Browsing by Author "Yassen, Ghaeth H."
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Item Attachment and proliferation of dental pulp stem cells on dentine treated with different regenerative endodontic protocols(Wiley, 2017) Alghilan, M. A.; Windsor, L. Jack; Palasuk, Jadesada; Yassen, Ghaeth H.; Department of Endodontics, School of DentistryAim To investigate the attachment and proliferation of dental pulp stem cells (DPSC) on dentine treated with various endodontic regeneration protocols. Methodology Standardized dentine samples were irrigated with sodium hypochlorite (1.5% NaOCl) and ethylenediaminetetraacetic acid (17% EDTA) and randomized into four treatment groups and two control groups. The treatment groups were treated with a clinically used concentration of triple antibiotic paste (TAP), double antibiotic paste (DAP), calcium hydroxide (Ca(OH)2) or diluted TAP in a methylcellulose system (DTAP) for 1 week. Each sample in the treatment groups was then irrigated with EDTA. The two control groups were treated with EDTA or received no treatment. Dental pulp stem cells were seeded on each dentine specimen (10 000 cells). Lactate dehydrogenase activity assays were then performed to evaluate the attached DPSC after 1 day of incubation. Water-soluble tetrazolium assays were used to determine DPSC proliferation after three additional days of incubation. Friedman's test followed by least significant difference were used for statistical analyses (α = 0.05). Results Triple antibiotic paste and DTAP regeneration protocols, as well as EDTA-treated dentine, caused significant increases in DPSC attachment to dentine. Triple antibiotic paste, DAP and Ca(OH)2 regeneration protocols caused significant reductions in DPSC proliferation on dentine. However, the DTAP regeneration protocol did not have any significant negative effects on DPSC proliferation. Conclusions The clinically used endodontic regeneration protocols that include the use of TAP, DAP or Ca(OH)2 medicament negatively affected DPSC proliferation on dentine. However, the use of DTAP medicament during regenerative endodontic treatment may not adversely affect the proliferation of DPSC.Item Effect of different endodontic regeneration protocols on wettability, roughness and chemical composition of surface dentin(Elsevier, 2015-06) Yassen, Ghaeth H.; Sabrah, Alaa H. A.; Eckert, George J.; Platt, Jeffrey A.; Department of Restorative Dentistry, IU School of DentistryIntroduction We investigated the changes in physiochemical properties of dentin surfaces after performing different endodontic regeneration protocols. Methods Human dentin slices were randomized into 4 treatment groups and 1 untreated control group (n = 10). One treatment group was irrigated with sodium hypochlorite (NaOCl) for 5 minutes followed by EDTA for 10 minutes. The other 3 treatment groups were irrigated with NaOCl; treated for 4 weeks with triple antibiotic paste (TAP), diluted triple antibiotic paste (DTAP), or calcium hydroxide (Ca[OH]2); and then irrigated with EDTA. After treatment, contact angles between a blood analog and dentin surfaces were evaluated. Surface roughness and chemical composition were characterized using optical profilometry and energy-dispersive X-ray spectroscopy, respectively. One-way analysis of variance followed by Fisher least significant difference tests were used for statistical analyses. Results All treatment groups showed a significant reduction in wettability and a significant increase in surface roughness when compared with untreated dentin. Dentin treated with Ca(OH)2 had significantly lower wettability compared with all other groups. No significant difference in wettability was found between dentin treated with DTAP and TAP protocols. Dentin treated with TAP had significantly higher surface roughness compared with all other groups. Untreated dentin and NaOCl + EDTA–treated dentin had significantly higher calcium and phosphorus as well as significantly lower carbon compared with dentin treated with Ca(OH)2, DTAP, and TAP. Conclusions Endodontic regeneration protocols had a significant effect on wettability, surface roughness, and chemical composition of surface dentin. The Ca(OH)2 protocol caused a significant reduction in dentin wettability compared with TAP or DTAP protocols.Item The Effect of Diluted Triple and Double Antibiotic Pastes on Dental Pulp