Tuning multi/pluri-potent stem cell fate by electrospun poly(L-lactic acid)-calcium-deficient hydroxyapatite nanocomposite mats.

In this study, we investigated whether multipotent (human-bone-marrow-derived mesenchymal stem cells [hBM-MSCs]) and pluripotent stem cells (murine-induced pluripotent stem cells [iPSCs] and murine embryonic stem cells [ESCs]) respond to nanocomposite fibrous mats of poly(L-lactic acid) (PLLA) loaded with 1 or 8 wt % of calcium-deficient nanohydroxyapatite (d-HAp). Remarkably, the dispersion of different amounts of d-HAp to PLLA produced a set of materials (PLLA/d-HAp) with similar architectures and tunable mechanical properties. After 3 weeks of culture in the absence of soluble osteogenic factors, we observed the expression of osteogenic markers, including the deposition of bone matrix proteins, in multi/pluripotent cells only grown on PLLA/d-HAp nanocomposites, whereas the osteogenic differentiation was absent on stem-cell-neat PLLA cultures. Interestingly, this phenomenon was confined only in hBM-MSCs, murine iPSCs, and ESCs grown on direct contact with the PLLA/d-HAp mats. Altogether, these results indicate that the osteogenic differentiation effect of these electrospun PLLA/d-HAp nanocomposites was independent of the stem cell type and highlight the direct interaction of stem cell-polymeric nanocomposite and the mechanical properties acquired by the PLLA/d-HAp nanocomposites as key steps for the differentiation process.

Mesoporous bioactive glass as a multifunctional system for bone regeneration and controlled drug release.

PURPOSE: Coupling the potential for bone regeneration and the ability for in situ controlled drug release in a single device is a challenging field of research in bone tissue engineering; in an attempt to pursue this aim, mesoporous bioactive glass (MBG) membranes belonging to the SiO2-P2O5-CaO ternary system were produced and characterized. METHODS: The glass was synthesized via a sol-gel route coupled with an evaporation-induced self-assembly process by using a non-ionic block co-polymer as a mesostructure former. MBG structure and morphology, as well as mesopores size and shape, were investigated by x-ray diffraction, transmission electron microscopy, and N2 adsorption-desorption measurements. In vitro bioactivity was investigated by soaking MBG membranes in simulated body fluid (SBF) for different time frames. Ibuprofen was encapsulated into MBG pores and drug release kinetics in SBF were assessed. Biological tests by using SAOS-2 cells were performed to assess the material cytocompatibility. RESULTS: The material revealed significant ability to induce hydroxyapatite formation on its surface (bioactivity). Drug release kinetics in SBF are very similar to those obtained for mesoporous silica having mesopore size comparable to that of the prepared MBG (∼5 nm). No evidence of cell viability depression was detected during in vitro culture, which demonstrates the good biological compatibility of the material. CONCLUSIONS: The easiness of tailoring and shaping, the highly bioactive and biocompatible behavior, and the drug uptake/release ability of the prepared materials may suggest their use as "smart" multifunctional grafts for bone reconstructive surgery.

Photoactivated disinfection (PAD) in endodontics: an in vitro microbiological evaluation.

PURPOSE: The objective of the present study was the in vitro evaluation by MTT test of the antimicrobial effect of photoactivated disinfection (PAD) and, comparatively, of a conventional 5.25% NaOCl irrigating solution. METHODS: Enterococcus faecalis, Streptococcus mutans and Streptococcus sanguis strains were selected for the test. Freshly extracted single-rooted human teeth were endodontically treated, inoculated with bacterial strains and then divided into different groups, each of them treated with PAD, with PAD plus 0.5% NaOCl solution, with TBO, with PAD for longer time and with 5% NaOCl solution (positive control). RESULTS: The results were significantly different among the various groups, and for Enterococcus faecalis, Streptococcus mutans and Streptococcus sanguis. PAD applied for a longer time (in respect to manufacturer's instructions) or PAD associated to 5% NaOCl showed the significantly higher antibacterial effects.

Antibacterial effects of six endodontic sealers.

