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Novel evaluation method of dentin repair by direct pulp capping using high-resolution micro-computed tomography

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Abstract

Objectives

We evaluated a novel micro-computed tomography (micro-CT) assessment for quality and quantity of dentin repair, which is difficult to visualize by histological analysis, after direct pulp capping under standardized cavity preparation.

Materials and methods

Standardized cavities were prepared on Wistar rats and direct pulp capping was performed using two commercial bioceramics, ProRoot MTA, and iRoot BP Plus. After 2 or 4 weeks, quality and quantity of tertiary dentin formation were evaluated using high-resolution micro-CT analyses including dentin mineral density, dentin mineral contents, compactness and integrity of tertiary dentin, and dentin volume with/without void space. Reproducibility of micro-CT analyses was confirmed by histological evaluation of the same specimen.

Results

The exposed pulp area sizes were similar between iRoot BP Plus and ProRoot MTA. Micro-CT analysis of 2-week samples showing compactness of tertiary dentin was significantly higher in iRoot BP Plus than ProRoot MTA (p < 0.05). Tertiary dentin volume without void space, dentin mineral contents, and density were not significantly different between the groups. In 4-week samples, a significant increase was observed in dentin mineral density, compactness, and dentin volume with/without void space induced by iRoot BP Plus (p < 0.05). Micro-CT analysis of tertiary dentin integrity demonstrated that some ProRoot MTA specimens had small defects and lacked continuity (6/512 images). No defects were observed with iRoot BP Plus.

Conclusions

Micro-CT analysis was confirmed as an accurate, objective, and inclusive approach for evaluating quality and quantity of dentin repair.

Clinical relevance

These multifaceted approaches to evaluate pulp capping materials may accelerate review processes, ultimately improving vital pulp therapy.

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References

  1. Takita T, Hayashi M, Takeichi O, Ogiso B, Suzuki N, Otsuka K, Ito K (2006) Effect of mineral trioxide aggregate on proliferation of cultured human dental pulp cells. Int Endod J 39(5):415–422. https://doi.org/10.1111/j.1365-2591.2006.01097.x

    Article  PubMed  Google Scholar 

  2. Iohara K, Nakashima M, Ito M, Ishikawa M, Nakasima A, Akamine A (2004) Dentin regeneration by dental pulp stem cell therapy with recombinant human bone morphogenetic protein 2. J Dent Res 83(8):590–595. https://doi.org/10.1177/154405910408300802

    Article  PubMed  Google Scholar 

  3. Ominsky MS, Boyd SK, Varela A, Jolette J, Felx M, Doyle N, Mellal N, Smith SY, Locher K, Buntich S, Pyrah I, Boyce RW (2017) Romosozumab improves bone mass and strength while maintaining bone quality in ovariectomized cynomolgus monkeys. J Bone Miner Res 32(4):788–801. https://doi.org/10.1002/jbmr.3036

    Article  PubMed  Google Scholar 

  4. Chen X, Wang C, Zhang K, Xie Y, Ji X, Huang H, Yu X (2016) Reduced femoral bone mass in both diet-induced and genetic hyperlipidemia mice. Bone 93:104–112. https://doi.org/10.1016/j.bone.2016.09.016

    Article  PubMed  Google Scholar 

  5. Ishimoto K, Hayano S, Yanagita T, Kurosaka H, Kawanabe N, Itoh S, Ono M, Kuboki T, Kamioka H, Yamashiro T (2015) Topical application of lithium chloride on the pulp induces dentin regeneration. PLoS One 10(3):e0121938. https://doi.org/10.1371/journal.pone.0121938

    Article  PubMed  PubMed Central  Google Scholar 

  6. Al-Hezaimi K, Salameh Z, Al-Fouzan K et al (2011) Histomorphometric and micro-computed tomography analysis of pulpal response to three different pulp capping materials. J Endod 37(4):507–512. https://doi.org/10.1016/j.joen.2010.11.001

    Article  PubMed  Google Scholar 

  7. Lee W, Oh JH, Park JC, Shin HI, Baek JH, Ryoo HM, Woo KM (2012) Performance of electrospun poly(ε-caprolactone) fiber meshes used with mineral trioxide aggregates in a pulp capping procedure. Acta Biomater 8(8):2986–2995. https://doi.org/10.1016/j.actbio.2012.04.032

    Article  PubMed  Google Scholar 

  8. Queiroz AM, Assed S, Leonardo MR et al (2005) MTA and calcium hydroxide for pulp capping. J Appl Oral Sci 13(2):126–130. https://doi.org/10.1590/S1678-77572005000200006

