Calcium Hydroxide–induced Proliferation, Migration, Osteogenic Differentiation, and Mineralization via the Mitogen-activated Protein Kinase Pathway in Human Dental Pulp Stem Cells

Functionalization of PCL-Based Fiber Scaffolds with Different Sources of Calcium and Phosphate and Odontogenic Potential on Human Dental Pulp Cells

This study investigated the incorporation of sources of calcium, phosphate, or both into electrospun scaffolds and evaluated their bioactivity on human dental pulp cells (HDPCs). Additionally, scaffolds incorporated with calcium hydroxide (CH) were characterized for degradation, calcium release, and odontogenic differentiation by HDPCs. Polycaprolactone (PCL) was electrospun with or without 0.5% w/v of calcium hydroxide (PCL + CH), nano-hydroxyapatite (PCL + nHA), or β-glycerophosphate (PCL + βGP). SEM/EDS analysis confirmed fibrillar morphology and particle incorporation. HDPCs were cultured on the scaffolds to assess cell viability, adhesion, spreading, and mineralized matrix formation. PCL + CH was also evaluated for gene expression of odontogenic markers (RT-qPCR). Data were submitted to ANOVA and Student's t-test (α = 5%). Added CH increased fiber diameter and interfibrillar spacing, whereas βGP decreased both. PCL + CH and PCL + nHA improved HDPC viability, adhesion, and proliferation. Mineralization was increased eightfold with PCL + CH. Scaffolds containing CH gradually degraded over six months, with calcium release within the first 140 days. CH incorporation upregulated DSPP and DMP1 expression after 7 and 14 days. In conclusion, CH- and nHA-laden PCL fiber scaffolds were cytocompatible and promoted HDPC adhesion, proliferation, and mineralized matrix deposition. PCL + CH scaffolds exhibit a slow degradation profile, providing sustained calcium release and stimulating HDPCs to upregulate odontogenesis marker genes.

Efficacy of a Novel Intracanal Medicament on Total Antioxidant Status in Patients With Apical Periodontitis: A Randomized Controlled Clinical Trial

Introduction Successful endodontic treatment relies upon the microbial debridement of the root canal system. This can be achieved to a great extent by using intracanal medicaments, which inhibit the microbes growing in the root canal. Evaluating the capacity of oxidants in the saliva is a crucial parameter for assessing the antioxidant capacity of any individual, which decreases in inflammatory conditions. An effective intracanal medicament can increase the total antioxidant capacity of saliva, which comes down because of inflammatory conditions. Aim To evaluate the effect of two intracanal medicaments on the antioxidant capacity of saliva. Materials and methods In a randomized prospective clinical trial, 42 patients with a mean age of 18-70 years were selected based on exclusion and inclusion criteria, and the baseline value of the total antioxidant capacity of saliva was recorded. The patients were categorized into two groups as per the block randomization method (Group I: calcium hydroxide (Maarc, New Delhi, India) intracanal medicament; Group II: Hekla lava (SBL Pvt. Ltd., Germany) intracanal medicament). Access opening, working length determination, and cleaning and shaping were conducted using hand K-files and ProTaper Gold rotary files. Intracanal medicaments were placed according to the groups assigned, and temporary restoration was placed. The patients were recalled after seven days. If the tooth was asymptomatic, obturation was completed, and a saliva sample was collected to assess the total antioxidant capacity. Results The total antioxidant capacity of saliva was increased after using intracanal medicaments and endodontic therapy, and there was a statistically significant difference before and after using both the medicaments (p=0.0005; i.e., calcium hydroxide and Hekla lava. When both medicaments were compared, there was no significant difference in the antioxidant capacity of saliva among medicaments (p=0.384). Conclusion The total antioxidant capacity of saliva was increased after using both the intracanal medicaments. Hence, Hekla lava can be potentially used as an alternative intracanal medicament.

The odontoblastic differentiation of dental mesenchymal stem cells: molecular regulation mechanism and related genetic syndromes

Dental mesenchymal stem cells (DMSCs) are multipotent progenitor cells that can differentiate into multiple lineages including odontoblasts, osteoblasts, chondrocytes, neural cells, myocytes, cardiomyocytes, adipocytes, endothelial cells, melanocytes, and hepatocytes. Odontoblastic differentiation of DMSCs is pivotal in dentinogenesis, a delicate and dynamic process regulated at the molecular level by signaling pathways, transcription factors, and posttranscriptional and epigenetic regulation. Mutations or dysregulation of related genes may contribute to genetic diseases with dentin defects caused by impaired odontoblastic differentiation, including tricho-dento-osseous (TDO) syndrome, X-linked hypophosphatemic rickets (XLH), Raine syndrome (RS), hypophosphatasia (HPP), Schimke immuno-osseous dysplasia (SIOD), and Elsahy-Waters syndrome (EWS). Herein, recent progress in the molecular regulation of the odontoblastic differentiation of DMSCs is summarized. In addition, genetic syndromes associated with disorders of odontoblastic differentiation of DMSCs are discussed. An improved understanding of the molecular regulation and related genetic syndromes may help clinicians better understand the etiology and pathogenesis of dentin lesions in systematic diseases and identify novel treatment targets.

