antibacterial activity was tested by Streptococcus mutans colony-forming units quantification. Cytotoxicity on fibroblasts was evaluated through a dentin barrier test. The modification of graphene improved the particle dispersion. Control presented the highest degree of conversion, flexural strength, and bond strength. In degree of conversion, 0.25% of groups were similar to control. In bond strength, groups of graphene modified by L-dopa were similar to Control. The modulus of elasticity was similar between groups. Cytotoxicity and water sorption/solubility decreased as particles increased. Compared to graphene, less graphene modified by L-dopa was needed to promote antibacterial activity. By modifying graphene with L-dopa, the properties of graphene and, therefore, the adhesives incorporated by it were enhanced.

On the Use of Nanoparticles in Dental Implants

Results obtained in physics, chemistry and materials science on nanoparticles have drawn significant interest in the use of nanostructures on dental implants. The main focus concerns nanoscale surface modifications of titanium-based dental implants in order to increase the surface roughness and provide a better bone-implant interfacial area. Surface coatings via the sol-gel process ensure the deposition of a homogeneous layer of nanoparticles or mixtures of nanoparticles on the titanium substrate. Nanotubular structures created on the titanium surface by anodic oxidation yield an interesting nanotopography for drug release. Carbon-based nanomaterials hold great promise in the field of dentistry on account of their outstanding mechanical properties and their structural characteristics. Carbon nanomaterials that include carbon nanotubes, graphene and its derivatives (graphene oxide and graphene quantum dots) can be used as coatings of the implant surface. Their antibacterial properties as well as their ability to be functionalized with adequate chemical groups make them particularly useful for improving biocompatibility and promoting osseointegration. Nevertheless, an evaluation of their possible toxicity is required before being exploited in clinical trials.

Biomaterials science and surface engineering strategies for dental peri-implantitis management

Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.

Graphene as a promising material in orthodontics: A review

Graphene is an extraordinary material with unique mechanical, chemical, and thermal properties. Additionally, it boasts high surface area and antimicrobial properties, making it an attractive option for researchers exploring innovative materials for biomedical applications. Although there have been various studies on graphene applications in different biomedical fields, limited reviews have been conducted on its use in dentistry, and no reviews have focused on its application in the orthodontic field. This review aims to present a comprehensive overview of graphene-based materials, with an emphasis on their antibacterial mechanisms and the factors that influence these properties. Additionally, the review summarizes the dental applications of graphene, spotlighting the studies of its orthodontic application as they can be used to enhance the antibacterial and mechanical properties of orthodontic materials such as adhesives, archwires, and splints. Also, they can be utilized to enhance bone remodeling during orthodontic tooth movement. An electronic search was carried out in Scopus, PubMed, Science Direct, and Wiley Online Library digital database platforms using graphene and orthodontics as keywords. The search was restricted to English language publications without a time limit. This review highlights the need for further laboratory and clinical research using graphene-based materials to improve the properties of orthodontic materials to make them available for clinical use.

Effects of novel additives on the mechanical and Biological properties of glass ionomer cement: An in vitro study

Aim

To evaluate the efficacy of incorporated novel additives in Glass Ionomer Cement to ameliorate biocompatibility and mechanical properties.

Introduction

Though Glass Ionomer Cement (GIC) has multiple advantages, it is not strong enough for medical applications, and its biocompatibility is questionable. To improve biocompatibility and its mechanical properties, a study was performed to investigate the potential benefits of adding graphene, carbon nanotubes, hydroxyapatite, and bioactive glass to GIC. The objective was to enhance both the mechanical properties and biocompatibility of GIC.

Material and Method

Modified Glass Ionomer Cement was prepared by creating five groups. Hydroxyapatite, multi-walled carbon nanotubes, graphene, and bioactive glass were incorporated in a 10:1 weight ratio, respectively. Group 5 was designated as the control group and used Fuji Type II GIC. After preparing 90 samples, they were kept in deionized water for a day and then evaluated their compressive strength, microhardness, and diametral tensile strength, and also checked their in vitro cytotoxicity by direct contact with L929 mammalian fibroblast cells.

Statistical Analysis

The data were examined using mean and standard deviation descriptive statistics. The comparative evaluation was done via Tukey HSD test and one-way ANOVA using S.P.S.S. software.

Result

It showed that Group 3 had better results in compressive strength (144.478+- 3.989), diametral tensile strength (20.29+- 0.8601), and microhardness (131+-3.536) when compared with other groups while in the biocompatibility (viability %) Group 1 [82.55], Group 3 [76.49], Group 4 [87.63], while Group 2[58.02].

Conclusion

Group 3 has better physical properties in microhardness, diametral tensile strength, and compressive strength, than the other groups. In Biocompatibility, Group 1, Group 3, Group 4, and Group 5 were noncytotoxic at the same time multi-walled carbon nanotubes group (Group 2) had cytotoxic potential.

In-office Bleaching Activated With Violet LED: Effect on Pulpal and Tooth Temperature and Pulp Viability

OBJECTIVES

This study evaluated the influence of hydrogen peroxide (HP) with or without titanium dioxide nanotubes (TiO2) associated with violet LED (VL) regarding: a) the temperature change in the pulp chamber and facial surface; b) the decomposition of HP; and c) the cytotoxicity of the gels on pulp cells.

METHODS AND MATERIALS

The experimental groups were: HP35 (35% HP/Whiteness HP, FGM); HP35+VL; HP35T (HP35+TiO2); HP35T+VL; HP7 (7.5% HP/White Class 7.5%, FGM); HP7+VL; HP7T (HP7+TiO2); and HP7T+VL. TiO2 was incorporated into the bleaching gels at 1%. Eighty bovine incisors were evaluated to determine temperature change in 8 experimental groups (n=10/group). A k-type thermocouple was used to evaluate the temperatures of the facial surface and in the pulp chamber, achieved by enabling endodontic access to the palatal surface, throughout the 30-minute session. HP decomposition (n=3) of gels was evaluated by using an automatic potentiometric titrator at the initial and 30-minute time points. Trans-enamel and trans-dentinal cell viability were assessed with a pulp chamber device as well as enamel and dentin discs (n=6), and the treatment extracts (culture medium + diffused components) were collected and applied to MDPC-23 odontoblast cells to evaluate cell viability according to the MTT test.

RESULTS

A temperature increase in the pulp chamber was observed in the presence of VL at 30 minutes (p<0.05) (Mann-Whitney test). Also at 30 minutes, HP35 showed greater decomposition in the presence of VL rather than in its absence (p<0.05) (mixed linear models and the Tukey-Kramer test). HP7 provided greater cell viability than the groups treated with HP35 (p<0.05) (generalized linear models test). Cell viability was significantly lower for HP7 in the presence of VL (p<0.05).

CONCLUSION

Pulpal temperature increased with VL (maximum of 1.9°C), but did not exceed the critical limit to cause pulp damage. Less concentrated HP resulted in higher cell viability, even when associated with VL.

