Ispitivanje biokompatibilnosti nanomaterijala na bazi kalcijum silikata i njegovog uticaja na pulpo-parodontalno tkivo

Introduction: Biocompatibility is interpreted as the material's ability to act within the adequate host response in a specific situation. The host’s response to foreign body will depend on its chemical reactivity, surface structure and topography. It has been shown that nanostructured surface more closely mimic the hierarchical organization of the bone tissue in comparison to microstructured, by increasing the concentration of active biomolecules that may affect cell migration, adhesion, differentiation and proliferation. During the nineties, mineral trioxide aggregate (MTA) was presented as a material of choice for retrograde fillings because of its lower apical microleakage, setting in the presence of moisture and high pH. Despite some favorable properties, MTA exhibits dry consistency, low flowability and long setting time which limit its clinical use. The aim of this study was to synthesize nanostructured materials based on highly active calcium silicates with enhanced properties and analyze their biocompatibility and bioactivity in comparison to MTA+ (Cerkamed, Stalowa Wola- Poland). Materials and Methods: The sol-gel method in a combination with hightemperature self-propagating reaction was applied for the synthesis of investigated materials. Phase analysis of investigated materials before and after hydratation was performed by XRD and FTIR, while the morphology of the samples was studied by SEM and EDS. The pH measurements were performed using pH-meter, while the amount of released ions was determined using ICP-OES. Biocompatibility of fresh investigated materials and their elutes (24h, 7 and 21 day) was conducted using indirect (MTT), direct test (LDH), proliferation test (3H-thymidine) and direct method (Neutral red). The interaction of directly applied investigated materials with dental pulp tissue was analyzed in an entire human tooth culture model (15 and 30 days). Eighteen guinea pigs received intramuscular sterile polyethylene tubes filled with investigated materials (15, 30 and 60 days). For intraosseous implementation twelve New Zealand white rabbits, divided into two groups (30 and 90 days) were used. Four calvary defects per animal were created with trepan burs and filled with freshly prepared investigated materials. The occurrence of inflammatory responses and hard tissue formation was categorized according to the previously established scores...Uvod: Biokompatibilnost se tumači kao sposobnost materijala da deluje uz adekvatan odgovor domaćina u određenoj situaciji. Odgovor domaćina na strano telo zavisiće od njegove hemijske reaktivnosti, površinske strukture i topografije. Dokazano je da nanostrukturirana površina bliže podražava hijerarhijsku organizaciju koštanog tkiva u odnosu na mikrostrukturiranu, povećanjem koncentracije aktivnih biomolekula koji utiču na ćelijsku migraciju, adheziju, diferencijaciju i proliferaciju. Tokom devedesetih godina, mineralni trioksidni agregat (MTA) predstavljen je kao materijal izbora za retrogradne kavitete zbog nižeg apikalnog mikropropuštanja, vezivanja u prisustvu vlage i visoke pH vrednosti. Uprkos povoljnim osobinama, MTA pokazuje suvu konzistenciju, nisku viskoznost i dugo vremena vezivanja, što ograničava njegovu kliničku upotrebu. Cilj ove studije bio je da se sintetišu nanomaterijali na bazi veoma aktivnih kalcijum-silikata unapređenih fizičko-hemijskih svojstava i ispitaju njihova biokompatibilnost i bioaktivnost u odnosu na MTA+ (Cerkamed, Stalowa Wola- Poljska). Materijali i Metod: Postupak sol-gel metode u kombinaciji sa metodom visoko-temperaturne lančane reakcije sagorevanja primenjen je u toku sinteze ispitivanih materijala. Analiza faza pre i posle hidratacija izvedena je pomoću XRD i FTIR, dok je morfologija uzoraka proučavana SEM i EDS. pH merenja su obavljena korišćenjem pH-metra, dok je količina oslobođenih jona određivana korišćenjem ICP-OES. Biokompatibilnost svežih materijala i njihovih ekstrakata (24h, 7 i 21 dan) je ispitana primenom indirektnog testa (MTT), direktnog testa (LDH), testa proliferacije (3H-timidin) i direktnom metodom (Neutralno crvena). Interakcija direktno primenjenih ispitivanih materijala sa pulpnim tkivom analizirana je na modelu kulture humanih zuba (15 i 30 dana). Osamnaest zamorca služilo je za intramišićnu implementaciju sterilnih polietilenskih cevčica ispunjenih ispitivanim materijalima (15, 30 i 60 dana). Za intrakoštani implantacioni test upotrebljeno je dvanaest novozelandskih belih zečeva podeljenih u dve grupe (30 i 90 dana)..

