Advanced functional polymers for regenerative and therapeutic dentistry.

Use of ceramics and polymers continues to dominate clinical procedures in modern dentistry. Polymers have provided the basis for adhesives, tissue void fillers, and artificial replacements for whole teeth. They have been remarkably effective in the clinic at restoration of major dental functions after damage or loss of teeth. With the rapid development of polymer science, dental materials science has significantly lagged behind in harnessing these advanced polymer products. What they offer is new and unique properties superior to traditional polymers and crucially a range of properties that more closely match natural biomaterials. Therefore, we should pursue more vigorously the benefits of advanced polymers in dentistry. In this review, we highlight how the latest generation of advanced polymers will enhance the application of materials in the dental clinic using numerous promising examples. Polymers have a broad range of applications in modern dentistry. Some major applications are to construct frameworks that mimic the precise structure of tissues, to restore tooth organ function, and to deliver bioactive agents to influence cell behavior from the inside. The future of polymers in dentistry must include all these new enhancements to increase biological and clinical effectiveness beyond what can be achieved with traditional biomaterials.

Type I and II collagen regulation of chondrogenic differentiation by mesenchymal progenitor cells.

Chondrogenic differentiation by mesenchymal progenitor cells (MPCs) is associated with cytokines such as transforming growth factor-beta 1 (TGF-beta1) and dexamethasone. Extracellular matrix (ECM) also regulates the differentiation by MPCs. To define whether ECM plays a functional role in regulation of the chondrogenic differentiation by MPCs, an in vitro model was used. That model exposed to dexamethasone, recombinant human TGF-beta1(rhTGF-beta1) and collagens. The results showed that MPCs incorporated with dexamethasone and rhTGF-beta1 increased proliferation and expression of glycosaminoglycan (GAG) after 14 days. Type II collagen enhanced the GAG synthesis, but did not increase alkaline phosphatase (ALP) activity. When adding dexamethasone and rhTGF-beta1 MPCs increased mRNA expression of Sox9. Incorporation with type II collagen, dexamethasone and rhTGF-beta1, MPCs induced mRNA expression of aggrecan and enhanced levels of type II collagen, and Sox9 mRNA. In contrast, incorporation with type I collagen, dexamethasone and rhTGF-beta1 MPCs reduced levels of aggrecan, and Sox9 mRNA, and showed no type II collagen mRNA. Altogether, these results indicate that type I and II collagen, in addition to the cytokine effect, may play a functional role in regulating of chondrogenic differentiation by MPCs.

Histological analysis of regeneration of temporomandibular joint discs in rabbits by using a reconstituted collagen template.

The aim of this study was to design a biodegradable implant, in the form of a reconstituted collagen template in order to promote and support regeneration of the temporomandibular joint disc. Bovine collagen (Major Type I) was pepsinized, reduced by beta-mercaptoethanol, and reconstituted by glutaraldehyde. The reconstitution of the collagen increased the resistance to biological degradation by collagenase, optimized the pore size and possessed maximum biological activity for tissue regeneration. Forty-four New Zealand rabbits underwent either sham surgical procedures or partial temporomandibular joint discectomy. In animals that underwent partial discectomy, the discs were replaced by either reconstituted collagen templates or subdermal grafts. Some of the surgerized animals did not receive any type of implant or disc substitute. Gross and histological examination of the surgerized temporomandibular joints was carried out at 1-, 2-, and 3-month intervals after surgery on the selected groups of animals. Marked arthritic changes were observed after 3 months in the partially discectomized joints without implantation. In contrast, the discs, which received a reconstituted collagen template or subdermal graft exhibited regeneration and nearly normal morpology. No foreign body response was observed in experimental groups 3 months after implantation. This study demonstrated that the reconstituted collagen did as well as subdermal grafts in supporting and facilitating regeneration of the disc and the former was found to have some advantages over the latter.

Two distinct classes of rat intestinal mucosal enzymes incorporating putrescine into protein.