Osseointegration, antimicrobial capacity and cytotoxicity of implant materials coated with graphene compounds: A systematic review

The use of graphecs excellent mechanical properties. However, it is necessary to evaluate the biological effects of this material. This systematic review aimed to observe and understand through studies the current state of the art regarding osseointegration, antimicrobial capacity, and the cytotoxicity of graphene coating applied to the surface of dental implant materials. Searches in PubMed, Embase, Science Direct, Web of Science, and Google Scholar databases were conducted between June and July 2021 and updated in May 2022 using the keywords: graphene, graphene oxide, dental implants, zirconium, titanium, peek, aluminum, disilicate, methyl-methacrylate, cytotoxicity, osseointegration, and bone regeneration. The criteria included in vivo and in vitro studies that evaluated antimicrobial capacity and/or osseointegration and/or cytotoxicity of dental implant materials coated with graphene compounds. The risk of bias for in vitro studies was assessed by the JBI tool, and for in vivo studies, Syrcle's risk of bias tool for animal studies was used. The database search resulted in 176 articles. Of the 18 articles selected for full reading, 16 remained in this systematic review. The use of graphene compounds as coatings on the surface of implant materials is promising because it promotes osseointegration and has antimicrobial capacity. However, further studies are needed to ensure its cytotoxic potential.

Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research

Objectives

This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.

Materials and Methods

Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed.

Results

Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies.

Conclusions

Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings.

Trial Registration

PROSPERO Identifier: CRD42022337192.

Nanomaterials Modulating the Fate of Dental-Derived Mesenchymal Stem Cells Involved in Oral Tissue Reconstruction: A Systematic Review

The critical challenges in repairing oral soft and hard tissue defects are infection control and the recovery of functions. Compared to conventional tissue regeneration methods, nano-bioactive materials have become the optimal materials with excellent physicochemical properties and biocompatibility. Dental-derived mesenchymal stem cells (DMSCs) are a particular type of mesenchymal stromal cells (MSCs) with great potential in tissue regeneration and differentiation. This paper presents a review of the application of various nano-bioactive materials for the induction of differentiation of DMSCs in oral and maxillofacial restorations in recent years, outlining the characteristics of DMSCs, detailing the biological regulatory effects of various nano-materials on stem cells and summarizing the material-induced differentiation of DMSCs into multiple types of tissue-induced regeneration strategies. Nanomaterials are different and complementary to each other. These studies are helpful for the development of new nanoscientific research technology and the clinical transformation of tissue reconstruction technology and provide a theoretical basis for the application of nanomaterial-modified dental implants. We extensively searched for papers related to tissue engineering bioactive constructs based on MSCs and nanomaterials in the databases of PubMed, Medline, and Google Scholar, using keywords such as "mesenchymal stem cells", "nanotechnology", "biomaterials", "dentistry" and "tissue regeneration". From 2013 to 2023, we selected approximately 150 articles that align with our philosophy.

Application of Graphene Oxide in Oral Surgery: A Systematic Review

The current review aims to provide an overview of the most recent research in the last 10 years on the potentials of graphene in the dental surgery field, focusing on the potential of graphene oxide (GO) applied to implant surfaces and prosthetic abutment surfaces, as well as to the membranes and scaffolds used in Guided Bone Regeneration (GBR) procedures. "Graphene oxide" and "dental surgery" and "dentistry" were the search terms utilized on the databases Scopus, Web of Science, and Pubmed, with the Boolean operator "AND" and "OR". Reviewers worked in pairs to select studies based on specific inclusion and exclusion criteria. They included animal studies, clinical studies, or case reports, and in vitro and in vivo studies. However, they excluded systematic reviews, narrative reviews, and meta-analyses. Results: Of these 293 studies, 19 publications were included in this review. The field of graphene-based engineered nanomaterials in dentistry is expanding. Aside from its superior mechanical properties, electrical conductivity, and thermal stability, graphene and its derivatives may be functionalized with a variety of bioactive compounds, allowing them to be introduced into and improved upon various scaffolds used in regenerative dentistry. This review presents state-of-the-art graphene-based dental surgery applications. Even if further studies and investigations are still needed, the GO coating could improve clinical results in the examined dental surgery fields. Better osseointegration, as well as increased antibacterial and cytocompatible qualities, can benefit GO-coated implant surgery. On bacterially contaminated implant abutment surfaces, the CO coating may provide the optimum prospects for soft tissue sealing to occur. GBR proves to be a safe and stable material, improving both bone regeneration when using GO-enhanced graft materials as well as biocompatibility and mechanical properties of GO-incorporated membranes.

Can Graphene Pave the Way to Successful Periodontal and Dental Prosthetic Treatments? A Narrative Review

Graphene, as a promising material, holds the potential to significantly enhance the field of dental practices. Incorporating graphene into dental materials imparts enhanced strength and durability, while graphene-based nanocomposites offer the prospect of innovative solutions such as antimicrobial dental implants or scaffolds. Ongoing research into graphene-based dental adhesives and composites also suggests their capacity to improve the quality and reliability of dental restorations. This narrative review aims to provide an up-to-date overview of the application of graphene derivatives in the dental domain, with a particular focus on their application in prosthodontics and periodontics. It is important to acknowledge that further research and development are imperative to fully explore the potential of graphene and ensure its safe use in dental practices.

Green and Sustainable Membranes: A review

Membranes are ubiquitous tools for modern water treatment technology that critically eliminate hazardous materials such as organic, inorganic, heavy metals, and biomedical pollutants. Nowadays, nano-membranes are of particular interest for myriad applications such as water treatment, desalination, ion exchange, ion concentration control, and several kinds of biomedical applications. However, this state-of-the-art technology suffers from some drawbacks, e.g., toxicity and fouling of contaminants, which makes the synthesis of green and sustainable membranes indeed safety-threatening. Typically, sustainability, non-toxicity, performance optimization, and commercialization are concerns centered on manufacturing green synthesized membranes. Thus, critical issues related to toxicity, biosafety, and mechanistic aspects of green-synthesized nano-membranes have to be systematically and comprehensively reviewed and discussed. Herein we evaluate various aspects of green nano-membranes in terms of their synthesis, characterization, recycling, and commercialization aspects. Nanomaterials intended for nano-membrane development are classified in view of their chemistry/synthesis, advantages, and limitations. Indeed, attaining prominent adsorption capacity and selectivity in green-synthesized nano-membranes requires multi-objective optimization of a number of materials and manufacturing parameters. In addition, the efficacy and removal performance of green nano-membranes are analyzed theoretically and experimentally to provide researchers and manufacturers with a comprehensive image of green nano-membrane efficiency under real environmental conditions.

