Use of calcium hydroxyapatite and growth factors in endodontic therapy

  • Aleksandar Mitić University of Niš, Faculty of Medicine, Dental Clinic, Niš, Serbia
  • Milan Živković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Dušan Živković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Lidija Popović University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Zorana Veličković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Milan Miladinović University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Ljiljana Šubarić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Dragan Marjanović University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Andrijana Cvetković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
Keywords: odontoblasts, endodontics, dentin, biocompatible materials, transforming growth factors, tooth root, rabbits

Abstract


Background/Aim. Hydroxyapatite (HAp)  is one of the most commonly used calcium phosphate bioceramics with osteoconductive properties. Growth factors are capable of directly inducing morphological and functional differentiation of neodontoblasts. The aim of this study  was to investigate the effectiveness of HAp-based biomaterial in combination with transforming growth factor-β1 (TGF-β1) in the creation of new dentine and obturation of the root canal apex in the teeth of an experimental animal model. Methods. Rodent (rabbit) teeth were used as the experimental animal model. After pulp removal with a pulp extirpator in vital pulpectomy, the biomaterial was applied using a Lentulo spiral in the apex portion at the level of the physiological foramen apicale. The experiment was performed in general anesthesia. Animals were kept alive for 3, 6, and 12 months after the treatment. The extracted teeth were analyzed by scanning electron microscopy (SEM). Results. Using SEM, it was found that the number of teeth with newly created dentine and apex canal obturation was greater 12 months after the treatment. Conclusion.  Apex obturation of the dental root canal with newly created dentine took place in our experimental groups treated by biomaterial with or without TGF-β1.

Author Biography

Aleksandar Mitić, University of Niš, Faculty of Medicine, Dental Clinic, Niš, Serbia

Telestomatologija, Telemedicina, Oralna hirurgija, Kompjuterizovana stomatologija, Internet, Digitalizacija u stomatologiji

References

Teodorović N. Hydroxyapatite-based ceramic materials in endo-dontic therapy of dental root canals. Monograph. Belgrade: University of Belgrade, Faculty of Dentistry; 2004. (Serbian)

Tronstad L. Tissue reactions following apical plugging of the root canal with dentin chips in monkey teeth subjected to pulpectomy. Oral Surg Oral Med Oral Pathol 1978; 45(2): 297‒304.

Tеоdorović N. Research in adhesive performances of three ca-nals sealers – SEM stady. 7th Congress of the Balcan Stomato-logical Society (BaSS); 2002 March 28‒30; Kushadasi, Turkie 2002.

Petrović V. Modalities of use of hydroxyapatite in apexogenesis [dissertation]. Belgrade: University of Belgrade, Faculty of Dentistry; 2007. (Serbian)

Taha NA, Abdulkhader SZ. Full Pulpotomy with Biodentine in Symptomatic Young Permanent Teeth with Carious Expo-sure. J Endod 2018; 44(6): 932‒7.

Gollmer L. The Use of Dentin Debris as a Root Canal Filling. Int J Orthod 1937; 23: 101–2.

Dianat O, Mashhadi Abas F, Paymanpour P, Eghbal MJ, Had-dadpour S, Bahrololumi N. Endodontic repair in immature dogs’ teeth with apical periodontitis: blood clot vs plasma rich in growth factors scaffold. Dent Traumatol 2017; 33(2): 84‒90.

Jacobsen EL, Bery PF, BeGole EA. The effectiveness of apical dentin plugs in sealing endodontically treated teeth. J Endod 1985; 11(7): 289‒93.

Popović-Bajić M. Impact of amelogenin, growth factors and new nanostructural materials based on calcium silicate cements on pulp regeneration [dissertation]. Belgrade: University of Bel-grade, Faculty of Dentistry; 2015. (Serbian)

Besinis A, van Noort R, Martin N. Remineralization potential of fully demineralized dentin infiltrated with silica and hydroxy-apatite nanoparticles. Dent Mater 2014; 30(3): 249‒62.

Jalan AL, Warhadpande MM, Dakshindas DM. A comparison of human dental pulp response to calcium hydroxide and Bio-dentine as direct pulp-capping agents. J Conserv Dent 2017; 20(2): 129‒33.

