The Effect of Calcium-Silicate Cements on Reparative Dentinogenesis Following Direct Pulp Capping on Animal Models

Strontium-Containing Piezoelectric Biofilm Promotes Dentin Tissue Regeneration

It remains an obstacle to induce the regeneration of hard dentin tissue in clinical settings. To overcome this, a P(VDF-TrFE) piezoelectric film with 2 wt% SrCl2 addition is designed. The biofilm shows a high flexibility, a harmonious biocompatibility, and a large piezoelectric d33 coefficient of 14 pC N-1, all contributing to building an electric microenvironment that favor the recruitment of dental pulp stem cells (DPSCs) and their differentiation into odontoblasts during normal chewing, speaking, etc. On the other hand, the strontium ions can be gradually released from the film, thus promoting DPSC odonto-differentiation. In vivo experiments also demonstrate that the film induces the release of dentin minerals and regeneration of dentin tissue. In the large animal dentin defect models, this piezoelectric film induces in situ dentin tissue formation effectively over a period of three months. This study illustrates a therapeutic potential of the piezoelectric film to improve dentin tissue repair in clinical settings.

Peptide KN-17-Loaded Supramolecular Hydrogel Induces the Regeneration of the Pulp-Dentin Complex

Regenerating the pulp-dentin complex remains a decisive factor during apexification for immature permanent teeth. Peptide KN-17, which was modified based on the structure of cecropin B, could effectively interfere with bacterial growth and induce the migration of human bone marrow stromal cells (hBMSCs). This study aimed to investigate the effect of KN-17 on the tissue regeneration. To our surprise, KN-17 can significantly stimulate angiogenesis in vitro and in vivo, which may provide a guarantee for apical closure. Herein, a novel peptide/KN-17 coassembled hydrogel is developed via a heating-cooling process. Npx-FFEY/KN-17 supramolecular hydrogel can induce vessel development, stimulate odontogenic differentiation of human dental pulp stem cells (hDPSCs), and exert an antibacterial effect on Enterococcus faecalis (E. faecalis). Furthermore, coronal pulp excised rat molars are supplied with KN-17 or KN-17-loaded hydrogel and transplanted subcutaneously in BALB/c-nu mice. After 4 weeks, the hydrogel Npx-FFEY/KN-17 stimulates the formation of multiple odontoblast-like cells and dentin-like structures. Our findings demonstrate that the KN-17-loaded hydrogel can promote the regeneration of the pulp-dentin complex for continued root development.

Hard tissue formation in pulpotomized primary teeth in dogs with nanomaterials MCM-48 and MCM-48/hydroxyapatite: an in vivo animal study

BACKGROUND

This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA).

METHODS

This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent.

RESULTS

The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320).

CONCLUSION

MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.

Synthesis of a Calcium Silicate Cement Containing a Calcinated Strontium Silicate Phase

Objectives

The positive effects of strontium on dental and skeletal remineralization have been confirmed in the literature. This study aimed to assess the properties of a calcium silicate cement (CSC) containing a sintered strontium silicate phase.

Materials and Methods

The calcium silicate and strontium silicate phases were synthesized by the sol-gel technique. Strontium silicate powder in 0 (CSC), 10 (CSC/10Sr), 20 (CSC/20Sr), and 30 (CSC/30Sr) weight percentages was mixed with calcium silicate powder. Calcium chloride was used in the liquid phase. X-ray diffraction (XRD) of specimens was conducted before and after hydration. The setting time and compressive strength were assessed at 1 and 7 days after setting. The set discs of the aforementioned groups were immersed in the simulated body fluid (SBF) for 1 and 7 days. The ion release profile was evaluated by inductively coupled plasma-optical emission spectrometry (ICP-OES). Biomineralization on the specimen surface was evaluated by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS). Data were analyzed by the Kolmogorov-Smirnov test, one-way and mixed ANOVA, Levene's test, and LSD post hoc test (P  < 0.05).

Results

Except for an increasement in the peak intensity of hydrated specimens, XRD revealed no other difference in the crystalline phases of hydrated and nonhydrated specimens. The compressive strength was not significantly different at 1 and 7 days in any group (P  > 0.05). The setting time significantly decreased by an increase in percentage of strontium (P  < 0.05). Release of Ca and Si ions significantly decreased by an increase in percentage of strontium (P  < 0.05). SEM/EDS showed the formation of calcium phosphate deposits at 1 and 7 days.

