Cerium and cerium-based materials in dental applications / 中国组织工程研究

ABSTRACT

BACKGROUND:Cerium(Ce)is the most abundant element among lanthanides,which is mostly in the form of ceria.The reversible transformation between Ce3+and Ce4+ ions contributes to the high redox activity of cerium.Because of its antibacterial,anti-inflammatory,osteogenic,angiogenic and anti-tumor properties,cerium has been widely used in stomatology. OBJECTIVE:To summarize the antibacterial,anti-inflammatory,osteogenic,angiogenic and anti-tumor mechanism of cerium,and to review the research status and application prospects of cerium and cerium-based materials in the modification of oral materials and the diagnosis and treatment of oral diseases in recent years. METHODS:The articles published from database inception to 2023 were retrieved from Web of Science,PubMed,CNKI and WanFang databases with the search terms"cerium,ceria,prosthodontics,prosthesis,restorative dentistry,denture,dental implant,caries,endodontics,pulpitis,periodontitis,periodontal diseases,oral cancer"in English and"cerium,ceria,prosthodontics,implant,dental caries,dental pulp,periodontitis,periodontal disease,oral cancer"in Chinese.By analyzing and reading literature for screening,according to the inclusion and exclusion criteria,73 articles were finally included in this review. RESULTS AND CONCLUSION:(1)Cerium exerts an antibacterial effect through direct contact with bacteria,oxidative stress and destroying bacterial biofilm,and exerts an anti-inflammatory function based on mimetic enzyme activity.The osteogenic and angiogenic activities of cerium involve a series of signaling pathways including ERK and Wnt signaling pathways.(2)Antibacterial,anti-inflammatory,osteogenic,and angiogenic activities allow cerium significant potential in the treatment of oral infectious diseases and regeneration of oral soft and hard tissues.However,there is still a certain gap in the application of cerium's anti-tumor properties in the oral field.(3)Due to excellent mechanical properties and a low light-transmitting property,ceria-stabilized zirconia as a dental ceramic material can be used for core ceramics,the frameworks of dental prostheses and dental implants.(4)Benefited from its biological properties,cerium-based materials have the ability to promote osseointegration and soft tissue integration,inhibit demineralization and cariogenic bacteria,facilitate regeneration of the dentin-pulp complex,lessen inflammatory response and enhance periodontal tissue regeneration.There are wide applications of cerium in surface modifications of implants and treatments of caries,pulpitis,periodontitis and oral cancers.(5)Cerium shows certain toxicity under conditions of high concentration and long-term administration.To further expand clinical applications of cerium in dentistry,biosafety and optimization of cerium-based materials need to be further explored in the future.