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1.
Mineral Trioxide Aggregate Partial Pulpotomy Versus Formocresol Pulpotomy: A Randomized, Split-Mouth, Controlled Clinical Trial with 24 Months Follow-Up.
Nematollahi, H, Noorollahian, H, Bagherian, A, Yarbakht, M, Nematollahi, S
Pediatric dentistry. 2018;(3):184-189
Abstract
PURPOSE The purpose of this study was to evaluate the clinical and radiographic success rates of mineral trioxide aggregate partial pulpotomy (PP) compared to formocresol pulpotomy (FP) in human primary molars. METHODS In this randomized, controlled, split-mouth, clinical trial, 25 healthy five- to eight-year-olds, with 50 carious primary mandibular second molars lacking clinical and radiographic evidence of pulp pathology, were selected. The selected teeth were randomly assigned into two groups, PP and FP, for vital pulp therapy. Stainless steel crowns were placed as final restorations for both groups. Clinical and radiographic evaluation at six, 12, and 24 months used the following criteria for failure: pain; swelling; sinus tract; mobility; internal or external root resorption; furcation or periapical radiolucency; and widening of periodontal ligament space. The data were analyzed using a binary logistic generalized estimating equation model. RESULTS At the 12-month and 24-month follow-ups, one child and three children, respectively, were lost to follow-up. At the 24-month follow-up, the clinical, radiographic, and overall success rates of PP were 90.9 percent, 90.5 percent, and 81.8 percent versus FP success of 100 percent, 95.2 percent, and 95.2 percent, respectively. CONCLUSION There were no significant differences between clinical, radiographic, and overall success rate of mineral trioxide aggregate partial pulpotomy and formocresol pulpotomy overall 24 months.
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Polylactic acid-based porous scaffolds doped with calcium silicate and dicalcium phosphate dihydrate designed for biomedical application.
Gandolfi, MG, Zamparini, F, Degli Esposti, M, Chiellini, F, Aparicio, C, Fava, F, Fabbri, P, Taddei, P, Prati, C
Materials science & engineering. C, Materials for biological applications. 2018;:163-181
Abstract
Polylactic acid (PLA), dicalcium phosphate dihydrate (DCPD) and/or hydraulic calcium silicate (CaSi) have been used to prepare highly-porous scaffolds by thermally induced phase separation technique (TIPS). Three experimental mineral-doped formulations were prepared (PLA-10CaSi, PLA-5CaSi-5DCPD, PLA-10CaSi-10DCPD). Pure PLA scaffolds constituted the control group. Scaffolds were tested for their chemical-physical and biological properties, namely calcium release, alkalinizing activity, surface microchemistry and micromorphology by ESEM, apatite-forming ability by EDX, micro-Raman and IR spectroscopy, thermal properties by differential scanning calorimetry, mechanical properties by quasi-static parallel-plates compression testing, porosity by a standard water-absorption method and direct-contact cytotoxicity. All mineral-doped scaffolds released biologically relevant ions (biointeractive). A B-type carbonated apatite layer (thickness decreasing along the series PLA-10CaSi-10DCPD>PLA-10CaSi>PLA-5CaSi-5DCPD>PLA) was detected on the surface of all the 28d-aged scaffolds. Surface pores of fresh scaffolds ranged from 10 to 20μm in pure PLA to 10-100μm in PLA-10CaSi. An increase in porosity was detected in 28d-aged pure PLA scaffolds (approx. 30% of material loss with decrease of the PLA chain length); differently, in mineral-doped scaffolds, the PLA degradation was balanced by deposition/nucleation of apatite. All scaffolds showed absence of toxicity, in particular PLA-10CaSi-10DCPD. The designed scaffolds are biointeractive (release biologically relevant ions), nucleate apatite, possess high surface and internal open porosity and can be colonized by cells, appearing interesting materials for bone regeneration.
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3.
Mineral trioxide aggregate affects cell viability and induces apoptosis of stem cells from human exfoliated deciduous teeth.
Tsai, CL, Ke, MC, Chen, YH, Kuo, HK, Yu, HJ, Chen, CT, Tseng, YC, Chuang, PC, Wu, PC
BMC pharmacology & toxicology. 2018;(1):21
Abstract
BACKGROUND Mineral trioxide aggregate (MTA) is widely used for pulp-capping procedures in permanent teeth and as a gold standard material in endodontics. The aim of the study was to investigate the effect of MTA on cell viability and apoptosis when MTA is directly in contact with Stem Cells from Human Exfoliated Deciduous Teeth (SHEDs). METHODS MTA was mixed and coated in the bottom of a 24-well plate. SHEDs collected and cultured from normal exfoliated human deciduous teeth (passages 3-4) were seeded on square cover glasses. The glasses with seeded SHEDs were incubated in the plates with or without MTA coating. They were divided into four groups: MTA direct contact, direct control, MTA indirect contact, and indirect control. After 1, 2 and 3 days of culturing, cell morphology was observed and cell viability was assessed by the WST-1 cell cytotoxicity assay. TUNEL assay, immunofluorescent labeling and western blot analysis were used to study the effects of MTA on SHEDs apoptosis. RESULTS MTA impaired cell viability of SHEDs in 1, 2 and 3 days, and the effect of direct contact was more severe. Cell apoptosis with positive Annexin V and TUNEL staining was noted when there was direct contact with MTA. Western blot analysis revealed that Bcl-2 and Bcl-xL decreased after SHEDs were in contact with MTA. CONCLUSIONS This study shows that direct contact with 1 week post-set MTA significantly decreases the viability of SHEDs and induced cell apoptosis. The results suggest that there is a possible cytotoxic effect of pulp tissue when there is direct contact with MTA. Different responses would be expected due to the strong alkaline characteristics of fresh mixed MTA.
