Supplementary solvent irrigation efficacy on filling remnants removal comparing XP-endo Finisher R vs IrriSafe.

This study aimed to compare the efficacy of XP-endo Finisher R and IrriSafe, with a solvent mixture of Methyl ethyl ketone/Tetrachloroethylene (MEK/TCE), in the removal of root filling residues. Twenty-four human mandibular incisors were pair-matched by micro-computed tomography according to volume and aspect ratio. After retreatment, specimens were allocated to two experimental groups (n = 12), according to the supplementary instrument used. The volume of residual filling material after each irrigating step and the time for retreatment was calculated. Statistical analyses were carried out using Mann-Whitney test, with a significance level of 5%. The volume of initial root canal filling material between the groups was similar (p > 0.05). With the final irrigation protocol (NaOCl and EDTA) the volume of the filling remnants decreased significantly (p < 0.05) with no differences between IrriSafe or XP-endo Finisher R (p > 0.05). The additional solvent mixture MEK/TCE increased the efficiency of filling materials reduction, regardless of the agitating instruments employed, IrriSafe or XP-endo Finisher R (p < 0.05). There was no difference between the two groups regarding the time (p = 0.149). Both supplementary instruments were effective in the reduction of filling remnants. The additional step with a solvent mixture of MEK/TCE enabled a total recovery of patency and the achievement of cleaner canals, independently of the agitation instrument.

Adjunctive procedure with solvent mixtures in non-surgical endodontic retreatment: does it affect root dentin hardness?

The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root's middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p < 0.05). Comparing to NaOCl + EDTA sequence, dentin hardness increased significantly with the additional exposure to MEK/TCE (3%NaOCl + 17%EDTA + MEK/TCE) or MEK/OOil (3%NaOCl + 17%EDTA + MEK/OOil) (p < 0.05). There were no significant differences regarding agitation effects on dentin hardness decrease. The irrigation protocols affected dentin hardness significantly. However, the additional solvent proposals do not seem to address further concerns on dentin's mechanical properties. Agitation did not show any influence on dentin's hardness reduction.

Efficacy and Cytotoxicity of Binary Mixtures as Root Canal Filling Solvents.

OBJECTIVES: This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity. METHODS: Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups (n = 15) of standardized stainless-steel molds filled with softened gutta-percha cones and twelve (n = 15) filled with AH Plus were immersed in the corresponding mixture or individual solvent, in an ultrasonic bath, for either 2 or 5 min. The effect of the solvents was assessed qualitatively by a topographical analysis (scanning electron microscopy) and chemical analysis (Fourier transform infrared spectroscopy), and quantitatively by a weight loss and viscoelastic property (dynamic mechanical analysis) evaluation. The cytotoxicity was assessed on MG63 human osteoblastic cells. RESULTS: The mixtures did not show the formation of new compounds. Both presented significantly higher efficacies compared to their individual solvents, suggesting a synergistic effect. Their dissolution efficacy was similar to that of chloroform, showing high cytocompatibility. CONCLUSIONS: The proposed strategy, incorporating ultrasound agitation and profiting from the synergy of adequate solvents, might enhance root canal cleanliness allowing a single-step procedure to dissolve gutta-percha and the sealer remnants, while assuring cytocompatibility with the periapical tissues.

Preparation of chitosan-hydroxyapatite composite mono-fiber using coagulation method and their mechanical properties.

Autograft has been carried out for anterior cruciate ligament (ACL) reconstruction surgery. However, it has negative aspect because patients lose their healthy ligaments from other part. We focus on a chitosan-hydroxyapatite (HAp) composite fiber as a scaffold of ligament regeneration. Chitosan- HAp composite fiber was made by using coagulation method. Chitosan-NaH2PO4 solution was coagulated with coagulation bath including calcium ion to get the mono-fiber and then treated with sodium hydroxide solution to form HAp in fiber matrix. The mechanical property of the fiber was improved by the stretching of the wet one because of the orientation of chitosan molecule and the interaction between chitosan and HAp. Maximum stress was improved with increasing of sodium dihydrogen phosphate until 0.03M. The swelling ratio of the fiber was inhibited by composited with HAp. Additionally, bone-bonding ability was confirmed by SBF soaking tests.

