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Odontology Jan 2023This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of... (Review)
Review
This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of different considerations: effect on smear layer removal, influence on sealer bond strength, activation effect by means of sonic or ultrasonic devices, effects on dentine surface, antibacterial activity, and effectiveness boost for regenerative procedures, releasing growth factors from dentin. To evaluate the results of CA as a final irrigant and compare them to other chelating agents. This review followed the PRISMA checklist. An electronic search was conducted in MEDLINE (OVID), Scopus (Elsevier) and the Web of Science (Thomson Reuters) databases. Risk of bias of included studies was evaluated using the modified CONSORT checklist and the PRIRATE checklist 2020 guidelines. 39 studies fulfilled the eligibility criteria to be included in this review: 27 in vitro studies using extracted human teeth, 10 in vitro studies using human dentin disks, and 2 RCT. Citric acid has proven to be effective in smear layer removal, showing better results in coronal and middle root thirds, improving its effect when combined with manual dynamic activation. There is no agreement regarding citric acid effect on sealer adhesion and adaptation to root canal walls due to heterogeneity within studies. Citric acid irrigation can decrease dentine microhardness and cause decalcification and erosion, especially when used before NaOCl. Citric acid has proven to be beneficial in regenerative endodontic procedures due to higher TGF-β1 release.Trial registration: Prospero database CRD42021267055.
Topics: Humans; Citric Acid; Edetic Acid; Smear Layer; Dental Pulp Cavity; Root Canal Preparation; Root Canal Irrigants; Dentin; Microscopy, Electron, Scanning; Sodium Hypochlorite
PubMed: 36220913
DOI: 10.1007/s10266-022-00744-2 -
Dental Materials : Official Publication... Oct 2021The objective of this study was to determine the effects of antimicrobial photodynamic therapy (aPDT) with indocyanine green (ICG) and toluidine blue (TB) on protease...
OBJECTIVES
The objective of this study was to determine the effects of antimicrobial photodynamic therapy (aPDT) with indocyanine green (ICG) and toluidine blue (TB) on protease activity (matrix-bound cathepsin K and matrix metalloproteinase (MMP) and dentin bond strength.
METHODS
Caries-free human third molars were assigned to five groups: 1-control group, 2-application of ICG with activation using an 810 nm diode (aPDT), 3-application of ICG, 4-application of TB with activation using a 660 nm diode (aPDT), and 5-application of TB. For the enzymatic investigation, dentin beams were incubated for either 3 days or 3 weeks. Aliquots of the incubation media were analyzed by ELISA for CTX (C-terminal cross-linked telopeptide of type I Collagen) and ICTP (cross-linked carboxy-terminal telopeptide of type I collagen). For microtensile bond strength testing (μTBS), composite resins were layered onto the tooth surface; the samples were then subjected to μTBS. Kruskall-Wallis and Mann-Whitney U tests were applied for statistical analysis of CTX and ICTP, one way-ANOVA and Tukey's test were applied for statistical analysis of μTBS.
RESULTS
Pretreating the dentin matrices with aPDT decreased the endogenous protease activity. ICG with laser activation resulted in the highest μTBS. Therefore, aPDT should be considered as a treatment method because it can reduce MMP-mediated dentin degradation and increase the μTBS.
SIGNIFICANCE
Inhibiting endogenous protease activity improves the stability of the dentin-adhesive bond and the durability of the bond strength.
Topics: Cathepsin K; Composite Resins; Dental Bonding; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Matrix Metalloproteinases; Photochemotherapy; Resin Cements; Tensile Strength
PubMed: 34503836
DOI: 10.1016/j.dental.2021.08.015 -
Journal of Applied Oral Science :... 2021To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive...
OBJECTIVE
To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges.
METHODOLOGY
Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05).
RESULTS
G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001).
CONCLUSION
All treatments effectively reduced dentin permeability and promoted tubule occlusion after application.
COMBINING ND
YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.
