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Objectives: To evaluate in vitro the effects of nano-sized sodium trimetaphosphate (TMPnano) and sodium fluoride (F) added to a 17.5 % hydrogen peroxide (H 2 O 2 ) bleaching gel on the color change, enamel mechanical and morphological properties, and H 2 O 2 transamelodentinal diffusion., Materials and Methods: Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 17.5 % H 2 O 2 (17.5 % HP); 17.5 % H 2 O 2 + 0.1 % F (HP/F); 17.5 % H 2 O 2 + 1 % TMPnano (HP/TMPnano); 17.5 % H 2 O 2 + 0.1 % F + 1 % TMPnano (HP/F/TMPnano) and 35 % H 2 O 2 (35 % HP). The gels were applied for 40 min on three sessions, each session spaced 7 days apart. The total color change (ΔE* ab ) according to the Commission Internationale de l'Eclairage (CIE) L*a*b* color change measured by CIEDE2000 (ΔE 00 ), whitening index (ΔWI D ), surface hardness (SH), surface roughness (Ra), cross-sectional hardness (ΔKHN), and transamelodentinal diffusion were assessed. Enamel surfaces were examined using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDS) analysis. The data were analyzed using ANOVA, followed by the Student-Newman-Keuls test (p < 0.05)., Results: ΔE* ab , ΔE 00 , and ΔWI D values were comparable among the gels that produced a bleaching effect post-treatment (p < 0.001). The HP/F/TMPnano group exhibited lower mineral loss (SH and ΔKHN), Ra, and H 2 O 2 diffusion compared to the 17.5 % HP and 35 % HP groups, which had the highest values (p < 0.001). SEM/EDS analysis revealed surface changes in all bleached groups, though these changes were less pronounced with F/TMPnano., Conclusions: The 17.5 % HP gel containing F/TMPnano maintains the bleaching effect while reducing enamel demineralization, roughness, H 2 O 2 diffusion, and enamel morphological changes., Clinical Relevance: Low-Concentration H 2 O 2 bleaching gel containing F/TMPnano can be used as a novel approach to enhance safety and maintain the performance of aesthetic effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper; except for the last author, who holds a patent for a product used in the study, issued on November 5, 2019, under BR 102013006761-0., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: This scoping review (SR) aimed to investigate the impact of quercetin on mineralized dental tissues intended to be used in preventive and restorative dentistry., Methods: This SR was conducted following the PRISMA-ScR statement. A comprehensive search was performed across databases for articles published up to March 2024. Eligible studies included in vitro and in situ studies and evaluating the potential therapeutic effects of quercetin on dental enamel and dentin. Data were extracted, and synthesis of study findings was conducted., Results: Out of the 2322 records screened, 22 studies were included in the review. Quercetin, in solution or into dental materials increased the bond strength to enamel and dentin. Additionally, quercetin also enhanced the bond strength of enamel after bleaching. Co-administration of quercetin with fluoride prevented erosive wear and inhibited the proteolytic activity in dentin more effectively than either agent alone. Hardness and modulus of elasticity was higher in dentin treated with quercetin compared to placebo. Reduction of nanoleakage at the composite-dentin interface was reduced in the presence of quercetin as a solution or incorporated into dental adhesives., Conclusions: Quercetin exhibits promising therapeutic effects on mineralized dental tissues, including remineralization and enhancement of bond strength. It shows potential as a multifunctional agent for improving the longevity and effectiveness of dental biomaterials, as well as in preventing erosion and dental caries. However, as these conclusions are largely drawn from lab-based (in vitro) studies, further research, including clinical trials, is needed to fully explore its therapeutic potential and applications in dentistry., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Barrier membranes (BM) for guided bone regeneration (GBR) aim to support the osteogenic healing process of a defined bony defect by excluding epithelial (gingival) ingrowth and enabling osteoprogenitor and stem cells to proliferate and differentiate into bone tissue. Currently, the most widely used membranes for these approaches are collagen-derived, and there is a discrepancy in defining the optimal collagen membrane in terms of biocompatibility, strength, and degradation rates. Motivated by these clinical observations, we designed a collagen-free membrane based on l-valine- co -l-phenylalanine-poly(ester urea) (PEU) copolymer via electrospinning. Degradation and mechanical properties of these membranes were performed on as-spun and water-aged samples. Alveolar-bone-derived stem cells (AvBMSCs) were seeded on the PEU BM to assess their cell compatibility and osteogenic characteristics, including cell viability, attachment/spreading, proliferation, and mineralized tissue-associated gene expression. In vivo , PEU BMs were subcutaneously implanted in rats to evaluate their potential to cause inflammatory responses and facilitate angiogenesis. Finally, critical-size calvarial defects and a periodontal model were used to assess the regenerative capacity of the electrospun PEU BM compared to clinically available Cytoflex synthetic membranes. PEU BM demonstrated equal biocompatibility to Cytoflex with superior mechanical performance in strength and elasticity. Additionally, after 14 days, PEU BM exhibited a higher expression of BGLAP/osteocalcin and superior in vivo performance-less inflammation and increased CD31 and VWF expression over time. When placed in critical-sized defects in the calvaria of rats, the PEU BM led to robust bone formation with high expression of osteogenesis and angiogenesis markers. Moreover, our membrane enhanced alveolar bone and cementum regeneration in an established periodontal model after 8 weeks. We demonstrate that the PEU BM exhibits favorable clinical properties, including mechanical stability, cytocompatibility, and facilitated bone formation in vitro and in vivo. This highlights its suitability for GBR in periodontal and craniofacial bone defects.

