iRoot BP Research Articles

Multi-faceted effects of mesenchymal stem cells (MSCs) determined by immune microenvironment and their implications on MSC/biomaterial-based inflammatory disease therapy

Inflammatory diseases result in destructive events, leading to tissue loss and functional impairment. Due to their anti-inflammatory effect and direct effect in tissue repair, mesenchymal stem cells (MSCs) are often exploited as ideal experimental cells to cure inflammatory tissue damage. Although a modicum of success has been reported, controversial therapeutic outcomes have also been observed, suggesting that MSCs may not be always beneficial and have multi-faceted functions with respect to inflammatory diseases. We chose dental pulpitis as a disease model and observed that human pulpitis tissue consists of infiltrating macrophages, whereas healthy tissue mainly consists of dental pulp stem cells (DPSCs), a type of MSC population. Through in vitro experiments, we found that lipopolysaccharide (LPS)-activated macrophages turned DPSCs into inflammatory cells with the upregulation of proinflammatory cytokines, IL-6, IL-1β, and TNFα. The underlying mechanism is related to the release of TNFα from macrophages, which led to a shutdown of the reparative capacity of DPSCs. Furthermore, the activated DPSCs became pro-inflammatory regulators, augmenting the inflammation response of macrophages via a mechanism related to the upregulation of WNT5a. Interestingly, when we applied a commonly used dental capping material (iRoot BP plus) to stimulate macrophages, the generated immune environment inhibited the inflammatory response of DPSCs and turned them into anti-inflammatory regulators with a high reparative capacity. This implies that manipulating the multi-faceted effects of DPSCs is vital for capping material-mediated pulpitis treatment. Our results collectively demonstrate the multi-faceted properties of MSCs in the progress of inflammatory disease as 1) reparative cells, 2) inflammatory cells, and 3) immunoregulatory cells. It should be noted that the immunoregulatory property of MSCs is not always anti-inflammatory; the immunoregulatory property is determined by the local immune environment. Such multi-faceted effects of MSCs should be considered when applying cell/biomaterial-based therapies to inflammatory tissue repair and regeneration.

Biocompatibility of new bioactive resin composite versus calcium silicate cements: an animal study

BackgroundThe purpose of this study was to compare the biocompatibility of three bioactive materials, namely ACTIVA bioactive restorative resin composite, iRoot BP plus and Mineral Trioxide Aggregate (MTA) Angelus-HP.MethodsSeventy-five Wistar male rats were subjected to subcutaneous implantation of four polyethylene tubes; one empty tube was used as control (Group 1), and the other tubes were filled with ACTIVA (Group 2), iRoot BP (Group 3) and MTA-HP (Group 4). Then, the rats were subdivided into 3 groups according to the sacrification time into one, two and 4 weeks (n = 25 rats). Tissue specimens were submitted to histopathological and immunohistochemical analysis of α-SMA and caspase 3.ResultsThe one-way Anova test revealed that ACTIVA group exhibited minimal inflammation in comparison to calcium silicate cements (iRoot BP and MTA-HP groups). iRoot BP group significantly revealed a more severe degree of chronic inflammation in comparison to other groups (P < 0.05). ACTIVA group showed marked regression of inflammation and fibrosis comparable to the control, while iRoot BP group revealed remarkable fibrosis and calcification, with less degrees in MTA-HP group (P < 0.05). Immunostaining of both α-SMA and caspase 3 revealed lower indexes in ACTIVA group consistent with the control (P < 0.05).ConclusionsACTIVA showed a higher degree of biocompatibility to subcutaneous tissues in comparison to both iRoot BP and MTA-HP cements in regard to decrease the intensity of inflammation, with subsequent fibrous connective tissue remodeling and better healing patterns.Clinical significancePreliminary data suggests that the application of ACTIVA in retrograde fillings.