    Article  PubMed  Google Scholar 

  9. Iwamoto CE, Adachi E, Pameijer CH, Barnes D, Romberg EE, Jefferies S (2006) Clinical and histological evaluation of white ProRoot MTA in direct pulp capping. Am J Dent 19(2):85–90

    PubMed  Google Scholar 

  10. De Souza Costa CA, Duarte PT, de Souza PP et al (2008) Cytotoxic effects and pulpal response caused by a mineral trioxide aggregate formulation and calcium hydroxide. Am J Dent 21(4):255–261

    PubMed  Google Scholar 

  11. Min KS, Park HJ, Lee SK, Park SH, Hong CU, Kim HW, Lee HH, Kim EC (2008) Effect of mineral trioxide aggregate on dentin bridge formation and expression of dentin sialoprotein and heme-oxygenase-1 in human dental pulp. J Endod 34(6):666–670. https://doi.org/10.1016/j.joen.2008.03.009

    Article  PubMed  Google Scholar 

  12. Paranjpe A, Smoot T, Zhang H, Johnson JD (2011) Direct contact with mineral trioxide aggregate activates and differentiates human dental pulp cells. J Endod 37(12):1691–1695. https://doi.org/10.1016/j.joen.2011.09.012

    Article  PubMed  PubMed Central  Google Scholar 

  13. Parirokh M, Torabinejad M (2010) Mineral trioxide aggregate: a comprehensive literature review—part III: clinical applications, drawbacks, and mechanism of action. J Endod 36(3):400–413. https://doi.org/10.1016/j.joen.2009.09.009

    Article  PubMed  Google Scholar 

  14. Mitsiadis TA, Woloszyk A, Jiménez-Rojo L (2012) Nanodentistry: combining nanostructured materials and stem cells for dental tissue regeneration. Nanomedicine 7(11):1743–1753. https://doi.org/10.2217/nnm.12.146

    Article  PubMed  Google Scholar 

  15. De-Deus G, Canabarro A, Alves GG et al (2012) Cytocompatibility of the ready-to-use bioceramic putty repair cement iRoot BP plus with primary human osteoblasts. Int Endod J 45(6):508–513. https://doi.org/10.1111/j.1365-2591.2011.02003.x

    Article  PubMed  Google Scholar 

  16. Zhou W, Zheng Q, Tan X, Song D, Zhang L, Huang D (2017) Comparison of mineral trioxide aggregate and iRoot BP plus root repair material as root-end filling materials in endodontic microsurgery: a prospective randomized controlled study. J Endod 43(1):1–6. https://doi.org/10.1016/j.joen.2016.10.010

    Article  PubMed  Google Scholar 

  17. Leal F, De-Deus G, Brandão C et al (2013) Similar sealability between bioceramic putty ready-to-use repair cement and white MTA. Braz Dent J 24(4):362–366. https://doi.org/10.1590/0103-6440201302051

    Article  PubMed  Google Scholar 

  18. Damlar I, Ozcan E, Yula E et al (2014) Antimicrobial effects of several calcium silicate-based root-end filling materials. Dent Mater J 33(4):453–457. https://doi.org/10.4012/dmj.2013-250

    Article  PubMed  Google Scholar 

  19. Zhang J, Zhu LX, Cheng X, Lin Y, Yan P, Peng B (2015) Promotion of dental pulp cell migration and pulp repair by a bioceramic putty involving FGFR-mediated signaling pathways. J Dent Res 94(6):853–862. https://doi.org/10.1177/0022034515572020

    Article  PubMed  Google Scholar 

  20. Stanley HR (1989) Pulp capping: conserving the dental pulp—can it be done? Is it worth it? Oral Surg Oral Med Oral Pathol 68(5):628–639. https://doi.org/10.1016/0030-4220(89)90252-1

    Article  PubMed  Google Scholar 

  21. Lin HP, Tu HP, Hsieh YP, Lee BS (2017) Controlled release of lovastatin from poly(lactic-co-glycolic acid) nanoparticles for direct pulp capping in rat teeth. Int J Nanomedicine 12:5473–5485. https://doi.org/10.2147/IJN.S138410

    Article  PubMed  PubMed Central  Google Scholar 

  22. Suzuki M, Taira Y, Kato C, Shinkai K, Katoh Y (2016) Histological evaluation of direct pulp capping of rat pulp with experimentally developed low-viscosity adhesives containing reparative dentin-promoting agents. J Dent 44:27–36. https://doi.org/10.1016/j.jdent.2015.11.005

