A comparative study of biological properties of three root canal sealers.

OBJECTIVES: The aim of this study was to evaluate the effects of Hiflow with other two kinds of root canal sealers on the biological behavior of stem cells from the apical papilla (SCAP), the influence on inflammatory cytokines release and its antibacterial effects. MATERIALS AND METHODS: Material extracts of Hiflow, iRoot SP, and AH Plus were prepared. Then, SCAP was incubated with extracts. The effects were evaluated by CCK-8, wound healing assay, ALP staining, alizarin red staining, and qRT-PCR. Meanwhile, polymorphonuclears (PMNs) and monocytes were isolated and treated with extracts for 4 h and 24 h respectively. Cell viability was analyzed by Annexin-V/PI double staining flow cytometry. The effects on the release of cytokines were observed by ELISA. The antibacterial effects of different sealers were tested against three kinds of bacteria found in chronic apical periodontitis. RESULTS: A series of results of SCAP showed that Hiflow and iRoot SP could promote cell proliferation, migration, and osteogenesis (p < 0.05). Although Hiflow was associated with greater cell apoptosis and necrosis when incubated with PMNs and monocytes (p < 0.05), it had an approximate release of anti-inflammatory cytokines with iRoot SP, which was higher than AH plus (p < 0.05). The co-culture showed that Hiflow and iRoot SP inhibited the colony formation of F. nucleatum (p < 0.05). However, both sealers had no obvious antibacterial effect on E. faecalis and P. gingivalis (p > 0.05). CONCLUSIONS: In summary, Hiflow and iRoot SP both had positive biological stimulus on SCAP. Meanwhile, Hiflow showed a better induction on anti-inflammatory cytokines over the others. All the properties mentioned above and its antibacterial effect of F. nucleatum promise Hiflow a bright application prospect in endodontic uses. CLINICAL RELEVANCE: References for clinical work to use BC Sealer Hiflow as a good biological root canal sealer.

The remineralization effect of GERM CLEAN on early human enamel caries lesions in vitro.

This study aimed to evaluate the remineralization effect of GERM CLEAN, a novel antibacterial peptide, on early enamel caries. Thirty human enamel blocks from thirty teeth were randomly divided into three groups: double distilled water (DDW group), GERM CLEAN (GC group), and 1000 ppm fluoride (NaF group). Specimens were demineralized for 3 days (pH 4.6) followed by pH cycling twice daily for 14 days. For a pH cycle, specimens received corresponding treatments for 5 min, then were immersed in demineralizing solution for 1 h, received corresponding treatments again, and finally were immersed in remineralizing solution (pH 7.0) for approximately 11 h. Specimens were washed with DDW after each treatment. Microindentation tests, atomic force microscopy (AFM), and transverse micro-radiography (TMR) were conducted to analyze enamel blocks. GC demonstrated a lower percentage of surface microhardness recovery (SMHR%) (p < 0.0001), rougher surfaces (p < 0.0001), deeper lesion depth (p = 0.001), and more mineral loss (p = 0.001) than NaF, but showed higher SMHR% (p < 0.0001), smoother surfaces (p < 0.0001), shallower lesion depth (p = 0.049), and less mineral loss (p = 0.001) than DDW. As a result, GERM CLEAN has the potential to promote the remineralization of demineralized enamel.

Investigation of the antibacterial effect, osteogenic activity, and tracing properties of hydroxyapatite co-doped with Tb3+ and Zn2.