Determination of chloramphenicol in food using nanomaterial-based electrochemical and optical sensors-A review

Chloramphenicol (CAP) is a widely used antibiotic for the treatment of sick animals owing to its potent action and low cost. However, the accumulation of CAP in the human body can cause irreversible aplastic anemia and hematopoietic toxicity. Accordingly, development of various analytical techniques for the rapid detection of CAP in animal products and the related processed foods is necessary. Among these analytical techniques, electrochemical and optical sensors offer many advantages for CAP detection, including high sensitivity, simple operation and fast analysis speed. In this review, we summarize recent application of carbon nanomaterials, metal nanoparticles, metal oxide nanoparticles and metal organic framework in the development of electrochemical and optical sensors for CAP detection (2010-2022). Based on the advantages and disadvantages of nanomaterials, electrochemical and optical sensors are summarized in this review. The preparation and synthesis of electrochemical and optical sensors and nanomaterials in the field of rapid detection are prospected.

Fracture Resistance Analysis of CAD/CAM Interim Fixed Prosthodontic Materials: PMMA, Graphene, Acetal Resin and Polysulfone

The aim of this study was to evaluate and compare the fracture resistance of temporary restorations made of polymethylmethacrylate (PMMA), graphene-modified PMMA (GRA), acetal resin (AR) and polysulfone (PS) obtained by a subtractive technique (milling) using a computer-aided design and manufacturing (CAD/CAM) system of a three-unit fixed dental prosthesis (FDP). Methods: Four groups of ten samples were fabricated for each material. Each specimen was characterized by a compression test on a universal testing machine, all specimens were loaded to fracture and the value in Newtons (N) was recorded by software connected to the testing machine. The fracture mode was evaluated on all samples using a stereomicroscope. Results: There were statistically significant differences (p value < 0.005) between PMMA and the other three materials (PMMA: 1302.71 N; GRA: 1990.02 N; RA: 1796.20 N; PS: 2234.97). PMMA presented a significantly lower value than the other materials, and PS showed the highest value. GRA and RA presented a similar range of values but they were still higher than those of PMMA. Conclusions: GRA, RA and PS are presented as valid options within the range of interim milled restorative materials and as alternatives to PMMA.

Graphene-Related Nanomaterials for Biomedical Applications

This paper builds on the context and recent progress on the control, reproducibility, and limitations of using graphene and graphene-related materials (GRMs) in biomedical applications. The review describes the human hazard assessment of GRMs in in vitro and in vivo studies, highlights the composition-structure-activity relationships that cause toxicity for these substances, and identifies the key parameters that determine the activation of their biological effects. GRMs are designed to offer the advantage of facilitating unique biomedical applications that impact different techniques in medicine, especially in neuroscience. Due to the increasing utilization of GRMs, there is a need to comprehensively assess the potential impact of these materials on human health. Various outcomes associated with GRMs, including biocompatibility, biodegradability, beneficial effects on cell proliferation, differentiation rates, apoptosis, necrosis, autophagy, oxidative stress, physical destruction, DNA damage, and inflammatory responses, have led to an increasing interest in these regenerative nanostructured materials. Considering the existence of graphene-related nanomaterials with different physicochemical properties, the materials are expected to exhibit unique modes of interactions with biomolecules, cells, and tissues depending on their size, chemical composition, and hydrophil-to-hydrophobe ratio. Understanding such interactions is crucial from two perspectives, namely, from the perspectives of their toxicity and biological uses. The main aim of this study is to assess and tune the diverse properties that must be considered when planning biomedical applications. These properties include flexibility, transparency, surface chemistry (hydrophil-hydrophobe ratio), thermoelectrical conductibility, loading and release capacity, and biocompatibility.

Polycaprolactone-MXene Nanofibrous Scaffolds for Tissue Engineering

New conductive materials for tissue engineering are needed for the development of regenerative strategies for nervous, muscular, and heart tissues. Polycaprolactone (PCL) is used to obtain biocompatible and biodegradable nanofiber scaffolds by electrospinning. MXenes, a large class of biocompatible 2D nanomaterials, can make polymer scaffolds conductive and hydrophilic. However, an understanding of how their physical properties affect potential biomedical applications is still lacking. We immobilized Ti3C2Tx MXene in several layers on the electrospun PCL membranes and used positron annihilation analysis combined with other techniques to elucidate the defect structure and porosity of nanofiber scaffolds. The polymer base was characterized by the presence of nanopores. The MXene surface layers had abundant vacancies at temperatures of 305-355 K, and a voltage resonance at 8 × 104 Hz with the relaxation time of 6.5 × 106 s was found in the 20-355 K temperature interval. The appearance of a long-lived component of the positron lifetime was observed, which was dependent on the annealing temperature. The study of conductivity of the composite scaffolds in a wide temperature range, including its inductive and capacity components, showed the possibility of the use of MXene-coated PCL membranes as conductive biomaterials. The electronic structure of MXene and the defects formed in its layers were correlated with the biological properties of the scaffolds in vitro and in bacterial adhesion tests. Double and triple MXene coatings formed an appropriate environment for cell attachment and proliferation with mild antibacterial effects. A combination of structural, chemical, electrical, and biological properties of the PCL-MXene composite demonstrated its advantage over the existing conductive scaffolds for tissue engineering.

A Review of Biomimetic and Biodegradable Magnetic Scaffolds for Bone Tissue Engineering and Oncology

Bone defects characterized by limited regenerative properties are considered a priority in surgical practice, as they are associated with reduced quality of life and high costs. In bone tissue engineering, different types of scaffolds are used. These implants represent structures with well-established properties that play an important role as delivery vectors or cellular systems for cells, growth factors, bioactive molecules, chemical compounds, and drugs. The scaffold must provide a microenvironment with increased regenerative potential at the damage site. Magnetic nanoparticles are linked to an intrinsic magnetic field, and when they are incorporated into biomimetic scaffold structures, they can sustain osteoconduction, osteoinduction, and angiogenesis. Some studies have shown that combining ferromagnetic or superparamagnetic nanoparticles and external stimuli such as an electromagnetic field or laser light can enhance osteogenesis and angiogenesis and even lead to cancer cell death. These therapies are based on in vitro and in vivo studies and could be included in clinical trials for large bone defect regeneration and cancer treatments in the near future. We highlight the scaffolds' main attributes and focus on natural and synthetic polymeric biomaterials combined with magnetic nanoparticles and their production methods. Then, we underline the structural and morphological aspects of the magnetic scaffolds and their mechanical, thermal, and magnetic properties. Great attention is devoted to the magnetic field effects on bone cells, biocompatibility, and osteogenic impact of the polymeric scaffolds reinforced with magnetic nanoparticles. We explain the biological processes activated due to magnetic particles' presence and underline their possible toxic effects. We present some studies regarding animal tests and potential clinical applications of magnetic polymeric scaffolds.

Graphene-Based Materials in Dental Applications: Antibacterial, Biocompatible, and Bone Regenerative Properties

Graphene-based materials have been shown to have advantageous properties in biomedical and dental applications due to their high mechanical, physiochemical, antibacterial, and stem cell differentiating properties. Although graphene-based materials have displayed appropriate biocompatible properties when used in implant materials for orthopedic applications, little research has been performed to specifically test the biocompatibility of graphene for dental applications. The oral environment, compared to the body, varies greatly and must be considered when evaluating biocompatibility requirements for dental applications. This review will discuss in vitro and in vivo studies that assess graphene's cytotoxicity, antibacterial properties, and cell differentiation ability to evaluate the overall biocompatibility of graphene-based materials for dental applications. Particle shape, size, and concentration were found to be major factors that affected overall biocompatibility of graphene.