Stem Cells and Established Enterococcus faecalis Biofilm(Springer, 2015-11) Sabrah, Alaa H. A.; Yassen, Ghaeth H.; Liu, Wai-Ching; Goebel, W. Scott; Gregory, Richard L.; Platt, Jeffrey A.; Department of Restorative Dentistry, IU School of DentistryObjectives To investigate the effect of various dilutions of antibiotic medicaments used in endodontic regeneration on the survival of human dental pulp stem cells (DPSCs) and to determine their antibacterial effect against established Enterococcus faecalis biofilm. Materials and methods The cytotoxic and antibacterial effects of different triple (TAP) and double antibiotic paste (DAP) dilutions (0.125, 0.25, 0.5, 1, and 10 mg/ml) were tested against Enterococcus faecalis established biofilm and DPSC. Established bacterial biofilm were exposed to antibiotic dilutions for 3 days. Then, biofilms were collected, spiral plated, and the numbers of bacterial colony forming units (CFU/ml) were determined. For the cytotoxic effect, lactate dehydrogenase activity assays (LDH) and cell viability assays (WST-1) were used to measure the percentage of DPSC cytotoxicity after 3-day treatment with the same antibiotic dilutions. A general linear mixed model was used for statistical analyses (α = 0.05). Results All antibiotic dilutions significantly decreased the bacterial CFU/ml. For WST-1 assays, all antibiotic dilutions except 0.125 mg/ml significantly reduced the viability of DPSC. For LDH assays, the three lowest tested concentrations of DAP (0.5, 0.25, 0.125 mg/ml) and the two lowest concentrations of TAP (0.25 and 0.125 mg/ml) were non-toxic to DPSC. Conclusions All tested dilutions had an antibacterial effect against E. faecalis. However, 0.125 mg/ml of DAP and TAP showed a significant antibacterial effect with no cytotoxic effects on DPSCs. Clinical relevance Using appropriate antibiotic concentrations of intracanal medicament during endodontic regeneration procedures is critical to disinfect root canal and decrease the adverse effects on stem cells.Item The effect of endodontic regeneration medicaments on mechanical properties of radicular dentin(2013) Yassen, Ghaeth H.; Platt, Jeffrey A., 1958-; Chu, Tien-Min Gabriel; Murray, Peter E.; Allen, Matthew R.; Vail, Mychel Macapagal, 1969-Endodontic regeneration treatment of necrotic immature teeth has gained popularity in recent years. The approach suggests a biological alternative to induce a continuous root development. In this project, three in vitro experiments were conducted to investigate the effect of three medicaments used in endodontic regeneration on mechanical properties and chemical structure of radicular dentin. In the first experiment, we investigated longitudinally the effect of medicaments on the indentation properties of the root canal surface of immature teeth using a novel BioDent reference point indenter. A significant difference in the majority of indentation parameters between all groups was found after one-week and one-month application of medicaments (p<0.0001): triple antibiotic paste (TAP) > double antibiotic paste (DAP) > control > calcium hydroxide [Ca(OH)2]. The four-week exposure of dentin to TAP and DAP caused 43% and 31% increase in total indentation distance outcome, respectively. In the second experiment, we investigated longitudinally the effect of medicaments on the chemical structure of immature radicular dentin by measuring the phosphate/amide I ratios of dentin using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy. Phosphate/amide I ratios were significantly different between the four groups after one week, two weeks and four week application of medicaments (p<0.0001): Ca(OH)2-treated dentin > untreated dentin > DAP-treated dentin > TAP-treated dentin. In the third experiment, we investigated longitudinally the effect of medicaments on root fracture resistance and microhardness of radicular dentin. For the microhardness, the two-way interaction between group and time was significant (p<0.001). TAP and DAP caused a significant and continuous decrease in dentin microhardness after one and three month application, respectively. The three-month intracanal application of Ca(OH)2 significantly increased the microhardness of root dentin. The time factor had a significant effect on fracture resistance (p<0.001). All medicaments caused significant decrease in fracture resistance ranging between 