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Umeizudike KA, Nwhator SO, Olaoye OI, Ogundana AC, Räisänen IT, Fasanmade OA, Ogundana O, Ajie O, Sorsa T. Effects of Non-Surgical Periodontal Therapy on Glycemic Control in Prediabetes and Diabetes Patients with Stage II-IV Periodontitis as Monitored by Active-Matrix Metalloproteinase-8 Levels. Biomedicines 2025; 13:969. [PMID: 40299548 PMCID: PMC12025252 DOI: 10.3390/biomedicines13040969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 04/09/2025] [Accepted: 04/10/2025] [Indexed: 05/01/2025] Open
Abstract
Background/Objectives: Previous research indicates that non-surgical periodontal therapy (NSPT) improves glycemic control in individuals with prediabetes and diabetes who have periodontitis. Few studies have demonstrated its effects on mouthrinse active-matrix metalloproteinase-8 (aMMP-8) levels as it relates to glycemic control. We assessed the periodontal treatment response of stage II-IV periodontitis patients with prediabetes, diabetes, and normoglycemia, regarding glycated hemoglobin (HbA1c) and mouthrinse aMMP-8 levels using point-of-care kits (PoC). Materials and Methods: Eighty-eight adults (11 normoglycemic, 32 prediabetic, 45 with type 2 diabetes), aged 25-78, with stage II-IV periodontitis were included. Full-mouth clinical examinations were used to evaluate their periodontal parameters. HbA1c and mouthrinse aMMP-8 levels were assessed using PoC kits before and approximately three months after scaling and root planing. Results: There were positive treatment effects of non-surgical periodontal therapy on periodontal clinical parameters, aMMP-8 and HbA1c levels in the prediabetes and diabetes groups. The aMMP-8 reduction was significant (p < 0.001) in the prediabetes and prediabetes + diabetes groups, while HbA1c decreased significantly in the diabetes and prediabetes + diabetes (p < 0.001) groups. In contrast, a non-significant increase in mean aMMP-8 levels, HbA1c, and CAL was observed in normoglycemia (p > 0.05). Stage III + IV periodontitis showed significant treatment effects for aMMP-8 (p < 0.001) and HbA1c (p < 0.01) compared to stage II, regardless of glycemic status. Conclusions: Non-surgical periodontal therapy significantly improves periodontal health as well as HbA1c and aMMP-8 levels in people living with prediabetes and diabetes.
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Grants
- CRC 2021/11 University of Lagos Research Grant (KAU)
- Y1014SULE1, Y1014SL018, Y1014SL017, TYH2019319, TYH2018229, TYH2017251, TYH2016251, and TYH2022225 (TS). the Finnish Dental Society Apollonia, Finland (TS); the Karolinska Institutet, Stockholm, Sweden (TS); the Helsinki and Uusimaa Hospital District (HUS)
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Affiliation(s)
- Kehinde Adesola Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos P.M.B. 12003, Nigeria;
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.S.)
| | - Solomon Olusegun Nwhator
- Department of Preventive and Community Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220005, Nigeria;
| | - Olayiwola Ibrahim Olaoye
- Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos 100271, Nigeria;
| | - Ayodele Charles Ogundana
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos P.M.B. 12003, Nigeria;
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.S.)
| | - Olufemi Adetola Fasanmade
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos P.M.B. 12003, Nigeria;
| | - Oladunni Ogundana
- Department of Oral and Maxillofacial Pathology and Oral Biology, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos P.M.B. 12003, Nigeria;
| | - Obiefuna Ajie
- Department of Clinical Pathology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-araba, Lagos P.M.B. 12003, Nigeria;
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (I.T.R.); (T.S.)
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
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Ioannou P, Katsoulieris E, Afratis NA. Matrix Dynamics and Microbiome Crosstalk: Matrix Metalloproteinases as Key Players in Disease and Therapy. Int J Mol Sci 2025; 26:3621. [PMID: 40332093 PMCID: PMC12027064 DOI: 10.3390/ijms26083621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2025] [Revised: 04/02/2025] [Accepted: 04/09/2025] [Indexed: 05/08/2025] Open
Abstract
Matrix metalloproteinases (MMPs) are key enzymes involved in extracellular matrix (ECM) remodeling, regulating a wide range of cellular and immune processes in both homeostatic and pathological conditions. Host-microbiota interactions play a critical role in maintaining ECM balance; however, during dysbiosis, this regulation is disrupted, leading to compromised barrier integrity, pathogen translocation into circulation, and the development of systemic diseases and cancer. This review highlights the bidirectional relationship between MMP expression/activity and microbiota dysbiosis, emphasizing tissue-specific alterations in MMP activity that contribute to disease progression. In addition, it integrates interdisciplinary evidence to illustrate the MMP-dependent mechanisms underlying various pathologies associated with oral and gut microbiome dysbiosis, including long-range effects through the gut-skin and gut-brain axes. Thus, this review introduces the emerging field of MatrixBiome, which explores the complex interactions between the ECM, microbiota, and host tissues. Finally, it also outlines therapeutic strategies to modulate MMP levels, either indirectly through microbiome-targeted approaches (e.g., prebiotics, probiotics, and postbiotics) or directly using MMP inhibitors, offering promising avenues for future clinical interventions.
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Affiliation(s)
- Paraskevi Ioannou
- Laboratory of Biotechnology and Molecular Analysis, Department of Agricultural Development, Agri-Food & Management of Natural Resources, National and Kapodistrian University of Athens, Evripos Campus, 34400 Psachna, Evia, Greece (E.K.)
| | - Elias Katsoulieris
- Laboratory of Biotechnology and Molecular Analysis, Department of Agricultural Development, Agri-Food & Management of Natural Resources, National and Kapodistrian University of Athens, Evripos Campus, 34400 Psachna, Evia, Greece (E.K.)
| | - Nikolaos A. Afratis
- Laboratory of Biotechnology and Molecular Analysis, Department of Agricultural Development, Agri-Food & Management of Natural Resources, National and Kapodistrian University of Athens, Evripos Campus, 34400 Psachna, Evia, Greece (E.K.)
- Department of Immunology and Regenerative Biology, Weizmann Institute of Science, 234 Herzl Street, Rehovot 7610001, Israel
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Mahapatra A, Panda S, Tumedei M, Panda S, Das AC, Kumar M, Del Fabbro M. Clinical and Microbiological Evaluation of 0.2% Tea Tree Oil Mouthwash in Prevention of Dental Biofilm-Induced Gingivitis. Dent J (Basel) 2025; 13:149. [PMID: 40277479 PMCID: PMC12025935 DOI: 10.3390/dj13040149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2025] [Revised: 03/18/2025] [Accepted: 03/26/2025] [Indexed: 04/26/2025] Open
Abstract
Background: Dental biofilm-induced gingivitis is a prevalent condition caused by dental plaque accumulation. Chlorhexidine mouthwash is a gold standard for plaque control but is associated with adverse effects such as tooth staining and altered taste. This study aimed to evaluate the clinical and antimicrobial effectiveness of 0.2% tea tree oil mouthwash as a natural alternative to 0.2% chlorhexidine mouthwash. Methods: A comparative study was conducted on 60 participants aged 18-60 years, divided into two groups: Group T (tea tree oil) and Group C (chlorhexidine), each comprising 30 participants. Clinical outcomes assessed included Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), and microbiological Colony Forming Units (CFUs). Parameters were recorded at baseline, 7 days, and 28 days. Results: Group T exhibited significantly lower PI and BOP scores at 7 and 28 days compared to Group C (p < 0.05). Both groups showed comparable reductions in CFU counts, indicating similar antimicrobial efficacy. Importantly, tea tree oil had fewer adverse effects, with no reports of tooth staining or altered taste, unlike chlorhexidine. Conclusion: Tea tree oil mouthwash demonstrated equivalent or superior clinical outcomes compared to chlorhexidine, with fewer side effects. It is a viable and well-tolerated alternative for managing plaque-induced gingivitis, supporting further research into its long-term use and efficacy.
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Affiliation(s)
- Adarsha Mahapatra
- Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030, India; (A.M.); (S.P.)
| | - Saurav Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030, India; (S.P.); (A.C.D.); (M.K.)
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sital Panda
- Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030, India; (A.M.); (S.P.)
| | - Abhaya Chandra Das
- Department of Periodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030, India; (S.P.); (A.C.D.); (M.K.)
| | - Manoj Kumar
- Department of Periodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030, India; (S.P.); (A.C.D.); (M.K.)
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Mejía K, Rodríguez-Hernández AP, Martínez-Hernández M. Insights Into the Mechanism of Action of Chlorhexidine on Porphyromonas gingivalis. Int J Dent 2025; 2025:1492069. [PMID: 40223868 PMCID: PMC11986949 DOI: 10.1155/ijod/1492069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 01/13/2025] [Accepted: 02/15/2025] [Indexed: 04/15/2025] Open
Abstract
Chlorhexidine (CHX) remains the most effective antiseptic in periodontal therapy, multiple reports have identified ultrastructural antibacterial effects of CHX on oral bacteria, however, little is known about its molecular mechanism of action on Porphyromonas gingivalis, an important pathobiont directly associated with the pathogenesis of periodontitis. A standardized suspension of P. gingivalis ATCC 33277 was expose to 0.20% CHX for 1 min, then counting colony forming units (CFUs) were recovered to determine the percentage of microbial inhibition. Protein extract integrity of the bacterial cells exposed to CHX was evaluated on a one-dimension sodium dodecyl sulfate polyacrylamide gel electrophoresis (1D SDS-PAGE) gel. The identification of the proteins expressed by P. gingivalis after its exposure to CHX was carried out by mass spectrometry (LC-MS). Exposure of P. gingivalis for 1 min to 0.20% CHX resulted in a 93% reduction in bacterial viability, in addition to an increase of 2.9-fold in protein expression, with the Lys gingipain protein showing the greatest increase. Exposure to 0.20% CHX 1 min on P. gingivalis resulted in 93% reduction in bacterial viability, in addition to inducing changes in the bacterial proteome, with an increased expression of gingipains, the main virulence factor of P. gingivalis.
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Affiliation(s)
- Karen Mejía
- BioInterphases Laboratory, Division of Graduate Studies and Research, Faculty of Dentistry, National Autonomous University of Mexico, Mexico City, Mexico
| | - Adriana-Patricia Rodríguez-Hernández
- Laboratory of Molecular Genetics, Division of Graduate Studies and Research, School of Dentistry, National Autonomous University of Mexico, Mexico City, Mexico
| | - Miryam Martínez-Hernández
- BioInterphases Laboratory, Division of Graduate Studies and Research, School of Dentistry, National Autonomous University of Mexico, Mexico City, Mexico
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Lin Q, Chen H, Zheng S, Lin L, Zhu S. Effect of antibacterial agents on dentin bonding system: A systematic review and meta-analysis. J Prosthet Dent 2025:S0022-3913(25)00048-4. [PMID: 39920034 DOI: 10.1016/j.prosdent.2025.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 01/10/2025] [Accepted: 01/15/2025] [Indexed: 02/09/2025]
Abstract
STATEMENT OF PROBLEM Research on antibacterial dental adhesives has increased over the last few years. However, whether antibacterial agents improve the efficacy of dentin bonding has not yet been determined. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate whether antibacterial agents improve the efficacy of dentin bonding at the resin-dentin interface and to identify possible mechanisms. MATERIAL AND METHODS Studies published within the last 10 years up to April 2024 were searched in 5 databases: PubMed (MedLine), EMBASE, Scopus, Web of Science, and Cochrane Library. A random-effects meta-analysis model was used, and pooled effect estimates were obtained by comparing the standardized mean difference (α=.05). RESULTS A total of 61 studies with 9 different types of antibacterial agent were included in the qualitative and quantitative analyses. The meta-analysis indicated that treatment with metal-based inorganic antibacterial agents improved both the immediate and long-term bond strength values (P<.05). Moreover, incorporating carbon-based substances, quaternary ammonium compounds, chlorhexidine, methacrylate derivatives, and antibiotics enhanced the long-term bond strength of the resin composites to dentin (P<.05). Subgroup analysis indicated that including metal-based inorganic antibacterial agents, quaternary ammonium compounds, and methacrylate derivatives in etch-and-rinse (ER) adhesives improved dentin bond strength (P<.05), whereas carbon-based materials in self-etching (SE) adhesives showed better bonding performance. CONCLUSIONS The introduction of some antibacterial agents into the bonding system improved in vitro bond strength and inhibited bacterial growth. However, clinical trials should be conducted to verify in vivo antibacterial effects and bond strength.
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Affiliation(s)
- Qi Lin
- Postgraduate student, Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, PR China
| | - Huan Chen
- Postgraduate student, Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, PR China
| | - Shuyao Zheng
- Postgraduate student, Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, PR China
| | - Lingkang Lin
- Postgraduate student, Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, PR China
| | - Song Zhu
- Professor, Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, PR China.