New Insight into the Dissolution of Epoxy Resin-based Sealers.

INTRODUCTION: The purpose of this study was to evaluate the use of solvents that are not traditionally used in dentistry for the dissolution of an epoxy resin-based sealer and the effect of ultrasonic agitation (UA). METHODS: The dissolution of the AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) and the effect of UA in various solvents (eucalyptol, xylene, chloroform, EndoSolv R [Septodont, Cedex, France], EndoSolv E [Septodont], methyl ethyl ketone [MEK], and ethyl acetate) were quantified. The dissolving capacity was assessed by weight loss, Vicker microhardness, scanning electron microscopy (SEM), and X-ray diffraction (XRD). The results were compared with factorial analysis of variance using IBM SPSS Statistics 23.0 software (IBM, Armonk, NY), considering a 0.05 significance level. A preliminary ex vivo study was performed in extracted teeth, with MEK activated by UA as the final irrigation after mechanical removal of the filling material. SEM was used for assessing the cleanliness of the root canal walls. RESULTS: The new solvent proposals, ethyl acetate and MEK, exhibited high dissolution ability, almost reaching chloroform. UA increased dissolution. Vicker values corroborated the dissolution assays. SEM and XRD revealed that solvents affected mainly the organic component of the sealer. Ex vivo results confirmed the immersion model findings. CONCLUSIONS: MEK and ethyl acetate proved to be excellent alternatives to chloroform or xylene solvents. MEK presented a high sealer dissolving ability in a short period, especially with UA, without the potential hazards of chloroform, suggesting it is a good approach to AH Plus sealer's dissolution empowered by UA. These results should encourage further studies in order to confirm their clinical relevance.

Long term performance evaluation of small-diameter vascular grafts based on polyvinyl alcohol hydrogel and dextran and MSCs-based therapies using the ovine pre-clinical animal model.

The functional and structural performance of a 5cm synthetic small diameter vascular graft (SDVG) produced by the copolymerization of polyvinyl alcohol hydrogel with low molecular weight dextran (PVA/Dx graft) associated to mesenchymal stem cells (MSCs)-based therapies and anticoagulant treatment with heparin, clopidogrel and warfarin was tested using the ovine model during the healing period of 24 weeks. The results were compared to the ones obtained with standard expanded polyetetrafluoroethylene grafts (ePTFE graft). Blood flow, vessel and graft diameter measurements, graft appearance and patency rate (PR), thrombus, stenosis and collateral vessel formation were evaluated by B-mode ultrasound, audio and color flow Doppler. Graft and regenerated vessels morphologic evaluation was performed by scanning electronic microscopy (SEM), histopathological and immunohistochemical analysis. All PVA/Dx grafts could maintain a similar or higher PR and systolic/diastolic laminar blood flow velocities were similar to ePTFE grafts. CD14 (macrophages) and α-actin (smooth muscle) staining presented similar results in PVA/Dx/MSCs and ePTFE graft groups. Fibrosis layer was lower and endothelial cells were only detected at graft-artery transitions where it was added the MSCs. In conclusion, PVA/Dx graft can be an excellent scaffold candidate for vascular reconstruction, including clinic mechanically challenging applications, such as SDVGs, especially when associated to MSCs-based therapies to promote higher endothelialization and lower fibrosis of the vascular prosthesis, but also higher PR values.

Long term performance evaluation of small-diameter vascular grafts based on polyvinyl alcohol hydrogel and dextran and MSCs-based therapies using the ovine pre-clinical animal model.

