Gels in Medicine and Surgery: Current Trends and Future Perspectives

Corneal wound healing and nerve regeneration by novel ophthalmic formulations based on cross-linked sodium hyaluronate, taurine, vitamin B6, and vitamin B12

Introduction: To evaluate the pharmacological profile of ocular formulations based on cross-linked sodium hyaluronate (CL-SH), taurine (Tau), vitamin B6 (Vit B6) and vitamin B12 (Vit B12) using in vitro and in vivo paradigms. Methods: Rabbit corneal epithelial cells were used to assess wound healing and reactive oxygen species (ROS) formation by scratch assay and oxidative stress (0.3 mM H₂O₂; 30 min), respectively with or without ocular formulations exposure. In vivo studies were carried out on albino rabbits to evaluate corneal nerve regeneration and corneal wound healing with or without treatment with six different formulations. Animals were anesthetized, the corneal epithelium was removed, and formulations were topically administered (30 μL/eye; 3 times/day for 6 days). Slit-lamp observation was carried out at different time points. After 6 days the animals were killed, and corneas were collected to evaluate corneal re-innervation by immunohistochemistry of selective neuronal marker β-III tubulin. Results: Formulations containing the concentrations 0.16% or 0.32% of cross-linked sodium hyaluronate, taurine, vitamin B6 and vitamin B12 accelerated corneal wound healing. Cells exposed to H₂O₂ led to significant (p < 0.05) increase of reactive oxygen species concentration that was significantly (p < 0.05) counteract by formulations containing cross-linked sodium hyaluronate (0.32%) and taurine with or without vitamins. The extent of re-innervation, in terms of β-III tubulin staining, was 5-fold greater (p < 0.01) in the eye of rabbits treated with formulation containing 0.32% cross-linked sodium hyaluronate, taurine, vitamins (RenerviX^®) compared with the control group (no treatment). Furthermore, re-innervation elicited by RenerviX^® was significantly greater (p < 0.01) compared with the group treated with the formulation containing 0.32% cross-linked sodium hyaluronate and taurine without vitamins, and with the group treated with the formulation containing 0.5% linear sodium hyaluronate (SH), taurine, and vitamin B12, respectively. Discussion: In conclusion, among the formulations tested, the new ophthalmic gel RenerviX^® was able to contrast oxidative stress, to accelerate corneal re-epithelization and to promote nerve regeneration.

Biomaterials Used for Periodontal Disease Treatment: Focusing on Immunomodulatory Properties

The growing use of biomaterials with different therapeutic purposes increases the need for their physiological understanding as well as to seek its integration with the human body. Chronic inflammatory local pathologies, generally associated with infectious or autoimmunity processes, have been a current therapeutic target due to the difficulty in their treatment. The recent development of biomaterials with immunomodulatory capacity would then become one of the possible strategies for their management in local pathologies, by intervening in situ, without generating alterations in the systemic immune response. The treatment of periodontal disease as an inflammatory entity has involved the use of different approaches and biomaterials. There is no conclusive, high evidence about the use of these biomaterials in the regeneration of periodontitis sequelae, so the profession keeps looking for other different strategies. The use of biomaterials with immunomodulatory properties could be one, with a promising future. This review of the literature summarizes the scientific evidence about biomaterials used in the treatment of periodontal disease.

Effectiveness of Combination of Chitosan Gel and Hydroxyapatite from Crabs Shells (Portunus pelagicus) Waste as Bonegraft on Periodontal Network Regeneration through IL-1 and BMP-2 Analysis

Background. Periodontitis can be treated by regenerating periodontal tissue using a bone graft. Several natural materials such as chitosan and minerals such as hydroxyapatite can be developed to increase periodontal tissue regeneration. Chitosan has a high potential in healing wounds. Hydroxyapatite has excellent properties such as biocompatibility, osteoconductive, osteoinductive, and osteogenesis, making it an ideal material for soft and hard tissue regeneration. Chitosan and hydroxyapatite can be obtained from the shells of crustaceans, such as crabs shells (Portunus pelagicus). Objective. To assess the effectiveness of the combination of chitosan gel and hydroxyapatite powder as a bone graft on periodontal tissue regeneration in experimental animals. Periodontal tissue regeneration was assessed by expressing inflammatory cytokine gene indicators IL-1 and BMP-2. Methods. Experimental laboratory research and clinical trials with posttest only control group design. Twenty-seven Wistar rats were divided into three groups. Then the femoral bone defect was made, the positive control group was given placebo gel, the positive control group was given BATAN hydroxyapatite, and the test group was given a combination of chitosan gel and hydroxyapatite crab shells. Wistar rats were sacrificed on days 7, 14, and 21, and the femur bone was then taken for immunohistochemical analysis to determine the levels of IL-1 and BMP-2. The Kolmogorov–Smirnov test, Levene test, and one-way ANOVA analyzed the data. Results. On days 7, 14, and 21, the expression levels of IL-1 and BMP2 were significantly different between the three groups. The group added with chitosan gel and crab shell HA showed a faster decrease in IL-1 expression than the control group. BMP-2 expression increased in the test group compared to the control group. Conclusion. The combination of chitosan gel and hydroxyapatite inhibited the production of proinflammatory cytokines and increased the production of BMP-2.

Effect of fluoride recharge on the microleakage of fluoride-releasing restorative materials: An ex vivo confocal laser scanning microscopy study

Context:

Success or failure of a restoration depends on its ability to bond to the tooth structure, to reduce microleakage, and to inhibit secondary caries. Fluoride-releasing materials have the inherent potential to release fluoride and are also capable of recharging themselves with topical agents.

Aim:

The aim of this study was to compare and evaluate the effect of fluoride recharge on microleakage of different restorative materials.

Materials and Methods:

Eighty extracted teeth were collected and split mesiodistally into 160 specimens. Class V cavities were prepared on buccal and lingual surfaces. Specimens were divided into four groups of 40 each based on the restorative material. Group I: Glass ionomer; Group II: Resin composite; Group III: Giomer; and Group IV: Alkasite. The restored teeth were stored in artificial saliva. Each group was divided into four subgroups for fluoride recharge and subsequent confocal laser scanning microscopy (CLSM) examination: (A) no fluoride recharge and CLSM examination after 24 h, (B) no fluoride recharge and CLSM examination after 3 weeks, (C) fluoride recharge once at third week followed by CLSM examination at 6 weeks, and (D) fluoride recharge twice at third week and sixth week followed by CLSM examination at 9 weeks.

Statistical Analysis:

Kruskal−Wallis and Mann−Whitney U tests were performed to analyze the obtained data.

Results:

A significant difference in microleakage was noted among resin composite and other groups except Cention-N, whereas no significant difference was noted pre- and post-fluoride recharge.

Conclusion:

Increased microleakage was noted post-fluoride recharge, although statistically not significant.

Interactions of Crosslinked Polyacrylic Acid Polyelectrolyte Gels with Nonionic and Ionic Surfactants

The morphology and stability of surfactant-loaded polyelectrolyte gels are of great interest for a variety of personal care, cosmetic, and pharmaceutical products. However, the mechanisms of surfactant interactions with gel-forming polymers are poorly understood and experimentally challenging. The aim of this work is to explore in silico the specifics of surfactant absorption within polyelectrolyte gels drawing on the examples of typical non-ionic octaethylene glycol monooctyl ether (C₈E₈) and anionic sodium dodecyl sulfate (SDS) surfactants and polyacrylic acid modified with hydrophobic sidechains mimicking the practically important Carbopol polymer. Using the systematically parameterized coarse-grained dissipative particle dynamics models, we generate and characterize the equilibrium conformations and swelling of the polymer films in aqueous solutions with the surfactant concentrations varied up to the critical micelle concentration (cmc). We discover the striking difference in interactions of Carbopol-like polymers with nonionic and ionic surfactants under mildly acidic conditions. The sorption of C₈E₈ within the polymer film is found substantial. As the surfactant concentration increases, the polymer film swells and, close to cmc, becomes unstable due to the formation and growth of water pockets filled with surfactant micelles. Sorption of SDS at the same bulk concentrations is found much lower, with only about 1% of surfactant mass fraction achieved at cmc. As the SDS concentration increases further, a lamellae structure is formed within the film, which remains stable. Reduced swelling and higher stability indicate better prospects of using SDS-type surfactants with Carbopol-based gels in formulations for detergents and personal care products.

