Gingival Mesenchymal Stem Cell (GMSC) Delivery System Based on RGD-Coupled Alginate Hydrogel with Antimicrobial Properties: A Novel Treatment Modality for Peri-Implantitis

Purpose Peri-implantitis is one of the most common inflammatory complications in dental implantology. Similar to periodontitis, in peri-implantitis, destructive inflammatory changes take place in the tissues surrounding a dental implant. Bacterial flora at the failing implant sites resemble the pathogens in periodontal disease and consist of Gram-negative anaerobic bacteria including Aggregatibacter actinomycetemcomitans (Aa). Here we demonstrate the effectiveness of a silver lactate (SL)-containing RGD-coupled alginate hydrogel scaffold as a promising stem cell delivery vehicle with antimicrobial properties. Materials and Methods Gingival mesenchymal stem cells (GMSCs) or human bone marrow mesenchymal stem cells (hBMMSCs) were encapsulated in SL-loaded alginate hydrogel microspheres. Stem cell viability, proliferation, and osteo-differentiation capacity were analyzed. Results Our results showed that SL exhibited antimicrobial properties against Aa in a dose-dependent manner, with 0.50 mg/ml showing the greatest antimicrobial properties while still maintaining cell viability. At this concentration, SL-containing alginate hydrogel was able to inhibit Aa on the surface of Ti discs and significantly reduce the bacterial load in Aa suspensions. Silver ions were effectively released from the SL-loaded alginate microspheres for up to 2 weeks. Osteogenic differentiation of GMSCs and hBMMSCs encapsulated in the SL-loaded alginate microspheres were confirmed by the intense mineral matrix deposition and high expression of osteogenesis-related genes. Conclusion Taken together, our findings confirm that GMSCs encapsulated in RGD-modified alginate hydrogel containing SL show promise for bone tissue engineering with antimicrobial properties against Aa bacteria in vitro

Pluronic F-127 hydrogel as a promising scaffold for encapsulation of dental-derived mesenchymal stem cells

Dental-derived mesenchymal stem cells (MSCs) provide an advantageous therapeutic option for tissue engineering due to their high accessibility and bioavailability. However, delivering MSCs to defect sites while maintaining a high MSC survival rate is still a critical challenge in MSC-mediated tissue regeneration. Here, we tested the osteogenic and adipogenic differentiation capacity of dental pulp stem cells (DPSCs) in a thermoreversible Pluronic F127 hydrogel scaffold encapsulation system in vitro. DPSCs were encapsulated in Pluronic(®) F-127 hydrogel and stem cell viability, proliferation and differentiation into adipogenic and osteogenic tissues were evaluated. The degradation profile and swelling kinetics of the hydrogel were also analyzed. Our results confirmed that Pluronic F-127 is a promising and non-toxic scaffold for encapsulation of DPSCs as well as control human bone marrow MSCs (hBMMSCs), yielding high stem cell viability and proliferation. Moreover, after 2 weeks of differentiation in vitro, DPSCs as well as hBMMSCs exhibited high levels of mRNA expression for osteogenic and adipogenic gene markers via PCR analysis. Our histochemical staining further confirmed the ability of Pluronic F-127 to direct the differentiation of these stem cells into osteogenic and adipogenic tissues. Furthermore, our results revealed that Pluronic F-127 has a dense tubular and reticular network morphology, which contributes to its high permeability and solubility, consistent with its high degradability in the tested conditions. Altogether, our findings demonstrate that Pluronic F-127 is a promising scaffold for encapsulation of DPSCs and can be considered for cell delivery purposes in tissue engineering

Isolation and characterisation of human gingival margin-derived STRO-1/MACS+ and MACS− cell populations