PURPOSE: The objective of this study was to perform an in vitro evaluation of the antibacterial properties of 6 endodontic sealers (Endomethasone C, Argoseal, Bioseal Normal, Acroseal, AH Plus, Sicura Seal). METHODS: The agar diffusion test (well and paper disc methods) with Enterococcus faecalis, Staphylococcus aureus and Streptococcus mutans was used. For the well method, Petri dishes were inoculated with bacterial suspensions. Each well was completely filled with freshly mixed endodontic sealer. For the paper disc method, sterile paper discs were immersed in freshly mixed sealers and put on agar plates. Diameters of halos formed around the sealers were measured after 24 h and 48 h. STATISTICAL ANALYSIS: The effects of well method and of paper disc method were analyzed by 1-way ANOVA. RESULTS: Endomethasone C, Argoseal and Bioseal showed the largest inhibition halos for all the tested microorganisms, while Sicura Seal and AH Plus showed low antibacterial effects. Moreover, the comparison of well method and paper disc methods showed significant statistical differences (P<0,01) for all sealers and indicated a dose-dependent antimicrobial effect.

In vitro evaluation of antimicrobial efficacy of endodontic irrigants.

PURPOSE: The objective of this study was to compare in vitro, by MTT assay, the antimicrobial efficacy of Niclor 5 (5% NaOCl solution), Cloreximid (0.2% chlorhexidine and 0.2% cetrimide solution), 3% hydrogen peroxide and 17% EDTA against two microorganisms associated with primary endodontic infections. METHODS: Enterococcus faecalis and Streptococcus mutans strains were selected for this test. Freshly extracted single-rooted human teeth were endodontically treated, inoculated with bacterial strains and then divided into different groups, each of them rinsed with Niclor 5 (5% NaOCl solution), Cloreximid (0.2% chlorhexidine and 0.2% cetrimide solution), 3% hydrogen peroxide,17% EDTA and with 5% NaOCl solution (positive control). RESULTS: Even though all the tested irrigating solutions demonstrated antibacterial effects against E. faecalis and S. mutans, the results were significantly different between the various groups. The greatest antimicrobial effects were observed in groups treated with 5% NaOCl and 17% EDTA. Interestingly, the effectiveness of EDTA could be ascribed to its capability of detaching biofilm from canal walls.

Bone reconstruction: Au nanocomposite bioglasses with antibacterial properties.

Bioglasses are of wide interest since they spontaneously bond and integrate with living bone in the body. By varying the glass chemistry and/or by adding some dopants, it is possible to improve their clinical applications. Gold nanoparticles (Au NPs) are a well-known antibacterial agent, as well as a unique probe for sensing and imaging applications. We report on the synthesis of a 58S bioglass doped with Au NPs at two doping levels: 0.1% wt. and 1% wt. Antibacterial properties were observed on the Gram-positive Staphylococcus aureus, whereas no significant effects were found on the Gram-negative Escherichia coli. A possible mechanism of action of Au NPs towards bacteria has been described.

Electrochemically induced anatase inhibits bacterial colonization on Titanium Grade 2 and Ti6Al4V alloy for dental and orthopedic devices.

Bacterial contamination of implanted devices is a common cause of their failure. The aim of the present study was to assess the capability of electrochemical procedures to: (a) promote the formation of anatase on the surface of commercially pure Grade 2 Ti and Ti Grade 5 (Ti6Al4V) alloy; (b) inhibit in vitro biofilm formation of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans and Porphyromonas gingivalis and oral plaque in vivo, (c) preserve favorable response of osteoblasts and fibroblasts to materials surfaces. Ti Grade 2 and Ti Grade 5 were respectively anodized at two different voltages: 90 and 130V for pure titanium; 100 and 120V for Ti6Al4V alloy. Surface characterization was performed by scanning electron microscopy (SEM) equipped with EDS probe, laser profilometry and X-ray diffractometry. Bacterial adhesion characterization was performed either in vitro and in vivo in patients. Osteoblast and fibroblast response was evaluated by metabolic activity assessment. The higher voltage applied in the anodization treatment of pure titanium (130V) and Ti6Al4V alloy (120V) surfaces, compared to the untreated pure titanium and Ti6Al4V and to lower voltage treatments, resulted in a greater decrease in bacterial attachment and biofilm formation in both in vitro and in vivo experiments. In contrast, the high voltage treatments were found to promote osteoblasts and fibroblasts proliferation. The observations indicated that the experimented high voltage anodization treatments may contribute to preserve the tissue integration and reduce bacteria colonization of titanium and titanium alloy for implantable applications.