Conclusion

Incorporation of 10-30 wt% sintered strontium silicate phase as premixed in CSC can significantly decrease the setting time without compromising the compressive strength or biomineralization process of the cement.

Evaluation of the genotoxicity, cytotoxicity, and bioactivity of calcium silicate-based cements

BACKGROUND

As calcium silicate-based cements (CSCs) have found success in various vital pulp therapy applications, several new CSC products have emerged. This study aimed to assess the genotoxicity, cytotoxicity, and bioactivity of four CSCs by comparing the newly introduced materials Bio MTA+ and MTA Cem with previously studied materials, Biodentine and NeoMTA.

METHODS

Genotoxicity was evaluated using the micronucleus (MN) assay in human peripheral blood lymphocyte cells, measuring MN frequency and nuclear division index (NDI). Cytotoxicity was assessed in human dental pulp stem cells through the Water-Soluble Tetrazolium Salt-1 (WST-1) colorimetric assay. Bioactivity was determined by ELISA, measuring the levels of angiogenic and odontogenic markers (BMP-2, FGF-2, VEGF, and ALP). Statistical analyses included ANOVA, Dunnet and Sidak tests, and Wald chi-square test. (p < .05).

RESULTS

The MN frequency in the groups was significantly lower than that in the positive control group (tetraconazole) (p < .05). NDI values decreased with increasing concentration (p < .05). Bio MTA+ and NeoMTA showed decreased cell viability at all concentrations in 7-day cultures (p < .01). All materials increased BMP-2, FGF-2, and VEGF levels, with Biodentine and NeoMTA showing the highest levels of BMP-2 and FGF-2 on day 7. Biodentine displayed the highest VEGF levels on day 7. Biodentine and NeoMTA groups exhibited significantly higher ALP activity than the Bio MTA+ and MTA Cem groups by day 7.

CONCLUSION

Bio MTA+ and MTA Cem demonstrated no genotoxic or cytotoxic effects. Moreover, this study revealed bioactive potentials of Bio MTA+ and MTA Cem by enhancing the expression of angiogenic and osteogenic growth factors.

Modern methods and materials used to treat root perforation: effectiveness comparison

This study aims to experimentally compare the efficacy of different endodontic materials (iRoot BP Plus, Biodentine, MTA, Rootdent, and Trioxide) in the treatment of pulpitis and perforations on extracted tooth specimens. Additionally, the study aims to investigate the influence of iRoot BP Plus endodontic material on the regenerative processes following pulp amputation in laboratory animals. The secondary goal is to evaluate the effect of iRoot BP Plus on the restoration process in laboratory animals after pulp removal. The study presents a micropermeability analysis of the selected biomaterials performed on a sample of 50 single-rooted apical teeth in 2022. All teeth underwent endodontic treatment. Changes in molar morphology were investigated with eight laboratory animals (rabbits, 3 months old, all males) after simulated pulp removal and subsequent treatment with the iRoot BP Plus biomaterials. iRoot BP Plus appeared to be more effective in retrograde apical root filling than other biomaterials, as evidenced by its higher sealing effect. An experiment involving animal participants revealed the presence of protective adaptive mechanisms, which manifested in the form of an inflammatory process within 6 weeks after the dental pulp was removed. The connective tissue replaced the necrosis, and new capillaries began to form intensively. These dental outcomes suggest that iRoot BP Plus enables hermetical sealing in tooth restoration with good adhesion. Thus, it may have the ability to promote more active tissue regeneration after pulp removal.

Direct pulp capping procedures - Evidence and practice

The aim of direct pulp capping (DPC) is to promote pulp healing and mineralized tissue barrier formation by placing a dental biomaterial directly over the exposed pulp. Successful application of this approach avoids the need for further and more extensive treatment. In order to ensure a complete pulp healing with the placement of restorative materials, a mineralized tissue barrier must form to protect the pulp from microbial invasion. The formation of mineralized tissue barrier can only be induced when there is a significant reduction in pulp inflammation and infection. Consequently, promoting the healing of pulp inflammation may provide a favorable therapeutic opportunity to maintain the sustainability of DPC treatment. Mineralized tissue formation was observed as the favorable reaction of exposed pulp tissue against a variety of dental biomaterials utilized for DPC. This observation reveals an intrinsic capacity of pulp tissue for healing. Therefore, this review focuses on the DPC and its healing procedure as well as the materials used for DPC treatment and their mechanisms of action to promote pulpal healing. In addition, the factors that can affect the healing process of DPC, clinical considerations and future perspective has been described.

