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Naik SV, Prakash AJ, Prabhakar Attiguppe R. A survey on awareness and knowledge among dentist practicing regenerative endodontics towards current regenerative endodontic protocols and the scaffolds used in regenerative dentistry. Saudi Dent J 2023; 35:559-566. [PMID: 37520602 PMCID: PMC10373079 DOI: 10.1016/j.sdentj.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/02/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
There are many inconsistencies in the protocols followed for Regenerative Endodontic Procedures (REP's).This study was formulated with an aim to conduct a survey among Pediatric Dentists, Endodontists and General Practioners treating Necrotic young permanent teeth to examine their awareness and Knowledge on Current Regenerative Endodontic Protocols and Scaffolds used in regenerative dentistry. Methods A Cross-Sectional Survey was carried out amongst 100 Pediatric dentists,100 Endodontists and 100 General Practioners. It was web-based survey and the questionnaire was formulated and all the items in the questionnaire were tested for reliability and validity before circulation of the questionnaire for the purpose of the study. Results The results of the study indicated that all the three groups were unaware that failure of cases should be reported to AEE (American Academy of Endodontics) REP Database and only 20.2, 20.1 and 0.3 % of Pediatric dentists,Endodontists and General Dentists preferred Regenerative Dentistry as a clinical protocol for REP. With respect to knowledge regarding irrigation and disinfection procedures all three groups were lacking in the knowledge regarding intracanal medicament for disinfection and the irrigation solutions. Conclusion There is a lack of homogeneity in protocols followed for REP among those practicing Regenerative Endodontics as a protocol. Since it's an evolving science there is a need to bring about a uniformity in practices to increase the evidences to support the causal effect relation of regenerative endodontics.
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Affiliation(s)
- Saraswathi V. Naik
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Aarathi J. Prakash
- Department of Pediatrics and Preventive Dentistry, Malabar Dental College and Research Center, India
| | - R. Prabhakar Attiguppe
- Department of Pediatrics and Preventive Dentistry, Malabar Dental College and Research Center, India
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Kato G, Araújo R, Rodrigues C, Gomes PS, Grenho L, Fernandes MH. Ex Vivo Osteogenesis Induced by Calcium Silicate-Based Cement Extracts. J Funct Biomater 2023; 14:314. [PMID: 37367277 DOI: 10.3390/jfb14060314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/27/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
Calcium silicate-based cements are used in a variety of clinical conditions affecting the pulp tissue, relying on their inductive effect on tissue mineralization. This work aimed to evaluate the biological response of calcium silicate-based cements with distinct properties-the fast-setting Biodentine™ and TotalFill® BC RRM™ Fast Putty, and the classical slow-setting ProRoot® MTA, in an ex vivo model of bone development. Briefly, eleven-day-old embryonic chick femurs were cultured for 10 days in organotypic conditions, being exposed to the set cements' eluates and, at the end of the culture period, evaluated for osteogenesis/bone formation by combining microtomographic analysis and histological histomorphometric assessment. ProRoot® MTA and TotalFill® extracts presented similar levels of calcium ions, although significantly lower than those released from BiodentineTM. All extracts increased the osteogenesis/tissue mineralization, assayed by microtomographic (BV/TV) and histomorphometric (% of mineralized area; % of total collagen area, and % of mature collagen area) indexes, although displaying distinct dose-dependent patterns and quantitative values. The fast-setting cements displayed better performance than that of ProRoot® MTA, with BiodentineTM presenting the best performance, within the assayed experimental model.