Effects of L-Chg10-Teixobactin on Viability, Proliferation, and Osteo/Odontogenic Differentiation of Stem Cells from Apical Papilla

INTRODUCTION

Intracanal medicament is one of the essential steps for ensuring success in regenerative endodontic procedures. _L-Chg₁₀-teixobactin is a novel antimicrobial agent that exhibited potent antibacterial and antibiofilm effects against Enterococcusfaecalis at low concentrations compared with ampicillin. At the same time, its cytotoxicity on dental stem cells has not been studied. This study aimed to investigate the effects of _L-Chg₁₀-teixobactin on the viability, proliferation, migration, and osteo/odontogenic differentiation of stem cells from apical papilla (SCAPs).

MATERIALS AND METHODS

SCAPs isolated from immature human third molars were treated with various concentrations of _L-Chg₁₀-teixobactin, calcium hydroxide, and dimethyl sulfoxide. The viability and proliferation of SCAPs were assessed using the LIVE/DEAD Viability/Cytotoxicity Kit and Cell Counting Kit-8. A scratch wound healing test was used to evaluate the lateral migration capacity of SCAPs. Alkaline phosphatase (ALP) activity, calcium mineralization ability tests -ie, ALP staining and alizarin red S staining, and quantitative real-time polymerase chain reaction were performed to assess the osteo /odontogenic differentiation of SCAPs.

RESULTS

The tested concentrations of _L-Chg₁₀-teixobactin (0.01, 0.02, and 0.03 mg/mL), 1 mg/mL calcium hydroxide, and 0.03% dimethyl sulfoxide had no significant cytotoxic effect on SCAPs at any time point (P > .05). Besides, there were no significant differences between the control and experimental groups in SCAPs' viability, proliferation, and migration. _L-Chg₁₀-teixobactin upregulated the gene expression of osteo/odontogenic markers in SCAPs, while no significant difference was found in the ALP activity and alizarin red S staining.

CONCLUSIONS

_L-Chg₁₀-teixobactin demonstrated excellent biocompatibility on SCAPs at concentrations from 0.01 to 0.03 mg/mL and potentially enhance the osteo/odontogenic differentiation of SCAPs; suggesting its promising role as root canal medicament for regenerative endodontic procedures.

Wnt/β-catenin plays a dual function in calcium hydroxide induced proliferation, migration, osteogenic differentiation and mineralization in vitro human dental pulp stem cells

AIM

Calcium hydroxide is the gold standard material for pulp capping and has been widely used in clinical dentistry. Calcium hydroxide promotes proliferation, migration and osteogenic differentiation of dental pulp stem cells (DPSCs). However, the underlying mechanism is not clear. Our study investigated the role of Wnt/β-catenin pathway in calcium hydroxide-induced proliferation, migration, osteogenic differentiation and mineralization of human DPSCs.

METHODOLOGY

Protein and gene expression was detected by western blot (WB), immunofluorescence staining and quantitative real-time PCR (qPCR). Cell viability was analysed using the Cell Counting Kit-8 (CCK-8) assay. Wound-healing assay was used to analyse cell migration. The expression of alkaline phosphatase (ALP) was detected using ALP staining. Mineralization was analysed by alizarin red staining.

RESULTS

Calcium hydroxide increased the protein expression of phosphorylated-GSK3β/GSK3β, β-catenin and the gene expression of LEF-1. Inhibition of Wnt/β-catenin abolished calcium hydroxide-induced proliferation and migration of DPSCs in 24 h. However, incubation with calcium hydroxide for 7 days and 14 days reduced Wnt/β-catenin signalling. Inhibition of Wnt/β-catenin promoted calcium hydroxide-induced osteogenic differentiation and mineralization in DPSCs.

CONCLUSION

Wnt/β-catenin pathway plays a dual role in calcium hydroxide-regulated DPSC behaviour. Incubation with calcium hydroxide promoted rapid proliferation and migration of DPSCs, while prolonged incubation negatively regulated osteogenic differentiation and mineralization.

Mesenchymal Stem Cell-Derived Extracellular Vesicles: The Novel Therapeutic Option for Regenerative Dentistry

Dental mesenchymal stem cells (MSCs) are characterized by unlimited self-renewal ability and high multidirectional differentiation potential. Since dental MSCs can be easily isolated and exhibit a high capability to differentiate into odontogenic cells, they are considered as attractive therapeutic agents in regenerative dentistry. Recently, MSC-derived extracellular vesicles (MSC-EVs) have attracted widespread attention as carriers for cell-free therapy due to their potential functions. Many studies have shown that MSC-EVs can mediate microenvironment at tissue damage site, and coordinate the regeneration process. Additionally, MSC-EVs can mediate intercellular communication, thus affecting the phenotypes and functions of recipient cells. In this review, we mainly summarized the types of MSCs that could be potentially applied in regenerative dentistry, the possible molecular cargos of MSC-EVs, and the major effects of MSC-EVs on the therapeutic induction of osteogenic differentiation.

