Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 11, November, p. 1541–1547

doi: 10.17219/acem/74197

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Odontogenic effects of two calcium silicate-based biomaterials in human dental pulp cells

Emel Olga Önay1,A,B,C,D,E,F, Erkan Yurtcu2,B,C,D,E, Yunus Kasim Terzi3,B,C,D,E, Mete Üngör1,E, Yener Oguz4,B, Feride Iffet Şahin3,E

1 Department of Endodontics, School of Dentistry, Baskent University, Ankara, Turkey

2 Department of Medical Biology, School of Medicine, Baskent University, Ankara, Turkey

3 Department of Medical Genetics, School of Medicine, Baskent University, Ankara, Turkey

4 Department of Oral Surgery and Implantology, Private practice (Drs Nicolas & Asp), Dubai, United Arab Emirates


Background. The goal of treating exposed pulp with an appropriate pulp capping material is to promote the dentinogenic potential of the pulpal cells. There have been recent attempts to develop more effective pulp-capping materials.
Objectives. The aim of this study was to evaluate the effect of newly developed calcium silicate-based material on odontogenic differentiation of primary human dental pulp cells (HDPCs), in comparison with a contemporary calcium silicate-based material.
Material and Methods. Human dental pulp cells isolated from dental pulps were cultured in standard culture conditions in Dulbecco’s Modified Eagle’s Medium (DMEM) and then the effects of Micro-Mega mineral trioxide aggregate (MM-MTA) (Micro-Mega, Besançon, France) and ProRoot MTA (MTA) (Dentsply Sirona, Tulsa, USA) (positive control) were evaluated on HDPCs at 1, 7 and 14 days. Untreated cells were used as a negative control. Odontoblastic differentiation was assessed by alkaline phosphatase (ALP) activity. Runtrelated transcription factor 2 (RUNX2), alkaline phosphatase liver/bone/kidney (ALPL), bone morphogenetic protein 2 (BMP2), dentin sialophosphoprotein (DSPP), and Distal-less homeobox 3 (DLX3), as odontoblastic/ osteoblastic expression markers, were evaluated by semi-quantitative real-time polymerase chain reaction (RT-PCR) analysis. Calcium levels of culture media were also determined.
Results. The MM-MTA group significantly increased the expression of BMP2 compared with that of the MTA group at 3 different time periods (p < 0.05). The up-regulation of ALPL between day 1 and 14 and the up-regulation of DSPP between day 7 and 14 were significant in both groups (p < 0.05). Micro-Mega MTA and MTA exhibited similar messenger RNA (mRNA) expression levels of ALPL, DSPP, RUNX2, DLX3, and ALP activities, as well as calcium levels.
Conclusion. Based on the cell responses observed in this study, MM-MTA might be used efficiently in dental pulp therapy as a potential alternative to MTA.

Key words

alkaline phosphatase, calcium silicate, dentinogenesis, mineral trioxide aggregate, transcription factors

References (37)

