Effect of benzalkonium chloride addition to EDTA on attachment and proliferation of dental pulp stem cells on dentin and on transforming growth factor-β1 release

Eren, Selen Küçükkaya; Zırh, Elham Bahador; Zeybek, Naciye Dilara; Örs, Sevinç Askerbeyli; Aksel, Hacer; Parashos, Peter

doi:10.1007/s10266-020-00545-5

Cited by 8 publications

(13 citation statements)

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“…Table 1 summarizes the studies that evaluated growth factors’ release/expression (Aksel et al, 2020; Atesci et al, 2020; Bracks et al, 2019; Cameron et al, 2019; Chae et al, 2018; Deniz Sungur et al, 2019; Duncan et al, 2017; Galler et al, 2015; Gonçalves et al, 2016; Ivica et al, 2019; Kucukkaya Eren et al, 2021; Li et al, 2020; Liu et al, 2019; Ranc et al, 2018; Sadaghiani et al, 2016; Widbiller et al, 2017; Zeng et al, 2016). Table 2 summarizes information from the in vitro studies that evaluated cell behaviour (Aksel et al, 2020; Alghilan et al, 2017; Atesci et al, 2020; Chae et al, 2018; Deniz Sungur et al, 2019; Galler et al, 2016; Gonçalves et al, 2016; Hashimoto et al, 2018; Huang et al, 2011; Ivica et al, 2019; Kawamura et al, 2016; Kim et al, 2015; Kucukkaya Eren et al, 2021; Li et al, 2020; Liu et al, 2019; Martin et al, 2014; Mollashahi et al, 2016; Pang et al, 2014; Park et al, 2015; Prompreecha et al, 2018; Ring et al, 2008; Sadaghiani et al, 2016; Scott et al, 2018; Shrestha et al, 2016; Tunç et al, 2019; Widbiller et al, 2019), and Table 3 shows studies that evaluated tissue regeneration in immature teeth models (El Ashry et al, 2016; Kawamura et al, 2016; Taweewattanapaisan et al, 2019; Yamauchi et al, 2011). According to the study design, 32 studies were only in vitro , three studies were in vivo , and one study used both models.…”

Section: Resultsmentioning

confidence: 99%

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review

et al. 2022

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Background The effects of ethylenediaminetetraacetic acid (EDTA) on regenerative endodontic procedures (REPs) are controversial, because, despite releasing growth factors from dentine, some studies show negative effects on cell behaviour. Objectives The aim of the study was to investigate the influence of the use of EDTA in REP on the growth factors’ release, cell behaviour and tissue regeneration. Methods A systematic search was conducted (PubMed/Medline, Scopus, Cochrane Library, Web of Science, Embase, OpenGrey and reference lists) up to February 2021. Only in vivo and in vitro studies evaluating the effects of EDTA on the biological factors of dentine, pulp/periapical tissues and cell behaviour were eligible. Studies without a control group or available full text were excluded. The growth factors’ release was the primary outcome. Risk of bias in the in vitro and in vivo studies was performed according to Joanna Briggs Institute's Checklist and SYRCLE’s RoB tool, respectively. Results Of the 1848 articles retrieved, 36 were selected. Amongst these, 32 were in vitro, three animal studies and one with both models. The EDTA concentrations ranged from 3% to 15%, at different times. Regarding growth factors’ release (17 studies), 15 studies found significant transforming growth factor (TGF)‐β release after dentine conditioning with EDTA, and most found no influence on vascular endothelial growth factor release. Regarding cell behaviour (26 studies), eight studies showed no influence of EDTA‐treated dentine on cell viability, whereas, five, nine and six studies showed higher cell migration, adhesion and differentiation respectively. No influence of EDTA conditioning was observed in animal studies. In vitro studies had a low risk of bias, whereas animal studies had high risk of bias. Meta‐analysis was unfeasible. Discussion This review found that EDTA increased TGF‐β release and improved cell activity. However, well‐designed histological analyses using immature teeth models are needed. Conclusions High‐quality in vitro evidence suggests that EDTA‐treated dentine positively influences TGF‐β release, cell migration, attachment and differentiation; further research to evaluate its influence on tissue regeneration is necessary due to low methodological quality of the animal studies.