Regenerative potential of a novel aloe vera modified tricalcium silicate cement as a pulp capping material: An animal study

This study compared the histologic response of a pulp capping material Matreva MTA modified with different concentrations of aloe vera (AV) solutions to Biodentine cement. Ninety dogs' teeth were included and categorized according to the capping material into five groups (18 teeth each); Group I (Biodentine), group II (Matreva MTA), group III (Matreva MTA 10% AV), group IV (Matreva MTA 20% AV) and group V (Matreva MTA 30% AV). The histopathological findings were recorded at 2, 4, and 8 weeks. Matreva MTA and Biodentine groups showed the highest inflammatory cell count compared to the AV-modified Matreva MTA groups at 2- and 4-week intervals (p>0.05). Moreover, the AV-modified Matreva MTA and Biodentine groups showed higher dentin bridge thickness compared to unmodified Matreva MTA at different follow-up periods (p<0.05). AV can significantly enhance the in vivo bioactivity of Matreva MTA, inducing mild inflammation and good dentine bridge formation comparable to Biodentine.

Histopathological and immunohistochemical profiles of pulp tissues in immature dogs' teeth to two recently introduced pulpotomy materials

OBJECTIVE

The pulpal response to Hoffmann's Pulpine mineral (PMIN) and Pulpine NE (PNE) was compared to mineral trioxide aggregate (MTA) when used as pulpotomy materials in immature permanent teeth in dogs.

MATERIALS AND METHODS

Immature premolars were randomly divided according to the observation period into three equal groups (n = 24) (10 days, 30 days, and 90 days) then furtherly subdivided into 3 subgroups according to the material used. Histopathological analysis regarding inflammatory cell infiltration and dentin bridge (DB) formation was done. Immunohistochemical analysis was performed using osteopontin marker.

RESULTS

The results showed that after 90 days, both MTA and PMIN subgroups had 100% complete thick DB without inflammation in 87.5% of the samples, while the PNE subgroup failed to form DB in 37.5% of the samples and 50% of samples showed thin initial DB with heavy inflammation in 62.5% of the samples. There was no significant difference between MTA and PMIN, while there was a statistically significant difference between PNE and the two other subgroups in DB formation and inflammatory cell infiltration (P > 0.05). After 90 days, MTA showed the highest mean value of osteopontin positive fraction area followed by PMIN without statistically significant differences, while the least value was recorded in PNE subgroup with statistically significant difference with the remaining subgroups (P < 0.05).

CONCLUSION

PMIN is a promising alternative to MTA when used for pulpotomy.

CLINICAL RELEVANCE

Vital pulp therapy in immature teeth can be done using PMIN as an alternative to MTA.

Fiber post bonding with beta-tricalcium phosphate incorporated root dentin adhesive. SEM, EDX, FTIR, rheometric and bond strength study

The aim was to formulate an experimental adhesive (EA) and added nanoparticles (NPs) of beta-tricalcium phosphate (β-TCP) to see the impact on pushout bond strength (PBS) and other mechanical properties. Three adhesives were prepared, including EA (control, without β-TCP NPs), 2.5%-β-TCP NPs containing adhesive (2.5%-NPA), and 5% β-TCP NPs containing adhesive (5%-NPA). For the characterization of the NPs, scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy was accomplished. For the adhesive's characterization, rheological assessment, and degree of conversion (DC) analysis were performed. PBS of these adhesives against resin fiber post to root dentin, interfacial failure categories, and resin dentin interface analysis were also assessed. The β-TCP NPs were seen as agglomerated asymmetrical particles on SEM. These NPs were composed primarily of calcium (Ca), and phosphorus (P). Rheological evaluation of the adhesive's showed a drop in the viscosity of all adhesives at greater angular frequencies. The greatest DC was detected for the EA group (67.54 ± 7.9) followed by 2.5%-NPA group (45.32 ± 5.1), whereas the lowest DC values were seen for the 5%-NPA group (38.97 ± 6.5). Concerning PBS, the 2.5%-NPA revealed the highest values at the coronal (12.81 ± 3.0) and middle (8.50 ± 2.3) sections, whereas, for the apical section, the highest PBS values were seen for the 5%-NPA (4.9 ± 1.6). Most of the failures for all adhesive groups were seen at the adhesive-dentin interface (cohesive type failures) for all root segments (coronal, middle, and apical). The resin-dentin interface analysis verified hybrid layer and resin tag formation for all adhesives, but the presence of dispersed β-TCP NPs was only seen in the two NP-reinforced adhesives. The adding of β-TCP NPs in the adhesive could be beneficial as it could improve its PBS. Suitable rheological properties and dentin interaction were also observed for NP-reinforced adhesives. A reduced DC was seen for both β-TCP NP-containing adhesives as compared to the EA. RESEARCH HIGHLIGHTS: Experimental adhesives were reinforced with beta-tricalcium phosphate (β-TCP) nanocrystals. The β-TCP NPs were seen as agglomerated asymmetrical particles on SEM. These NPs were composed primarily of calcium (Ca), and phosphorus (P). β-TCP adhesives demonstrated superior pushout bond strength and a drop in the adhesive viscosity at greater angular frequencies compared to control adhesive. The greatest DC was detected for the EA group followed by 2.5%- β-TCP group, whereas the lowest DC values were for the 5%- β-TCP group.

