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Leveque M, Guittat M, Thivichon-Prince B, Reuzeau A, Eveillard M, Faure M, Farges JC, Richert R, Bekhouche M, Ducret M. Next generation antibacterial strategies for regenerative endodontic procedures: A scoping review. Int Endod J 2024; 57:804-814. [PMID: 37485747 DOI: 10.1111/iej.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The clinical results following regenerative endodontic procedures (REPs) vary according to numerous parameters, including the presence of bacteria. This limitation reduces the indications for REPs and calls for the development of next generation antibacterial strategies (NGAS) providing alternatives to current antibacterial strategies (CAS) such as double or triple antibiotic paste (DAP/TAP) and (Ca(OH)2). OBJECTIVES The present scoping review aims to describe the current trends regarding the use of such strategies and highlight future perspectives. METHODS Four databases (PUBMed, Cochrane, ClinicalTrials and Science Direct) were searched until 1st May 2023. RESULTS A total of 918 records were identified, 133 were screened and assessed for eligibility, and 87 articles were included. The findings show that (1) clinical studies are only available for CAS, (2) although next generation strategies are the most studied approach since 2017, they are all at the pre-clinical stage, (3) most of the next generation strategies use galenic forms which offer cell support and colonization and which simultaneously contain antibacterial molecules as alternatives to CAS and to antibiotics in general, (4) standardization is required for future research, specifically regarding the bacterial strains studied, the use of biofilm studies and the cellular behaviour assessments. CONCLUSION Although NGAS are promising strategies to improve REPs in the context of infection, the current evidence is mostly limited to pre-clinical studies. Further methodological improvement is required to allow relevant comparisons between studies and to reduce the time from bench to bedside.
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Affiliation(s)
- Marianne Leveque
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Guittat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Thivichon-Prince
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Alicia Reuzeau
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Matthieu Eveillard
- Département de Biologie des Agents Infectieux, CHU Angers, Angers, France
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, INCIT, Angers, France
| | - Marjorie Faure
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Farges
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Raphaël Richert
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Mécanique Des Contacts et Structures, CNRS/INSA, Villeurbanne, France
| | - Mourad Bekhouche
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
| | - Maxime Ducret
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/Université Claude Bernard Lyon 1, Lyon, France
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
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2
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Huang L, Chen X, Yang X, Zhang Y, Qiu X. GelMA-based hydrogel biomaterial scaffold: A versatile platform for regenerative endodontics. J Biomed Mater Res B Appl Biomater 2024; 112:e35412. [PMID: 38701383 DOI: 10.1002/jbm.b.35412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 02/26/2024] [Accepted: 04/13/2024] [Indexed: 05/05/2024]
Abstract
Endodontic therapy, while generally successful, is primarily limited to mature teeth, hence the pressing need to explore regenerative approaches. Gelatin methacryloyl (GelMA) hydrogels have emerged as pivotal biomaterials, promising a bright future for dental pulp regeneration. Despite advancements in tissue engineering and biomaterials, achieving true pulp tissue regeneration remains a formidable task. GelMA stands out for its injectability, rapid gelation, and excellent biocompatibility, serving as the cornerstone of scaffold materials. In the pursuit of dental pulp regeneration, GelMA holds significant potential, facilitating the delivery of stem cells, growth factors, and other vital substances crucial for tissue repair. Presently, in the field of dental pulp regeneration, researchers have been diligently utilizing GelMA hydrogels as engineering scaffolds to transport various effective substances to promote pulp regeneration. However, existing research is relatively scattered and lacks comprehensive reviews and summaries. Therefore, the primary objective of this article is to elucidate the application of GelMA hydrogels as regenerative scaffolds in this field, thereby providing clear direction for future researchers. Additionally, this article provides a comprehensive discussion on the synthesis, characterization, and application of GelMA hydrogels in root canal therapy regeneration. Furthermore, it offers new application strategies and profound insights into future challenges, such as optimizing GelMA formulations to mimic the complex microenvironment of pulp tissue and enhancing its integration with host tissues.
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Affiliation(s)
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - XiaoXia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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Nasr El-Din S, Hassan R. The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris. BDJ Open 2024; 10:2. [PMID: 38182568 PMCID: PMC10770069 DOI: 10.1038/s41405-023-00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study evaluated the effect of the XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation using side-vented needle (SVN) on the amount of apically extruded debris and canal cleanliness following the removal of double antibiotic paste (DAP) from immature root canal models. MATERIAL AND METHODS Forty-eight extracted mandibular premolars were drilled using peeso drills to simulate immature apices. The canals were filled with DAP and were randomly assigned into 3 groups according to the DAP removal method: XPF, PUI, and SVN (n = 16). The amount of extruded debris was assessed with an analytical balance then roots were split longitudinally and imaged using stereomicroscope to evaluate the residual medicament. Data were statistically analyzed using Kruskal-Wallis and Dunn's test. Spearman's correlation coefficient was used to determine significant correlation between extruded debris and the residual DAP scores. RESULTS There was no significant difference between debris extrusion values for all groups (P value 0.237). For canal cleanliness, the amount of remaining DAP was significantly lower in the XPF and PUI compared to SVN (P value < 0.001). A non-significant positive (direct) correlation was found between the amounts of apically extruded debris and residual DAP scores (P value 0.087). CONCLUSION XPF and PUI were associated with better canal cleanliness during removal of DAP, no difference could be found between the three irrigation techniques regarding the debris extrusion.
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Affiliation(s)
| | - Reham Hassan
- Faculty of Dentistry, The Egyptian Russian University, Badr city, Egypt.
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Leveque M, Bekhouche M, Farges JC, Aussel A, Sy K, Richert R, Ducret M. Bioactive Endodontic Hydrogels: From Parameters to Personalized Medicine. Int J Mol Sci 2023; 24:14056. [PMID: 37762359 PMCID: PMC10531297 DOI: 10.3390/ijms241814056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Regenerative endodontic procedures (REPs) aim at recreating dental pulp tissue using biomaterials such as hydrogels. Their bioactivity is mostly related to the nature of biomolecules or chemical compounds that compose the endodontic hydrogel. However, many other parameters, such as hydrogel concentration, bioactive molecules solubility, and apex size, were reported to influence the reciprocal host-biomaterial relationship and hydrogel behavior. The lack of knowledge regarding these various parameters, which should be considered, leads to the inability to predict the clinical outcome and suggests that the biological activity of endodontic hydrogel is impossible to anticipate and could hinder the bench-to-bedside transition. We describe, in this review, that most of these parameters could be identified, described, and studied. A second part of the review lists some challenges and perspectives, including development of future mathematical models that are able to explain, and eventually predict, the bioactivity of endodontic hydrogel used in a clinical setting.
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Affiliation(s)
- Marianne Leveque
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
| | - Mourad Bekhouche
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
| | - Jean-Christophe Farges
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Audrey Aussel
- BIOTIS—Laboratory for the Bioengineering of Tissues (UMR Inserm 1026), University of Bordeaux, Inserm, 33076 Bordeaux, France;
- UFR d’Odontologie, Université de Bordeaux, 33600 Bordeaux, France
- CHU de Bordeaux, Pôle de Médecine et Chirurgie Bucco-Dentaire, 33076 Bordeaux, France
| | - Kadiatou Sy
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, 69622 Villeurbanne, France
| | - Raphaël Richert
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | - Maxime Ducret
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305 CNRS/UCBL, 69007 Lyon, France; (M.L.); (M.B.); (J.-C.F.)