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Breschi L, Maravic T, Mazzitelli C, Josic U, Mancuso E, Cadenaro M, Pfeifer CS, Mazzoni A. The evolution of adhesive dentistry: From etch-and-rinse to universal bonding systems. Dent Mater 2025; 41:141-158. [PMID: 39632207 DOI: 10.1016/j.dental.2024.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 11/20/2024] [Accepted: 11/27/2024] [Indexed: 12/07/2024]
Abstract
OBJECTIVES This review aimed at presenting the mechanisms and pitfalls of adhesion to enamel and dentin, advances in the materials science and in the development of strategies to improve hybrid layer (HL) longevity. METHODS Search of the literature was performed on PubMed, Scopus and Web of Science with keywords related to the structure of the dental substrate, HL degradation mechanisms and strategies to contrast them. RESULTS Albeit the advances in the dental materials' properties, HL degradation is still a relevant and current issue in adhesive dentistry. However, adhesive materials have become more resistant and less operator sensitive, and good adhesion is currently in the hands of every practitioner. Numerous novel strategies are being developed, able to improve the resistance of adhesive resins to degradation, their ability to infiltrate and chemically bond to dentin, to remove the unbound/residual water within the HL, reinforce the dentin collagen matrix, and inhibit endogenous metalloproteinases. Many of the strategies have turned to nature in search for powerful biomodifying compounds, and for the inspiration as to mimic naturally occurring regenerative processes. SIGNIFICANCE Extensive knowledge on the structure of the dental substrate and the complexity of adhesion to dentin has led to the development of improved formulations of dental adhesives and numerous valid strategies to improve the strength and longevity of the HL. Nevertheless, for many of them the road from bench to chairside still seems long. We encourage practitioners to know their materials well and use the strategies readily available to them.
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Affiliation(s)
- Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy.
| | - Tatjana Maravic
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy
| | - Claudia Mazzitelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy
| | - Uros Josic
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy
| | - Edoardo Mancuso
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Strada di Fiume 447, Trieste 34149, Italy; Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Via dell'Istria 65/1, Trieste 34137, Italy
| | - Carmem S Pfeifer
- School of Dentistry, Division of Biomaterial and Biomedical Sciences, Oregon Health & Science University, 2730 S Moody Ave., Portland, OR 97201, USA
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Via San Vitale 59, Bologna 40125, Italy
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Pfeifer CS, Lucena FS, Tsuzuki FM. Preservation Strategies for Interfacial Integrity in Restorative Dentistry: A Non-Comprehensive Literature Review. J Funct Biomater 2025; 16:42. [PMID: 39997576 PMCID: PMC11856648 DOI: 10.3390/jfb16020042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/21/2025] [Accepted: 01/23/2025] [Indexed: 02/26/2025] Open
Abstract
The preservation of interfacial integrity in esthetic dental restorations remains a critical challenge, with hybrid layer degradation being a primary factor in restoration failure. This degradation is driven by a combination of host-derived enzymatic activity, including matrix metalloproteinases (MMPs), bacterial proteases, and hydrolytic breakdown of the polymerized adhesive due to moisture exposure. This review examines the multifactorial mechanisms underlying hybrid layer degradation and presents current advancements in restorative materials aimed at counteracting these effects. Principal strategies include collagen preservation through the inhibition of enzymatic activity, the integration of antimicrobial agents to limit biofilm formation, and the use of ester-free, hydrolysis-resistant polymeric systems. Recent research highlights acrylamide-based adhesives, which exhibit enhanced resistance to acidic and enzymatic environments, as well as dual functionality in collagen stabilization. Furthermore, innovations in bioactive resins and self-healing materials present promising future directions for developing adhesives that actively contribute to long-term restoration stability. These findings underscore the importance of continuous advancements in adhesive technology to enhance the durability and clinical performance of dental restorations.
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Affiliation(s)
- Carmem S. Pfeifer
- Department of Oral Rehabilitation and Biosciences, School of Dentistry, Oregon Health & Science University, Portland, OR 97239, USA; (F.S.L.); (F.M.T.)
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Farias-Neto ADM, Landmayer K, Liberatti GA, Shimokawa CAK, Wang L, Honório HM, Matos AB, Francisconi-Dos-Rios LF. Bond strength to eroded dentin as per chlorhexidine use for controlling erosive wear or interface aging: an 18-month assay. Braz Oral Res 2025; 39:e003. [PMID: 39813483 PMCID: PMC11729448 DOI: 10.1590/1807-3107bor-2025.vol39.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/06/2024] [Accepted: 08/28/2024] [Indexed: 01/30/2025] Open
Abstract
The aim of this study was to assess the effect of a chlorhexidine digluconate solution (CHX) applied as an antiproteolytic agent for controlling erosive tooth wear or as part of the adhesive treatment on long-term bond strength to eroded dentin. Dentin specimens were abraded with a 600-grit silicon carbide (SiC) paper for 1 min (sound dentin - S), subsequently treated with 2% CHX for 1 min (with excess removed, followed by a 6-hour rest), and eroded by exposure to Coca-Cola for 5 min, three times a day, for 5 days (CHX-treated and eroded dentin - CHXE), or only eroded (eroded dentin - E). The specimens were acid-etched (15 s), rinsed (30 s), dried (15 s), and rehydrated with 1.5 μL of distilled water for 1 min, with excess removed (control - S.C/CHXE.C/E.C) or 2% CHX (S.CHX/CHXE.CHX/E.CHX). Adper Single Bond 2 was scrubbed twice on the surface for 15 s each and then light-cured for 10 s, and resin composite cores were built up. Specimens were sectioned into beams and microtensile bond strength was tested (μTBS; 0.5 mm/min) immediately or after 18-month aging. Failure modes were analyzed using a digital microscope. Data (μTBS/MPa) were analyzed by three-way ANOVA, followed by Tukey's test (α = 0.05). μTBS to E and CHXE, irrespective of the rehydration solution and aging period, were equivalent to each other and lower than that to S. CHX as the rehydration solution reduced immediate and long-term µTBS to S. Aging reduced μTBS. By controlling tooth wear or interface aging, CHX could not influence long-term bonding to eroded dentin.
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Affiliation(s)
- Aloísio de Melo Farias-Neto
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Karin Landmayer
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Giovanni Aguirra Liberatti
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | | | - Linda Wang
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, University of São Paulo, Bauru, SP, Brazil
| | - Heitor Marques Honório
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | - Adriana Bona Matos
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
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Sharafeddin F, Aghaei F. Evaluation of the Effect of Applying Chitosan, Neem, Tulsi, Aloe vera, and Chlorhexidine Solutions on the Shear Bond Strength of Composite to Dentin. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2024; 25:334-341. [PMID: 39713107 PMCID: PMC11662170 DOI: 10.30476/dentjods.2023.98834.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/09/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2024]
Abstract
Statement of the Problem Dentin adhesion is challenging and needs modifications. Newly introduced nature-derived materials may be a useful solution in improving dentin adhesion. The use of natural antimicrobial agents for pretreating prepared dentin surfaces before restoration has become of interest. Purpose The present study investigated the effect of natural compounds on the shear bond strength (SBS) of resin composite adhesively bonded to dentin. Materials and Method Sixty extracted human molar teeth were randomly divided into six groups (n= 10); Group I: two-step etch and rinse adhesive system, Adper Single Bond 2 (SB2) (experimental control), Group II: 2.5% Chitosan+etch+SB2, Group III: 15% Neem (Azadirachta indica)+etch+SB2, Group IV: 15% Tulsi (Ocimum sanctum)+etch+SB2, Group V: 2% Aloe vera+etch+SB2, and group VI: 2% Chlorhexidine (CHX)+etch+SB2. Resin composite (Z350, 3M ESPE USA) was placed over the prepared dentin surfaces and was light cured. Data analysis was performed using One-way ANOVA and post hoc Tukey's test (p< 0.05). Results Neem specimens showed the highest mean SBS, statistically greater than the control (p= 0.042). Other experimental groups showed no significant differences in SBS comparison to the control. The mean SBS values of 2.5% Chitosan, 15% Neem, 15% Tulsi, and 2% Aloe vera were significantly higher than 2% CHX (p= 0.046, p= 0.001, p= 0.010 and p= 0.002 respectively). Conclusion Dentin pretreatment with Neem may improve the bond strength of a two-step etch and rinse adhesive system. The application of Chitosan, Tulsi, Aloe vera, and CHX did not demonstrate significantly different SBS values from that of the Control, although CHX was lower.
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Affiliation(s)
- Farahnaz Sharafeddin
- Dept. of Operative Dentistry, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Aghaei
- Postgraduate Student, Dept. of Operative Dentistry, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Elseoudy N, Sanon K, Hiraishi N, Tamura Y, Tagami J, Shimada Y. MMP inhibition, marginal integrity and cytotoxicity of zinc-releasing GIC. J Dent 2024; 151:105450. [PMID: 39505291 DOI: 10.1016/j.jdent.2024.105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 10/31/2024] [Accepted: 11/03/2024] [Indexed: 11/08/2024] Open
Abstract
OBJECTIVES The degradation of the restorative-dentin interface due to endogenous dentin enzymes, such as matrix metalloproteinases (MMPs), is a significant issue that accelerates the deterioration of the dentin matrix and leads to the failure of restorative treatments. Caredyne Restore (CR), a novel glass ionomer cement (GIC) with zinc ions in its formulation, represents the latest effort to mitigate this issue. This investigation aimed to evaluate the MMPs inhibitory effect, marginal integrity, and cytotoxicity of CR compared to a conventional GIC, Fuji IX (FIX). METHODS The inhibitory effect of CR on MMPs activity was evaluated using in-situ zymography to visualize the endogenous gelatinolytic activity in the GIC-dentin interface. Additionally, CR's sealing properties were investigated using dye-assisted confocal laser microscopy (CLSM) to assess marginal leakage across the GIC-dentin interface. Both in-situ zymography and CLSM observations were conducted 1 day and seven days after pH cycling. Finally, the cytotoxicity of the GIC eluates was examined on rat dental pulp cells (RPCC2A). Assay measurements were performed after 24 and 48 h of incubation with test solutions prepared using various GIC eluate concentrations. RESULTS The MMPs activity of the CR specimens was significantly lower than that of FIX specimens after seven days of pH cycling. Signs of marginal leakage were also lower in the CR specimens. Comparison of CR and FIX eluates at the same concentration showed no significant difference in terms of biocompatibility. CONCLUSIONS Caredyne restore is capable of inhibiting endogenous enzyme activity and improving sealing properties, while maintaining sufficient biocompatibility. CLINICAL SIGNIFICANCE Zinc ions released from Caredyne Restore offer a safe way to improve the quality of dental restorations and promote minimally invasive treatment, especially in lesions where the dentin matrix is susceptible to enzymatic degradation and recurrent caries.
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Affiliation(s)
- Nader Elseoudy
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kittisak Sanon
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Noriko Hiraishi
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yukihiko Tamura
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junji Tagami
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Yasushi Shimada
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Valdez-Montoya M, Avendaño-Félix MM, Basurto-Flores JC, Ramírez-Álvarez M, Cázarez-Camacho MDR, Casillas-Santana MÁ, Zavala-Alonso NV, Sarmiento-Hernández SN, Silva-Benítez EDL, Soto-Sainz JE. Role of Metalloproteinases in Adhesion to Radicular Dentin: A Literature Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:5674. [PMID: 39597497 PMCID: PMC11596517 DOI: 10.3390/ma17225674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 11/10/2024] [Accepted: 11/15/2024] [Indexed: 11/29/2024]
Abstract
INTRODUCTION Root dentin is a porous and complex dental surface that may have irregularities and deposits of organic material. To achieve an effective bond between restorative materials and root dentin, it is necessary that the restorative materials adhere intimately to the dentin surface. Metalloproteinases (MMPs) are a group of proteolytic enzymes that perform an important role in degrading the extracellular matrix and remodeling connective tissue. The aim of this research was to determine the scientific evidence available on the role played by MMPs in adhesion to root dentin and their putative inhibitors. MATERIALS AND METHODS Several techniques have been used to evaluate the presence of MMPs in the root dentin of human and bovine teeth, such as Western blot, immunohistochemistry, immunofluorescence, and zymography, the latter also being used together with the EnzCheck assay to evaluate the inhibitory effect of adhesion protocols on the activity of root MMPs in vitro. RESULTS When analyzing the databases, 236 articles were found, 12 of which met the selection criteria. The variables analyzed were articles that evaluated different MMP inhibitors in root dentin. CONCLUSIONS In the adhesion to radicular dentin, MMPs have a crucial role in the degradation of the extracellular matrix of dentin and the remodeling of the dentin surface because excessive MMP activity can be harmful to dental health, since excessive degradation of the extracellular matrix of dentin can weaken the tooth structure and decrease fracture resistance. Therefore, it is important to monitor MMP activity during root dentin bonding procedures.
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Affiliation(s)
- Marihana Valdez-Montoya
- Maestría en Ciencias Odontológicas, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78290, Mexico; (M.V.-M.); (N.V.Z.-A.)
| | - Mariana Melisa Avendaño-Félix
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico; (M.M.A.-F.); (J.C.B.-F.); (E.d.L.S.-B.)
| | - Julio César Basurto-Flores
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico; (M.M.A.-F.); (J.C.B.-F.); (E.d.L.S.-B.)
| | - Maricela Ramírez-Álvarez
- Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico; (M.R.-Á.); (M.d.R.C.-C.)
| | | | | | - Norma Verónica Zavala-Alonso
- Maestría en Ciencias Odontológicas, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78290, Mexico; (M.V.-M.); (N.V.Z.-A.)
| | - Seyla Nayjaá Sarmiento-Hernández
- Maestría en Odontología Integral del Niño y el Adolescente, Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico;
| | - Erika de Lourdes Silva-Benítez
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico; (M.M.A.-F.); (J.C.B.-F.); (E.d.L.S.-B.)
| | - Jesús Eduardo Soto-Sainz
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Sinaloa 80040, Mexico; (M.M.A.-F.); (J.C.B.-F.); (E.d.L.S.-B.)
