Mineralization-inducing potentials of calcium silicate-based pulp capping materials in human dental pulp cells

Abstract

Background: This study was performed to provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs). Methods: Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials. Results: BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05). Conclusion: Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.

Present status and future directions: Hydraulic materials for endodontic use

“…Research undertaken on cement extracts revealed no difference between ProRoot MTA and Biodentine with both groups exhibiting improved mineralization (Manaspon et al, 2021; Paula et al, 2019) whilst other studies reported a greater viability of HDPCs exposed to Biodentine cement extract in comparison with ProRoot MTA after 1 and 3 days (Kang, 2020). After 72 h, Biodentine had a significantly greater number of viable cells compared with MTA Angelus and ProRoot MTA using the Alamar Blue assay.…”

“…However, MTT assay revealed no significant differences in cell viability amongst the three materials and the negative control after 72 h (Poggio et al, 2014), suggesting the specific evaluation methods may also influence the result. Alkaline phosphatase (ALP) activity was lower in cells cultured with Biodentine compared with ProRoot MTA, whilst a similar pattern of mineralization-related gene expressions was observed (Widbiller et al, 2016) and the opposite was observed in another study (Kang, 2020). Both materials upregulated the expression of DSPP at 14 and 21 days (Widbiller et al, 2016).…”

“…The cellular effects for instance viability, proliferation, migration and odontoblastic differentiation are dose-and time-dependent (Collado-González et al, 2017;Giacomino et al, 2019;Tu et al, 2019;Zhu et al, 2014). The inconsistency in the results obtained from different studies (Kang, 2020;Manaspon et al, 2021;Youssef et al, 2019) should be attributed to different methodologies applied. In general, three main approaches have been used, the cells were either cultured directly or indirectly with material discs, or with material extracts obtained from freshly prepared or set cements.…”

“…A higher viability in 3T3 fibroblasts cultured with cement extracts from 24-h set MTA Angelus, NeoMTA Plus and Biodentine cements was observed than that from the fresh cement (Pinheiro et al, 2018). In some studies, the ratio of the surface area of the cement disc to the volume of cement extract was set to 150-600 mm 2 /ml (Collado-González et al, 2017;Manaspon et al, 2021;Omidi et al, 2020;Paula et al, 2019;Tomás-Catalá et al, 2018), this in accordance with the guidelines of the ISO standard 10993-12, whilst in other studies the ratio of the surface area of the cement disc to the volume of cement extract was either not mentioned or varied from 1.96 to 62.8 mm 2 / ml (Kang, 2020;Kim et al, 2015a;Park et al, 2014;Pérard et al, 2013;Pinheiro et al, 2018;Rodrigues et al, 2017;Zhang et al, 2013;Zhu et al, 2014). In addition, the clinical diffusion of the surrounding tissues and blood vessels that refreshes the cement extracts should be taken into consideration when preparing cement extracts.…”

The scientific management of deep carious lesions in vital teeth using contemporary materials—a narrative review

“…When tested in contact with human dental pulp stem cells, to assess cell proliferation, viability mineralization potential and morphology, Biodentine exhibited adequate biological characteristics (133, 134) even when employing advanced cell culture models (135). The cells adhered well to the material surface (136) and the material extracts exhibited cell proliferation and expression as well (137)(138)(139). A calcific bridge was shown in animal studies employing Biodentine as pulp preservation material (140)(141)(142).…”