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Bilge K, Ataş O, Yildiz Ş, Çalik I, Dündar S, Gezer Ataş A. Histological evaluation of tissue reaction and new bone formation of different calcium silicate-based cements in rats. Aust Dent J 2024; 69:18-28. [PMID: 37715562 DOI: 10.1111/adj.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the local reactions and new bone formation of rat subcutaneous and bone tissue to different calcium silicate cements. METHODS In this study, 80 rats were divided into five groups as control, BIOfactor MTA (BIO), NeoMTA Plus (NEO), MTA Repair Hp (REP), Biodentine (DENT) and then into two subgroups according to sacrification times (7, 30 days; n = 8). Polyethylene tubes filled with appropriate materials (test groups); empty tubes (control group) were implanted into the dorsum of each rat subcutaneously. For intraosseous implantation, materials were placed in the cavities created in tibia of rats. Subcutaneous tissue and tibia samples were stained with haematoxylin-eosin and subjected to histopathological analysis. A score (0-3) was used to grade inflammatory reaction and new bone formation. Data were analysed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). RESULTS Inflammatory reaction observed in subcutaneous and intraosseous tissues for 7 days decreased significantly in all groups over time (P < 0.05). It was determined that there was significant increase in new bone formation in REP, BIO, DENT groups over time (P < 0.05). CONCLUSION Four contemporary bioceramic materials induced local inflammation and tissues changes shortly after subcutaneous implantation, which were reduced over time. In ıntraosseous implantation, all materials induced new bone formation over time. REGISTRATION NUMBER ADJ-03-23-0134. © 2023 Australian Dental Association.
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Affiliation(s)
- K Bilge
- Department of Restorative Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - O Ataş
- Department of Pediatric Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - Ş Yildiz
- Department of Pediatric Dentistry, Faculty of Dentistry Firat University, Elazıg, Turkey
| | - I Çalik
- Department of Pathology, Faculty of Medicine, Firat University, Elazıg, Turkey
| | - S Dündar
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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3
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Chung M, Lee S, Kim S, Kim E. Inflammatory response and odontogenic differentiation of inflamed dental pulp treated with different pulp capping materials: An in vivo study. Int Endod J 2023; 56:1118-1128. [PMID: 37350351 DOI: 10.1111/iej.13947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
AIM Previous studies have evaluated the pulpal responses to calcium silicate cements (CSCs) on normal dental pulp, but investigations on the effects of CSCs on inflamed pulp are limited. This study aimed to test the inflammatory response and odontogenic differentiation of inflamed rat dental pulp after direct pulp capping with CSCs. METHODOLOGY Wistar rat molars pulps were exposed for 48 h to induce inflammation and then capped with ProRoot MTA (Dentsply), Biodentine (Septodont), RetroMTA (Bio MTA) and Dycal (Dentsply Caulk). The degree of pulpal inflammation and hard tissue formation was evaluated by histological analysis. Immunofluorescence staining for interleukin (IL)-6, osteocalcin (OCN) and runt-related transcription factor 2 (RUNX2) was also performed. RESULTS After 4 weeks, complete recovery from inflammation was evident in 22%, 37.5%, 10% and none of the ProRoot MTA, Biodentine, RetroMTA and Dycal samples, respectively. Heavy hard tissue deposition as a continuous hard tissue bridge was observed in 77.8%, 75%, 70% and 60% of the ProRoot MTA, Biodentine, RetroMTA and Dycal samples, respectively. IL-6, OCN and RUNX2 were detected in all materials, mainly adjacent to areas of inflammation and reparative dentine formation. At one, two and 4 weeks, significant differences were not observed between the inflammation and hard tissue formation scores of the four material groups (p > .05). CONCLUSIONS In this study, pulpal inflammation was still present in most specimens at 4 weeks after pulp capping and a significant number of samples showed incomplete and discontinuous dentine bridge formation. The results of this study suggest that initial inflammatory conditions of the pulp may risk the prognosis of teeth treated with CSCs.