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12
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Dhok VD, Khanvilkar UD, Moogi PP, Bandekar SD, Kshirsagar S, Jadhav SR. A comparative evaluation of the effect of matrix metalloproteinase inhibitor on the fracture resistance of endodontically treated teeth restored with Everstick-reinforced composite resin: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:1104-1109. [PMID: 39777387 PMCID: PMC11702874 DOI: 10.4103/jcde.jcde_274_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/07/2024] [Accepted: 09/09/2024] [Indexed: 01/11/2025]
Abstract
Aim To evaluate the effect of applying a matrix metalloproteinase (MMP) inhibitor on the fracture resistance of root-filled teeth restored with Everstick fiber-reinforced composite resin. Subjects and Methods After the selection of 60 freshly extracted human mandibular first molar, root canal access and standard uniformly sized mesio-occluso-distal (MOD) cavities were made and the teeth were randomly assigned into three groups (n = 20 each): Group I, the MOD cavity was first lined with flowable composite resin and then restored with composite resin. In Group II, Everstick fiber was placed into the bed of flowable composite in buccal-pulpal-lingual direction before the composite restoration was placed. In Group III, after etching of the cavity, a 2% chlorhexidine MMP inhibitor was applied. Then, the MOD cavity was restored same as group II. A universal testing machine was employed to compressively load the teeth at a cross-head speed of 0.5 mm/min till fracture. The maximum fracture loads were recorded in Newtons (N) and data were analyzed with one-way ANOVA and post-hoc Tukey tests. Results Group III exhibited significantly higher fracture resistance compared to all other groups (P < 0.001), whereas Group I demonstrated the lowest fracture resistance. Conclusion The utilization of Everstick glass fiber, combined with MMP inhibitor treatment, yielded the greatest fracture resistance. Hence, this method may be prioritized over conventional restoration techniques for strengthening root canal-treated teeth with structurally compromised crowns.
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Affiliation(s)
- Vaishnavi Deepak Dhok
- Department of Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpari, Pune, Maharashtra, India
| | - Unmesh Deepak Khanvilkar
- Department of Conservative Dentistry and Endodontics, Yogita Dental College and Hospital, Ratnagiri, Maharashtra, India
| | - Prashant Prakash Moogi
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Siddhesh Dattatray Bandekar
- Department of Conservative Dentistry and Endodontics, Yogita Dental College and Hospital, Ratnagiri, Maharashtra, India
| | - Shirin Kshirsagar
- Department of Conservative Dentistry and Endodontics, Yogita Dental College and Hospital, Ratnagiri, Maharashtra, India
| | - Sanket Rajendra Jadhav
- Department of Prosthodontics, D. Y. Patil Dental School, Lohegaon, Pune, Maharashtra, India
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13
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Sharma N, Susila A, Veronica AK, Fiona RJ, Sai S, Anguswamy S. Effect of Selective Dentine Pre-Treatment with Butane Tetracarboxylic Acid on Composite-Dentine Bond. Indian J Dent Res 2024; 35:443-448. [PMID: 40156530 DOI: 10.4103/ijdr.ijdr_146_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 09/23/2024] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Composites are prone to time-dependent bond degradation. Many measures have been taken to stabilize the bond. AIM This in vitro study aims to evaluate the effect of pretreatment with 1,2,3,4-Butane Tetracarboxylic acid (BTCA) on the micro-tensile bond strength (µTBS) of composite resin to dentine and to compare it with the pretreatment using 2% chlorhexidine (CHX). MATERIALS AND METHODS Permanent molars (40) extracted for periodontal reasons were selected. Dentine surfaces were exposed using a diamond bur, preconditioned with BTCA for the test group (SIGMA-ALDRICH) and with CHX for the control group, followed by the application of self-etch adhesive (GC G-Premio bond) and composite restoration (GC Solare X). Each group was subdivided to be tested as: Group 1A: after 24 hours with BTCA; Group 1B: after 1 month with BTCA; Group 2A: after 24 hours with CHX; Group 2B: after 1 month with CHX. The µTBS was tested using a universal testing machine. The mode of failure was determined using a stereomicroscope and a scanning electron microscope (SEM). RESULT BTCA pretreatment was able to preserve the bond slightly better than the control group, though not statistically significant either at 24 hours (P = 0.492) or 1 month (P = 0.181). There was no significant reduction in the µTBS between immediate testing and 1-month storage for both groups (P = 0.213 for acid; P = 0.914 for CHX). The mode of failure was predominantly cohesive for both groups, with fewer adhesive failures. CONCLUSIONS BTCA pre-conditioning is capable of preserving the dentin-composite bond as efficiently as CHX.
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Affiliation(s)
- Nikita Sharma
- Department of Conservative Dentistry and Endodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Anand Susila
- Department of Conservative Dentistry and Endodontics, Madha Dental College, Kundrathur, Chennai, Tamil Nadu, India
| | - Aruna Kumari Veronica
- Department of Conservative Dentistry and Endodontics, Madha Dental College, Kundrathur, Chennai, Tamil Nadu, India
| | - R J Fiona
- Department of Conservative Dentistry and Endodontics, Madha Dental College, Kundrathur, Chennai, Tamil Nadu, India
| | - Shamini Sai
- Department of Conservative Dentistry and Endodontics, Dr Shamini Sai Dental Clinic, Alwarpet, Chennai, Tamil Nadu, India
| | - Sriganesh Anguswamy
- Department of Conservative Dentistry and Endodontics, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu, India
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14
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Tiyapitsanupaisan N, Kantrong N, Puasiri S, Makeudom A, Krisanaprakornkit S, Chailertvanitkul P. Effects of Thai propolis mixed in mineral trioxide aggregate on matrix metalloproteinase-2 expression and activity in inflamed human dental pulp cells. J Appl Oral Sci 2024; 32:e20240168. [PMID: 39319905 PMCID: PMC11464073 DOI: 10.1590/1678-7757-2024-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/17/2024] [Accepted: 07/28/2024] [Indexed: 09/26/2024] Open
Abstract
OBJECTIVES This study sought to determine effects of Thai propolis extract mixed in mineral trioxide aggregate (MTA) on matrix metalloproteinase-2 (MMP-2) expression and its activity in inflamed human dental pulp cells (HDPCs). MATERIALS AND METHODS Interleukin-1β-primed HDPCs were treated with either the eluate of MTA mixed with distilled water, of MTA mixed with 0.75 mg/ml of the propolis extract, or of Dycal®, 0.75 mg/ml of the propolis extract, or 0.2% (v/v) of chlorhexidine for 24 or 72 h. The viability of HDPCs was determined by the PrestoBlue® cytotoxic assay. HDPCs' lysates were analyzed for MMP-2 mRNA expression by RT-qPCR, while their supernatants were measured for MMP-2 activity by gelatin zymography. RESULTS At 24 and 72 h, a non-toxic dose of the propolis extract at 0.75 mg/ml by itself or mixed in MTA tended to reduce MMP-2 expression upregulated by MTA, while it further decreased the MMP-2 activity as compared to that of MTA mixed with distilled water. The MMP-2 activity of interleukin-1β-primed HDPCs treated with the eluate of the propolis extract mixed in MTA was significantly lower than that of interleukin-1β-primed HDPCs at 24 h (p=0.012). As a control, treatment with chlorhexidine significantly inhibited MMP-2 expression induced by MTA and MMP-2 activity enhanced by interleukin-1β (p<0.05). Treatment with Dycal® caused a significant increase in HDPC's death, resulting in a significant decrease in MMP-2 expression and activity (p<0.05). CONCLUSIONS MTA mixed with Thai propolis extract can reduce MMP-2 mRNA expression and activity when compared to MTA mixed with distilled water in inflamed HDPCs.
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Affiliation(s)
- Nutnicha Tiyapitsanupaisan
- Khon Kaen University, Faculty of Dentistry, Department of Restorative Dentistry, Khon Kaen 40002, Thailand
| | | | - Subin Puasiri
- Khon Kaen University, Faculty of Dentistry, Department of Preventive Dentistry, Khon Kaen 40002, Thailand
| | - Anupong Makeudom
- Mae Fah Luang University, School of Dentistry, Chiang Rai 57100, Thailand
| | | | - Pattama Chailertvanitkul
- Khon Kaen University, Faculty of Dentistry, Department of Restorative Dentistry, Khon Kaen 40002, Thailand
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15
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Khoury RD, de Carvalho LS, do Nascimento MFR, Alhussain F, Abu Hasna A. Endodontic irrigants from a comprehensive perspective. World J Clin Cases 2024; 12:4460-4468. [PMID: 39070803 PMCID: PMC11235474 DOI: 10.12998/wjcc.v12.i21.4460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/30/2024] Open
Abstract
This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping. It reviews commonly used endodontic irrigant, namely sodium hypochlorite (NaOCl), herbal extracts, chlorhexidine (CHX), and chelating agents, highlighting their properties, applications, and potential drawbacks. NaOCl, a key antimicrobial agent, demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity. Herbal extracts, gaining recognition in endodontics, present an alternative with potential advantages in preserving dentin integrity. CHX, known for its broad-spectrum antimicrobial activity, is discussed in both liquid and gel formulations, emphasizing its role in reducing smear layer formation and preserving hybrid layer durability. Chelating agents, specifically ethylenediaminetetraacetic acid and citric acid, play a vital role in removing the smear layer, enhancing dentin permeability, and facilitating the penetration of antimicrobial agents. The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures. It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.
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Affiliation(s)
- Rayana Duarte Khoury
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Lara Steffany de Carvalho
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Mauro Felipe Rios do Nascimento
- School of Dentistry, The National Institute of Higher Education and Postgraduate Studies Padre Gervásio-INAPÓS, Pouso Alegre 37550-121, MG, Brazil
| | - Fadi Alhussain
- School of Dentistry, Syrian Private University, Al Kiswah 877C+P2, Damascus, Syria
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
- School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador
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16
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Gayathrie B, Krishnan M, Srinivasan S, Raza FB, Muthukumar B. Comparison of microtensile bond strength of prepared teeth treated with proanthocyanidin, Camellia sinensis - Polyphenols, and metal crowns luted with resin-modified glass ionomer cement: An in vitro study. J Indian Prosthodont Soc 2024; 24:279-283. [PMID: 38946512 PMCID: PMC11321478 DOI: 10.4103/jips.jips_127_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/02/2024] Open
Abstract
AIM The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC). SETTING AND DESIGN This was an in vitro study. MATERIALS AND METHODS Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated. STATISTICAL ANALYSIS The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD. RESULTS Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin. CONCLUSION C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.
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Affiliation(s)
- B Gayathrie
- Department of Prosthodontics, SRM Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Murugesan Krishnan
- Department of Prosthodontics, Priyadarshini Dental College and Hospital, Pandur, India
| | | | - Fathima Banu Raza
- Department of Prosthodontics, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
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Perarivalan I, Karunakaran J, Anbalagan N, Harishma S, Prasad V. Matrix metalloproteinase inhibitors in restorative dentistry. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:566-571. [PMID: 38989495 PMCID: PMC11232771 DOI: 10.4103/jcde.jcde_199_24] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 07/12/2024]
Abstract
Matrix metalloproteinases (MMPs) have been identified as agents that disintegrate the collagen structures of dental hybrid layers, resulting in reduced restorative bond strength. Multiple MMP inhibitors (MMPIs) are known to counteract this degenerative mechanism, thereby preserving bond strength and promoting the longevity of resin-based restorations. Additionally, literature suggests that certain MMPI materials possess antimicrobial/anticariogenic properties, potentially reducing the risk of secondary caries development. Therefore, this review article aims to narrate on the integration of matrix metalloproteinase inhibitors into adhesive systems and their impact on bond strength.
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Affiliation(s)
- I Perarivalan
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - Janani Karunakaran
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - Nathashri Anbalagan
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - S Harishma
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - Vishnu Prasad
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
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18
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Kijsamanmith K, Srisatayasatien P, Thanindratarn N, Vichainarong C, Panyasukum J. The effect of 2% chlorhexidine iontophoresis on dentin sealing ability of etch-and-rinse adhesive: An in vitro study. J Dent Sci 2024; 19:846-854. [PMID: 38618063 PMCID: PMC11010672 DOI: 10.1016/j.jds.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/01/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Iontophoresis could enhance the delivery of chlorhexidine into oral tissue. This study aimed to determine the effect of 2% chlorhexidine iontophoresis (CHI) on the sealing ability of etch-and-rinse adhesive in human dentin using hydraulic conductance (HD) measurement, scanning electron microscopy and energy dispersive x-ray spectroscopy (SEM-EDS). Materials and methods Thirty-nine sound dentin specimens were prepared from 39 extracted intact third molars. Thirty specimens were used for HD measurement and randomly divided into 3 equal-sized groups; (1) No chlorhexidine treatment (control), (2) passive chlorhexidine treatment (CHT) and (3) CHI on acid-etched dentin. Each dentin surface was treated with etch-and-rinse adhesive. HD of each specimen was measured before treatment, after immediate bonding and after 14 days. The other 9 specimens were subjected to SEM-EDS analysis of the acid-etched dentin and the dentin treated with CHT and CHI. ANOVA test and Student-Newman-Keuls method were used for statistical analysis. Results After bonding, there was no significant difference in percentage decrease of HD among the treatment groups (P > 0.05). After 14 days, CHI and CHT groups had greater percentage decrease of HD than the control (P < 0.001 and P = 0.009, respectively). Under SEM-EDS analysis, acid-etched dentin with CHI presented opened dentinal tubule orifices and more chlorhexidine precipitates on dentin than the dentin with CHT, which strongly related to a higher percentage of chloride ions on the CHI dentin surface (P < 0.001). Conclusion The use of CHI on acid-etched dentin had a positive effect on dentin sealing ability of etch-and-rinse adhesive.