Influence of Direct Pulp Capping with Calcium Hydroxide and Mineral Trioxide Aggregate on Systemic Oxidative Stress in Rats

Direct pulp capping is a procedure where materials are placed on exposed vital pulp tissue in order to stimulate reparative dentinogenesis and preserve pulp vitality. Carious pulp exposure and direct pulp capping are usually accompanied by pulp inflammation which can affect pro- and anti-oxidative systems locally or systemically. Therefore, this study aimed to investigate the potential influence of direct capping of inflamed rat dental pulp with calcium hydroxide (CH) and mineral trioxide aggregate (MTA) on parameters of systemic oxidative status.

Dental pulps of the first maxillary molars of Albino rats (n=32) were exposed and capped with either CH (n=8), MTA (n=8) or were left untreated (n=8). Animals with healthy pulp were used as a healthy control (n=8). After four weeks, animals were euthanized and blood samples were collected for biochemical analysis of parameters of systemic oxidative stress by spectrophotometric method.

Untreated control had the significantly higher (p <0.05) values of pro-oxidative parameters and lower (p <0.05) values of anti-oxidative parameters (superoxide dismutase and reduced glutathione) compared to healthy control. CH and MTA groups showed reduced values of pro-oxidative parameters compared to untreated control and values of anti-oxidative parameters comparable to healthy control.

Pulp exposure led to disbalance in systemic oxidative parameters while direct pulp capping with calcium hydroxide and mineral trioxide aggregate restored the levels of systemic oxidative parameters to that of animals with healthy dental pulp. These results indicate the importance of direct pulp capping and the potential influence of untreated inflamed pulp on systemic health.

Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model

(1) Background: This study aimed to assess the pulpal response of primary teeth by pulse-oximetry (PO) in a canine model, following direct pulp capping (DPC). (2) Methods: Forty-eight primary teeth from eight canine subjects were divided into three treatment groups, based on the DPC material—calcium hydroxide (CH), MTA, BiodentineTM)—and three corresponding control groups. Data from PO pulp testing were correlated with laser Doppler flowmetry (LDF) testing, computer tomographic (CT) densitometry and histological analysis; the experiment lasted 14 days. (3) Results: SpO₂ recordings revealed statistically significant differences (p = 0.002, <0.05) between the treatment and control groups, and no significant differences (p = 0.257, >0.05) were observed between treatment groups. LDF recordings showed significant differences (p = 0.002, <0.05) between the treatment and control groups and identified significant differences between materials (p = 0.001, <0.05). CT densitometry indicated vital pulps in all teeth, with pulpal inflammation detected in 6/8 CH-capped teeth and 2/8 MTA-capped teeth. Histologic evaluation confirmed vital pulp in all specimens, with different degrees of inflammation. (4) Conclusions: Within its limitations, the present study confirms the diagnostic value of PO evaluation of pulpal status in primary teeth with histologic means after pulp-capping procedures in a canine model. However, various degrees of pulpal inflammation elicited by different pulp-capping materials seem not to correlate with the obtained PO values.