Silver Nanoparticles Alone or in Combination with Calcium Hydroxide Modulate the Viability, Attachment, Migration, and Osteogenic Differentiation of Human Mesenchymal Stem Cells

This study aimed to evaluate the effect of silver nanoparticles (AgNPs) alone or in combination with calcium hydroxide (Ca(OH)2) on the proliferation, viability, attachment, migration, and osteogenic differentiation of human mesenchymal stem cells (hMSCs). Different concentrations of AgNPs alone or mixed with Ca(OH)2 were prepared. Cell proliferation was measured using AlamarBlue, and hMSCs attachment to dentin disks was evaluated using scanning electron microscopy. Live-dead imaging was performed to assess apoptosis. Wound healing ability was determined using the scratch-migration assay. To evaluate osteogenic differentiation, the expression of Runt-related transcription factor (RUNX2), Transforming growth factor beta-1 (TGF-β1), Alkaline Phosphatase (ALP), and Osteocalcin (OCN) were measured using real-time reverse transcriptase polymerase chain reaction. ALP staining and activity were also performed as indicators of osteogenic differentiation. AgNPs alone seemed to favor cell attachment. Lower concentrations of AgNPs enhanced cell proliferation. AgNP groups showed markedly less apoptosis. None of the medicaments had adverse effects on wound closure. The expression of TGF-β1 was significantly upregulated in all groups, and OCN was highly expressed in the AgNP groups. AgNPs 0.06% showed the most enhanced ALP gene expression levels, activity, and marked cytochemical staining. In conclusion, AgNPs positively affect hMSCs, making them a potential biomaterial for various clinical applications.

Evaluation of the characteristics of root canal calcification after regenerative endodontic procedures: A retrospective cohort study over 3 years

AIM

This study aimed to evaluate the characteristics of root canal calcification after regenerative endodontic procedures (REPs) during long-term follow-up.

DESIGN

Data of children who underwent REPs and were followed up for >3 years in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China, from January 2013 to January 2019, were collected. All the patients were treated by the protocol of REPs based on the American Association of Endodontists (AAE) protocol. A total of 91 teeth of 54 boys and 37 girls (average age 10.4 ± 1.9 years) with follow-up duration >3 years were included. The follow-up duration ranged from 36 to 92 months (average, 53.2 ± 13.4 months). The prevalence, contributing factors, and long-term prognoses of root canal calcification after REPs are discussed. Independent t-test and χ² test were used for statistical analysis.

RESULTS

The incidence of root canal calcification was 78% (71/91). The use of calcium hydroxide paste was significantly correlated with the occurrence of root canal calcification (p < .05). Some teeth showed aggravation of calcification with time; however, not all teeth showed calcification after longer follow-up duration.

CONCLUSIONS

Teeth treated with REPs had a relatively high probability of root canal calcification detection during the long-term follow-up. The occurrence of calcification is related to the use of calcium hydroxide paste but does not affect the long-term prognosis of teeth.

Biocompatible Properties and Mineralization Potential of Premixed Calcium Silicate-Based Cements and Fast-Set Calcium Silicate-Based Cements on Human Bone Marrow-Derived Mesenchymal Stem Cells

Premixed calcium silicate-based cements (CSCs) and fast-set CSCs were developed for the convenience of retrograde filling during endodontic microsurgery. The aim of this study was to analyze the biocompatible properties and mineralization potential of premixed CSCs, such as Endocem MTA Premixed (EM Premixed) and EndoSequence BC RRM putty (EndoSequence), and fast-set RetroMTA on human bone marrow-derived mesenchymal stem cells (BMSCs) compared to ProRoot MTA. Using CCK-8, a significantly higher proliferation of BMSCs occurred only in the EM Premixed group on days 2 and 4 (p < 0.05). On day 6, the ProRoot MTA group had significantly higher cell proliferation than the control group (p < 0.05). Regardless of the experimental materials, all groups had complete cell migration by day 4. Alizarin Red-S staining and alkaline phosphatase assay demonstrated higher mineralization potential of all CSCs similar to ProRoot MTA (p < 0.05). The EndoSequence group showed more upregulation of SMAD1 and OSX gene expression than the other experimental groups (p < 0.05), and all experimental cements upregulated osteogenic gene expression more than the control group (p < 0.05). Therefore, using premixed CSCs and fast-set CSCs as retrograde filling cements may facilitate satisfactory biological responses and comparable osteogenic potential to ProRoot MTA.