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Affiliation(s)
- M Chung
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - S Lee
- Oral Science Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - S Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - E Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, South Korea
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Alqassab F, Atmeh AR, Aldossary N, Alzahrani N, Madi M, Omar O. Inflammatory and differentiation cellular response to calcium silicate cements: An in vitro study. Int Endod J 2023; 56:593-607. [PMID: 36689321 DOI: 10.1111/iej.13894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
AIM Inflammatory-regenerative cell interaction is believed to mediate hard tissue formation. This study aimed to investigate the interaction between human inflammatory monocytes with human regenerative fibroblasts after exposure to different calcium silicate materials. METHODOLOGY Human monocytes were cultured on three materials, polystyrene (PS), mineral trioxide aggregates (MTA) and biodentine (BD), in the presence or absence of lipopolysaccharide (LPS). Half of the monocyte-conditioned media (MoCM) of each group was used to analyse inflammatory cytokine secretion, namely TNF-α, IL-1β, IL-1RA and IL-6. The remaining MoCM was used to culture recipient fibroblasts, measuring the cell number (proliferation) and levels of alkaline phosphatase (differentiation) and lactic acid dehydrogenase (cytotoxicity). RESULTS In absence of LPS, MTA was associated with higher secretion of TNF-α and lower secretion of IL-1β, while BD triggered higher secretions of both cytokines when both materials were compared to control (PS). When LPS was added, higher levels of all analysed cytokines were observed in the PS and BD groups, whereas for the MTA group, only TNF-α and IL-6 were increased. Fibroblasts responded differently to the MoCM from the different groups, revealing significant increases in proliferation and differentiation capacities, particularly when cultured in CM from monocytes exposed to MTA. The morphological evaluation revealed different patterns of fibroblast shape and spread in the different MoCM groups. CONCLUSION Calcium silicate materials modulate the monocyte inflammatory response, which subsequently induce differential effects on the recipient fibroblasts. MTA appears to promote the secretion of prodifferentiation signals from the monocytes, which are received by fibroblasts, promoting their proliferation and differentiation. The model represents a promising tool to evaluate the interaction of different cells in response to different materials.
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Affiliation(s)
- Fadela Alqassab
- Fellowship in Endodontics Program, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amre R Atmeh
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohmmed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Nada Aldossary
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nada Alzahrani
- Blood Bank, Laboratory Medicine, King Fahad University Hospital, Al Khobar, Saudi Arabia
| | - Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Xavier MT, Costa AL, Caramelo FJ, Palma PJ, Ramos JC. Evaluation of the Interfaces between Restorative and Regenerative Biomaterials Used in Vital Pulp Therapy. Materials (Basel) 2021; 14:5055. [PMID: 34501145 DOI: 10.3390/ma14175055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/21/2021] [Accepted: 08/27/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Calcium-silicate-based cements (CSC) have gained an increasing scientific and clinical relevance, enabling more conservative approaches, namely pulp preservation and regeneration therapies. This research aims to study the influence of four clinical variables on the interfaces between CSC and composite adhesive restoration, concerning shear bond strength (SBS) and ultra-morphological patterns. METHODS SBS tests were performed in 320 specimens divided in 16 groups (n = 20) according to: two CSC (NuSmile® NeoMTA, BiodentineTM); two adhesive systems (ClearfilTM SE Bond 2 (CSEB2), ClearfilTM Universal Bond Quick (CUBQ)); optional application of an additional hydrophobic bonding layer (HBL); two restoration times (immediate, seven days). Scanning electron microscopy (SEM) was performed to conduct the ultra-morphology interface analysis in 32 deciduous molars prepared and randomly allocated into the 16 groups. RESULTS Globally, SBS tests showed higher bond strength of CUBQ compared to CSEB2 (p < 0.001), as with an additional HBL application (p = 0.014) and delayed restoration (p < 0.001). SEM showed the interpenetration between adhesive systems and CSC forming a hybrid layer, whose depth and thickness depended on the restoration time and adhesive strategy. CONCLUSIONS The independent clinical variables adhesive system, application of an additional HBL and restoration time affected the bond performance and ultra-morphological interface between composite adhesive restoration and CSC.
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Santos JM, Pereira JF, Marques A, Sequeira DB, Friedman S. Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes. ACTA ACUST UNITED AC 2021; 57:573. [PMID: 34205149 DOI: 10.3390/medicina57060573] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022]
Abstract
Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.