Topics: Calcium; Dentin; Dentin Desensitizing Agents; Dentin Permeability; Lasers, Solid-State; Microscopy, Electron, Scanning
PubMed: 33825753
DOI: 10.1590/1678-7757-2020-0736 -
The Journal of Adhesive Dentistry Dec 2021To characterize experimental adhesives containing natural antimicrobial agents (proanthocyanidins, apigenin, tt-farnesol) in the primer and to evaluate their anti-caries...
PURPOSE
To characterize experimental adhesives containing natural antimicrobial agents (proanthocyanidins, apigenin, tt-farnesol) in the primer and to evaluate their anti-caries effect.
MATERIALS AND METHODS
Natural agents were incorporated in the primer of an experimental adhesive: 4.5% proanthocyanidins (PA), 1 mM apigenin (API), 1 mM apigenin + 5 mM tt-farnesol (API + FAR), and primer without antimicrobial agent (control). Microtensile bond strength (μTBS) to dentin and nanoleakage were measured immediately (n = 7) and after 1 year of storage (n = 7). Water sorption (WS), solubility (SO), and degree of conversion (DC%) of the adhesives were measured. The hardness loss of enamel (n = 6) and dentin (n = 6) at the restorative margin was evaluated after biofilm formation.
RESULTS
DC%, nanoleakage, and immediate μTBS were similar for all groups. After 1 year, API + FAR showed higher nanoleakage and lower μTBS than the other groups, which were similar. WS and SO of API + FAR were lower than in the other groups. PA, API, and API + FAR presented less hardness loss than did the control group. At enamel, PA and API presented less hardness loss than the control and API + FAR groups at distances 50 µm and 100 µm; the hardness loss of enamel was similar for all groups 150 µm from the margin.
CONCLUSION
The addition of proanthocyanidins and apigenin to the adhesives decreased the hardness loss of dentin and enamel submitted to biofilm formation, without jeopardizing the physical properties of the adhesives. The combination of apigenin + tt-farnesol decreased the hardness loss of dentin but not of enamel, and decreased the μTBS after 1 year of storage.
Topics: Anti-Infective Agents; Cariostatic Agents; Dental Bonding; Dental Caries; Dental Cements; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Resin Cements; Tensile Strength
PubMed: 34817968
DOI: 10.3290/j.jad.b2287719 -
Acta Biomaterialia Mar 2023Hard dental tissue pathologies, such as caries, are conventionally managed through replacement by tooth-colored inert biomaterials. Tissue engineering provides novel...
Hard dental tissue pathologies, such as caries, are conventionally managed through replacement by tooth-colored inert biomaterials. Tissue engineering provides novel treatment approaches to regenerate lost dental tissues based on bioactive materials and/or signaling molecules. While regeneration in the form of reparative dentin (osteo-dentin) is feasible, the recapitulation of the tubular microstructure of ortho-dentin and its special features is sidelined. This study characterized in vitro, and in vivo human EDTA-treated, freeze-dried dentin matrices (HTFD scaffolds) conditioned with calcium phosphate nanoparticles (NPs) bearing plasmids encoding dentinogenesis-inducing factors (pBMP2/NPs or pDMP1/NPs). The uptake and transfection efficiency of the synthesized NPs on dental pulp stem cells (DPSCs) increased in a concentration- and time-dependent manner, as evaluated qualitatively by confocal laser microscopy and transmission electron microscopy, and quantitatively by flow cytometry, while, in parallel, cell viability decreased. HTFD scaffolds conditioned with the optimal transfectability-to-viability concentration at 4 µg Ca/mL of each of the pBMP2/NPs or pDMP1/NPs preserved high levels of cell viability, evidenced by live/dead staining in vitro and caused no adverse reactions after implantation on C57BL6 mice in vivo. HTFD/NPs constructs induced rapid and pronounced odontogenic shift of the DPSCs, as evidenced by relevant gene expression patterns of RunX2, ALP, BGLAP, BMP-2, DMP-1, DSPP by real-time PCR, and acquirement of polarized meta-mitotic phenotype with cellular protrusions entering the dentinal tubules as visualized by scanning electron microscopy. Taken together, HTFD/NPs constitute a promising tool for customized reconstruction of the ortho-dentin/odontoblastic layer barrier and preservation of pulp vitality. STATEMENT OF SIGNIFICANCE: In clinical dentistry, the most common therapeutic approach for the reconstruction of hard dental tissue defects is the replacement by resin-based restorative materials. Even modern bioactive materials focus on reparative dentinogenesis, leading to amorphous dentin-bridge formation in proximity to the pulp. Therefore, the natural microarchitecture of tubular ortho-dentin is not recapitulated, and the sensory and defensive role of odontoblasts is sidelined. This study approaches the reconstruction at the dentin-pulp interface using a construct of human treated dentin (HTFD) scaffold and plasmid-carrying nanoparticles (NPs) encoding dentinogenic factors (DMP-1 or BMP-2) with excellent in vitro and in vivo properties. As a future perspective, the HTFD/NPs constructs could act as bio-fillings for personalized reconstruction of the dentin-pulp interface.