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Affiliation(s)
- Kanittha Kijsamanmith
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Nichapa Thanindratarn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chanisa Vichainarong
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jirapat Panyasukum
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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19
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Campos RP, Mailart MC, Matuda AGN, Yui KCK, Chagas GDS, Rocha MB, Tay FR, Pucci CR. Effect of Nisin-based pretreatment solution on dentin bond strength, antibacterial property, and MMP activity of the adhesive interface. J Mech Behav Biomed Mater 2024; 152:106407. [PMID: 38277911 DOI: 10.1016/j.jmbbm.2024.106407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To evaluate the effect of a Nisin-based dentin pretreatment solution on microtensile bond strength, antibacterial activity, and matrix metalloproteinase (MMP) activity of the adhesive interface. MATERIALS AND METHODS 100 human molars were sectioned to expose dentin. The teeth were assigned to five groups (n = 20), according to the dentin pretreatment: 0.5%, 1.0%, or 1.5% Nisin; 0.12% chlorhexidine (positive control), and no solution (negative control), and divided into 2 subgroups: no aging, and thermomechanical aging. Specimens were etched with 37% H3PO4 for 15 s and submitted to the dentin pretreatment. Then, they were bonded with an adhesive (Adper Single Bond 2) and a resin composite for microtensile bond strength (μTBS) evaluation. Antibacterial activity against Streptococcus mutans was qualitatively examined using an agar diffusion test. Anti-MMP activity within hybrid layers was examined using in-situ zymography. Data were analyzed with two-factor ANOVA and post-hoc Tukey's test (α = 0.050). RESULTS For μTBS, significant differences were identified for the factors "solutions" (p = 0.002), "aging" (p = 0.017), and interaction of the two factors (p = 0.002). In the absence of aging, higher μTBS was observed for the group 0.5% Nisin. In the presence of aging, all groups showed similar μTBS values. All Nisin concentrations were effective in inhibiting the growth of S. mutans. Endogenous MMP activity was more significantly inhibited using 0.5% and 1.0% Nisin (p < 0.050). CONCLUSION 0.5% and 1.0% Nisin solutions do not adversely affect resin-dentin bond strength and exhibit a potential bactericidal effect against S. mutans. Both concentrations effectively reduce endogenous gelatinolytic activity within the hybrid layer. CLINICAL RELEVANCE The use of 0.5% and 1.0% Nisin solutions for dentin pretreatment potentially contributes to preserving the adhesive interface, increasing the longevity of composite restorations.
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Affiliation(s)
- Raquel Pinto Campos
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
| | - Mariane Cintra Mailart
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil.
| | - Amanda Guedes Nogueira Matuda
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
| | - Karen Cristina Kazue Yui
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
| | - Gabriela da Silva Chagas
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
| | - Marcella Batista Rocha
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, USA
| | - Cesar Rogerio Pucci
- Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University, Sao José dos Campos, SP, Brazil
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20
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Radzki D, Negri A, Kusiak A, Obuchowski M. Matrix Metalloproteinases in the Periodontium-Vital in Tissue Turnover and Unfortunate in Periodontitis. Int J Mol Sci 2024; 25:2763. [PMID: 38474009 DOI: 10.3390/ijms25052763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
The extracellular matrix (ECM) is a complex non-cellular three-dimensional macromolecular network present within all tissues and organs, forming the foundation on which cells sit, and composed of proteins (such as collagen), glycosaminoglycans, proteoglycans, minerals, and water. The ECM provides a fundamental framework for the cellular constituents of tissue and biochemical support to surrounding cells. The ECM is a highly dynamic structure that is constantly being remodeled. Matrix metalloproteinases (MMPs) are among the most important proteolytic enzymes of the ECM and are capable of degrading all ECM molecules. MMPs play a relevant role in physiological as well as pathological processes; MMPs participate in embryogenesis, morphogenesis, wound healing, and tissue remodeling, and therefore, their impaired activity may result in several problems. MMP activity is also associated with chronic inflammation, tissue breakdown, fibrosis, and cancer invasion and metastasis. The periodontium is a unique anatomical site, composed of a variety of connective tissues, created by the ECM. During periodontitis, a chronic inflammation affecting the periodontium, increased presence and activity of MMPs is observed, resulting in irreversible losses of periodontal tissues. MMP expression and activity may be controlled in various ways, one of which is the inhibition of their activity by an endogenous group of tissue inhibitors of metalloproteinases (TIMPs), as well as reversion-inducing cysteine-rich protein with Kazal motifs (RECK).
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Affiliation(s)
- Dominik Radzki
- Department of Periodontology and Oral Mucosa Diseases, Faculty of Medicine, Medical University of Gdańsk, 80-208 Gdańsk, Poland
- Division of Molecular Bacteriology, Institute of Medical Biotechnology and Experimental Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Alessandro Negri
- Division of Molecular Bacteriology, Institute of Medical Biotechnology and Experimental Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosa Diseases, Faculty of Medicine, Medical University of Gdańsk, 80-208 Gdańsk, Poland
| | - Michał Obuchowski
- Division of Molecular Bacteriology, Institute of Medical Biotechnology and Experimental Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
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21
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Prado MC, Campos P, Pasetto S, Marciano MA, Sinhoreti MAC, Geraldeli S, de-Jesus-Soares A, Abuna G. Development of nanobiosilicate, tricalcium phosphate and chlorhexidine materials for biomineralization with crystallographic similarity to hydroxyapatite and biomodified collagen. Dent Mater 2024; 40:267-275. [PMID: 37989699 DOI: 10.1016/j.dental.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/24/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES The aim of this work is to test experimental cements, doped with a silicate based bioactive nanoparticle (NanoBiosilicate). Methods, we synthesized a glass nanoparticle by Sol-Gel Stöber method, used to be incorporated in a dental material for endodontic uses. MATERIALS AND METHODS We assess the mineralizing properties and biocompatibility. Besides the crystallography characterization of the resultant new crystals. Results, After analysis, and comparison with commercial materials, the material tested was similar in mechanical properties required by ISO, The ion release was effective after 2 hr. of setting and the novel material was cell compatible accepted by ISO. RESULTS We found new formed Calcium Phosphate peaks in the spectroscopic analysis (FTIR), remarkably the crystals formed were comparable to hydroxyapatite when analyzed with a Selected Area Electron Diffractometer, with rings of 2.84 Å for 002, and the 2.77 Å is also visible for 210. The 6.83 Å and 6.88 Å, for respective 222 and 004. The incorporation of Chlorhexidine was not detrimental for this property, Significance, the features mentioned represented a progress in biomineralization field that was associated to an improved mineral structure formation with increased crystallographic similarity to natural hydroxyapatite. When chlorhexidine was added a favorable biomodification of the remaining collagen in dentinal walls and antimicrobial activity potential were also observed.
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Affiliation(s)
- Marina C Prado
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil; Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA.
| | - Paulo Campos
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Silvana Pasetto
- Department of Biology, East Carolina University (ECU-SoDM), Greenville, NC, USA
| | - Marina A Marciano
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Mário A C Sinhoreti
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Saulo Geraldeli
- Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Gabriel Abuna
- Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA.
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22
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Ng TYK, Lee AHC, Chang JWW, Leung WSF, Cen R, Cheung GSP, Zhang C. Effect of MMP Inhibitors on the Bond Strength of Fibre Posts After Ageing. Int Dent J 2023; 73:834-839. [PMID: 37230841 PMCID: PMC10658439 DOI: 10.1016/j.identj.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/07/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023] Open
Abstract
AIM This in vitro study aimed to evaluate the effect of matrix metalloproteinase (MMP) inhibitors on the bond strength of resin-cemented fibre posts to radicular dentin under an aged-loaded condition. MATERIALS AND METHODS Radicular dentin was prepared and irrigated by MMP inhibitor solution after root canal obturation in 60 extracted single-rooted teeth based on 6 groups: (1) 2% chlorhexidine (CHX) + loaded; (2) CHX + unloaded; (3) 0.5% benzalkonium chloride (BAC) + loaded; (4) BAC + unloaded; (5) 17% ethylenediaminetetraacetic acid (EDTA) + loaded; and (6) EDTA + unloaded. After final rinsing, all specimens were sliced cross-sectionally and kept in a water bath for 12 months of ageing. Groups 1, 3, and 5 were subjected to cyclic loading. Push-out tests were conducted using a universal testing machine, and failure mode was examined. The data were analysed using 3-way analysis of variance and post hoc tests at α = 0.05. RESULTS BAC + unloaded demonstrated the highest mean bond strength (3.12 ± 0.18 MPa; P < .001), while the BAC + loaded and CHX + loaded groups showed a significantly lower push-out bond strength than their unloaded counterparts. Mixed adhesive-cohesive failure was the most common failure mode observed. CONCLUSIONS Without cycling loading, BAC was superior to CHX and EDTA in preserving the bond strength of resin-cemented fibre posts after 12 months of ageing. Loading significantly weakened the effectiveness of BAC and CHX in preserving the bond strength.
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Affiliation(s)
- Tai Yin Kelvin Ng
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Angeline Hui Cheng Lee
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Jeffrey Wen Wei Chang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Wing See Fiona Leung
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Rong Cen
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Gary Shun Pan Cheung
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China.
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23
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Jamal H, Yaghmoor R, Abed H, Young A, Ashley P. Impact of Dentine Pretreatment with Matrix Metalloproteinase Inhibitors on Bond Strength of Coronal Composite Restorations: A Systematic Review and Meta-analysis of In Vitro Studies. Eur J Dent 2023; 17:974-999. [PMID: 36400108 PMCID: PMC10756735 DOI: 10.1055/s-0042-1757582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Matrix metalloproteinase (MMP) enzymes participate in collagen matrix degradation, including in dentine, potentially compromising bond strength. Therefore, MMP inhibitors have been hypothesized to improve restoration bond strength and stability. This systematic review aimed to evaluate the influence of different MMP inhibitors applied as dentine surface pretreatments on the immediate (24 hours) and longer term (months) bond strength of direct coronal composite restorations. This systematic literature review followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement. A systematic literature search of three databases (Ovid MEDLINE, Ovid Embase, and Google Scholar) was conducted independently by two reviewers from inception to April 2022. An adapted quality assessment tool was independently applied by two reviewers for risk of bias assessment. RevMan v5.4 software was used for meta-analyses. A randomeffectsmodel was used to generatemean differences with 95% confidence intervals for treatment and control comparisons. The Q-test and I2-test were used to test for heterogeneity. The proportion of total variance across studies attributable to heterogeneity rather than chance was calculated. Overall effects were tested using the Z-test, while subgroup differences were tested using Chi-squared tests. Of 934 studies, 64 studies were included in the systematic review and 42 in the meta-analysis. Thirty-one MMP inhibitors were reported, three of which were included in the meta-analysis: 2% chlorhexidine (CHX), 0.3M carbodiimide (EDC), and 0.1% riboflavin (RIBO). Pretreatment with 2% CHX for 30 and 60 seconds did not significantly improve bond strength compared with controls either immediately or after long-termageing. However, pretreatment with 0.3MEDC and 0.1% RIBO (but not CHX) significantly improved bond strength compared with control groups both immediately and over time. Most studies showed a medium risk of bias. These in vitro findings pave the way for rationale clinical trialing of dentine surface pretreatment with MMP inhibitors to improve clinical outcomes.