Recently, gingival margin-derived stem/progenitor cells isolated via STRO-1/magnetic activated cell sorting (MACS) showed remarkable periodontal regenerative potential in vivo. As a second-stage investigation, the present study's aim was to perform in vitro characterisation and comparison of the stem/progenitor cell characteristics of sorted STRO-1-positive (MACS+) and STRO-1-negative (MACS−) cell populations from the human free gingival margin. Cells were isolated from the free gingiva using a minimally invasive technique and were magnetically sorted using anti-STRO-1 antibodies. Subsequently, the MACS+ and MACS− cell fractions were characterized by flow cytometry for expression of CD14, CD34, CD45, CD73, CD90, CD105, CD146/MUC18 and STRO-1. Colony-forming unit (CFU) and multilineage differentiation potential were assayed for both cell fractions. Mineralisation marker expression was examined using real-time polymerase chain reaction (PCR). MACS+ and MACS− cell fractions showed plastic adherence. MACS+ cells, in contrast to MACS− cells, showed all of the predefined mesenchymal stem/progenitor cell characteristics and a significantly higher number of CFUs (P<0.01). More than 95% of MACS+ cells expressed CD105, CD90 and CD73; lacked the haematopoietic markers CD45, CD34 and CD14, and expressed STRO-1 and CD146/MUC18. MACS− cells showed a different surface marker expression profile, with almost no expression of CD14 or STRO-1, and more than 95% of these cells expressed CD73, CD90 and CD146/MUC18, as well as the haematopoietic markers CD34 and CD45 and CD105. MACS+ cells could be differentiated along osteoblastic, adipocytic and chondroblastic lineages. In contrast, MACS− cells demonstrated slight osteogenic potential. Unstimulated MACS+ cells showed significantly higher expression of collagen I (P<0.05) and collagen III (P<0.01), whereas MACS− cells demonstrated higher expression of osteonectin (P<0.05; Mann–Whitney). The present study is the first to compare gingival MACS+ and MACS− cell populations demonstrating that MACS+ cells, in contrast to MACS− cells, harbour stem/progenitor cell characteristics. This study also validates the effectiveness of the STRO-1/MACS+ technique for the isolation of gingival stem/progenitor cells. Human free gingival margin-derived STRO-1/MACS+ cells are a unique renewable source of multipotent stem/progenitor cells

Mechanical, antibacterial and bond strength properties of nano-titanium-enriched glass ionomer cement

The use of nanoparticles (NPs) has become a significant area of research in Dentistry. Objective The aim of this study was to investigate the physical, antibacterial activity and bond strength properties of conventional base, core build and restorative of glass ionomer cement (GIC) compared to GIC supplemented with titanium dioxide (TiO2) nanopowder at 3% and 5% (w/w). Material and Methods Vickers microhardness was estimated with diamond indenter. Compressive and flexural strengths were analyzed in a universal testing machine. Specimens were bonded to enamel and dentine, and tested for shear bond strength in a universal testing machine. Specimens were incubated with S. mutans suspension for evaluating antibacterial activity. Surface analysis of restorative conventional and modified GIC was performed with SEM and EDS. The analyses were carried out with Kolmogorov-Smirnov, ANOVA (post-hoc), Tukey test, Kruskal-Wallis, and Mann Whitney. Results Conventional GIC and GIC modified with TiO2 nanopowder for the base/liner cement and core build showed no differences for mechanical, antibacterial, and shear bond properties (p>0.05). In contrast, the supplementation of TiO2 NPs to restorative GIC significantly improved Vickers microhardness (p<0.05), flexural and compressive strength (p<0.05), and antibacterial activity (p<0.001), without interfering with adhesion to enamel and dentin. Conclusion GIC supplemented with TiO2 NPs (FX-II) is a promising material for restoration because of its potential antibacterial activity and durable restoration to withstand the mastication force

The ART approach: clinical aspects reviewed

The success of ART as a caries management approach is supported by more than 20 years of scientific evidence. ART follows the contemporary concepts of modern cariology and restorative dentistry. It challenges treatment concepts such as step-wise excavation and the need for complete removal of affected dentine. The ART approach so far has mainly used high-viscosity glass-ionomer as the sealant and restorative material. Cariostatic and remineralization properties have been ascribed to this material which requires further research to establish its clinical relevance. The adhesion of high-viscosity glass-ionomer to enamel in pits and fissures is apparently strong, as its remnants, blocking the pits and fissures, have been considered a possible reason for the low prevalence of carious lesion development after the glass-ionomer has clinically disappeared from it. Encapsulated high-viscosity glass-ionomers may lead to higher restoration survival results than those of the hand-mixed version and should, therefore, not be neglected when using ART. Similarly, the use of resin-modified glass-ionomer with ART should be researched. The effectiveness of ART when compared to conventional caries management approaches has been shown in numerous studies. Proper case selection is an important factor for long-lasting ART restoration survival. This is based on the caries risk situation of the individual, the size of the cavity opening, the strategic position of the cavitated tooth and the presence of adequate caries control measures. As the operator is one of the main causes for failure of ART restorations, attending a well-conducted ART training course is mandatory for successful implementation of ART

Effects of incorporation of hydroxyapatite and fluoroapatite nanobioceramics into conventional glass ionomer cements (GIC)