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Rodrigues NS, França CM, Tahayeri A, Ren Z, Saboia VPA, Smith AJ, Ferracane JL, Koo H, Bertassoni LE. Biomaterial and Biofilm Interactions with the Pulp-Dentin Complex-on-a-Chip. J Dent Res 2021; 100:1136-1143. [PMID: 34036838 DOI: 10.1177/00220345211016429] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Calcium silicate cements (CSCs) are the choice materials for vital pulp therapy because of their bioactive properties, promotion of pulp repair, and dentin bridge formation. Despite the significant progress made in understanding CSCs' mechanisms of action, the key events that characterize the early interplay between CSC-dentin-pulp are still poorly understood. To address this gap, a microfluidic device, the "tooth-on-a-chip," which was developed to emulate the biomaterial-dentin-pulp interface, was used to test 1) the effect of CSCs (ProRoot, Biodentine, and TheraCal) on the viability and proliferation of human dental pulp stem cells, 2) variations of pH, and 3) release within the pulp chamber of transforming growth factor-β (TGFβ) as a surrogate of the bioactive dentin matrix molecules. ProRoot significantly increased the extraction of TGFβ (P < 0.05) within 24 to 72 h and, along with Biodentine, induced higher cell proliferation (P > 0.05), while TheraCal decreased cell viability and provoked atypical changes in cell morphology. No correlation between TGFβ levels and pH was observed. Further, we established a biofilm of Streptococcus mutans on-chip to model the biomaterial-biofilm-dentin interface and conducted a live and dead assay to test the antimicrobial capability of ProRoot in real time. In conclusion, the device allows for direct characterization of the interaction of bioactive dental materials with the dentin-pulp complex on a model of restored tooth while enabling assessment of antibiofilm properties at the interface in real time that was previously unattainable.
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Affiliation(s)
- N S Rodrigues
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - C M França
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - A Tahayeri
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Z Ren
- Department of Orthodontics, Divisions of Community Oral Health & Pediatric Dentistry, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - V P A Saboia
- Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - A J Smith
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - J L Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - H Koo
- Department of Orthodontics, Divisions of Community Oral Health & Pediatric Dentistry, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - L E Bertassoni
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.,Center for Regenerative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.,Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA.,Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Portland, OR, USA
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Sanz JL, Forner L, Llena C, Guerrero-Gironés J, Melo M, Rengo S, Spagnuolo G, Rodríguez-Lozano FJ. Cytocompatibility and Bioactive Properties of Hydraulic Calcium Silicate-Based Cements (HCSCs) on Stem Cells from Human Exfoliated Deciduous Teeth (SHEDs): A Systematic Review of In Vitro Studies. J Clin Med 2020; 9:jcm9123872. [PMID: 33260782 PMCID: PMC7761433 DOI: 10.3390/jcm9123872] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023] Open
Abstract
The implementation of hydraulic calcium silicate-based endodontic cements (HCSCs) in biologically based endodontic procedures for the primary dentition has been recently investigated, focusing on the biological response of stem cells from human exfoliated deciduous teeth (SHEDs) towards them. The present systematic review aimed to present a qualitative synthesis of the available literature consisting of in vitro assays, which assessed the cytocompatibility and bioactive properties of HCSCs in direct contact with SHEDs. Following the PRISMA statement, an electronic database search was carried out in Medline, Scopus, Embase, Web of Science, and SciELO on March 31st and updated on November 16th, 2020. In vitro studies evaluating the biological response of SHEDs to the treatment with HCSCs were eligible. Within the term biological response, assays assessing the cytocompatibility (i.e., cell viability, migration, proliferation), cell plasticity or differentiation (i.e., osteo/odontogenic marker expression), and bioactivity or biomineralization (i.e., mineralized nodule formation) were included. A total of seven studies were included after the selection process. The study sample comprised an extensive range of cell viability, migration, proliferation, adhesion, and bioactivity assays regarding the biological response of SHEDs towards five different commercially available HCSCs (MTA, ProRoot MTA, Biodentine, iRoot BP Plus, and Theracal LC). Biodentine, MTA, and iRoot BP Plus showed significant positive results in cytocompatibility and bioactivity assays when cultured with SHEDs. The results from in vitro assays assessing the cytocompatibility and bioactivity of the HCSCs MTA, Biodentine, and iRoot BP Plus towards SHEDs support their use in vital pulp treatment for the primary dentition.
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Affiliation(s)
- José Luis Sanz
- Departament d’Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (C.L.); (M.M.)
| | - Leopoldo Forner
- Departament d’Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (C.L.); (M.M.)
- Correspondence: ; Tel.: +34-963864175
| | - Carmen Llena
- Departament d’Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (C.L.); (M.M.)
| | - Julia Guerrero-Gironés
- Cellular Therapy and Hematopoietic Transplant Research Group, Biomedical Research Institute, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, 30120 Murcia, Spain; (J.G.-G.); (F.J.R.-L.)