IRoot BP Plus promotes osteo/odontogenic differentiation of bone marrow mesenchymal stem cells via MAPK pathways and autophagy

BackgroundiRoot BP Plus is a novel bioceramic endodontic material. Recently, it has been considered as an alternative to MTA which is the most popular scaffold cover during regenerative endodontic therapy. This study aimed to evaluate the effects of iRoot BP Plus on the osteo/odontogenic capacity of bone marrow mesenchymal stem cells (BMMSCs), including the underlying mechanisms.MethodsBMMSCs were collected by a whole marrow method and treated with iRoot BP Plus-conditioned medium (BP-CM). The proliferation ability was evaluated by cell counting kit 8 and flow cytometry. Complete medium was used as a blank control, and 2 mg/ml MTA-conditioned medium was served as a positive control. Alkaline phosphatase (ALP) activity assay, ALP staining, western blot, real-time RT-PCR, Alizarin Red S staining, and immunofluorescence staining were performed to explore the osteo/odontogenic potential and the involvement of MAPK pathways. Besides, autophagy was investigated by western blot, immunofluorescence staining, and transmission electron microscopy.Results

Evaluation of bioceramic putty repairment in primary molars pulpotomy

To evaluate the clinical characteristics and effectiveness of bioceramic putty repairment (iroot BP Plus) used as pulp capping agents on pulpotomy in primary molars. Forty primary molars were treated by pulpotomy with bioceramic putty repairmen as the pulp capping agents at the Third Clinical Division of Peking University School and Hospital of Stomatology, from September 2016 to September 2017. The children who were followed up over one year were selected as the subjects of this study. The teeth were checked clinically and radiographically during fixed intervals, and classified into one of five outcomes: N, H, P0, PX, PY. N, absence of clinical symptoms, and absence of apical radiolucency; H, absence of clinical symptoms, and nonpathologic radiographic change present; P0, absence of clinical symptoms, and pathologic change present, no need for treatment; PX, present or absence of clinical symptoms, pathologic change present treatment or extract immediately; PY, premature loss of deciduous tooth. Molars classified into N and H were regarded as successful, classified into P0, PX and PY were regarded as failed. Followed up for 12-24 months (the average follow up time was 16months), thirty four children were finally included, aged from 3.1 years to 8.5 yaers (the average age was 4.3 years), forty primary molars were included. Thirty four primary molars were included into N group, with absence of clinical symptoms, absence of apical radiolucency. Two molars were included into H group with physiological root absorption. One molar was included into P0group with absence of clinical symptoms butinternal absorption of the root. Three molars were included into PX group, with gingival fistula and apical radiolucency. None was included into PY group. Thirty six teeth got successful treatment, four molars failed. One year success rate of pulpotomy of primary molars using bioceramic putty repairment was 95%. Current evidence suggests that bioceramic putty repairment as a pulpotomy medicament showed satisfied clinical and radiographic result in pulpotomy of primary molars. Bioceramic putty repairment is an acceptable material when used in pulpotomy of primary molars.

Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review.

Introduction:iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent.Materials and Methods:A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected.Results:A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate.Conclusion:iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation.

Comparison of cytotoxic effects of calcium silicate-based materials on human pulp fibroblasts Mehmet.

Background. This study aimed to compare the in vitro cytotoxicity of Theracal LC, BiodentineTM, iRoot BP Plus, and MTA Angelus on human pulp fibroblasts (HPF). Methods. Fifteen discs from each calcium silicate-based material were prepared in sterile Teflon molds. After setting, the fabricated discs were eluated with a culture medium for 24 h. HPF cells were plated onto 24-well plates at 5×103 cells/well, and the cells were exposed to the material eluates. The cell viability was evaluated with MTT assay at three different times (24, 48, and 72 h). Data were statistically analyzed. The apoptotic/necrotic status of HPF cells exposed to material eluates was determined by flow cytometry. Results. The differences between the effects of Theracal LC, BiodentineTM, MTA Angelus, and iRoot BP Plus on HPF cells were found to be statistically significant (P<0.05). Theracal LC was found to be more cytotoxic considering other vital pulp capping materials at 24- (28.3%), 48- (44.9%), and 72-hour (49.2%) intervals. On the other hand, BiodentineTM showed the least cytotoxic effects (97.1%, 130.0%, and 103.7%, respectively) According to flow cytometry results, Theracal LC material increased apoptosis/necrosis ratios compared to the other materials. Conclusion. Based on the results of the present study, BiodentineTM, MTA Angelus, and iRoot BP Plus can be classified as biocompatible materials in vital endodontic treatments. However, the Theracal LC materials should be used carefully due to their cytotoxic effects.

