Skip to main content

Advertisement

SpringerLink
Log in

Histological evaluation of the regenerative potential of a novel treated dentin matrix hydrogel in direct pulp capping

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

To produce a novel injectable treated dentin matrix hydrogel (TDMH) to be used as a novel pulp-capping agent for dentin regeneration compared with Biodentine and MTA.

Materials and methods

Thirty intact fully erupted premolars scheduled to be extracted for orthodontic reasons were included. Pulps were mechanically exposed in the middle of the cavity floor. TDMH was composed of TDM powder (500-μm particle size) and sodium alginate as an injectable scaffold. The capped teeth were divided into three equal groups (n = 10): TDMH, Biodentine, and MTA respectively. Clinical examination and assessment of periapical response were performed. The teeth were extracted after 2-weeks and 2-month intervals, stained with hematoxylin-eosin, and categorized by using a histologic scoring system. Statistical analysis was performed using chi-square and Kruskal-Wallis test (p = 0.05).

Results

All teeth were vital during observation periods. Histological analysis after 2 months showed complete dentin bridge formation and absence of inflammatory pulp response with no significant differences between groups. However, the formed dentin was significantly thicker with the TDMH group with layers of well-arranged odontoblasts that were found to form a homogenous tubular structure with numerous dentinal tubule lines showing a positive trend to dentin regeneration.

Conclusions

TDMH could achieve dentin regeneration and conservation of pulp vitality and might serve as a feasible natural substitute for silicate-based cements in restoring in vivo dentin defect in direct pulp-capping procedure.

Trial registration

PACTR201901866476410

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Bjørndal L, Mjör IA (2001) Pulp-dentin biology in restorative dentistry Part 4: dental caries – characteristics of lesions and pulpal reactions. Quintessence Int 32:717–736

    PubMed  Google Scholar 

  2. Paranjpe A, Zhang H, Johnson JD (2010) Effects of mineral trioxide aggregate on human dental pulp cells after pulp-capping procedures. J Endod 36:1042–1047. https://doi.org/10.1016/j.joen.2010.02.013

    Article  PubMed  Google Scholar 

  3. Gandolfi MG, Siboni F, Botero T, Bossù M, Riccitiello F, Prati C (2015) Calcium silicate and calcium hydroxide materials for pulp capping: biointeractivity, porosity, solubility and bioactivity of current formulations. J Appl Biomater Funct Mater 13:43–60. https://doi.org/10.5301/jabfm.5000201

    Article  PubMed  Google Scholar 

  4. Collado-González M, García-Bernal D, Oñate-Sánchez RE, Ortolani-Seltenerich PS, Álvarez-Muro T, Lozano A, Forner L, Llena C, Moraleda JM, Rodríguez-Lozano FJ (2017) Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth. Int Endod J 50(Suppl2):e19–e30. https://doi.org/10.1111/iej.12751

    Article  PubMed  Google Scholar 

  5. Moussa DG, Aparicio C (2019) Present and future of tissue engineering scaffolds for dentin-pulp complex regeneration. J Tissue Eng Regen Med 13:58–75. https://doi.org/10.1002/term.2769

    Article  PubMed  Google Scholar 

  6. Paula AB, Laranjo M, Marto CM, Paulo S, Abrantes AM, Casalta-Lopes J, Marques-Ferreira M, Botelho MF, Carrilho E (2018) Direct pulp capping: what is the most effective therapy?-systematic review and meta-analysis. J Evid Based Dent Pract 18:298–314. https://doi.org/10.1016/j.jebdp.2018.02.002

    Article  PubMed  Google Scholar 

  7. Horst OV, Chavez MG, Jheon AH, Desai T, Klein OD (2012) Stem cell and biomaterials research in dental tissue engineering and regeneration. Dent Clin N Am 56:495–520. https://doi.org/10.1016/j.cden.2012.05.009

    Article  PubMed  Google Scholar 

  8. Tran HLB, Nguyen MT, Doan VN (2015) Fabrication and evaluation of human dentin as scaffold for dental pulp stem cells. Tissue Eng Regen Med 12:222–230. https://doi.org/10.1007/s13770-014-0103-y

    Article  Google Scholar 

  9. Li R, Guo W, Yang B, Guo L, Sheng L, Chen G, Li Y, Zou Q, Xie D, An X, Chen Y (2011) Human treated dentin matrix as a natural scaffold for complete human dentin tissue regeneration. Biomaterials 32:4525–4538. https://doi.org/10.1016/j.biomaterials.2011.03.008