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4.
Bond Strength of Experimental Root Canal Sealers Based on MTA and Butyl Ethylene Glycol Disalicylate.
Prado, MC, Carvalho, NK, Vitti, RP, Ogliari, FA, Sassone, LM, Silva, EJNL
Brazilian dental journal. 2018;(2):195-201
Abstract
This study investigated the bond strength of two experimental root canal sealers based on MTA and butyl ethylene glycol disalicylate: MTAe and MTAe-HA. The reference materials used for comparison were AH Plus and MTA Fillapex. Twenty human upper incisors were selected and one 1 mm slice was obtained from the cervical third of each root. On the coronal surface of each slice, four 0.9 mm wide holes were drilled through the dentine. Standardized irrigation was performed and holes were filled with one of the four tested sealers: AH Plus, MTA Fillapex, MTAe, and MTAe-HA. The filled slices were stored in a PBS solution (pH 7.2) for 7 days at 37 °C. A push-out assessment was performed with a 0.7 mm plunger tip. Load was applied at a crosshead speed of 0.5 mm/min until sealer displacement. The results were expressed in MPa. The Kruskal-Wallis test was applied to assess the effect of each sealer on the push-out bond strength. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05. Significant differences among medians values obtained by materials were observed (p<0.001). AH Plus displayed the highest value of bond strength (p<0.001). In contrast, MTA Fillapex presented the lowest bond strength among all tested sealers (p<0.001). Experimental sealers showed intermediary bond strength values, with no statistical differences between them (p>0.05). In conclusion, experimental root canal sealers presented suitable bond strength outcomes when compared to MTA Fillapex.
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5.
Response of periodontium to mineral trioxide aggregate and Biodentine: a pilot histological study on humans.
Tirone, F, Salzano, S, Piattelli, A, Perrotti, V, Iezzi, G
Australian dental journal. 2018;(2):231-241
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Abstract
BACKGROUND The aim of this study was to investigate for the first time the histological response of human periodontium to mineral trioxide aggregate (MTA) and Biodentine. METHODS Six patients scheduled for implant full-arch rehabilitation were randomly assigned to one of the two test groups: MTA or Biodentine treatment. For each patient, two teeth scheduled for strategic extraction were randomly assigned either to the test or to the control treatment. A lateral perforation was drilled on the root and either repaired with MTA/Biodentine or filled with gutta-percha(control). Three months later, the teeth were extracted along with the coronal third of the alveolar bone and a portion of gingival tissue, while performing implant placement, and processed for histological analysis. RESULTS Biodentine resulted in less extrusion into the periodontal environment. All the materials showed good biocompatibility. A new mineralized cementum-like tissue incorporating periodontal fibres was visible in all cases treated with MTA. A small amount of new mineralized tissue was found in two Biodentine cases but not in control cases. Biodentine resulted in less damage to the periodontal ligament. CONCLUSIONS Bioactivity and biocompatibility of MTA were confirmed in human models. Biodentine proved to be biocompatible, but it seems not to induce cementum regeneration.
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The Repair of Furcal Perforations in Different Diameters with Biodentine, MTA, and IRM Repair Materials: A Laboratory Study Using an E. Faecalis Leakage Model.
Övsay, E, Kaptan, RF, Şahin, F
BioMed research international. 2018;:5478796
Abstract
The aim of this study is to evaluate the microleakage of repair materials MTA, IRM, and Biodentine applied on furcal perforations with different diameters. One hundred and forty extracted human teeth were used in this study. The teeth were divided into 2 main groups (60 teeth in each) which were then divided into 3 subgroups (n = 20). The remaining 20 teeth were divided into 2 groups (10 in each) to serve as controls. The furcal areas of the teeth were perforated with #2 cylindrical burs in Group 1 whereas perforations were made using #4 cylindrical burs in Group 2. Each subgroup of both Groups 1 and 2 received ProRoot MTA (ProRoot, USA), Biodentine (Septodont), or IRM (Dentsply, USA) to repair the perforations. An experimental set-up was established to contaminate repaired perforations with E. Faecalis (ATCC29212). The turbidity of bacteria was observed on the 7th, 15th, 30th, and 45th days. The data was analysed by chi-square test (p > 0.05). The number of bacteria in the group perforated by bur #2 and closed by MTA was found to be lower than the other groups on the 7th day (p < 0.05). There was no statistical difference in the bacterial counts of other groups on the 15th, 30th, and 45th days (p > 0.05). ProRoot MTA was found to be more successful in the prevention of bacterial leakage compared to IRM and Biodentine in smaller perforations during the 1st week.
