Ex Vivo Osteogenesis Induced by Calcium Silicate-Based Cement Extracts

Calcium silicate-based cements are used in a variety of clinical conditions affecting the pulp tissue, relying on their inductive effect on tissue mineralization. This work aimed to evaluate the biological response of calcium silicate-based cements with distinct properties-the fast-setting Biodentine™ and TotalFill^® BC RRM™ Fast Putty, and the classical slow-setting ProRoot^® MTA, in an ex vivo model of bone development. Briefly, eleven-day-old embryonic chick femurs were cultured for 10 days in organotypic conditions, being exposed to the set cements' eluates and, at the end of the culture period, evaluated for osteogenesis/bone formation by combining microtomographic analysis and histological histomorphometric assessment. ProRoot^® MTA and TotalFill^® extracts presented similar levels of calcium ions, although significantly lower than those released from Biodentine^TM. All extracts increased the osteogenesis/tissue mineralization, assayed by microtomographic (BV/TV) and histomorphometric (% of mineralized area; % of total collagen area, and % of mature collagen area) indexes, although displaying distinct dose-dependent patterns and quantitative values. The fast-setting cements displayed better performance than that of ProRoot^® MTA, with Biodentine^TM presenting the best performance, within the assayed experimental model.

Analysis of the Activity and Expression of Cyclooxygenases COX1 and COX2 in THP-1 Monocytes and Macrophages Cultured with BiodentineTM Silicate Cement

Biodentine^TM is a material based on hydrated calcium silicate with odontotropic properties. However, from the clinician’s perspective, every material used to fill a tooth—even those showing the optimal biochemical parameters—is in fact a foreign body introduced to the organism of the host. Therefore, apart from the chemical parameters of such materials, equally important is the so-called biocompatibility of such materials. The aim of the study was to investigate whether Biodentine^TM, used in the regeneration of the pulp-dentine complex, may affect the expression of the enzymes cyclooxygenase 1 (COX1) and cyclooxygenase 2 (COX2) in THP-1 monocytes/macrophages and the amount of prostanoids synthesized by these enzymes-precursors of biologically active prostanoids such as prostaglandin E2 (PGE2) and thromboxane (TXB2) which are mediators of inflammation. An original aspect of this research is the use of the THP-1 monocyte/macrophage cell model and the use of biomaterial in direct contact with cells. In this way we tried to reflect the clinical conditions of regenerative pulp and periodontal tissue treatment using Biodentine^TM. The results of our study showed a lack of macrophage activation (measured by flow cytometry) and a lack of stimulation of the expression of the studied cyclooxygenase enzymes (measured by Western blotting and fluorescent microscopy), as well as a lack of increase in the concentration (measured by ELISA method) of their inflammatory mediators (PGE2 and TXB2) in vitro incubated with Biodentine^TM.

Characterization of the biological effect of BiodentineTM on primary dental pulp stem cells

Background

Biodentine™ is relatively a new tricalcium silicate cement that has gained great attention of the researchers due to its biological potential in comparison with other materials. The aim of this study was to investigate the optimum concentrations of Biodentine in relation to its stimulatory or inhibitory effect on proliferation, migration and adhesion of stem cells of human exfoliated deciduous teeth (SHED). The cell cultures of SHED were treated with Biodentine™ extract at four different concentrations; 20mg/ml, 2mg/ml, 0.2mg/ml and 0.02mg/ml. Cells cultured without Biodentine™ were kept as a blank control. The proliferation potential of SHED cells was evaluated by MTT viability analysis for 6 days. Migration potential was investigated by wound healing and transwell migration assays. The growth, survival and communication potential of these cells was determined by Adhesion assay.

Results

A significant increase was observed in the proliferation and migration of SHED at (2mg/ml, 0.2mg/ml and 0.02mg/ml) while higher concentration of Biodentine™ (20mg/ml) exhibited cytotoxic effect on the cells. However, three tested Biodentine™ concentrations were similar in effect (non-significant) to adhesion ability of cells when compared with blank control.

Conclusion

Our findings suggest that lower concentrations of Biodentine™ can be considered as the optimum concentrations to enhance the stimulatory effect of Biodentine on SHED.

BiodentineTM versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial

BACKGROUND

The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars.

METHODS

A randomized, split-mouth study design was used with a sample of 37 healthy children aged 4- to 8-year-old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed-up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05.

RESULTS

At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12-month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively.

CONCLUSIONS

Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference.

TRIAL REGISTRATION

Registered on NCT03779698 . Date of Registration: 18 December 2018.