  1. Kuratate M, Yoshiba K, Shigetani Y, et al. Immunohistochemical analysis of nestin, osteopontin, and proliferating cells in the reparative process of exposed dental pulp capped with mineral trioxide aggregate. J Endod. 2008;34(8):970–974.
  2. Nair PNR, Duncan HF, Pitt Ford TR, et al. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: A randomized controlled trial. Int Endod J. 2008;41(2):128–150.
  3. Regan JD, Gutmann JL, Witherspoon DE. Comparison of Diaket and MTA when used as root-end filling materials to support regeneration of the periradicular tissues. Int Endod J. 2002;35(10):840–847.
  4. Torabinejad M, Pitt Ford TR, Mckendry DJ, et al. Histologic assessment of mineral trioxide aggregate as a root-end filling in monkeys. J Endod. 1997;23(4):225–228.
  5. Koh ET, Torabinejad M, Pitt Ford TR, et al. Mineral trioxide aggregate stimulates a biological response in human osteoblasts. J Biomed Mater Res. 1997;37(3):432–439.
  6. Mitchell PJ, Pitt Ford TR, Torabinejad M, et al. Osteoblast biocompatibility of mineral trioxide aggregate. Biomaterials. 1999;20(2):167–173.
  7. Balto HA. Attachment and morphological behavior of human periodontal ligament fibroblasts to mineral trioxide aggregate: A scanning electron microscope study. J Endod. 2004;30(1):25–29.
  8. Bonson S, Jeansonne BG, Lallier TE. Root-end filling materials alter fibroblast differentiation. J Dent Res. 2004;83(5):408–413.
  9. Gandolfi MG, Ciapetti G, Taddei P, et al. Apatite formation on bioactive calcium-silicate cements for dentistry affects surface topography and human marrow stromal cells proliferation. Dent Mater. 2010;26(10):974–992.
  10. Gandolfi MG, Shah SN, Feng R, et al. Biomimetic calcium-silicate cements support differentiation of human orofacial mesenchymal stem cells. J Endod. 2011;37(8):1102–1108.
  11. Min KS, Park HJ, Lee SK, et al. Effect of mineral trioxide aggregate on dentin bridge formation and expression of dentin sialoprotein and heme oxygenase-1 in human dental pulp. J Endod. 2008;34(6):666–670.
  12. Seo MS, Hwang KG, Lee J, et al. The effect of mineral trioxide aggregate on odontogenic differentiation in dental pulp stem cells. J Endod. 2013;39(2):242–248.
  13. Ber BS, Hatton JF, Stewart GP. Chemical modification of ProRoot MTA to improve handling characteristics and decrease setting time. J Endod. 2007;33(10):1231–1234.
  14. Johnson BR. Considerations in the selection of a root-end filling material. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(4):398–404.
  15. Kum KY, Kim EC, Yoo YJ, et al. Trace metal contents of three tricalcium silicate materials: MTA Angelus, Micro Mega MTA and Bioaggregate. Int Endod J. 2014;47:704–710.
  16. Khalil I, Naaman A, Camilleri J. Investigation of a novel mechanically mixed mineral trioxide aggregate (MM-MTA™). Int Endod J. 2015;48(8):757–767.
  17. Tanalp J, Karapınar-Kazandağ M, Dölekoğlu S, et al. Comparison of the radiopacities of different root-end filling and repair materials. The Scientific World Journal. 2013;23:594950. doi: 10.1155/2013/594950
  18. Celik D, Er K, Serper A, et al. Push-out bond strength of three calcium silicate cements to root canal dentine after two different irrigation regimes. Clin Oral Investig. 2014;18:1141–1146.
  19. Khalil IT, Sarkis T, Naaman A. MM-MTA for direct pulp capping: A histologic comparison with ProRoot MTA in rat molars. J Contemp Dent Pract. 2013;14(6):1019–1023.
  20. Margunato S, Taşlı PN, Aydın S, et al. In vitro evaluation of ProRoot MTA, Biodentine, and MM-MTA on human alveolar bone marrow stem cells in terms of biocompatibility and mineralization. J Endod. 2015;41(10):1646–1652.
  21. Chang SW, Bae WJ, Yi JK, et al. Odontoblastic differentiation, inflammatory response, and angiogenic potential of 4 calcium silicate-based cements: Micromega MTA, ProRoot MTA, RetroMTA, and experimental calcium silicate cement. J Endod. 2015;41(9):1524–1529.
  22. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) method. Methods. 2001;25(4):402–408.
  23. Linde A. Dentin mineralization and role of odontoblasts in calcium transport. Connect Tissue Res. 1995;33(1–3):163–170.
  24. Iohara K, Nakashima M, Ito M, et al. Dentin regeneration by dental pulp stem cell therapy with recombinant human bone morphogenetic protein 2. J Dent Res. 2004;83(8):590–595.
  25. Kim JY, Kim MR, Kim SJ. Modulation of osteoblastic/odontoblastic differentiation of adult mesenchymal stem cells through gene introduction: A brief review. J Korean Assoc Oral Maxillofac Surg. 2013;39(2):55–62.
  26. Tylzanowski P, Verschueren K, Huylebroeck D, et al. Smad-interacting protein 1 is a repressor of liver/bone/kidney alkaline phosphatase transcription in bone morphogenetic protein-induced osteogenic differentiation of C2C12 cells. J Biol Chem. 2001;276:40001–40007.
  27. Yang F, Xu N, Li D, et al. A feedback loop between RUNX2 and the E3 ligase SMURF1 in regulation of differentiation of human dental pulp stem cells. J Endod. 2014;40:1579–1586.
  28. Li X, Yang G, Fan M. Effects of homeobox gene distal-less 3 on proliferation and odontoblastic differentiation of human dental pulp cells. J Endod. 2012;38(11):1504–1510.
  29. Wöltgens JH, Lyaruu DM, Bronckers AL, et al. Biomineralization during early stages of the developing tooth in vitro with special reference to secretory stage of amelogenesis. Int J Dev Biol. 1995;39:203–212.
  30. Bellows CG, Aubin JE, Heersche JN. Initiation and progression of mineralization of bone nodules formed in vitro: The role of alkaline phosphatase and organic phosphate. Bone Miner. 1991;14(1):27–40.
  31. Paranjpe A, Smoot T, Zhang H, et al. Direct contact with mineral trioxide aggregate activates and differentiates human dental pulp cells. J Endod. 2011;37(12):1691–1695.
  32. Chang SW, Lee SY, Kum KY, et al. Effects of ProRoot MTA, Bioaggregate, and Micromega MTA on odontoblastic differentiation in human dental pulp cells. J Endod. 2014;40(1):113–118.
  33. Güven EP, Taşli PN, Yalvac ME, et al. In vitro comparison of induction capacity and biomineralization ability of mineral trioxide aggregate and a bioceramic root canal sealer. Int Endod J. 2013;46(12):1173–1182.
  34. Setbon HM, Devaux J, Iserentant A, et al. Influence of composition on setting kinetics of new injectable and/or fast setting tricalcium silicate cements. Dent Mater. 2014;30(12):1291–1303.
  35. Park KD, Lee BA, Piao XH, et al. Effect of magnesium and calcium phosphate coatings on osteoblastic responses to the titanium surface. J Adv Prosthodont. 2013;5:402–408.
  36. Thomas B, Sharpe P. Patterning of the murine dentition by homeobox genes. Eur J Oral Sci. 1998;106:48–54.
  37. Viale-Bouroncle S, Felthaus O, Schmalz G, et al. The transcription factor DLX3 regulates the osteogenic differentiation of human dental follicle precursor cells. Stem Cells Dev. 2012;21(11):1936–1947.