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Affiliation(s)
- Gabriel Kato
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Rita Araújo
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Cláudia Rodrigues
- Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Pedro Sousa Gomes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Liliana Grenho
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
| | - Maria Helena Fernandes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- LAQV/Requimte, University of Porto, 4100-007 Porto, Portugal
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Rathinam E, Rajasekharan S, Declercq H, Vanhove C, De Coster P, Martens L. Effect of Intracoronal Sealing Biomaterials on the Histological Outcome of Endodontic Revitalisation in Immature Sheep Teeth-A Pilot Study. J Funct Biomater 2023; 14:jfb14040214. [PMID: 37103304 PMCID: PMC10144940 DOI: 10.3390/jfb14040214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/28/2023] Open
Abstract
The influence of intracoronal sealing biomaterials on the newly formed regenerative tissue after endodontic revitalisation therapy remains unexplored. The objective of this study was to compare the gene expression profiles of two different tricalcium silicate-based biomaterials alongside the histological outcomes of endodontic revitalisation therapy in immature sheep teeth. The messenger RNA expression of TGF-β, BMP2, BGLAP, VEGFA, WNT5A, MMP1, TNF-α and SMAD6 was evaluated after 1 day with qRT-PCR. For evaluation of histological outcomes, revitalisation therapy was performed using Biodentine (n = 4) or ProRoot white mineral trioxide aggregate (WMTA) (n = 4) in immature sheep according to the European Society of Endodontology position statement. After 6 months' follow-up, one tooth in the Biodentine group was lost to avulsion. Histologically, extent of inflammation, presence or absence of tissue with cellularity and vascularity inside the pulp space, area of tissue with cellularity and vascularity, length of odontoblast lining attached to the dentinal wall, number and area of blood vessels and area of empty root canal space were measured by two independent investigators. All continuous data were subjected to statistical analysis using Wilcoxon matched-pairs signed rank test at a significance level of p < 0.05. Biodentine and ProRoot WMTA upregulated the genes responsible for odontoblast differentiation, mineralisation and angiogenesis. Biodentine induced the formation of a significantly larger area of neoformed tissue with cellularity, vascularity and increased length of odontoblast lining attached to the dentinal walls compared to ProRoot WMTA (p < 0.05), but future studies with larger sample size and adequate power as estimated by the results of this pilot study would confirm the effect of intracoronal sealing biomaterials on the histological outcome of endodontic revitalisation.
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Affiliation(s)
- Elanagai Rathinam
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Sivaprakash Rajasekharan
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Human Structure and Repair, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Tissue Engineering Laboratory, Department of Development and Regeneration, KU Leuven, 8500 Kortrijk, Belgium
| | - Christian Vanhove
- Medical Imaging & Signal Processing, Infinity Laboratory, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Dental School, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Luc Martens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Paediatric Dentistry, Oral Health Sciences, Ghent University Hospital, 9000 Ghent, Belgium
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Kumar N, Maher N, Amin F, Ghabbani H, Zafar MS, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Biomimetic Approaches in Clinical Endodontics. Biomimetics (Basel) 2022; 7:biomimetics7040229. [PMID: 36546929 PMCID: PMC9775094 DOI: 10.3390/biomimetics7040229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.
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Affiliation(s)
- Naresh Kumar
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
| | - Nazrah Maher
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Faiza Amin
- Department of Science of Dental Materials, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Ricardo E. Oñate-Sánchez
- Department of Special Care in Dentistry, Hospital Morales Meseguer, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
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Caviedes-Bucheli J, Muñoz-Alvear HD, Lopez-Moncayo LF, Narvaez-Hidalgo A, Zambrano-Guerrero L, Gaviño-Orduña JF, Portigliatti R, Gomez-Sosa JF, Munoz HR. Use of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella review. Int Endod J 2022; 55:967-988. [PMID: 35821587 DOI: 10.1111/iej.13799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Current treatment of immature necrotic permanent teeth with a periapical lesion is regenerative endodontics, which is based on tissue engineering under the triade of stem cells, scaffolds and bioactive molecules. OBJECTIVES This Umbrella Review was aimed to evaluate the success of scaffold and regenerative materials used for the treatment of these teeth, in terms of apical closure, tooth length increase, widening of root canal