Chitosan/Xanthan/Hydroxyapatite-graphene oxide porous scaffold associated with mesenchymal stem cells for dentin-pulp complex regeneration

The aim of this paper was to synthesize and characterize polymeric scaffolds of Chitosan/Xanthan/Hydroxyapatite-Graphene Oxide nanocomposite associated with mesenchymal stem cells for regenerative dentistry application. The chitosan-xanthan gum (CX) complex was associated with Hydroxyapatite-Graphene Oxide (HA-GO) nanocomposite with different Graphene Oxides (GO) concentration (0.5 wt%; 1.0 wt%; 1.5 wt%). The scaffolds characterizations were performed by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Raman spectroscopy, thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and contact angle. The mechanical properties were assessed by compressive strength. The in vitro bioactivity and the in vitro cytotoxicity test (MTT test) were analyzed as well. The data was submitted to the Normality and Homogeneity tests. In vitro Indirect Cytotoxicity assay data was statistically analyzed by ANOVA two-way, followed by Tukey's test (α = 0.05). Compressive strength and contact angle data were statistically analyzed by one-way ANOVA, followed by Tukey's test (α = 0.05). XRD showed the presence of Hydroxyapatite (HA) peaks in the structures CXHA, CXHAGO 0.5%,1.0% and 1.5%. FT-IR showed amino and carboxylic bands characteristic of CX. Raman spectroscopy analysis evidenced a high quality of the GO. In the TGA it was observed the mass loss associated with the CX degradation by depolymerization. SEM analysis showed pores in the scaffolds, in addition to HA incorporated and adhered to the polymer. Contact angle test showed that scaffolds have a hydrophilic characteristic, with the CX group the highest contact angle and CXHA the lowest (p < 0.05). 1.0 wt% GO significantly increased the compressive strength compared to other compositions. In the bioactivity test, the apatite crystals precipitation on the scaffold surface was observed. MTT test showed high cell viability in CXHAGO 1.0% and CXHAGO 1.5% scaffold. CXHAGO scaffolds are promising for regenerative dentistry application because they have morphological characteristics, mechanical and biological properties favorable for the regeneration process.

Evaluation of Cytotoxic Effect of Graphene Oxide Added to Mineral Trioxide Aggregate

Aim:

Recently, although studies have shown that biomaterials containing graphene oxide (GO) in biomedicine stand out for their positive effects, the effect of GO on dental tissues when used with dental materials is not well known. The aim of this study was an evaluation of the cytotoxic effects of GO on gingival fibroblasts when it is combined in two different ratios with Mineral Trioxide Aggregate (MTA).

Materials and Methods:

In this in-vitro study, a homogenous mixture of adding +0.1 weight (wt)% and +0.3 wt% GO to Angelus MTA was created (two experimental groups) and compared with pure Angelus MTA and negative control groups. The materials were mixed according to the manufacturer’s instructions, and Teflon molds were used to form 24 disc-shaped samples for each group. The samples were divided into groups according to the simple random sampling method. The cytotoxic effect of samples was determined on gingival fibroblast cells by using the MTT test, and total oxidant status (TOS) and total antioxidant capacity (TAC) kits in 24 and 72 hours. The data were statistically analyzed using one-way ANOVA and Tukey tests.

Results:

A significant difference was found between the material-applied groups and the control group at the TAC 24 and 72 hours and between the groups containing GO and the control group at the MTT 72 hours and TAC and TOS 24 and 72 hours ( p < .05).

Conclusion:

The addition of GO to MTA increased the dose and time-based toxicity and oxidant amount, and decreased antioxidant capacity.

Antimicrobial Activity of Graphene-Based Nanocomposites: Synthesis, Characterization, and Their Applications for Human Welfare

Graphene (GN)-related nanomaterials such as graphene oxide, reduced graphene oxide, quantum dots, etc., and their composites have attracted significant interest owing to their efficient antimicrobial properties and thus newer GN-based composites are being readily developed, characterized, and explored for clinical applications by scientists worldwide. The GN offers excellent surface properties, i.e., a large surface area, pH sensitivity, and significant biocompatibility with the biological system. In recent years, GN has found applications in tissue engineering owing to its impressive stiffness, mechanical strength, electrical conductivity, and the ability to innovate in two-dimensional (2D) and three-dimensional (3D) design. It also offers a photothermic effect that potentiates the targeted killing of cells via physicochemical interactions. It is generally synthesized by physical and chemical methods and is characterized by modern and sophisticated analytical techniques such as NMR, Raman spectroscopy, electron microscopy, etc. A lot of reports show the successful conjugation of GN with existing repurposed drugs, which improves their therapeutic efficacy against many microbial infections and also its potential application in drug delivery. Thus, in this review, the antimicrobial potentialities of GN-based nanomaterials, their synthesis, and their toxicities in biological systems are discussed.

Synthetic materials in craniofacial regenerative medicine: A comprehensive overview

The state-of-the-art approach to regenerating different tissues and organs is tissue engineering which includes the three parts of stem cells (SCs), scaffolds, and growth factors. Cellular behaviors such as propagation, differentiation, and assembling the extracellular matrix (ECM) are influenced by the cell's microenvironment. Imitating the cell's natural environment, such as scaffolds, is vital to create appropriate tissue. Craniofacial tissue engineering refers to regenerating tissues found in the brain and the face parts such as bone, muscle, and artery. More biocompatible and biodegradable scaffolds are more commensurate with tissue remodeling and more appropriate for cell culture, signaling, and adhesion. Synthetic materials play significant roles and have become more prevalent in medical applications. They have also been used in different forms for producing a microenvironment as ECM for cells. Synthetic scaffolds may be comprised of polymers, bioceramics, or hybrids of natural/synthetic materials. Synthetic scaffolds have produced ECM-like materials that can properly mimic and regulate the tissue microenvironment's physical, mechanical, chemical, and biological properties, manage adherence of biomolecules and adjust the material's degradability. The present review article is focused on synthetic materials used in craniofacial tissue engineering in recent decades.

The Effect of Liquid-Phase Exfoliated Graphene Film on Neurodifferentiation of Stem Cells from Apical Papilla

BACKGROUND

Dental stem cells, which originate from the neural crest, due to their easy accessibility might be good candidates in neuro-regenerative procedures, along with graphene-based nanomaterials shown to promote neurogenesis in vitro. We aimed to explore the potential of liquid-phase exfoliated graphene (LPEG) film to stimulate the neuro-differentiation of stem cells from apical papilla (SCAP).

METHODS

The experimental procedure was structured as follows: (1) fabrication of graphene film; (2) isolation, cultivation and SCAP stemness characterization by flowcytometry, multilineage differentiation (osteo, chondro and adipo) and quantitative PCR (qPCR); (3) SCAP neuro-induction by cultivation on polyethylene terephthalate (PET) coated with graphene film; (4) evaluation of neural differentiation by means of several microscopy techniques (light, confocal, atomic force and scanning electron microscopy), followed by neural marker gene expression analysis using qPCR.