Introduction: The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population., Materials and Methods: This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001)., Results: The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001)., Conclusion: The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F., Clinical Significance: This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The field of tissue engineering has witnessed significant advancements in recent years, driven by the pursuit of innovative solutions to address the challenges of bone regeneration. In this study, we developed an electrospun composite scaffold for bone tissue engineering. The composite scaffold is made of a blend of poly(L-lactide-co-ε-caprolactone) (PLCL) and polyethylene glycol (PEG), with the incorporation of calcined and lyophilized silicate-chlorinated bioactive glass (BG) particles. Our investigation involved a comprehensive characterization of the scaffold's physical, chemical, and mechanical properties, alongside an evaluation of its biological efficacy employing alveolar bone-derived mesenchymal stem cells. The incorporation of PEG and BG resulted in elevated swelling ratios, consequently enhancing hydrophilicity. Thermal gravimetric analysis confirmed the efficient incorporation of BG, with the scaffolds demonstrating thermal stability up to 250°C. Mechanical testing revealed enhanced tensile strength and Young's modulus in the presence of BG; however, the elongation at break decreased. Cell viability assays demonstrated improved cytocompatibility, especially in the PLCL/PEG+BG group. Alizarin red staining indicated enhanced osteoinductive potential, and fluorescence analysis confirmed increased cell adhesion in the PLCL/PEG+BG group. Our findings suggest that the PLCL/PEG/BG composite scaffold holds promise as an advanced biomaterial for bone tissue engineering., (© 2024 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals LLC.)

Introduction: Citric acid (CA) conditioning may be a promising alternative to ethylenediaminetetraacetic acid (EDTA) in regenerative endodontic procedures, as reported to improve growth factors' release from dentin. This review systematically investigated the effect of CA conditioning on the growth factors release from dentin and cell behavior compared to EDTA conditioning., Methods: Searches were conducted (PubMed/MEDLINE, Scopus, Web of Science, Embase, SciELO, Cochrane Library, and grey literature) until May-2023. Only in vitro studies that evaluated the effects of CA on growth factors' release from dentin and cell behavior outcomes compared to EDTA were included. The studies were critically appraised using a modified Joanna Briggs Institute's checklist. Meta-analysis was unfeasible., Results: Out of the 335 articles screened, nine were included. Among these, three studies used dentin discs/roots from permanent human teeth; the rest combined them with stem cells. 10% CA for 5 or 10 minute was the most used protocol. Meanwhile, EDTA concentrations ranged from 10% to 17%. In eight studies examining the release of growth factors, five reported a significant release of transforming growth factor-β after dentin conditioning with 10% CA compared to 17% EDTA. Regarding cell behavior (6 studies), three studies assessed cell viability. The findings revealed that 10% CA conditioning showed cell viability similar to those of 17% EDTA. Additionally, in two out of three studies, it was observed that 10% CA conditioning did not affect cell morphology. The studies had a low risk of bias., Conclusions: The use of 10% CA to condition dentin for 5-10 minutes resulted in a notable transforming growth factor -β1 release, but its cell responses were similar to those of EDTA., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To evaluate in vitro the effects of sodium fluoride (F) and nano-sized sodium trimetaphosphate (TMPnano) added to a 35% hydrogen peroxide (H 2 O 2 ) bleaching gel on the color alteration, enamel mechanical and morphological properties, and H 2 O 2 transamelodentinal diffusion., Materials and Methods: Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 35% H 2 O 2 (HP); 35% H 2 O 2  + 0.1% F (HP/F); 35% H 2 O 2  + 1% TMPnano (HP/TMPnano); 35% H 2 O 2  + 0.1% F + 1% TMPnano (HP/F/TMPnano) and 35% H 2 O 2  + 2% calcium gluconate (HP/Ca). The gels were applied 3 times by 40 min; once each 7-day. The Commission