New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and ¼ dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the ¼ dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials’ cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

In rats, an alcoholic diet had a significant effect on the severity of apical periodontitis, exacerbating the inflammatory response and osteoclastogenesis.

Bioactive molecules stored in dentin, such as transforming growth factor beta1 (TGF-b1), may be involved in the signaling events related to dental tissue repair. The authors conducted an in vitro evaluation of the amount of TGF-b1 released from dentin slices after treatment with 10% ethylenediaminetetraacetic acid (EDTA), 2.5% sodium hypochlorite (NaOCl) or phosphate-buffered saline (PBS), and the effect of this growth factor on stem cell migration from human exfoliated deciduous teeth (SHED). Sixty 1-mm-thick tooth slices were prepared with or without the predentin layer, and treated with either 10% EDTA for 1 minute, 2.5% NaOCl for 5 days or kept in PBS. Tooth slice conditioned media were prepared and used for TGF-b1 ELISA and migration assays. Culture medium with different concentrations of recombinant human TGF-b1 (0.5, 1.0, 5.0 or 10.0 ng/mL) was also tested by migration assay. The data were evaluated by ANOVA and Tukey's test. Optical density values corresponding to media conditioned by tooth slices either containing or not containing the predentin layer and treated with 10% EDTA were statistically greater than the other groups and close to 1 ng/mL. Increased rates of migration toward media conditioned by tooth slices containing the predentin layer and treated with PBS, 10% EDTA or 2.5% NaOCl were observed. Recombinant human TGF-b1 also stimulated migration of SHED, irrespective of the concentration used. EDTA may be considered an effective extractant of TGF-b1 from the dentin matrix. However, it does not impact SHED migration, suggesting that other components may account for the cell migration.

Aim To evaluate the inflammatory response and ability to induce mineral deposition through histological and immunohistochemical analysis for osteocalcin (OCN), osteopontin (OPN) and bone sialoprotein (BSP) of a new calcium silicate‐based cement, Bio‐C Pulpo (Angelus), compared to white mineral trioxide aggregate (White MTA‐Ang) (Angelus). Methodology Polyethylene tubes containing Bio‐C Pulpo and White MTA‐Ang as well as empty tubes were implanted into the dorsal connective tissue of 30 Wistar rats, which were arranged in five groups according to the period of analysis: 7, 15, 30, 60 and 90 days. After each experimental period, the tubes with surrounding tissue were removed and histologically processed to be analysed using haematoxylin–eosin and immunohistochemistry for the detection of OCN, OPN and BSP. The data were statistically analysed (Friedman's test) at a 5% significance level. Results The inflammatory response observed with Bio‐C Pulpo and White MTA‐Ang was greater after 7 and 15 days and decreased from 30 days onwards. No significant difference was found between the control, Bio‐C Pulpo and White MTA‐Ang at the different periods of analysis (P > 0.05). The immunolabelling for OCN, OPN and BSP was more intense for Bio‐C Pulpo and White MTA‐Ang after 60 and 90 days, but there was no difference between Bio‐C Pulpo and White MTA‐Ang at the different periods of analysis (P > 0.05). Conclusion Bio‐C Pulpo is biocompatible and induces immunolabelling of osteogenic markers such as OCN, OPN and BSP similar to White MTA‐Ang.

