Bio Mimetic Materials

7/31/2019 Bio Mimetic Materials

1/60

BIOMIMETIC

MATERIALS


2/60

DEFINITION OFBIOMIMETIC MATERIALS

Biomimetic materials are materials that have

been designed such that they elicit specifiedcellular responses mediated by interactions withscaffold-tethered peptides from extracellular

matrix (ECM) proteins; essentially, the

incorporation of cell-binding peptides intobiomaterials via chemical or physicalmodification.

http://en.wikipedia.org/wiki/Biomimetic_materials. Accessed on 15/02/09


3/60

: Collagen MembranesEnamel Matrix Proteins

Graft materials

Platelet Rich Plasma

Implants

: Mineral Trioxide Aggregate

Calcium Hydroxide

Bioactive glass


4/60

CALCIUM HYDROXIDE:

THE PRODIGAL CHILD OF HERMANN


5/60

CALCIUM HYDROXIDE


6/60

CALCIUM HYDROXIDE

EFFECT ON HEALTHY PULP TISSUE

Superficial zone : application of pressure

Latter zone: chemical injury; edema and liquefactivenecrosis

Apical most region: Coagulation necrosis

Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp

cell migration, proliferation and differentiation.J Dent Res 1985; 64 (Spec Iss): 541- 548


7/60

CALCIUM HYDROXIDE


cell migration, proliferation and differentiation.

J Dent Res 1985; 64 (Spec Iss): 541- 548


8/60

CALCIUM HYDROXIDE

MATRIX FORMATION




9/60

CALCIUM HYDROXIDE

MINERALIZATION OF THE BARRIER ANDCELLULAR DIFFERENTIATION




10/60

CALCIUM HYDROXIDE




11/60

CALCIUM HYDROXIDE

THE ROLE OF CALCIUM

Holland et. al. (1982) demonstrated that the calcium of the calcifiedtissues is derived from the calcium hydroxide

Used calcium, Barium and Strontium hydroxides in histochemicalstudies of dog pulp following pulpotomy and found the two zones

seen with calcium hydroxide pulp capping agents

Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulpcell migration, proliferation and differentiation.

J Dent Res 1985; 64 (Spec Iss): 541- 548


12/60

CALCIUM HYDROXIDE

CONTRADICTORY FINDING

Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23: 383- 297


13/60

CALCIUM HYDROXIDECa(OH)2

Ca2+ OH-

Neutralizes acids producedby osteoclasts

Reduced serum flow Optimum pH forpyrophosphatse activity

Reduced levels ofinhibitory pyrophosphatase Increased levels of Ca2+

dependant pyrophosphatase

Uncontrolled mineralization

Reduced capillarypermeability

Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23: 383- 297


14/60

CALCIUM HYDROXIDE

Cvek M. A clinical report on partial pulpotomy and capping with

calcium hydroxide in permanent incisors with complicated crown

fracture. J Endod 1978; 4(8):232- 237

O


15/60

CALCIUM HYDROXIDE

Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg

1974; 38(6): 945- 953

CALCIUM HYDROXIDE


16/60

CALCIUM HYDROXIDE

In 1985, Stanley HR reported the advantages of a light- cured

calcium hydroxide.

Prisma VLC Dycal

Dentinal bridge formation

Chemical cautery effect

Resistance to dissolution in acid and water

Improved strength

Stanley HR, Pameijer CH. Pulp Capping with a new visible- light- curing calcium hydroxidecomposition (Prisma VLC Dycal). Oper Dent 1985; 10: 152- 163

CALCIUM HYDROXIDE


17/60

CALCIUM HYDROXIDE

COMPOSITIONBase paste: Titanium dioxide- 56.7%

Glycol salicylate

Catalyst paste: Calcium hydroxide- 53.5%

Zinc oxide- 9.7%Ethyltoluene sulfonamide

Drawbacks

Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg 1974; 38(6): 945- 953


18/60


19/60

The initial patented form of MTA :50- 75wt% CaO and 15-

25wt% SiO2. (Torabinejad and White, 1995)

Tricalcium silicate, dicalcium silicate, tricalcium aluminateand tetracalcium aluminoferrite

Hydrates to form silicate hydrate gel

Camilleri J and Pitt ford TR. Mineral Trioxide Aggregate: a review of the constituents andbiological properties of the material. Int Endod J 2006; 39: 747- 754

Water

CONSTITUENTS


20/60

According to the patent:MTA is a type I ordinary Portland cement

(American society for Testing Materials) witha fineness in the range of 4500- 4600cm/g.Radiopacifier, bismuth oxide is added to the

cement for dental radiological diagnosis

Camilleri J and Pitt ford TR. Mineral Trioxide Aggregate: a review of the constituents andbiological properties of the material. Int endod J 2006; 39: 747- 754