Hydroxyapatite (HA) is a biomimetic biomaterial that has been widely used in bone repair for many years. However, the increased risk of infection after surgery and long-time tracing for the material distribution and degradation during bone reconstruction remain challenges in the clinic. Zinc (Zn) is considered as an indispensable microelement for humans and is characterized with antibacterial action and osteogenic activity. Terbium (Tb), a rare-earth element, emits stable fluorescence under ultraviolet light. Here, Tb3+/Zn2+ co-doped hydroxyapatite (HA:Tb/Zn) was prepared to synchronously realize the antibacterial effect, osteogenic activity, and long-time tracing property. We found that HA:Tb/Zn had a strong antibacterial effect on both Gram-positive and Gram-negative clinical infectious bacteria, as well as improved osteogenic activity. HA:Tb/Zn also displayed stable green fluorescence in vitro and in vivo, which indicated great potential for recognizing the material changes during the bone reconstruction process. The combination of the ternary functions is of great significance to control the overuse of antibiotics and realize long-time tracing, and provide a versatile design on biomaterials in bone repair.

The landscape of endodontic education research area: A bibliometric analysis.

OBJECTIVES: Educational research is essential for rationalizing curriculum design, improving evaluation systems, and updating teaching content. This bibliometric study aimed at analyzing the characteristics of publications relevant to endodontic education, thus forming a comprehensive scope of this research area. METHODS: The search was conducted in the Web of Science Core Collection database in May 2022. Knowledge units of the included publications, such as year of publication, journal, country/institution/author, keywords, and highly cited articles/references, were analyzed. RESULTS: The United States ranked first in the number of articles with a total of 17 articles. The majority of included articles were published in Journal of Dental Education (n = 25), International Endodontic Journal (n = 21), and European Journal of Dental Education (n = 14). The top 3 most frequent keywords were Endodontics, Education, and Root canal treatment. The main topic in endodontic education were curriculum, preclinical education, educational technology, and continuing education. CONCLUSION: Forming a full scope of the endodontic research area, this bibliomertic analysis can help mine the hot topic, predict the frontiers in the field and provide the data necessary to determine the direction of research, rationalize resource allocation, and formulate policy.

An in vitro evaluation of antimicrobial activity of a fast-setting endodontic material.

The aim of this study is to evaluate the antimicrobial activity of the fast-setting iRoot Fast Set Root Repair Material (iRoot FS), Mineral trioxide aggregate (MTA) and Biodentine. The materials were freshly mixed or set for 1 and 7 days to conduct the agar diffusion test, direct contact test and carry-over effect test against E. faecalis and P. gingivalis, and the pH values were also measured. The data were analyzed by an analysis of variance and one-way ANOVA or Dunnett's T3 test, and the Tukey's post hoc test for multiple comparisons (α = 0.05). In the direct contact test, all three materials showed good antibacterial activity after setting for 20 min. The antibacterial properties of the three materials decreased with the increase of setting time (p < 0.05). The suspension of all the three materials showed high pH values (11-12) and no significant difference was observed (p > 0.05). With the extension of setting time, the pH of iRoot FS and Biodentine slightly decreased (p < 0.05). Fresh iRoot FS, Biodentine, and MTA killed E. faecalis and P. gingivalis effectively, but their antimicrobial effect decreased after 24 h, and distinctly decreased after 7 days after mixing. iRoot FS, Biodentine, and MTA showed a tendency of alkalinity during this 7-day experiment.

Natural products from traditional medicine as promising agents targeting at different stages of oral biofilm development.

Oral cavity is an ideal habitat for more than 1,000 species of microorganisms. The diverse oral microbes form biofilms over the hard and soft tissues in the oral cavity, affecting the oral ecological balance and the development of oral diseases, such as caries, apical periodontitis, and periodontitis. Currently, antibiotics are the primary agents against infectious diseases; however, the emergence of drug resistance and the disruption of oral microecology have challenged their applications. The discovery of new antibiotic-independent agents is a promising strategy against biofilm-induced infections. Natural products from traditional medicine have shown potential antibiofilm activities in the oral cavity with high safety, cost-effectiveness, and minimal adverse drug reactions. Aiming to highlight the importance and functions of natural products from traditional medicine against oral biofilms, here we summarized and discussed the antibiofilm effects of natural products targeting at different stages of the biofilm formation process, including adhesion, proliferation, maturation, and dispersion, and their effects on multi-species biofilms. The perspective of antibiofilm agents for oral infectious diseases to restore the balance of oral microecology is also discussed.