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Affiliation(s)
- Hasan Jamal
- Paediatric Dentistry Department, Eastman Dental Institute, University College London, London, United Kingdom
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom
| | - Rayan Yaghmoor
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom
- Department of Microbial Diseases, UCL Eastman Dental Institute, Royal Free Hospital, London, United Kingdom
- Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hassan Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Anne Young
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom
| | - Paul Ashley
- Paediatric Dentistry Department, Eastman Dental Institute, University College London, London, United Kingdom
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24
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Ozdemir ZM, Surmelioglu DG. Comparative evaluation of effect of chlorhexidine application on dentin bond strength with two different adhesives after ER, CR: YSGG phototherapy: an in vitro study. Lasers Med Sci 2023; 38:224. [PMID: 37773548 DOI: 10.1007/s10103-023-03878-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 09/08/2023] [Indexed: 10/01/2023]
Abstract
This study aimed to assess the efficacy of phototherapy with an Er, Cr:YSGG laser on the bond strength of dentin using two different adhesive systems after chlorhexidine (CHX) application. Twenty-four non-carious human molar teeth were separated into three main groups: negative control Group A (Group A), CHX and phototherapy with an Er, Cr:YSGG laser (Group PC), and CHX with conventional diamond bur (no phototherapy) (Group C). These groups were divided into two subgroups based on adhesives: Clearfil Universal Quick Bond and Clearfil SE Bond. To evaluate the microtensile bond strength, the occlusal enamel surfaces of the teeth were removed with a low-speed, water-cooled diamond bur to expose hard dentin tissue. The teeth within Group PC were treated with Er, Cr:YSGG phototherapy. The surfaces were then disinfected with 0.2% chlorhexidine gluconate. Subgroups were applied according to the manufacturer's instructions using the adhesive systems mentioned above. Following adhesive application, the teeth were restored with composite resin. A microtensile bond strength test was performed on the test sticks obtained from the teeth using a universal test device. Data were analyzed using variance analysis (ANOVA) at a significance level of p < 0.05. Among all groups, the highest bond strength was achieved with Clearfil SE Bond with CHX + phototherapy (45.6 ± 4.2), while the lowest was achieved with Clearfil Universal Quick Bond without phototherapy (control group) (27.0 ± 6.7) (p < 0.05). Phototherapy with Er, Cr: YSGG following chlorhexidine application enhanced the bond strength of both the bond systems (p < 0.05).
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Affiliation(s)
- Zeyneb Merve Ozdemir
- Department of Restorative Dentistry, Faculty of Dentistry, Kahramanmaras Sutcu Imam University, Onikisubat, Kahramanmaras, Turkey
| | - Derya Gursel Surmelioglu
- Department of Restorative Dentistry, Faculty of Dentistry, Gaziantep University, University Boulevard, Sehitkamil, Gaziantep, 27310, Turkey.
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25
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Petrovic J, Sekundo C, Gehrig H, Rampf S, El-Sayed S, Ritz A, Mente J. Outcome after Partial Pulpotomy: Long-term Results of the Prospective Clinical MMP-9 Study. ORAL HEALTH & PREVENTIVE DENTISTRY 2023; 21:331-338. [PMID: 37753855 PMCID: PMC11619879 DOI: 10.3290/j.ohpd.b4438901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/07/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE While the objective of partial pulpotomy is to preserve the vitality and function of the pulp tissue, the preopera-tive pulp status is the main prognostic factor for its success. To date, however, there is little data on long-term success rates. Therefore, the aim of this prospective pilot study was to assess the long-term outcome of partial pulpotomy in per-manent teeth after carious pulp exposure without signs or symptoms of irreversible pulpitis, verified clinically, radio-graphically, and via MMP-9 levels. MATERIALS AND METHODS Patients in whom permanent teeth with extremely deep carious lesions were diagnosed as com-pletely asymptomatic (n = 8) or with signs of reversible pulpitis (n = 10) underwent non-selective caries removal followed by a blood test to assess the level of MMP-9. The teeth were thereafter partially pulpotomised, MTA-capped, and immedi-ately restored with composite resin. Follow-up examinations were performed by endodontically experienced examiners focusing on clinical and radiographic assessment. RESULTS One patient could not be contacted and was lost to follow-up. Overall, the follow-up period ranged from 2-8 years (mean = 4.4 years). The majority of teeth remained functional and without pathology; one tooth was classified as having failed because of a vertical root fracture. There was no statistically significant difference in the groups' success rate (p = 0.3). The estimated overall survival rate was 94.1% (95% CI: 0.84-1.00) after 4 years according to the Kaplan-Meier method. CONCLUSION Pulp vitality in permanent teeth can be preserved with high success rates by means of partial pulpotomy after carious pulp exposure in asymptomatic teeth or in teeth with reversible pulpitis.
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Affiliation(s)
- Jelena Petrovic
- Dentist and Lecturer, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Germany. Conceptualisation, data curation, formal analysis, investigation, validation, wrote original draft of the manuscript, reviewed and edited the manuscript
| | - Caroline Sekundo
- Dentist and Lecturer, Department of Conservative Dentistry, Division of Preventive and Restorative Dentistry, University Hospital Heidelberg, Germany. Visualisation, formal analysis, validation, supervision, wrote and edited the manuscript
| | - Holger Gehrig
- Dentist, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Germany. Conceptualisation, methodology, investigation, data curation, supervision, wrote, reviewed and edited the manuscript
| | - Sarah Rampf
- Dentist and Lecturer, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Germany. Conceptualisation, methodology, investigation, wrote, reviewed and edited the manuscript
| | - Shirin El-Sayed
- Dentist and Lecturer, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Germany. Investigation, data curation, validation, wrote, reviewed and edited the manuscript
| | - Alexander Ritz
- Statistician, Faculty of Mathematics/Computer Science and Mechanical Engineering, Technische Universität Clausthal, Clausthal-Zellerfeld, Germany. Formal analysis, supervision, wrote, reviewed and edited the manuscript
| | - Johannes Mente
- Professor, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Germany. Conceptualisation, methodology, data curation, investigation, project administration, supervision, validation, wrote original draft of the manuscript, reviewed and edited manuscript
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26
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Bedir MGA, Karadas M, Bedir F. Effect of matrix metalloproteinase inhibitors on bonding durability of universal adhesives. Dent Mater J 2023; 42:581-590. [PMID: 37302822 DOI: 10.4012/dmj.2022-282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study aimed to evaluate the effect of different matrix metalloproteinase inhibitors (MMPIs) on the microtensile bond strength (μTBS) and nanoleakage of universal adhesives. One hundred twenty non-carious human molars were prepared and randomly assigned to two groups: Scotchbond Bond Universal (SBU) and Gluma Bond Universal (GBU). The samples in each group were assigned to five subgroups (n=12) based on one control (water) and four MMPIs (Benzalkonium-chloride (BAC), Batimastat (BB94), Chlorhexidine (CHX), and Epigallocatechin-gallate (EGCG)). Each adhesive was applied in self-etch (SE) mode or etch-and-rinse (ER) mode. Dentin/composite sticks were fabricated and subjected to the μTBS test after 24 h or 6 months. At 6 months, MMPIs did not affect the μTBS of the adhesives, regardless of etching mode. Nanoleakage was more pronounced in ER mode than in SE mode for all subgroups. All MMPIs, with the exception of CHX, decreased the nanoleakage of GBU in ER mode.
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Affiliation(s)
| | - Muhammet Karadas
- Department of Restorative Dentistry, Faculty of Dentistry, Recep Tayyip Erdogan University
| | - Fatih Bedir
- Department of Restorative Dentistry, Faculty of Dentistry, Recep Tayyip Erdogan University
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Tartari T, Wichnieski C, Silva RM, Letra A, Duarte MAH, Bramante CM. Final irrigation protocols can be used to promote stable long-term bond strength of AH Plus to dentin. J Appl Oral Sci 2023; 31:e20230005. [PMID: 37255081 DOI: 10.1590/1678-7757-2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023] Open
Abstract
Irrigation solutions might affect dentin surface characteristics and, consequently, endodontic sealers adhesion. This study analyzed the effect of different final irrigation protocols on push-out bond strength (BS) of AH Plus to dentin seven days and 20 months after obturation. Scanning electron micrographs were obtained from the dentin surface of one sample/group after final irrigation. Canals of bovine incisors were instrumented and received final irrigation with (n=21): G1 - 2.5% sodium hypochlorite (NaOCl) + distilled water; G2 - 2.5% NaOCl + 17% EDTA; G3 - 2.5% NaOCl + 17% EDTA + 2.5% NaOCl; G4 - 2.5% NaOCl + 17% EDTA + 2% chlorhexidine (CHX); G5 - mixture 5% NaOCl + 18% etidronate (HEDP); and G6 - mixture 5% NaOCl + 10% tetrasodium EDTA (Na4EDTA). After irrigation, one root/group was split and images were obtained by scanning electron microscopy (SEM). The other 20 roots/group were filled with only AH Plus sealer. Three slices/root were used for push-out assessment seven days and 20 months after obturation. One-way analysis of variance and Tukey (α<0.05) were used to compare the results among experimental groups, and unpaired t-test (α<0.05) was used to compare the results of the same group over time. The photomicrographs showed that, excepting G1, all groups completely removed the smear layer from the samples. In G2 and G4, the opening of the dentin tubules enlarged. In G3, erosion was observed in the peritubular and intertubular dentin. Values of the BS in the seven days were G2=G3=G4=G5>G6=G1 and in the 20 months were G3=G5>G6=G4>G1=G2. G3, G5, and G6 presented values of BS in 20 months similar to the values of seven days (P>0.05). The final irrigation protocols tested produced dentin surfaces with different characteristics. Only G3 and G5 presented high BS values that were stable over time.
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Affiliation(s)
- Talita Tartari
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brasil
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Caroline Wichnieski
- Faculdade Herrero, Curso de Odontologia, Curitiba, PR, Brasil
- Pontifícia Universidade Católica, Departamento de Endodontia, Curitiba, PR, Brasil
| | - Renato Menezes Silva
- University of Pittsburgh, School of Dental Medicine, Department of Endodontics, Pittsburgh, PA, USA
| | - Ariadne Letra
- University of Pittsburgh, School of Dental Medicine, Department of Endodontics, Pittsburgh, PA, USA
- University of Pittsburgh, School of Dental Medicine, Department of Oral and Craniofacial Sciences, Pittsburgh, PA, USA
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Clovis Monteiro Bramante
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
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Sakurai I, Mayanagi G, Yamada S, Takahashi N. In situ detection of endogenous proteolytic activity and the effect of inhibitors on tooth root surface. J Dent 2023; 131:104471. [PMID: 36828151 DOI: 10.1016/j.jdent.2023.104471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to clarify the distribution and activity of proteolytic enzymes and examine the inhibitory effects of various substances on this proteolytic activity on tooth root surfaces in situ. METHODS Disk-shaped bovine tooth root samples were partly pretreated in acid solution (50 mM lactic acid buffer, pH 4.0) for 48 h. The fluorescence intensity of samples was detected with fluorescent substrate solution for collagenase and gelatinase using a stereoscopic fluorescence microscope for 60 min. The acid-pretreated and non-acid-pretreated root samples were treated with chlorhexidine (CHX), sodium fluoride (NaF), epigallocatechin gallate (EGCG), and calcium hydroxide (Ca(OH)2) for 10 min, and silver diamine fluoride (SDF) for 10, 30, and 60 s. These samples were immersed in the fluorescence substrate solution at pH 7.0, and the fluorescence intensity of samples was detected. The fluorescence intensity was calculated using analysis software. RESULTS Gelatinase activity was detected in root samples. Gelatinase activity of the acid-pretreated side was significantly higher than that of the non-acid-pretreated side (1.63 times) at 60 min. CHX, EGCG, Ca(OH)2, and SDF decreased the gelatinase activity of root samples, while NaF had no effect. CONCLUSIONS Gelatinase activity was detected from the root in situ and it was increased by acid-pretreatment. CHX, EGCG, Ca(OH)2, and SDF inhibited gelatinase activity. CLINICAL SIGNIFICANCE Substances that inhibit proteolytic activity found in this research method will be useful for root caries prevention.
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Affiliation(s)
- Izumi Sakurai
- Division of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Japan; Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Gen Mayanagi
- Division for Advanced Education Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Japan
| | - Satoru Yamada
- Division of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Japan
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
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29
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Jacomine JC, Giacomini MC, Agulhari M, Honório HM, Wang L. Twenty-month Performance of a Universal Bonding System on Simulated-challenged Dentin Substrates Pretreated with Chlorhexidine. Oper Dent 2023; 48:196-206. [PMID: 36656311 DOI: 10.2341/21-142-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Since the use of dentin antiproteolytic agents with universal adhesives (UAs) can potentially degrade the bonding interface, this study evaluated bond strengths with and without chlorhexidine (CHX) on variously altered dentin surfaces for up to 20 months. METHODS Human molar specimens (n=20) were categorized by substrates as S=sound, E=eroded, and C=carious, and by pretreatment as W=water or CHX. These specimens were subjected to micro-tensile bond strength (μTBS) testing at 24 hours, 6 months, and 20 months, after 30 seconds of pretreatment with CHX or W, followed by self-etching and bonding (Adper Single Bond Universal, 3M ESPE). Modes of failure were assessed using optical microscopy (40×) and scanning electron microscopy (SEM), and the results were analyzed by 3-way ANOVA and Tukey's statistical tests (α=0.05). RESULTS Substrate (p<0.001), pre-treatment (p=0.0413), and time (p<0.0001) were statistically significant. The sound-dentin group in initial time (W=39.27/CHX=40.55) yielded the higher μTBS values (MPa) in comparison with altered substrates pre-treated with CHX (E-CHX=19.84; C-CHX=18.24) after 20 months, which showed the lowest values. Under SEM analysis, heterogeneous patterns appeared in the hybrid layer of the CHX-treated group, particularly in the altered substrates. CONCLUSIONS Bond strength to dentin decreased over a period of 20 months using UA with 10-methacryloyloxydecyl-dihydrogen phosphate (MDP) in self-etching mode. Substrates altered by erosion or caries have impaired adhesion and associated clinical use of UA with MDP and CHX should be avoided.