Novel evaluation method of dentin repair by direct pulp capping using high-resolution micro-computed tomography.

We evaluated a novel micro-computed tomography (micro-CT) assessment for quality and quantity of dentin repair, which is difficult to visualize by histological analysis, after direct pulp capping under standardized cavity preparation. Standardized cavities were prepared on Wistar rats and direct pulp capping was performed using two commercial bioceramics, ProRoot MTA, and iRoot BP Plus. After 2 or 4weeks, quality and quantity of tertiary dentin formation were evaluated using high-resolution micro-CT analyses including dentin mineral density, dentin mineral contents, compactness and integrity of tertiary dentin, and dentin volume with/without void space. Reproducibility of micro-CT analyses was confirmed by histological evaluation of the same specimen. The exposed pulp area sizes were similar between iRoot BP Plus and ProRoot MTA. Micro-CT analysis of 2-week samples showing compactness of tertiary dentin was significantly higher in iRoot BP Plus than ProRoot MTA (p < 0.05). Tertiary dentin volume without void space, dentin mineral contents, and density were not significantly different between the groups. In 4-week samples, a significant increase was observed in dentin mineral density, compactness, and dentin volume with/without void space induced by iRoot BP Plus (p < 0.05). Micro-CT analysis of tertiary dentin integrity demonstrated that some ProRoot MTA specimens had small defects and lacked continuity (6/512 images). No defects were observed with iRoot BP Plus. Micro-CT analysis was confirmed as an accurate, objective, and inclusive approach for evaluating quality and quantity of dentin repair. These multifaceted approaches to evaluate pulp capping materials may accelerate review processes, ultimately improving vital pulp therapy.

Comparison of Mineral Trioxide Aggregate and iRoot BP Plus Root Repair Material as Root-end Filling Materials in Endodontic Microsurgery: A Prospective Randomized Controlled Study

IntroductionThis prospective randomized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material (BP-RRM; Innovative BioCeramix Inc, Vancouver, BC, Canada) or mineral trioxide aggregate (MTA) as the retrograde filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery. MethodsBy using strict inclusion and exclusion criteria, 240 teeth were successfully enrolled and randomly and equally allocated to either the MTA or BP-RRM treatment group. A standardized surgical procedure was performed by a single operator. The patients were followed up at 1 week, 3 months, 6 months, and 12 months; follow-up included clinical and radiographic examination. Clinical and radiographic evaluations acquired at the 12-month follow-up were taken as the primary outcome. For the identification of prognostic factors, the dichotomous outcome (success vs failure) was taken as the dependent variable. ResultsA total of 158 teeth were analyzed at the 12-month follow-up, including 87 teeth in the MTA group and 71 teeth in the BP-RRM group. The success rate in the MTA and BP-RRM groups was 93.1% (81/87 teeth) and 94.4% (67/71 teeth), respectively (P > .05). Three significant outcome predictors were identified: quality of root filling (P < .05), tooth type (P < .05), and size of the lesion (P < .05) ConclusionsThese results suggest that BP-RRM is comparable with MTA in clinical outcome when used as root-end filling materials in endodontic microsurgery.