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
| | - María Melo
- Departament d’Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain; (J.L.S.); (C.L.); (M.M.)
| | - Sandro Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy; (S.R.); (G.S.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy; (S.R.); (G.S.)
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow 119146, Russia
| | - Francisco Javier Rodríguez-Lozano
- Cellular Therapy and Hematopoietic Transplant Research Group, Biomedical Research Institute, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, 30120 Murcia, Spain; (J.G.-G.); (F.J.R.-L.)
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
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Sequeira DB, Seabra CM, Palma PJ, Cardoso AL, Peça J, Santos JM. Effects of a New Bioceramic Material on Human Apical Papilla Cells. J Funct Biomater 2018; 9:E74. [PMID: 30558359 PMCID: PMC6306901 DOI: 10.3390/jfb9040074] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The development of materials with bioregenerative properties is critically important for vital pulp therapies and regenerative endodontic procedures. The aim of this study was to evaluate the cytocompatibility and cytotoxicity of a new endodontic biomaterial, PulpGuard, in comparison with two other biomaterials widely used in endodontic procedures, ProRoot Mineral Trioxide Aggregate (MTA) and Biodentine. METHODS Apical papilla cells (APCs) were isolated from third molars with incomplete rhizogenesis from patients with orthodontic indication for dental extraction. Cultured APCs were incubated for 24, 48, or 72 h with different dilutions of eluates prepared from the three materials. Cellular viability, mobility, and proliferation were assessed in vitro using the Alamar Blue assay and a wound-healing test. The cells were also cultured in direct contact with the surface of each material. These were then analyzed via Scanning Electron Microscopy (SEM), and the surface chemical composition was determined by Energy-Dispersive Spectroscopy (EDS). RESULTS Cells incubated in the presence of eluates extracted from ProRoot MTA and PulpGuard presented rates of viability comparable to those of control cells; in contrast, undiluted Biodentine eluates induced a significant reduction of cellular viability. The wound-healing assay revealed that eluates from ProRoot MTA and PulpGuard allowed for unhindered cellular migration and proliferation. Cellular adhesion was observed on the surface of all materials tested. Consistent with their disclosed composition, EDS analysis found high relative abundance of calcium in Biodentine and ProRoot MTA and high abundance of silicon in PulpGuard. Significant amounts of zinc and calcium were also present in PulpGuard discs. Concerning solubility, Biodentine and ProRoot MTA presented mild weight loss after eluate extraction, while PulpGuard discs showed significant water uptake. CONCLUSIONS PulpGuard displayed a good in vitro cytocompatibility profile and did not significantly affect the proliferation and migration rates of APCs. Cells cultured in the presence of PulpGuard eluates displayed a similar profile to those cultured with eluates from the widely used endodontic cement ProRoot MTA.
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Affiliation(s)
- Diana B Sequeira
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-504, Portugal.
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra 3030-789, Portugal.
- PhD Program in Experimental Biology and Biomedicine (PDBEB), University of Coimbra, Coimbra 3004-504, Portugal.
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra 3000-075 Portugal.
| | - Catarina M Seabra
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-504, Portugal.
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra 3030-789, Portugal.
| | - Paulo J Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra 3000-075 Portugal.
| | - Ana Luísa Cardoso
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-504, Portugal.
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra 3030-789, Portugal.
| | - João Peça
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra 3004-504, Portugal.
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra 3030-789, Portugal.
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra 3000-075 Portugal.
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Pushpa S, Maheshwari C, Maheshwari G, Sridevi N, Duggal P, Ahuja P. Effect of pH on solubility of white Mineral Trioxide Aggregate and Biodentine: An in vitro study. J Dent Res Dent Clin Dent Prospects 2018; 12:201-207. [PMID: 30443306 PMCID: PMC6231146 DOI: 10.15171/joddd.2018.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/16/2018] [Indexed: 11/09/2022] Open
Abstract
Background. The aim of this study was to evaluate the effect of acidic, neutral and alkaline environments on the solubility
of white mineral trioxide aggregate (WMTA) and Biodentine (BD).