Hegde S, Sowmya B, Mathew S, Bhandi SH, Nagaraja S, Dinesh K. Clinical evaluation of mineral trioxide aggregate and bio-dentine as direct pulp capping agents in carious teeth. J Con-serv Dent 2017; 20(2): 91‒5.

Li Z, Cao L, Fan M, Xu Q. Direct pulp capping with calcium hydroxide or mineral trioxide aggregate: A meta-analysis. J Endod 2015; 41(9): 1412‒7.

Bimstein E, Rotstein I. Cvek pulpotomy - revisited. Dent Traumatol 2016; 32(6): 438‒42.

Teodorovic, N. Use of ceramic biomaterials in dental root canal treatment canals [dissertation]. Belgrade: University of Bel-grade, Faculty of Dentistry; 1998. (Serbian)

Djordjevic M. Comparative study of hydroxyapatie and calcium hydroxyde as the materials for direct and indirect pulp capping [dissertation]. Belgrade: University of Belgrade, Faculty of Dentistry; 2004. (Serbian)

Melih I. Experimental and clinical evaluation of adhesion of different materials for the root canal obturation [dissertation]. Pančevo: Faculty of Dentistry, University of Economics Academy in Novi Sad; 2015. (Serbian)

Brizuela C, Ormeño A, Cabrera C, Cabezas R, Silva CI, Ramírez V, et al. Direct Pulp Capping with Calcium Hydroxide, Min-eral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial. J Endod 2017; 43(11): 1776‒80.

Pissiotis E, Spangberg LS. Biological evaluation of collagen gels containing calcium hydroxide and hydroxyapatite. J Endod 1990; 16(10): 468‒73.

Grossman L. Short-cuts in endodontic practice: are they worth the risks? Oral Health 1976; 66(12): 9‒10.

Sugawara A, Chow LC, Takagi S, Chohayeb H. In vitro evalua-tion of the sealing ability of a calcium phosphate cement when used as a root canal sealer-filler. J Endod 1990; 16(4): 162‒5.

Mongiorgi R, Prati C, Bertocchi G, Monti S. Chemistry and struc-ture of a new canal sealer showing a dynamical behaviour. Boll Soc Ital Biol Sper 1993; 69(6): 415‒22.

Melin M, Joffre-Romeas A, Farges JC, Couble ML, Magloire H, Bleicher F. Effects of TGFbeta1 on dental pulp cells in cul-tured human tooth slices. J Dent Res 2000; 79(9): 1689‒96.

Santos SCNDS, Sigurjonsson ÓE, Custódio CA, Mano JFCDL. Blood Plasma Derivatives for Tissue Engineering and Regen-erative Medicine Therapies. Tissue Eng Part B Rev 2018; 24(6): 454‒62.

Verstraete FJM, Osofsky A. Dentistry in pet rabbits. Comp Cont Educ Pract 2005; 27(9): 671–84.

Tziafa C, Koliniotou-Koumpia E, Papadimitriou S, Tziafas D. Den-tinogenic responses after direct pulp capping of miniature swine teeth with Biodentine. J Endod 2014; 40(12): 1967‒71.

Orhan EO, Maden M, Senguüven B. Odontoblast-like cell num-bers and reparative dentine thickness after direct pulp capping with platelet-rich plasma and enamel matrix derivative: a his-tomorphometric evaluation. Int Endod J 2012; 45(4): 317‒25.

Laurent P, Camps J, About I. Biodentine(TM) induces TGF-β1 release from human pulp cells and early dental pulp minerali-zation. Int Endod J 2012; 45(5): 439‒48.

Girish K, Mandava J, Chandra RR, Ravikumar K, Anwarullah A, Athaluri M. Effect of obturating materials on fracture re-sistance of simulated immature teeth. J Conserv Dent 2017; 20(2): 115‒9.

Teodorović N, Martinović Ž. Significance of apico-coronal tech-nique of dental root canal preparation in endodontic therapy using hydroxyapatite-based sealants. Vojnosanit Pregl 2005; 62(6): 447‒52. (Serbian)

Zhang L, Li QL, Cao Y, Wang Y. Regenerating a monoblock to obturate root canalsvia a mineralising strategy. Sci Rep 2018; 8(1): 13356

Published
2021/04/02
Section
Original Paper