Internationale de l'Eclairage (CIE) L*a*b* total color alteration (ΔE), color alteration by CIEDE2000 (ΔE 00 ), whitening index (ΔWI D ), surface (SH) and cross-sectional hardness (ΔKHN), surface roughness (Ra), and transamelodentinal diffusion were determined. Enamel surfaces were evaluated by Scanning Electron Microscopy (SEM) and X-ray Dispersive Energy (EDX). Data were submitted to ANOVA, followed by the Student-Newman-Keuls test (p <0.05)., Results: ΔE, ΔE 00 , and ΔWID were similar among the gels that promoted a bleaching effect after treatment (p <0.001). Mineral loss (SH and ΔKHN), Ra, and H 2 O 2 diffusion were lower for HP/F/TMPnano; the HP and HP/Ca groups presented the highest values (p <0.001). For SEM/EDX, surface changes were observed in all bleached groups, but less intense with TMPnano., Conclusions: Gels containing F/TMPnano do not interfere with the bleaching effect and reduce enamel demineralization, roughness, H 2 O 2 diffusion, and morphological changes., Clinical Relevance: Whitening gels containing F/TMPnano can be used as a new strategy to increase safety and maintain clinical performance., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The last author holds a patent for a product used in the study, by the National Institute of Industrial Property – INPI/SP, issued on November 05, 2019, under number BR 102,013,006,761–0., (Copyright © 2023. Published by Elsevier Ltd.)

Keeping sodium hypochlorite (NaOCl) within the root canal is challenging in regenerative endodontics. In this study, we developed a drug delivery system using a gelatin methacryloyl (GelMA) hydrogel incorporated with aluminosilicate clay nanotubes (HNTs) loaded with NaOCl. Pure GelMA, pure HNTs, and NaOCl-loaded HNTs carrying varying concentrations were assessed for chemo-mechanical properties, degradability, swelling capacity, cytocompatibility, antimicrobial and antibiofilm activities, and in vivo for inflammatory response and degradation. SEM images revealed consistent pore sizes of 70-80 µm for all samples, irrespective of the HNT and NaOCl concentration, while HNT-loaded hydrogels exhibited rougher surfaces. The hydrogel's compressive modulus remained between 100 and 200 kPa, with no significant variations. All hydrogels demonstrated a 6-7-fold mass increase and complete degradation by the seventh day. Despite an initial decrease in cell viability, all groups recovered to 65-80% compared to the control. Regarding antibacterial and antibiofilm properties, 12.5 HNT(Double) showed the highest inhibition zone on agar plates and the most significant reduction in biofilm compared to other groups. In vivo, the 12.5 HNT(Double) group displayed partial degradation after 21 days, with mild localized inflammatory responses but no tissue necrosis. In conclusion, the HNT-NaOCl-loaded GelMA hydrogel retains the disinfectant properties, providing a safer option for endodontic procedures without harmful potential.

The objective of this research was to create and appraise biodegradable polymer-based nanofibers containing distinct concentrations of calcium trimetaphosphate (Ca-TMP) for periodontal tissue engineering. Poly(ester urea) (PEU) (5% w / v ) solutions containing Ca-TMP (15%, 30%, 45% w / w ) were electrospun into fibrous scaffolds. The fibers were evaluated using SEM, EDS, TGA, FTIR, XRD, and mechanical tests. Degradation rate, swelling ratio, and calcium release were also evaluated. Cell/Ca-TMP and cell/scaffold interaction were assessed using stem cells from human exfoliated deciduous teeth (SHEDs) for cell viability, adhesion, and alkaline phosphatase (ALP) activity. Analysis of variance (ANOVA) and post-hoc tests were used (α = 0.05). The PEU and PEU/Ca-TMP-based membranes presented fiber diameters at 469 nm and 414-672 nm, respectively. Chemical characterization attested to the Ca-TMP incorporation into the fibers. Adding Ca-TMP led to higher degradation stability and lower dimensional variation than the pure PEU fibers; however, similar mechanical characteristics were observed. Minimal calcium was released after 21 days of incubation in a lipase-enriched solution. Ca-TMP extracts enhanced cell viability and ALP activity, although no differences were found between the scaffold groups. Overall, Ca-TMP was effectively incorporated into the PEU fibers without compromising the morphological properties but did not promote significant cell function.