19%-30% after three month application compared to one week application. The three medicaments used in endodontic regeneration caused significant change in the chemical integrity of the superficial radicular dentin and significantly affected the indentation properties of the root canal surface. Furthermore, the three month intracanal application of medicaments significantly reduced the fracture resistance of roots.Item The effects of concentration and treatment time on the residual antibacterial properties of DAP(2016) Jenks, Daniel Brent; Spolnik, Kenneth J.; Bringas, Josef; Gregory, Richard L.; Yassen, Ghaeth H.; Ehrlich, Ygal; Warner, Ned A.Introduction: Regenerative endodontic procedures are used to treat immature teeth with pulpal necrosis in order to control infection, enable continued root development and enhance formation of a pulp like tissue in the canal. Canal disinfection is an integral part the regenerative endodontic process. Double antibiotic paste (DAP; i.e., equal parts of ciprofloxacin and metronidazole) has been successfully used for canal disinfection in regenerative endodontics. A comparison of the residual antibacterial effect of dentin treated with various dilutions of DAP pastes on biofilm formation has not yet been investigated thoroughly. Objectives: The aims of this in-vitro study were to investigate how concentration and time of treatment affect the residual antibacterial properties of DAP in preventing E. faecalis biofilm formation on human dentin. Materials and Methods: Extracted human teeth were used to obtain 4x4mm radicular dentin specimens. Each specimen was pretreated for 1 or 4 weeks with the 77 clinically used concentration of DAP (500 mg/mL), low concentrations of DAP (1, 5 or 50 mg/mL) loaded into a methylcellulose system, calcium hydroxide (Ca(OH)2), or placebo paste. After treatment, samples were rinsed and placed in sterile phosphate buffered saline (PBS) for three weeks. Samples were then inoculated with cultured E. faecalis and incubated in anaerobic conditions for three weeks to allow mature biofilm formation. The dentin samples were rinsed and biofilms detached. The detached biofilm cells were then diluted and spirally plated for enumeration on blood agar plates. The plates were then incubated for 24 h and the number of CFUs/mL was determined using an automated colony counter. Data was analyzed using Fisher’s Exact and Wilcoxon rank sum tests were used for statistical comparisons (α=0.05). Results: Dentin pretreatment for 4 weeks with 5, 50 or 500 mg/mL of DAP demonstrated significantly higher residual antibacterial effects and complete eradication of E. faecalis biofilms in comparison to a 1 week pretreatment with similar concentrations. However, dentin pretreated with 1 mg/mL of DAP or Ca(OH)2 did not provide a substantial residual antibacterial effect regardless of the application time. Conclusion: Dentin treated with 500, 50, or 5 mg/mL of DAP for 4 weeks was able to completely prevent the colonization of bacterial biofilm. Four-week treatment of dentin with DAP offers superior residual antibacterial effect in comparison to a one-week treatment. Intracanal application of DAP for 4 weeks during endodontic regeneration may offer an extended residual antibacterial effect.Item The effects of radicular dentine treated with double antibiotic paste and ethylenediaminetetraacetic acid on the attachment and proliferation of dental pulp stem cells(Wiley, 2015-10) Kim, Ki Wan; Yassen, Ghaeth H.; Ehrlich, Ygal; Spolnik, Kenneth; Platt, Jeffrey A.; Windsor, L. Jack; Department of Biomedical and Applied Sciences, IU School of DentistryAim This study explored the effects of dentine treated with two concentrations of double antibiotic paste (DAP) and ethylenediaminetetraacetic acid (EDTA) on the attachment and proliferation of dental pulp stem cells (DPSCs). Materials and Methods Radicular dentine samples were prepared with identical dimensions and randomized into six groups (n = 4). Four groups were treated with double antibiotic paste (DAP) at concentrations of 500 mg ml−1 or 1 mg ml−1 with or without EDTA. The other two groups were treated with EDTA only or received no treatment. DPSCs were seeded on each dentine sample (10 000 cells per sample). Lactate dehydrogenase activity assays were used to calculate the attached DPSCs after 1 day of incubation. Water soluble tetrazolium