Biocompatibility, bioactivity and immunomodulatory properties of three calcium silicate-based sealers: an in vitro study on hPDLSCs

  1. Mora, Alejandro 1
  2. García-Bernal, David 1
  3. Rodríguez-Lozano, Francisco Javier 1
  4. Sanz, José Luis
  5. Forner, Leopoldo
  6. Ghilotti, James
  7. Lozano, Adrián
  8. López-García, Sergio 1
  1. 1 Universidad de Murcia
    info

    Universidad de Murcia

    Murcia, España

    ROR https://ror.org/03p3aeb86

Revista:
Clinical Oral Investigations

ISSN: 1436-3771

Any de publicació: 2024

Volum: 28

Número: 8

Tipus: Article

DOI: 10.1007/S00784-024-05812-1 GOOGLE SCHOLAR lock_openAccés obert editor

Altres publicacions en: Clinical Oral Investigations

Resum

Objectives To assess the biocompatibility, bioactivity, and immunomodulatory properties of three new calcium silicatecement-based sealers: Ceraseal (CS), Totalfill BC Sealer (TFbc) and WellRoot ST (WR-ST) on human periodontal ligamentstem cells (hPDLSCs).Materials and methods HPDLSCs were isolated from extracted third molars from healthy patients. Eluates (1:1, 1:2, and 1:4ratio) and sample discs of CS, TFbc and WR-ST after setting were prepared. A series of assays were performed: cell characterization, cell metabolic activity (MTT assay) cell attachment and morphology (SEM assay), cell migration (wound-healingassay), cytoskeleton organization (phaloidin-based assay); IL-6 and IL-8 release (ELISA); differentiation marker expression(RT-qPCR assay), and cell mineralization (Alizarin Red S staining). HPDLSCs cultured in unconditioned (negative control)or osteogenic (positive control) culture media were used as a comparison. Statistical significance was established at p<0.05.Results All the tested sealers exhibited similar results in the cytocompatibility assays (cell metabolic activity, migration,attachment, morphology, and cytoskeleton organization) compared with a negative control group. CS and TFbc exhibited anupregulation of at least one osteo/cementogenic marker compared to the negative and positive control groups. CS and TFbcalso showed a significantly higher calcified nodule formation than the negative and positive control groups. Both the markerexpression and calcified nodule formation were significantly higher in CS-treated cells than TFbc treated cells. WR-STexhibited similar results to the control group. CS and TFbc-treated cells exhibited a significant downregulation of IL-6 after72 h of culture compared to the negative control group (p<0.05).Conclusion All the tested sealers exhibited an adequate cytocompatibility. CS significantly enhances cell differentiation byupregulating the expression of key genes associated with bone and cementum formation. Additionally, CS was observedto facilitate the mineralization of the extracellular matrix effectively. In contrast, the effects of TFbc and WR-ST on theseprocesses were less pronounced compared to CS. Furthermore, both CS and TFbc exhibited an anti-inflammatory potential,contributing to their potential therapeutic benefits in regenerative endodontics.Clinical relevance This is the first study to compare the biological properties and immunomodulatory potential of Ceraseal,Totalfill BC Sealer, and WellRoot ST. The results act as supporting evidence for their use in root canal treatment.