RESULTS

SCAP demonstrated exceptional stemness, as judged by mesenchymal markers' expression (CD73, CD90 and CD105), and by multilineage differentiation capacity (osteo, chondro and adipo-differentiation). Neuro-induction of SCAP grown on PET coated with graphene film resulted in neuron-like cellular phenotype observed under different microscopes. This was corroborated by the high gene expression of all examined key neuronal markers (Ngn2, NF-M, Nestin, MAP2, MASH1).

CONCLUSIONS

The ability of SCAPs to differentiate toward neural lineages was markedly enhanced by graphene film.

Dentin Particulate for Bone Regeneration: An In Vitro Study

The aim of this in vitro study was to investigate the commitment and behavior of dental pulp stem cells (DPSCs) seeded onto two different grafting materials, human dentin particulate (DP) and deproteinized bovine bone matrix (BG), with those cultured in the absence of supplements. Gene expression analyses along with epigenetic and morphological tests were carried out to examine odontogenic and osteogenic differentiation and cell proliferation. Compressive testing of the grafting materials seeded with DPSCs was performed as well. DPSC differentiation into odontoblast-like cells was identified from the upregulation of odontogenic markers (DSPP and MSX) and osteogenic markers (RUNX2, alkaline phosphatase, osteonectin, osteocalcin, collagen type I, bmp2, smad5/8). Epigenetic tests confirmed the presence of miRNAs involved in odontogenic or osteogenic commitment of DPSCs cultured for up to 21 days on DP. Compressive strength values obtained from extracellular matrix (ECM) synthesized by DPSCs showed a trend of being higher when seeded onto DP than onto BG. High expression of VEGF factor, which is related to angiogenesis, and of dentin sialoprotein was observed only in the presence of DP. Morphological analyses confirmed the typical phenotype of adult odontoblasts. In conclusion, the odontogenic and osteogenic commitment of DPSCs and their respective functions can be achieved on DP, which enables exceptional dentin and bone regeneration.

Recent advances and trends in the applications of MXene nanomaterials for tissue engineering and regeneration

MXene, as a new two-dimensional nanomaterial, is endowed with lots of particular properties, such as large surface area, excellent conductivity, biocompatibility, biodegradability, hydrophilicity, antibacterial activity, and so on. In the past few years, MXene nanomaterials have become a rising star in biomedical fields including biological imaging, tumor diagnosis, biosensor, and tissue engineering. In this review, we sum up the recent applications of MXene nanomaterials in the field of tissue engineering and regeneration. First, we briefly introduced the synthesis and surface modification engineering of MXene. Then we focused on the application and development of MXene and MXene-based composites in skin, bone, nerve and heart tissue engineering. Uniquely, we also paid attention to some research on MXene with few achievements at present but might become a new trend in tissue engineering and regeneration in the future. Finally, this paper will also discuss several challenges faced by MXene nanomaterials in the clinical application of tissue engineering.

Engineering alginate hydrogel films with poly(3-hydroxybutyrate-co-3-valerate) and graphene nanoplatelets: Enhancement of antiviral activity, cell adhesion and electroactive properties

A new biodegradable semi-interpenetrated polymer network (semi-IPN) of two US Food and Drug Administration approved materials, poly(3-hydroxybutyrate-co-3-valerate) (PHBV) and calcium alginate (CA) was engineered to provide an alternative strategy to enhance the poor adhesion properties of CA. The synthesis procedure allows the additional incorporation of 10 % w/w of graphene nanoplatelets (GNPs), which have no cytotoxic effect on human keratinocytes. This quantity of multilayer graphene provides superior antiviral activity to the novel semi-IPN against a surrogate virus of SARS-CoV-2. Adding GNPs hardly affects the water absorption or electrical conductivity of the pure components of CA and PHBV. However, the semi-IPN's electrical conductivity increases dramatically after adding GNP due to molecular rearrangements of the intertwined polymer chains that continuously distribute the GNP nanosheets, This new hydrophilic composite biomaterial film shows great promise for skin biomedical applications, especially those that require antiviral and/or biodegradable electroconductive materials.

Graphene Oxide Loaded on TiO2-Nanotube-Modified Ti Regulates the Behavior of Human Gingival Fibroblasts

Surface topography, protein adsorption, and the loading of coating materials can affect soft tissue sealing. Graphene oxide (GO) is a promising candidate for improving material surface functionalization to facilitate soft tissue integration between cells and biomaterials. In this study, TiO₂ nanotubes (TNTs) were prepared by the anodization of Ti, and TNT-graphene oxide composites (TNT-GO) were prepared by subsequent electroplating. The aim of this study was to investigate the effect of TNTs and TNT-GO surface modifications on the behavior of human gingival fibroblasts (HGFs). Commercially pure Ti and TNTs were used as the control group, and the TNT-GO surface was used as the experimental group. Scanning electron microscopy, X-ray photoelectron spectroscopy, and X-ray diffraction were used to perform sample characterization. Cell adhesion, cell proliferation, cell immunofluorescence staining, a wound-healing assay, real-time reverse-transcriptase polymerase chain reaction (RT-PCR), and Western blotting showed that the proliferation, adhesion, migration, and adhesion-related relative gene expression of HGFs on TNT-GO were significantly enhanced compared to the control groups, which may be mediated by the activation of integrin β1 and the MAPK-Erk1/2 pathway. Our findings suggest that the biological reactivity of HGFs can be enhanced by the TNT-GO surface, thereby improving the soft tissue sealing ability.

Carbon nanostructures: a comprehensive review of potential applications and toxic effects

There is no doubt that nanotechnology has revolutionized our life since the 1970s when it was first introduced. Nanomaterials have helped us to improve the current products and services we use. Among the different types of nanomaterials, the application of carbon-based nanomaterials in every aspect of our lives has rapidly grown over recent decades. This review discusses recent advances of those applications in distinct categories, including medical, industrial, and environmental applications. The first main section introduces nanomaterials, especially carbon-based nanomaterials. In the first section, we discussed medical applications, including medical biosensors, drug and gene delivery, cell and tissue labeling and imaging, tissue engineering, and the fight against bacterial and fungal infections. The next section discusses industrial applications, including agriculture, plastic, electronic, energy, and food industries. In addition, the environmental applications, including detection of air and water pollutions and removal of environmental pollutants, were vastly reviewed in the last section. In the conclusion section, we discussed challenges and future perspectives.

Advancements and Applications in the Composites of Silk Fibroin and Graphene-Based Materials

Silk fibroin and three kinds of graphene-based materials (graphene, graphene oxide, and reduced graphene oxide) have been widely investigated in biomedical fields. Recently, the hybrid composites of silk fibroin and graphene-based materials have attracted much attention owing to their combined advantages, i.e., presenting outstanding biocompatibility, mechanical properties, and excellent electrical conductivity. However, maintaining bio-toxicity and biodegradability at a proper level remains a challenge for other applications. This report describes the first attempt to summarize the hybrid composites’ preparation methods, properties, and applications to the best of our knowledge. We strongly believe that this review will open new doors for coming researchers.