Tissue-transglutaminase (t-TGase) is a family of calcium-dependent enzymes. A Ca2+-independent soluble enzyme, in addition to t-TGase, capable of incorporating polyamines into proteins was demonstrated in rat intestinal mucosa. The Ca2+-independent enzyme was stimulated 2- to 5-fold by Fe2+ and Co2+ ions but inhibited by Cu2+ and Zn2+ ions. The Ca2+-stimulated t-TGase activity was inhibited by divalent ions in the following order: Zn2+, Fe2+ >Co2+ > Cu2+. The opposite effects of EGTA, Fe2+ and Co2+ on these two enzyme activities indicate that they are two distinct classes of enzymes. Competition studies demonstrated differential preferences of the two enzymes for substrates. The Ca2+-dependent enzyme preferred putrescine, monodansylcadaverine > cadaverine, spermidine, spermine > 1,10-diaminodecane > triethylbutylamine. On the other hand, the Ca2+-independent enzyme preferred putrescine > cadaverine > spermine, I,10-diaminodecane > spermidine > monodansylcadaverine > triethylbutylamine. Further studies with divalent ions excluded the possible association of this novel Ca2+-independent enzyme with diamine oxidase. Finally, the Ca2+-independent enzyme had a higher affinity for putrescine (Km = 0.02 mM) than did Ca2+-dependent t-TGase (0.2 mM). As judged by gel filtration on HiPrep Sephacryl 200 column, the Ca2+-independent enzyme had a molecular weight of approximately 48 kDa, the intestinal Ca2+-dependent t-TGase was about 188 kDa while that of testicular t-TGase was about 96 kDa. In conclusion, the Ca2+-independent enzyme is stimulated by cobalt or ferric ions, and selectively incorporates aliphatic diamines or polyamines with symmetric amino groups. The observed Ca2+-independent enzyme activity is not related to diamine oxidase or its products. With a 10 times greater affinity for putrescine, the calcium-independent, 48-kDa intestinal enzyme may mediate polyamine function better than calcium dependent, 188-kDa intestinal tissue transglutaminase in the intestinal mucosa.

Evaluation of shear stress of the human temporomandibular joint disc.

The aim of this study was to determine the shear stress of the human postmortem temporomandibular joint (TMJ) disc. Correlation of shear stress with age or with the region of the disc was determined. Nine discs were removed unilaterally from postmortem humans, ages 36 to 76 years. Discs were sectioned into lateral (eight), central (eight), and medial (eight) specimens. Each specimen was attached by cyanoacrylate adhesive to a servohydraulic test system apparatus within 48 hours of retrieval. Shear properties were measured under quasistatic conditions with a linear increase of displacement until the specimen failed to maintain maximum resistance to the applied force. The shear moduli were analyzed by means of the Wilcoxon's signed ranks test. The results showed that values of shear moduli on peripheral portions (lateral and medial) were significantly higher than on central portions (P = 0.0013). The correlation between the shear moduli of TMJ discs and age showed a regression slope for shear moduli of -0.326 + 0.031 x age (r = 0.769; P < 0.01). Peripheral portions (lateral and medial) have a higher shear moduli and are stiffer than the central portions of discs and shear moduli or stiffness of TMJ discs increase with age.

MRI and histology of collagen template disc implantation and regeneration in rabbit temporomandibular joint: preliminary report.

INTRODUCTION: We aimed to evaluate regeneration of injured temporomandibular joint (TMJ) discs following reconstituted collagen template implantation in rabbits using contrast-enhanced magnetic resonance imaging (MRI) and to correlate these findings with histology. METHODS: Twenty-four adult rabbits were divided into five groups: group A, partial discectomy without implantation (n = 6); group B, partial discectomy with collagen template implantation (n = 6); group C, partial discectomy with subdermal graft implantation (n = 6); group D, sham operation (n = 4); and group E, control (n = 2). All rabbits received baseline MRI scans before surgery and follow-up MRI studies at 3 months after surgery. All rabbits were sacrificed for histologic analysis after the follow-up MRI. RESULTS: In group A, follow-up MRI showed marked joint effusion in all six injured TMJs, which was accompanied by bony erosion at the tympanic fossa and mandibular condyle. In group B, MRI showed a homogenous low signal intensity in five of six discs, suggestive of regeneration. One disc showed higher signal intensity at its lateral portion than that of the original disc, indicating partial regeneration. MRI of group C depicted a low signal intensity, bandlike regenerative structure in four of the six discs. One disc with partial regeneration demonstrated relatively high signal intensity. The disc in the sixth animal of this group showed no evidence of regeneration. All of the MRI findings were in agreement with the histologic findings. CONCLUSION: TMJ discs can regenerate following implantation of a reconstituted collagen template in discectomied rabbits. Contrast-enhanced MRI can be used to monitor and determine the degree of disc regeneration.