€ Mostra el finançament

Informació de finançament

Finançadors

  • Universitat de Valencia

Referències bibliogràfiques

  • Miteva M, Mihaylova Z, Mitev V, Aleksiev E, Stanimirov P, Praskova M et al (2024) A review of Stem Cell attributes derived from the oral cavity. Int Dent J. https://doi.org/10.1016/j.identj.2024.03.008
  • Yang F, Zhang R, Xu J, Du J, Leng S, Zhang L et al (2022) Comparative effects of concentrated growth factors on the Biological Characteristics of Periodontal Ligament Cells and stem cells from Apical Papilla. J Endod 48(8):1029–1037. https://doi.org/10.1016/j.joen.2022.05.001
  • Sanz JL, Lopez-Garcia S, Rodriguez-Lozano FJ, Melo M, Lozano A, Llena C et al (2022) Cytocompatibility and bioactive potential of AH Plus Bioceramic Sealer: an in vitro study. Int Endod J 55(10):1066–1080. https://doi.org/10.1111/iej.13805
  • Raman V, Camilleri J (2024) Characterization and Assessment of Physical Properties of 3 Single Syringe Hydraulic Cement-based Sealers. J Endod 50(3):381–388. https://doi.org/10.1016/j.joen.2024.01.001
  • Cardinali F, Camilleri J (2023) A critical review of the material properties guiding the clinician’s choice of root canal sealers. Clin Oral Investig 27(8):4147–4155. https://doi.org/10.1007/s00784-023-05140-w
  • Lozano-Guillen A, Lopez-Garcia S, Rodriguez-Lozano FJ, Sanz JL, Lozano A, Llena C et al (2022) Comparative cytocompatibility of the new calcium silicate-based cement NeoPutty versus NeoMTA plus and MTA on human dental pulp cells: an in vitro study. Clin Oral Investig 26(12):7219–7228. https://doi.org/10.1007/s00784-022-04682-9
  • Castro-Jara S, Antilef B, Osben C, Alcantara R, Fraga M, Nova-Lamperti E et al (2023) Bioactivity analysis of calcium silicate-based sealers and repair cements on the phenotype and cytokine secretion profile of CD14(+) monocytes: an ex vivo study. Int Endod J 56(1):80–91. https://doi.org/10.1111/iej.13847
  • Bhandari SS, Palin W, Kuehne SA, Camilleri J (2023) Investigating best practice for specimen preparation for biological testing of root canal sealers. Dent Mater. https://doi.org/10.1016/j.dental.2023.12.001
  • International Organization for Standardization (ISO) (2009) Biological evaluation of medical devices. Part 5. Test for in vitro cytotoxicity
  • Rodriguez-Lozano FJ, Lozano A, Lopez-Garcia S, Garcia-Bernal D, Sanz JL, Guerrero-Girones J et al (2021) Biomineralization potential and biological properties of a new tantalum oxide (Ta2O5)-containing calcium silicate cement. Clin Oral Investig. https://doi.org/10.1007/s00784-021-04117-x
  • Lopez-Garcia S, Rodriguez-Lozano FJ, Sanz JL, Forner L, Pecci-Lloret MP, Lozano A et al (2023) Biological properties of Ceraputty as a retrograde filling material: an in vitro study on hPDLSCs. Clin Oral Investig 27(8):4233–4243. https://doi.org/10.1007/s00784-023-05040-z
  • Pedano MS, Li X, Li S, Sun Z, Cokic SM, Putzeys E et al (2018) Freshly-mixed and setting calcium-silicate cements stimulate human dental pulp cells. Dent Mater 34(5):797–808. https://doi.org/10.1016/j.dental.2018.02.005
  • Pedano MS, Li X, Yoshihara K, Landuyt KV, Van Meerbeek B (2020) Cytotoxicity and bioactivity of Dental Pulp-Capping agents towards human tooth-pulp cells: a systematic review of In-Vitro studies and Meta-Analysis of Randomized and controlled clinical trials. Mater (Basel) 13(12). https://doi.org/10.3390/ma13122670
  • Lopez-Garcia S, Pecci-Lloret MR, Guerrero-Girones J, Pecci-Lloret MP, Lozano A, Llena C et al (2019) Comparative cytocompatibility and mineralization potential of Bio-C Sealer and TotalFill BC Sealer. Mater (Basel) 12(19). https://doi.org/10.3390/ma12193087
  • Collado-Gonzalez M, Garcia-Bernal D, Onate-Sanchez RE, Ortolani-Seltenerich PS, Alvarez-Muro T, Lozano A et al (2017) Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth. Int Endod J 50:E19–E30. https://doi.org/10.1111/iej.12751
  • Tatullo M, Piattelli A, Ruggiero R, Marano RM, Iaculli F, Rengo C et al (2024) Functionalized magnesium alloys obtained by superplastic forming process retain osteoinductive and antibacterial properties: an in-vitro study. Dent Mater 40(3):557–562. https://doi.org/10.1016/j.dental.2024.01.005
  • Bueno CRE, Benetti F, Cury MTS, Vasques AMV, Cosme-Silva L, Queiroz IOA et al (2023) Biological investigation of resinous endodontic sealers containing calcium hydroxide. PLoS ONE 18(7):e0287890. https://doi.org/10.1371/journal.pone.0287890
  • de Almeida-Junior LA, de Campos Chaves Lamarque G, Herrera H, Arnez MFM, Lorencetti-Silva F, Silva RAB et al (2024) Analysis of the cytotoxicity and bioactivity of CeraSeal, BioRoot and AH Plus((R)) sealers in pre-osteoblast lineage cells. BMC Oral Health 24(1):262. https://doi.org/10.1186/s12903-024-04021-2
  • Kumar A, Kour S, Kaul S, Malik A, Dhani R, Kaul R (2023) Cytotoxicity evaluation of Bio-C, CeraSeal, MTA - fillapex, and AH Plus root canal sealers by microscopic and 3-(4, 5 dimethythiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. J Conserv Dent 26(1):73–78. https://doi.org/10.4103/jcd.jcd_320_22