Recent advances and challenges in graphene-based nanocomposite scaffolds for tissue engineering application

Graphene-based nanocomposites have recently attracted increasing attention in tissue engineering because of their extraordinary features. These biocompatible substances, in the presence of an apt microenvironment, can stimulate and sustain the growth and differentiation of stem cells into different lineages. This review discusses the characteristics of graphene and its derivatives, such as their excellent electrical signal transduction, carrier mobility, outstanding mechanical strength with improving surface characteristics, self-lubrication, antiwear properties, enormous specific surface area, and ease of functional group modification. Moreover, safety issues in the application of graphene and its derivatives in terms of biocompatibility, toxicity, and interaction with immune cells are discussed. We also describe the applicability of graphene-based nanocomposites in tissue healing and organ regeneration, particularly in the bone, cartilage, teeth, neurons, heart, skeletal muscle, and skin. The impacts of special textural and structural characteristics of graphene-based nanomaterials on the regeneration of various tissues are highlighted. Finally, the present review gives some hints on future research for the transformation of these exciting materials in clinical studies.

Histological and Biological Response to Different Types of Biomaterials: A Narrative Single Research Center Experience over Three Decades

Background: In more than three decades of work of the Retrieval Bank of the Laboratory for Undemineralized Hard Tissue Histology of the University of Chieti-Pescara in Italy, many types of biomaterials were received and evaluated. The present retrospective review aimed to evaluate the histological and biological aspects of the evaluated bone substitute biomaterials. Methods: In the present study, the authors prepared a retrospective analysis after the screening of some databases (PubMed, Scopus, and EMBASE) to find papers published from the Retrieval Bank of the Laboratory for Undermineralized Hard Tissue Histology of the University of Chieti-Pescara analyzing only the papers dealing with bone substitute biomaterials and scaffolds, in the form of granules and block grafts, for bone regeneration procedures. Results: Fifty-two articles were found, including in vitro, in vivo, and clinical studies of different biomaterials. These articles were evaluated and organized in tables for a better understanding. Conclusions: Over three decades of studies have made it possible to assess the quality of many bone substitute biomaterials, helping to improve the physicochemical and biological properties of the biomaterials used in daily clinical practice.

Green Polymer Nanocomposites for Skin Tissue Engineering

Fabrication of an appropriate skin scaffold needs to meet several standards related to the mechanical and biological properties. Fully natural/green scaffolds with acceptable biodegradability, biocompatibility, and physiological properties quite often suffer from poor mechanical properties. Therefore, for appropriate skin tissue engineering and to mimic the real functions, we need to use synthetic polymers and/or additives as complements to green polymers. Green nanocomposites (either nanoscale natural macromolecules or biopolymers containing nanoparticles) are a class of scaffolds with acceptable biomedical properties window (drug delivery and cardiac, nerve, bone, cartilage as well as skin tissue engineering), enabling one to achieve the required level of skin regeneration and wound healing. In this review, we have collected, summarized, screened, analyzed, and interpreted the properties of green nanocomposites used in skin tissue engineering and wound dressing. We particularly emphasize the mechanical and biological properties that skin cells need to meet when seeded on the scaffold. In this regard, the latest state of the art studies directed at fabrication of skin tissue and bionanocomposites as well as their mechanistic features are discussed, whereas some unspoken complexities and challenges for future developments are highlighted.

Regulation of Neural Differentiation of ADMSCs using Graphene-Mediated Wireless-Localized Electrical Signals Driven by Electromagnetic Induction

Although adipose-derived mesenchymal stem cells (ADMSCs) isolated from patients' fat are considered as the most important autologous stem cells for tissue repair, significant difficulties in the neural differentiation of ADMSCs still impede stem cell therapy for neurodegenerative diseases. Herein, a wireless-electrical stimulation method is proposed to direct the neural differentiation of ADMSCs based on the electromagnetic effect using a graphene film as a conductive scaffold. By placing a rotating magnet on the top of a culture system without any inducer, the ADMSCs cultured on graphene differentiate into functional neurons within 15 days. As a conductive biodegradable nanomaterial, graphene film acts as a wireless electrical signal generator driven by the electromagnetic induction, and millivolt-level voltage generated in situ provokes ADMSCs to differentiate into neurons, proved by morphological variation, extremely high levels of neuron-specific genes, and proteins. Most importantly, Ca2+ intracellular influx is observed in these ADMSC-derived neurons once exposure to neurotransmitters, indicating that these cells are functional neurons. This research enhances stem cell therapy for neurodegenerative diseases using autologous ADMSCs and overcomes the lack of neural stem cells. This nanostructure-mediated physical-signal simulation method is inexpensive, safe, and localized, and has a significant impact on neural regeneration.

Graphene-Based Nanomaterials for Dental Applications: Principles, Current Advances, and Future Outlook

With the development of nanotechnology, nanomaterials have been used in dental fields over the past years. Among them, graphene and its derivatives have attracted great attentions, owing to their excellent physicochemical property, morphology, biocompatibility, multi-differentiation activity, and antimicrobial activity. In our review, we summarized the recent progress about their applications on the dentistry. The synthesis methods, structures, and properties of graphene-based materials are discussed. Then, the dental applications of graphene-based materials are emphatically collected and described. Finally, the challenges and outlooks of graphene-based nanomaterials on the dental applications are discussed in this paper, aiming at inspiring more excellent studies.

Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review

BACKGROUND

For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications.

METHODS

A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines.

RESULTS

After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct.

CONCLUSIONS

The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.

Impact of Graphene Derivatives as Artificial Extracellular Matrices on Mesenchymal Stem Cells

Thanks to stem cells' capability to differentiate into multiple cell types, damaged human tissues and organs can be rapidly well-repaired. Therefore, their applicability in the emerging field of regenerative medicine can be further expanded, serving as a promising multifunctional tool for tissue engineering, treatments for various diseases, and other biomedical applications as well. However, the differentiation and survival of the stem cells into specific lineages is crucial to be exclusively controlled. In this frame, growth factors and chemical agents are utilized to stimulate and adjust proliferation and differentiation of the stem cells, although challenges related with degradation, side effects, and high cost should be overcome. Owing to their unique physicochemical and biological properties, graphene-based nanomaterials have been widely used as scaffolds to manipulate stem cell growth and differentiation potential. Herein, we provide the most recent research progress in mesenchymal stem cells (MSCs) growth, differentiation and function utilizing graphene derivatives as extracellular scaffolds. The interaction of graphene derivatives in human and rat MSCs has been also evaluated. Graphene-based nanomaterials are biocompatible, exhibiting a great potential applicability in stem-cell-mediated regenerative medicine as they may promote the behaviour control of the stem cells. Finally, the challenges, prospects and future trends in the field are discussed.