assays were performed to investigate DPSCs proliferation on the treated dentine samples after three additional days of incubation. Two-way anova followed by Tukey–Kramer tests was used for statistical analyses (α = 0.05). Results Dentine treated with 1 or 500 mg ml−1 of DAP followed by EDTA caused significant increases in DPSCs attachment compared to the dentine treated with the DAP alone. The 500 mg ml−1 of DAP with or without EDTA caused significant reductions in DPSCs proliferation. However, the treatment of dentine with 1 mg ml−1 of DAP did not have significant negative effects on DPSCs proliferation regardless of the use of EDTA. Conclusion The use of 1 mg ml−1 of DAP followed by 10 min of irrigation with EDTA in endodontic regeneration procedure may have no negative effects on the attachment and proliferation of DPSCs.Item Effects of Radiopaque Double Antibiotic Pastes on the Proliferation, Alkaline Phosphatase Activity and Mineral Deposition of Dental Pulp Stem Cells(Elsevier, 2020-09) Wu, Jennifer L.; McIntyre, Patrick W.; Hong, Jung Min; Yassen, Ghaeth H.; Bruzzaniti, Angela; Biomedical Sciences and Comprehensive Care, School of DentistryObjective The aim of this study was to investigate the effects of two radiopaque agents, barium sulfate (BaSO4) or zirconium oxide (ZrO2) in double antibiotic paste (DAP), on the proliferation and mineral deposition of human dental pulp stem cells (DPSC). Materials and methods Radiopaque antimicrobial medicaments composed of methylcellulose (MC) thickening polymer with BaSO4 or ZrO2 and either 1 or 5 mg/mL DAP (equal portions of metronidazole and ciprofloxacin) were used to investigate DPSC proliferation after 3 days, and alkaline phosphatase (ALP) activity and mineral deposition after 7 and 14 days. Radiopaque agents without DAP and Ca(OH)2 were used as controls. Results MC-BaSO4 DAP and MC-ZrO2 DAP at 1 or 5 mg/mL had no adverse effect on DPSC proliferation, compared to the media and MC controls. MC-ZrO2 (DAP-free) greatly increased ALP activity after 7 days. DPSC mineral deposition was modestly reduced at 7 days by MC-BaSO4 DAP and MC-ZrO2 DAP, but not by DAP-free radiopaque agents, and was most reduced by 5 mg/mL DAP in the 14-day cultures. Conclusions MC-BaSO4 or MC-ZrO2 medicaments containing up to 5 mg/mL of DAP supported the proliferation and early osteogenic differentiation of DPSC. Low DAP concentrations and short culture times led to more favorable effects on ALP activity and mineral deposition by DPSC. The findings suggest that radiopaque agents added for the purpose of detecting whether medicaments occupy the full extent of the root canal may have clinical applications. Radiopaque antibiotic medicaments containing low DAP concentrations may be an alternative to Ca(OH)2 for regenerative endodontic procedures.Item Evaluation of selected properties of a new root repair cement containing surface pre-reacted glass ionomer fillers(Springer, 2016) Yassen, Ghaeth H.; Huang, Ruijie; Al-Zain, Afnan; Yoshida, Takamitsu; Gregory, Richard L.; Platt, Jeffrey A.; Department of Biomedical and Applied Sciences, IU School of DentistryObjective This study evaluated selected properties of a prototype root repair cement containing surface pre-reacted glass ionomer fillers (S-PRG) in comparison to mineral trioxide aggregate (MTA) and intermediate restorative material (IRM). Materials and methods The antibacterial effect of S-PRG, MTA, and IRM cements was tested against Porphyromonas gingivalis and Enterococcus faecalis after 1 and 3 days of aging of the cements. The set cements were immersed in distilled water for 4 h to 28 days, and ion-releasing ability was evaluated. Initial and final setting times of all cements were evaluated using Gilmore needles. The push-out bond strength between radicular dentin and all cements was tested at different levels of the roots. Results S-PRG and IRM cements, but not MTA cement, demonstrated significant antibacterial effect against P. gingivalis. All types of cements exhibited significant antibacterial effect against E. faecalis without being able to eliminate the bacterium. S-PRG cement provided continuous release of fluoride, strontium, boron, sodium, aluminum, and zinc throughout all tested time points. Both initial and final setting times were significantly shorter for S-PRG and IRM cements in comparison to MTA. The push-out bond strength was