  • Nguyen LCH, Pham LNG, Van Pham K, Nguyen MD, Ngo LTQ (2023) Cytocompatibility and cell migration evaluation of calcium silicate-based root canal sealer compared to epoxide-amine resin sealer in stem cells from human apical papilla: an in-vitro study. Aust Endod J. https://doi.org/10.1111/aej.12786
  • Sanz JL, Soler-Doria A, Lopez-Garcia S, Garcia-Bernal D, Rodriguez-Lozano FJ, Lozano A et al (2021) Comparative biological properties and mineralization potential of three endodontic materials for vital pulp therapy: Theracal PT, theracal LC, and Biodentine on human dental pulp stem cells (hDPSCs). J Endod. https://doi.org/10.1016/j.joen.2021.08.001
  • Lopez-Garcia S, Myong-Hyun B, Lozano A, Garcia-Bernal D, Forner L, Llena C et al (2020) Cytocompatibility, bioactivity potential, and ion release of three premixed calcium silicate-based sealers. Clin Oral Investig 24(5):1749–1759. https://doi.org/10.1007/s00784-019-03036-2
  • Rohr N, Bergemann C, Nebe JB, Fischer J (2020) Crystal structure of zirconia affects osteoblast behavior. Dent Mater 36(7):905–913. https://doi.org/10.1016/j.dental.2020.04.017
  • Zamparini F, Prati C, Taddei P, Spinelli A, Di Foggia M, Gandolfi MG (2022) Chemical-Physical properties and Bioactivity of New Premixed Calcium Silicate-Bioceramic Root Canal Sealers. Int J Mol Sci 23(22). https://doi.org/10.3390/ijms232213914
  • Zamparini F, Spinelli A, Cardinali F, Ausiello P, Gandolfi MG, Prati C (2023) The Use of Premixed Calcium Silicate Bioceramic Sealer with warm carrier-based technique: a 2-Year study for patients treated in a Master Program. J Funct Biomater 14(3). https://doi.org/10.3390/jfb14030164
  • Santos JM, Coelho CM, Sequeira DB, Marques JA, Pereira JF, Sousa V et al (2021) Subcutaneous Implantation Assessment of New Calcium-Silicate based sealer for warm obturation. Biomedicines 9(1). https://doi.org/10.3390/biomedicines9010024
  • Diomede F, Caputi S, Merciaro I, Frisone S, D’Arcangelo C, Piattelli A et al (2014) Pro-inflammatory cytokine release and cell growth inhibition in primary human oral cells after exposure to endodontic sealer. Int Endod J 47(9):864–872. https://doi.org/10.1111/iej.12230
  • Alchawoosh A, Hashimoto K, Kawashima N, Noda S, Nozaki K, Okiji T (2023) Hydraulic calcium silicate-based root canal sealers mitigate proinflammatory cytokine synthesis and promote osteogenesis in vitro. J Dent Sci 18(4):1731–1739. https://doi.org/10.1016/j.jds.2022.12.019
  • Malta CP, Barcelos RCS, Fernandes PS, Martins MO, Sagrillo MR, Bier CAS et al (2024) In silico toxicity and immunological interactions of components of calcium silicate-based and epoxy resin-based endodontic sealers. Clin Oral Investig 28(2):148. https://doi.org/10.1007/s00784-024-05548-y
  • Rodriguez-Lozano FJ, Collado-Gonzalez M, Tomas-Catala CJ, Garcia-Bernal D, Lopez S, Onate-Sanchez RE et al (2019) GuttaFlow Bioseal promotes spontaneous differentiation of human periodontal ligament stem cells into cementoblast-like cells. Dent Mater 35(1):114–124. https://doi.org/10.1016/j.dental.2018.11.003
  • Rodriguez-Lozano FJ, Lopez-Garcia S, Garcia-Bernal D, Tomas-Catala CJ, Santos JM, Llena C et al (2020) Chemical composition and bioactivity potential of the new Endosequence BC Sealer formulation HiFlow. Int Endod J 53(9):1216–1228. https://doi.org/10.1111/iej.13327
  • Yan Y, Li Y, Chi Y, Ji M, Shen Y, Zou L (2023) A comparative study of biological properties of three root canal sealers. Clin Oral Investig 28(1):11. https://doi.org/10.1007/s00784-023-05402-7
  • Li J, Zhang F, Zhang N, Geng X, Meng C, Wang X et al (2019) Osteogenic capacity and cytotherapeutic potential of periodontal ligament cells for periodontal regeneration in vitro and in vivo. PeerJ 7:e6589. https://doi.org/10.7717/peerj.6589
  • Sanz JL, Guerrero-Gironés J, Pecci‐Lloret MP, Pecci‐Lloret MR, Melo M (2021) Biological interactions between calcium silicate‐based endodontic biomaterials and periodontal ligament stem cells: a systematic review of in vitro studies. Int Endod J 54(11):2025–2043. https://doi.org/10.1111/iej.13600
  • González-Pita Lina C, Katherine V-SP (2023) Bombonato-Prado Karina Fittipaldi, Delgado-Mejía Edgar, Torres-Rodríguez Carolina. Response of non-differentiated pulp cells (OD-21) to a novel bioceramic for dental pulp capping. G Ital Endod 37(1):28–36. https://doi.org/10.32067/GIE.2023.37.01.12
  • Elkhashab Rana A, Mahran Abeer H, Mahmoud B, Abu-Seida Ashraf M (2024) Histopathology and immunohistochemical reactions of Nano-White MTA vs. NeoMTATM Plus® and MTA Angelus® as immediate furcation perforation repair materials in a dog model. G Ital Endod 38(1):16–27. https://doi.org/10.32067/GIE.2023.37.01.27
  • Ameghani B, Aghamohammadi T, Azin TM, Hasani V, Sara (2021) Effects of mineral trioxide aggregate and platelet-rich fibrin on histological results of direct pulp capping in dogs. G Ital Endod 35(1):13–22. https://doi.org/10.32067/GIE.2021.35.01.01