CONSTITUENTS


21/60

Traces of SiO2, CaO, MgO, gypsum,K2SO4, andNa2SO4

MTA

Refined Portland cement

Bismuth Oxide

Dicalcium SilicateTricalcium SilicateTricalcium AluminateTetracalcium Aluminoferrite

Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral Trioxide Aggregate material use inendodontic treatment: A review of the literature. Dental Materials 2008; 24: 149- 164

CONSTITUENTS


22/60

CHEMICAL GMTA WMTA

CaO 44.23 40.45

SiO2 21.20 17.00

Bi2O3 16.13 15.90

Al2O3 1.92 4.26

MgO 1.35 3.10

SO3 0.53 0.51

Cl 0.43 0.43

FeO 0.40 4.39P2O5 0.21 0.18

TiO2 0.11 0.06

H2O + CO2 14.49 13.72

CHEMICAL COMPOSITION OF GMTA AND WMTA (wt%)

Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate material use in endodontictreatment: A review of the literature. Dental Materials 2008; 24: 149- 164


23/60

Similar to other mineral cementsOriginal material: anhydrous

Hydrated calcium silicate gel

Crystallization of the hydrated mass

SETTING MECHANICS AND SET CEMENT

FLUIDS

Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate material use inendodontic treatment: A review of the literature. Dental Materials 2008; 24: 149- 164


24/60

Sarkar NK, Caicedo R, Ritwik P, Mioseyeva R and Kawashima L. Physiochemical basis of thebiologic properties of Mineral Trioxide Aggregate. J Endod 2005; 31(2): 97- 100


25/60

Zhu Q, Haglund R, Safavi KE. Adhesion of human osteoblasts on root- end fillingmaterials.

J Endod 2000; 26(7): 404- 406

Cell morphology of osteoblasts on MTA

SEM image of osteoblasts cultured

on MTA after 24hrs

The study used SEM to evaluate the cellular response of humanosteoblasts to commonly used root- end filling materials in vitro.

Composite resin, amalgam , IRM and Mineral Trioxide Aggregate.Adhesion and spreading of cells on a material surface are the initialphases of cellular function.The persistence of rounded cells with little or no spreading suggeststhat the surface material could toxic.

Favorable response was seen with MTA and composite resin.


26/60

The study characterized the interactions of MTA withsynthetic tissue fluid composed of a neutral phosphatebuffer saline solution and root canal dentin in extractedhuman teeth.

Atomic Emission SpectroscopyScanning Electron MicroscopyEnergy Dispersive X- Ray analysisX- Ray diffraction

10Ca2+ + 6(PO4)3- + 2(OH)- Ca10 (PO4)6 (OH)2

Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic properties ofMineral Trioxide Aggregate . J endod 2005; 31(2): 97- 100


27/60

The pH at which the reaction occurs

Porous nature of MTA

Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic properties of MineralTrioxide Aggregate . J Endod 2005; 31(2): 97- 100


28/60

Experiments measuring the cytokineexpression:

Huang TH, Yang CC, Ding SJ. Inflammatory cytokines reaction elicited by root- end fillingmaterials. J Biomed Mater Res, Part B Applied biomaterials2005; 73: 123- 128


29/60

Saidon J, He J, Zhu Q, Safavi K, Spngberg SW. Cell and tissue reactions tomineral trioxide aggregate and Portland cement.Oral surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 483- 489

The study compared the cytotoxic effect in vitro and the tissuereaction of MTA and Portland Cement in bone implantation in themandibles of guinea pigs.

Two types of reactions :Type I: new bone apposition in direct contact with the materialType II: Newly formed bone separated from the material by a thinlayer of fibrous connective tissue.

Area under a freshly prepared materialProRoot implant at 2weeks observation perioProRoot impant at 12 weeks observation


30/60

This study investigated cell growth and morphology ofcementoblast like cells on MTA by Scanning electronMicroscopy and to determine if MTAallows the prodiction of

gene and protein markers consistent with the expression ofmineralized cell phenotype in tissue cultures.

Materials used: Amalgam, IRM and MTA

Cellular morphology: Scanning Electron MicroscopyGene expression: Reverse Polymerase Chain ReactionIn vivo matrix protein evaluation: Confocal Microscopy

Thomson TS, Berry JE, somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate.J Endod 2003; 29(6): 407- 412


31/60

Cells adhering to IRM and amalgam: few, showed cytoplasmic

shrinking, rounded CYTOTOXICITY

Cells adhering to MTA: abundant, normal cellular morphology

Thomson TS, Berry JE, Somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate.J Endod 2003; 29(6): 407- 412

Cementoblasts on MTA Cementoblasts on amalgamCementoblasts on IRM


32/60

Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregateand calcium hydroxide as pulp- capping agents in human teeth: a perliminaryreport. Int Endod J 2002; 36: 225- 231

2 months sample covered with MTA 3 months sample capped withcalcium hydroxide

The study aimed to compare MTA and calcium hydroxide whenused as pulp- capping agents in human teeth.