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Affiliation(s)
- J C Jacomine
- Juliana Carvalho Jacomine, DDS, MS, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - M C Giacomini
- Marina Ciccone Giacomini, DDS, MS, PhD, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil, and University Centre Integrated Faculties of Ourinhos, Ourinhos, SP, Brazil
| | - Mas Agulhari
- Maria Angélica Silvério Agulhari, DDS, MS, PhD, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - H M Honório
- Heitor Marques Honório, Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - L Wang
- *Linda Wang, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Zhao S, Zhang Y, Chen Y, Xing X, Wang Y, Wu G. Evaluation of Chitosan-Oleuropein Nanoparticles on the Durability of Dentin Bonding. Drug Des Devel Ther 2023; 17:167-180. [PMID: 36712950 PMCID: PMC9879028 DOI: 10.2147/dddt.s390039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/14/2023] [Indexed: 01/23/2023] Open
Abstract
Purpose To evaluate the effects of dentin pretreatment with chitosan-loaded oleuropein nanoparticles (CONPs) on the durability of resin-dentin bonding interfaces. Methods Eighty freshly extracted non-carious human third molars were randomly divided into four groups (n = 20 each): a de-ionized water (DW) group, a chitosan (CS) group, a chlorhexidine (CHX) group and a CONP group. The dentin in the DW, CS, CHX, and CONP groups were pretreated with de-ionized water, 1.0 mg/L CS solution, 2% chlorhexidine solution, and CONP suspension (prepared with 100 mg/L oleuropein), respectively, followed by the universal adhesive and resin composites. The bonded teeth of each group were randomly divided into two subgroups: an immediate subgroup and an aged subgroup. The bonded teeth of each group were then cut into the bonded beams. We measured their microtensile bond strength (μTBS), observed the characteristics of bonding interface by atomic force microscope, calculated the percentage of silver particles in a selected area for interfacial nanoleakage analysis, and evaluated the endogenous gelatinase activity within the bonding interface for in-situ zymogram analysis. Data were analyzed with two-way ANOVA and LSD multiple comparison test (P < 0.05). Results Regardless of after 24 h or after thermocycling, CONP exhibited better μTBS (P < 0.05) than the other three groups except that there was not a statistical significance (P > 0.05) in the CONP and CHX groups after 24 h. Besides, the CONP group presented significantly higher modulus of elasticity in the hybrid layers (P < 0.05), lower expression of nanoleakage (P < 0.05), and better inhibitory effect of matrix metalloproteinases than the other three groups before and after thermocycling. Conclusion Altogether, the CONPs had the potential to act as a dentin primer, which could effectively improve the dentin-resin binding durability.
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Affiliation(s)
- Shuya Zhao
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
| | - Yunyang Zhang
- Center of Modem Analysis, Nanjing University, Nanjing, People’s Republic of China
| | - Yun Chen
- Department of Pediatric Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Xianghui Xing
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
| | - Yu Wang
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
| | - Guofeng Wu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China,Correspondence: Guofeng Wu; Xianghui Xing, Email ;
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Gupta S, Sahni V, Räisänen IT, Grigoriadis A, Sakellari D, Gieselmann DR, Sorsa T. Linking oral microbial proteolysis to aMMP-8 PoC diagnostics along with the stage and grade of periodontitis: A cross-sectional study. Oral Dis 2023; 29:285-289. [PMID: 34402146 DOI: 10.1111/odi.14008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Shipra Gupta
- Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Grigoriadis
- 424 General Military Training Hospital, Thessaloniki, Greece
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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In Vitro and In Silico Evaluations of Boswellia carterii Resin Dermocosmetic Activities. COSMETICS 2022. [DOI: 10.3390/cosmetics9060131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Boswellia carterii is a plant species belonging to the Burseraceae family. It grows up in trees or shrubs, and it is known for producing an aromatic resin commonly named frankincense or olibanum. This resin has been used in traditional medicine to treat various conditions such as inflammations, gastrointestinal disorders and traumatic injuries. Virtual screening and molecular docking are two in silico approaches used to predict potential interactions between ligands and the active site of a protein. These approaches are mainly used in natural product chemistry and pharmacology as a screening tool to select plant extracts or fractions for in vitro testing, as well as for the prediction of mechanisms of action. The aim of this research is the in silico and in vitro evaluations of the potential collagenase and elastase inhibitory activities of Boswellia carterii resin organic extracts (viz., methanol, n-hexane and ethyl acetate). The obtained results revealed that methanol and n-hexane exhibited the best collagenase inhibitory activity with values superior to 85%, whereas the methanol and ethyl acetate showed the highest elastase inhibition activity with inhibition values ranging between 40 and 60%. The molecular docking prediction confirmed the experimental results; moreover, the visualization of the ligand–protein interactions showed that the main compounds of the organic extracts may have mechanisms of action similar to the positive controls. Those findings are very promising and open new perspectives for the exploitation of Boswellia carterii resin as active agents for the development of anti-aging cosmeceuticals.
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Yaghmoor RB, Jamal H, Abed H, Allan E, Ashley P, Young A. Incorporation of MMP inhibitors into dental adhesive systems and bond strength of coronal composite restorations: A systematic review and meta-analysis of in vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:298-315. [PMID: 36247748 PMCID: PMC9557023 DOI: 10.1016/j.jdsr.2022.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/31/2022] [Accepted: 09/22/2022] [Indexed: 10/31/2022] Open
Abstract
Purpose To systematically review in vitro studies that incorporated MMP inhibitors into adhesive systems in terms of the effect on immediate and aged bond strength of dental composite to dentine. Materials and methods Independently, two reviewers conducted an electronic search in three databases (MEDLINE, EMBASE, and Google Scholar) following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P), up to 6 March 2022. Results The search resulted in 894 papers, 33 of which were eligible to be included in the review; of those, 13 fulfilled the meta-analysis eligibility criteria. Nineteen inhibitors were used among the studies, and those included in the meta-analysis were 2%, 0.2% chlorhexidine (CHX), 5 µM GM1489, and 0.5%, 1% benzalkonium chloride (BAC). In the meta-analysis, while above inhibitors showed no adverse effect on bond strength, 0.2% CHX and 5 µM GM1489 caused a significant increase in immediate and 12-months bond strength. All other inhibitors resulted in a significant increase in bond strength at six months of ageing. Conclusions Incorporation of MMP inhibitors into the adhesive system has no unfavourable effect on immediate bond strength but a favourable effect on longer-term bond strength. Additionally, inhibitors other than CHX could have similar or better effects on bond strength.
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Affiliation(s)
- Rayan B. Yaghmoor
- Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, Royal Free Hospital London, NW3 2PF, UK
- Department of Microbial Diseases, UCL Eastman Dental Institute, Royal Free Hospital, London NW3 2PF, UK
- Corresponding author at: Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
| | - Hasan Jamal
- Unit of Paediatric Dentistry, UCL Eastman Dental Institute, London WC1E 6DE, UK
| | - Hassan Abed
- Department of Basic and Clinical Oral Sciences, Umm Al-Qura University, Faculty of Dentistry, Makkah 24381, Saudi Arabia
| | - Elaine Allan
- Department of Microbial Diseases, UCL Eastman Dental Institute, Royal Free Hospital, London NW3 2PF, UK
| | - Paul Ashley
- Unit of Paediatric Dentistry, UCL Eastman Dental Institute, London WC1E 6DE, UK
| | - Anne Young
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, Royal Free Hospital London, NW3 2PF, UK
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Shirur KS, Padya BS, Pandey A, Hegde MM, Narayan AI, Rao BSS, Bhat VG, Mutalik S. Development of Lipidic Nanoplatform for Intra-Oral Delivery of Chlorhexidine: Characterization, Biocompatibility, and Assessment of Depth of Penetration in Extracted Human Teeth. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3372. [PMID: 36234500 PMCID: PMC9565570 DOI: 10.3390/nano12193372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/19/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Abstract
Microorganisms are the major cause for the failure of root canal treatment, due to the penetration ability within the root anatomy. However, irrigation regimens have at times failed due to the biofilm mode of bacterial growth. Liposomes are vesicular structures of the phospholipids which might help in better penetration efficiency into dentinal tubules and in increasing the antibacterial efficacy. Methods: In the present work, chlorhexidine liposomes were formulated. Liposomal chlorhexidine was characterized by size, zeta potential, and cryo-electron microscope (Cryo-EM). Twenty-one single-rooted premolars were extracted and irrigated with liposomal chlorhexidine and 2% chlorhexidine solution to evaluate the depth of penetration. In vitro cytotoxicity study was performed for liposomal chlorhexidine on the L929 mouse fibroblast cell line. Results: The average particle size of liposomes ranged from 48 ± 4.52 nm to 223 ± 3.63 nm with a polydispersity index value of <0.4. Cryo-EM microscopic images showed spherical vesicular structures. Depth of penetration of liposomal chlorhexidine was higher in the coronal, middle, and apical thirds of roots compared with plain chlorhexidine in human extracted teeth when observed under the confocal laser scanning microscope. The pure drug exhibited a cytotoxic concentration at which 50% of the cells are dead after a drug exposure (IC50) value of 12.32 ± 3.65 µg/mL and 29.04 ± 2.14 µg/mL (on L929 and 3T3 cells, respectively) and liposomal chlorhexidine exhibited an IC50 value of 37.9 ± 1.05 µg/mL and 85.24 ± 3.22 µg/mL (on L929 and 3T3 cells, respectively). Discussion: Antimicrobial analysis showed a decrease in colony counts of bacteria when treated with liposomal chlorhexidine compared with 2% chlorhexidine solution. Nano-liposomal novel chlorhexidine was less cytotoxic when treated on mouse fibroblast L929 cells and more effective as an antimicrobial agent along with higher penetration ability.
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Affiliation(s)
- Krishnaraj Somyaji Shirur
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Bharath Singh Padya
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Abhijeet Pandey
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Manasa Manjunath Hegde
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Aparna I. Narayan
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Bola Sadashiva Satish Rao
- Department of Radiation Biology & Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Varadaraj G. Bhat
- Department of Pharmaceutical Chemistry, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
| | - Srinivas Mutalik
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka State, India
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Bapat RA, Parolia A, Chaubal T, Yang HJ, Kesharwani P, Phaik KS, Lin SL, Daood U. Recent Update on Applications of Quaternary Ammonium Silane as an Antibacterial Biomaterial: A Novel Drug Delivery Approach in Dentistry. Front Microbiol 2022; 13:927282. [PMID: 36212832 PMCID: PMC9539660 DOI: 10.3389/fmicb.2022.927282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Quaternary ammonium silane [(QAS), codename – k21] is a novel biomaterial developed by sol-gel process having broad spectrum antimicrobial activities with low cytotoxicity. It has been used in various concentrations with maximum antimicrobial efficacy and biocompatibility. The antimicrobial mechanism is displayed via contact killing, causing conformational changes within the bacterial cell membrane, inhibiting Sortase-A enzyme, and causing cell disturbances due to osmotic changes. The compound can attach to S1' pockets on matrix metalloproteinases (MMPs), leading to massive MMP enzyme inhibition, making it one of the most potent protease inhibitors. Quaternary ammonium silane has been synthesized and used in dentistry to eliminate the biofilm from dental tissues. QAS has been tested for its antibacterial activity as a cavity disinfectant, endodontic irrigant, restorative and root canal medication, and a nanocarrier for drug delivery approaches. The review is first of its kind that aims to discuss applications of QAS as a novel antibacterial biomaterial for dental applications along with discussions on its cytotoxic effects and future prospects in dentistry.
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Affiliation(s)
- Ranjeet Ajit Bapat
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Abhishek Parolia
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Tanay Chaubal
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Ho Jan Yang
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Prashant Kesharwani
- School of Pharmaceutical Education and Research, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Khoo Suan Phaik
- Division of Clinical Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Seow Liang Lin
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Umer Daood
- Restorative Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
- *Correspondence: Umer Daood
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Effect of Dentin-Disinfection Chemicals on Shear Bond Strength and Microhardness of Resin-Infiltrated Human Dentin in Different Adhesive Protocols. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091244. [PMID: 36143921 PMCID: PMC9501625 DOI: 10.3390/medicina58091244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/25/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Bacteria and its remnants beneath the restorations predispose the tooth to secondary caries and pulpal pathology. Hence, various chemical antibacterial agents are suggested to disinfect the prepared tooth structure before the definitive restorative procedure. This study aimed to investigate the effects of chemical disinfectant solutions on the micro-shear bond strength (µSBS) and microhardness of total-etch and self-etch resin-infiltrated human dentin. Materials and Methods: 100 caries-free intact permanent third molar teeth were vertically sectioned into the buccal and lingual half. All these specimens were mounted on acrylic resin and underlying dentin surfaces were exposed by grinding. Samples were randomly divided into five groups [n = 20] following total-etch and self-etch adhesive protocol. Teeth samples were divided according to surface treatment, as Group I (Control-CNT), Group II (2% chlorhexidine-CHX), Group III (5.25% sodium hypochlorite-NaOCl), Group IV (17% ethylenediaminetetraacetate acid—EDTA) and Group V (10% povidone iodine-PVI). A randomly selected 10 samples from each subgroup were used for µSBS and microhardness tests. After surface treatment and bonding procedure, nono-hybrid composite cylinders with a 3-mm diameter and 2-mm height were directly cured over the dentin substrate. The samples for µSBS were subjected to 5000 thermocycles and tested using a universal testing machine. Microhardness was assessed using a micro-indenter instrument, data were statistically analyzed using a one-way analysis of variance and Tukey HSD tests at p < 0.05. Results: Amongst the chemical disinfectant assessed, 2% CHX did not affect µSBS and produced a marginal reduction in dentin microhardness compared to the control group. The 5.25% NaOCl and 17% EDTA significantly compromised the microhardness of the dentin substrate. Meanwhile, 10% PVI surface treatment resulted in a substantial reduction in µSBS between composite and dentin. Conclusions: CHX with preservation of bonding to dentin and insignificant negative effect on dentin microhardness is a safe option for tooth disinfection.