    Article  PubMed  Google Scholar 

  23. Costa CA, Oliveira MF, Giro EM et al (2003) Biocompatibility of resin-based materials used as pulp-capping agents. Int Endod J 36(12):831–839. https://doi.org/10.1111/j.1365-2591.2003.00702.x

    Article  PubMed  Google Scholar 

  24. Chang SW, Lee SY, Ann HJ, Kum KY, Kim EC (2014) Effects of calcium silicate endodontic cements on biocompatibility and mineralization-inducing potentials in human dental pulp cells. J Endod 40(8):1194–1200. https://doi.org/10.1016/j.joen.2014.01.001

    Article  PubMed  Google Scholar 

  25. Andelin WE, Shabahang S, Wright K et al (2003) Identification of hard tissue after experimental pulp capping using dentin sialoprotein (DSP) as a marker. J Endod 29(10):646–650. https://doi.org/10.1097/00004770-200310000-00008

    Article  PubMed  Google Scholar 

  26. Zhang S, Yang X, Fan M (2013) BioAggregate and iRoot BP plus optimize the proliferation and mineralization ability of human dental pulp cells. Int Endod 46(10):923–929. https://doi.org/10.1111/iej.12082

    Article  Google Scholar 

  27. Chang SW, Lee SY, Kum KY, Kim EC (2014) Effects of ProRoot MTA, Bioaggregate, and micromega MTA on odontoblastic differentiation in human dental pulp cells. J Endod 40(1):113–118. https://doi.org/10.1016/j.joen.2013.09.036

    Article  PubMed  Google Scholar 

  28. Tian J, Zhang Y, Lai Z, Li M, Huang Y, Jiang H, Wei X (2017) Ion release, microstructural, and biological properties of iRoot BP plus and ProRoot MTA exposed to an acidic environment. J Endod 43(1):163–168. https://doi.org/10.1016/j.joen.2016.10.011

    Article  PubMed  Google Scholar 

  29. Yildirim S, Can A, Arican M et al (2011) Characterization of dental pulp defect and repair in a canine model. Am J Dent 24:331–335

    PubMed  Google Scholar 

  30. Zhu L, Yang J, Zhang J, Lei D, Xiao L, Cheng X, Lin Y, Peng B (2014) In vitro and in vivo evaluation of a nanoparticulate bioceramic paste for dental pulp repair. Acta Biomater 10(12):5156–5168. https://doi.org/10.1016/j.actbio.2014.08.014

    Article  PubMed  Google Scholar 

  31. Torabinejad M, Parirokh M (2010) Mineral trioxide aggregate: a comprehensive literature review—part II: leakage and biocompatibility investigations. J Endod 36(2):190–202. https://doi.org/10.1016/j.joen.2009.09.010

    Article  PubMed  Google Scholar 

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Funding

This work was supported by JSPS KAKENHI (grant numbers JP16K20453, 17H06848, and 17K11704).

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Authors and Affiliations

  1. Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Motoki Okamoto, Yusuke Takahashi, Shungo Komichi, Manahil Ali, Naomichi Yoneda & Mikako Hayashi

  2. Division of Materials and Manufacturing Science, Osaka University Graduate School of Engineering, Suita, Osaka, 565-0871, Japan

    Takuya Ishimoto & Takayoshi Nakano

Authors
  1. Motoki Okamoto
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  2. Yusuke Takahashi
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  3. Shungo Komichi
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  4. Manahil Ali
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  5. Naomichi Yoneda
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  6. Takuya Ishimoto
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  7. Takayoshi Nakano
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  8. Mikako Hayashi
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Corresponding author

Correspondence to Yusuke Takahashi.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The animal experimental protocol in this study was approved by the Ethical Guidelines Committee for Animal Care of Osaka University Graduate School of Dentistry (no. 23-005-1). All surgeries were performed under general anesthesia and efforts were made to minimize suffering.

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For this type of study, formal consent is not required.

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Okamoto, M., Takahashi, Y., Komichi, S. et al. Novel evaluation method of dentin repair by direct pulp capping using high-resolution micro-computed tomography. Clin Oral Invest 22, 2879–2887 (2018). https://doi.org/10.1007/s00784-018-2374-5

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  • DOI: https://doi.org/10.1007/s00784-018-2374-5

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