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69008 Lyon, France; (K.S.); (R.R.)
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
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AlShehri AM, Kamocki K, Viana ÍEL, Scaramucci T, Hara A, Windsor LJ, Platt JA, Cook NB, Sochacki SF. Effect of a modified adhesive system with encapsulated arginine and calcium carbonate on dentin permeability. J Biomed Mater Res B Appl Biomater 2023. [PMID: 36971053 DOI: 10.1002/jbm.b.35253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
To modify an adhesive system with halloysite clay nanotubes (HNTs) containing arginine and calcium carbonate and to evaluate their cytocompatibility, viscosity and efficacy in reducing dentin permeability. HNTs containing arginine and calcium carbonate were incorporated into the primer and adhesive of a three-step adhesive system (SBMP), and their viscosity was measured. Discs (n = 4/group) were prepared: SBMP (control), HNT-PR (modified primer), HNT-ADH (modified adhesive) and HNT-PR + ADH (modified primer and adhesive) were evaluated regarding cell death and viability. Dentin discs were prepared and randomly assigned into the following treatments (n = 10): NC (no treatment), SBMP, HNT-PR, HNT-ADH, HNT-PR + ADH and COL (Colgate® Sensitive Pro-relief™ prophylaxis paste). After, they were submitted to an erosive-abrasive cycling. Dentin permeability (hydraulic conductance) was evaluated at baseline, 24 h after treatment and after cycling. Both the modified primer and adhesive showed significantly higher viscosity than their controls. Group HNT-PR resulted in significantly higher cytotoxicity when compared to SBMP and HNT-PR + ADH groups. Group HNT-ADH resulted in the highest cell viability compared to all other groups. All groups showed significantly lower dentin permeability when compared to the NC group. Post-cycling, SBMP and HNT-ADH groups showed significantly lower permeability when compared to COL group. The addition of encapsulated arginine and calcium carbonate did not affect the cytocompatibility of the materials nor their ability to reduce dentin permeability.
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Affiliation(s)
- Aram Mushabbab AlShehri
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Krzysztof Kamocki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | | | - Taís Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, SP, Brazil
| | - Anderson Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | - L Jack Windsor
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | - Jeffrey A Platt
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | - Norman Blaine Cook
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | - Sabrina Feitosa Sochacki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
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Huang F, Cheng L, Li J, Ren B. Nanofibrous scaffolds for regenerative endodontics treatment. Front Bioeng Biotechnol 2022; 10:1078453. [PMID: 36578510 PMCID: PMC9790898 DOI: 10.3389/fbioe.2022.1078453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Untreated dental caries, tooth trauma and dental anatomical variations such as dens invaginatus can result in pulpitis. However, standard root canal therapy cannot treat immature permanent teeth due to an open apical foramen and thin dentinal walls. Thus, regenerative endodontics treatment (RET) following a disinfection step with pulp regeneration has been developed. Pulp connective-tissue, dentin formation, revascularization and reinnervation can occur in this procedure which should be supplemented with intelligent biomaterials to improve repeatability and support well-coordinated regeneration. Furthermore, nanofibrous scaffolds, as one of the most commonly used materials, show promise. The purpose of this article is to highlight the advantages of nanofibrous scaffolds and discuss the future modification and application of them.
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Affiliation(s)
- Fangting Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, Sichuan, China,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, Sichuan, China,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, Sichuan, China,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Jiyao Li, ; Biao Ren,
| | - Biao Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Jiyao Li, ; Biao Ren,
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7
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Muacevic A, Adler JR, Balaraman Ravindrran M, Alagarsamy V, Palanisamy GS. Functionalized Nanoparticles: A Paradigm Shift in Regenerative Endodontic Procedures. Cureus 2022; 14:e32678. [PMID: 36660521 PMCID: PMC9846381 DOI: 10.7759/cureus.32678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Clinical treatment of inflamed tooth pulp mostly involves the removal of the entire pulp tissue. Because the vitality of the tooth is important for its ability to function, optimal regenerative biomaterials must be developed to maintain the vitality. Despite vast advances in the field of endodontics, the clinical translation of regenerative endodontic procedures and materials remains challenging. Patient-specific, tissue-derived stem cells play a major role in regeneration and revascularization, and these stem cells require an infection-free environment for a successful outcome. However, the high doses of antibiotics currently used to maintain an infection-free environment for tissue regeneration can be toxic for the stem cells. The introduction of nanotechnology in the field of regenerative procedures has overcome these issues and demonstrated promising results. Nanoparticles can be used to deliver antibiotics at very low doses owing to their small size, thereby enhancing antimicrobial activity and reducing the cytotoxic effect. Additionally, nanofibrous scaffolds provide an environment that is favorable for stem-cell migration and proliferation, thereby favoring the regeneration of the pulp-dentin complex. Nanotechnology can be used in the construction of nanofibrous scaffolds incorporated with different bioactive nanoparticles for favorable clinical outcomes. Nonetheless, the role of nanotechnology and the controlled release of various bioactive nanomolecules enhancing stem cell proliferation and regeneration of true pulp-dentin complex remains poorly understood. Given the importance of nanotechnology in tissue regeneration, this review provides an overview of the potential applications of nanotechnology in tooth pulp-dentin regeneration.
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8
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Brimo N, Serdaroğlu DÇ, Uysal B. Comparing Antibiotic Pastes with Electrospun Nanofibers as Modern Drug Delivery Systems for Regenerative Endodontics. Curr Drug Deliv 2021; 19:904-917. [PMID: 34915834 DOI: 10.2174/1567201819666211216140947] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 11/22/2022]
Abstract
Nanomaterials have various features that make these types of materials able to be applied in different biomedical applications like, diagnosis, treatment, and drug delivery. Using such materials in endodontic filed both to face the challenges that occur during treatment processes and to make these materials have an antibacterial effect without showing any harm on the host cells. The approach of nanofibers loaded with various antibacterial drugs offers a potential treatment method to enhance the elimination procedure of intracanal biofilms. Clinically, many models of bacterial biofilms have been prepared under in vitro conditions for different aims. The process of drug delivery from polymeric nanofibers is based on the principle that the releasing ratio of drug molecules increases due to the increase in the surface area of the hosted structure. In our review, we discuss diverse approaches of loading/releasing drugs on/from nanofibers and we summarized many studies about electrospun nanofibers loaded various drugs applied in the endodontic field. Moreover, we argued both the advantages and the limitations of these modern endodontic treatment materials comparing them with the traditional ones.