Effect of Electrolytic Medium on the Electrochemical Reduction of Graphene Oxide on Si(111) as Probed by XPS

The wafer-scale integration of graphene is of great importance in view of its numerous applications proposed or underway. A good graphene–silicon interface requires the fine control of several parameters and may turn into a high-cost material, suitable for the most advanced applications. Procedures that can be of great use for a wide range of applications are already available, but others are to be found, in order to modulate the offer of different types of materials, at different levels of sophistication and use. We have been exploring different electrochemical approaches over the last 5 years, starting from graphene oxide and resulting in graphene deposited on silicon-oriented surfaces, with the aim of understanding the reactions leading to the re-establishment of the graphene network. Here, we report how a proper choice of both the chemical environment and electrochemical conditions can lead to a more controlled and tunable graphene–Si(111) interface. This can also lead to a deeper understanding of the electrochemical reactions involved in the evolution of graphene oxide to graphene under electrochemical reduction. Results from XPS, the most suitable tool to follow the presence and fate of functional groups at the graphene surface, are reported, together with electrochemical and Raman findings.

Carbon Nanomaterials Modified Biomimetic Dental Implants for Diabetic Patients

Dental implants are used broadly in dental clinics as the most natural-looking restoration option for replacing missing or highly diseased teeth. However, dental implant failure is a crucial issue for diabetic patients in need of dentition restoration, particularly when a lack of osseointegration and immunoregulatory incompetency occur during the healing phase, resulting in infection and fibrous encapsulation. Bio-inspired or biomimetic materials, which can mimic the characteristics of natural elements, are being investigated for use in the implant industry. This review discusses different biomimetic dental implants in terms of structural changes that enable antibacterial properties, drug delivery, immunomodulation, and osseointegration. We subsequently summarize the modification of dental implants for diabetes patients utilizing carbon nanomaterials, which have been recently found to improve the characteristics of biomimetic dental implants, including through antibacterial and anti-inflammatory capabilities, and by offering drug delivery properties that are essential for the success of dental implants.

Stem Cells and Their Derivatives-Implications for Alveolar Bone Regeneration: A Comprehensive Review

Oral and craniofacial bone defects caused by congenital disease or trauma are widespread. In the case of severe alveolar bone defect, autologous bone grafting has been considered a “gold standard”; however, the procedure has several disadvantages, including limited supply, resorption, donor site morbidity, deformity, infection, and bone graft rejection. In the last few decades, bone tissue engineering combined with stem cell-based therapy may represent a possible alternative to current bone augmentation techniques. The number of studies investigating different cell-based bone tissue engineering methods to reconstruct alveolar bone damage is rapidly rising. As an interdisciplinary field, bone tissue engineering combines the use of osteogenic cells (stem cells/progenitor cells), bioactive molecules, and biocompatible scaffolds, whereas stem cells play a pivotal role. Therefore, our work highlights the osteogenic potential of various dental tissue-derived stem cells and induced pluripotent stem cells (iPSCs), the progress in differentiation techniques of iPSCs into osteoprogenitor cells, and the efforts that have been made to fabricate the most suitable and biocompatible scaffold material with osteoinductive properties for successful bone graft generation. Moreover, we discuss the application of stem cell-derived exosomes as a compelling new form of “stem-cell free” therapy.

Renewable Carbon Nanomaterials: Novel Resources for Dental Tissue Engineering

Dental tissue engineering (TE) is undergoing significant modifications in dental treatments. TE is based on a triad of stem cells, signaling molecules, and scaffolds that must be understood and calibrated with particular attention to specific dental sectors. Renewable and eco-friendly carbon-based nanomaterials (CBMs), including graphene (G), graphene oxide (GO), reduced graphene oxide (rGO), graphene quantum dots (GQD), carbon nanotube (CNT), MXenes and carbide, have extraordinary physical, chemical, and biological properties. In addition to having high surface area and mechanical strength, CBMs have greatly influenced dental and biomedical applications. The current study aims to explore the application of CBMs for dental tissue engineering. CBMs are generally shown to have remarkable properties, due to various functional groups that make them ideal materials for biomedical applications, such as dental tissue engineering.

Magnetic Nanoparticles Used in Oncology

Recently, magnetic nanoparticles (MNPs) have more and more often been used in experimental studies on cancer treatments, which have become one of the biggest challenges in medical research. The main goal of this research is to treat and to cure advanced or metastatic cancer with minimal side effects through nanotechnology. Drug delivery approaches take into account the fact that MNPs can be bonded to chemotherapeutical drugs, nucleic acids, synthetized antibodies or radionuclide substances. MNPs can be guided, and different treatment therapies can be applied, under the influence of an external magnetic field. This paper reviews the main MNPs’ synthesis methods, functionalization with different materials and highlight the applications in cancer therapy. In this review, we describe cancer cell monitorization based on different types of magnetic nanoparticles, chemotherapy, immunotherapy, magnetic hyperthermia, gene therapy and ferroptosis. Examples of applied treatments on murine models or humans are analyzed, and glioblastoma cancer therapy is detailed in the review. MNPs have an important contribution to diagnostics, investigation, and therapy in the so called theranostics domain. The main conclusion of this paper is that MNPs are very useful in different cancer therapies, with limited side effects, and they can increase the life expectancy of patients with cancer drug resistance.

Nanomaterials Application in Endodontics

In recent years, nanomaterials have become increasingly present in medicine, especially in dentistry. Their characteristics are proving to be very useful in clinical cases. Due to the intense research in the field of biomaterials and nanotechnology, the efficacy and possibilities of dental procedures have immensely expanded over the years. The nano size of materials allows them to exhibit properties not present in their larger-in-scale counterparts. The medical procedures in endodontics are time-consuming and mostly require several visits to be able to achieve the proper result. In this field of dentistry, there are still major issues about the removal of the mostly bacterial infection from the dental root canals. It has been confirmed that nanoparticles are much more efficient than traditional materials and appear to have superior properties when it comes to surface chemistry and bonding. Their unique antibacterial properties are also promising features in every medical procedure, especially in endodontics. High versatility of use of nanomaterials makes them a powerful tool in dental clinics, in a plethora of endodontic procedures, including pulp regeneration, drug delivery, root repair, disinfection, obturation and canal filling. This study focuses on summing up the current knowledge about the utility of nanomaterials in endodontics, their characteristics, advantages, disadvantages, and provides a number of reasons why research in this field should be continued.

Synergistic effects of graphene quantum dots and carbodiimide in promoting resin-dentin bond durability

OBJECTIVE

Resin-based dental adhesion is mostly utilized in minimally invasive operative dentistry. However, improving the durability and stability of resin-dentin bond interfaces remain a challenge. Graphene quantum dots (GQDs) reinforced by 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) were introduced to modify the resin-dentin bond interfaces, thereby promoting their durability and stability.