Histological evaluation

At 1wk, 2, 3, 4 and 6mths after treatment


33/60

Calcium hydroxide specimens:At 6mths: thickness of dentinal bridge: 0.15mm

MTA specimens:At 2mths: thickness of dentinal bridge: 0.28mmAt 6mths: 0.43mm

Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregate andcalcium hydroxide as pulp- capping agents in human teeth: a perliminary report. Int EndodJ 2002; 36: 225- 231


34/60

Compared WMTA and calcium hydroxide for direct pulp cappingin 3rd molars

Single blinded, randomized, controlled clinical study

At 20day post treatment:WMTA group: 20 teeth- clinically normal pulps

3 teeth: reversible pulpitis

Calcium hydroxide group: 17 teeth- clinically normal pulps6 teeth- reversible pulpitis1 tooth- irreversible pulpitis

Iwamoto CE, Adachi E, Pameijer CH, et. al. Clinical and histological evaluation ofwhite ProRoot MTA in direct pulp capping. Am J Dent 2006; 19: 85- 90


35/60

At 136 day recall:WMTA group: 23 teeth- clinically successful

Calcium hydroxide group: 22 teeth- clinically successful

NO SIGNIFICANT DIFFERENCES AT BOTH PERIODS

Iwamoto CE, Adachi E, Pameijer CH, et. al. Clinical and histological evaluation of whiteProRoot MTA in direct pulp capping. Am J Dent 2006; 19: 85- 90


36/60

Abedi et. al. : greater tendency of dentin bridge formationwith MTAAbedi HR,Torabinejad M, Pitt Ford TR, Bakland LK. The use of Mineral Trioxide

Aggrgate cement as a direct pulp capping agent. J Endod 1996; 22: 199

Samples capped with Calcium Hydroxide vs. those cappedwith MTA

Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK. Using Mineral Aggregate as a

pulp capping material. J Am Dent Assoc 1996; 127: 1491- 1494


37/60

CERAMICS AND GLASSES



38/60


Virtually inert ceramics :alumina (Al2O3) andzirconia (ZrO2)

Porous ceramics:such as synthetic hydroxyapatite

calcium silicate-based glasses,

ceramics and glass-ceramic composites

calcium phosphate cements

www.rsc.org/Education/Issues/2006Nov/GlassBones . Accessed on 20/02/09

http://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBones


39/60


BIOACTIVE GLASSES

Synthetic, alloplastic, non ceramic material

Bioactive: osteoconductive and osteoinductive

Regeneration of bone

Glass and Bioabsorbable Membrane in the treatment of maxillary Class II

furcation defects: Case report with 6 month re- entry.

Compennd Cont Educ Dent 2005; 26(1): 41- 50



40/60


The Bioactive Glass formula 45S5 is a very active

bone inducer, many times more active thanhydroxyapatite.

Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modified

Bioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232



41/60


SiO2- 46mol%

CaO- 26.9mol%Na2O- 24.4mol%

P2O5- 2.6mol%

Bioactive Glass and Bioabsorbable Membrane in the treatment of maxillary Class II

furcation defects: Case report with 6 month re- entry. Compennd Cont Educ Dent

2005; 26(1): 41- 50



42/60


.

THE MELT GLASS TECHNIQUE

www.rsc.org/Education/Issues/2006Nov/GlassBones . Accessed on 20/02/09

http://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBones


43/60

Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modifiedBioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232



44/60





45/60



46/60

The gel can be obtained by the dispersion ofcolloidal powders or by the controlled

hydrolysis and condensation of liquid metal

alkoxide precursors under acidic or basicconditions.

THE SOL- GEL TECHNIQUE



47/60

X-ray microcomputed tomography (CT) image of a typical

Bioactive Glass scaffold produced by the sol-gel foaming

process, with streak lines showing calculated paths of fluid

flow

elements.geoscienceworld.org/.../coverfig.gif. Accessed on 20/02/09



48/60

Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp

capping with a modified Bioglass formula (#A68-

Modified). Am J Dent 2001; 14: 227- 232

Oguntebi et. al

The Bioactive Glass formulae given by Clark et. al. in 1996 were:

A58: 58% SiO2

38% CaO

4% P2O5

A68: 68% SiO2

28% CaO

4% P2O5

Particle size : 90m to 350m



49/60

Advantages of the modified BAG preparation

The particle size of these particles ranges from 90m to

350m.



50/60

BAGA58 at 25 days



A better attempt of dentin bridging at 70 daysA solid dentin bridge with modified BioGlass formula



51/60

.