Methods. Thirty-nine ring molds were randomly divided into three groups of A, B, and C (n = 12) with pH values of 7.4, 4.4
and 10.4, respectively, and an empty mold was used as a control. Each group was further divided into two subgroups (1 and
2) according to the material studied. The samples in groups A, B and C were transferred into synthetic tissue fluid buffered at
pH values of 7.4, 4.4 and 10.4, respectively, and kept in an incubator at 37°C with 100% humidity. Daily solubility at 1-, 2-,
5-, 14-, 21-, and 30-day intervals and cumulative solubility up to 5-, 14-, and 30-day intervals were calculated. Statistical
analysis was carried out with independent-samples t-test, two-way ANOVA and post hoc Tukey tests using SPSS 18. Statistical
significance was set at P<0.05.
Results. Both WMTA and BD exhibited the highest solubility in acidic pH with 5.4235±0.1834 and 10.7516±0.0639 mean
cumulative solubility values at 30-day interval, respectively. At all exposure times, BD was significantly more soluble than
WMTA (P<0.001).
Conclusion. Acidic periapical environment jeopardized the solubility of both WMTA and BD, affecting their sealing characteristics
in clinical applications like perforation repair procedures and blunderbuss canals.
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Affiliation(s)
- S Pushpa
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
| | - Chakit Maheshwari
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
| | - Garima Maheshwari
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
| | - N Sridevi
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
| | - Puneeta Duggal
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
| | - Puneet Ahuja
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur - 208024, Uttar Pradesh, India
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11
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Kang CM, Hwang J, Song JS, Lee JH, Choi HJ, Shin Y. Effects of Three Calcium Silicate Cements on Inflammatory Response and Mineralization-Inducing Potentials in a Dog Pulpotomy Model. Materials (Basel) 2018; 11:ma11060899. [PMID: 29861475 PMCID: PMC6025164 DOI: 10.3390/ma11060899] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 11/16/2022]
Abstract
This beagle pulpotomy study compared the inflammatory response and mineralization-inducing potential of three calcium silicate cements: ProRoot mineral trioxide aggregate (MTA) (Dentsply, Tulsa, OK, USA), OrthoMTA (BioMTA, Seoul, Korea), and Endocem MTA (Maruchi, Wonju, Korea). Exposed pulp tissues were capped with ProRoot MTA, OrthoMTA, or Endocem MTA. After 8 weeks, we extracted the teeth, then performed hematoxylin-eosin and immunohistochemical staining with osteocalcin and dentin sialoprotein. Histological evaluation comprised a scoring system with eight broad categories and analysis of calcific barrier areas. We evaluated 44 teeth capped with ProRoot MTA (n = 15), OrthoMTA (n = 18), or Endocem MTA (n = 11). Most ProRoot MTA specimens formed continuous calcific barriers; these pulps contained inflammation-free palisading patterns in the odontoblastic layer. Areas of the newly formed calcific barrier were greater with ProRoot MTA than with Endocem MTA (p = 0.006). Although dentin sialoprotein was highly expressed in all three groups, the osteocalcin expression was reduced in the OrthoMTA and Endocem MTA groups. ProRoot MTA was superior to OrthoMTA and Endocem MTA in all histological analyses. ProRoot MTA and OrthoMTA resulted in reduced pulpal inflammation and more complete calcific barrier formation, whereas Endocem MTA caused a lower level of calcific barrier continuity with tunnel defects.
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Affiliation(s)
- Chung-Min Kang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, 03722, Korea.
- Department of Pharmacology, College of Medicine, Yonsei University, Seoul 03722, Korea.
| | - Jiwon Hwang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, 03722, Korea.
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, 03722, Korea.
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea.
| | - Jae-Ho Lee
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, 03722, Korea.
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea.
| | - Hyung-Jun Choi
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, 03722, Korea.
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea.
| | - Yooseok Shin
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul 03722, Korea.
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, 50-1 Yonseiro, Seodaemun-Gu, Seoul 03722, Korea.