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: 3-Dimensional Analysis Using Cone-Beam Computed Tomography on the Outcomes of Non-Surgical Endodontic Treatment Using A-PRF+ and Calcium Hydroxide: A Retrospective Cohort Study

The study presents results of periapical lesion healing after one-visit root canal treatment (RCT) with Advanced Platelet Rich Fibrin plus (A-PRF+) application compared to a two-visit RCT with an inter-appointment calcium hydroxide filling. The comparison was made based on CBCT-Periapical Index (PAI) lesion volume changes and the occurrence of post endodontic pain. The results of 3D radiographic healing assessments based on volume reduction criteria were different from the CBCT-PAI. Based on volume changes, the healing assessment criteria-9 cases from the Study Group and six cases in the Control Group were defined as healed. Based on the CBCT-PAI healing assessment criteria, 8 cases from the Study Group and 9 cases from the Control Group were categorized as healed. The volumes of apical radiolucency were, on average, reduced by 85.93% in the Study Group and by 72.31% in the Control Group. Post-endodontic pain occurred more frequently in the Control than in the Study Group. The highest score of pain in the Study Group was five (moderate pain, n = 1), while in the Control Group, the highest score was eight (severe pain, n = 2). In the 6-month follow-up, CBCT scans showed a better healing tendency for patients in the Study Group.

Nanoarchitectonics of Fullerene Based Enzyme Mimics for Osteogenic Induction of Stem Cells

Enzyme mimicry is a topic of considerable interest in the development of multifunctional biomimetic materials. Mimicking enzyme activity is a major challenge in biomaterials research, and artificial analogs that simultaneously recapitulate the catalytic and metabolic activity of native enzymes are considered to be the ultimate goal of this field. This consensus may be challenged by self-assembling multifunctional nanostructures to develop close-to-fidelity enzyme mimics. Here, we present the ability of fullerene nanostructures decorated with active units to form enzyme-like materials that can mimic phosphatases in a metal-free manner. These nanostructures self-assemble into nanoclusters forming multiple random active sites that can cleave both phosphomonoesters and phosphodiesters while being more specific for the phosphomonoesters. Moreover, they are reusable and show an increase in catalytic activity over multiple cycles similar to their natural counterparts. In addition to having enzyme-like catalytic properties, these nanocatalysts imitate the biological functions of their natural analogs by inducing biomineralization and osteoinduction in preosteoblast and mesenchymal stem cells in vitro studies. This article is protected by copyright. All rights reserved.

Effect of Different Intracanal Medicaments on the Viability and Survival of Dental Pulp Stem Cells

Background: Stem cells play an important role in the success of regenerative endodontic procedures. They are affected by the presence of medicaments that are used before the induction of bleeding or the creation of a scaffold for endodontic regeneration. This study examines the effects of different intracanal medicaments on the viability and survival of dental pulp stem cells at different doses and over different exposure times. Methods: Dental pulp stem cells were cultured from healthy third molar teeth using the long-term explant culture method and characterized using flow cytometry and exposed to different concentrations of calcium hydroxide, doxycycline, potassium iodide, triamcinolone, and glutaraldehyde, each ranging from 0 (control) to 1000 µg/mL. Exposure times were 6, 24, and 48 h. Cell viability was measured using the MTT assay, and apoptosis was measured using the Annexin V-binding assay. Results: All medicaments significantly reduced cell viability at different concentrations over different exposure times. Calcium hydroxide and triamcinolone favored cell viability at higher concentrations during all exposure times compared to other medicaments. The apoptosis assay showed a significant increase in cell death on exposure to doxycycline, potassium iodide, and glutaraldehyde. Conclusion: The intracanal medicaments examined in our study affected the viability of dental pulp stem cells in a time and dose-dependent manner. They also adversely affected the survival of dental pulp stem cells. Further studies are needed to better understand the effect of prolonged exposure to medicaments according to clinical protocols and their effect on the stemness of dental pulp stem cells.

Anti-Inflammatory and Repairing Effects of Mesoporous Silica-Loaded Metronidazole Composite Hydrogel on Human Dental Pulp Cells

In order to test an effective biopolymer scaffold in promoting the growth of human dental pulp stem cells (HDPSCs), mesoporous silica @ hydrogel (MSN@Gel) nanocomposites are invented as a new type of biopolymer scaffold for HDPSCs proliferation in this paper. The expression levels of alkaline phosphatase (ALP), dentin matrix protein 1 (DMP1), and dentin sialophosphoprotein (DSPP) are significantly increased in the MSN@Gel group so as to better repair damaged dentin. In order to inhibit the proliferation of bacteria in the dental pulp, metronidazole (MTR) is loaded into MSN. The study found that MSN could effectively prolong the half-life of MTR by 1.75 times, and the viability of HDPSCs could be better maintained in the MSN-MTR@Gel group so as to better promote its proliferation to repair pulpitis. However, with the increase of the MTR concentration, its proliferation effect on HDPSCs decreased gradually, and the proliferation effect is the best in 10 μmol/L. Therefore, the MSN-MTR@Gel scaffold is expected to become an effective method for pulpitis therapy in the future.