Comparison of the Sealing Ability of Biodentine, iRoot BP Plus and Mineral Trioxide Aggregate

Objective: The aim of this study was to compare the properties of two new root repair materials, Biodentine and iRoot BP Plus against ProRoot MTA when used as root-end fillings. Methods: The root canals of 45 extracted maxillary anterior teeth were prepared with ProTaper instruments. After apical resection and ultrasonic root-end cavity preparation, the teeth were divided into three groups. The cavities in the first group of 15 were filled with Biodentine, the second with iRoot BP Plus and the third with ProRoot MTA. A computerized fluid filtration method assessed the seal at 2, 10 and 28 days. Results: Significant differences were found between Groups 1-2, Groups 1-3 and between Groups 2-3 at all-time intervals (P 0.05). Conclusion: The two new root repair materials showed good performance and both offered improved handling properties compared to MTA. KEYWORDS endodontics; calcium silicate-based cement; bioceramic root repair material;

Ion Release, Microstructural, and Biological Properties of iRoot BP Plus and ProRoot MTA Exposed to an Acidic Environment

IntroductionThis study evaluated how exposing the novel calcium silicate nanoparticulate bioceramic iRoot BP Plus (Innovative Bioceramix, Vancouver, Canada) to an acidic environment affects ion release from this material and alters MC3T3-E1 preosteoblast viability on and attachment to this material. These factors were compared against those of ProRoot MTA under similar conditions. MethodsEach material was exposed to phosphate-buffered saline (pH = 7.4) or butyric acid (pH = 5.4) for 5 days. Trace metal elements within the 2 materials and released ions were identified using inductively coupled plasma optical emission spectroscopy. The microstructures and elemental compositions of MTA and iRoot BP Plus after treatment with butyric acid were determined using scanning electron microscopy with an energy-dispersive X-ray spectrometer. Furthermore, the viability of MC3T3-E1 cells on and their levels of attachment to the materials after the butyric acid treatment were compared. ResultsiRoot BP Plus contained fewer toxic metal elements than MTA. Under acidic conditions, both materials displayed similar ion release abilities, with increased release of Si and Ca ions. Substantial changes in microstructure, including reduced apatite formation, were observed for both materials after exposure to acidic pH. Furthermore, exposing iRoot BP Plus and MTA to an acidic environment increased and decreased MC3T3-E1 cell viability on these materials, respectively. MC3T3-E1 cell attachment to both materials was not significantly affected by acidic pH. ConclusionsiRoot BP Plus seems more biologically appropriate for application in an inflamed acidic environment than ProRoot MTA.

Evaluation of the in vitro biocompatibility of a new fast‐setting ready‐to‐use root filling and repair material

To evaluate the invitro biocompatibility of iRoot FS (Innovative BioCeramix Inc., Vancouver, BC, Canada) and to compare its performance with those of iRoot BP Plus (Innovative BioCeramix Inc.) and ProRoot mineral trioxide aggregate (MTA; Dentsply Tulsa Dental, Tulsa, OK, USA). MC3T3-E1 cells were cultured for 1, 2 and 3days in various dilutions of iRoot FS, iRoot BP Plus and MTA extracts after 7days of setting to assess cell viability using a cell counting kit-8 (Dojindo, Kumamoto, Japan). The cell apoptosis induced by the set material extracts was evaluated through annexin V-propidium iodide flow cytometry. Changes in the cytoskeletal organization and stress fibres were observed through immunofluorescence by labelling the fibrous actin and nuclei of the cells. Cell attachment was observed under a scanning electron microscope after the MC3T3-E1 cells were cultured on the surface of a material disc set for 1day. The data were analysed using one-way anova. iRoot FS extracts induced higher cell viability than the control extracts (P<0.05) at levels comparable to those of iRoot BP Plus and MTA. Compared with the control group, iRoot FS did not promote cell apoptosis. Stretched stress fibres and cytoskeletons were detected in the cells treated with iRoot FS extracts. Scanning electron microscopy revealed that the MC3T3-E1 cells attached to iRoot FS appeared flatter and exhibited better stretch than those attached to the other extracts. iRoot FS displayed invitro biocompatibility with MC3T3-E1 cells by promoting cellular proliferation and attachment without causing cell apoptosis.