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Affiliation(s)
- Nura Brimo
- Department of Biomedical Engineering, Başkent University Bağlıca Campus, 06530, Ankara. Turkey
| | | | - Busra Uysal
- Department of Endodontics, Faculty of Dentistry, Ordu University, 52200, Ordu. Turkey
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9
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Ferreira JA, Kantorski KZ, Dubey N, Daghrery A, Fenno JC, Mishina Y, Chan HL, Mendonça G, Bottino MC. Personalized and Defect-Specific Antibiotic-Laden Scaffolds for Periodontal Infection Ablation. ACS APPLIED MATERIALS & INTERFACES 2021; 13:49642-49657. [PMID: 34637255 DOI: 10.1021/acsami.1c11787] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Periodontitis compromises the integrity and function of tooth-supporting structures. Although therapeutic approaches have been offered, predictable regeneration of periodontal tissues remains intangible, particularly in anatomically complex defects. In this work, personalized and defect-specific antibiotic-laden polymeric scaffolds containing metronidazole (MET), tetracycline (TCH), or their combination (MET/TCH) were created via electrospinning. An initial screening of the synthesized fibers comprising chemo-morphological analyses, cytocompatibility assessment, and antimicrobial validation against periodontopathogens was accomplished to determine the cell-friendly and anti-infective nature of the scaffolds. According to the cytocompatibility and antimicrobial data, the 1:3 MET/TCH formulation was used to obtain three-dimensional defect-specific scaffolds to treat periodontally compromised three-wall osseous defects in rats. Inflammatory cell response and new bone formation were assessed by histology. Micro-computerized tomography was performed to assess bone loss in the furcation area at 2 and 6 weeks post implantation. Chemo-morphological and cell compatibility analyses confirmed the synthesis of cytocompatible antibiotic-laden fibers with antimicrobial action. Importantly, the 1:3 MET/TCH defect-specific scaffolds led to increased new bone formation, lower bone loss, and reduced inflammatory response when compared to antibiotic-free scaffolds. Altogether, our results suggest that the fabrication of defect-specific antibiotic-laden scaffolds holds great potential toward the development of personalized (i.e., patient-specific medication) scaffolds to ablate infection while affording regenerative properties.
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Affiliation(s)
- Jessica A Ferreira
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Karla Z Kantorski
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
- Post-Graduate Program in Oral Sciences (Periodontology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, 97105-900, Brazil
| | - Nileshkumar Dubey
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Arwa Daghrery
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Yuji Mishina
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
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10
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Strategies for differentiation of hiPSCs into dental epithelial cell lineage. Cell Tissue Res 2021; 386:415-421. [PMID: 34302527 DOI: 10.1007/s00441-021-03512-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
Different stem cell-based strategies, especially induced pluripotent stem cells (iPSCs), have been exploited to regenerate teeth or restore biological and physiological functions after tooth loss. Further research is needed to establish an optimized protocol to effectively differentiate human iPSCs (hiPSCs) into dental epithelial cells (DECs). In this study, various factors were precisely modulated to facilitate differentiation of hiPSCs into DECs, which are essential for the regeneration of functional teeth. Embryoid bodies (EBs) were formed from hiPSCs as embryo-like aggregates, retinoic acid (RA) was used as an early ectodermal inducer, and bone morphogenic protein 4 (BMP4) activity was manipulated. The characteristics of DECs were enhanced and preserved after culture in keratinocyte serum-free medium (K-SFM). The yielded cell population exhibited noticeable DEC characteristics, consistent with the expression of epithelial cell and ameloblast markers. DECs demonstrated odontogenic abilities by exerting an inductive effect on human dental pulp stem cells (hDPSCs) and forming a tooth-like structure with the mouse tooth mesenchyme. Overall, our differentiation protocol provides a practical approach for applying hiPSCs for tooth regeneration.
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11
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Platform technologies for regenerative endodontics from multifunctional biomaterials to tooth-on-a-chip strategies. Clin Oral Investig 2021; 25:4749-4779. [PMID: 34181097 DOI: 10.1007/s00784-021-04013-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this review is to highlight recent progress in the field of biomaterials-mediated dental pulp tissue engineering. Specifically, we aim to underscore the critical design criteria of biomaterial platforms that are advantageous for pulp tissue engineering, discuss models for preclinical evaluation, and present new and innovative multifunctional strategies that hold promise for clinical translation. MATERIALS AND METHODS The current article is a comprehensive overview of recent progress over the last 5 years. In detail, we surveyed the literature in regenerative pulp biology, including novel biologic and biomaterials approaches, and those that combined multiple strategies, towards more clinically relevant models. PubMed searches were performed using the keywords: "regenerative dentistry," "dental pulp regeneration," "regenerative endodontics," and "dental pulp therapy." RESULTS Significant contributions to the field of regenerative dentistry have been made in the last 5 years, as evidenced by a significant body of publications. We chose exemplary studies that we believe are progressive towards clinically translatable solutions. We close this review with an outlook towards the future of pulp regeneration strategies and their clinical translation. CONCLUSIONS Current clinical treatments lack functional and predictable pulp regeneration and are more focused on the treatment of the consequences of pulp exposure, rather than the restoration of healthy dental pulp. CLINICAL RELEVANCE Clinically, there is great demand for bioinspired biomaterial strategies that are safe, efficacious, and easy to use, and clinicians are eager for their clinical translation. In particular, we place emphasis on strategies that combine favorable angiogenesis, mineralization, and functional tissue formation, while limiting immune reaction, risk of microbial infection, and pulp necrosis.
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Rafiee A, Memarpour M, Taghvamanesh S, Karami F, Karami S, Morowvat MH. Drug Delivery Assessment of a Novel Triple Antibiotic-Eluting Injectable Platelet-Rich Fibrin Scaffold: An In Vitro Study. Curr Pharm Biotechnol 2021; 22:380-388. [PMID: 32503405 DOI: 10.2174/1389201021666200605110250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Intracanal disinfection is a critical, yet challenging goal for long-term success in regenerative-based treatments. This in-vitro study aimed to assess the release profile of triple antibiotic- eluting Injectable Platelet-Rich Fibrin (I-PRF) constructs in 28 days. METHODS I-PRF scaffolds containing triple antibiotic mixture [Metronidazole (MET), Ciprofloxacin (CIP), and Minocycline (MINO)] by immersion (group one), I-PRF scaffolds containing triple antibiotic mixture by integration (group two), and antibiotic-free I-PRF scaffolds (group three) were fabricated. The antibiotic release from the scaffolds was measured using High-Performance Liquid Chromatography (HPLC) (the mobile phase of 0.1% formic acid and methanol (35:65 v/v), a C18 analytical column (150 × 4.6 mm, 5 μm) at a flow rate of 0.7 mL/min, at 25ºC) at days 1, 3, 7, 14, 21, and 28. RESULTS Retention times for MINO, CIP, and MET were achieved as 2.3, 2.6, and 3.1 min, respectively. The maximum UV absorbance values for CIP, MET, and MINO were 268 nm, 278 nm, and 350 nm, respectively. The results of the first group showed burst release within the first 24 hours followed by sustained maintenance of all three antibiotics up to 14 days. MINO and MET were still detectable in the third week. The second group could not sustainably release the antibiotics. CONCLUSION The developed method for the simultaneous identification and quantification of each antibiotic in I-PRF was sensitive and quick. Overall, group one could take up the antibiotics in adequate quantities and then subsequently release them over the study period.
