Comparative Study of Technologies for Tubule Occlusion and Treatment of Dentin Hypersensitivity.

This study aimed to evaluate the occluding/remineralization performance and resistance to acid attacks of the mineralization layer formed by a tooth-desensitizing gel containing amorphous calcium magnesium phosphate (ACMP) particles and compare it to six other desensitizing products available on the market. Similar comprehensive studies are few and there is especially a lack of studies that are up to date. A dentin-disc model was used for in vitro evaluation of the desensitizing toothpastes/gels. Application of the products was performed twice daily for seven days. One set of specimens were evaluated using scanning electron microscopy (SEM) directly after the final treatment and another set was evaluated after an acid challenge, exposing specimens to 2 wt% citric acid. The ACMP desensitizing gel was the only product resulting in complete occlusion by the formation of mineralized material on the dentin surface and inside the tubules. Particle deposition was dominant after treatment with the other desensitizing products, with little or no mineralization, resulting in partial occlusion only. Sensodyne Repair & Protect and Oral-B Pro-Expert showed the highest resistance toward acid attacks. Material inside the tubules remained relatively unaffected by acid attacks in all specimens. The results in this study indicated a great variability among the occluding agents in terms of occlusion and acid resistance of the mineralization layer. The high degree of occlusion and intra-tubular mineralization that could mitigate the effect of acid solubilization indicate that the ACMP desensitizing gel may be a superior option for the treatment of dentin hypersensitivity.

Sequential macrophage transition facilitates endogenous bone regeneration induced by Zn-doped porous microcrystalline bioactive glass.

Macrophages play an important role in the immune microenvironment during bone healing, and sequential macrophage phenotypic transition could achieve superior osteogenic outcomes. Microcrystalline bioactive glasses (MCBGs) with osteoimmunomodulatory effects show potential in bone tissue regeneration. Zinc (Zn) has been approved to coordinate innate and adaptive immunity. Therefore, in this study, different amounts of ZnO were incorporated into microcrystalline bioactive glass to improve its immunomodulatory ability. The effect of Zn-MCBG ionic extracts on macrophage transition was studied, and the 5Zn-MCBG extracts could orchestrate sequential M1-to-M2 macrophage transition and promote the expression of proinflammatory and anti-inflammatory genes and cytokine expression to induce human bone marrow stromal cells (hBMSCs) osteogenic differentiation in vitro. Macroporous Zn-MCBG scaffolds containing mesopores were fabricated and showed good cell adhesion and feasible apatite formation when immersed in SBF in vitro. Furthermore, a rat calvarial defect model was used to confirm that the Zn-MCBG scaffold could modulate macrophage phenotypic transition and create a desirable osteogenic microenvironment to promote osteogenesis in vivo.

Amorphous Calcium Magnesium Phosphate Particles for Treatment of Dentin Hypersensitivity: A Mode of Action Study.

Occlusion of exposed dentin tubules may eliminate or reduce dentin hypersensitivity by hindering fluid movements within the tubules. In this study, the mode of action of spherical particles of amorphous calcium magnesium phosphate (180-440 nm in diameter) was studied. A degradation study of the particles in Tris-HCl buffer showed that the particles continuously released Ca2+, Mg2+, and phosphate, and XRD analysis revealed the formation of hydroxyapatite (HA) after 1 week. The occluding effect and efficacy of the spherical particles as an occluding agent were evaluated in an in vitro study. The ACMP particles were incorporated in a gel intended for at-home use and tested on extracted human molars. Application of the particles followed by incubation in artificial saliva resulted in occlusion of exposed tubules, and examination with SEM showed that the particles could penetrate the tubules down to 100 µm from the dentin surface. Transformation of the particles into nanocrystalline HA-structures (nanoHA) was initiated at the dentin surface within 12 h of application, and tubule penetration of the particles, accompanied by further ion release and diffusion of ions, resulted in deep intratubular occlusion in the majority of the tubules within 3 days from application. NanoHA was tightly adhered to the tubule walls, filling the entire tubule volume after 7 days. The results of this study demonstrate the mode of action of the amorphous calcium magnesium phosphate particles in occluding exposed dentin tubules. Interaction with saliva and transformation of the particles within the tubules inducing further mineralization indicate that the particles may be used as an effective treatment to reduce dentin hypersensitivity.