significantly lower for S-PRG cement in comparison to MTA and IRM at coronal and middle levels of the roots. Conclusions S-PRG cement demonstrated significant antibacterial effects against endodontic pathogens, multiple ion-releasing ability, relatively short setting time, and low bonding strength. Clinical relevance S-PRG cement can be used as a one-visit root repair material with promising antibacterial properties and ion-releasing capacity.Item Inhibitory effect of gels loaded with a low concentration of antibiotics against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis(2015-09) Algarni, Amnah A.; Yassen, Ghaeth H.; Gregory, Richard L.; Department of Biomedical and Applied Sciences, IU School of DentistryWe explored longitudinally the inhibitory effect of gels loaded with 1 mg/mL modified triple antibiotic paste (MTAP) or double antibiotic paste (DAP) against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis. Methylcellulose-based antibiotic gels of MTAP (ciprofloxacin, metronidazole and clindamycin) and DAP (ciprofloxacin and metronidazole) were prepared at a concentration of 1 mg/mL. Individually cultured E. faecalis and P. gingivalis bacterial suspensions were treated with MTAP, DAP, or placebo (vehicle only) gels at different dilutions and allowed to grow in 96-well microtiter plates. Untreated bacterial suspensions served as a negative control. Crystal violet assays were used to evaluate biofilm formation after 48 h. The ability of the gels to inhibit biofilm formation was determined immediately, and at 1 month and 3 months after the gels had been prepared. Data were analyzed using a mixed-model ANOVA. The MTAP and DAP gels significantly reduced biofilm formation by both bacterial species at all time points, regardless of the tested dilution. No-significant differences in biofilm-inhibitory effects between MTAP and DAP gels were observed at the majority of the tested dilutions through various time points. Gels loaded with 1 mg/mL MTAP and DAP demonstrated a significant antibiofilm effect against E.faecalis and P. gingivalis.Item The Longevity of Residual Antibacterial Effect of Dentin Treated with Various Concentrations of Triple Antibiotic Paste(2016) Alyas, Sarmad Mazin; Yassen, Ghaeth H.; Ehrlich, Ygal; Bringas, Josef; Gregory, Richard L.; Warner, Ned Alan; Spolnik, Kenneth J.Introduction: Triple antibiotic paste (TAP, 1000 mg/ml) is composed of equal portions of ciprofloxacin, metronidazole and minocycline and is used as an intracanal dressing to disinfect the infected immature root canal during endodontic regeneration procedures. Lower concentrations of TAP have been recommended to minimize detrimental effects on pulp stem cells. TAP can be retained within the dentin matrix and its continual release confers an antibacterial effect to the dentin. Objective: The aim of this in vitro study was to investigate the residual antibacterial effect of dentin treated with various concentrations of TAP loaded into a gel system. Materials and Methods: Radicular dentin slabs were prepared from human teeth after obtaining IRB approval. The slabs were sterilized and treated with methylcellulose-based TAP of 100 mg/mL, 10 mg/mL, 1 mg/mL, 1.5% NaOCl, placebo paste with no TAP, or a positive control group with pure 1000 mg/mL TAP. Samples in each group were treated with the assigned TAP concentration for three weeks or immersed in 1.5% NaOCl for five minutes (n =18 per group). All samples were then irrigated with sterile water followed by 17% EDTA and incubated in phosphate buffered saline for either 2 or 4 weeks. Samples were then inoculated with Enterococcus faecalis and incubated for an additional 3 weeks. Biofilm formed on each sample was then dislodged and spiral plated to evaluate the bacterial colony-forming units. Data were analyzed using Fisher’s Exact tests and Wilcoxon rank sum tests (α = 0.05). Results: Dentin treated with 10, 100, or 1000 mg/mL of TAP demonstrated significant residual antibacterial effects up to four weeks. However, only 100 mg/mL TAP was able to completely prevent bacterial colonization after four weeks. No considerable residual antibacterial effect was observed in dentin treated with placebo gel, 1 mg/ml TAP or 1.5% NaOCl. Conclusion: At least 10 mg/mL of TAP loaded into a methylcellulose system is required to achieve a substantial residual antibacterial effect for four weeks.