MiR-151b inhibits osteoblast differentiation via downregulating Msx2

PURPOSE

MicroRNA-151b (miR-151b) showed altered expression in ovariectomized rat model of osteoporosis. This study established an ovariectomy-induced osteoporotic rat model to investigate the role of miR-151b in osteoblasts.

METHODS

Eighteen female Sprague-Dawley (SD) rats were divided randomly into Sham and OVX group (n = 9). The transfections with different miRNAs and expression vectors were confirmed by RT-qPCR. The protein expression of Msx2 was detected by Western blots. The interaction between miR-151b and Msx2D was evaluated by RNA pull-down and dual luciferase reporter assay.

RESULTS

The expression of miR-151b was significantly increased in femoral tissues of ovariectomy-induced osteoporotic rats. The expression of osteogenesis marker genes including RUNX2, ALP, OCN, OSX, and Msx2 were all significantly increased in osteogenic medium (OM) incubated primary osteoblasts and MC3T3-E1 cells. The interaction between miR-151b and Msx2 was confirmed by luciferase reporter assay and RNA pull-down. Moreover, overexpression of miR-151b significantly inhibited Msx2 in both MC3T3-E1 cells and primary osteoblasts, while miR-151b inhibitor had the opposite effect on the expression of Msx2. In addition, in primary osteoblasts and MC3T3-E1 cells, miR-151b overexpression, or Msx2 silence significantly decreased the expression of OSX, ALP, RUNX2, and OCN.

CONCLUSION

MiR-151b could inhibit osteoblast proliferation, differentiation, and mineralization via downregulating Msx2 in both MC3T3-E1 cells and primary osteoblasts. MiR-151b might serve as a novel therapeutic target for osteoporosis.

ABBREVIATIONS

miR-151b: microRNA-151b; miRNAs: microRNAs; Msx2: Msh homeobox 2; MAPK: mitogen-activated protein kinase; STAT: signal transducer and activator of transcription; SD: Sprague-Dawley; BMD: bone mineral density; qRT-PCR: quantitative reverse transcription PCR; MTT: methyl thiazolyl tetrazolium; OVX: ovariectomy; ALP: alkaline phosphatase.

Chemical Compounds Released from Specific Osteoinductive Bioactive Materials Stimulate Human Bone Marrow Mesenchymal Stem Cell Migration

In this work, a poly(L-lactide-co-glycolide) (PLGA)-based composite was enriched with one of the following sol-gel bioactive glasses (SBG) at 50 wt.%: A1—40 mol% SiO2, 60 mol% CaO, CaO/SiO2 ratio of 1.50; S1—80 mol% SiO2, 20 mol% CaO, CaO/SiO2 ratio of 0.25; A2—40 mol% SiO2, 54 mol% CaO, 6 mol% P2O5, CaO/SiO2 ratio of 1.35; S2—80 mol% SiO2,16 mol% CaO, 4 mol% P2O5, CaO/SiO2 ratio of 0.20. The composites and PLGA control sheets were then soaked for 24 h in culture media, and the obtained condition media (CM) were used to treat human bone marrow stromal cells (hBMSCs) for 72 h. All CMs from the composites increased ERK 1/2 activity vs. the control PLGA CM. However, expressions of cell migration-related c-Fos, osteopontin, matrix metalloproteinase-2, C-X-C chemokine receptor type 4, vascular endothelial growth factor, and bone morphogenetic protein 2 were significantly increased only in cells treated with the CM from the A1/PLGA composite. This CM also significantly increased the rate of human BMSC migration but did not affect cell metabolic activity. These results indicate important biological markers that are upregulated by products released from the bioactive composites of a specific chemical composition, which may eventually prompt osteoprogenitor cells to colonize the bioactive material and accelerate the process of tissue regeneration.

Comparison of Biocompatibility of Calcium Silicate-Based Sealers and Epoxy Resin-Based Sealer on Human Periodontal Ligament Stem Cells

The aim of this study was to evaluate the biocompatibility of calcium silicate-based sealers (CeraSeal and EndoSeal TCS) and epoxy resin-based sealer (AH-Plus) in terms of cell viability, inflammatory response, expression of mesenchymal phenotype, osteogenic potential, cell attachment, and morphology, of human periodontal ligament stem cells (hPDLSCs). hPDLSCs were acquired from the premolars (n = 4) of four subjects, whose ages extended from 16 to 24 years of age. Flow cytometry analysis showed stemness of hPDLSCs was maintained in all materials. In cell viability test, AH-Plus showed the lowest cell viability, and CeraSeal showed significantly higher cell viability than others. In ELISA test, AH-Plus showed higher expression of IL-6 and IL-8 than calcium silicate-based sealers. In an osteogenic potential test, AH-Plus showed a lower expression level than other material; however, EndoSeal TCS showed a better expression level than others. All experiments were repeated at least three times per cell line. Scanning electronic microscopy studies showed low degree of cell proliferation on AH-Plus, and high degree of cell proliferation on calcium silicate-based sealers. In this study, calcium silicate-based sealers appear to be more biocompatible and less cytotoxic than epoxy-resin based sealers.