Topics: Humans; Animals; Mice; Tissue Engineering; Tissue Scaffolds; Cell Differentiation; Cells, Cultured; Stem Cells; Mice, Inbred C57BL; DNA; Nanoparticles; Calcium Phosphates; Dentin; Plasmids; Dental Pulp; Bone Morphogenetic Protein 2
PubMed: 36708852
DOI: 10.1016/j.actbio.2023.01.044 -
Dental Materials : Official Publication... Jan 2022This study investigated the chemical and structural changes in the mineral phase and collagen of dentin during application of a mild universal adhesive. Particular...
OBJECTIVE
This study investigated the chemical and structural changes in the mineral phase and collagen of dentin during application of a mild universal adhesive. Particular attention was paid to the role of isopropanol and changes in water molecules.
METHODS
In vitro application of the mild universal adhesive on dentin with two established etching modes (self-etch and etch-and-rinse) was studied using solid state nuclear magnetic resonance spectroscopy.
RESULTS
It was evidenced that the etch-and-rinse mode leads to a decrease of the inorganic apatite and a reorganization of the residual mineral phase with a low amount of adhesive phosphate monoesters calcium salt formed, compared to the self-etch mode. In contrast, the adhesive interacts very similarly to the level of dentin collagen in both protocols, with a strong decrease in the amount of the free water molecules induced by the presence of isopropanol as the adhesive solvent, but without significant changes in the initial collagen structure. For both modes, the adhesive acrylates monomers remain mobile and can infiltrate the collagen.
SIGNIFICANCE
Understanding the molecular interactions between dentin and adhesive solutions is a major challenge for designing products that lead to the formation of ideal dentin resin hybrid layer. Notably, one point considered essential is the presence of unbound water which, over time, is associated with a hydrolytic degradation of the organic matrix. Isopropanol, as an adhesive solvent, leads to a decrease in the amount of the less stable water molecules while the water molecules strongly attached to the collagen are retained, thus preserving the collagen structure.
Topics: 2-Propanol; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Magnetic Resonance Spectroscopy; Materials Testing; Resin Cements; Solvents; Tensile Strength
PubMed: 34736760
DOI: 10.1016/j.dental.2021.10.001 -
The Journal of Adhesive Dentistry Nov 2022To evaluate the microtensile bond strength (μTBS) and silver nitrate uptake (SNU) of three universal adhesives used in etch-and-rinse (ER) and self-etch (SE) modes on...
PURPOSE
To evaluate the microtensile bond strength (μTBS) and silver nitrate uptake (SNU) of three universal adhesives used in etch-and-rinse (ER) and self-etch (SE) modes on dry, wet, and oversaturated dentin surfaces after 24 h and 1 year of water storage. The morphology of the hybrid layer (MHL) and the degree of conversion (DC) were also evaluated.
MATERIALS AND METHODS
Human molars were divided into 36 groups according to combinations of the following variables: (i) universal adhesives (Ambar Universal APS [AMB], Prime&Bond Active [PBA], Scotchbond Universal Adhesive [SBU]), (ii) adhesive strategies (ER or SE), (iii) moisture level (dry, wet, or oversaturated dentin surface), and (iv) storage time (24 h or 1 year). After restoration, the specimens were sectioned into resin-dentin sticks and tested for μTBS and SNU according to storage time. For MHL, the specimens were sectioned and evaluated after 24 h using SEM. DC was evaluated using FTIR. ANOVA and Tukey's test were used for statistical analyses (5%).
