CTS242 - Artículos

Efficacy of topical application of corticosteroids in the remineralization of dental pulp tissue. A systematic review of the literature

Efficacy of topical application of corticosteroids in the remineralization of dental pulp tissue. A systematic review of the literature Vallecillo Rivas, Marta; Fernández-Romero, Enrique; Pérez-Segura, Michelle; Toledano, Raquel; Amar-Zetouni, Anisa; Toledano Pérez, Manuel; Vallecillo Rivas, María Cristina Objectives: The aim of this systematic review was to demonstrate the efficacy of topical application of corticosteroids in remineralization of dental pulp tissues to preserve their vitality and function. Data, sources and study selection: An electronic search was performed using MEDLINE by PubMed, EMBASE, Web of Science (WOS), and Scopus databases. The inclusion criteria were in vitro studies that employed dental pulp tissue obtained from extracted healthy permanent human teeth and were subjected to topical administration of corticosteroids and evaluated tissue remineralization by performing any mineralization assay. A total of 11 studies were selected for inclusion. PRISMA guidelines were followed, and the methodological quality and risk of bias of the included studies were evaluated using the RoBDEMAT guidelines. Also, tables were designed for data extraction, including tissue mineralization and osteogenic differentiation as primary and secondary outcomes, respectively. Conclusions: Alizarin Red S (ARS) has been able to demonstrate a possible mineralizing power of corticosteroids, applied at an adequate dose. The up-regulation of Alkaline phosphatase (ALP), osteocalcin (OCN), osteopontin (OSP), sialophosphoprotein (DSPP), runt-related transcription factor 2 (RUNX2), collagen type 1 alpha 1 (COL1α1) and dentin matrix protein 1 (DMP-1) induced the osteogenic/odontogenic differentiation of dental pulp stem cells (DPSCs). Clinical significance: Deep carious lesions treatment is still challenging in restorative dentistry. Some treatments have been focused on dental pulp tissue remineralization to maintain the function and vitality. After corticosteroids topical application, mineral deposition and osteogenic differentiation have been detected. The present study was supported by Grant PID2020–114694RB-I00 funded by MCIN/AEI 10.13039/501100011033.

Investigation of the effect of Tideglusib on the hydroxyapatite formation, crystallinity and elasticity of conditioned resin-dentin interfaces

Investigation of the effect of Tideglusib on the hydroxyapatite formation, crystallinity and elasticity of conditioned resin-dentin interfaces Toledano Pérez, Manuel; Fernández-Romero, Enrique; Osorio, María T.; Osorio Ruiz, María Estrella; Sánchez Aguilera, Fátima; Toledano, Raquel; Osorio Ruiz, Raquel Objectives: To investigate the effect of dentin infiltration with polymeric nanoparticles (NPs) doped with tideglusib (TDg) (TDg-NPs) on hydroxyapatite formation, crystallinity and elasticity of conditioned resin-dentin interfaces. Methods: Dentin conditioned surfaces were infiltrated with NPs or TDg-NPs. Bonded interfaces were created, stored for 24 h and submitted to mechanical and thermal challenging. Resin-dentin interfaces were evaluated through nanoindentation to determine the modulus of elasticity, X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-filed imaging. Results: TDg-NPs provoked peaks narrowing after the diffraction-intensity analysis that corresponded with high crystallinity, with an increased modulus of Young after load cycling in comparison with the samples treated with undoped NPs. New minerals, in the group of TDg-NPs, showed the greatest both deviation of line profile from perfect crystal diffraction and dimension of the lattice strain, i.e., crystallite, grain size and microstrain and 002 plane-texture. The new minerals generated after TDg-NPs application and mechanical loading followed a well defined lineation. Undoped NPs mostly produced small hydroxyapatite crystallites, non crystalline or amorphous in nature with poor maturity. Conclusions: Tideglusib promoted the precipitation of hydroxyapatite, as a major crystalline phase, at the intrafibrillar compartment of the collagen fibrils, enabling functional mineralization. TDg-NPs facilitated nucleation of crystals randomly oriented, showing less structural variation in angles and distances that improved crystallographic relative order of atoms and maturity. Nanocrystals inducted by TDg-NPs were hexagonal prisms of submicron size. Thermal challenging of dentin treated with TDg-NPs have provoked a decrease of functional mineralization and crystallinity, associated to immature hydroxyapatite. Clinical significance: New polycrystalline lattice formation generated after TDg-NPs infiltration may become correlated with high mechanical performance. This association can be inferred from the superior crystallinity that was obtained in presence of tideglusib. Immature crystallites formed in dentin treated with undoped NPs will account for a high remineralizing activity. The present study was supported by Grant PID2020–114694RB-I00 funded by MCIN/AEI 10.13039/501100011033. This research is part of E. F-R.’s Ph.D. research study. Funding for open access charge: Universidad de Granada / CBUA.

Dexamethasone and zinc loaded polymeric nanoparticles reinforce and remineralize coronal dentin. A morpho-histological and dynamic-biomechanical study.