Partial Pulpotomy of Immature Teeth with Apical Periodontitis using Bioceramics and Mineral Trioxide Aggregate: A Report of Three Cases.

Pulpal necrosis of an immature permanent tooth with an open apex poses a challenge for the clinician. The conventional apexification technique using calcium hydroxide has yielded short-term success, but this technique has inevitable shortcomings. Hence, this case series aimed to evaluate the effectiveness of using bioceramics (iRoot BP) or mineral trioxide aggregate (MTA) for partial pulpotomies. Three boys aged 9 to 11 years old presented with partial pulp necrosis and symptomatic apical periodontitis of the mandibular right and left second premolar. The involved teeth were treated with a partial pulpotomy using either iRoot BP (case 1 and 2) or MTA (case 3). At the 8-month follow-up, no abnormal clinical signs or symptoms were observed. Periapical radiographs revealed a significant reduction in periapical radiolucency, a marked increase in the root canal wall thickness and ongoing closure of the apical opening. The bioceramic material (iRoot BP) and MTA both produced successful outcomes in the partial pulpotomy of immature teeth with partial pulp necrosis and apical periodontitis. However, iRoot BP was superior in terms of ease of clinical application, and would therefore be a better treatment alternative than MTA.

Gene expression changes in bioceramic paste-treated human dental pulp cells.

We evaluated the gene expression profiles of human dental pulp cells exposed to iRoot BP using microarray after 24 and 72 h. The results were verified using quantitative reverse transcriptase PCR analysis. Of the 36,000 transcripts arrayed, 21 were up-regulated and 15 were down-regulated by more than two fold. The largest group of up-regulated genes included those involved in nucleobase-containing compound metabolic processes, cell communication, protein metabolic processes, developmental processes, and biological regulation. The largest groups of down-regulated genes were those involved in cell communication, development, and biological regulation processes. In conclusion, iRoot BP affects the expression of genes involved in different biological processes in human dental pulp cells. (J Oral Sci 58, 307-315, 2016).

Promotion of Dental Pulp Cell Migration and Pulp Repair by a Bioceramic Putty Involving FGFR-mediated Signaling Pathways

Mineral trioxide aggregate is the currently recommended material of choice for clinical pulp repair despite several disadvantages, including handling inconvenience. Little is known about the signaling mechanisms involved in bioceramic-mediated dental pulp repair—particularly, dental pulp cell (DPC) migration. This study evaluated the effects of iRoot BP Plus, a novel ready-to-use nanoparticulate bioceramic putty, on DPC migration in vitro and pulp repair in vivo, focusing on possible involvement of fibroblast growth factor receptor (FGFR)–related signaling, including mitogen-activated protein kinase and Akt pathways. Treatment with iRoot BP Plus extracts enhanced horizontal and vertical migration of DPCs, which was comparable with the effects induced by mineral trioxide aggregate extracts. The DPCs exposed to iRoot BP Plus extracts demonstrated no evident apoptosis. Importantly, treatment with iRoot BP Plus extracts resulted in rapid activation of FGFR, p38 mitogen-activated protein kinase, extracellular signal-regulated kinase (ERK) 1/2, c-Jun-N-terminal kinase (JNK), and Akt signaling in DPCs. Confocal immunofluorescence staining revealed that iRoot BP Plus stimulated focal adhesion formation and stress fiber assembly in DPCs, in addition to upregulating the expression of focal adhesion molecules, including p–focal adhesion kinase, p-paxillin, and vinculin. Moreover, activation of FGFR, ERK, JNK, and Akt were found to mediate the upregulated expression of focal adhesion molecules, stress fiber assembly, and enhanced DPC migration induced by iRoot BP Plus. Consistent with the in vitro results, we observed induction of homogeneous dentin bridge formation and expression of p–focal adhesion kinase, p-FGFR, p-ERK 1/2, p-JNK, and p-Akt near injury sites by iRoot BP Plus in an in vivo pulp repair model. These data demonstrate that iRoot BP Plus can promote DPC migration and pulp repair involving the FGFR-mediated ERK 1/2, JNK, and Akt pathways. These findings provide valuable insights into the signaling mechanisms underlying nanoparticulate bioceramic-mediated pulp repair.