Objectives: This in vitro study evaluated the efficacy of toothpaste containing fluoride (F), sodium trimetaphosphate (TMP), and xylitol and erythritol (XE) to inhibit or repair initial enamel erosion lesions., Materials and Methods: Bovine enamel blocks (n = 120) were selected according to surface hardness (SH) and randomly divided into 5 experimental groups (n = 24 blocks/group): Placebo (no F, TMP, XE); 1100 ppm F; 16% xylitol + 4% erythritol (XE); 200 ppm F + 0.2% TMP (200 ppm F/TMP); and 200 ppm F + 0.2% TMP + 16% xylitol + 4% erythritol (200 ppm F/TMP/XE). The sound and softened blocks were immersed in toothpaste slurry in human saliva for 2 min. The blocks were then submitted to 4 erosive challenges in citric acid (0.75%, pH 3.5), each challenge for 1 min, with stirring. The SH of the blocks was determined after treatment (t) and after the 4 erosive challenges. In addition, the precipitates were analyzed by scanning electron microscopy (SEM). Variables were submitted to a two-way repeated-measures analysis of variance followed by a Student-Newman-Keuls test (p < 0.05)., Results: Toothpaste containing 200 ppm F/TMP/XE led to the highest protective and repair effect compared to the other groups (p < 0.001). The protective and repair effect was XE > 200 ppm F/TMP > 1100 ppm F > placebo (p < 0.001). All groups produced precipitates with a thicker layer for XE and TMP groups., Conclusions: Toothpaste containing 200 ppm F, TMP, and polyols demonstrated a superior protective and repair effect in initial enamel erosive lesions in vitro., Clinical Relevance: Toothpaste containing F and polyols could be an advantage in patients affected by dental erosion, due to its higher preventive potential, mainly in individuals who frequently drink acidic beverages. However, future studies are needed to confirm these results., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To evaluate the hydraulic conductance of dentin after treatment with fluoride toothpastes containing sodium trimetaphosphate microparticles (TMPmicro) or nanoparticles (TMPnano)., Materials and Methods: The dentinal tubules of bovine dentin blocks (4 × 4 × 1 mm) were unobstructed for determination of the maximum hydraulic conductance of the dentin. The dentin blocks were randomized into four groups (n = 15/group) of toothpastes (placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano) which were applied for 7 days (2×/day) using a brushing machine. The dentin surface (5/group) was analyzed by scanning electron microscopy. The hydraulic conductance post-treatment was measured in the other ten blocks. Thereafter, the same blocks were immersed in citric acid (pH 3.2) for 1 min, and the conductance was determined again. The data were submitted to 2-way ANOVA repeated measures, followed by the Student-Newman-Keuls test (p < 0.05)., Results: The percentage conductance reduction post-treatment for the groups were placebo = 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). After acid attack, the percentage reduction was placebo < 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). The toothpastes containing TMP showed the highest obliteration of dentinal tubules., Conclusions: The addition of TMPmicro to fluoride toothpaste produced a greater reduction in hydraulic conductance when compared with 1100 ppm F toothpaste., Clinical Relevance: The increased capacity of toothpastes containing TMP to reduce hydraulic conductance indicates their potential to reduce symptoms of dentinal hypersensitivity.

Objectives: This in vitro study evaluated the effect of microparticles (TMPmicro) or nanoparticles (TMPnano) TMP associated with fluoride (F) in toothpaste formulations on the obliteration of dentinal tubules (DT)., Materials and Methods: The dentinal tubules of bovine dentin blocks were unobstructed by immersion in 37% phosphoric acid solution. Blocks (n = 20/group) underwent mechanical brushing (2×/day) during 7 days with toothpastes: placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano. After that, ten blocks of each group were immersed in citric acid (pH 3.2) for 1 min. The number, diameter and area of unobstructed DT, atomic % of chemical elements from precipitates, and the mineral concentration were quantified. Data were submitted to two-way ANOVA, followed by Student-Newman-Keuls test (P < 0.05)., Results: Toothpastes containing TMPmicro and TMPnano promoted greater obliteration of DT and greater mineral concentration compared to other groups (P < 0.05). Placebo and 1100 ppm F group presented similar obliteration but 1100 ppm F group promoted higher mineral concentration. Higher Ca/P ratios were observed in groups treated with TMP; the acid challenge reduced Ca/P ratio for all groups. The atomic % of C and N was significantly lower for TMP toothpastes before acid challenge, but increased afterwards., Conclusions: It was concluded that the addition of TMPmicro or TMPnano to F toothpastes produced greater obliteration of dentinal tubules and higher mineral concentration when compared with 1100 ppm F., Clinical Relevance: By the addition of TMP, fluoride toothpastes may occlude the dentinal tubules, with potential to reduce dentin hypersensitivity.