    Article  PubMed  Google Scholar 

  10. Tabatabaei FS, Tatari S, Samadi R, Torshabi M (2016) Surface characterization and biological properties of regular dentin, demineralized dentin, and deproteinized dentin. J Mater Sci Mater Med 27:164. https://doi.org/10.1007/s10856-016-5780-8

    Article  PubMed  Google Scholar 

  11. Widbiller M, Eidt A, Wölflick M, Lindner SR, Schweikl H, Hiller KA, Buchalla W, Galler KM (2018) Interactive effects of LPS and dentin matrix proteins on human dental pulp stem cells. Int Endod J 51:877–888. https://doi.org/10.1111/iej.12897

    Article  PubMed  Google Scholar 

  12. Chen J, Cui C, Qiao X, Yang B, Yu M, Guo W, Tian W (2017) Treated dentin matrix paste as a novel pulp capping agent for dentin regeneration. J Tissue Eng Regen Med 11:3428–3436. https://doi.org/10.1002/term.2256

    Article  PubMed  Google Scholar 

  13. Mehrvarzfar P, Abbott PV, Mashhadiabbas F, Vatanpour M, Savadkouhi S (2018) Clinical and histological responses of human dental pulp to MTA and combined MTA/treated dentin matrix in partial pulpotomy. Aust Endod J 44:46–53. https://doi.org/10.1111/aej.12217

    Article  PubMed  Google Scholar 

  14. Bidarra SJ, Barrias CC, Granja PL (2014) Injectable alginate hydrogels for cell delivery in tissue engineering. Acta Biomater 10:1646–1662. https://doi.org/10.1016/j.actbio.2013.12.006

    Article  PubMed  Google Scholar 

  15. Antoine EE, Vlachos PP, Rylander MN (2014) Review of collagen I hydrogels for bioengineered tissue microenvironments: characterization of mechanics, structure, and transport. Tissue Eng B Rev 20:683–696. https://doi.org/10.1089/ten.teb.2014.0086

    Article  Google Scholar 

  16. Tan H, Shen Q, Jia X, Yuan Z, Xiong D (2012) Injectable nanohybrid scaffold for biopharmaceuticals delivery and soft tissue engineering. Macromol Rapid Commun 33:2015–2022. https://doi.org/10.1002/marc.201200360

    Article  PubMed  Google Scholar 

  17. Cardoso DA, van den Beucken JJ, Both LL, Bender J, Jansen JA, Leeuwenburgh SC (2014) Gelation and biocompatibility of injectable alginate-calcium phosphate gels for bone regeneration. J Biomed Mater Res A 102:808–817. https://doi.org/10.1002/jbm.a.34754

    Article  PubMed  Google Scholar 

  18. Espona-Noguera A, Ciriza J, Cañibano-Hernández A, Fernandez L, Ochoa I, del Burgo LS, Pedraz JL (2018) Tunable injectable alginate-based hydrogel for cell therapy in Type 1 Diabetes Mellitus. Int J Biol Macromol 107(PtA):1261–1269. https://doi.org/10.1016/j.ijbiomac.2017.09.103

    Article  PubMed  Google Scholar 

  19. Nowicka A, Lipski M, Parafiniuk M, Sporniak-Tutak K, Lichota D, Kosierkiewicz A, Kaczmarek W, Buczkowska-Radlińska J (2013) Response of human dental pulp capped with biodentine and mineral trioxide aggregate. J Endod 39:743–747. https://doi.org/10.1016/j.joen.2013.01.005

    Article  PubMed  Google Scholar 

  20. Silva GA, Lanza LD, Lopes-Júnior N, Moreira A, Alves JB (2006) Direct pulp capping with a dentin bonding system in human teeth: a clinical and histological evaluation. Oper Dent 31:297–307. https://doi.org/10.2341/05-65

    Article  PubMed  Google Scholar 

  21. Bollu IP, Velagula LD, Bolla N, Kumar KK, Hari A, Thumu J (2016) Histological evaluation of mineral trioxide aggregate and enamel matrix derivative combination in direct pulp capping: an in vivo study. J Conserv Dent 19:536–540. https://doi.org/10.4103/0972-0707.194031

    Article  PubMed  PubMed Central  Google Scholar 

  22. 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 19:85–90

    PubMed  Google Scholar 

  23. Medina V, Shinkai K, Shirono M, Tanaka N, Katoh Y (2002) Histopathologic study on pulp response to single-bottle and self-etching adhesive systems. Oper Dent 27:330–342

    PubMed  Google Scholar 

  24. Asgary S, Ahmadyar M (2013) Vital pulp therapy using calcium-enriched mixture: an evidence-based review. J Conserv Dent 16:92–98. https://doi.org/10.4103/0972-0707.108173