walls, tissue vitality and periapical lesion repair. METHODS An extensive literature research was carried out in the Medline, ISI Web of Science, and Scopus databases for relevant systematic reviews matching the keyword search strategy. Based on inclusion and exclusion criteria, reviewers independently rated the quality of each study to determine their level of evidence. Methodological quality assessment of each article was obtained using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2 tool, and risk of bias was assessed with the Risk of Bias in Systematic Reviews (ROBIS) tool. RESULTS After removing duplicates, 155 articles were found; from which 133 were excluded for being non-relevant and 15 other due to exclusion criteria. One more was discarded after methodological quality evaluation, for a total of six articles remaining. The most common scaffold used was the blood clot, others used were poly lactic-co-glycolic acid and platelet-rich fibrin matrix. The most common regeneration material used was Mineral Trioxide Aggregate (MTA), followed by Biodentine. An increase in tooth length and widening of root canal walls were reported in all selected studies with different proportions, as well as periapical lesion repair. ROBIS analysis showed that only one article had low bias, two were classified as unclear bias, while the remaining three had high risk of bias. DISCUSSION An exhaustive literature search was carried out applying language filters, high-quality indexed journals, year of publication, which ensures the best quality articles were included. Blood clot was the most used scaffold as is the most easy to place inside the canal and does not require to extract blood from the patient. The use of MTA and Biodentine as sealing materials has been associated with thickening of canal walls, apical closure and reduced signs and symptoms of apical periodontitis. However, most of the included reviews assessed were case reports and only in a few of them were clinical trials included. There is also a lack of risk of bias analysis in most reviews. CONCLUSION The blood clot is the most common scaffold used for inducing regeneration during the treatment of immature necrotic teeth. Tooth length increase and widening of root canal walls are the most common criteria used in the studies as success indicators. MTA and Biodentine did not show differences in the results analysed. Quality assessment and bias risk evaluation showed that it is necessary to design better studies with rigorous methodology to recommend a trustable and predictable protocol for the treatment of immature necrotic permanent teeth with periapical lesions. REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42021248404.
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Affiliation(s)
| | | | | | | | | | - José F Gaviño-Orduña
- Odonto-Stomatology Department, School of Dentistry, Universidad de Barcelona, Barcelona, Spain
| | | | - Jose F Gomez-Sosa
- Endodontics Department, Universidad Central de Venezuela, Caracas, Venezuela
| | - Hugo R Munoz
- Endodontics Department, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
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Riaz S, Azlina A, Mahmood Z, Htun AT. Long-term treatment of dentine with triple antibiotic paste promotes stem cell viability and attachment. J Taibah Univ Med Sci 2022; 17:630-639. [PMID: 35983454 PMCID: PMC9356367 DOI: 10.1016/j.jtumed.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/30/2021] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Successful regenerative endodontic procedures in dental treatment are critically associated with complete disinfection of the root canal and require irrigants and medicaments. One factor for consideration is the biocompatibility of the medicament as this can affect the intracanal dentine and subsequently the dental stem cell viability required for the repair of the dentine–pulp complex. This in vitro study investigated the effect of a 4-week treatment of calcium hydroxide [Ca(OH)2] and triple antibiotic paste (TAP) on the irrigated radicular dentine by analysing dentine interaction with dental stem cells. Methods TAP consists of metronidazole, ciprofloxacin and minocycline. Dentine chips were prepared and treated with either Ca(OH)2 or TAP for 4-weeks, irrigated by 1.5% sodium hypochlorite (NaOCl), rinsed with saline, followed by 17% ethylenediaminetetraacetic acid (EDTA). Dental pulp stem cells (DPSCs) cultured on the surface of the dentine chips were analysed on days 1, 3 and 7 of cell seeding for PrestoBlue viability assays, 6-diamidino-2 phenylindole (DAPI) staining and scanning electron microscopy (SEM). An independent t-test (SPSS software version 24.0) was used to statistically analyse the PrestoBlue assay data. Results DPSCs grown from dentine treated with TAP showed significantly higher cell viability than the Ca(OH)2 and control groups (p < 0.05). DAPI staining of the seeded DPSCs on the treated dental chips complemented the findings of the viability assay. SEM studies also revealed improvements in the cell spreading and attachment of DPSCs grown on TAP-treated dentine compared with Ca(OH)2. Conclusion The treatment of dentine with TAP for 4 weeks provided a better microenvironment for the viability and attachment of DPSCs when compared to Ca(OH)2.