BIocompatibility investigation of nanosynthesized materials based on calcium silicates and its impact on pulpo-periodontal tissue

Увод: Биокомпатибилност се тумачи као способност материјала да делује уз адекватан одговор домаћина у одређеној ситуацији. Одговор домаћина на страно тело зависиће од његове хемијске реактивности, површинске структуре и топографије. Доказано је да наноструктурирана површина ближе подражава хијерархијску организацију коштаног ткива у односу на микроструктурирану, повећањем концентрације активних биомолекула који утичу на ћелијску миграцију, адхезију, диференцијацију и пролиферацију. Током деведесетих година, минерални триоксидни агрегат (МТА) представљен је као материјал избора за ретроградне кавитете због нижег апикалног микропропуштања, везивања у присуству влаге и високе pH вредности. Упркос повољним особинама, МТА показује суву конзистенцију, ниску вискозност и дуго времена везивања, што ограничава његову клиничку употребу. Циљ ове студије био је да се синтетишу наноматеријали на бази веома активних калцијум-силиката унапређених физичко-хемијских својстава и испитају њихова биокомпатибилност и биоактивност у односу на МТА+ (Cerkamed, Stalowa Wola- Пољска). Материјали и Метод: Поступак сол-гел методе у комбинацији са методом високо-температурне ланчане реакције сагоревања примењен је у току синтезе испитиваних материјала. Анализа фаза пре и после хидратација изведена је помоћу XRD и FTIR, док је морфологија узорака проучавана SEM и EDS. pH мерења су обављена коришћењем pH-метра, док је количина ослобођених јона одређивана коришћењем ICP-OES. Биокомпатибилност свежих материјала и њихових екстраката (24h, 7 и 21 дан) је испитана применом индиректног теста (МТТ), директног теста (LDH), теста пролиферације (3H-тимидин) и директном методом (Неутрално црвена). Интеракција директно примeњених испитиваних материјала са пулпним ткивом анализирана је на моделу културе хуманих зуба (15 и 30 дана). Осамнаест заморца служило је за интрамишићну имплементацију стерилних полиетиленских цевчица испуњених испитиваним материјалима (15, 30 и 60 дана). За интракоштани имплантациони тест употребљено је дванаест новозеландских белих зечева подељених у две групе (30 и 90 дана)...Introduction: Biocompatibility is interpreted as the material's ability to act within the adequate host response in a specific situation. The host’s response to foreign body will depend on its chemical reactivity, surface structure and topography. It has been shown that nanostructured surface more closely mimic the hierarchical organization of the bone tissue in comparison to microstructured, by increasing the concentration of active biomolecules that may affect cell migration, adhesion, differentiation and proliferation. During the nineties, mineral trioxide aggregate (MTA) was presented as a material of choice for retrograde fillings because of its lower apical microleakage, setting in the presence of moisture and high pH. Despite some favorable properties, MTA exhibits dry consistency, low flowability and long setting time which limit its clinical use. The aim of this study was to synthesize nanostructured materials based on highly active calcium silicates with enhanced properties and analyze their biocompatibility and bioactivity in comparison to MTA+ (Cerkamed, Stalowa Wola- Poland). Materials and Methods: The sol-gel method in a combination with hightemperature self-propagating reaction was applied for the synthesis of investigated materials. Phase analysis of investigated materials before and after hydratation was performed by XRD and FTIR, while the morphology of the samples was studied by SEM and EDS. The pH measurements were performed using pH-meter, while the amount of released ions was determined using ICP-OES. Biocompatibility of fresh investigated materials and their elutes (24h, 7 and 21 day) was conducted using indirect (MTT), direct test (LDH), proliferation test (3H-thymidine) and direct method (Neutral red). The interaction of directly applied investigated materials with dental pulp tissue was analyzed in an entire human tooth culture model (15 and 30 days). Eighteen guinea pigs received intramuscular sterile polyethylene tubes filled with investigated materials (15, 30 and 60 days). For intraosseous implementation twelve New Zealand white rabbits, divided into two groups (30 and 90 days) were used. Four calvary defects per animal were created with trepan burs and filled with freshly prepared investigated materials. The occurrence of inflammatory responses and hard tissue formation was categorized according to the previously established scores..