The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update

Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures.

Effects of radiopaque double antibiotic pastes on the proliferation, alkaline phosphatase activity and mineral deposition of dental pulp stem cells

OBJECTIVE

The aim of this study was to investigate the effects of two radiopaque agents, barium sulfate (BaSO₄) or zirconium oxide (ZrO₂) in double antibiotic paste (DAP), on the proliferation and mineral deposition of human dental pulp stem cells (DPSC).

MATERIALS AND METHODS

Radiopaque antimicrobial medicaments composed of methylcellulose (MC) thickening polymer with BaSO₄ or ZrO₂ and either 1 or 5 mg/mL DAP (equal portions of metronidazole and ciprofloxacin) were used to investigate DPSC proliferation after 3 days, and alkaline phosphatase (ALP) activity and mineral deposition after 7 and 14 days. Radiopaque agents without DAP and Ca(OH)₂ were used as controls.

RESULTS

MC-BaSO₄ DAP and MC-ZrO₂ DAP at 1 or 5 mg/mL had no adverse effect on DPSC proliferation, compared to the media and MC controls. MC-ZrO₂ (DAP-free) greatly increased ALP activity after 7 days. DPSC mineral deposition was modestly reduced at 7 days by MC-BaSO₄ DAP and MC-ZrO₂ DAP, but not by DAP-free radiopaque agents, and was most reduced by 5 mg/mL DAP in the 14-day cultures.

CONCLUSIONS

MC-BaSO₄ or MC-ZrO₂ medicaments containing up to 5 mg/mL of DAP supported the proliferation and early osteogenic differentiation of DPSC. Low DAP concentrations and short culture times led to more favorable effects on ALP activity and mineral deposition by DPSC. The findings suggest that radiopaque agents added for the purpose of detecting whether medicaments occupy the full extent of the root canal may have clinical applications. Radiopaque antibiotic medicaments containing low DAP concentrations may be an alternative to Ca(OH)₂ for regenerative endodontic procedures.

The efficacy of a traditional medicine preparation on second-degree burn wounds in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Lime Salve (L.S) has been well documented from the 9th to the 19th century AD by traditional Iranian medicine (TIM) as an effective remedy for burn healing.

AIM OF THE STUDY

The present study was undertaken to evaluate the healing effect and related underlying mechanisms of Lime Salve in a model of deep second-degree thermal burn in male Wistar rats.

MATERIALS AND METHOD

L.S was made up of a combination of refined calcium hydroxide powder, beeswax and sesame oil and its quality control was assessed. A deep second-degree burn was created by a hot plate in 48 male Wistar rats. Afterwards, they were randomly divided into four groups including normal saline (C group), L.S (T group), basement of formulation composed of beeswax and sesame oil (B group) and silver sulfadiazine (S group). On days 5, 10, 17 and 24, the wounds were digitally photographed by a camera and after sacrifice of the rats, skin samples were obtained for performing qRT-PCR, immunohistochemistry staining and histological examination.

RESULTS

L.S prominently augmented the wound closure rate, neovascularization on day 10 and collagen formation on days 17 and 24 in comparison with the C group. Furthermore, the Salve-exposed specimens showed a significant higher epithelialization during the experiment with a peak on day 24. qRT-PCR also showed that on day 10, VEGF and TGF-β1 genes were significantly higher in the T group as compared with the C group. Also, MMP-9 and MMP-2 genes had a significant peak of expression on day 17 and rapid reduction of expression on day 24. Expression levels of IL-6 and TNF-α genes peaked on day 10 in the T group, followed by a progressive reduction until the end of the examination.

CONCLUSION

L.S could effectively accelerate the healing process of deep second-degree burn wounds and therefore, it may be recommended as a promising topical medication for treating burn wounds in the future clinical trials.