THE GLASS- BONE BOND



52/60



53/60

Salako M, Joseph B, Ritwik P, Salonen J, John P andJunaid TA. Comparison of bioactive glass, mineraltrioxide aggregate, ferric sulfate, and formocresol aspulpotomy agents in rat molar. Dent Traumatol 2003;19: 314- 320



54/60

FUTURE TRENDS.


55/60

REFERENCES


56/60

Andreason JO, rud J. Mode of healing histologically after endodonticsurgery in 70 cases. Int J Oral Surg 1972; 1: 148- 160

Rud J, Andreason JO, Moller- Jensen JE. A multivariate analysis of theinfluence of various factors upon the helaing after endodontic surgery. IntJ Oral Surg 1972; 1: 258- 271

Barrier membrane techniques in endodontic microsurgery. Dent Clin NAm 1997; 41(3): 585- 602

Kao RT, Conte G, Nishimine D, Dault S. Tissue engeneering forperiodontal

regeneration. J Californ Dent Assoc 2005; 33(3): 205- 215

Melcher AH. Repair potential of periodontal tissues. J Periodontol 1976;47:256-60.

Sato N. Periodontal Surgery. A Clinical Atlas. 2000. Quint Pub, Illinois Greenstein G and Caton JG. Resorbable Barriers and Periodontal

Regeneration in Periodontal Regeneration : current Status and Directions.1994. Quint Pub, Hong Kong

Bunyaratavej P and Wang HL. Collagen membranes: A Review. J

Periodontol 2001; 72: 215- 229

REFERENCES


57/60

Postlethwaite AE , Seyer JM, and Kang AH Chemotactic attraction of humanfibroblasts to type I, II, and III collagens and collagen-derived peptides Proc. Natl.Acad. Sci. (USA) 1978; 75(2): 871-875

Hirooka H. The biologic concept for the use of enamel matrix protein: trueperiodontal regeneration. Quint Int 1998; 29: 621- 630

Nanci A. Ten Cates Oral Histology. Development, Structure and Function.7th Ed.

2008. Mosby, Elsevier, St. Louis, Missouri

Cochran DL.Biomimetics in Periodontal Regeneration. Rationale and clinical Useof Enamel Matrix Derivative. 2003. quint Pub, Illinois.

Iqbal MK Bamaas NS. Effect of enamel matrix derivative (EMDOGAIN) uponperiodontal healing after replantation of permanent incisors in Beagle dogs. DentTraumatol 2001; 17: 36- 45

Marx R and Garg A.Dental and Craniofacial Application of Platelet rich Plasma

2005. Quint Pub, Illinois

Carranza FA, Mc Clain P and Schallhorn R. Regenerative Osseous surgery inCarranzas Clinical Periodontology. 9th Ed. 2003. Elsevier, Pennsylvania

Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23:383- 297


cell migration, proliferation and differentiation J Dent Res 1985; 64 (Spec Iss):

REFERENCES


58/60

Salako M, Joseph B, Ritwik P, Salonen J, John P and Junaid TA. Comparison ofbioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol aspulpotomy agents in rat molar. Dent Traumatol 2003; 19: 314- 320

Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregate

and calcium hydroxide as pulp- capping agents in human teeth: a perliminaryreport. Int Endod J 2002; 36: 225- 231

Thomson TS, Berry JE, Somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate. J Endod2003; 29(6): 407- 412

Saidon J, He J, Zhu Q, Safavi K, Spngberg SW. Cell and tissue reactions tomineral trioxide aggregate and Portland cement. Oral surg Oral Med Oral PatholOral Radiol Endod 2003; 95: 483- 489

Huang TH, Yang CC, Ding SJ. Inflammatory cytokines reaction elicited by root-end filling materials. J Biomed Mater Res, Part B Applied biomaterials2005; 73:123- 128

Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic propertiesof Mineral Trioxide Aggregate . J Endod 2005; 31(2): 97- 100

Zhu Q, Haglund R, Safavi KE. Adhesion of human osteoblasts on root- end fillingmaterials. J Endod 2000; 26(7): 404- 406

Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate

material use in endodontic treatment: A review of the literature. Dental Materials-

REFERENCES


59/60

REFERENCES Abedi HR,Torabinejad M, Pitt Ford TR, Bakland LK. The use of Mineral

Trioxide Aggrgate cement as a direct pulp capping agent. J Endod 1996;22: 199

Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK. Using MineralAggregate as a pulp capping material. J Am Dent Assoc 1996; 127: 1491-1494

Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg 1974;38(6): 945- 953

Cvek M. A clinical report on partial pulpotomy and capping with calciumhydroxide in permanent incisors with complicated crown fracture. J Endod1978; 4(8):232- 237

Stanley HR, Pameijer CH. Pulp Capping with a new visible- light- curingcalcium hydroxide composition (Prisma VLC Dycal). Oper Dent 1985; 10:152- 163


60/60

Bio Mimetic Materials

Documents

Transcript of Bio Mimetic Materials