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zarrabi MH, Javidi M, Jafarian AH, Joushan B (2010) Histologic assessment of human pulp response to capping with mineral trioxide aggregate and a novel endodontic cement. J Endod 36:1778–1781. https://doi.org/10.1016/j.joen.2010.08.024

    Article  PubMed  Google Scholar 

  26. Tran XV, Gorin C, Willig C, Baroukh B, Pellat B, Decup F (2012) Effect of a calcium-silicate-based restorative cement on pulp repair. J Dent Res 91:1166–1171. https://doi.org/10.1177/0022034512460833

    Article  PubMed  Google Scholar 

  27. Yaemkleebbua K, Osathanon T, Nowwarote N, Limjeerajarus CN, Sukarawan W (2019) Analysis of hard tissue regeneration and Wnt signalling in dental pulp tissues after direct pulp capping with different materials. Int Endod J 52:1605–1616. https://doi.org/10.1111/iej.13162

    Article  PubMed  Google Scholar 

  28. Grech L, Mallia B, Camilleri J (2013) Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials. Dent Mater 29:e20–e28. https://doi.org/10.1016/j.dental.2012.11.007

    Article  PubMed  Google Scholar 

  29. De Rossi A, Silva LA, Gatón-Hernández P, Sousa-Neto MD, Nelson-Filho P, Silva RA, de Queiroz AM (2014) Comparison of pulpal responses to pulpotomy and pulp capping with biodentine and mineral trioxide aggregate in dogs. J Endod 40:1362–1369. https://doi.org/10.1016/j.joen.2014.02.006

    Article  PubMed  Google Scholar 

  30. Camilleri J, Sorrentino F, Damidot D (2013) Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, biodentine and MTA angelus. Dent Mater 29:580–593. https://doi.org/10.1016/j.dental.2013.03.007

    Article  PubMed  Google Scholar 

  31. Giraud T, Jeanneau C, Bergmann M, Laurent P, About I (2018) Tricalcium silicate capping materials modulate pulp healing and inflammatory activity in vitro. J Endod 44:1686–1691. https://doi.org/10.1016/j.joen.2018.06.009

    Article  PubMed  Google Scholar 

  32. Kim J, Song Y, Min K, Kim S, Koh J, Lee B, Chang HS, Hwang IN, Oh WM, Hwang YC (2016) Evaluation of reparative dentin formation of ProRoot MTA, Biodentine and BioAggregate using micro-CT and immunohistochemistry. Restor Dent Endod 41:29–36. https://doi.org/10.5395/rde.2016.41.1.29

    Article  PubMed  PubMed Central  Google Scholar 

  33. Shayegan A, Jurysta C, Atash R, Petein M, Abbeele A (2012) Biodentine used as a pulp-capping agent in primary pig teeth. Pediatr Dent 34:e202–e28e

    PubMed  Google Scholar 

  34. Sohn S, Park Y, Srikanth S, Arai A, Song M, Yu B, Shin KH, Kang MK, Wang C, Gwack Y, Park NH (2015) The role of ORAI1 in the odontogenic differentiation of human dental pulp stem cells. J Dent Res 94:1560–1567. https://doi.org/10.1177/0022034515608128

    Article  PubMed  PubMed Central  Google Scholar 

  35. da Silva GS, Moreira MS, Fukushima KA, Raggio DP, Mello-Moura ACV, Lara JS, Gimenez T, Junior SA, Morimoto S, Tedesco TK (2020) Current evidence of tissue engineering for dentine regeneration in animal models: a systematic review. Regen Med 15:1345–1360. https://doi.org/10.2217/rme-2019-0005

    Article  PubMed  Google Scholar 

  36. 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 83:590–595. https://doi.org/10.1177/154405910408300802

    Article  PubMed  Google Scholar 

  37. Guo W, He Y, Zhang X, Lu W, Wang C, Yu H, Liu Y, Li Y, Zhou Y, Zhou J, Zhang M (2009) The use of dentin matrix scaffold and dental follicle cells for dentin regeneration. Biomaterials 30:6708–6723. https://doi.org/10.1016/j.biomaterials.2009.08.034

    Article  PubMed  Google Scholar 

  38. Jiao L, Xie L, Yang B, Yu M, Jiang Z, Feng L, Guo W, Tian W (2014) Cryopreserved dentin matrix as a scaffold material for dentin-pulp tissue regeneration. Biomaterials 35:4929–4939. https://doi.org/10.1016/j.biomaterials.2014.03.016