Effect of electrospun fiber diameter and alignment on macrophage activation and secretion of proinflammatory cytokines and chemokines.

Macrophage activation can be modulated by biomaterial topography according to the biological scale (micrometric and nanometric range). In this study, we investigated the effect of fiber diameter and fiber alignment of electrospun poly(L-lactic) (PLLA) scaffolds on macrophage RAW 264.7 activation and secretion of proinflammatory cytokines and chemokines at 24 h and 7 days. Macrophages were cultured on four different types of fibrous PLLA scaffold (aligned microfibers, aligned nanofibers, random microfibers, and random nanofibers) and on PLLA film (used as a reference). Substrate topography was found to influence the immune response activated by macrophages, especially in the early inflammation stage. Secretion of proinflammatory molecules by macrophage cells was chiefly dependent on fiber diameter. In particular, nanofibrous PLLA scaffolds minimized the inflammatory response when compared with films and microfibrous scaffolds. The histological evaluation demonstrated a higher number of foreign body giant cells on the PLLA film than on the micro- and nanofibrous scaffolds. In summary, our results indicate that the diameter of electrospun PLLA fibers, rather than fiber alignment, plays a relevant role in influencing in vitro macrophage activation and secretion of proinflammatory molecules.

In vitro calcified matrix deposition by human osteoblasts onto a zinc-containing bioactive glass.

Bioactive glasses synthesized by the sol-gel technique possess many of the qualities associated with an ideal scaffold material for a bone graft substitute. In view of the potential clinical applications, we performed a detailed in vitro study of the biological reactivity of synthesized 58S bioactive glass containing-zinc, in terms of osteoblast morphology, proliferation, and deposition of a mineralized extracellular matrix (ECM). Human Sarcoma Osteoblast (SAOS-2) cells were used to i) assess cytotoxicity by lactate dehydrogenase (LDH) release and ii) evaluate the deposition of a calcified extracellular matrix by ELISA assay and quantitative RT-PCR (qRT-PCR). In comparison with pure silica and 58S, the 58S-Zn0.4 bioglass showed a significant increase in cellular proliferation and deposition of ECM components such as decorin, fibronectin, osteocalcin, osteonectin, osteopontin, type-I and -III collagens. Calcium deposition was significantly higher than on pure silica and 58S samples. Also Alkaline phosphatase (ALP) activity and its protein content was higher with respect to pure silica and 58S. qRT-PCR analysis revealed the up-regulation of type-I collagen, bone sialoprotein and osteopontin genes. All together these results demonstrate the cytocompatibility of 58S-Zn0.4 bioglass and its capability to promote osteoblast differentiation.

Use of a gelatin cryogel as biomaterial scaffold in the differentiation process of human bone marrow stromal cells.

Biomaterials have been widely used in reconstructive bone surgery to heal critical-size long bone defects due to trauma, tumor resection, and tissue degeneration. In particular, gelatin cryogel scaffolds are promising new biomaterials owing to their biocompatibility; in addition, the in vitro modification of biomaterials with osteogenic signals enhances the tissue regeneration in vivo, suggesting that the biomaterial modification could play an important role in tissue engineering. In this study we have followed a biomimetic strategy where differentiated human bone marrow stromal cells built their extracellular matrix onto gelatin cryogel scaffolds. In comparison with control conditions without differentiation medium, the use of a differentiation medium increased, in vitro, the coating of gelatin cryogel with bone proteins (decorin, osteocalcin, osteopontin, type-I collagen, and type-III collagen). The differentiation medium aimed at obtaining a better in vitro modification of gelatin cryogel in terms of cell colonization and coating with osteogenic signals, like bone matrix proteins. The modified biomaterial could be used, in clinical applications, as an implant for bone repair.

Photodynamic action of Tri-meso (N-methyl-pyridyl), meso (N-tetradecyl-pyridyl) porphine on Staphylococcus epidermidis biofilms grown on Ti6Al4V alloy.