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Section: Resultsmentioning

confidence: 99%

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review

et al. 2022

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“…Of these, 15 were excluded for not investigating or comparing endodontic irrigants, and seven studies did not include dentin. Sixteen studies that met the criteria were included in the qualitative synthesis [ 10 , 13 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], and eight were included in the quantitative synthesis [ 10 , 13 , 22 , 24 , 29 , 32 , 33 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the included studies are shown in Table 1 . Most studies have employed dentin slices as the test system [ 10 , 22 , 23 , 26 , 27 , 28 , 29 , 31 , 32 , 35 ]. Five studies used root canal segments [ 13 , 23 , 24 , 25 , 33 ], and two studies used solubilized dentin powder [ 30 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, most studies fully met the test system domain, specifying the parameters used in the management of test substances, for both reporting quality [ 23 , 24 , 25 , 26 , 29 , 30 , 31 , 32 , 33 , 35 ] and methodological quality [ 10 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], and also the domain related to the doses used and the number of replicates performed, named the administration of test compound, for reporting quality [ 10 , 22 , 23 , 25 , 26 , 28 , 29 , 30 , 33 , 34 ] and methodological quality [ 10 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 ]. Furthermore, all studies were classified as directly relevant and with an overall low risk.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies [ 10 , 13 , 22 , 29 , 33 ] and 43 comparisons of means and standard deviation of TGF-β1 detected by ELISA method after exposure to 17% EDTA versus other irrigants were included in this analysis ( Figure 3 ). Samples irrigated with 17% EDTA presented similar TGF-β1 release when compared to samples irrigated with distilled water (MD −714.52 [−4800.12, 3371.08] p = 0.73 I 2 = 69%), 10% citric acid (MD −236.48 [−579.92, 106.95] p = 0.18 I 2 = 92%), etidronic acid (MD 9975.44 [−1580.53, 21,531.42] p = 0.09 I 2 = 97%), and 0.008% BAC (MD −16.34 [−94.91, 62.24] p = 0.68) very low certainty, according to GRADE.…”

Section: Resultsmentioning

confidence: 99%

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Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis

et al. 2021

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Irrigant solutions are used to promote dentin-growth factors (GF) release for regenerative endodontics. This review aimed to evaluate the reports comparing the release of GFs using different root canal irrigant solutions. Eligible studies compared the in vitro GF release in human teeth after the use of at least two distinct solutions. A search was conducted on Pubmed, Scopus, Web of Science, and Lilacs on 11 August 2021. Risk of bias was assessed using SciRAP. Study characteristics and quantitative data were extracted, and meta-analyses were performed for the mean difference (95% confidence interval) of the release of transforming growth factors Beta 1 (TGF-β1) by EDTA compared to other irrigants. Of sixteen eligible studies, eight were included in quantitative analysis. ELISA assays showed higher TGF-β1 release from 10% EDTA compared to 10% citric acid (p < 0.00001). Immunogold assays showed higher levels of TGF-β1 for 17% EDTA (p < 0.00001) compared to 10% citric acid. GRADE identified a low to very low certainty of evidence. These results point to an increased release of TGF-β1 in dentin treated with EDTA. The high heterogeneity and very low certainty of the evidence demand further studies before EDTA indication as a better irrigant for regenerative endodontics. Registration: CRD42020160871 (PROSPERO).

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Transforming growth factor-β1 promotes early odontoblastic differentiation of dental pulp stem cells via activating AKT, Erk1/2 and p38 MAPK pathways

Bai

Cheng²,

Liu³

et al. 2023

Journal of Dental Sciences

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Effect of benzalkonium chloride addition to EDTA on attachment and proliferation of dental pulp stem cells on dentin and on transforming growth factor-β1 release

Cited by 8 publications

References 36 publications

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review

Influence of ethylenediaminetetraacetic acid on regenerative endodontics: A systematic review

Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis

Transforming growth factor-β1 promotes early odontoblastic differentiation of dental pulp stem cells via activating AKT, Erk1/2 and p38 MAPK pathways

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