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Affiliation(s)
- Samiya Riaz
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
- Dental Clinics, Hospital Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Azlina
- Basic Sciences and Oral Biology Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
- Correspondence address: Basic Sciences and Oral Biology Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - Zuliani Mahmood
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
- Dental Clinics, Hospital Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
| | - Aung T. Htun
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
- Dental Clinics, Hospital Universiti Sains Malaysia, Health Campus Kubang Kerian, Kelantan, Malaysia
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Rojas-Gutiérrez WJ, Pineda-Vélez E, Agudelo-Suárez AA. Regenerative Endodontics Success Factors and their Overall Effectiveness: An Umbrella Review. Iran Endod J 2022; 17:90-105. [PMID: 36704087 PMCID: PMC9869004 DOI: 10.22037/iej.v17i3.32703] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 01/28/2023]
Abstract
Introduction Regenerative endodontics is a developing field of dentistry and aims to recover the physiological and anatomical functions of the tooth for cases of severe dental caries, pulpal pathologies and dental trauma. Materials and Methods This umbrella review seeks to discover the scientific evidence on the effectiveness and the factors result in successful regenerative endodontic therapies in teeth with necrotic pulps and with incomplete root development. The study was conducted following the PRISMA Guidelines. There were no restrictions regarding search period. A comprehensive literature search was carried out in EMBASE, LILACS, PubMed, Cochrane, Scopus, and Google Scholar. A quality evaluation was conducted by using AMSTAR-2. A descriptive analysis of the included systematic reviews and meta-analysis were conducted. Results Thirteen descriptive systematic reviews and 7 meta-analyses were included. Three articles evidenced low methodological quality according to AMSTAR-2 tool. Overall success rates for the endodontic regeneration procedures ranged from 50% to 98% and the survival rates were between 94% and 100%. Pulp regeneration had a high success rate, evidenced by factors such as the resolution of symptoms, healing, increased root length, dentin thickening and recovery of sensitivity. Follow-up varied from 1 to 48 months for the original studies included in the systematic reviews and meta-analyses. Conclusions Endodontic practice offers the clinician a good treatment option in case of necrotic pulp with immature roots such as the endodontic regeneration, that is supported by high and moderate quality scientific literature.
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Affiliation(s)
| | | | - Andrés A. Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Medellín, Colombia,Corresponding author: Andrés A. Agudelo-Suárez, Faculty of Dentistry, University of Antioquia, Medellín, Colombia PC 050010. E-mail:
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Slaboseviciute M, Vasiliauskaite N, Drukteinis S, Martens L, Rajasekharan S. Discoloration Potential of Biodentine: A Systematic Review. Materials (Basel) 2021; 14:ma14226861. [PMID: 34832263 PMCID: PMC8619462 DOI: 10.3390/ma14226861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
The aim of this systematic review is to investigate the teeth discoloration potential of Biodentine. An electronic search in six databases (PubMed, Cochrane Library, LILACS, SCIELO, Web of Science, and Scopus) was conducted by three independent reviewers to identify eligible articles. The following search terms were used: ((discolo*, staining potential, color, colour, or spectrophotomet*), (teeth or tooth), and (Biodentine)). Methodology following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was adopted for this investigation. At the end of the selection process, 30 articles were identified as eligible, of which 14 in vitro studies were included in this systematic review. Nine of the included studies evaluated the discoloration potential of Biodentine in the presence of blood. Within the limitations of this review, teeth discoloration using Biodentine is highly expected when material is placed in direct contact with blood during dental procedures. In the absence of blood, Biodentine causes less teeth color changes than MTA-based materials, but it is still unclear what clinically relevant results could be expected regarding the discoloration frequency and intensity induced by Biodentine.