In Vitro Effect of Putty Calcium Silicate Materials on Human Periodontal Ligament Stem Cells

New bioactive materials have been developed for retrograde root filling. These materials come into contact with vital tissues and facilitate biomineralization and apical repair. The objective of this study was to evaluate the cytocompatibility and bioactivity of two bioactive cements, Bio-C Repair (Angelus, Londrina, Pr, Brazil) and TotalFill BC RRM putty (FGK, Dentaire SA, La-Chaux-de-fonds, Switzerland). The biological properties in human periodontal ligament stem cells (hPDLSCs) that were exposed to Bio-C Repair and TotalFill BC RRM putty were studied. Cell viability, migration, and cell adhesion were analyzed. Moreover, qPCR and mineralization assay were performed to evaluate the bioactivity potential of these cements. The results were statistically analyzed using ANOVA and the Tukey test (p < 0.05). It was observed that cell viability and cell migration in Bio-C Repair and TotalFill BC RRM putty were similar to the control without statistically significant differences, except at 72 h when TotalFill BC RRM putty was slightly lower (p < 0.05). Excellent cell adhesion and morphology were observed with both Bio-C Repair and TotalFill BC RRM putty. Both cements promoted the osteo- and cementogenic differentiation of hPDLSCs. These results suggest that Bio-C Repair and TotalFill BC RRM putty are biologically appropriate materials to be used as retrograde obturation material.

Conductive nanostructured Si biomaterials enhance osteogeneration through electrical stimulation

It is well known that the differentiation of stem cells is affected by the cell culture medium, the scaffold surface and electrochemical signals. However, stimulation of patterned biomaterials seeded with stem cell cultures has not been explored. Herein the effect of electrical stimulation on osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (rBMSCs) cultured on solid and nanoporous micropyramid patterned Si surfaces was evaluated. It was found that both stimulation and scaffold patterning significantly enhanced osteo-differentiation. The stimulated nanoporous micropyramid scaffolds were more promising compared to the stimulated solid micropyramid surfaces, as they significantly promoted the osteogenic differentiation of rBMSCs via BMP/Smad signaling pathway. Particularly, as compared to the unstimulated patterned biomaterials, the stimulated patterned scaffolds allowed for a significant increase in core binding factor alpha l, alkaline phosphatase, the alpha l chain of type I Col, osteocalcin, and osteonectin, all of which are characteristic for osteo-differentiation. The proposed combination of electrical stimulation with scaffold patterning may provide novel promising strategies for bone tissue engineering and regenerative medicine.

Berberine Accelerates Odontoblast Differentiation by Wnt/β-Catenin Activation

Berberine, a Chinese medical herbal extract, plays a key role in antidiabetic, antiangiogenesis, anti-inflammatory, antimicrobial, anticancer, and antihypercholesterolemic. Our previous studies revealed that berberine exerted odontoprotective effect by increasing odontoblast differentiation. However, the mechanisms involved in the odontoprotective effect of berberine have not been fully explored. The Wnt/β-catenin pathway is involved in odontoblast differentiation of dental pulp stem cells (DPSCs). If β-catenin is nuclear translocation, the Wnt/β-catenin pathway is activation. In this study, DPSCs were treated with or without berberine. Then, we examined the accelerative effects of berberine on odontoblast differentiation and mineralized nodules formation by real-time polymerase chain reaction, alizarin red S staining, and alkaline phosphatase staining. In addition, while treated with berberine, β-catenin translocated to the nucleus evaluated by western blot and immunofluorescent staining. Our results revealed that berberine functions as a promoter of odontoblast differentiation by promoting Wnt/β-catenin pathway, suggesting that it may be useful in guiding therapeutic strategies for the treatment of dental caries.

Effect of tissue inhibitor of metalloprotease 1 on human pulp cells in vitro and rat pulp tissue in vivo

AIM

To evaluate the dentinogenetic effects of tissue inhibitor of metalloprotease (TIMP1) on human pulp cells in vitro and rat pulp tissue in vivo.

METHODOLOGY

The effect of TIMP1 on pulp cell functions related to hard tissue formation as part of the wound healing process (i.e. biocompatibility, proliferation, differentiation and mineralized nodule formation) was evaluated in vitro and using a direct pulp capping experimental animal model in vivo. The effects of different-sized cavity preparations on hard tissue formation induced by ProRoot MTA at 2 weeks were evaluated using micro-computed tomography (micro-CT). Tertiary dentine formation quality and quantity after pulp capping using TIMP1, ProRoot MTA and phosphate-buffered saline (PBS) was also evaluated after 4 weeks using micro-CT in term of dentine volume (DV), dentine mineral density (DVD) and histological analysis. The data were evaluated by Student's t-test, one-way ANOVA with Tukey's post hoc test, the Kruskal-Wallis test or the Steel-Dwass test. P values < 0.05 were considered statistically significant.

RESULTS

TIMP1 significantly stimulated dental pulp stem cell proliferation, differentiation, and mineralization and was more biocompatible compared with the PBS control (P < 0.05). In the pulp capping model, the amount of tertiary dentine that formed was directly proportional to the size of the pulp exposure; greater amounts of tertiary dentine were observed in pulps with larger exposures after 2 weeks. 4-week samples of TIMP1 and ProRoot MTA had similar characteristics, but both sample significantly induced tertiary dentine formation beneath the cavity compared with PBS (P <  0.05) under standardized cavity preparations.