Evaluation of toothbrush contamination

Background/Aim: Toothbrushes are one of the main means of cleaning teeth and maintaining oral hygiene, but toothbrushes are also potential reservoir of microorganisms, including pathogens. The aim of this paper was to evaluate the oral health, oral hygiene awareness and assess the degree of contamination of toothbrushes among students attending Secondary Medical School. Material and Methods: Sixty students (32 boys, 28 girls; mean age ≅ 15,7±2,1) attending highschool were randomly selected for this study. Each student included in the study filled out a questionnaire regarding his/her life habits and oral hygiene. Clinical examinations were initiated in order to determine the DMFT, as well as the CIP, CIT, CIA and CPITN indexes, based of which the assessment of oral health status was performed. One stack of fiber was collected from each toothbrush used by the participantes in the study, and than prepared for further microbiological sampling. Results: Only 11% of the students had the awareness of potential sources of toothbrushes contamination. The average value of DMFT was 3,2 (%D = 22,5; %M = 4,96; %F = 72,5). A statistically significant difference in comparison of the CPITN index and subjects' response to the professional plague removal in the last 12 months was identified (χ2 = 13,55; p= 0,033). Staphylococcus aureus, Streptococcus mutans, Micrococcus species and Streptococcus salivarius were most commonly present microorganisms. In most cases, G-positive bacilli or cocci were isolated, while the presence of Candidae albicans was identified in four samples. Conclusions: Raising the awareness of dental hygiene through the oral health education may improve better plaque control and subsequently the oral health. Hands-on training how to maintain the oral hygiene are not expensive and more over they are easy to be organized can be useful in oral heath promotion

Metode magnetronskog raspršivanja za površinsku modifikaciju memorijskih legura za primenu u ortodonciji i endodonciji

Various magnetron-sputtering methods for surface modification of shape memory alloys (SMA) are described in this paper. These methods belong to the most effective methods, which enable mechanical reinforcing of the SMA, showing numerous advantages over conventional methods of electro-polishing. In addition, surface modified SMA, particularly with equiatomic TiNi coatings, is crucial for further development of various endodontic instruments; wires and brackets used for orthodontic teeth movements. Active coatings with bactericide properties and coatings that can be used as barrier for release of toxic Ni ions from the bulk body of SMA obtained by various magnetron-sputtering methods can be successfully combined. Therefore, the review of these methods is given in this paper, with their main characteristics and drawbacks. Magnetron sputtering deposition involves surface modification of SMA in a single-layer, multilayer, graded layers, and nanocomposite thin coatings for obtaining systems with superior "functional" characteristics. These are hardness, scratch, abrasion, and erosion resistance, improved adhesion to various technologically important substrate materials such as polymers, hydrophobicity or hydrophilicity, long-term chemical, thermal, and environmental stability, gas and vapor impermeability, and others. This paper is critical review of the advances in the development of magnetron sputtering modified SMA products in dentistry, with in advance predictable physicochemical, structural and antimicrobial properties.U ovom radu su opisane različite metode magnetronskog raspršivanja za površinsku modifikaciju memorijskih legura (shape memory alloys - SMA). Ove metode spadaju u najefikasnije metode koje omogućavaju mehaničko ojačavanje SMA, pokazujući brojne prednosti u odnosu na konvencionalne metode elektropoliranja, koje su najčešće korišćene u savremenoj ortodontskoj i endodontskoj praksi. Pored toga, površinski modifikovane SMA, posebno sa ekviatomskim Ti i Ni udelima unutar prevlake, presudne su za dalji razvoj različitih endodontskih instrumenata, žica i konzola koje se koriste za ortodontska pomeranja zuba. Aktivne prevlake sa baktericidnim svojstvima i prevlake koje služe kao barijere protiv otpuštanja toksičnih Ni jona iz SMA unutar organizma mogu biti dobijene različitim metodama magnetronskog raspršivanja, pri čemu se različite varijante ove metode mogu uspešno kombinovati. Zbog svega toga u ovom radu je dat pregled ovih metoda, sa njihovim glavnim karakteristikama i nedostacima. Magnetronsko nanošenje raspršivanjem uključuje površinsku modifikaciju SMA u jednoslojnim, višeslojnim, gradiranim slojevima i nanokompozitne tanke prevlake za dobijanje sistema sa superiornim "funkcionalnim" karakteristikama, kao što su vrlo visoka tvrdoća, otpornost na habanje, abraziju i eroziju, poboljšano prijanjanje na različite tehnološki važne supstratne materijale kao što su polimeri, hidrofobnost ili hidrofilnost, dugotrajna hemijska, termička i ekološka stabilnost, nepropusnost gasa i para i drugi. Ovaj rad predstavlja neku vrstu kritičkog pregleda napretka u razvoju magnetronskog raspršivanja modifikovanih SMA proizvoda u stomatologiji, sa unapred predvidljivim fizičko-hemijskim, strukturnim i antimikrobnim osobinama