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Affiliation(s)
- Monika Slaboseviciute
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Neringa Vasiliauskaite
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
- Correspondence: ; Tel.: +370-610-41808
| | - Luc Martens
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
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Prasetyo EP, Kuntjoro M, Goenharto S, Juniarti DE, Cahyani F, Hendrijantini N, Nugraha AP, Hariyani N, Rantam FA. Calcium Hydroxide Increases Human Umbilical Cord Mesenchymal Stem Cells Expressions of Apoptotic Protease-Activating Factor-1, Caspase-3 and Caspase-9. Clin Cosmet Investig Dent 2021; 13:59-65. [PMID: 33727863 PMCID: PMC7954029 DOI: 10.2147/ccide.s284240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/10/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose Calcium hydroxide is a gold standard dental material generally used for pulpal and periapical therapy including regenerative endodontic procedures because of its positive properties. However, evaluation about this material on stem cells is limited. Human umbilical cord mesenchymal stem cells (HUCMSCs) are potential to be used in regenerative therapy. Regenerative therapy needs a sustainable cell supply to maintain its regenerative capacity. The aim of this study was to ascertain the apoptosis result of calcium hydroxide on HUCMSCs through the expression of apoptotic protease-activating factor-1 (APAF-1), caspase-3, and caspase-9. Materials and Methods This study used a thawed frozen stock of passage 5 HUCMSCs, grown in minimum essential medium (MEM) alpha containing calcium hydroxide at concentration of 0.1 microgram/mL for 1, 3 and 7 days. Polyclonal antibody with fluorescence isothiocyanate (FITC) label was used to evaluate the expressions. APAF-1, caspase-3, and caspase-9 expressions were recorded and compared on every observation day using fluorescence microscope. Analysis of variance was performed to analyze the significance among the results of treatment groups. The results were concluded significant if p<0.05. Results The addition of calcium hydroxide in MEM alpha medium increases HUCMSCs expression of APAF-1, caspase-3 and caspase-9 significantly, compared to the control group without calcium hydroxide (p<0.05) in all the times. Day 1 showed the lowest increase followed by higher expressions on day 3 and day 7. Conclusion HUCMSCs express increased APAF-1, caspase-3 and caspase-9 after in-vitro calcium hydroxide exposure. This should be considered when using calcium hydroxide on HUCMSCs for regenerative procedures with regard to other positive properties.
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Affiliation(s)
- Eric Priyo Prasetyo
- Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mefina Kuntjoro
- Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Setyabudi Goenharto
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Devi Eka Juniarti
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Febriastuti Cahyani
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nike Hendrijantini
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Alexander Patera Nugraha
- Department of Orthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ninuk Hariyani
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Fedik Abdul Rantam
- Stem Cell Research and Development Center, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Virology, Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
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Krupińska AM, Skośkiewicz-malinowska K, Staniowski T. Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics. Applied Sciences 2021; 11:1699. [DOI: 10.3390/app11041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.
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Rathinam E, Govindarajan S, Rajasekharan S, Declercq H, Elewaut D, De Coster P, Martens L. Transcriptomic profiling of human dental pulp cells treated with tricalcium silicate-based cements by RNA sequencing. Clin Oral Investig 2020; 25:3181-3195. [PMID: 33108483 DOI: 10.1007/s00784-020-03647-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Tricalcium silicate (TCS)-based biomaterials induce differentiation of human dental pulp cells (hDPCs) into odontoblasts/osteoblasts, which is regulated by the interplay between various intracellular pathways and their resultant secretome. The aim of this study was to compare the transcriptome-wide effects by next-generation RNA sequencing of custom-prepared hDPCs stimulated with TCS-based biomaterials: ProRoot white MTA (WMTA) (Dentsply, Tulsa; Tulsa, OK) and Biodentine (Septodont, Saint Maur des Fosses, France). METHODS Self-isolated hDPCs were seeded in a 6-well plate at a density of 5 × 105 cells per well. ProRoot white MTA and Biodentine were then placed in transwell inserts with a pore size of 0.4 μm and inserted in the well plate. RNA sequencing was performed after 3 and 7 days treatment. For post-validation, RT-PCR analyses were done on some of the RNA samples used for RNA sequencing. RESULTS Our RNA sequencing results for the first time identified 7533 differentially expressed genes (DEGs) between different treatments and the number of DEGs in Biodentine was higher than ProRoot WMTA at both 3 and 7 days. Despite their differential gene expression, both the TCS-based biomaterial treatments showed gene expressions mainly involved in odontoblast differentiation, angiogenesis, neurogenesis, dentinogenesis, and tooth mineralization. CONCLUSIONS The results of the present study illustrate that several important signalling pathways are induced by hDPCs stimulated with TCS-based biomaterials. CLINICAL RELEVANCE The differential expression of the genes associated with odontogenesis, angiogenesis, neurogenesis, dentinogenesis, and mineralization may affect the prognosis of teeth treated with Biodentine or ProRoot white MTA.
