A novel patient-specific three-dimensional drug delivery construct for regenerative endodontics.
A novel patient-specific three-dimensional drug delivery construct for regenerative endodontics.
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DOI：
10.1002/jbm.b.34250
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发表时间：
2019-07
期刊：
影响因子：
--
通讯作者：
Edwards PC
中科院分区：
文献类型：
--
作者：
Bottino MC;Albuquerque MTP;Azabi A;Münchow EA;Spolnik KJ;Nör JE;Edwards PC
诱发出血（EB）临床手术包括消毒步骤，然后撕裂根尖周组织，以诱导牙周膜和牙槽骨中未分化干细胞向内生长，是目前美国批准的唯一基于再生的治疗方法，用于治疗未发育（未成熟）恒牙的牙髓组织坏死。然而，使用基于抗生素的糊剂的消毒步骤会导致细胞毒性，需要采用生物相容性策略来促进根管消毒，而不会产生或最小化副作用，从而最大限度地提高再生效果。本研究的目的是开发一种用于管内药物输送的管状三维 (3D) 三重抗生素洗脱结构。对基于聚二氧环己酮的三重抗生素洗脱纤维的形态（扫描电子显微镜）、化学（傅里叶变换红外光谱）和机械（拉伸测试）特性进行了评估。分别使用受感染的（内氏放线菌）牙本质牙齿切片模型和犬根尖周疾病方法在体外和体内测定管状 3D 结构的抗菌特性。体外数据表明具有显着的抗菌活性和消除牙本质小管内细菌生物膜的能力。体内组织学结果表明，使用 EB 程序，管状 3D 三重抗生素洗脱结构可以形成适当的环境，导致根尖闭合和骨牙本质样组织薄层向内生长到根管中。总而言之，这些研究结果表明，我们的新型药物输送结构对于具有坏死牙髓的未成熟恒牙来说是一种有前途的生物相容性消毒策略。
Evoked bleeding (EB) clinical procedure, comprising a disinfection step followed by periapical tissue laceration to induce the ingrowth of undifferentiated stem cells from the periodontal ligament and alveolar bone, is currently the only regenerative-based therapeutic approach to treating pulp tissue necrosis in undeveloped (immature) permanent teeth approved in the United States. Yet, the disinfection step using antibiotic-based pastes leads to cytotoxic, warranting a biocompatible strategy to promote root canal disinfection with no or minimal side-effects to maximize the regenerative outcomes. The purpose of this investigation was to develop a tubular three-dimensional (3D) triple antibiotic-eluting construct for intracanal drug delivery. Morphological (scanning electron microscopy), chemical (Fourier transform infrared spectroscopy), and mechanical (tensile testing) characteristics of the polydioxanone-based triple antibiotic-eluting fibers were assessed. The antimicrobial properties of the tubular 3D constructs were determined in vitro and in vivo using an infected (Actinomyces naeslundii) dentin tooth slice model and a canine method of periapical disease, respectively. The in vitro data indicated significant antimicrobial activity and the ability to eliminate bacterial biofilm inside dentinal tubules. In vivo histological findings demonstrated that, using the EB procedure, the tubular 3D triple antibiotic-eluting construct allowed the formation of an appropriate environment that led to apex closure and the ingrowth of a thin layer of osteodentin-like tissue into the root canal. Taken together, these findings indicate that our novel drug delivery construct is a promising biocompatible disinfection strategy for immature permanent teeth with necrotic pulps.
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