Endodontic treatment of traumatized teeth with chronic periapical lesions using antibiotic paste and mineral trioxide aggregate obturation - a preliminary study

Introduction/Objective The purpose of this study was to assess effectiveness of endodontic root canal procedures in traumatized permanent teeth with necrotic pulps and chronic periapical lesions after definitive obturation with mineral trioxide aggregate (MTA) products. Adobe Photoshop CS (San Jose, CA, USA) image-analysis software was used for healing assessment. Methods Twenty-seven traumatized single-rooted permanent teeth diagnosed with necrotic pulps and chronic periapical lesions were treated with non-surgical procedure using a tri-antibiotic paste and calcium hydroxide as intra-canal medication. Definitive obturation was performed with ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or MTA+ Cerkamed (Cerkamed, Stalowa Wola, Poland). Control follow-ups were done three, six, 12, and 24 months following the completion of treatment. Results The positive clinical outcome was recorded in 24 (88.9%) cases, while radiographic success was present in 26 (96.3%) cases. A statistically significant decrease in the sizes of periapical lesions was consistently observed at follow-up periods (p 0.05). Conclusion The MTA products were effective for the root canal obturation and appeared to contribute to the significant reduction or complete regression of periapical lesions in teeth treated. The presented procedure may be proposed for everyday clinical practice. © 2019, Serbia Medical Society. All rights reserved

In vitro biocompatibility of nanostructured endodontic materials using SCAP cells

Background/Aim: Lately, fully innovative sol-gel method with high-temperature self-propagating reaction was used for the synthesis of new nanostructured endodontic materials, in combination with different radiopacifiers: bismuth (ALBO-MPCA1) and barium (ALBO-MPCA2). The aim of this study was to investigate the biocompatibility of nanostructured endodontic materials based on highly active calcium silicates and mixed with different radiopacifiers in comparison to MTA+ using human stem cells from the apical papilla- SCAP cells. Material and Methods: Morphology of the samples was studied by SEM. The tested materials were mixed with distilled water in a ratio 2:1 (m/m). Fifteen minutes after the preparation, samples were used in the experiment. The biocompatibility of fresh materials, after 3h and 7 days, was tested using 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide- MTT test. Results: Samples mostly consisted of spherical and rode-like. The relative viability of cells increased following the exposure time. Conclusion: The biocompatibility of synthesized materials is comparable to the control material MTA+, and therefore these materials can be recommended for further clinical studies