CONCLUSIONS

TIMP1 has an important role in pulpal wound healing, which makes it a potential biological pulp capping material and candidate molecule for regenerative endodontic therapy.

microRNA-203 promotes proliferation, differentiation, and migration of osteoblasts by upregulation of Msh homeobox 2

Despite the improvements in fracture healing, about 10% of patients undergo abnormal healing. As a tumor suppressor, upregulation of microRNA (miR)-203 has been observed in osteogenic differentiation. Herein, we aimed to explore the functional role of miR-203 in osteoblasts as well as the underlying mechanisms. The expression of miR-203 in MC3T3-E1 cells that underwent osteogenic differentiation was determined by quantitative reverse transcription PCR (qRT-PCR). The effects of aberrantly expressed miR-203 on cell viability, migration, and expressions of proteins associated with proliferation, migration, and osteogenic differentiation were measured by using a Cell Counting Kit-8 assay, Transwell cell migration assay, and western blot/qRT-PCR, respectively. The possible downstream factor of miR-203 was subsequently studied. Finally, involvements of the mitogen-activated protein kinase (MAPK)/activator of transcription (STAT) pathways were assessed by western blot. We found that the miR-203 level was increased in osteogenic differentiation of MC3T3-E1 cells with increasing duration time (28th day, p < 0.001). After cell transfection, we interestingly found that miR-203 overexpression could increase cell viability (p < 0.05), promote proliferation, migration (p < 0.05), and osteogenic differentiation, and upregulate Msh homeobox 2 (Msx2) expression. Furthermore, Msx2 knockdown was proved to abrogate the effects of miR-203 overexpression on MC3T3-E1 cells. Finally, phosphorylated levels of key kinases in the MAPK/STAT pathways were increased by miR-203 overexpression via upregulating Msx2 expression. In conclusion, miR-203 overexpression promoted proliferation, migration, and osteogenic differentiation of MC3T3-E1 cells through upregulating Msx2 along with activation of the MAPK/STAT pathways.

Elucidation on Predominant Pathways Involved in the Differentiation and Mineralization of Odontoblast-Like Cells by Selective Blockade of Mitogen-Activated Protein Kinases

Aim

To analyze the effect of three mitogen-activated protein kinase (MAPK) inhibitors, namely, SB202190 (p38 inhibitor), SP600125 (JNK inhibitor), and PD98059 (ERK inhibitor) in Dex-stimulated MDPC-23 cell differentiation and mineralization.

Methods

Experiment was divided into five groups, control (cells without Dex and inhibitors treatment), Dex (cells with Dex treatment but without inhibitors), Dex + SB202190, Dex + SP600125, and Dex + PD98059. Cell differentiation was assessed by alkaline phosphatase (ALP) activity assay and real time RT-PCR. Cell mineralization was investigated by alizarin red staining.

Results

Exposure to SB202190 (20 μM) significantly decreased the mineral deposition in Dex-treated cells as demonstrated by alizarin red staining. Treatment of SP600125 (20 μM) attenuated the mineralization as well, albeit at a lower degree as compared to SB202190 (20 μM). Similarly, SB202190 (20 μM) completely abrogated the ALP activity stimulated by Dex at six days in culture, while no changes were observed with regard to ALP activity in SP600125 (20 μM) and PD98059 (20 μM) treated cells. The upregulation of bone sialoprotein (BSP), ALP, and osteopontin (OPN) in Dex challenged cells was completely inhibited by SB202190.

Conclusion

Blockade of p38-MAPK signaling pathway resulted in significant inhibition of ALP activity, mineralization, and downregulation of osteogenic markers. The data implicated that p38 signaling pathway plays a critical role in the regulation of MDPC-23 cells differentiation and mineralization.

Bioengineered Osteoinductive Broussonetia kazinoki/Silk Fibroin Composite Scaffolds for Bone Tissue Regeneration

In this article, Broussonetia kazinoki (BK) powdery extract is utilized to modify the silk fibroin (SF) scaffold and applied to the bone defect area. The BK/SF scaffold is an efficient cell carrier which promotes cell proliferation and osteogenic differentiation of rBMSCs (bone marrow derived mesenchymal stem cells). We confirmed biocompatibility and osteogenic differentiation capacity of BK/SF scaffolds compared to pristine SF scaffold in both in vitro and in vivo evaluation. Gene expression related to osteogenic differentiation and bone regeneration significantly upregulated in the BK/SF scaffold group. The implanted scaffolds were attached well to the surface of the bone defect region and integrated with surrounding tissues without significant inflammatory reaction. Furthermore, almost 45% of bone volume has been recovered at 8 weeks postsurgery, while the SF and control group showed 20% recovery. These results suggest that BK powdery extract incorporated with an SF scaffold might be a suitable substitute for an alternative bone graft for bone regeneration.