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Affiliation(s)
- Elanagai Rathinam
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.
| | - Srinath Govindarajan
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, Zwijnaarde, 9052, Ghent, Belgium
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
| | - Heidi Declercq
- Tissue Engineering and Biomaterials Group, Department of Human Structure and Repair, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Tissue Engineering Lab, Department of Development and Regeneration, KU Leuven, 8500, Kortrijk, Belgium
| | - Dirk Elewaut
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, Zwijnaarde, 9052, Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Dental School, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
| | - Luc Martens
- Department of Paediatric Dentistry & Special Care, PAECOMEDIS Research Cluster, Ghent University, Ghent University Hospital, 9000, Ghent, Belgium
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12
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Mori GG, Andrade BS, Araujo MB. Endodontic approach in a replanted tooth with an immature root apex and chronic apical periodontitis: a case report. Restor Dent Endod 2020; 45:e29. [PMID: 32839710 PMCID: PMC7431930 DOI: 10.5395/rde.2020.45.e29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/30/2019] [Accepted: 01/03/2020] [Indexed: 11/11/2022] Open
Abstract
This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.
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Affiliation(s)
- Graziela Garrido Mori
- Dental School of Presidente Prudente, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil.,Graduate Program in Dentistry, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil
| | - Bruna Souza Andrade
- Dental School of Presidente Prudente, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil
| | - Marina Bardelli Araujo
- Dental School of Presidente Prudente, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil
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13
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Huang CS, Hsieh SC, Teng NC, Lee WF, Negi P, Belem WF, Wu HC, Yang JC. A Silk Fibroin Based Hydration Accelerator for Root Canal Filling Materials. Polymers (Basel) 2020; 12:E994. [PMID: 32344691 PMCID: PMC7240371 DOI: 10.3390/polym12040994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022] Open
Abstract
Mineral trioxide aggregate (MTA) is widely used in various dental endodontic applications such as root-end filling, furcal perforation repair, and vital pulp therapy. In spite of many attempts to improve handling properties and reduce the discoloration of MTA, the ideal root canal filling material has yet to be fully developed. The objective of this study was to investigate the setting time, mechanical properties, and biocompatibility of MTA set by a silk fibroin solution. A 5 wt% silk fibroin (SF) solution (a novel hydration accelerant) was used to set SavDen® MTA and ProRoot® white MTA (WMTA). Changes in setting time, diametral tensile strength (DTS), material crystallization, in vitro cell viability, and cell morphology were assessed by Vicat needle measurement, a universal testing machine, scanning electron microscopy (SEM), and WST-1 assay, respectively. The initial setting time of ProRoot® MTA and SavDen® MTA experienced a drastic decrease of 83.9% and 42.1% when deionized water was replaced by 5 wt% SF solution as the liquid phase. The DTS of SavDen® MTA showed a significant increase after set by the SF solution in 24 h. A human osteoblast-like cell (MG-63)-based WST-1 assay revealed that both ProRoot® MTA and SavDen® MTA hydrated using SF solution did not significantly differ (p > 0.05) in cell viability. MG-63 cells with pseudopodia attachments and nuclear protrusions represent a healthier and more adherent status on the surface of MTA when set with SF solution. The results suggest that the 5 wt% SF solution may be used as an alternative hydration accelerant for MTA in endodontic applications.
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Affiliation(s)
- Ching-Shuan Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110-31, Taiwan; (C.-S.H.); (S.-C.H.); (N.-C.T.)
| | - Sung-Chih Hsieh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110-31, Taiwan; (C.-S.H.); (S.-C.H.); (N.-C.T.)