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Inhibitory activity of S-PRG filler on collagen-bound MMPs and dentin matrix degradation. J Dent 2022; 124:104237. [PMID: 35863550 DOI: 10.1016/j.jdent.2022.104237] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To evaluate the inhibitory activity of an ion-releasing filler (S-PRG) eluate on dentin collagen-bound metalloproteinases (MMPs) and dentin matrix degradation. METHODS Dentin beams (5 × 2 × 0.5 mm) from human molars were completely demineralized to produce dentin matrix specimens. The dry mass was measured, and a colorimetric assay (Sensolyte) determined the initial total MMP activity to allocate the beams into four treatment groups (n = 10/group): 1) water for 1 min (negative control); 2) 2% chlorhexidine digluconate (CHX - inhibitor control) for 1 min; 3) S-PRG eluate for 1 min; 4) S-PRG eluate for 30 min. After the treatments, the total MMP activity was reassessed. The specimens were stored in simulated body fluid (SBF) at 37 °C for up to 21 days. The dry mass was reassessed weekly. On day 7, the dentin matrix degradation was analyzed for the presence of collagen fragments (CF; Sirius Red) and hydroxyproline (Hyp) in the SBF. Statistical analyses were performed with ANOVA/Tukey, paired t-tests, and RM-ANOVA/Sidak (α = 5%). RESULTS S-PRG eluate exposure for 1 and 30 min reduced (p < 0.0001) MMP activity. S-PRG exposure for 30 min presented MMP activity inhibition equivalent to CHX (p = 0.061). S-PRG and CHX decreased CF (p ≤ 0.007) and Hyp (p < 0.046) release. After 21 days of storage, S-PRG-treated beams, regardless of exposure time, presented a reduced (p ≤ 0.017) mass loss, intermediate between CHX and control. CONCLUSION Treating demineralized dentin with S-PRG eluate for 1 or 30 min reduced matrix-bound MMP activity and dentin matrix degradation for up to 21 days. CLINICAL SIGNIFICANCE S-PRG filler may hinder the progression of dentin carious/erosive lesions and enhance the stabilization of dentin bonding interfaces.
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Mussel-inspired monomer - A new selective protease inhibitor against dentine collagen degradation. Dent Mater 2022; 38:1149-1161. [PMID: 35680429 DOI: 10.1016/j.dental.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/03/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the inhibitory effect of a novel mussel-inspired monomer (N-(3,4-dihydroxyphenethyl)methacrylamide (DMA) on the soluble and matrix-bound proteases. METHODS The inhibitory effect of DMA (0, 1, 5, and 10 mM) and 1 mM chlorhexidine (CHX) dissolved in 50% ethanol/water on soluble recombinant human matrix metalloproteinases (rhMMP-2, -8, and -9), as well as cysteine cathepsins (B and K) were evaluated using both fluorometric assay kits and molecular docking. The effect of CHX and DMA on matrix-bound proteases was examined by in situ zymography, and the fluorescence intensity and relative area were calculated by Image J software. All data obtained were analyzed by one-way ANOVA followed by Tukey test (α = 0.05). RESULTS The anti-proteolytic ability of DMA increased in a dose-dependent manner except that of rhMMP-9. Inhibitory effect of 1 mM DMA against rhMMP-2, - 8, - 9, as well as cathepsin B and K was all significantly lower than 1 mM CHX (p < 0.05). The molecular docking analysis was in good agreement with the experimental results, that the binding energy of DMA was lower than CHX for all proteases. In situ zymography revealed that all DMA- and CHX-treated groups significantly inactivated the matrix-bound proteases, with a dramatic reduction of the fluorescence intensity and relative area compared with the control group (p < 0.05). SIGNIFICANCE Under the prerequisite condition that the overall inhibitory performance on matrix-bound proteases was comparable by DMA and CHX, the more selective property of DMA could avoid inducing potential negative effects by suppressing MMP-9 when applied in dental treatment compared with CHX.
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Perote LCCC, Barcellos DC, Matuda AGN, Campos RP, Rosetti EP, Pucci CR. Influence of chlorhexidine, propolis, pulpal pressure simulation, and aging on dentin bond strength. Microsc Res Tech 2022; 85:3014-3024. [PMID: 35593488 DOI: 10.1002/jemt.24150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 03/09/2022] [Accepted: 05/01/2022] [Indexed: 11/05/2022]
Abstract
The present study evaluated the bond strength (μTBS) of dentin treated with chlorhexidine and propolis subjected to simulated pulpal pressure (SPP) and thermocycle aging. One hundred and twenty healthy human molars were sectioned to obtain 2 mm of dentin thickness and were divided into two groups (n = 60): SPP (15 cm H2 O) and no SPP (Control group). Dentin surfaces were conditioned with 37% phosphoric acid for 15 s and were divided according to the dentin treatment (n = 20): Control; Chlorhexidine gluconate (0.2% for 30 s) and Propolis (aqueous propolis extract for 30 s). Half of the specimens were submitted to 15,000 thermocycle aging (5 ± 2°C and 55 ± 2°C). The samples were sectioned into beams and submitted to μTBS. Data were analyzed by three-way ANOVA (SPP × Dentin treatment × Thermocycle aging) and the Tukey's tests (p < .001). With regard to the SPP, ANOVA revealed that the Control group (32.98 MPa) had significantly higher values of μTBS when compared to the SPP (29.19 MPa). With regard to Thermocycle aging, no aging (34.05 MPa) had significantly higher values of μTBS when compared to the aging (28.12 MPa). With regard to the dentin treatment, Propolis and Chlorhexidine did not statistically influence the results (p > .05). The SPP and thermocycle aging negatively influenced the bond strength between the dentin and resin; the 0.2% chlorhexidine digluconate and aqueous propolis extract solutions did not interfere in the bond strength between the resin and dentin. The use of chlorhexidine and propolis as a dental treatment may not influence the dentin bond strength, but SPP and thermocycle aging may damage the longitudinal dentin bond strength.
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Affiliation(s)
| | | | - Amanda Guedes Nogueira Matuda
- Department Restorative Dentistry, Institute of Science and technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Raquel Pinto Campos
- Department Restorative Dentistry, Institute of Science and technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | | | - César Rogério Pucci
- Department Restorative Dentistry, Institute of Science and technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
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Combined Release of Antiseptic and Antibiotic Drugs from Visible Light Polymerized Biodegradable Nanocomposite Hydrogels for Periodontitis Treatment. Pharmaceutics 2022; 14:pharmaceutics14050957. [PMID: 35631542 PMCID: PMC9146496 DOI: 10.3390/pharmaceutics14050957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023] Open
Abstract
The in situ application of the combination of different types of drugs revolutionized the area of periodontal therapy. The purpose of this study was to develop nanocomposite hydrogel (NCHG) as a pH-sensitive drug delivery system. To achieve local applicability of the NCHG in dental practice, routinely used blue-light photopolymerization was chosen for preparation. The setting time was 60 s, which resulted in stable hydrogel structures. Universal Britton–Robinson buffer solutions were used to investigate the effect of pH in the range 4–12 on the release of drugs that can be used in the periodontal pocket. Metronidazole was released from the NCHGs within 12 h, but chlorhexidine showed a much longer elution time with strong pH dependence, which lasted more than 7 days as it was corroborated by the bactericidal effect. The biocompatibility of the NCHGs was proven by Alamar-blue test and the effectiveness of drug release in the acidic medium was also demonstrated. This fast photo-polymerizable NCHG can help to establish a locally applicable combined drug delivery system which can be loaded with the required amount of medicines and can reduce the side effects of the systemic use of drugs that have to be used in high doses to reach an ideal concentration locally.
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Ballal N, Duncan H, Wiedemeier D, Rai N, Jalan P, Bhat V, Belle V, Zehnder M. MMP-9 Levels and NaOCl Lavage in Randomized Trial on Direct Pulp Capping. J Dent Res 2022; 101:414-419. [PMID: 34706567 PMCID: PMC8935528 DOI: 10.1177/00220345211046874] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant (P < 0.001 and P = 0.004, respectively) impact on pulp survival, while mild preoperative discomfort did not. In conclusion, MMP-9/TP showed great promise as a predictive local biomarker, and NaOCl lavage considerably improved the survival time of cariously exposed and directly capped pulps.
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Affiliation(s)
- N.V. Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences–Manipal, Manipal Academy of Higher Education, Manipal, India
| | - H.F. Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - D.B. Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - N. Rai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences–Manipal, Manipal Academy of Higher Education, Manipal, India
| | - P. Jalan
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences–Manipal, Manipal Academy of Higher Education, Manipal, India
| | - V. Bhat
- Department of Biochemistry, Kasturba Medical College–Manipal, Manipal Academy of Higher Education, Manipal, India
| | - V.S. Belle
- Department of Biochemistry, Kasturba Medical College–Manipal, Manipal Academy of Higher Education, Manipal, India
| | - M. Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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Speranza Zabeu G, Candia Scaffa PM, Ciccone Giacomini M, de Mattos Pimenta Vidal C, Tjäderhane L, Wang L. Gelatinolytic activity after dentin pretreatment with dimethyl sulfoxide (DMSO) combined to dental bonding systems: Perspectives for biological responses. J Mech Behav Biomed Mater 2022; 130:105188. [PMID: 35344756 DOI: 10.1016/j.jmbbm.2022.105188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 11/15/2022]
Abstract
Endogeneous proteolytic responses in dentin bonding interface have addressing to strategies to preventive and therapeutic approaches of clinical use of dentin bonding systems (DBSs), but still present limitations. The aim of this study was to examine the gelatinolytic profile by means of in situ zymography regarding the use of 1% dimethyl sulfoxide (DMSO) as an aprotic solvent. Sound human third molars were prepared and randomized in 10 groups, following the factors 1- DBS: Adper™ Scotchbond Multipurpose [MP], Adper™ Single Bond 2 [SB], Clearfil™ SE Bond [CSE] and Adper™ Scotchbond Universal - Etch-and-rinse [SU-ER] mode and self-etch mode [SU-SE], 2- dentin pretreatment: Control - Water [C], 2% CHX and 1% DMSO and 3- time: Initial-24 h [I], 6 months [6M] and 30 months [30M]. Pretreatments were applied before primer application for 30s. After restoration, specimens were cut into slices, in which one third were incubated with fluorescein-conjugated gelatin for 24h at 37 °C and analyzed by confocal laser scanning microscopy. The other two-thirds were stored for 6 or 30 months at 37 °C. Fluorescence was quantified using Image J and data was subjected for two-way ANOVA followed by Tukey test (p<0.05). Neither DMSO nor CHX affected initial analyses for any tested conditions. After 6 months, it was observed increased fluorescence for MP using both pretreatments and for SB using only DMSO. Regardless time and pretreatment, CSE and SU-SE showed stabilized gelatinolytic pattern. For SU-ER, both CHX and DMSO were able to maintain a lower fluorescence compared to control group after 6 months. 30-month performance states the susceptibility of degradation for all etched-dentin systems. DMSO pretreatment can be promising to reduce gelatinolytic activity combined with an universal adhesive system under etch-and-rinse mode. For self-etching strategies, DMSO was successful to stabilize the gelatinolytic reactions.
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Affiliation(s)
- Giovanna Speranza Zabeu
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Zip Code, 17012-901, Bauru, SP, Brazil; School of Dentistry, Centro Universitário Sagrado Coração - UNISAGRADO, Rua Irmã Arminda, 10-50, Jardim Brasil, Zip Code, 17011-160, Bauru, SP, Brazil.
| | - Polliana Mendes Candia Scaffa
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, Oregon Health & Science University, OHSU, 2730 SW Moody Ave, Zip Code, 97201, Portland, OR, USA.
| | - Marina Ciccone Giacomini
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Zip Code, 17012-901, Bauru, SP, Brazil; University Centre Integrated Faculties of Ourinhos, Rodovia BR-153, Km 338 S/N Água do Cateto, Zip Code, 19909-100, Ourinhos, SP, Brazil.
| | - Cristina de Mattos Pimenta Vidal
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA, 801 Newton Rd, DSB S245, Zip Code, 52242, Iowa City, IA, USA.
| | - Leo Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland and Helsinki University Hospital, Helsinki, Zip Code, 90220, Oulu, Finland; Research Unit of Oral Health Sciences and Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Kajaanintie 50, Zip Code, 90220, Oulu, Finland.
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Zip Code, 17012-901, Bauru, SP, Brazil.
