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      Characterization of Chlorhexidine-Loaded Calcium-Hydroxide Microparticles as a Potential Dental Pulp-Capping Material

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          Abstract

          This study explores the delivery of novel calcium hydroxide [Ca(OH) 2] microparticles loaded with chlorhexidine (CHX) for potential dental therapeutic and preventive applications. Herein, we introduce a new approach for drug-delivery to deep dentin-surfaces in the form of drug-loaded microparticles. Unloaded Ca(OH) 2 [Ca(OH) 2/Blank] and CHX-loaded/Ca(OH) 2 microparticles were fabricated by aqueous chemical-precipitation technique. The synthesized-microparticles were characterized in vitro for determination of surface-morphology, crystalline-features and thermal-properties examined by energy-dispersive X-ray scanning and transmission electron-microscopy (EDX-SEM/TEM), Fourier-transform infrared-spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA) and differential scanning-calorimetry (DSC). Time-related pH changes, initial antibacterial/biofilm-abilities and cytotoxicity of CHX-loaded/Ca(OH) 2 microparticles were evaluated. Microparticles were delivered to dentin-surfaces with subsequent SEM examination of treated dentin-substrates. The in vitro and ex vivo CHX-release profiles were characterized. Ca(OH) 2/Blank were hexagonal-shaped with highest z-average diameter whereas CHX-inclusion evidenced micro-metric spheres with distinguishable surface “rounded deposits” and a negative-shift in diameter. CHX:Ca(OH) 2/50 mg exhibited maximum encapsulation-efficiency with good antibacterial and cytocompatible properties. SEM examination revealed an intact layer of microparticles on exposed dentin-surfaces with retention of spherical shape and smooth texture. Microparticles loaded on dentin-surfaces showed prolonged release of CHX indicating substantial retention on dentin-substrates. This study validated the inherent-applicability of this novel drug-delivery approach to dentin-surfaces using micro-metric CHX-loaded/Ca(OH) 2 microparticles.

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          Diffusion in biofilms.

          Philip Stewart (2003)
          Article 0 comments Cited 284 times – based on 0 reviews     Review now
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            The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics.

            B Athanassiadis, Amanda L. Walsh, Markus Walsh … (2007)
            Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections.
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              Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips.

              Anibal Diogenes, Jose Trevino, N O Dybdal … (2011)
              Intracanal disinfection is a crucial step in regenerative endodontic procedures. However, this novel endodontic treatment lacks standardization, and numerous treatment protocols have been reported without knowledge of the effect of disinfection protocols on the survival of stem cells. The aim of this study was to test the hypothesis that different root canal irrigation protocols alter survival of stem cells from the apical papilla (SCAP). SCAP were isolated from immature human third molars, and a subpopulation of STRO-1 expressing cells was selected and expanded in vitro. Standardized human root segments (n = 5/group) were irrigated with 1 of 4 protocols: (1) 17% ethylenediaminetetraacetic acid (EDTA), (2) 6% NaOCl/17% EDTA/6% NaOCl, (3) 17% EDTA/2% chlorhexidine (CHX), or (4) 6% NaOCl/17% EDTA/6% NaOCl/isopropyl alcohol/2% CHX. Subsequently, STRO-1-enriched SCAP were mixed with platelet-rich-plasma, seeded into the root tips, and cultured for 21 days. Roots were then decalcified, processed for immunohistochemistry, and stained for vimentin and TO-PRO-3. The proportion of viable (vimentin-positive) cells was calculated on the basis of the total cell counts (TO-PRO-3) for each group. Irrigation with 17% EDTA best supported cell survival (89% viability; P < .001 versus all other groups), followed by irrigation with 6% NaOCl/17% EDTA/6% NaOCl (74%; P < .001 versus the 2 groups containing 2% CHX). Conversely, protocols that included 2% CHX lacked any viable cells. Collectively, the results suggest that irrigants alone greatly affect the survivability of STRO-1-enriched SCAP within the root canal environment and that inclusion of EDTA in irrigation protocols might be beneficial in regenerative procedures. Published by Elsevier Inc.
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                Author and article information

                Contributors
                Frank Alexis: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Bioengineering (Basel)
                Journal ID (iso-abbrev): Bioengineering (Basel)
                Journal ID (publisher-id): bioengineering
                Title: Bioengineering
                Publisher: MDPI
                ISSN (Electronic): 2306-5354
                Publication date (Electronic): 22 June 2017
                Publication date Collection: September 2017
                Volume: 4
                Issue: 3
                Electronic Location Identifier: 59
                Affiliations
                [1 ]Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore; a0106278@ 123456u.nus.edu
                [2 ]Department of Chemistry, Myongji University, Natural Science Campus, 116 Myongji-ro, Cheoin-gu, Yongin, Gyeonggi-do 449-728, Korea; selvant@ 123456mju.ac.kr
                [3 ]Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, #04-01, Singapore 138669, Singapore; karthisurya2002@ 123456gmail.com
                Author notes
                [* ]Correspondence: denasfmf@ 123456nus.edu.sg
                Article
                Publisher ID: bioengineering-04-00059
                DOI: 10.3390/bioengineering4030059
                PMC ID: 5615305
                PubMed ID: 28952538
                SO-VID: 1d475a49-2495-4863-978b-a90d6c51a7d2
                Copyright © © 2017 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 15 May 2017
                Date accepted : 19 June 2017
                Categories
                Subject: Article

                Keywords: chlorhexidine,dentin surfaces,dentinal tubules,microparticles,calcium hydroxide
                Data availability:
                Keywords: chlorhexidine, dentin surfaces, dentinal tubules, microparticles, calcium hydroxide

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