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12
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Kohli MR, Berenji H, Setzer FC, Lee SM, Karabucak B. Outcome of Endodontic Surgery: A Meta-analysis of the Literature-Part 3: Comparison of Endodontic Microsurgical Techniques with 2 Different Root-end Filling Materials. J Endod 2018; 44:923-31. [PMID: 29681480 DOI: 10.1016/j.joen.2018.02.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate the influence of root-end preparation and filling material on endodontic surgery outcome. A systematic review and meta-analysis was conducted to determine the outcome of resin-based endodontic surgery (RES, the use of high-magnification preparation of a shallow and concave root-end cavity and bonded resin-based root-end filling material) versus endodontic microsurgery (EMS, the use of high-magnification ultrasonic root-end preparation and root-end filling with SuperEBA [Keystone Industries, Gibbstown, NJ], IRM [Dentsply Sirona, York, PA], mineral trioxide aggregate [MTA], or other calcium silicate cements). METHODS An exhaustive literature search was conducted to identify prognostic studies on the outcome of root-end surgery. Human studies conducted from 1966 to the end of December 2016 in 5 different languages (ie, English, French, German, Italian, and Spanish) were searched in 4 electronic databases (ie, Medline, Embase, PubMed, and Cochrane Library). Relevant review articles on the subject were scrutinized for cross-references. In addition, 5 dental and medical journals (Journal of Endodontics; International Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics; Journal of Oral and Maxillofacial Surgery; and International Journal of Oral and Maxillofacial Surgery) were hand checked dating back to 1975. All abstracts were screened by 3 independent reviewers (H.B., M.K., and F.S.). Strict inclusion-exclusion criteria were defined to identify relevant articles. Raw data were extracted from the full-text review of these selected articles independently by each of the 3 reviewers. In case of disagreement, an agreement was reached by discussion, and qualifying articles were assigned to group RES. For EMS, the same search strategy was performed for the time frame October 2009 to December 2016, whereas up to October 2009 the data were obtained from a previous systematic review with identical criteria and search strategy. Weighted pooled success rates and a relative risk assessment between RES and EMS were calculated. To make a comparison between groups, a random effects model was used. RESULTS Sixty-eight articles were eligible for full-text review. Of these, per strict inclusion exclusion criteria, 14 studies qualified, 3 for RES (n = 862) and 11 for EMS (n = 915). Weighted pooled success rates for RES were 82.20% (95% confidence interval [CI], 0.7965-0.8476) and 94.42% for EMS (95% CI, 0.9295-0.9590). This difference was statistically significant (P < .0005). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for RES, providing best available evidence on the influence of cavity preparation with ultrasonic tips and/or SuperEBA (Keystone Industries, Gibbstown, NJ), IRM (Dentsply Sirona, York, PA), MTA, or silicate cements as root-end filling material instead of a shallow cavity preparation and placement of a resin-based material. Additional large-scale randomized clinical trials are needed to assess other predictors of outcome.
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13
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Ha W, Kahler B, Walsh LJ. Classification and Nomenclature of Commercial Hygroscopic Dental Cements. Eur Endod J 2017; 2:1-10. [PMID: 33403348 PMCID: PMC7757965 DOI: 10.5152/eej.2017.17006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/03/2017] [Accepted: 09/09/2017] [Indexed: 11/22/2022] Open
Abstract
Objective Under the Global Medical Device Nomenclature (GMDN) system, the newly introduced term 'hygroscopic dental cement' (HDC) encompasses MTA as well as cements based on bioceramics, calcium silicate or calcium sulphate. Many HDCs have a long history of use in dentistry. There is a need for a consistent, logical and informed approach to the nomenclature of traditional and novel HDCs. Methods Commercial manufacturers of HDC were contacted requesting information on the compositions of products. Manufacturers that were unknown to the authors, that were unable to be contacted, that wished to be excluded from this paper, or that did not send their information on compositions in due time were not included. Results The compositions of commercial HDCs include various hybrids of calcium silicates, calcium aluminates, calcium phosphates, calcium sulphate as well as zinc sulphates. Furthermore, there are variations in the radiopacifier as well as additives that change the handling or setting processes. Conclusion The inclusion of different additives to HDCs enables variation in handling properties such that they now exist as distinct putties and sealers as well as cements.
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Affiliation(s)
- William Ha
- School of Dentistry, University of Queensland, Queensland, Australia
| | - Bill Kahler
- School of Dentistry, University of Queensland, Queensland, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Queensland, Australia
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14
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Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J 2017; 51:177-205. [PMID: 28836288 DOI: 10.1111/iej.12841] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/21/2017] [Indexed: 01/09/2023]
Abstract
Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new BECs have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, NeoMTA Plus, OrthoMTA, Quick-Set, RetroMTA, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, the chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and VPT applications of BECs had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term 'bioactive endodontic cements (BECs)', which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used MTA for VPT. In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.
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Affiliation(s)
- M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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