Super-paramagnetic iron oxide nanoparticles for use in extrapulmonary tuberculosis diagnosis.

The limited sensitivity of serological tests for mycobacterial antigens has encouraged the development of a nanoparticle probe specific for the extrapulmonary form of Mycobacterium tuberculosis (Mtb). We developed an innovative probe comprised of super-paramagnetic iron oxide (SPIO) nanoparticles conjugated with Mtb surface antibody (MtbsAb-nanoparticles) to provide ultrasensitive imaging of biomarkers involved in extrapulmonary Mtb infection. MtbsAb-nanoparticles were significantly conjugated with Mtb bacilli. The extent of contrast enhancement reduction on magnetic resonance imaging (MRI) for Mtb and human monocytic THP1 cells was proportional to the concentration of MtbsAb-nanoparticles. When MtbsAb-nanoparticles were intravenously injected into mice bearing Mtb granulomas, the granulomatous site showed a 14-fold greater reduction in signal intensity enhancement on T(2) -weighted MR images compared with an opposing site that received PBS injection. Mtb sAb-nanoparticles represent a new non-invasive technology for the diagnosis of extrapulmonary Mtb.

A novel calcium-independent enzyme capable of incorporating putrescine into proteins.

A Ca(++)-independent enzyme capable of incorporating [3H]-putrescine into proteins was detected in the rat intestine mucosa. The Ca(++)-independent incorporation of [3H]-putrescine into proteins was temperature-, pH-, time-, and dose-dependent. However, this enzyme was absent in the gastric mucosa. Similar to testicular Ca(++)-dependent transglutaminase, the optimal pH of intestinal Ca(++)-independent enzyme was 9.0. At 10(-5) M or less putrescine concentrations, the Ca(++)-independent enzyme in an intestinal cytosol preparation showed a greater activity than did the Ca(++)-dependent transglutaminase. However, at higher putrescine concentrations, the latter showed a greater activity than did the former. Both the intestinal Ca(++)-dependent and independent enzymes were inhibited by cystamine, thermal labile at 50 degrees C and precipitated by 30 to 50% saturation of ammonium sulfate. The fact that these two enzymes shared many similar characteristics, with the exceptions of Ca(++)-requirement, suggests that they may have similar active site and intrinsic molecular function(s).

Evaluation of biomechanical properties of Expanded-Polytetrafluoroethylene Soft Tissue Patch after dorsal implantation in the rat to mimic TMJ lateral reconstruction.

Clinically, Gore-Tex Expanded-Polytetrafluoroethylene (E-PTFE) has been used to reconstruct the lateral temporomandibular joint (TMJ) ligament. The purpose of this study was to assess changes in the biomechanical properties of implanted E-PTFE over time with respect to tissue infiltration. Ninety-six specimens of implants were divided into four groups. Group A was the experimental group. Thirty-six autoclave-sterilized specimens were subcutaneously implanted into the backs of 36 rats. The rats were randomly sacrificed at 2 (n = 12), 7 (n = 12) and 12 (n = 12) weeks. The implants were tested for mechanical properties including maximal stress, strain and Young's modulus of elasticity (E) using the servo-hydraulic material testing system (MTS). Group B was the in vitro control group. Thirty-six specimens were placed in tissue culture media at 37 degrees C for a time period equivalent to the experimental group to simulate the effect of a moist, warm environment on biomechanical properties. Group C was the temperature and pressure control group. Twelve specimens were autoclave-sterilized to determine the changes of tensile strength under high temperature and pressure. Control group D (no treatment) was tested to determine the initial tensile strength. The results showed significantly larger maximal stress as well as an increase in E and smaller maximal strain in experimental group A than in control groups B, C and D. There was no significant difference among control groups B, C and D. Histological examination of implants at 12 weeks demonstrated that 0.2-0.3 mm of 1-mm thick implants were occupied by connective tissue from each side. It may be concluded that E-PTFE implants become stronger and less flexible after implantation in vivo.

Suppression of type I collagen gene expression by prostaglandins in fibroblasts is mediated at the transcriptional level.