The Arginine Biosynthesis Pathway of Candida albicans Regulates Its Cross-Kingdom Interaction with Actinomyces viscosus to Promote Root Caries.

The cross-kingdom interactions between Candida albicans and Actinomyces viscosus play critical roles in root caries. However, the key pathway by which C. albicans regulates its interactions with A. viscosus is unclear. Here, we first employed 39 volunteers with root caries and 37 caries-free volunteers, and found that the abundances of C. albicans and A. viscosus were significantly increased in the individuals with root caries and showed a strong positive correlation. Their dual-species combination synergistically promoted biofilm formation and root caries in rats. The arginine biosynthesis pathway of C. albicans was significantly upregulated in dual-species biofilms and dental plaques from another 10 root caries volunteers compared with the 10 caries-free volunteers. The exogenous addition of arginine increased the cariogenicity of the dual-species biofilm. The C. albicans ARG4, a key gene from the arginine biosynthesis pathway, null mutant failed to promote dual-species biofilm formation and root caries in rats; however, the addition of arginine restored its synergistic actions with A. viscosus. Our results identified the critical roles of the C. albicans arginine biosynthesis pathway in its cross-kingdom interactions with A. viscosus for the first time and indicated that targeting this pathway was a practical way to treat root caries caused by multiple species. IMPORTANCE Root caries is a critical problem that threatens the oral health of the elderly population. Our results identified the essential roles of the C. albicans arginine biosynthesis pathway in its cross-kingdom interactions with A. viscosus in root caries for the first time and indicated that targeting this pathway was a practical way to treat root caries caused by multiple species.

Drug-free and non-crosslinked chitosan scaffolds with efficient antibacterial activity against both Gram-negative and Gram-positive bacteria.

Treatment of oral pathogens is important for both oral and systemic health. The antimicrobial activity of chitosan (CS)-based scaffolds either loading antibiotics or compositing with other agents are well documented. However, the intrinsic antibacterial activity of CS scaffolds alone has never been reported. Herein, we fabricated the non-crosslinked CS scaffold and investigated its antibacterial activity against typical oral pathogens, Gram-negative Porphyromonas gingivalis and Gram-positive Streptococcus mutans. We found both pathogens were completely killed by 1 mg CS scaffolds at 6 h, due largely to the CS-induced time-dependent bacteria clustering. Interestingly, ß-glycerophosphate crosslinked scaffolds showed no antibacterial activity. In conclusion, the bactericidal activity of CS scaffolds alone is reported for the first time. Together with the biodegradability, physical stability, biocompatibility and great antibacterial activity, the non-crosslinked CS scaffolds may have great potentials not only in treating oral diseases but also in wound healing and tissue engineering.

Understanding the sheet size-antibacterial activity relationship of graphene oxide and the nano-bio interaction-based physical mechanisms.

The antibiotics-independent antimicrobial activity of graphene oxide (GO) is of great importance since antibiotic therapy is facing great challenges from drug resistance. However, the relations of GO size with its antimicrobial activity and how the size regulates the antibacterial mechanisms are still unknown. Herein, we fabricated four GO suspensions with different sizes and demonstrated the parabolic relationship between GO size and its antibacterial activity against the Gram-positive cariogenic bacterium Streptococcus mutans. More interestingly, we found out how GO size regulated the nano-bio interaction-based physical antibacterial mechanisms. Increasing the size reduced the cutting effect but enhanced the cell entrapment effect, and vice versa. In conclusion, GO size affects its edge density and lateral dimension, further regulates its physical antibacterial mechanisms in different orientations and ultimately determines its activity. These findings provide a deep understanding of GO antibacterial property and may guide the design and development of GO for clinical use.