Staphylococcus epidermidis is a leading cause of nosocomial infections, and its virulence is attributable to formation of biofilm, especially on implanted devices. Photodynamic treatment (PDT) has been actively investigated for the eradication of bacterial biofilm growing on dental plaques and oral implants. In this study, we used Tri-meso (N-methyl-pyridyl), meso (N-tetradecyl-pyridyl) porphine (C14) for inactivation of two structurally distinct S. epidermidis biofilms grown on Ti6Al4V alloy and compared its photosensitizing efficiency with that of the parent molecule, tetra-substituted N-methyl-pyridyl-porphine (C1). A more significant reduction in bacterial survival was observed when both bacterial biofilms were exposed to a lower dose of C14, and simultaneously to visible light in comparison with C1. The different responses of both staphylococcal biofilms to C1- or C14-treatment appeared to depend on photosensitizer endocellular concentration. C14 bound to both biofilms to a greater extent than C1. Moreover, C14 penetrates deeper into the bacterial membranes, as determined by fluorescence quenching experiments with methylviologen, allowing for better bacterial killing photoefficiency. Confocal laser scanning microscope (CLSM) analysis indicated damage to bacterial cell membranes in both photodynamically treated biofilms, while disruption of PDT-treated biofilm was confirmed by scanning electron microscopy (SEM). In summary, C14 may be a potential photosensitizer for the inactivation of staphylococcal biofilms for many device-related infections which are accessible to visible light.

Low-power ultrasounds as a tool to culture human osteoblasts inside cancellous hydroxyapatite.

Bone graft substitutes and cancellous biomaterials have been widely used to heal critical-size long bone defects due to trauma, tumor resection, and tissue degeneration. In particular, porous hydroxyapatite is widely used in reconstructive bone surgery owing to its biocompatibility. In addition, the in vitro modification of cancellous hydroxyapatite with osteogenic signals enhances the tissue regeneration in vivo, suggesting that the biomaterial modification could play an important role in tissue engineering. In this study, we have followed a tissue-engineering strategy where ultrasonically stimulated SAOS-2 human osteoblasts proliferated and built their extracellular matrix inside a porous hydroxyapatite scaffold. The ultrasonic stimulus had the following parameters: average power equal to 149 mW and frequency of 1.5 MHz. In comparison with control conditions, the ultrasonic stimulus increased the cell proliferation and the surface coating with bone proteins (decorin, osteocalcin, osteopontin, type-I collagen, and type-III collagen). The mechanical stimulus aimed at obtaining a better modification of the biomaterial internal surface in terms of cell colonization and coating with bone matrix. The modified biomaterial could be used, in clinical applications, as an implant for bone repair.

Human adipose-derived stem cells (hASCs) proliferate and differentiate in osteoblast-like cells on trabecular titanium scaffolds.

The use of stem cells in regenerative medicine is an appealing area of research that has received a great deal of interest in recent years. The population called human adipose tissue-derived stem cells (hASCs) share many of the characteristic of its counterpart of marrow including extensive proliferative potential and the ability to undergo multilineage differentiation along classical mesenchymal lineages: adipogenesis, chondrogenesis, osteogenesis, and myogenesis. The aim of this study was to evaluate with biochemical and morphological methods the adhesion and differentiation of hASCs grown on trabecular titanium scaffolds. The hASCs isolated from subcutaneous adipose tissue after digestion with collagenase were seeded on monolayer and on trabecular titanium scaffolds and incubated at 37 degrees C in 5% CO(2) with osteogenic medium or control medium.The results showed that hASCs were able to adhere to titanium scaffolds, to proliferate, to acquire an osteoblastic-like phenotype, and to produce a calcified extracellular matrix with protein, such as, decorin, fibronectin, osteocalcin, osteonectin, osteopontin, and type I collagen. These data suggest that this kind of scaffold/cells construct is effective to regenerate damaged tissue and to restore the function of bone tissue.

Stem Cells Grown in Osteogenic Medium on PLGA, PLGA/HA, and Titanium Scaffolds for Surgical Applications.