The functional and structural performance of a 5cm synthetic small diameter vascular graft (SDVG) produced by the copolymerization of polyvinyl alcohol hydrogel with low molecular weight dextran (PVA/Dx graft) associated to mesenchymal stem cells (MSCs)-based therapies and anticoagulant treatment with heparin, clopidogrel and warfarin was tested using the ovine model during the healing period of 24 weeks. The results were compared to the ones obtained with standard expanded polyetetrafluoroethylene grafts (ePTFE graft). Blood flow, vessel and graft diameter measurements, graft appearance and patency rate (PR), thrombus, stenosis and collateral vessel formation were evaluated by B-mode ultrasound, audio and color flow Doppler. Graft and regenerated vessels morphologic evaluation was performed by scanning electronic microscopy (SEM), histopathological and immunohistochemical analysis. All PVA/Dx grafts could maintain a similar or higher PR and systolic/diastolic laminar blood flow velocities were similar to ePTFE grafts. CD14 (macrophages) and α-actin (smooth muscle) staining presented similar results in PVA/Dx/MSCs and ePTFE graft groups. Fibrosis layer was lower and endothelial cells were only detected at graft-artery transitions where it was added the MSCs. In conclusion, PVA/Dx graft can be an excellent scaffold candidate for vascular reconstruction, including clinic mechanically challenging applications, such as SDVGs, especially when associated to MSCs-based therapies to promote higher endothelialization and lower fibrosis of the vascular prosthesis, but also higher PR values.

Antimicrobial Approaches for Textiles: From Research to Market.

The large surface area and ability to retain moisture of textile structures enable microorganisms' growth, which causes a range of undesirable effects, not only on the textile itself, but also on the user. Due to the public health awareness of the pathogenic effects on personal hygiene and associated health risks, over the last few years, intensive research has been promoted in order to minimize microbes' growth on textiles. Therefore, to impart an antimicrobial ability to textiles, different approaches have been studied, being mainly divided into the inclusion of antimicrobial agents in the textile polymeric fibers or their grafting onto the polymer surface. Regarding the antimicrobial agents, different types have been used, such as quaternary ammonium compounds, triclosan, metal salts, polybiguanides or even natural polymers. Any antimicrobial treatment performed on a textile, besides being efficient against microorganisms, must be non-toxic to the consumer and to the environment. This review mainly intends to provide an overview of antimicrobial agents and treatments that can be performed to produce antimicrobial textiles, using chemical or physical approaches, which are under development or already commercially available in the form of isolated agents or textile fibers or fabrics.

Evaluation of biodegradable electric conductive tube-guides and mesenchymal stem cells.

AIM: To study the therapeutic effect of three tube-guides with electrical conductivity associated to mesenchymal stem cells (MSCs) on neuro-muscular regeneration after neurotmesis. METHODS: Rats with 10-mm gap nerve injury were tested using polyvinyl alcohol (PVA), PVA-carbon nanotubes (CNTs) and MSCs, and PVA-polypyrrole (PPy). The regenerated nerves and tibialis anterior muscles were processed for stereological studies after 20 wk. The functional recovery was assessed serially for gait biomechanical analysis, by extensor postural thrust, sciatic functional index and static sciatic functional index (SSI), and by withdrawal reflex latency (WRL). In vitro studies included cytocompatibility, flow cytometry, reverse transcriptase polymerase chain reaction and karyotype analysis of the MSCs. Histopathology of lung, liver, kidneys, and regional lymph nodes ensured the biomaterials biocompatibility. RESULTS: SSI remained negative throughout and independently from treatment. Differences between treted groups in the severity of changes in WRL existed, showing a faster regeneration for PVA-CNTs-MSCs (P < 0.05). At toe-off, less acute ankle joint angles were seen for PVA-CNTs-MSCs group (P = 0.051) suggesting improved ankle muscles function during the push off phase of the gait cycle. In PVA-PPy and PVA-CNTs groups, there was a 25% and 42% increase of average fiber area and a 13% and 21% increase of the "minimal Feret's diameter" respectively. Stereological analysis disclosed a significantly (P < 0.05) increased myelin thickness (M), ratio myelin thickness/axon diameter (M/d) and ratio axon diameter/fiber diameter (d/D; g-ratio) in PVA-CNT-MSCs group (P < 0.05). CONCLUSION: Results revealed that treatment with MSCs and PVA-CNTs tube-guides induced better nerve fiber regeneration. Functional and kinematics analysis revealed positive synergistic effects brought by MSCs and PVA-CNTs. The PVA-CNTs and PVA-PPy are promising scaffolds with electric conductive properties, bio- and cytocompatible that might prevent the secondary neurogenic muscular atrophy by improving the reestablishment of the neuro-muscular junction.

