Oroactive dental biomaterials and their use in endodontic therapy

Abstract

Dental biomaterials have revolutionized modern therapies. Untreated dental caries remains the major etiological factor for endodontic treatment, and together with a decreasing rate of tooth loss escalates the importance of continuously improving the materials used for endodontic therapies. Endodontic biomaterials are used for vital pulp therapies, irrigation, intracanal medicaments, obturation and regenerative procedures. These materials offer several functions including: antimicrobial activity, mechanical reinforcement, aesthetics, and therapeutic effects. Vital pulp therapies have seen an improvement in clinical results with an incremental approach to build on the strengths of past materials such as calcium hydroxide and calcium silicates. While sodium hypochlorite remains the gold standard for canal irrigation, numerous nanoparticle formulations have been developed to promote sustained antimicrobial action. Gutta‐percha based bulk fillers remain the most common materials for root filling. However, while multiple studies focus on the development of novel formulations containing drugs, glass derivatives or ionic‐, polymeric‐, or drug‐ loaded nanoparticles, a lack of reliable and long‐term clinical evidence obligates further study as experienced clinicians prefer to use what has worked for decades. This review delves in to the biochemistry of the materials to scrutinize their shortcomings, and where opportunity lies to further enhance their efficacy in endodontic practice. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:201–212, 2020.

Evaluation of dentinogenesis inducer biomaterials: an in vivo study

“…This process involves progenitor cells migration to the lesion site and subsequent proliferation and differentiation of these cells into odontoblasts. Thus, when the dental pulp tissue is exposed to the external environment, reparative dentinogenesis can be induced by pulp capping, to maintain pulp tissue vitality and function 1 – 4 …”

“…Some characteristics are common to most biomaterials indicated for therapeutics, protecting the pulp tissue vitality and which induce reparative dentin. These characteristics include high pH, antimicrobial activity and release of calcium ions 4 , 7 – 10 …”

Current Overview of Remineralization Materials and Technologies

“…22,23 Araştırmacılar bioaktif camın diş hekimliğinde kullanım alanları ilgili çalışmalar yapmıştır. Bu çalışmalar sonucunda kemikte rejenerasyonu ve yeni ataçman sağlayabileceği için periodontolojide 24 , kemik ve bazı durumlarda yumuşak dokuya kimyasal bağlanabilme özelliğinden dolayı implantolojide 25 , çürük etkeni olan patojenler üzerindeki anlamlı antibakteriyel etkinliği ve biyoinert olması nedeniyle restoratif diş tedavisi ve endodontide 26 , dentin tübüllerindeki sıvı ile reaksiyona girerek mineralizasyonu uyardığı ve doğal bir tıkama oluşturabileceği için dentin hassasiyeti tedavisinde, pulpa histolojisini iyileştirebildiği 24 ve mineralizasyonu uyardığı için kuafaj tedavisinde 22 kullanabileceği bildirilmiştir. Biyoaktif camların ostekondüktif olmaları ve apatit tabakası oluşturarak kemik dokuya kimyasal bağlanabilme yeteneği nedeniyle mine ve dentin yüzeylerinde mineralizasyon ajanı olarak kullanılabileceği düşünülmektedir.…”

Tooth Formation: Are the Hardest Tissues of Human Body Hard to Regenerate?

“…In contrast to periodontal bone and other bone grafts, where numerous scaffold compounds have been developed and tested within the last decade [59][60][61][62][63][64], studies on artificial scaffolds for tooth regeneration are still rare due to the rather complex nature of teeth [14,65]. Recent studies in biomaterial development involve hybrids and composites of inorganic/organic components to be used as scaffolds to mimic the complex composition of the natural tooth [55,58,66]. New investigations have shown also that the functionalization of scaffolds using cell-free methods is possible.…”