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Affiliation(s)
- Azade Rafiee
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Memarpour
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Taghvamanesh
- Student Research Committee, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Forough Karami
- Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Karami
- Food and Drug Control Laboratory, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad H Morowvat
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Bekhouche M, Bolon M, Charriaud F, Lamrayah M, Da Costa D, Primard C, Costantini A, Pasdeloup M, Gobert S, Mallein-Gerin F, Verrier B, Ducret M, Farges JC. Development of an antibacterial nanocomposite hydrogel for human dental pulp engineering. J Mater Chem B 2021; 8:8422-8432. [PMID: 32804177 DOI: 10.1039/d0tb00989j] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Hydrogel-based regenerative endodontic procedures (REPs) are considered to be very promising therapeutic strategies to reconstruct the dental pulp (DP) tissue in devitalized human teeth. However, the success of the regeneration process is limited by residual bacteria that may persist in the endodontic space after the disinfection step and contaminate the biomaterial. The aim of this work was to develop an innovative fibrin hydrogel incorporating clindamycin (CLIN)-loaded Poly (d,l) Lactic Acid (PLA) nanoparticles (NPs) to provide the hydrogel with antibacterial properties. CLIN-PLA-NPs were synthesized by a surfactant-free nanoprecipitation method and their microphysical properties were assessed by dynamic light scattering, electrophoretic mobility and scanning electron microscopy. Their antimicrobial efficacy was evaluated on Enteroccocus fæcalis by the determination of the minimal inhibitory concentration (MIC) and the minimal biofilm inhibition and eradication concentrations (MBIC and MBEC). Antibacterial properties of the nanocomposite hydrogel were verified by agar diffusion assays. NP distribution into the hydrogel and release from it were evaluated using fluorescent PLA-NPs. NP cytotoxicity was assessed on DP mesenchymal stem cells (DP-MSCs) incorporated into the hydrogel. Type I collagen synthesis was investigated after 7 days of culture by immunohistochemistry. We found that CLIN-PLA-NPs displayed a drug loading of 10 ± 2 μg per mg of PLA polymer and an entrapment efficiency of 43 ± 7%. Antibiotic loading did not affect NP size, polydispersity index and zeta potential. The MIC for Enterococcus fæcalis was 32 μg mL-1. MBIC50 and MBEC50 were 4 and 16 μg mL-1, respectively. CLIN-PLA-NPs appeared homogenously distributed throughout the hydrogel. CLIN-PLA-NP-loaded hydrogels clearly inhibited E. faecalis growth. DP-MSC viability and type I collagen synthesis within the fibrin hydrogel were not affected by CLIN-PLA-NPs. In conclusion, CLIN-PLA-NP incorporation into the fibrin hydrogel gave the latter antibacterial and antibiofilm properties without affecting cell viability and function. This formulation could help establish an aseptic environment supporting DP reconstruction and, accordingly, might be a valuable tool for REPs.
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Affiliation(s)
- M Bekhouche
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France and Faculté d'Odontologie, Université de Lyon, Université Lyon 1, Lyon, France
| | - M Bolon
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - F Charriaud
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - M Lamrayah
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - D Da Costa
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France and Adjuvatis®, Lyon, France
| | | | - A Costantini
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - M Pasdeloup
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - S Gobert
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - F Mallein-Gerin
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - B Verrier
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France
| | - M Ducret
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France and Faculté d'Odontologie, Université de Lyon, Université Lyon 1, Lyon, France and Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - J-C Farges
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, Lyon, France and Faculté d'Odontologie, Université de Lyon, Université Lyon 1, Lyon, France and Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
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Antimicrobial Efficacy of a Novel Antibiotic-Eluting Injectable Platelet-Rich Fibrin Scaffold against a Dual-Species Biofilm in an Infected Immature Root Canal Model. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6623830. [PMID: 33490247 PMCID: PMC7787745 DOI: 10.1155/2020/6623830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/14/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022]
Abstract
Background and Aims This study was aimed at evaluating the antibacterial property of an injectable platelet-rich fibrin (I-PRF) scaffold containing triple antibiotic mixture against an Actinomyces naeslundii (A. naeslundii) and Enterococcus faecalis (E. faecalis) biofilm in an infected immature root canal model. Methods A dual-species biofilm was inoculated inside the root canals via a series of centrifugal cycles. The samples were allocated to three experimental groups (i.e., G1: triple antibiotic mixture, G2: I-PRF containing triple antibiotic mixture, and G3: antibiotic-free I-PRF scaffold) and two control groups (G4: seven-day biofilm untreated and G5: bacteria-free untreated). Results Bacterial gene quantification change and the overall reduction of live bacteria were evaluated. The highest antibacterial activity against A. naeslundii belonged to G2. However, G1 and G2 had similar antibacterial property against E. faecalis (p value = 0.814). In general, experimental groups revealed higher levels of antibacterial activity against E. faecalis than against A. naeslundii (p value < 0.001). Notably, G2 could dramatically decrease the number of live bacteria up to near 92%. Conclusions The current study provides insight into the antibacterial property of an antibiotic-eluting I-PRF scaffold against a dual-species biofilm colonized inside the root canal. The fabricated scaffold contains not only the antibiotics but also the growth factors, which favor the regeneration.
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Ribeiro JS, Daghrery A, Dubey N, Li C, Mei L, Fenno JC, Schwendeman A, Aytac Z, Bottino MC. Hybrid Antimicrobial Hydrogel as Injectable Therapeutics for Oral Infection Ablation. Biomacromolecules 2020; 21:3945-3956. [PMID: 32786527 DOI: 10.1021/acs.biomac.0c01131] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oral bacterial infection represents the leading cause of the gradual destruction of tooth and periodontal structures anchoring the teeth. Lately, injectable hydrogels have gained increased attention as a promising minimally invasive platform for localized delivery of personalized therapeutics. Here, an injectable and photocrosslinkable gelatin methacryloyl (GelMA) hydrogel is successfully engineered with ciprofloxacin (CIP)-eluting short nanofibers for oral infection ablation. For this purpose, CIP or its β-cyclodextrin (β-CD)-inclusion complex (CIP/β-CD-IC) has been incorporated into polymeric electrospun fibers, which were subsequently cut into short nanofibers, and then embedded in GelMA to obtain an injectable hybrid antimicrobial hydrogel. Thanks to the solubility enhancement of CIP by β-CD-IC and the tunable degradation profile of GelMA, the hydrogels promote localized, sustained, and yet effective cell-friendly antibiotic doses, as measured by a series of bacterial assays that demonstrated efficacy in attenuating the growth of Gram-positive Enterococcus faecalis. Altogether, we foresee significant potential in translating this innovative hybrid hydrogel as an injectable platform technology that may have broad applications in oral infection ablation, such as periodontal disease and pulpal pathology.
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Affiliation(s)
- Juliana S Ribeiro
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Arwa Daghrery
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Nileshkumar Dubey
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Christina Li
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Ling Mei
- Department of Pharmaceutical Sciences, Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Anna Schwendeman
- Department of Pharmaceutical Sciences, Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Zeynep Aytac
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan 48109, United States
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Dentinal Tubule Penetration and Dislocation Resistance of a New Bioactive Root Canal Sealer Following Root Canal Medicament Removal Using Sonic Agitation or Laser-Activated Irrigation. Eur Endod J 2020; 5:264-270. [PMID: 33353924 PMCID: PMC7881371 DOI: 10.14744/eej.2020.92905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: To investigate the influence of sonic agitation or laser-activated irrigation techniques on the removal chlorhexidine (CHX) and modified triple antibiotic paste (mTAP) on the sealer penetration depth and dislocation resistance of Guttaflow Bioseal. Methods: Single-rooted mandibular premolars (n=96) were prepared with rotary nickel titanium instruments and randomly divided into two groups (n=48) based on the intracanal medicaments used: Group 1, mTAP; Group 2, CHX gel. After 7 days, the specimens in each group were divided into three subgroups (n=16) based on the supplementary irrigation technique used to remove the medicaments: laser activated irrigation (Er, Cr: YSGG laser, Waterlase MD, Biolase Technology Inc., San Clemente, CA, USA), sonic agitation (EndoActivator, Dentslpy Sirona Endodontics, PA, USA) and syringe-and-needle irrigation (control) techniques. Canals were filled with single matched-taper gutta-percha cone and a calcium silicate-based sealer (GuttaFlow® Bioseal, Coltène/Whaledent, Langenau, Germany). At the end of three weeks, sealer penetration was investigated using confocal microscopy (n=6), and dislocation resistance was calculated by measuring the push-out bond strength (n=10). Statistical analysis was performed using three-way analysis of variance (ANOVA) and Tukey post-hoc test (P=0.05). Results: Laser activated irrigation resulted in significantly higher depth of sealer penetration compared to sonic agitation and syringe irrigation (P<0.01). The average sealer penetration depths were recorded as 846.6 µm, 786.5 µm and 505 µm in the Er, Cr: YSGG laser, EndoActivator and control groups, respectively. The mean bond strength obtained in group 3 (syringe-and-needle irrigation) was significantly less than the other groups (P<0.05). The mean values were 9.08 in the Er, Cr: YSGG laser group, 8.44 in the EndoActivator group and 5.08 in the needle group. Conclusion: Er,Cr;YSGG laser irrigation to remove the medicaments was advantageous to other irrigation techniques in sealer penetration and dislocation resistance of the sealer.
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Shahri F, Parhizkar A. Pivotal Local Drug Delivery Systems in Endodontics; A Review of Literature. IRANIAN ENDODONTIC JOURNAL 2020; 15:65-78. [PMID: 36704444 PMCID: PMC9709838 DOI: 10.22037/iej.v15i2.30374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/05/2020] [Accepted: 03/19/2020] [Indexed: 01/28/2023]
Abstract
Endodontic pathosis is preliminary caused by bacteria and their by-products that interact with pulpal and periradicular host tissues. The purge of the root canal system (RCS) from bacteria is a necessity for successful endodontic treatment. Different approaches have been considered to reduce the number of microorganisms and confront microbiota in the radicular area; namely chemomechanical preparation and intracanal medication. However, various studies have shown that, due to the intricate anatomy of RCS, bacteria can persist in distant areas and significantly decrease the degree of success in endodontic ministrations. Thereby, elimination of bacteria remains a challenge, specifically from the infectious root canals. In recent years, local drug delivery systems (LDDS), loaded with drugs and/or antibacterial agents, have been deliberated for the removal of microorganisms or as a medicinal adjunct to mechanical instrumentation. Owing to the resistant species and complexities in the structure of root canals, it seems that LDDS may be able to closely affect microorganisms and improve the success rate of endodontic treatment. Furthermore, they are capable of limiting drugs to RCS, and can achieve a more effective therapeutic dose/concentration in the target site. Furthermore, and due to successful outcomes, administration of LDDS has also been given great attention for regenerative purposes. Micro/nanoparticles, liposomes, nanofibers, sealers and so forth represent typical delivery systems used for endodontic treatments. This study addresses pivotal LDDS used in endodontics and their applications.
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Affiliation(s)
- Fereshteh Shahri
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ardavan Parhizkar
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Ardavan Parhizkar, ICER, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd., Daneshgah Square, Velenjak, Shahid Chamran Highway, Tehran, Iran. Postal code: 19839-63113 Tel: +98-21 22413897. E-mail:
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Celebioglu A, Uyar T. Metronidazole/Hydroxypropyl-β-Cyclodextrin inclusion complex nanofibrous webs as fast-dissolving oral drug delivery system. Int J Pharm 2019; 572:118828. [DOI: 10.1016/j.ijpharm.2019.118828] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022]
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Antibiotics Used in Regenerative Endodontics Modify Immune Response of Macrophages to Bacterial Infection. J Endod 2019; 45:1349-1356. [DOI: 10.1016/j.joen.2019.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/08/2019] [Accepted: 08/06/2019] [Indexed: 12/24/2022]
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20
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Sotomil JM, Münchow EA, Pankajakshan D, Spolnik KJ, Ferreira JA, Gregory RL, Bottino MC. Curcumin-A Natural Medicament for Root Canal Disinfection: Effects of Irrigation, Drug Release, and Photoactivation. J Endod 2019; 45:1371-1377. [PMID: 31542283 DOI: 10.1016/j.joen.2019.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/25/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Curcumin incorporation into polymeric fibers was tested for its antimicrobial properties and potential use in root canal disinfection. METHODS Curcumin-modified fibers were processed via electrospinning and tested against a 7-day old established Actinomyces naeslundii biofilm. The medicaments tested were as follows: curcumin-modified fibers at 2.5 and 5.0 mg/mL, curcumin-based irrigant at 2.5 and 5.0 mg/mL, saline solution (negative control), and the following positive controls: 2% chlorhexidine, 1% sodium hypochlorite, and triple antibiotic paste (TAP, 1 mg/mL). All medicaments, except for the positive controls, were allocated according to the light exposure protocol (ie, photoactivation with a light-emitting diode every 30 seconds for 4 minutes or without photoactivation). After treatment, the medicaments were removed, and 1 mL saline solution was added; the biofilm was scraped from the well and used to prepare a 1:2000 dilution. Spiral plating was performed using anaerobic blood agar plates. After 24 hours, colony-forming units (colony-forming units/mL, n = 11/group) were counted to determine the antimicrobial effects. RESULTS Data exhibited significant antimicrobial effects on the positive control groups followed by the curcumin irrigants and, lastly, the photoactivated curcumin-modified fibers. There was a significant reduction of viable bacteria in curcumin-based irrigants, which was greater than the TAP-treated group. Curcumin-free fibers, saline, and the nonphotoactivated curcumin-modified fibers did not display antimicrobial activity. CONCLUSIONS Curcumin seems to be a potential alternative to TAP when controlling infection, but it requires a minimal concentration (2.5 mg/mL) to be effective. Photoactivation of curcumin-based medicaments seems to be essential to obtain greater antibiofilm activity.
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Affiliation(s)
- Julian M Sotomil
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Eliseu A Münchow
- Department of Dentistry, Health Science Institute, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Divya Pankajakshan
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Kenneth J Spolnik
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Jessica A Ferreira
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Richard L Gregory
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan.
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Sağlam BC, HAZAR E, Koçak S, Koçak MM. Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.490589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Saberi E, Farhad-Mollashahi N, Saberi M. Interaction of intracanal medicaments with apical papilla stem cells: quantitative cytotoxicity assessment by methyl thiazolyl tetrazolium, trypan blue and lactate dehydrogenase. ACTA ACUST UNITED AC 2019; 68:36-41. [DOI: 10.23736/s0026-4970.18.04172-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bottino MC, Albuquerque MTP, Azabi A, Münchow EA, Spolnik KJ, Nör JE, Edwards PC. A novel patient-specific three-dimensional drug delivery construct for regenerative endodontics. J Biomed Mater Res B Appl Biomater 2018; 107:1576-1586. [PMID: 30281899 DOI: 10.1002/jbm.b.34250] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/15/2018] [Accepted: 09/09/2018] [Indexed: 12/13/2022]
Abstract
Evoked bleeding (EB) clinical procedure, comprising a disinfection step followed by periapical tissue laceration to induce the ingrowth of undifferentiated stem cells from the periodontal ligament and alveolar bone, is currently the only regenerative-based therapeutic approach to treating pulp tissue necrosis in undeveloped (immature) permanent teeth approved in the United States. Yet, the disinfection step using antibiotic-based pastes leads to cytotoxic, warranting a biocompatible strategy to promote root canal disinfection with no or minimal side-effects to maximize the regenerative outcomes. The purpose of this investigation was to develop a tubular three-dimensional (3D) triple antibiotic-eluting construct for intracanal drug delivery. Morphological (scanning electron microscopy), chemical (Fourier transform infrared spectroscopy), and mechanical (tensile testing) characteristics of the polydioxanone-based triple antibiotic-eluting fibers were assessed. The antimicrobial properties of the tubular 3D constructs were determined in vitro and in vivo using an infected (Actinomyces naeslundii) dentin tooth slice model and a canine method of periapical disease, respectively. The in vitro data indicated significant antimicrobial activity and the ability to eliminate bacterial biofilm inside dentinal tubules. In vivo histological findings demonstrated that, using the EB procedure, the tubular 3D triple antibiotic-eluting construct allowed the formation of an appropriate environment that led to apex closure and the ingrowth of a thin layer of osteodentin-like tissue into the root canal. Taken together, these findings indicate that our novel drug delivery construct is a promising biocompatible disinfection strategy for immature permanent teeth with necrotic pulps. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1576-1586, 2019.
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Affiliation(s)
- Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, 48109
| | - Maria T P Albuquerque
- Department of Clinical Dentistry (Endodontics), Federal University of Bahia, Salvador, Bahia, 40110, Brazil
| | - Asma Azabi
- Department of Biomedical & Applied Sciences, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, 46202
| | - Eliseu A Münchow
- Department of Dentistry, Health Science Institute, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, 35010, Brazil
| | | | - Jacques E Nör
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, 48109
| | - Paul C Edwards
- Department of Oral Pathology, Medicine, and Radiology, IUSD, Indianapolis, Indiana, 46202
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Abstract
No current therapy promotes root canal disinfection and regeneration of the pulp-dentin complex in cases of pulp necrosis. Antibiotic pastes used to eradicate canal infection negatively affect stem cell survival. Three-dimensional easy-to-fit antibiotic-eluting nanofibers, combined with injectable scaffolds, enriched or not with stem cells and/or growth factors, may increase the likelihood of achieving predictable dental pulp regeneration. Periodontitis is an aggressive disease that impairs the integrity of tooth-supporting structures and may lead to tooth loss. The latest advances in membrane biomodification to endow needed functionalities and technologies to engineer patient-specific membranes/constructs to amplify periodontal regeneration are presented.
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Meireles AB, Corrêa DK, da Silveira JVW, Millás ALG, Bittencourt E, de Brito-Melo GEA, González-Torres LA. Trends in polymeric electrospun fibers and their use as oral biomaterials. Exp Biol Med (Maywood) 2018; 243:665-676. [PMID: 29763386 PMCID: PMC6378505 DOI: 10.1177/1535370218770404] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Electrospinning is one of the techniques to produce structured polymeric fibers in the micro or nano scale and to generate novel materials for biomedical proposes. Electrospinning versatility provides fibers that could support different surgical and rehabilitation treatments. However, its diversity in equipment assembly, polymeric materials, and functional molecules to be incorporated in fibers result in profusion of recent biomaterials that are not fully explored, even though the recognized relevance of the technique. The present article describes the main electrospun polymeric materials used in oral applications, and the main aspects and parameters of the technique. Natural and synthetic polymers, blends, and composites were identified from the available literature and recent developments. Main applications of electrospun fibers were focused on drug delivery systems, tissue regeneration, and material reinforcement or modification, although studies require further investigation in order to enable direct use in human. Current and potential usages as biomaterials for oral applications must motivate the development in the use of electrospinning as an efficient method to produce highly innovative biomaterials, over the next few years. Impact statement Nanotechnology is a challenge for many researchers that look for obtaining different materials behaviors by modifying characteristics at a very low scale. Thus, the production of nanostructured materials represents a very important field in bioengineering, in which the electrospinning technique appears as a suitable alternative. This review discusses and provides further explanation on this versatile technique to produce novel polymeric biomaterials for oral applications. The use of electrospun fibers is incipient in oral areas, mainly because of the unfamiliarity with the technique. Provided disclosure, possibilities and state of the art are aimed at supporting interested researchers to better choose proper materials, understand, and design new experiments. This work seeks to encourage many other researchers-Dentists, Biologists, Engineers, Pharmacists-to develop innovative materials from different polymers. We highlight synthetic and natural polymers as trends in treatments to motivate an advance in the worldwide discussion and exploration of this interdisciplinary field.
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Affiliation(s)
- Agnes B Meireles
- Pharmacy Department, Laboratory of Immunology, UFVJM and PPGCF-UFVJM, Diamantina, MG 39100-000, Brazil
| | - Daniella K Corrêa
- Institute of Science and Technology – UFVJM, Diamantina, MG 39100-000, Brazil
| | - João VW da Silveira
- Institute of Science and Technology – UFVJM, Diamantina, MG 39100-000, Brazil
| | - Ana LG Millás
- Chemical Engineering Department, UNICAMP, Campinas, SP 13083-852, Brazil
| | - Edison Bittencourt
- Chemical Engineering Department, UNICAMP, Campinas, SP 13083-852, Brazil
| | - Gustavo EA de Brito-Melo
- Pharmacy Department, Laboratory of Immunology, UFVJM and PPGCF-UFVJM, Diamantina, MG 39100-000, Brazil
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Montero-Miralles P, Martín-González J, Alonso-Ezpeleta O, Jiménez-Sánchez MC, Velasco-Ortega E, Segura-Egea JJ. Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review. Int Endod J 2018; 51:981-988. [PMID: 29480932 DOI: 10.1111/iej.12913] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/20/2018] [Indexed: 12/13/2022]
Abstract
Regenerative endodontic procedures (REPs) are biologically based procedures planned to replace damaged tissues, including dentinee and root structures, as well as cells of the pulp-dentine complex. Effective sterilization of the root canal is essential in REPs, and antibiotics have been widely used to disinfect root canals. The aim of this paper was to review the scientific literature on (i) Effectiveness of antibiotics used in REPs against bacteria implicated in endodontic disease; (ii) Scientific evidence supporting the use of topical antibiotics in REPs; (iii) Clinical implications of the use of antibiotics in REPs and the possible side effects; (iv) Effect of antibiotics on dental pulp stem cells; and (v) Ongoing research on the use of antibiotics in REPs. Antibiotics used in REPs are effective against bacteria implicated in endodontic infections. Triple antibiotic pastes with minocycline attain complete disinfection of immature teeth with necrotic pulps, without affecting SCAP. Experimental studies carried out in dogs support the use of antibiotics in REPs. Clinical studies report high success rates of RET using antibiotics as intracanal dressings. However, tooth discolouration is an important side effect of the use of TAP. An antibiotic paste containing only metronidazole and ciprofloxacin could be a good alternative to the use of TAP. The use of antibiotic-containing scaffolds or clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin and clindamycin) polymer could be a biologically safe antimicrobial drug delivery system in REPs.