Samarium doped glass-reinforced hydroxyapatite with enhanced osteoblastic performance and antibacterial properties for bone tissue regeneration.

A novel bioactive bone substitute with improved osteoblastic performance and effective antibacterial activity was developed, using a completely new approach based on samarium (Sm3+) doped P2O5 glass-reinforced hydroxyapatite composites (GR-HA). The composites were prepared by adding 2.5% (w/w) of the P2O5 glass to 97.5% (w/w) of HA. Four composites were developed, i.e. one non-doped composite, and three Sm3+ doped composites prepared with the P2O5 glass containing 0.5, 1 and 2 (mol%) of Sm2O3. The composites were labeled as GR-HA_control, GR-HA_0.5Sm, GR-HA_1Sm and GR-HA_2Sm. The composites were physicochemical and mechanically characterized, namely performing SEM, EDS and XRD analysis and flexural bending strength (FBS) assessment. The incorporation of Sm3+ in the GR-HA matrix resulted in the presence of a residual Sm3+ containing phase besides HA, ß-TCP and α-TCP phases, increased surface hydrophilicity and slightly higher FBS. Sm3+ doped composites exhibited improved osteoblastic cell response, as evidenced by a better F-actin cytoskeleton organization and higher cell proliferation and expression of relevant osteoblastic genes. In addition, adhesion of Staphylococcus aureus and Staphylococcus epidermidis was greatly reduced on these composites. The improved osteoblastic behavior and the antibacterial effects were dependent on the amount of Samarium in the composite, this being particularly evident in the composite with a higher Sm3+ content. Therefore, the developed composite GR-HA_2Sm appears as a successful bone substitute with osteoconductive and antibacterial properties.

Perspectives of employing mesenchymal stem cells from the Wharton's jelly of the umbilical cord for peripheral nerve repair.

Mesenchymal stem cells (MSCs) from Wharton's jelly present high plasticity and low immunogenicity, turning them into a desirable form of cell therapy for the injured nervous system. Their isolation, expansion, and characterization have been performed from cryopreserved umbilical cord tissue. Great concern has been dedicated to the collection, preservation, and transport protocols of the umbilical cord after the parturition to the laboratory in order to obtain samples with higher number of viable MSCs without microbiological contamination. Different biomaterials like chitosan-silicate hybrid, collagen, PLGA90:10, poly(DL-lactide-ɛ-caprolactone), and poly(vinyl alcohol) loaded with electrical conductive materials, associated to MSCs have also been tested in the rat sciatic nerve in axonotmesis and neurotmesis lesions. The in vitro studies of the scaffolds included citocompatibility evaluation of the biomaterials used and cell characterization by imunocytochemistry, karyotype analysis, differentiation capacity into neuroglial-like cells, and flow cytometry. The regeneration process follow-up has been performed by functional analysis and the repaired nerves processed for stereological studies permitted the morphologic regeneration evaluation. The MSCs from Wharton's jelly delivered through tested biomaterials should be regarded a potentially valuable tool to improve clinical outcome especially after trauma to sensory nerves. In addition, these cells represent a noncontroversial source of primitive mesenchymal progenitor cells, which can be harvested after birth, cryogenically stored, thawed, and expanded for therapeutic uses. The importance of a longitudinal study concerning tissue engineering of the peripheral nerve, which includes a multidisciplinary team able to develop biomaterials associated to cell therapies, to perform preclinical trials concerning animal welfare and the appropriate animal model is here enhanced.

Degradation studies and biological behavior on an artificial cornea material.