Improvement of Biological Effects of Root-Filling Materials for Primary Teeth by Incorporating Sodium Iodide

Therapeutic iodoform (CHI₃) is commonly used as a root-filling material for primary teeth; however, the side effects of iodoform-containing materials, including early root resorption, have been reported. To overcome this problem, a water-soluble iodide (NaI)-incorporated root-filling material was developed. Calcium hydroxide, silicone oil, and NaI were incorporated in different weight proportions (30:30:X), and the resulting material was denoted DX (D5~D30), indicating the NaI content. As a control, iodoform instead of NaI was incorporated at a ratio of 30:30:30, and the material was denoted I30. The physicochemical (flow, film thickness, radiopacity, viscosity, water absorption, solubility, and ion releases) and biological (cytotoxicity, TRAP, ARS, and analysis of osteoclastic markers) properties were determined. The amount of iodine, sodium, and calcium ion releases and the pH were higher in D30 than I30, and the highest level of unknown extracted molecules was detected in I30. In the cell viability test, all groups except 100% D30 showed no cytotoxicity. In the 50% nontoxic extract, D30 showed decreased osteoclast formation compared with I30. In summary, NaI-incorporated materials showed adequate physicochemical properties and low osteoclast formation compared to their iodoform-counterpart. Thus, NaI-incorporated materials may be used as a substitute for iodoform-counterparts in root-filling materials after further (pre)clinical investigation.

Manufacturing nano novel composites using sugarcane and eggshell as an alternative for producing nano green mortar

The purpose of this study is to demonstrate the impact of incorporating two different types of green nanomaterials (sugarcane and eggshell) on destructive and non-destructive properties of mortar. Nano sugarcane (NSC) was manufactured by calcining sugarcane at temperatures of 600 °C for 3 h. On the other hand, nano eggshell (NES) was manufactured by calcining eggshell at temperatures of 600 °C for 6 h. The sugarcane ash and eggshell ash were then milled to nano size. The final nano-sized product replaced Portland cement with different dosages of 2, 4 and 6%. Sixteen mortar mixtures were designed and prepared using only NSC or only NES or a combined hybrid of NSC and NES. Consistency, compressive strength, flexural strength and microstructure analysis (scanning electron microscopy and energy-dispersive X-ray) tests were conducted to investigate the influence of replacement materials on the performance and properties of mortars. The results showed that the use of nano sugarcane and nano eggshell enhanced the compressive strength and reduced permeability of green mortar due to the micropore structure. At the ages of 7 and 28 days, mortars containing a replacement ratio of 2% (0.5% NSC + 1.5% NES) had remarkably improved mechanical properties, and the improvement in compressive strength reached 21.3% and flexural strength to 10.08% when compared to the control sample. The efficiency of NSC and NES in increasing mortar strength was also confirmed by microstructure analysis.

Effectiveness of Direct Pulp Capping Bioactive Materials in Dentin Regeneration: A Systematic Review

Background: Regenerative endodontics aims to restore normal pulp function in necrotic and infected teeth, restoring protective functions, such as innate pulp immunity, pulp repair through mineralization, and pulp sensibility. The aim of this systematic review was to assess the dentin regeneration efficacy of direct pulp capping (DPC) biomaterials. Methods: The literature published between 2005 and 2021 was searched by using PubMed, Web of Science, Science Direct, Google Scholar, and Scopus databases. Clinical controlled trials, randomized controlled trials, and animal studies investigating DPC outcomes or comparing different capping materials after pulp exposure were included in this systematic review. Three independent authors performed the searches, and information was extracted by using a structured data format. Results: A total of forty studies (21 from humans and 19 from animals) were included in this systemic review. Histological examinations showed complete/partial/incomplete dentin bridge/reparative dentin formation during the pulp healing process at different follow-up periods, using different capping materials. Conclusions: Mineral trioxide aggregate (MTA) and Biodentine can induce dentin regeneration when applied over exposed pulp. This systematic review can conclude that MTA and its variants have better efficacy in the DPC procedure for dentin regeneration.