METHODS

GQDs, EDC, and EDC+GQDs groups were designed to evaluate the effects of GQDs and EDC on collagenase activity, the interaction of GQDs with collagen, and the resin-dentin interface. First, the effects of GQDs and EDC on collagenase activity was evaluated by Collagenase (EC 3.4.24.3) reacting with its substrate. The interaction of GQDs and EDC with collagen were evaluated by cross-linking degree analysis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, attenuated total reflection Fourier transform infrared spectroscopy and enzymatic hydrolysis. Second, the acid-etched and rinse adhesive system was used to evaluate the resin-dentin bond on the basis of microtensile bond strength, in situ zymography and fluorescence confocal laser scanning microscopy.

RESULTS

GQDs could inhibit collagenase activity. GQDs with the aid of EDC could cross-link collagen via covalent bonds and improve the anti-enzymatic hydrolysis of collagen. In the resin-dentin adhesion model, the μTBS of the EDC+GQDs group was significantly higher than the other control groups after thermocycling. The addition of EDC to GQDs could inhibit matrix metalloproteinase activity and promote the integrity of the bonding interfaces after thermocycling.

SIGNIFICANCE

This study presents a novel strategy to modify the resin-dentin interface and provides a new application for GQDs. This strategy has the potential to improve the durability of resin-based restoration in dentistry.

Graphene nanofiber composites for enhanced neuronal differentiation of human mesenchymal stem cells

Aim: To differentiate mesenchymal stem cells into functional dopaminergic neurons using an electrospun polycaprolactone (PCL) and graphene (G) nanocomposite. Methods: A one-step approach was used to electrospin the PCL nanocomposite, with varying G concentrations, followed by evaluating their biocompatibility and neuronal differentiation. Results: PCL with exiguous graphene demonstrated an ideal nanotopography with an unprecedented combination of guidance stimuli and substrate cues, aiding the enhanced differentiation of mesenchymal stem cells into dopaminergic neurons. These newly differentiated neurons were seen to exhibit unique neuronal arborization, enhanced intracellular Ca²⁺ influx and dopamine secretion. Conclusion: Having cost-effective fabrication and room-temperature storage, the PCL-G nanocomposites could pave the way for enhanced neuronal differentiation, thereby opening a new horizon for an array of applications in neural regenerative medicine.

Ex vivo exposure to different types of graphene-based nanomaterials consistently alters human blood secretome

The biomedical applications of graphene-based nanomaterials (GBN) have significantly grown in the last years. Many of these applications suppose their intravenous exposure and, in this way, GBN could encounter blood cells triggering an immunological response of unknown effects. Consequently, understanding the relationships between GBN and the immune system response should be a prerequisite for its adequate use in biomedicine. In the present study, we have conducted a little explored ex vivo exposure method in order to study the complexity of the secretome given by the interactions between GBN and blood cells. Blood samples from different healthy donors were exposed to three different types of GBN widely used in the biomedical field. In this sense, graphene oxide (GO), graphene nanoplatelets (GNPs), graphene nanoribbons (GNRs) and a panel of 105 proteins representatives of the blood secretome were evaluated. The results show broad changes in both the cytokines number and the expression levels, with important changes in inflammatory response markers. Furthermore, the indirect soft-agar assay was used as a tool to unravel the global functional impact of the found secretome changes. Our results indicate that the GBN-induced altered secretome can modify the natural anchorage-independent growth capacity of HeLa cells, used as a model. As a conclusion, this study describes an innovative approach to study the potential harmful effects of GBN, providing relevant data to be considered in the biomedical context when GBN are planned to be used in patients.

Graphene oxide-coated porous titanium for pulp sealing: an antibacterial and dentino-inductive restorative material

Pulp treatment techniques such as pulp capping, pulpotomy and pulp regeneration are all based on the principle of preserving vital pulp. However, specific dental restorative materials that can simultaneously protect pulp vitality and repair occlusal morphology have not been developed thus far. Traditional pulp capping materials cannot be used as dental restorative materials due to their long-term solubility and poor mechanical behavior. Titanium (Ti) is used extensively in dentistry and is regarded as a promising material for pulp sealing because of its favorable biocompatibility, processability and mechanical properties. Originally, we proposed the concept of "odontointegration", which represents direct dentin-like mineralization contact between pulp and the surface of the pulp sealing material; herein, we report the fabrication of a novel antibacterial and dentino-inductive material via micro-arc oxidation (MAO), incorporating self-assembled graphene oxide (GO) for Ti surface modification. The hierarchical micro/nanoporous structure of the MAO coating provides a suitable microenvironment for odontogenic differentiation of human dental pulp stem cells, and GO loading contributes to antibacterial activity. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy and Raman spectroscopy were employed for structure and elemental analysis. In vitro studies, including cell adhesion, Live/Dead and CCK-8 assays, alkaline phosphatase activity and calcium deposition assay, real-time polymerase chain reaction, western blot analysis and immunofluorescence staining were used to examine cell adhesion, viability, proliferation, mineralization, and odontogenic differentiation ability. Antibacterial properties against Streptococcus mutans were analyzed by SEM, spread plate, Live/Dead and Alamar blue tests. The Ti-MAO-1.0 mg mL-1 GO group exhibited excellent cell adhesion, odontoblast differentiation, mineralization, and antibacterial ability, which are beneficial to odontointegration.

Comprehensive Survey on Nanobiomaterials for Bone Tissue Engineering Applications

One of the most important ideas ever produced by the application of materials science to the medical field is the notion of biomaterials. The nanostructured biomaterials play a crucial role in the development of new treatment strategies including not only the replacement of tissues and organs, but also repair and regeneration. They are designed to interact with damaged or injured tissues to induce regeneration, or as a forest for the production of laboratory tissues, so they must be micro-environmentally sensitive. The existing materials have many limitations, including impaired cell attachment, proliferation, and toxicity. Nanotechnology may open new avenues to bone tissue engineering by forming new assemblies similar in size and shape to the existing hierarchical bone structure. Organic and inorganic nanobiomaterials are increasingly used for bone tissue engineering applications because they may allow to overcome some of the current restrictions entailed by bone regeneration methods. This review covers the applications of different organic and inorganic nanobiomaterials in the field of hard tissue engineering.

Mineral Trioxide Aggregate Applications in Endodontics: A Review

A current topic in dentistry concerns the biocompatibility of the materials, and in particular, conservative dentistry and endodontics ones. The mineral trioxide aggregate (MTA) is a dental material with biocompatibility properties to oral and dental tissues. MTA was developed for dental root repair in endodontic treatment and it is formulated from commercial Portland cement, combined with bismuth oxide powder for radiopacity. MTA is used for creating apical plugs during apexification, repairing root perforations during root canal therapy, treating internal root resorption, and pulp capping. The objective of this article is to investigate MTA features from a clinical point of view, even compared with other biomaterials. All the clinical data regarding this dental material will be evaluated in this review article. Data obtained from the analysis of the past 10 years' literature highlighted 19 articles in which the MTA clinical aspects could be recorded. The results obtained in this article are an important step to demonstrate the safety and predictability of oral rehabilitations with these biomaterials and to promote a line to improve their properties in the future.