Aim To evaluate the effect of systemic administration of probiotics on the severity of apical periodontitis (AP). Methodology Twenty‐four male Wistar rats were used. AP was induced in the maxillary left/right first molars. The animals were arranged into groups: Control, Lactobacillus rhamnosus, and Lactobacillus acidophilus. Probiotics were administered orally for gavage (109 colony‐forming units diluted in 5 mL of water for 30 days) during the development of AP. After 30 days, cardiac puncture was performed to analyse the complete blood count. Moreover, microbiological analysis of the root canal contents and saliva was performed. Then, the animals were euthanized and the jaw removed for histopathological and IL‐10, IL‐1β and IL‐6 immunolabeling analyses. After the Shapiro–Wilk test of normality, the Kruskal–Wallis followed by Dunn's test was performed for nonparametric data, and analysis of variance followed by the Tukey test was performed for parametric data (P < 0.05). Results No significance difference was observed in the blood profiles and in the counts of microorganisms from the saliva samples among the groups (P > 0.05). Total microorganism counts in the root canal, the inflammatory infiltrate and the immunostaining for IL‐1β and IL‐6 in AP were significantly lower in the probiotic groups when compared with the control group (P < 0.05). IL‐10 was significantly more immunolabled in the probiotic groups than in the control group (P < 0.05). Conclusion Supplementation with probiotics (Lactobacillus rhamnosus and Lactobacillus acidophilus) had a significant effect on the severity of apical periodontitis in rats, demonstrating the anti‐inflammatory effect of probiotics on the development of apical periodontitis.

ObjectiveThe aim of the study was to evaluate the effects of the capping materials mineral trioxide aggregate (MTA), calcium hydroxide (CH) and BiodentineTM (BD) on stem cells from human exfoliated deciduous teeth (SHED) in vitro. Material and MethodsSHED were cultured for 1 – 7 days in medium conditioned by incubation with MTA, BD or CH (1 mg/mL), and tested for viability (MTT assay) and proliferation (SRB assay). Also, the migration of serum-starved SHED towards conditioned media was assayed in companion plates, with 8 μm-pore-sized membranes, for 24 h. Gene expression of dentin matrix protein-1 (DMP-1) was evaluated by reverse-transcription polymerase chain reaction. Regular culture medium with 10% FBS (without conditioning) and culture medium supplemented with 20% FBS were used as controls.ResultsMTA, CH and BD conditioned media maintained cell viability and allowed continuous SHED proliferation, with CH conditioned medium causing the highest positive effect on proliferation at the end of the treatment period (compared with BD and MTA) (p<0.05). In contrast, we observed increased SHED migration towards BD and MTA conditioned media (compared with CH) (p<0.05). A greater amount of DMP-1 gene was expressed in MTA group compared with the other groups from day 7 up to day 21.ConclusionOur results show that the three capping materials are biocompatible, maintain viability and stimulate proliferation, migration and differentiation in a key dental stem cell population.

AimTo evaluate the relationship between systemic administration of probiotics and inflammation/resorption processes associated with apical periodontitis (AP) in a rat model.MethodologyTwenty‐four male Wistar rats were used. AP was induced in the mandibular left/right first molars. The animals were arranged into three groups: Control, Lactobacillus rhamnosus and L. acidophilus. Probiotics were orally administered via gavage (109 colony‐forming units (CFU) diluted in 5 mL of water) for 30 days during the development of AP. On the 30th day, blood was collected to analyse the calcium, phosphorus and alkaline phosphatase concentrations in plasma. Then, the animals were euthanized and the jaws removed for micro‐computed tomography and immune‐histopathological analysis for receptor activator of NF‐κB ligand (RANKL), osteoprotegerin (OPG) and tartrate‐resistant acid phosphatase (TRAP). After the Shapiro–Wilk test of normality, the Kruskal–Wallis followed by Dunn’s test was performed for nonparametric data, and analysis of variance followed by the Tukey test was performed for parametric data (P < 0.05).ResultsThere was no significant difference in the calcium and phosphorus levels in plasma amongst the groups (P > 0.05). The level of alkaline phosphatase was significantly higher in the groups that consumed probiotics (P < 0.05). A significantly lower volume of bone resorption was observed in groups that consumed probiotics (P < 0.05). The inflammatory infiltrates and the immunolabelling for RANKL and TRAP were significantly lower in probiotic groups when compared to the control (P < 0.05). Also, the OPG was significantly more immunolabelled in the L. acidophilus group than in the L. rhamnosus and control groups (P < 0.05).ConclusionProbiotic supplementation through gavage (L. rhamnosus and L. acidophilus) had a significant effect on the reduction of inflammation and bone resorption in apical periodontitis development in rats.

The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue.