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Research Article
Comparative evaluation of Emblica officinalis as an etchant and an MMP inhibitor with orthophosphoric acid and chlorhexidine on the microshear bond strength of composite resin: an ex vivo study
Divya Sangeetha Rajkumar, Annapoorna Ballagere Mariswamy
Restor Dent Endod 2021;46(3):e36.   Published online June 8, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e36
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate Emblica officinalis (Indian gooseberry or amla) as an acid etchant and matrix metalloproteinase (MMP) inhibitor, and to compare its effect on the microshear bond strength of composite resin with orthophosphoric acid (OPA) and 2% chlorhexidine (CHX) as an acid etchant and MMP inhibitor, respectively.

Materials and Methods

The etching effect and MMP-inhibiting action of amla on dentin samples were confirmed by scanning electron microscopy (SEM) and gelatin zymography, respectively. Dentinal slabs (3 mm thick) from 80 extracted human molars were divided into 10 and 20 samples to form 2 control groups and 3 experimental groups. Groups 1, 2, and 4 were etched with OPA and groups 3 and 5 with amla juice. An MMP inhibitor was then applied: CHX for group 2 and amla extract for groups 4 and 5. Groups 1 and 3 received no MMP inhibitor. All specimens received a standardized bonding protocol and composite resin build-up, and were subjected to microshear bond strength testing. The force at which the fracture occurred was recorded and statistically analyzed.

Results

Amla juice had a similar etching effect as a self-etch adhesive in SEM and 100% amla extract was found to inhibit MMP-9 by gelatin zymography. The microshear bond strength values of amla were lower than those obtained for OPA and CHX, but the difference was not statistically significant.

Conclusions

Amla has a promising role as an acid etchant and MMP inhibitor, but further studies are necessary to substantiate its efficacy.

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Review Article
Inhibition of matrix metalloproteinases: a troubleshooting for dentin adhesion
Izadora Quintela Souza de Moraes, Ticiano Gomes do Nascimento, Antonio Thomás da Silva, Lilian Maria Santos Silva de Lira, Abhishek Parolia, Isabel Cristina Celerino de Moraes Porto
Restor Dent Endod 2020;45(3):e31.   Published online May 22, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e31
AbstractAbstract PDFPubReaderePub

Matrix metalloproteinases (MMPs) are enzymes that can degrade collagen in hybrid layer and reduce the longevity of adhesive restorations. As scientific understanding of the MMPs has advanced, useful strategies focusing on preventing these enzymes' actions by MMP inhibitors have quickly developed in many medical fields. However, in restorative dentistry, it is still not well established. This paper is an overview of the strategies to inhibit MMPs that can achieve a long-lasting material-tooth adhesion. Literature search was performed comprehensively using the electronic databases: PubMed, ScienceDirect and Scopus including articles from May 2007 to December 2019 and the main search terms were “matrix metalloproteinases”, “collagen”, and “dentin” and “hybrid layer”. MMPs typical structure consists of several distinct domains. MMP inhibitors can be divided into 2 main groups: synthetic (synthetic-peptides, non-peptide molecules and compounds, tetracyclines, metallic ions, and others) and natural bioactive inhibitors mainly flavonoids. Selective inhibitors of MMPs promise to be the future for specific targeting of preventing dentin proteolysis. The knowledge about MMPs functionality should be considered to synthesize drugs capable to efficiently and selectively block MMPs chemical routes targeting their inactivation in order to overcome the current limitations of the therapeutic use of MMPs inhibitors, i.e., easy clinical application and long-lasting effect.

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Research Articles
Biocompatibility of two experimental scaffolds for regenerative endodontics
Dephne Jack Xin Leong, Frank C. Setzer, Martin Trope, Bekir Karabucak
Restor Dent Endod 2016;41(2):98-105.   Published online March 28, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.98
AbstractAbstract PDFPubReaderePub
Objectives

The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated.

Materials and Methods

One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility).

Results

Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01).

Conclusions

The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes.

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The effects of bone morphogenetic protein-2 and enamel matrix derivative on the bioactivity of mineral trioxide aggregate in MC3T3-E1cells
Youngdan Jeong, Wonkyung Yang, Hyunjung Ko, Miri Kim
Restor Dent Endod 2014;39(3):187-194.   Published online June 19, 2014
DOI: https://doi.org/10.5395/rde.2014.39.3.187
AbstractAbstract PDFPubReaderePub
Objectives

The effects of bone morphogenetic protein-2 (BMP-2) and enamel matrix derivative (EMD) respectively with mineral trioxide aggregate (MTA) on hard tissue regeneration have been investigated in previous studies. This study aimed to compare the osteogenic effects of MTA/BMP-2 and MTA/EMD treatment in MC3T3-E1 cells.

Materials and Methods

MC3T3-E1 cells were treated with MTA (ProRoot, Dentsply), BMP-2 (R&D Systems), EMD (Emdogain, Straumann) separately and MTA/BMP-2 or MTA/EMD combination. Mineralization was evaluated by staining the calcium deposits with alkaline phosphatase (ALP, Sigma-Aldrich) and Alizarin red (Sigma-Aldrich). The effects on the osteoblast differentiation were evaluated by the expressions of osteogenic markers, including ALP, bone sialoprotein (BSP), osteocalcin (OCN), osteopontin (OPN) and osteonectin (OSN), as determined by reverse-transcription polymerase chain reaction analysis (RT-PCR, AccuPower PCR, Bioneer).

Results

Mineralization increased in the BMP-2 and MTA/BMP-2 groups and increased to a lesser extent in the MTA/EMD group but appeared to decrease in the MTA-only group based on Alizarin red staining. ALP expression largely decreased in the EMD and MTA/EMD groups based on ALP staining. In the MTA/BMP-2 group, mRNA expression of OPN on day 3 and BSP and OCN on day 7 significantly increased. In the MTA/EMD group, OSN and OCN gene expression significantly increased on day 7, whereas ALP expression decreased on days 3 and 7 (p < 0.05).

Conclusions

These results suggest the MTA/BMP-2 combination promoted more rapid differentiation in MC3T3-E1 cells than did MTA/EMD during the early mineralization period.

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Case Report
Biodentine-a novel dentinal substitute for single visit apexification
Gurudutt Nayak, Mohammad Faiz Hasan
Restor Dent Endod 2014;39(2):120-125.   Published online March 21, 2014
DOI: https://doi.org/10.5395/rde.2014.39.2.120
AbstractAbstract PDFPubReaderePub

Use of an apical plug in management of cases with open apices has gained popularity in recent years. Biodentine, a new calcium silicate-based material has recently been introduced as a dentine substitute, whenever original dentine is damaged. This case report describes single visit apexification in a maxillary central incisor with necrotic pulp and open apex using Biodentine as an apical barrier, and a synthetic collagen material as an internal matrix. Following canal cleaning and shaping, calcium hydroxide was placed as an intracanal medicament for 1 mon. This was followed by placement of small piece of absorbable collagen membrane beyond the root apex to serve as matrix. An apical plug of Biodentine of 5 mm thickness was placed against the matrix using pre-fitted hand pluggers. The remainder of canal was back-filled with thermoplasticized gutta-percha and access cavity was restored with composite resin followed by all-ceramic crown. One year follow-up revealed restored aesthetics and function, absence of clinical signs and symptoms, resolution of periapical rarefaction, and a thin layer of calcific tissue formed apical to the Biodentine barrier. The positive clinical outcome in this case is encouraging for the use of Biodentine as an apical plug in single visit apexification procedures.

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Research Article
Enamel matrix derivative for replanted teeth in animal models: a systematic review and meta-analysis
Sahng G. Kim, Steven I. Ryu
Restor Dent Endod 2013;38(4):194-203.   Published online November 12, 2013
DOI: https://doi.org/10.5395/rde.2013.38.4.194
AbstractAbstract PDFPubReaderePub
Objectives

To investigate the effect of enamel matrix derivative (EMD) on periodontal healing of replanted teeth in animal models.

Materials and Methods

The authors searched MEDLINE, PubMed, EMBASE, Cochrane Library, Web of Knowledge and Scopus for articles published up to Oct 2012. Animal studies in which EMD was applied in transplanted or replanted teeth with adequate controls and histological data were considered. Normal periodontal healing or root resorption determined by histology after EMD was applied in replanted teeth with adequate controls was used as outcome measures. The following search strategy was used: ('Emdogain' OR 'enamel matrix proteins' OR 'enamel matrix derivative') AND ('avulsion' OR 'transplantion' OR 'autotransplantation' OR 'replantation').

Results

Six animal studies were included in the final review. There was great heterogeneity in study design among included studies. Two studies with similar study designs were identified and analyzed by a meta-analysis. The pooled estimates showed a significantly higher normal healing and surface resorption and significantly less inflammatory and replacement resorption in EMD-treated groups compared with non-EMD-treated groups.

Conclusions

With the limitations of this systematic review, the use of EMD led to greater normal periodontal healing and surface root resorption and less inflammatory and replacement root resorption in the presence of periodontal ligaments. However, no definite conclusion could be drawn with regard to the effect of EMD on periodontal healing and root resorption when no periodontal ligaments exist.

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Review Article
Effects of matrix metallproteinases on dentin bonding and strategies to increase durability of dentin adhesion
Jung-Hyun Lee, Juhea Chang, Ho-Hyun Son
Restor Dent Endod 2012;37(1):2-8.   Published online March 2, 2012
DOI: https://doi.org/10.5395/rde.2012.37.1.2
AbstractAbstract PDFPubReaderePub

The limited durability of resin-dentin bonds severely compromises the longevity of composite resin restorations. Resin-dentin bond degradation might occur via degradation of water-rich and resin sparse collagen matrices by host-derived matrix metalloproteinases (MMPs). This review article provides overview of current knowledge of the role of MMPs in dentin matrix degradation and four experimental strategies for extending the longevity of resin-dentin bonds. They include: (1) the use of broad-spectrum inhibitors of MMPs, (2) the use of cross-linking agents for silencing the activities of MMPs, (3) ethanol wet-bonding with hydrophobic resin, (4) biomimetic remineralization of water-filled collagen matrix. A combination of these strategies will be able to overcome the limitations in resin-dentin adhesion.

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Basic Research
The effect of tumor necrosis factor (TNF)-α to induce matrix metalloproteinase (MMPs) from the human dental pulp, gingival, and periodontal ligament cells
Eun-Mi Rhim, Sang-Hyuk Park, Duck-Su Kim, Sun-Young Kim, Kyoung-Kyu Choi, Gi-Woon Choi
J Korean Acad Conserv Dent 2011;36(1):26-36.   Published online January 31, 2011
DOI: https://doi.org/10.5395/JKACD.2011.36.1.26
AbstractAbstract PDFPubReaderePub
Objectives

In the present study, three kinds of tissues cells (pulp, gingiva, and periodontal ligament) were investigated if those cells express MMP and TIMP when they were stimulated with neuropeptides (substance P, CGRP) or proinflammatory cytokine, TNF-α.

Materials and Methods

The cells cultured from human dental pulp (PF), gingiva (GF) and periodontal ligament were (PDLF) stimulated with Mock, SP, TNF-α, and CGRP for 24 hrs and 48 hrs. for an RNase protection assay and Enzyme Linked Immunosorbent Assay.

Cells (PF, GF and PDLF) seeded in 100 mm culture dish were stimulated with SP (10-5, 10-8 M) or only with medium (Mock stimulation) for 4hrs and for 24 hrs for RNase Protection Assay, and they were stimulated with CGRP (10-5 M) and TNF-α (2 ng/mL) for 24 hrs and with various concentraion of TNF-α (2, 10, and 100 ng/mL) for Rnase Protection Assay with a human MMP-1 probe set including MMP 1, 2, 8, 7, 8, 9, 12, and TIMP 2, 3.

In addition, cells (PF, GF and PDLF) were stimulated with Mock and various concentraion of TNF-α (2, 10, and 100 ng/mL) for 24 hrs and with TNF-α (10 ng/mL) for 48 hrs, and the supernatents from the cells were collected for Enzyme Linked Immunosorbent Assay (ELISA) for MMP-1 and MMP-13.

Results

The expression of MMPs in PF, GF, PDLF after stimulation with SP and CGRP were not changed compared with Mock stimulation for 4 hrs and 24 hrs. The expression of MMP-1, -12, -13 24 hrs after stimulation with TNF-α were upregulated, however the expression of TIMP-3 in PF, GF, PDLF after stimulation with TNF-α were downregulated. TNF-α (2 ng/mL, 10 ng/mL, 100 ng/mL) increased MMP-1 and MMP-12 expression in PF dose dependently for 24 hrs.

Conclusions

TNF-α in the area of inflammation may play an important role in regulating the remodeling of dentin, cementum, and alveolar bone.

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Original Article
Tissue engineering of dental pulp on type I collagen
Gwang-Hee Lee, Sung-Yoon Huh, Sang-Hyuk Park
J Korean Acad Conserv Dent 2004;29(4):370-377.   Published online July 31, 2004
DOI: https://doi.org/10.5395/JKACD.2004.29.4.370
AbstractAbstract PDFPubReaderePub

The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 (1 × 105 cells/ml/well) were cultured at 12-well plate at 37℃ for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin.

According to this study, the results were as follows:

1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05).

2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days.

3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively).

4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05).

5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels.

This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.

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