- Department of Dentistry, Taipei Municipal Wan-Fang Hospital, Taipei 116-96, Taiwan
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110-31, Taiwan; (C.-S.H.); (S.-C.H.); (N.-C.T.)
- Department of Dentistry, Taipei Medical University Hospital, Taipei 110-31, Taiwan
| | - Wei-Fang Lee
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Poonam Negi
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173 212, India;
| | - Wendimi Fatimata Belem
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-31, Taiwan;
| | - Hsuan-Chen Wu
- Department of Biochemical Science and Technology, National Taiwan University, Taipei 106, Taiwan;
| | - Jen-Chang Yang
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-31, Taiwan;
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-31, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei 110-52, Taiwan
- Research Center of Digital Oral Science and Technology, Taipei Medical University, Taipei 110-52, Taiwan
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14
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Prasetyo EP, Widjiastuti I, Cahyani F, Kuntjoro M, Hendrijantini N, Hariyani N, Winoto ER, Nugraha AP, Goenharto S, Susilowati H, Hendrianto E, Rantam FA. Cytotoxicity of Calcium Hydroxide on Human Umbilical Cord Mesenchymal Stem Cells. Pesqui Bras Odontopediatria Clín Integr 2020. [DOI: 10.1590/pboci.2020.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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15
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Fagogeni I, Metlerska J, Lipski M, Falgowski T, Maciej G, Nowicka A. Materials used in regenerative endodontic procedures and their impact on tooth discoloration. J Oral Sci 2019; 61:379-385. [PMID: 31378754 DOI: 10.2334/josnusd.18-0467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
There is some evidence of tooth discoloration after regenerative endodontic procedures. The aim of this review is to determine which materials used in regenerative procedures induce tooth discoloration. The authors searched six digital databases in February 2018: PubMed, Google Scholar, the Cochrane Library, Scopus, Web of Science, and Lilacs. As a result, 353 studies were found. Eleven studies that met the established criteria were selected. Analysis of the selected studies showed that most materials used in regenerative endodontic procedures have the potential to stain tooth tissues. To decrease tooth discoloration, sealing dentin with a dentin-bonding agent before the placement of a disinfectant paste and barrier materials should be considered. Only a small number of in vitro studies have been performed; therefore, further studies on this topic are warranted.
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Affiliation(s)
- Irini Fagogeni
- Faculty of Dentistry, Pomeranian Medical University in Szczecin
| | | | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics,Pomeranian Medical University in Szczecin
| | | | - Górski Maciej
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin
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16
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Aly MM, Taha SEED, El Sayed MA, Youssef R, Omar HM. Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non-vital immature permanent anterior teeth (randomized clinical study). Int J Paediatr Dent 2019; 29:464-473. [PMID: 30702789 DOI: 10.1111/ipd.12474] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/12/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To asses clinically and radiographically the effect of using two types of coronal plug materials in revascularization of non-vital immature teeth. METHODS A total of 26 necrotic immature permanent anterior teeth were enrolled for pulp revascularization using a double antibiotic mix for root canal disinfection. They were randomly divided into the following based on coronal plug materials used: Biodentine (Group I) and white Mineral Trioxide Aggregate (Group II; n = 13). Clinical and radiographic assessments were performed after 3, 6, 9, and 12 months. RESULTS When comparing the overall clinical successes and percentage of increase in root length between the two groups, there was no statistically significant difference (P > 0.05). There was a significant difference in the distribution of discoloration between the two groups. One case was reported in Group I, and seven cases were reported in Group II (P = 0.01). CONCLUSIONS Both Biodentine and Mineral Trioxide Aggregate were successful clinically regarding the resolution of signs and symptoms associated with the necrotic teeth.