Evaluation of a Bioceramic as a Pulp Capping Agent In Vitro and In Vivo

IntroductionThis study aims to investigate the effects of the bioceramic iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) as a pulp capping agent in vitro and in vivo. MethodsIn vitro, human dental pulp cells (hDPCs) were seeded into plates with the prepared iRoot BP Plus or mineral trioxide aggregate (MTA) packed in the bottom of different wells. The proliferation of hDPCs was determined using the 3,(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay. Meanwhile, 2 animal models of direct pulp capping and pulpotomy were applied in Wistar rats in vivo. The exposed pulps were capped with iRoot BP Plus or MTA. After 1 and 4 weeks, maxillary segments were obtained and prepared for histologic analysis. ResultshDPCs grew very well even in the place contacted with MTA or iRoot BP plus in vitro. MTA and iRoot BP Plus both enhanced the proliferation of hDPCs (P < .05). In vivo, results revealed that few inflammatory cells were present in the pulpal area corresponding to the pulp exposure. A slight layer of newly generated matrix was also observed next to MTA and iRoot BP Plus after 1 week. A complete reparative dentin bridge with polarizing odontoblastlike cells was detected in all specimens in the iRoot BP Plus group after 4 weeks. ConclusionsiRoot BP Plus exhibited good biocompatibility to pulp tissue and induced the proliferation of dental pulp cells and the formation of reparative dentin bridge. iRoot BP plus may be used as a pulp capping material for vital pulp therapy

Effects of iRoot BP and white mineral trioxide aggregate on cell viability and the expression of genes associated with mineralization.

To evaluate the cytotoxicity and mineralization effects of iRoot BP in human dental pulp cells (hDPCs) and to compare them with those of white mineral trioxide aggregate (WMTA). hDPCs were exposed to prepared dilutions (1 : 1-1 : 10) of the test materials. Cell viability was evaluated using the XTT assay after incubation periods of 24, 48 or 72 h. The expression of mineralization-related genes (bone morphogenic protein, osteonectin, bone sialoprotein, osteopontin, dentine sialophosphoprotein and collagen type 1) and heme oxygenase 1 was measured by quantitative real-time polymerase chain reaction (qRT-PCR) at 24 and 72 h. Statistical differences between test materials were analysed with the Mann-Whitney test. The 1 : 1 and 1 : 2 dilutions of iRoot BP were associated with higher cell viability after 24 h (P < 0.05). Only the 1 : 1 dilution of iRoot BP had higher cell viability after 48 h (P < 0.05), and there was no difference between iRoot BP and WMTA after 72 h (P > 0.05). Although somewhat variable, according to the gene expression results, iRoot BP had a mineralization potential similar to that of WMTA. WMTA revealed a higher heme oxygenase 1 (HO-1) mRNA level than iRoot BP (P < 0.001). iRoot BP and WMTA were biocompatible and facilitated odontoblastic differentiation of hDPCs.

In vitro and in vivo evaluation of a nanoparticulate bioceramic paste for dental pulp repair

Bioactive materials play an important role in facilitating dental pulp repair when living dental pulp is exposed after injuries. Mineral trioxide aggregate is the currently recommended material of choice for pulp repair procedures though has several disadvantages, especially the inconvenience of handling. Little information is yet available about the early events and molecular mechanisms involved in bioceramic-mediated dental pulp repair. We aimed to characterize and determine the apatite-forming ability of the novel ready-to-use nanoparticulate bioceramic iRoot BP Plus, and investigate its effects on the in vitro recruitment of human dental pulp stem cells (DPSCs), as well as its capacity to induce dentin bridge formation in an in vivo model of pulp repair. It was found that iRoot BP Plus was nanosized and had excellent apatite-forming ability in vitro. Treatment with iRoot BP Plus extracts promoted the adhesion, migration and attachment of DPSCs, and optimized focal adhesion formation (Vinculin, p-Paxillin and p-Focal adhesion kinase) and stress fibre assembly. Consistent with the in vitro results, we observed the formation of a homogeneous dentin bridge and the expression of odontogenic (dentin sialoprotein, dentin matrix protein 1) and focal adhesion molecules (Vinculin, p-Paxillin) at the injury site of pulp repair model by iRoot BP Plus. Our findings provide valuable insights into the mechanism of bioceramic-mediated dental pulp repair, and the novel revolutionary ready-to-use nanoparticulate bioceramic paste shows promising therapeutic potential in dental pulp repair application.