Hydroxyapatite (HA) has excellent biological behavior, and its composition and crystal structure are similar to the apatite in the human dental structure and skeletal system; a number of researchers have attempted to evaluate the effect of the addition of HA powders to restorative dental materials. In this study, nanohydroxy and fluoroapatite were synthesized using an ethanol based sol-gel technique. The synthesized nanoceramic particles were incorporated into commercial glass ionomer powder (Fuji II GC) and were characterized using Fourier transform infrared and Raman spectroscopy, X-ray diffraction and scanning electron microscopy. Compressive, diametral tensile and biaxial flexural strengths of the modified glass ionomer cements were evaluated. The effect of nanohydroxyapatite and fluoroapatite on the bond strength of glass ionomer cement to dentin was also investigated. Results showed that after 1 and 7 days of setting, the nanohydroxyapatite/fluoroapatite added cements exhibited higher compressive strength (177-179 MPa), higher diametral tensile strength (19-20 MPa) and higher biaxial flexural strength (26-28 MPa) as compared with the control group (160 MPa in CS, 14 MPa in DTS and 18 MPa in biaxial flexural strength). The experimental cements also exhibited higher bond strength to dentin after 7 and 30 days of storage in distilled water. It was concluded that glass ionomer cements containing nanobioceramics are promising restorative dental materials with both improved mechanical properties and improved bond strength to dentin. © 2007 Acta Materialia Inc

Effects of N-vinylpyrrolidone (NVP) containing polyelectrolytes on surface properties of conventional glass-ionomer cements (GIC)

It has been found that polyacids containing an N-vinylpyrrolidinone (NVP) comonomer produces a glass inomer cement with improved mechanical and handling properties. The objective of this study was to investigate the effect of NVP modified polyelectrolytes on the surface properties and shear bond strength to dentin of glass ionomer cements. Poly(acrylic acid (AA)-co-itaconic acid (IA)-co-N-vinylpyrrolidone) was synthesized by free radical polymerization. The terpolymer was characterized using 1H NMR, FTIR spectroscopy and viscometry for solution properties. The synthesized polymers were used in glass ionomer cement formulations (Fuji II commercial GIC). Surface properties (wettability) of modified cements were studied by water contact angle measurements as a function of time. Work of adhesion values of different surfaces was also determined. The effect of NVP modified polyacid, on bond strength of glass-ionomer cement to dentin was also investigated. The mean data obtained from contact angle and bonding strength measurements were subjected to one- and two-way analysis of variance (ANOVA) at α = 0.05. Results showed that NVP modified glass ionomer cements showed significantly lower contact angles (θ = 47°) and higher work of adhesion (WA = 59.4 erg/cm2) in comparison to commercially available Fuji II GIC (θ = 60° and WA = 50.3 erg/cm2, respectively). The wettability of dentin surfaces conditioned with NVP containing terpolymer was higher (θ = 21°, WA = 74.2 erg/cm2) than dentin conditioned with Fuji conditioner (θ = 30°, WA = 69 erg/cm2). The experimental cement also showed higher but not statistically significant values for shear bond strength to dentin (7.8 MPa), when compared to control group (7.3 MPa). It was concluded that NVP containing polyelectrolytes are better dentin conditioners than the commercially available dentin conditioner (Fuji Cavity Conditioner, GC). NVP containing terpolymers can enhance the surface properties of GICs and also increase their bond strength to the dentin. © 2009 Academy of Dental Materials

Synthesis and characterization of a novel fast-set proline-derivative-containing glass ionomer cement with enhanced mechanical properties

In this study, a methacryloyl derivative of l-proline was synthesized, characterized and incorporated into a conventional glass ionomer cement (GIC) with a polyacid composition. Subsequently, the effects of incorporation of synthesized N-methacryloyl-proline and terpolymer on the GIC's mechanical and working properties were studied. 1-Methacryloylpyrrolidone-2-carboxylic acid was synthesized and used in a polymerization reaction with acrylic acid and itaconic acid in order to form terpolymer which was used in Fuji II commercial GIC formulations. Chemical structural characterization of the resulting products was performed using 1H nuclear magnetic resonance and Fourier transform infrared spectroscopy. The viscosity and molecular weight of the terpolymer were also measured. The mechanical strength properties of the modified GICs were evaluated after 24 h or 1 week of immersion in distilled water at 37 °C. Analysis of variance was used to study the statistical significance of the mechanical strengths and working properties, and to compare them with a control group. Results showed that N-methacryloyl-proline modified GICs exhibited significantly higher compressive strength (CS; 195-210 MPa), higher diametral tensile strength (DTS; 19-26 MPa) and higher biaxial flexural strength (38-46 MPa) in comparison to Fuji II GIC (161-166 MPa in CS, 12-14 MPa in DTS and 13-18 MPa in biaxial flexural strength). The working properties (setting and working time) of the modified samples showed that the modified cement was a fast-set cement. It was concluded that a novel amino acid-containing GIC has been developed in this study with 27%, 94% and 170% increases in values for compressive, diametral tensile and biaxial flexural strength, respectively, in comparison to commercial Fuji II GIC. © 2008 Acta Materialia Inc