Application of β-Tricalcium Phosphate in Adhesive Dentin Bonding

The study aimed at synthesizing β-tricalcium phosphate (β-TCP) nanoparticles and comparing the mechanical properties and dentin interaction of two adhesives: experimental adhesive (EA) and EA with 5 wt.% β-TCP nanoparticles (β-TCP-5%). These filler nanoparticles were synthesized and then characterized with scanning electron microscopy (SEM) and micro-Raman spectroscopy. The β-TCP nanoparticles were incorporated in the adhesives to form two groups: gp-1: EA (control) and gp-2: β-TCP-5%. These adhesives were characterized by SEM, energy-dispersive X-ray (EDX) spectroscopy and were also assessed for their micro-tensile bond strength (μTBS) with (TC) and without thermocycling (NTC). Fourier Transform Infrared (FTIR) spectroscopy was performed to evaluate the degree of conversion (DC) of two adhesives. The β-TCP filler was seen as irregularly shaped agglomerates on SEM. The micro-Raman spectra revealed characteristic peaks associated with β-TCP nanoparticles. Both adhesives presented suitable dentin interaction, which was demonstrated by the formation of resin tags of variable depths. The EDX analysis verified the existence of calcium (Ca) and phosphate (P) for the β-TCP-5% group. The greatest μTBS values were shown by β-TCP-5% group samples when they were non-thermocycled (NTC) (β-TCP-5%-NTC: 34.11 ± 3.46) followed by the thermocycled (TC) samples of the same group (β-TCP-5%-TC: 30.38 ± 3.66), compared with the EA group. Although the DC presented by β-TCP-5% group was comparable to the EA group, it was still lower. The addition of β-TCP nanoparticles in the adhesive improved its μTBS and resulted in a suitable dentin interaction, seen in the form of hybrid layer and resin tag formation. Nonetheless, a decreased DC was observed for the β-TCP-5% adhesive. Future studies probing the effect of different filler concentrations on various properties of the adhesive are warranted.

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

Mineral trioxide aggregate (MTA) is an alternative endodontic material that predicts conductive or inductive calcified tissue formation from immature pulp mesenchymal stem cells (IPMSCs). The purpose of this study was to investigate whether MTA could promote reparative odontoblast differentiation via IPMSCs in the early phase of regeneration and compare with calcium hydroxide (CH). Direct pulp capping using calcium hydroxide (CH), MTA, and MTA with platelet-rich plasma (MTA + PRP) was performed on maxillary first molars of 8-week-old male Wistar rats (n = 36). After 3, 7, or 14 days, the teeth were analyzed for mineral density (MD) and volume of MD (VMD) via micro-focusing computed tomography (µCT), nestin, dentin matrix acidic phosphoprotein 1 (DMP1) immunohistochemistry, and real-time PCR for DMP1 mRNA expression. MTA stimulated the early phase differentiation of the IPMSCs into odontoblasts, with positive results for nestin and DMP1 compared with CH. Moreover, MTA + PRP stimulated calcified granule and dentin bridge formation through calcium mineral deposition, following the induction of DMP1 mRNA expression in IPMSCs. Our results suggested that the combination of MTA and PRP is an effective and clinically applicable method for activating endogenous dental pulp stem cells into odontoblasts in the early stages of pulp regeneration.

Advances in 3D-Printed Surface-Modified Ca-Si Bioceramic Structures and Their Potential for Bone Tumor Therapy

Bioceramics such as calcium silicate (Ca-Si), have gained a lot of interest in the biomedical field due to their strength, osteogenesis capability, mechanical stability, and biocompatibility. As such, these materials are excellent candidates to promote bone and tissue regeneration along with treating bone cancer. Bioceramic scaffolds, functionalized with appropriate materials, can achieve desirable photothermal effects, opening up a bifunctional approach to osteosarcoma treatments-simultaneously killing cancerous cells while expediting healthy bone tissue regeneration. At the same time, they can also be used as vehicles and cargo structures to deliver anticancer drugs and molecules in a targeted manner to tumorous tissue. However, the traditional synthesis routes for these bioceramic scaffolds limit the macro-, micro-, and nanostructures necessary for maximal benefits for photothermal therapy and drug delivery. Therefore, a different approach to formulate bioceramic scaffolds has emerged in the form of 3D printing, which offers a sustainable, highly reproducible, and scalable method for the production of valuable biomedical materials. Here, calcium silicate (Ca-Si) is reviewed as a novel 3D printing base material, functionalized with highly photothermal materials for osteosarcoma therapy and drug delivery platforms. Consequently, this review aims to detail advances made towards functionalizing 3D-printed Ca-Si and similar bioceramic scaffold structures as well as their resulting applications for various aspects of tumor therapy, with a focus on the external surface and internal dispersion functionalization of the scaffolds.