Comparison of pulp response to mineral trioxide aggregate and a bioceramic paste in partial pulpotomy of sound human premolars: a randomized controlled trial

This randomized clinical trial evaluated clinical sign/symptoms as well as histological pulp reactions in terms of inflammation and mineralized bridge formation after partial pulpotomy of sound human premolars and placement of a bioceramic paste (iRoot BP) or tooth-colored ProRoot MTA as pulp-covering biomaterials. Twenty-four human sound premolars were randomly allocated into two experimental groups (n = 12) treated either with iRoot BP or MTA subsequent to partial pulpotomy. Six weeks after treatment, clinical sign/symptoms and radiographic changes were evaluated. The teeth were then extracted and examined histologically for inflammatory status of the pulp, formation of hard tissue bridge and appearance of the bridge. In terms of pulp inflammation and dentinal bridge formation, the Mann-Whitney U, and for clinical signs, the chi-square test was used (α = 0.05). In terms of pulp inflammation, formation of hard tissue bridge and its appearance, the differences between the two experimental groups were not significant. However, clinical sensitivity to cold was significantly less for teeth treated with MTA (P < 0.05). All cases had formed a hard tissue bridge, and none of the specimens in either group had pulpal necrosis. When treating teeth with healthy pulps, the response to partial pulpotomy treatment with both MTA and iRoot BP was favourable. However, pulps covered with iRoot BP were more sensitive to cold stimuli.

Antimicrobial effects of several calcium silicate-based root-end filling materials

The purpose of this study was to evaluate, in vitro, the antimicrobial effect of iRoot BP, iRoot BP Plus, and mineral trioxide aggregate (MTA) against Entercoccus faecalis and Candida albicans by using direct contact test. The materials were tested immediately after application to the microtiter wells and after setting for 1-day and for 7-days. Ten microliters of microbial suspension was added to each well for direct contact with each material for 1 h at 37°C and 100% humidity. Then fresh media was added and, survival of bacteria and fungi was determined by using 10-fold serial dilution and inoculated onto agar plates. In fresh and 1-day samples all of tested materials showed statistically significant antimicrobial effects compared to control groups (p<0.05). In 7-day samples, there were no significantly differences compared to control groups. MTA, iRoot BP and iRoot BP Plus had similar antimicrobial efficacy against E. faecalis and C. albicans.

A Comparative Study on Root Canal Repair Materials: A Cytocompatibility Assessment in L929 and MG63 Cells

Cytocompatibility of repair materials plays a significant role in the success of root canal repair. We conducted a comparative study on the cytocompatibility among iRoot BP Plus, iRoot FS, ProRoot MTA, and Super-EBA in L929 cells and MG63 cells. The results revealed that iRoot FS was able to completely solidify within 1 hour. iRoot BP Plus required 7-day incubation, which was much longer than expected (2 hours), to completely set. ProRoot MTA and Super-EBA exhibited a similar setting duration of 12 hours. All the materials except Super-EBA possessed negligible in vitro cytotoxicity. iRoot FS had the best cell adhesion capacity in both L929 and MG63 cells. With rapid setting, negligible cytotoxicity, and enhanced cell adhesion capacity, iRoot FS demonstrated great potential in clinical applications. Future work should focus on longer-term in vitro cytocompatibility and an in vivo assessment.