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Affiliation(s)
- Mariam Mohsen Aly
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Sherine Ezz El-Din Taha
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Manal Ahmed El Sayed
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Randa Youssef
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
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17
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Li Q, Hurt AP, Coleman NJ. The Application of 29Si NMR Spectroscopy to the Analysis of Calcium Silicate-Based Cement using Biodentine™ as an Example. J Funct Biomater 2019; 10:E25. [PMID: 31151191 PMCID: PMC6617092 DOI: 10.3390/jfb10020025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/25/2019] [Accepted: 05/28/2019] [Indexed: 12/13/2022] Open
Abstract
Biodentine is one of the most successful and widely studied among the second generation of calcium silicate-based endodontic cements. Despite its popularity, the setting reactions of this cement system are not currently well understood. In particular, very little is known about the formation and structure of the major calcium silicate hydrate (C-S-H) gel phase, as it is difficult to obtain information on this poorly crystalline material by the traditional techniques of powder X-ray diffraction analysis (XRD) and Fourier transform infrared spectroscopy (FTIR). In this study, the hydration reactions of Biodentine are monitored by XRD, FTIR, isothermal conduction calorimetry and, for the first time, 29Si magic angle spinning nuclear magnetic resonance spectroscopy (29Si MAS NMR) is used to investigate the structures of the anhydrous calcium silicate phases and the early C-S-H gel product. XRD analysis indicated that the anhydrous powder comprises 73.8 wt% triclinic tricalcium silicate, 4.45 wt% monoclinic β-dicalcium silicate, 16.6 wt% calcite and 5.15 wt% zirconium oxide. Calorimetry confirmed that the induction period for hydration is short, and that the setting reactions are rapid with a maximum heat evolution of 28.4 mW g-1 at 42 min. A progressive shift in the FTIR peak maximum from 905 to 995 cm-1 for the O-Si-O stretching vibrations accompanies the formation of the C-S-H gel during 1 week. The extent of hydration was determined by 29Si MAS NMR to be 87.0%, 88.8% and 93.7% at 6 h, 1 day and 1 week, respectively, which is significantly higher than that of MTA. The mean silicate chain length (MCL) of the C-S-H gel was also estimated by this technique to be 3.7 at 6 h and 1 day, and to have increased to 4.1 after 1 week. The rapid hydration kinetics of Biodentine, arising from the predominance of the tricalcium silicate phase, small particle size, and 'filler effect' of calcite and zirconium oxide, is a favorable characteristic of an endodontic cement, and the high values of MCL are thought to promote the durability of the cement matrix.
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Affiliation(s)
- Qiu Li
- State Key Lab of Silicate Materials for Architectures, Wuhan University of Technology, Wuhan 430070, China.
| | - Andrew P Hurt
- Faculty of Engineering and Science, University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK.
| | - Nichola J Coleman
- Faculty of Engineering and Science, University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK.
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18
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Rajasekharan S, Vercruysse C, Martens L, Verbeeck R. Effect of Exposed Surface Area, Volume and Environmental pH on the Calcium Ion Release of Three Commercially Available Tricalcium Silicate Based Dental Cements. Materials (Basel) 2018; 11:E123. [PMID: 29342837 DOI: 10.3390/ma11010123] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 12/13/2022]
Abstract
Tricalcium silicate cements (TSC) are used in dental traumatology and endodontics for their bioactivity which is mostly attributed to formation of calcium hydroxide during TSC hydration and its subsequent release of calcium and hydroxide ions. The aim of this study was to determine the effect of volume (Vol), exposed surface area (ESA) and pH of surrounding medium on calcium ion release. Three commercially available hydraulic alkaline dental cements were mixed and condensed into cylindrical tubes of varying length and diameter (n = 6/group). For the effect of ESA and Vol, tubes were immersed in 10 mL of deionized water. To analyze the effect of environmental pH, the tubes were randomly immersed in 10 mL of buffer solutions with varying pH (10.4, 7.4 or 4.4). The solutions were collected and renewed at various time intervals. pH and/or calcium ion release was measured using a pH glass electrode and atomic absorption spectrophotometer respectively. The change of pH, short-term calcium ion release and rate at which calcium ion release reaches maximum were dependent on ESA (p < 0.05) while maximum calcium ion release was dependent on Vol of TSC (p < 0.05). Maximum calcium ion release was significantly higher in acidic solution followed by neutral and alkaline solution (p < 0.05).
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