Abstract
Portland cement used in the construction industry improves its properties when wet. Since most dental materials are used in a moist environment, Portland cement has been developed for use in dentistry. The first generation material is mineral trioxide aggregate (MTA), used in surgical procedures, thus in contact with blood. The aim of this study was to compare the setting of MTA in vitro and in vivo in contact with blood by subcutaneous implantation in rats. The tissue reaction to the material was also investigated. ProRoot MTA (Dentsply) was implanted in the subcutaneous tissues of Sprague-Dawley rats in opposite flanks and left in situ for 3 months. Furthermore the material was also stored in physiological solution in vitro. At the end of the incubation time, tissue histology and material characterization were performed. Surface assessment showed the formation of calcium carbonate for both environments. The bismuth was evident in the tissues thus showing heavy element contamination of the animal specimen. The tissue histology showed a chronic inflammatory cell infiltrate associated with the MTA. MTA interacts with the host tissues and causes a chronic inflammatory reaction when implanted subcutaneously. Hydration in vivo proceeds similarly to the in vitro model with some differences particularly in the bismuth oxide leaching patterns.
Highlights
Portland cement is used in the construction industry as a binder in concrete
mineral trioxide aggregate (MTA) is often placed in contact with vital tissues that ooze blood/ serum or in situations where blood pools on its surface and the impact of blood contamination on the material properties is important
The ProRoot MTA caused a black hue, which was observed in all the samples retrieved from the subcutaneous tissues (Fig. 1)
Summary
Portland cement is used in the construction industry as a binder in concrete. Its main feature is its hydraulic nature as the material sets and develops its properties in the presence of moisture. The Portland cement component when mixed with water results in the formation of calcium silicate hydrate, calcium hydroxide, and ettringite[2]. When in clinical use the calcium hydroxide, which is a by-product of material hydration reacts with phosphates present in physiological fluids forming hydroxyapatite[3,4]. This is postulated to be the reason for the material success. MTA is often placed in contact with vital tissues that ooze blood/ serum (pulp capping) or in situations where blood pools on its surface (root-end filling) and the impact of blood contamination on the material properties is important. Maximum gap width and gap perimeter in the blood-exposed group were significantly larger than those in the synthetic tissue fluid-exposed group[11]
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