Pluripotent adipose tissue-derived stem cells (hASCs) can differentiate into various mesodermal cell types such as osteoblasts, chondroblasts, and myoblasts. We isolated hASCs from subcutaneous adipose tissue during orthopaedic surgery and induced the osteogenic differentiation for 28 days on three different synthetic scaffolds such as polylactide-co-glycolide (PLGA), polylactide-co-glycolide/hydroxyapatite (PLGA/HA), and trabecular titanium scaffolds (Ti6Al4V). Pore size can influence certain criteria such as cell attachment, infiltration, and vascularization. The aim of this study was to investigate the performance of PLGA and PLGA/HA scaffolds with a higher porosity, ranging between 75% and 84%, with respect to Ti scaffolds but with smaller pore size, seeded with hASCs to develop a model that could be used in the treatment of bone defects and fractures. Osteogenesis was assessed by ELISA quantitation of extracellular matrix protein expression, von Kossa staining, X-ray microanalysis, and scanning electron microscopy. The higher amount of protein matrix on the Ti scaffold with respect to PLGA and PLGA/HA leads to the conclusion that not only the type of material but the structure significantly affects cell proliferation.

In vitro electromagnetically stimulated SAOS-2 osteoblasts inside porous hydroxyapatite.

One of the key challenges in reconstructive bone surgery is to provide living constructs that possess the ability to integrate in the surrounding tissue. Bone graft substitutes, such as autografts, allografts, xenografts, and biomaterials have been widely used to heal critical-size long bone defects due to trauma, tumor resection, congenital deformity, and tissue degeneration. In particular, porous hydroxyapatite is widely used in reconstructive bone surgery owing to its biocompatibility. In addition, the in vitro modification of hydroxyapatite with osteogenic signals enhances the tissue regeneration in vivo, suggesting that the biomaterial modification could play an important role in tissue engineering. In this study we have followed a biomimetic strategy where electromagnetically stimulated SAOS-2 human osteoblasts proliferated and built their extracellular matrix inside a porous hydroxyapatite scaffold. The electromagnetic stimulus had the following parameters: intensity of the magnetic field equal to 2 mT, amplitude of the induced electric tension equal to 5 mV, frequency of 75 Hz, and pulse duration of 1.3 ms. In comparison with control conditions, the electromagnetic stimulus increased the cell proliferation and the surface coating with bone proteins (decorin, osteocalcin, osteopontin, type-I collagen, and type-III collagen). The physical stimulus aimed at obtaining a better modification of the biomaterial internal surface in terms of cell colonization and coating with bone matrix.

In vitro enhancement of SAOS-2 cell calcified matrix deposition onto radio frequency magnetron sputtered bioglass-coated titanium scaffolds.

In bone tissue engineering, bioglass coating of titanium (Ti) scaffolds has drawn attention as a method to improve osteointegration and implant fixation. In this in vitro study, bioactive glass layers with an approximate thickness of 1 microm were deposited at 200 degrees C onto a three-dimensional Ti-6Al-4V scaffold using a radio frequency (r.f.) magnetron sputtering system. After incubation with SAOS-2 human osteoblasts, in comparison with the uncoated scaffolds, the bioglass-coated scaffolds showed a twofold increase in cell proliferation (p < 0.05) up to 68.4 x 10(6), and enhanced the deposition of extracellular matrix components such as decorin, fibronectin, osteocalcin, osteonectin, osteopontin, and type-I and -III collagens (p < 0.05). Calcium deposition was twofold greater on the bioglass-coated scaffolds (p < 0.05). The immunofluorescence related to the preceding bone matrix proteins and calcium showed their colocalization to the cell-rich areas. Alkaline phosphatase activity increased twofold (p < 0.001) and its protein content was threefold higher with respect to the uncoated sample. Quantitative reverse transcriptase-polymerase chain reaction analysis revealed upregulated transcription specific for type-I collagen and osteopontin (p < 0.001). All together, these results demonstrate that the bioglass coating of the three-dimensional Ti scaffolds by the r.f. magnetron sputtering technique determines an in vitro increase of the bone matrix elaboration and may potentially have a clinical benefit.

Adhesion of Streptococcus mutans to different restorative materials.