RESULTS
When 24-h vs 1-year data were compared, there was a significant decrease in μTBS and an increase in SNU values for the majority of experimental groups (p < 0.0001). On dry (ER) and oversaturated (ER and SE) dentin, AMB showed higher μTBS than did PBA (p < 0.00001). No significant decrease in μTBS was observed when universal adhesives were applied in the SE mode to dry dentin (p > 0.05). Regarding SNU, at all moisture levels, AMB showed lower SNU values than SBU (p < 0.001). Regarding MHL, SBU showed several imperfections when applied to oversaturated dentin in comparison with AMB and PBA. Regarding DC, when dentin was kept dry or was oversaturated, AMB showed a higher DC than PBA (p < 0.0001).
CONCLUSION
The behavior of the different universal adhesives evaluated did not vary when applied to wet or dry dentin. However, the results with oversaturated dentin were dependent on the universal adhesive. Independent of the moisture level and the universal adhesive evaluated, significant degradation of the bonding properties occurred after 1 year of water storage, with the exception of universal adhesives applied to dry dentin in the SE strategy.
Topics: Humans; Dentin-Bonding Agents; Dental Bonding; Composite Resins; Dental Cements; Dentin; Dental Leakage; Tensile Strength; Materials Testing; Resin Cements; Water; Adhesives
PubMed: 36346400
DOI: 10.3290/j.jad.b3559027 -
Journal of Endodontics Jan 2020This study aims to develop and characterize the regenerative potential of an atelopeptidized treated dentin matrix xenograft using in vitro and in vivo models.
INTRODUCTION
This study aims to develop and characterize the regenerative potential of an atelopeptidized treated dentin matrix xenograft using in vitro and in vivo models.
METHODS
Freshly extracted bovine dentin was pulverized into 250- to 500-μm particles and demineralized with 17% EDTA for 1, 7, and 13 days. The samples were atelopeptidized with pepsin. The degree of demineralization and the effect of atelopeptidization were assessed using field emission scanning electron microscopy combined with energy-dispersive X-ray spectroscopy and Fourier transform infrared spectroscopy, respectively. The expression of dentin matrix acidic phosphoprotein 1, dentin sialophosphoprotein, and osteopontin was evaluated in dental pulp stem cells using quantitative real-time polymerase chain reaction. The samples were then implanted intramuscularly in rats for 30 days, and the inflammatory cells were quantified histologically.
RESULTS
Field emission scanning electron microscopy combined with energy-dispersive X-ray spectroscopy revealed an exposed tubular structure of dentin after 1 and 7 days of demineralization. Fourier transform infrared spectroscopy confirmed the absence of amide peaks at 1260 to 1640/cm after atelopeptidization. The dental pulp stem cell expression of dentin matrix acidic phosphoprotein 1 and dentin sialophosphoprotein increased in all compared with the untreated control group (P < .05). The maximum expression rates were observed for the 1-day demineralized and atelopeptidized group. The 1-day demineralized group elicited the highest inflammatory response compared with the 7- or 13-day demineralized groups (P < .001). Atelopeptidization significantly decreased the inflammatory response only in the 1-day demineralized dentin group (P < .05).
CONCLUSIONS
Atelopeptidization of 1-day demineralized dentin xenograft preserved the collagen structure, minimized the immune reaction, and provided sufficient regenerative potential.
Topics: Animals; Cattle; Dental Pulp; Dentin; Heterografts; Microscopy, Electron, Scanning; Peptides; Rats; Tissue Engineering
PubMed: 31759677
DOI: 10.1016/j.joen.2019.10.005 -
Journal of Dentistry Sep 2022This study examined the ability of a borate adhesive to protect enamel/dentin surfaces from acidic erosion and its effect on the shear bond strength (SBS) of...
OBJECTIVES
This study examined the ability of a borate adhesive to protect enamel/dentin surfaces from acidic erosion and its effect on the shear bond strength (SBS) of enamel/dentin to resin composite.