Structure and conformational properties of ideal nanogel particles in athermal solutions

We investigate the conformational properties of "ideal" nanogel particles having a lattice network topology by molecular dynamics simulations to quantify the influence of polymer topology on the solution properties of this type of branched molecular architecture. In particular, we calculate the mass scaling of the radius of gyration (Rg), the hydrodynamic radius, as well as the intrinsic viscosity with the variation of the degree of branching, the length of the chains between the branched points, and the average mesh size within these nanogel particles under good solvent conditions. We find competing trends between the molecular characteristics, where an increase in mesh size or degree of branching results in the emergence of particle-like characteristics, while an increase in the chain length enhances linear polymer-like characteristics. This crossover between these limiting behaviors is also apparent in our calculation of the form factor, P(q), for these structures. Specifically, a primary scattering peak emerges, characterizing the overall nanogel particle size. Moreover, a distinct power-law regime emerges in P(q) at length scales larger than the chain size but smaller than Rg of the nanogel particle, and the Rg mass scaling exponent progressively approaches zero as the mesh size increases, the same scaling as for an infinite network of Gaussian chains. The "fuzzy sphere" model does not capture this feature, and we propose an extension to this popular model. These structural features become more pronounced for values of molecular parameters that enhance the localization of the branching segments within the nanogel particle.

Surface Treatment of the Dental Implant with Hyaluronic Acid: An Overview of Recent Data

Recently, interest has grown by focusing on the evaluation of a molecule already produced in the human body such as hyaluronic acid (HA), as an application to the surface of the titanium implant. Its osteo-conductive characteristics and positive interaction with the progenitor cells responsible for bone formation, consequently, make it responsible for secondary stability. The aim of this work was to analyze the various surface treatments in titanium implants, demonstrating that the topography and surface chemistry of biomaterials can correlate with the host response; also focusing on the addition of HA to the implant surface and assessing the biological implications during early stages of recovery. Used as a coating, HA acts on the migration, adhesion, proliferation and differentiation of cell precursors on titanium implants by improving the connection between implant and bone. Furthermore, the improvement of the bioactivity of the implant surfaces through HA could therefore facilitate the positioning of the dental prosthesis precisely in the early loading phase, thus satisfying the patients’ requests. It is important to note that all the findings should be supported by further experimental studies in animals as well as humans to evaluate and confirm the use of HA in any field of dentistry.

Dental Pulp Stem Cells on Implant Surface: An In Vitro Study

In the field of biology and medicine, one hears often about stem cells and their potential. The dental implant new surfaces, subjected to specific treatments, perform better and allow for quicker healing times and better clinical performance. The purpose of this study is to evaluate from a biological point of view the interaction and cytotoxicity between stem cells derived from dental pulp (DPSCs) and titanium surfaces. Through the creation of complex cells/implant, this study is aimed at analyzing the cytotoxicity of dental implant surfaces (Myth (Maipek Manufacturer Industrial Care, Naples, Italy)) and the adhesion capacity of cells on them and at considering the essential factors for implant healing such as osteoinduction and vasculogenesis. These parameters are pointed out through histology (3D cell culture), immunofluorescence, proliferation assays, scanning electron microscopy, and PCR investigations. The results of the dental implant surface and its interaction with the DPSCs are encouraging, obtaining results increasing the mineralization of the tissues. The knowledge of this type of interaction, highlighting its chemical and biological features, is certainly also an excellent starting point for the development of even more performing surfaces for having better healing in the oral surgical procedures related to dental implant positioning.

An Eventual Sars-CoV-2 Infection Prevention Protocol in the Medical Setting and Dental Office

The current Coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population, and in particular the medical-health field, especially dentistry [...].