Dexamethasone and zinc loaded polymeric nanoparticles reinforce and remineralize coronal dentin. A morpho-histological and dynamic-biomechanical study. Toledano, Manuel; Osorio Ruiz, María Estrella; Sánchez Aguilera, Fátima; Osorio Ruiz, María Estrella; Toledano, Raquel; López-López, Modesto T.; Lunch, Christopher D.; Osorio Ruiz, Raquel Objective: To investigate the effect of novel polymeric nanoparticles (NPs) doped with dexamethasone (Dex) on viscoelasticity, crystallinity and ultra-nanostructure of the formed hydroxyapatite after NPs dentin infiltration. Methods: Undoped-NPs, Dex-doped NPs (Dex-NPs) and zinc-doped-Dex-NPs (Zn-Dex-NPs) were tested at dentin, after 24 h and 21 d. A control group without NPs was included. Coronal dentin surfaces were studied by nano-dynamic mechanical analysis measurements, atomic force microscopy, X-ray diffraction and transmission electron microscopy. Mean and standard deviation were analyzed by ANOVA and Student-Newman-Keuls multiple comparisons (p < 0.05). Results: At 21 d of storage time, both groups doped with Dex exhibited the highest complex, storage and loss moduli among groups. Zn-Dex-NPs and Dex-NPs promoted the highest and lowest tan delta values, respectively. Dex-NPs contributed to increase the fibril diameters of dentin collagen over time. Dentin surfaces treated with Zn-Dex-NPs attained the lowest nano-roughness values, provoked the highest crystallinity, and produced the longest and shortest crystallite and grain size. These new crystals organized with randomly oriented lattices. Dex-NPs induced the highest microstrain. Crystalline and amorphous matter was present in the mineral precipitates of all groups, but Zn and Dex loaded NPs helped to increase crystallinity. Significance: Dentin treated with Zn-Dex-NPs improved crystallographic and atomic order, providing structural stability, high mechanical performance and tissue maturation. Amorphous content was also present, so high hydroxyapatite solubility, bioactivity and remineralizing activity due to the high ion-rich environment took place in the infiltrated dentin.

Polymeric zinc-doped nanoparticles for high performance in restorative dentistry

Polymeric zinc-doped nanoparticles for high performance in restorative dentistry Toledano Pérez, Manuel; Vallecillo-Rivas, Marta; Sánchez Aguilera, Fátima; Osorio Ruiz, María Estrella; Osorio Ruiz, Raquel Objectives: The aim was to state the different applications and the effectiveness of polymeric zinc-doped nanoparticles to achieve dentin remineralization. Data, Sources and Study selection: Literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. A narrative exploratory review was undertaken. Conclusions: Polymeric nanospheres (NPs) were efficiently loaded with zinc. NPs sequestered calcium and phosphate in the presence of silicon, and remained effectively embedded at the hybrid layer. NPs incorporation did not alter bond strength and inhibited MMP-mediated dentin collagen degradation. Zn-loaded NPs remineralized the hybrid layer inducing a generalized low-carbonate substitute apatite precipitation, chemically crystalline with some amorphous components, and an increase in mechanical properties was also promoted. Viscoelastic analysis determined that dentin infiltrated with Zn-NPs released the stress by breaking the resin-dentin interface and creating specific mineral formations in response to the energy dissipation. Bacteria were scarcely encountered at the resin-dentin interface. The combined antibacterial and remineralizing effects, when Zn-NPs were applied, reduced biofilm formation. Zn-NPs application at both cervical and radicular dentin attained the lowest microleakage and also promoted durable sealing ability. The new zinc-based salt minerals generated covered the dentin surface totally occluding cracks, porosities and dentinal tubules. Clinical significance: Zinc-doped NPs are proposed for effective dentin remineralization and tubular occlusion. This offers new strategies for regeneration of eroded cervical dentin, effective treatment of dentin hypersensitivity and in endodontically treated teeth previous to the canal filling. Zn-NPs also do reduce biofilm formation due to antibacterial properties.

Polymeric nanoparticles protect the resin-dentin bonded interface from cariogenic biofilm degradation

Polymeric nanoparticles protect the resin-dentin bonded interface from cariogenic biofilm degradation Toledano Osorio, Manuel; Osorio Ruiz, Raquel; Sánchez Aguilera, Fátima; Medina Castillo, Antonio Luis; Toledano Pérez, Manuel; Osorio Ruiz, María Estrella; Acosta, Sergio; Chen, Ruoqiong; Aparicio, Conrado The objective was to assess doxycycline (Dox) and zinc (Zn) doped nanoparticles' (NPs) potential to protect the resin-dentin interface from cariogenic biofilm. Three groups ofpolymeric NPs were tested: unloaded, loaded with zinc and with doxycycline. NPs were appliedafter dentin etching. The disks were exposed to a cariogenic biofilm challenge in a Drip-FlowReactor during 72 h and 7 d. Half of the specimens were not subjected to biofilm formation butstored 72 h and 7 d. LIVE/DEAD® viability assay, nano-dynamic mechanicalassessment, Raman spectroscopy and field emission electron microscopy (FESEM) analysiswere performed. The measured bacterial death rates, at 7 d were 46% for the control group, 51%for the undoped-NPs, 32% for Dox-NPs, and 87% for Zn-NPs; being total detected bacteriareduced five times in the Dox-NPs group. Zn-NPs treated samples reached, in general, thehighest complex modulus values at the resin-dentin interface over time. Regarding the mineralcontent, Zn-NPs-treated dentin interfaces showed the highest mineralization degree associatedto the phosphate peak and the relative mineral concentration. FESEM images after Zn-NPsapplication permitted to observe remineralization of the etched and non-resin infiltratedcollagen layer, and bacteria were scarcely encountered. The combined antibacterial andremineralizing effects, when Zn-NPs were applied, reduced biofilm formation. Dox-NPs exertedan antibacterial role but did not remineralize the bonded interface. Undoped-NPs did notimprove the properties of the interfaces. Application of Zn-doped NPs during the bondingprocedure is encouraged.