MATERIALS AND METHODS
180 human enamel/dentin specimens were utilized. Enamel buccal surfaces were etched with phosphoric-acid then divided into: (EBG) borate glass adhesive group; (ERS) resin-adhesive system group; (EF) fluoride gel 1.23% group, and enamel control (EC) group; followed by bonding to orthodontic-buttons. The dentin specimens were conditioned by EDTA (Ethylene-diamine-tetra-acetic acid) and divided into: (DBG) borate glass resin, (DRS) resin adhesive; (DDA) group had a dentin-desensitizing agent VivaSens (VivaDent, Liechtenstein) and (DC) control group. The treated enamel/dentin specimens had their SBS to composite. The enamel/dentin specimens were exposed to 1% citric acid (18 min). Enamel/dentin specimens were examined by (SEM/EDS) scanning-electron-microscope equipped with electron-dispersive-spectroscopy and (FTIR/ATR). Analysis-of-Variance (ANOVA) was used to compare the SBS and Wilcoxon-signed-rank test was used to compare the enamel/dentin areas protected by the applied agents before/after erosion (p = 0.05).
RESULTS
There was no significance difference in SBS among all groups except for (DDA) group that showed significant decrease p < 0.05. (EBG) and (DBG) groups were the only groups significantly protected enamel and dentin from erosion p < 0.05. FTIR/ATR showed that erosion altered the chemical structure of (DRS), (DDA), and (DC) groups but did not affect the other enamel/dentin groups. Degree of conversion of the borate-adhesive system was acceptable.
CONCLUSION
The Borate adhesive system released calcium and phosphate compounds that decreased the erosive activity of the citric acid resulting in protecting simulated dentin-hypersensitive areas and enamel from erosion without affecting the SBS to resin-composite.
CLINICAL SIGNIFICANCE
A Borate adhesive system can be adopted as a therapeutic agent in a fully integrated program for protecting dentin-hypersensitive areas and in enamel next to orthodontic fixed appliances.
Topics: Acid Etching, Dental; Borates; Citric Acid; Dental Bonding; Dental Cements; Dental Enamel; Dental Stress Analysis; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Resin Cements; Shear Strength
PubMed: 35781000
DOI: 10.1016/j.jdent.2022.104208 -
Journal of Endodontics Jan 2024The aim was to evaluate the stress distributions on dentin and repair materials caused by static force applied to teeth, with cervical external root resorption (CER)...
INTRODUCTION
The aim was to evaluate the stress distributions on dentin and repair materials caused by static force applied to teeth, with cervical external root resorption (CER) after repair with different materials using finite element analysis.
METHODS
This study was performed with the 3-dimensional finite element analysis method. Access cavity, root canal cavity dimensions, and supporting tissues other than cementum were modeled in the maxillary central tooth. The CER cavity was created on the labial side of the tooth model. The coronal side of the resorption cavity was restored with composite, and the radicular side with different materials (MTA, Biodentine, BioAggregate, calcium-enriched cement [CEM], glass ionomer cement [GIC], and resin-modified glass ionomer cement [RMGIC]). A static force of 300 N was applied to the palatal surface of the crown at an angle of 135° to the long axis of the tooth. The stress distributions in dentin and repair materials were analyzed.
RESULTS
The highest stress in dentin was seen in the fFigmodel with unrepaired CER. In the models repaired with MTA, GIC, and RMGIC, von Mises stress values in dentin were greater than for repairs with Biodentine, BioAggregate, and CEM materials. The von Mises stress on the repair materials applied to the root were highest for the BioAggregate material. This was followed by CEM, Biodentine, MTA, RMGIC, and GIC materials, respectively.
CONCLUSION
The repair of CER in the tooth significantly decreased the stress values in dentin. Biodentine, BioAggregate, and CEM absorbed more force and caused less stress to be transmitted to dentin compared to MTA, GIC, and RMGIC.
Topics: Humans; Flexural Strength; Silicates; Glass Ionomer Cements; Dental Cements; Dental Caries; Finite Element Analysis; Stress, Mechanical; Dentin; Composite Resins
PubMed: 37879603
DOI: 10.1016/j.joen.2023.10.007