    Article  PubMed  Google Scholar 

  39. Koga T, Minamizato T, Kawai Y, Miura K, Takashi I, Nakatani Y, Sumita Y, Asahina I (2016) Bone regeneration using dentin matrix depends on the degree of demineralization and particle size. PLoS One 11:e0147235. https://doi.org/10.1371/journal.pone.0147235

    Article  PubMed  PubMed Central  Google Scholar 

  40. Gao X, Qin W, Wang P, Wang L, Weir MD, Reynolds MA, Zhao L, Lin Z, Xu HH (2019) Nano-structured demineralized human dentin matrix to enhance bone and dental repair and regeneration. Appl Sci 9:1013. https://doi.org/10.3390/app9051013

    Article  Google Scholar 

  41. Togari K, Miyazawa K, Yagihashi K, Tabuchi M, Maeda H, Kawai T, Goto S (2011) Bone regeneration by demineralized dentin matrix in skull defects of rats. J Hard Tissue Biol 21:25–34. https://doi.org/10.2485/jhtb.21.25

    Article  Google Scholar 

  42. Smith JG, Smith AJ, Shelton RM, Cooper PR (2012) Antibacterial activity of dentine and pulp extracellular matrix extracts. Int Endod J 45:749–755. https://doi.org/10.1111/j.1365-2591.2012.02031.x

    Article  PubMed  Google Scholar 

  43. Kim YK, Bang K, Murata M, Mitsugi M, Um IW (2017) Retrospective clinical study of allogenic demineralized dentin matrix for alveolar bone repair. J Hard Tissue Biol 26:95–102. https://doi.org/10.2485/jhtb.26.95

    Article  Google Scholar 

  44. Chen G, Chen J, Yang B, Li L, Luo X, Zhang X, Feng L, Jiang Z, Yu M, Guo W, Tian W (2015) Combination of aligned PLGA/Gelatin electrospun sheets, native dental pulp extracellular matrix and treated dentin matrix as substrates for tooth root regeneration. Biomaterials 52:56–70. https://doi.org/10.1016/j.biomaterials.2015.02.011

    Article  PubMed  Google Scholar 

  45. Yang B, Chen G, Li J, Zou Q, Xie D, Chen Y, Wang H, Zheng X, Long J, Tang W, Guo W (2012) Tooth root regeneration using dental follicle cell sheets in combination with a dentin matrix - based scaffold. Biomaterials 33:2449–2461. https://doi.org/10.1016/j.biomaterials.2011.11.074

    Article  PubMed  Google Scholar 

  46. Mirmalek-Sani SH, Sullivan DC, Zimmerman C, Shupe TD, Petersen BE (2013) Immunogenicity of decellularized porcine liver for bioengineered hepatic tissue. Am J Pathol 183:558–565. https://doi.org/10.1016/j.ajpath.2013.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  47. Moharamzadeh K, Freeman C, Blackwood K (2008) Processed bovine dentine as a bone substitute. Br J Oral Maxillofac Surg 46:110–113. https://doi.org/10.1016/j.bjoms.2007.07.209

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

    Ahmed A. Holiel, Elsayed M. Mahmoud & Wegdan M. Abdel-Fattah

  2. Oral Biology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

    Khadiga Y. Kawana

Authors
  1. Ahmed A. Holiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elsayed M. Mahmoud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wegdan M. Abdel-Fattah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Khadiga Y. Kawana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed A. Holiel.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were conducted strictly in full accordance with the ethical principles and standards of the institutional and national research committee and with the 1964 World Medical Association Declaration of Helsinki and its later amendments (version 2008). All experimental protocols were independently reviewed and approved by the Institutional Ethical Committee, Faculty of Dentistry, Alexandria University (IRB No. 00010556-IORG 0008839). This study was registered by the Pan African Clinical Trial Registry (PACTR) managed by Cochrane SA with identification number PACTR201901866476410.

Informed consent

Informed written consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Clinical relevance

This is the first histological study using the treated dentin matrix as a pulp-capping agent on humans showing a positive trend to dentin regeneration.

Appendix

Appendix

Table 1 Criteria and scores used for histological assessment
Full size table
Table 2 Comparison between the studied groups according to different parameters in the two studied periods
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holiel, A., Mahmoud, E., Abdel-Fattah, W. et al. Histological evaluation of the regenerative potential of a novel treated dentin matrix hydrogel in direct pulp capping. Clin Oral Invest 25, 2101–2112 (2021). https://doi.org/10.1007/s00784-020-03521-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-020-03521-z

Keywords

Search

Navigation