Diode laser irradiation in endodontic therapy through cycles: In vitro study

Background/Aim: The aim of this in vitro study was to investigate the influence of irradiation cycles and resting periods, on thermal effects on the external root surface during root canal irradiation of two diode laser systems (940 nm and 975 nm), at output powers of 1 W and 2 W in continuous mode. In previous studies the rising of temperature above 7°C has been reported as biologically accepted to avoid periodontal damage on the external root surface. Material and Methods: Twenty human inferior incisors were randomly distributed into four groups, the 940 nm, and the 975 nm diode laser irradiation, both with an output power of 1 W and 2 W, in continuous mode. The thermographic camera was used to detect temperature variations on the external root surface. Digital radiography of the samples was made. Results: After three cycles of irradiation, at apical third of the root, mean temperature variation by 940 nm diode laser irradiation was 2.88°C for output power of 1 W, and 6.52°C for output power of 2 W. The 975 nm laser caused a higher temperature increase in the apical region, with temperature variation of 13.56°C by an output power of 1 W, and 30.60°C at 2 W, with a statistical significance of p ≤ 0.0001 between two laser systems compared for the same power. The resting periods of 20 s between cycles were enough to lower temperature under 7°C in the case of 1 W and 2 W for 940 nm diode laser, while for 975 nm laser, after three irradiation cycles overheating occurred at both output power rates. Conclusion: Three cycles irradiation of 940 nm diode laser, with resting periods of 20 seconds, allowed safe usage of 1 W and 2 W in CW for endodontic treatment. For 975 nm at a power rate of 1 W, the last resting period drop the temperature near the safe limit and it came under 7°C in a period less than a minute, while at the power of 2 W the resting periods were not long enough for the safe temperature decrease

Use of mineral trioxide aggregate in the treatement of traumatized teeth in children - Two case reports

Introduction. Dental injuries in immature permanent teeth often result in endodontic complications. Apexification technique using calcium hydroxide is associated with certain flaws, such as long treatment time, the possibility of tooth fracture and incomplete calcification. The use of an apical plug employing mineral trioxide aggregate (MTA) is an alternative treatment option. Case report. We reported the successful treatment of 4 maxillary incisors (in a 7-year-old boy and a 10-year-old girl) with open apices and periapical lesions. Apical portions of the canals were filled with MTA plugs in both cases. Coronal parts of the root canals were filled with gutta-percha and sealer. Clinical findings were clear 6 months after the definite obturation with no pathological changes on the radiographs in both cases. Conclusion. The use of MTA for apical plugging appears to be a valid treatment option in traumatized immature teeth with endodontic complications

Antibakterijski efekti novih endodontskih materijala na bazi kalcijum silikata

Background/Aim. The main task of endodontic treatment is to eliminate pathologically altered tissue, to disinfect root canal space and to obtain its three-dimensional hermetic obturation. The main purpose of this study was to evaluate antimicrobial activity of new endodontic nano-structured highly active calcium silicates based materials albo-mineral plyoxide carbonate aggregate (ALBO-MPCA) and calcium silicates (CS) in comparison to mineral trioxide aggregate (MTA+) and UltraCal XS (CH). Methods. The antimicrobial activity of materials was tested against Staphylococcus aureus (ATCC 25923) and Enterococcus faecalis (ATCC 14506) strains, and following clinical isolates: Rothia dentocariosa, Enterococcus faecalis, Staphylococcus aureus, Streptococcus anginosus and Streptococcus vestibularis using a double layer agar diffusion test. The pH measurements were performed using the pH meter. Total amount of released ions was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). Results. All tested materials showed the best antibacterial potential after 1 h of incubation. After 3h and 24h of the incubation period, the antibacterial potential of all tested materials were similar. The Agar diffusion test showed that ALBO-MPCA, CS and MTA+ had similar inhibition zones (p > 0.05), except in the activity against Staphylococcus aureus where ALBO-MPCA showed better antimicrobial properties than MTA+ in 3h and 24h of the incubation period (p < 0.05). Following 24h of the incubation, the inhibition zones were the strongest with CH against Staphylococcus aureus (16.67 ± 2.34 mm) followed by ALBO-MPCA (14.67 ± 1.21 mm) and the weakest with CS against Enterococcus faecalis (6.50 ± 1.76 mm). CH showed the highest pH, followed by ALBO-MPCA, CS and MTA+. Conclusion. The expressed antibacterial effects indicate that materials based on nano-structured highly active calcium silicates represent effective therapeutic agents for root canal obturation in one-visit apexification treatment, therefore they are recommend for further examination and clinical trials as they are proposed for MTA substitution