PURPOSE: Patients with dry eye syndrome, Stevens-Johnson syndrome, or recurrent transplant rejections are unsuitable to receive a keratoprosthesis. The present work aims at developing a highly biocompatible keratoprosthesis that could be successfully implanted in such patients. METHODS: Glass-reinforced hydroxyapatite (GRHA) was used to construct this new artificial cornea. To grant the device an adequate porosity, a porogen agent was added in the following percentages: 10, 30, and 50%. Samples were physicochemically analyzed in terms of density, porosity, roughness, degradation, and surface imaging. Biological relevance was assessed by cell culture, MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrasodium bromide) assays, and cell imaging. RESULTS: Samples B (30% porogen) and C (50% porogen) were found to be the most porous and also had the roughest topography. Degradation studies showed that under simulated physiologic conditions, no mass loss was found. Conversely, under acidic conditions, a significant mass loss was found. The biological performance of these samples was satisfactory when cultured with human fibroblasts. The MTT assay revealed that samples B and C had greater propensity to cell invasion and proliferation than that of the other tested materials. Cell imaging demonstrated that fibroblasts organized around the pore edges before colonizing it. CONCLUSIONS: A material with physicochemical and biological characteristics close to an ideal artificial cornea has been fabricated. The GRHA cornea containing 30% porogen is the most promising substitute material due to the biological performance, adequate porosity, and low degradation propensity.

Physical, chemical and in vitro biological profile of chitosan hybrid membrane as a function of organosiloxane concentration.

We attempted to prepare chitosan-silicate hybrid for use in a medical application and evaluated the physico-chemical properties and osteocompatibility of the hybrids as a function of gamma-glycidoxypropyltrimethoxysilane (GPTMS) concentration. Chitosan-silicate hybrids were synthesized using GPTMS as the reagent for cross-linking of the chitosan chains. Fourier transform infrared spectroscopy, (29)Si CP-MAS NMR spectroscopy and the ninhydrin assay were used to analyze the structures of the hybrids, and stress-strain curves were recorded to estimate their Young's modulus. The swelling ability, contact angle and cytocompatibility of the hybrids were investigated as a function of the GPTMS concentration. A certain fraction of GPTMS in each hybrid was linked at the epoxy group to the amino group of chitosan, which was associated with the change in the methoxysilane group of GPTMS due to hybridization. The cross-linking density was around 80% regardless of the volume of GPTMS. As the content of GPTMS increased, the water uptake decreased and the hydrophilicity of the hybrids increased except when the content exceeded amolar ratio of 1.5, when it caused a decrease. The values of the mechanical parameters assessed indicated that significant stiffening of the hybrids was obtained by the addition of GPTMS. The adhesion and proliferation of the MG63 osteoblast cells cultured on the chitosan-GPTMS hybrid surface were improved compared to those on the chitosan membrane, regardless of the GPTMS concentration. Moreover, human bone marrow osteoblast cells proliferated on the chitosan-GPTMS hybrid surface and formed a fibrillar extracellular matrix with numerous calcium phosphate globular structures, both in the presence and in the absence of dexamethasone. Therefore, the chitosan-GPTMS hybrids are promising candidates for basic materials that can promote bone regeneration because of their controllable composition (chitosan/GPTMS ratio).

In vitro cytocompatibility of MG63 cells on chitosan-organosiloxane hybrid membranes.

Chitosan-silicate hybrids were synthesized using gamma-glycidoxypropyltrimethoxysilane (GPSM) as the agent for cross-linking the chitosan chains. CaCl2 was introduced in the hybrids in expectation that it would improve cell adhesion and differentiation of the hybrid surfaces. Fourier-transform infrared (FT-IR) spectroscopy and 29Si CP-MAS NMR spectroscopy were used to analyze the structures of the hybrids. Cytocompatibility of the hybrids was investigated in terms of proliferation of an osteoblastic cell line, MG63. The adhesion and proliferation of the osteoblastic cells cultured on the surface of a chitosan-GPSM hybrid without calcium were similar to those on a control culture plate, and were better than those on a chitosan membrane. The ALP activity of the cells cultured on this hybrid was higher than that on the chitosan membrane. Contrary to expectations, the incorporation of calcium ions into the hybrids did not improve cell attachment and proliferation on their surfaces.