Adherence of oral bacteria to the surface of dental restorative materials is considered an important step in the development of secondary caries and periodontal disease. The aim of this study was to investigate and compare the adherence of different restorative materials to Streptococcus mutans strain (CCUG35176) in order to ascertain possible differences. The materials tested ranged across different classes including: flowable composites (Gradia Direct LoFlo; Filtek Supreme XT Flowable), anterior composites (Gradia Direct Anterior), universal composites (Filtek Supreme XT), packable composites (Filtek Silorane; Filtek P60), glass-ionomers (Fuji IX Gp Extra; Equia) and a control reference material (Thermanox plastic coverlips). Bacterial suspension was deposited onto each material and the adhesion was evaluated trough the colony forming units (CFUs) determination. Packable silorane-based composite was found to be less adhesive than posterior packable composite P60, flowable composites and glass ionomers. The fluoride of glass ionomers did not prevent the attachment of S. mutans; furthermore, after roughness analysis and SEM investigations, the hypothesis that the difference in bacterial adhesion can be determined by the particular surface chemistry of the material itself as well as by different electrostatic forces between bacteria and restorative surfaces must be given serious consideration.

The photodynamic effect of tetra-substituted N-methyl-pyridyl-porphine combined with the action of vancomycin or host defense mechanisms disrupts Staphylococcus epidermidis biofilms.

The skin commensal and opportunistic pathogen Staphylococcus epidermidis is an important cause of nosocomial infections. Virulence is attributable to formation of biofilm, which provides a microenvironment that protects the bacterium from attack by the host immune system and by chemotherapy. In this study we extended to S. epidermidis strategies previously aimed at treatment of S. aureus biofilms using photodynamic treatment (PDT) combined with chemotherapy or phagocytosis. A significant reduction in bacterial survival was observed when structurally distinct biofilms were exposed to the cationic porphyrin, tetra-substituted N-methyl-pyridyl-porphine (TMP), and simultaneously to visible light. Of note, the extent of biofilm clearance depended on its maturation stage: developing, young biofilms, were more sensitive towards PDT than mature biofilms. Furthermore, PDT-treated biofilms exposed to vancomycin or subjected to phagocytic action of whole blood were almost completely eradicated. The data we obtained establish that PDT combined with antibiotics or host defenses may also be a useful approach for the inactivation of S. epidermidis biofilms.

Ultrasonic and electromagnetic enhancement of a culture of human SAOS-2 osteoblasts seeded onto a titanium plasma-spray surface.

Several studies suggest that the surface coating of titanium could play an important role in bone tissue engineering. In the present study, we have followed a particular biomimetic strategy where ultrasonically or electromagnetically stimulated SAOS-2 human osteoblasts proliferated and built their extracellular matrix on a titanium plasma-spray surface. In comparison with control conditions, the ultrasonic stimulation (average power, 149 mW; frequency, 1.5 MHz) and the electromagnetic stimulation (magnetic field intensity, 2 mT; frequency, 75 Hz) caused higher cell proliferation, and increased surface coating with decorin, osteocalcin, osteopontin, and type I collagen together with higher incorporation of calcium and phosphorus inside the extracellular matrix. The immunofluorescence related to the preceding bone matrix proteins showed their colocalization in the cell-rich areas. The use of the two physical stimulations aimed at obtaining the coating of the rough titanium plasma-spray surface in terms of cell colonization and deposition of extracellular matrix. The superficially cultured biomaterial could be theoretically used, in clinical applications, as an implant for bone repair.

Electromagnetic enhancement of a culture of human SAOS-2 osteoblasts seeded onto titanium fiber-mesh scaffolds.

The surface properties of a biomaterial are fundamental to determine the response of the host tissue. In the present study, we have followed a particular biomimetic strategy where electromagnetically stimulated SAOS-2 human osteoblasts proliferated and built a calcified extracellular matrix on a titanium fiber-mesh surface. In comparison with control conditions, the electromagnetic stimulation (magnetic field intensity, 2 mT; frequency, 75 Hz) caused higher cell proliferation and increased surface coating with type-I collagen, decorin, and osteopontin (9.8-fold, 11.3-fold, and 9.5-fold, respectively). Reverse transcriptase-polymerase analysis revealed the electromagnetically upregulated transcription specific for the foregoing matrix proteins and for the growth factor TGF-beta1. The immunofluorescence of type-I collagen, decorin, and osteopontin showed their colocalization in the cell-rich areas. The use of an electromagnetic bioreactor aimed at obtaining the surface modification of the biocompatible metallic scaffold in terms of cell colonization and coating with calcified extracellular matrix. The superficially modified biomaterial could be used, in clinical applications, as an implant for bone repair.