BACKGROUND: Tissues undergoing a chronic inflammatory process, such as the synovium in rheumatoid arthritis, are characterized by the infiltration of lymphocytes of different subsets and activation of monocyte/macrophages. Interleukin-1 (IL-1), a monocyte/ macrophage product that stimulates synovial fibroblasts to produce matrix metalloproteinases (MMPs), prostaglandins, and other cytokines, also has profound effects on the synthesis of extracellular matrix components such as type I collagen. In previous studies, we have shown that synovial fibroblasts and chondrocytes isolated from human joint tissues are particularly sensitive to prostaglandins, which modulate the effects of IL-1 on collagen gene expression in an autocrine manner. MATERIALS AND METHODS: BALBc/3T3 fibroblasts were treated with IL-1 and prostaglandins in the absence and presence of indomethacin to inhibit endogenous prostaglandin biosynthesis. Collagen synthesis was analyzed by SDS-PAGE as [3H]proline-labeled, secreted proteins, and prostaglandin production and cyclic adenosine 3',5'-cyclic monophosphate (camp) content were assayed. The expression of type I collagen gene (Col1a1) promoter-reporter gene constructs was examined in transient transfection experiments, and the binding of nuclear factors to the Col1a1 promoter region spanning -222 bp/+ 116 bp was analyzed by DNase I footprinting and electrophoretic mobility shift (EMSA) assays. RESULTS: IL-1 increased the synthesis of type I and type III collagens in BALBc/3T3 fibroblasts; greater increases were observed when IL-1-stimulated synthesis of PGE2 was blocked by indomethacin. Transient transfection experiments demonstrated dose-dependent inhibition of the-222 bp Col1a1 promoter by exogenously added prostaglandins with the order of potency of PGF2alpha > PGE2 > PGE1 DNase I footprinting showed increased protection, which extended from the region immediately upstream of the TATA box, owing to the binding of nuclear factors from PGE2- or PGE1-treated BALBc/3T3 cells. EMSA analysis showed zinc-dependent differences in the binding of nuclear factors from untreated and prostaglandin-treated cells to the -84 bp/-29 bp region of the Col1a1 promoter. CONCLUSIONS: These results show that the inhibition of Col1a1 expression by IL-1 in fibroblasts is mediated by prostaglandins at the transcriptional level and suggest that PGE-responsive factors may interact directly or indirectly with basal regulatory elements in the proximal promoter region of the Col1a1 gene.

Cytotoxicity and immunogenicity of SACCHACHITIN and its mechanism of action on skin wound healing.

SACCHACHITIN membrane, a weavable skin substitute made from the residual fruiting body of Ganoderma tsugae, has been demonstrated to promote skin wound healing. Prior to its clinical application, it is critical to learn more about any possible cytotoxicity, immunogenicity, or allergy response, and at least some of its mechanism(s) of action(s). In the present studies, it has been found that SACCHACHITIN suspension at less than 0.05% shows no cytotoxicity to the primary culture of rat fibroblasts. However, at higher concentrations (> or = 0.1%), it does reduce the growth of fibroblasts, based on MTT assays. This might be caused by positive charges on chitin molecules that are too strong, and may be harmful to the cell membrane. SACCHACHITIN showed no immunogenicity after it was inoculated into rats three times; however, the unmodified, purified rabbit type I and type II collagens did. Subcutaneous injection of SACCHACHITIN suspension into rats showed no gross allergic responses on skin. Nevertheless, it did cause local acute inflammation, as observed by histological investigation. This is similar to what occurred in the wound site covered with SACCHACHITIN membrane. The chemotactic effect of SACCHACHITIN was exhibited in both intact and wounded skin tissues. This may be one of the initial beneficial effects of SACCHACHITIN membrane to wound healing. The rapid acute inflammatory process was followed by the appearance of angiogenesis and granulation tissue formation, which occurred earlier than it normally would. Coverage of the wound area with SACCHACHITIN membrane also induced an earlier formation of scar tissue to replace the granulation tissue. A 1.5 x 1.5 cm(2) wound area covered by SACCHACHITIN completely healed by 21 days, while that covered with cotton gauze did not. Therefore, SACCHACHITIN is a safe biomaterial for use as a wound dressing for skin healing. Its promoting action for wound healing might be due to its chemotactic effect for inflammatory cells. This, in turn, may facilitate subsequent angiogenesis, granulation tissue formation, and faster new tissue formation, leading to faster wound healing.