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Clinical, Radiographic and Histological Evaluation of Primary Teeth Pulpotomy Using MTA And Ferric Sulfate.
Junqueira, MA, Cunha, NNO, Caixeta, FF, Marques, NCT, Oliveira, TM, Moretti, ABDS, Cosme-Silva, L, Sakai, VT
Brazilian dental journal. 2018;(2):159-165
Abstract
The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue.
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Calcium silicate as a graft material for bone fractures: a systematic review.
Sanmartin de Almeida, M, Fernandes, GVO, de Oliveira, AM, Granjeiro, JM
The Journal of international medical research. 2018;(7):2537-2548
Abstract
Objective The goal of this review was to determine whether calcium silicate (wollastonite) as a bone graft material is a viable alternative to autogenous bone or whether the evidence base for its use is weak. Methods In this systematic review, electronic databases (MEDLINE/PubMed and BVS) were searched for relevant articles in indexed journals. Articles published in a 10-year period were identified (n = 48). After initial selection, 17 articles were assessed for eligibility; subsequently, seven articles were excluded and 10 articles were included. Results Among the studies included, 20% emphasized the importance of randomization, which adds reliability to the study, minimizing the risk of bias. High variability was observed in the material used, such as additives, amounts, dosage, and chemical alterations, rendering direct comparison among these studies impossible. The experimental periods varied considerably; one of the studies did not include statistical analysis, weakening the evaluation. Nonetheless, the true potential of wollastonite as a graft material conducive to new bone formation was reported in all studies. Conclusion The results support the use of wollastonite as a bone graft material. The initial research question was answered despite the significant variability observed among these preclinical studies, which hindered the precision of this analysis.
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Biomechanical Evaluation of a Novel Apatite-Wollastonite Ceramic Cage Design for Lumbar Interbody Fusion: A Finite Element Model Study.
Bozkurt, C, Şenköylü, A, Aktaş, E, Sarıkaya, B, Sipahioğlu, S, Gürbüz, R, Timuçin, M
BioMed research international. 2018;:4152543
Abstract
OBJECTIVES Cage design and material properties play a crucial role in the long-term results, since interbody fusions using intervertebral cages have become one of the basic procedures in spinal surgery. Our aim is to design a novel Apatite-Wollastonite interbody fusion cage and evaluate its biomechanical behavior in silico in a segmental spinal model. MATERIALS AND METHODS Mechanical properties for the Apatite-Wollastonite bioceramic cages were obtained by fitting finite element results to the experimental compression behavior of a cage prototype. The prototype was made from hydroxyapatite, pseudowollastonite, and frit by sintering. The elastic modulus of the material was found to be 32 GPa. Three intact lumbar vertebral segments were modelled with the ANSYS 12.0.1 software and this model was modified to simulate a Posterior Lumbar Interbody Fusion. Four cage designs in different geometries were analyzed in silico under axial loading, flexion, extension, and lateral bending. RESULTS The K2 design had the best overall biomechanical performance for the loads considered. Maximum cage stress recorded was 36.7 MPa in compression after a flexion load, which was within the biomechanical limits of the cage. CONCLUSION Biomechanical analyses suggest that K2 bioceramic cage is an optimal design and reveals essential material properties for a stable interbody fusion.
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Calcium and Phosphate Metabolism, Blood Lipids and Intestinal Sterols in Human Intervention Studies Using Different Sources of Phosphate as Supplements-Pooled Results and Literature Search.
Trautvetter, U, Ditscheid, B, Jahreis, G, Glei, M
Nutrients. 2018;(7)
Abstract
Phosphates are associated with negative physiological effects. The objectives of this publication were to compare differential effects of supplementation with calcium phosphate or phosphate alone in healthy humans. Four adult human studies were conducted with pentacalcium hydroxy-trisphosphate supplementation (CaP; 90 subjects) and their data were pooled for assessment. For literature search; PubMed and ISI Web of Knowledge were used and 21 items were assigned to three main topics. The pooled study results show that following CaP supplementation, faecal calcium and phosphorus and urinary calcium were increased, blood lipids were positively modulated, and faecal bile acids were increased, as compared with placebo. The literature search reveals that following calcium phosphate supplementation, urinary calcium was increased. Following solely phosphate supplementation, urinary phosphorus was increased and urinary calcium was decreased. Postprandial calcium concentrations were increased following calcium phosphate supplementation. Postprandial phosphate concentrations were increased following solely phosphate supplementation. Calcium phosphate supplementation resulted in rather positively modulated blood lipids and gut-related parameters. The presented results show the relevance to distinguish between calcium phosphate and solely phosphate supplementations, and the importance of a balanced calcium and phosphorus intake.