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Affiliation(s)
- P Montero-Miralles
- Endodontics Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - J Martín-González
- Endodontics Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - O Alonso-Ezpeleta
- Endodontics Section, Department of Stomatology, School of Dentistry, University of Zaragoza, Zaragoza, Spain
| | - M C Jiménez-Sánchez
- Endodontics Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - E Velasco-Ortega
- Comprehensive Dentistry, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - J J Segura-Egea
- Endodontics Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Hwang D, Fong H, Johnson JD, Paranjpe A. Efficacy of different carriers for the triple antibiotic powder during regenerative endodontic procedures. AUST ENDOD J 2017; 44:208-214. [PMID: 29034570 DOI: 10.1111/aej.12228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 11/29/2022]
Abstract
Chemical debridement during Regenerative Endodontic procedures is important. Previous research studies have evaluated various antibiotics and their concentrations but none have addressed the concern of delivering these materials. Hence, the purpose of this study was to determine what carrier could be used effectively in a clinical setting. Sixty caries-free maxillary incisors were used and inoculated with Enterococcus faecalis and divided into positive and irrigation controls and experimental groups that had triple antibiotic powder (1:1:1 ciprofloxacin:metronidazole:minocycline) delivered using various carriers: saline, cotton, sponge and methylcellulose. Current AAE regenerative protocols were followed. S2 sampling was performed and tested for bacterial presence via culturing and SEM. The results demonstrated that saline was the most effective carrier for the triple antibiotic powder while cotton and sponge were most ineffective. Saline and methylcellulose both reduced bacterial counts to a significant level. Overall, this study demonstrated that saline as a carrier was most effective and should be routinely used.
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Affiliation(s)
- David Hwang
- Department of Endodontics, University of Washington, Seattle, Washington, USA
| | - Hanson Fong
- Department of Material Science and Engineering, University of Washington, Seattle, Washington, USA
| | - James D Johnson
- Department of Endodontics, University of Washington, Seattle, Washington, USA
| | - Avina Paranjpe
- Department of Endodontics, University of Washington, Seattle, Washington, USA
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Albuquerque MTP, Nagata J, Bottino MC. Antimicrobial Efficacy of Triple Antibiotic-eluting Polymer Nanofibers against Multispecies Biofilm. J Endod 2017; 43:S51-S56. [PMID: 28778504 DOI: 10.1016/j.joen.2017.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The elimination of microbial flora in cases of immature permanent teeth with necrotic pulp is both key and a challenging goal for the long-term success of regenerative therapy. Recent research has focused on the development of cell-friendly intracanal drug delivery systems. This in vitro study aimed to investigate the antimicrobial action of 3-dimensional (3D) tubular-shaped triple antibiotic-eluting nanofibrous constructs against a multispecies biofilm on human dentin. Polydioxanone polymer solutions, antibiotic-free or incorporated with metronidazole, ciprofloxacin, and minocycline, were electrospun into 3D tubular-shaped constructs. A multispecies biofilm consisting of Actinomyces naeslundii, Streptococcus sanguinis, and Enterococcus faecalis was forced inside the dentinal tubules via centrifugation in a dentin slice in vitro model. The infected specimens were exposed to 2 experimental groups (ie, 3D tubular-shaped triple antibiotic-eluting constructs and triple antibiotic paste [TAP]) and 2 control groups (7-day biofilm untreated and antibiotic-free 3D tubular-shaped constructs). Biofilm elimination was quantitatively analyzed with confocal laser scanning microscopy. Confocal laser scanning microscopic (CLSM) analysis showed a dense population of viable (green) bacteria adhered to dentin and penetrated into the dentinal tubules. Upon 3D tubular-shaped triple antibiotic-eluting nanofibrous construct exposure, nearly complete elimination of viable bacteria on the dentin surface and inside the dentinal tubules was shown in the CLSM images, which was similar (P < .05) to the bacterial death promoted by the TAP group but significantly greater when compared with both the antibiotic-free 3D tubular-shaped constructs and the control (saline). The proposed 3D tubular-shaped antibiotic-eluting construct showed pronounced antimicrobial effects against the multispecies biofilm tested and therefore holds significant clinical potential as a disinfection strategy before regenerative endodontics.
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Affiliation(s)
- Maria T P Albuquerque
- Division of Dental Biomaterials, Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Clinical Dentistry, Endodontics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Juliana Nagata
- Dentistry Department, Endodontics, Federal University of Sergipe, Lagarto, Sergipe, Brazil
| | - Marco C Bottino
- Division of Dental Biomaterials, Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana.
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Pankajakshan D, Albuquerque MTP, Evans JD, Kamocka MM, Gregory RL, Bottino MC. Triple Antibiotic Polymer Nanofibers for Intracanal Drug Delivery: Effects on Dual Species Biofilm and Cell Function. J Endod 2017; 42:1490-5. [PMID: 27663615 DOI: 10.1016/j.joen.2016.07.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Root canal disinfection and the establishment of an intracanal microenvironment conducive to the proliferation/differentiation of stem cells play a significant role in regenerative endodontics. This study was designed to (1) investigate the antimicrobial efficacy of triple antibiotic-containing nanofibers against a dual-species biofilm and (2) evaluate the ability of dental pulp stem cells (DPSCs) to adhere to and proliferate on dentin upon nanofiber exposure. METHODS Seven-day-old dual-species biofilm established on dentin specimens was exposed for 3 days to the following: saline (control), antibiotic-free nanofibers (control), and triple antibiotic-containing nanofibers or a saturated triple antibiotic paste (TAP) solution (50 mg/mL in phosphate buffer solution). Bacterial viability was assessed using the LIVE/DEAD assay (Molecular Probes, Inc, Eugene, OR) and confocal laser scanning microscopy. For cytocompatibility studies, dentin specimens after nanofiber or TAP (1 g/mL in phosphate buffer solution) exposure were evaluated for cell adhesion and spreading by actin-phalloidin staining. DPSC proliferation was assessed on days 1, 3, and 7. Statistics were performed, and significance was set at the 5% level. RESULTS Confocal laser scanning microscopy showed significant bacterial death upon antibiotic-containing nanofiber exposure, differing significantly (P < .05) from antibiotic-free fibers and the control (saline). DPSCs showed enhanced adhesion/spreading on dentin specimens treated with antibiotic-containing nanofibers when compared with its TAP counterparts. The DPSC proliferation rate was similar on days 1 and 3 in antibiotic-free nanofibers, triple antibiotic-containing nanofibers, and TAP-treated dentin. Proliferation was higher (9-fold) on dentin treated with antibiotic-containing nanofibers on day 7 compared with TAP. CONCLUSIONS Triple antibiotic-containing polymer nanofibers led to significant bacterial death, whereas they did not affect DPSC attachment and proliferation on dentin.
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Affiliation(s)
- Divya Pankajakshan
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Maria T P Albuquerque
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Clinical Dentistry, Endodontics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Joshua D Evans
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Malgorzata M Kamocka
- Division of Nephrology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Richard L Gregory
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Marco C Bottino
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, Indiana.
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30
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Chung SH, Park YS. Local drug delivery in endodontics: A literature review. J Drug Deliv Sci Technol 2017. [DOI: 10.1016/j.jddst.2017.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gokturk H, Ozkocak I, Buyukgebiz F, Demir O. An in vitro evaluation of various irrigation techniques for the removal of double antibiotic paste from root canal surfaces. J Appl Oral Sci 2017; 24:568-574. [PMID: 28076461 PMCID: PMC5161255 DOI: 10.1590/1678-775720160286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/01/2016] [Indexed: 12/04/2022] Open
Abstract
Objective The aim of this study was to investigate the effectiveness of conventional syringe irrigations, passive ultrasonic irrigation (PUI), Vibringe, CanalBrush, XP-endo Finisher, and laser-activated irrigation (LAI) systems in removing double antibiotic paste (DAP) from root canals. Material and Methods One hundred five extracted single-rooted teeth were instrumented. The roots were split longitudinally. Three standard grooves were created and covered with DAP. The roots were distributed into seven groups: Group 1, beveled needle irrigation; Group 2, double side-vented needle irrigation; Group 3, CanalBrush; Group 4, XP-endo Finisher; Group 5, Vibringe; Group 6, PUI; Group 7, LAI. The amount of remaining DAP was scored under a stereomicroscope. Results Group 4, Group 6, and Group 7 removed significantly more DAP than the other protocols in the coronal region. Group 7 was more efficient in the middle region; however, no significant difference was found between Group 7 and Group 6. No differences were found between groups in the apical region either, except for the comparisons between groups 7 and 2, and groups 2 and 3. Conclusions None of the investigated protocols were able to completely remove the DAP from the grooves. The Vibringe and XP-endo Finisher systems showed results similar to those of conventional needle irrigation.