BIocompatibility investigation of nanosynthesized materials based on calcium silicates and its impact on pulpo-periodontal tissue

Увод: Биокомпатибилност се тумачи као способност материјала да делује уз адекватан одговор домаћина у одређеној ситуацији. Одговор домаћина на страно тело зависиће од његове хемијске реактивности, површинске структуре и топографије. Доказано је да наноструктурирана површина ближе подражава хијерархијску организацију коштаног ткива у односу на микроструктурирану, повећањем концентрације активних биомолекула који утичу на ћелијску миграцију, адхезију, диференцијацију и пролиферацију. Током деведесетих година, минерални триоксидни агрегат (МТА) представљен је као материјал избора за ретроградне кавитете због нижег апикалног микропропуштања, везивања у присуству влаге и високе pH вредности. Упркос повољним особинама, МТА показује суву конзистенцију, ниску вискозност и дуго времена везивања, што ограничава његову клиничку употребу. Циљ ове студије био је да се синтетишу наноматеријали на бази веома активних калцијум-силиката унапређених физичко-хемијских својстава и испитају њихова биокомпатибилност и биоактивност у односу на МТА+ (Cerkamed, Stalowa Wola- Пољска). Материјали и Метод: Поступак сол-гел методе у комбинацији са методом високо-температурне ланчане реакције сагоревања примењен је у току синтезе испитиваних материјала. Анализа фаза пре и после хидратација изведена је помоћу XRD и FTIR, док је морфологија узорака проучавана SEM и EDS. pH мерења су обављена коришћењем pH-метра, док је количина ослобођених јона одређивана коришћењем ICP-OES. Биокомпатибилност свежих материјала и њихових екстраката (24h, 7 и 21 дан) је испитана применом индиректног теста (МТТ), директног теста (LDH), теста пролиферације (3H-тимидин) и директном методом (Неутрално црвена). Интеракција директно примeњених испитиваних материјала са пулпним ткивом анализирана је на моделу културе хуманих зуба (15 и 30 дана). Осамнаест заморца служило је за интрамишићну имплементацију стерилних полиетиленских цевчица испуњених испитиваним материјалима (15, 30 и 60 дана). За интракоштани имплантациони тест употребљено је дванаест новозеландских белих зечева подељених у две групе (30 и 90 дана)...Introduction: Biocompatibility is interpreted as the material's ability to act within the adequate host response in a specific situation. The host’s response to foreign body will depend on its chemical reactivity, surface structure and topography. It has been shown that nanostructured surface more closely mimic the hierarchical organization of the bone tissue in comparison to microstructured, by increasing the concentration of active biomolecules that may affect cell migration, adhesion, differentiation and proliferation. During the nineties, mineral trioxide aggregate (MTA) was presented as a material of choice for retrograde fillings because of its lower apical microleakage, setting in the presence of moisture and high pH. Despite some favorable properties, MTA exhibits dry consistency, low flowability and long setting time which limit its clinical use. The aim of this study was to synthesize nanostructured materials based on highly active calcium silicates with enhanced properties and analyze their biocompatibility and bioactivity in comparison to MTA+ (Cerkamed, Stalowa Wola- Poland). Materials and Methods: The sol-gel method in a combination with hightemperature self-propagating reaction was applied for the synthesis of investigated materials. Phase analysis of investigated materials before and after hydratation was performed by XRD and FTIR, while the morphology of the samples was studied by SEM and EDS. The pH measurements were performed using pH-meter, while the amount of released ions was determined using ICP-OES. Biocompatibility of fresh investigated materials and their elutes (24h, 7 and 21 day) was conducted using indirect (MTT), direct test (LDH), proliferation test (3H-thymidine) and direct method (Neutral red). The interaction of directly applied investigated materials with dental pulp tissue was analyzed in an entire human tooth culture model (15 and 30 days). Eighteen guinea pigs received intramuscular sterile polyethylene tubes filled with investigated materials (15, 30 and 60 days). For intraosseous implementation twelve New Zealand white rabbits, divided into two groups (30 and 90 days) were used. Four calvary defects per animal were created with trepan burs and filled with freshly prepared investigated materials. The occurrence of inflammatory responses and hard tissue formation was categorized according to the previously established scores..