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Borompiyasawat P, Putraphan B, Luangworakhun S, Sukarawan W, Techatharatip O. Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro. BMC Oral Health 2022; 22:60. [PMID: 35248048 PMCID: PMC8898514 DOI: 10.1186/s12903-022-02098-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare the mean mineral density (MMD) and examine the remineralization of carious dentin after cavity disinfection with chlorhexidine gluconate (CHX) and restoration with high viscosity glass ionomer cement (H-GIC) in vitro.
Methods
Selective caries removal to leathery dentin was performed in 40 extracted primary molars. The samples were scanned using micro-computed tomography (micro-CT) to determine the MMD baseline and randomly divided into 4 groups (n = 10): Equia™ group, applied dentin conditioner and restored with H-GIC (Equia Forte™), CHX-Equia™ group, disinfected the cavity with 2% CHX before applying dentin conditioner and restored with H-GIC (Equia Forte™), Ketac™ group, restored with H-GIC (Ketac Universal™) and CHX-Ketac™ group, disinfected the cavity with 2% CHX before restored with H-GIC (Ketac Universal™). The samples underwent micro-CT scanning post-restoration and post-pH-cycling to determine their respective MMDs. One sample from each group was randomly selected to analyze by scanning electron microscopy (SEM).
Results
The MMD gain in the 4 groups post-restoration was significantly different between the Equia™ and CHX-Ketac™ groups (oneway ANOVA with Post hoc (Tukey) test, P = 0.045). There was a significant difference in MMD gain post-restoration between the Equia™ and CHX-Equia™ groups (Independent t-test, P = 0.046). However, the Ketac™ and CHX-Ketac™ group’s MMD were similar. The SEM images revealed that the CHX-Ketac™ group had the smallest dentinal tubule orifices and the thickest intertubular dentin among the groups. However, the CHX-Equia™ group had thicker intertubular dentin than the Equia™ group.
Conclusion
Applying 2% CHX on demineralized dentin enhances the remineralization of the dentin beneath the restoration.
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Molecular Docking, Tyrosinase, Collagenase, and Elastase Inhibition Activities of Argan By-Products. COSMETICS 2022. [DOI: 10.3390/cosmetics9010024] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The argan tree (Argania spinosa (L.) Skeels) is one of the most important floristic resources in Morocco. This Moroccan endemic tree is known for its numerous therapeutic and medicinal uses. In addition to some medicinal and cosmetic uses, argan fruit pulp and press cake are traditionally used by the Berber population for heating and feeding livestock. Molecular docking is an in silico approach that predicts the interaction between a ligand and a protein. This approach is mainly used in chemistry and pharmacology of natural products as a prediction tool with the purpose of selecting plant extracts or fractions for in vitro tests. The aim of this research is to study the evaluation of potential tyrosinase, collagenase, and elastase inhibitory activities of argan fruit press-cake and pulp extracts. Extracts were evaluated for their total phenolic content (TPC), and the major polyphenols of both press-cake and pulp extracts were submitted to molecular docking in order to determine the mechanisms of action of these compounds. Obtained results revealed that fruit pulp had the strongest dermocosmetic activities, as well as the highest TPC, with values above 55 mg gallic-acid equivalent per gram of dry matter (mgeq AG/gDM). Moreover, those results were positively correlated with the docking findings, suggesting that the pulp lead compounds have higher affinity with tyrosinase, collagenase, and elastase action sites. The results here presented are very promising and open new perspectives for the exploitation of argan-tree by-products as cosmetic agents towards the development of new anti-aging products.
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Steckiewicz KP, Cieciórski P, Barcińska E, Jaśkiewicz M, Narajczyk M, Bauer M, Kamysz W, Megiel E, Inkielewicz-Stepniak I. Silver Nanoparticles as Chlorhexidine and Metronidazole Drug Delivery Platforms: Their Potential Use in Treating Periodontitis. Int J Nanomedicine 2022; 17:495-517. [PMID: 35140461 PMCID: PMC8820264 DOI: 10.2147/ijn.s339046] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Karol P Steckiewicz
- Department of Pharmaceutical Pathophysiology, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | | | - Ewelina Barcińska
- Department of Pharmaceutical Pathophysiology, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | - Maciej Jaśkiewicz
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Narajczyk
- Laboratory of Electron Microscopy, Faculty of Biology, University of Gdansk, Gdansk, Poland
| | - Marta Bauer
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Kamysz
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | | | - Iwona Inkielewicz-Stepniak
- Department of Pharmaceutical Pathophysiology, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
- Correspondence: Iwona Inkielewicz-Stepniak Tel +48 58 349 1516Fax +48 58 349 1517 Email
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Karila T, Tervahartiala T, Cohen B, Sorsa T. The collagenases: are they tractable targets for preventing cartilage destruction in osteoarthritis? Expert Opin Ther Targets 2022; 26:93-105. [PMID: 35081858 DOI: 10.1080/14728222.2022.2035362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The etiology and pathogenesis of osteoarthritis (OA) have been intensely investigated; however, the disease course and progression are not completely understood. A prominent role for interstitial collagenases is recognized in this degenerative process, hence strategies to target them are of major interest. AREAS COVERED The pathogenesis of OA, the role of interstitial collagenases (MMP-1, -8 and -13) and collagenase modifying drugs are examined and discussed. We reviewed relevant papers from PubMed and Google Scholar. EXPERT OPINION There is strong evidence for the therapeutic potential of MMP inhibitors in OA; however, they are not expected to impact the inflammatory process. Therefore, there is a need for a relative inhibitor of MMP-13 collagenase which possesses anti-inflammatory properties. The identification of novel broad-spectrum relative multiple peptidase inhibitors could provide desirable tools for the prophylaxis, cure, or treatment of diseases involving articular cartilage (AC) degradation, in particular OA.
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Affiliation(s)
- Tuomo Karila
- Hospital Orton, Helsinki, Finland.,Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland
| | | | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Shu C, Zheng X, Wang Y, Xu Y, Zhang D, Deng S. Captopril inhibits matrix metalloproteinase activity and improves dentin bonding durability. Clin Oral Investig 2022; 26:3213-3225. [PMID: 34999991 DOI: 10.1007/s00784-021-04303-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We investigated the inhibitory effects of captopril on matrix metalloproteinases (MMPs) and its effect as a primer on dentin bonding durability. MATERIALS AND METHODS One hundred fifty human third molars were selected. Flat surfaces of the middle dentin were exposed, etched 15 s, and followed by pretreatment with a primer for 60 s, including distilled water (control, the negative control primer), 2% chlorhexidine digluconate (CHD, the positive control primer), and captopril solution. Inhibitory effects of primers on MMPs were evaluated by hydroxyproline and gelatinase activity tests. All primers were applied on dentin followed by bonding. Some of the samples were sliced into slabs, placed in a fluorescent solution containing gelatin, and incubated for in situ zymography. Some were cut into sticks, and after aging for 1 day, 12 months, or 24 months, microtensile bonding strength was tested. Some were cut into slabs, aged for 1 day, 12 months, or 24 months, and taken out for nanoleakage tests to reveal interface defects. RESULTS Hydroxyproline and gelatinase activity analyses showed that captopril exerted better inhibitory effects on MMPs, relative to 2% CHD (p < 0.05). A 0.2% captopril aqueous solution (0.2% CapW) was chosen to apply to the dentin. In situ zymography showed that inhibitory effects of captopril on gelatinase were significantly higher compared to 2% CHD (p < 0.01). Microtensile strength revealed that the bonding effects of the 0.2% CapW group lasted longer, compared to the control and 2% CHD groups (p < 0.05). Interface defects, detected by nanoleakage, were significantly reduced in the 0.2% CapW group, compared to the control and 2% CHD groups (p < 0.05). CONCLUSIONS Captopril inhibits dentin MMP activities and effectively improves dentin bonding durability. CLINICAL RELEVANCE Captopril is a promising dentin bonding primer for improving bonding durability.
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Affiliation(s)
- Chang Shu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Disease, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China
| | - Xinyu Zheng
- Department of Stomatology, Zhejiang University Hospital, Zhejiang University, Hangzhou, People's Republic of China
| | - Yang Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Disease, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China
| | - Yi Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Disease, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China
| | - Denghui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Disease, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Disease, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China.
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Mojtabavi S, Khoshayand MR, Torshabi M, Gilani K, Fazeli MR, Faramarzi MA, Samadi N. Formulation, characterization, and bioactivity assessments of a laccase-based mouthwash. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Teixeira FFC, Cardoso FGR, Ferreira NS, Gomes APM, Corazza BJM, Valera MC, Martinho FC. Clinical influence of calcium hydroxide intracanal medications on matrix metalloproteinases and tissue inhibitors of metalloproteinases in apical periodontitis. Clin Oral Investig 2022; 26:643-650. [PMID: 34255199 DOI: 10.1007/s00784-021-04042-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study investigated the influence of calcium hydroxide intracanal medications on the levels of metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in apical periodontitis (AP). MATERIALS AND METHODS Twenty primarily infected root canals with AP were randomly divided into two groups: Ca(OH)2 + sterile saline solution (SSL) group and Ca(OH)2 + 2% chlorhexidine gel (CHX gel) group. We collected samples from the periradicular tissue fluid (PTF) before (s1) and after 14 days of intracanal medication (s2). MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were measured by ELISA assay. RESULTS MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were detected in all PTF samples at s1 and s2 (20/20). At s1, MMP-2 and MMP-9 were detected at higher levels than MMP-1 (p < .05). Higher levels of TIMP-1 than TIMP-2 were found in AP (p < .05). Additionally, we detected higher MMP-1, MMP-2, and MMP-9 over TIMP-1 and TIMP-2 levels in AP (p < .05). At s2, Ca(OH)2 + SSL was as effective as Ca(OH)2 + 2% CHX gel in lowering the levels of MMP-1, MMP-2, and MMP-9 after 14 days of intracanal medication, with no significant difference between them (p > .05). Both Ca(OH) 2 intracanal medications had no significant impact on the levels of TIMP-1 and TIMP-2 (both p > .05). At s2, TIMP-1 levels were higher than TIMP-2 (p < .05). Moreover, there were positive correlations between the levels of MMP-1 and TIMP-1 and MMP-1 and TIMP-2 (p < .05). CONCLUSIONS Calcium hydroxide medications effectively lowered the levels of MMP-1, MMP-2, and MMP-9 in periapical tissues after 14 days of treatment, with no difference between them. Moreover, the calcium hydroxide intracanal medications tested here had no impact in TIMP-1 and TIMP-2 in periapical tissues. CLINICAL RELEVANCE MMPs and TIMPs play an essential role in the degradation of the extracellular matrix. The imbalance MMPs and TIMPs can cause periapical tissue destruction. Therefore, the reestablishment of the balance between activated MMPs and TIMPs with root canal therapy is essential to restore tissue homeostasis.
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Affiliation(s)
- Flavia F C Teixeira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Flavia G R Cardoso
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Nadia S Ferreira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Ana P M Gomes
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
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DE Moraes MDR, Passos VF, Padovani GC, Bezerra LCBDR, Vasconcelos IM, Santiago SL. Protective effect of green tea catechins on eroded human dentin: an in vitro/in situ study. Braz Oral Res 2021; 35:e108. [PMID: 34816896 DOI: 10.1590/1807-3107bor-2021.vol35.0108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/23/2021] [Indexed: 11/22/2022] Open
Abstract
The present study sought to evaluate the protective effect of Epigallocatechin-3-gallate (EGCG) and commercial green tea (GT) on eroded dentin using in vitro and in situ experimental models. For the in vitro experiment, matrix metalloproteinases (MMPs) were extracted from demineralized human coronary dentin powder (citric acid, pH 2.3) and assessed via a colorimetric assay and electrophoresis in gelatin. The gels were exposed to buffers with: control (no treatment), 0.05% sodium fluoride (NaF), 0.12% chlorhexidine digluconate (CHX), GT infusion, and 0.1% EGCG, and their respective activity was analyzed by zymography. For the in situ experiment, 20 healthy volunteers (aged 20-32 years) participated in this single-center, blind, crossover study. The subjects wore upper removable devices containing four human dentin blocks. Erosive challenge (coke-1 min) was performed four times/day/5 days. Blocks were treated for 1 min with: control (No treatment), 0.05% NaF, 0.1% EGCG, and GT. Thereafter, the specimens were subjected to stylus profilometry and SEM. ANOVA was used to evaluate dentin roughness and wear, with a significance level of 5%. In the zymography analysis, 0.12% CHX, GT, and 0.1% EGCG were found to inhibit the action of MMPs; however, in the colorimetric assay, only green tea inhibited the activity of MMPs. There were no significant differences observed in dentin roughness or wear (p > 0.05). Herein, EGCG and GT inhibited the activity of endogenous proteases, resulting in protection against erosion-induced dentin damage; however, they could not prevent tooth tissue loss in situ.
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Affiliation(s)
| | - Vanara Florêncio Passos
- Universidade Federal do Ceara - UFC, Faculty of Pharmacy, Nursing and Dentistry, Department of Operative Dentistry, Fortaleza, CE, Brazil
| | | | | | | | - Sérgio Lima Santiago
- Universidade Federal do Ceara - UFC, Faculty of Pharmacy, Nursing and Dentistry, Department of Operative Dentistry, Fortaleza, CE, Brazil
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