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Affiliation(s)
- Hakan Gokturk
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Ismail Ozkocak
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Fevzi Buyukgebiz
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Osman Demir
- - Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics, Tokat, Turkey
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Clinical Perspective of Electrospun Nanofibers as a Drug Delivery Strategy for Regenerative Endodontics. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s40496-016-0103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yang J, Yuan G, Chen Z. Pulp Regeneration: Current Approaches and Future Challenges. Front Physiol 2016; 7:58. [PMID: 27014076 PMCID: PMC4779938 DOI: 10.3389/fphys.2016.00058] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 02/05/2016] [Indexed: 01/06/2023] Open
Abstract
Regenerative endodontics aims to replace inflamed/necrotic pulp tissues with regenerated pulp-like tissues to revitalize teeth and improve life quality. Pulp revascularization case reports, which showed successful clinical and radiographic outcomes, indicated the possible clinical application of pulp regeneration via cell homing strategy. From a clinical point of view, functional pulp-like tissues should be regenerated with the characterization of vascularization, re-innervation, and dentin deposition with a regulated rate similar to that of normal pulp. Efficient root canal disinfection and proper size of the apical foramen are the two requisite preconditions for pulp regeneration. Progress has been made on pulp regeneration via cell homing strategies. This review focused on the requisite preconditions and cell homing strategies for pulp regeneration. In addition to the traditionally used mechanical preparation and irrigation, antibiotics, irrigation assisted with EndoVac apical negative-pressure system, and ultrasonic and laser irradiation are now being used in root canal disinfection. In addition, pulp-like tissues could be formed with the apical foramen less than 1 mm, although more studies are needed to determine the appropriate size. Moreover, signaling molecules including stromal cell derived factor (SDF-1α), basic Fibroblast Growth Factor (bFGF), Platelet Derived Growth Factor (PDGF), stem cell factor (SCF), and Granulocyte Colony-Stimulating Factor (G-CSF) were used to achieve pulp-like tissue formation via a cell homing strategy. Studies on the cell sources of pulp regeneration might give some indications on the signaling molecular selection. The active recruitment of endogenous cells into root canals to regenerate pulp-like tissues is a novel concept that may offer an unprecedented opportunity for the near-term clinical translation of current biology-based therapies for dental pulp regeneration.
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Affiliation(s)
- Jingwen Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityWuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan UniversityWuhan, China
| | - Guohua Yuan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityWuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan UniversityWuhan, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University Wuhan, China
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Porter MLA, Münchow EA, Albuquerque MTP, Spolnik KJ, Hara AT, Bottino MC. Effects of Novel 3-dimensional Antibiotic-containing Electrospun Scaffolds on Dentin Discoloration. J Endod 2015; 42:106-12. [PMID: 26602451 DOI: 10.1016/j.joen.2015.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/17/2015] [Accepted: 09/19/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Although intracanal application of the triple antibiotic paste (TAP) may offer advantages (eg, disinfection), this practice has been associated with significant drawbacks, including tooth discoloration. In this study, the color change of dentin was monitored during treatment with distinct TAP pastes and novel tubular-shaped 3-dimensional electrospun scaffolds containing minocycline (MINO) or doxycycline (DOX). METHODS Two TAP pastes (TAPMINO [MINO, metronidazole, and ciprofloxacin] and TAPDOX [DOX, metronidazole, and ciprofloxacin]), 4 scaffold-based groups containing MINO or DOX at distinct concentrations, 1 antibiotic-free scaffold, and 1 untreated group (control) were investigated. Human canines were sectioned at the cementoenamel junction and tubular-shaped scaffolds or paste were placed into the root canals and sealed. Color measurements (CIEL(*)a(*)b(*) parameters) were performed at baseline and after 1, 3, 7, 14, 21, and 28 days. Color changes were expressed as ΔE(*) values. In addition, scanning electron microscopy and energy-dispersive X-ray spectroscopy were also performed on the specimens after treatment. Data were analyzed using repeated measures analysis of variance (alpha = 0.05). RESULTS All antibiotic-containing groups led to greater discoloration than the antibiotic-free groups. A severe discoloration occurred after 1 day. At the end of the experiment, antibiotic-treated samples exhibited crusts/agglomerates over the dentin surface, which totally or partially obliterated the dentinal tubules. The presence of MINO resulted in a greater color change than DOX. CONCLUSIONS Scaffolds containing MINO or DOX produced similar color change to dentin when compared with their respective TAP systems, although DOX-related discoloration was less pronounced.
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Affiliation(s)
- Margaret Louise A Porter
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Eliseu A Münchow
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Operative Dentistry, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil
| | - Maria T P Albuquerque
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Universidade Estadual Paulista, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil
| | - Kenneth J Spolnik
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Anderson T Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Marco C Bottino
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana.
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Antimicrobial Effects of Novel Triple Antibiotic Paste-Mimic Scaffolds on Actinomyces naeslundii Biofilm. J Endod 2015; 41:1337-43. [PMID: 25917945 DOI: 10.1016/j.joen.2015.03.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Actinomyces naeslundii has been recovered from traumatized permanent teeth diagnosed with necrotic pulps. In this work, a triple antibiotic paste (TAP)-mimic scaffold is proposed as a drug-delivery strategy to eliminate A. naeslundii dentin biofilm. METHODS Metronidazole, ciprofloxacin, and minocycline were added to a polydioxanone (PDS) polymer solution and spun into fibrous scaffolds. Fiber morphology, mechanical properties, and drug release were investigated by using scanning electron microscopy, microtensile testing, and high-performance liquid chromatography, respectively. Human dentin specimens (4 × 4 × 1 mm(3), n = 4/group) were inoculated with A. naeslundii (ATCC 43146) for 7 days for biofilm formation. The infected dentin specimens were exposed to TAP-mimic scaffolds, TAP solution (positive control), and pure PDS (drug-free scaffold). Dentin infected (7-day biofilm) specimens were used for comparison (negative control). Confocal laser scanning microscopy was done to determine bacterial viability. RESULTS Scaffolds displayed a submicron mean fiber diameter (PDS = 689 ± 312 nm and TAP-mimic = 718 ± 125 nm). Overall, TAP-mimic scaffolds showed significantly (P ≤ .040) lower mechanical properties than PDS. Within the first 24 hours, a burst release for all drugs was seen. A sustained maintenance of metronidazole and ciprofloxacin was observed over 4 weeks, but not for minocycline. Confocal laser scanning microscopy demonstrated complete elimination of all viable bacteria exposed to the TAP solution. Meanwhile, TAP-mimic scaffolds led to a significant (P < .05) reduction in the percentage of viable bacteria compared with the negative control and PDS. CONCLUSIONS Our findings suggest that TAP-mimic scaffolds hold significant potential in the eradication/elimination of bacterial biofilm, a critical step in regenerative endodontics.
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