Abstract
This study evaluated the physicochemical, biological, and antimicrobial properties of a new hydraulic calcium silicate-based modified material, and compared it with MTA Repair HP and MTA Angelus. The materials were assessed regarding color luminosity (L), color change, radiopacity, setting time, and ISO 6876:2012 linear flow. Volumetric filling and volume change were evaluated using microcomputed-tomography (µCT). Chemical characterization after 28 days in Hank's Balanced Salt Solution (HBSS) and pH analysis were also assessed. Biological characterization of cytotoxicity and microbiological assessment were also undertaken. Shapiro-Wilk, ANOVA, Levene and post hoc analyses with Bonferroni correction were performed, adopting a 5% significance level (p <0.05). Bio-C Pulpo exhibited the highest L values after 90 days. All tested materials demonstrated color change during the analyses, and had radiopacity above 5 mm Al. MTA Repair HP set faster than Bio-C Pulpo, whereas the latter had the highest linear flow. MTA Repair HP had the highest volumetric filling in µCT analysis. Bio-C Pulpo showed the highest alkalinity during all tested periods, and the highest volumetric loss (above 9%), in comparison with MTA Repair HP and MTA Angelus. Bio-C Pulpo did not form calcium hydroxide after hydration. MTA Repair HP demonstrated the highest cytocompatibility, and Bio-C Pulpo, the highest cytotoxicity. No inhibition halos were observed for any material, and similar higher turbidity values were seen after direct contact. Composition additives used in Bio-C Pulpo modified its properties, and both the absence of calcium hydroxide deposition after hydration, and the related cytotoxicity of this material are of particular concern.
Highlights
Vital pulp therapy techniques and the use of adequate biomaterials can establish predictable, minimally invasive biological therapies with high success rates
Materials used in vital pulp treatments should ideally possess physicochemical properties, such as flow and consistency that facilitate their insertion in cavities, short setting time to allow restoration in the same operative session, antimicrobial effect, and compatibility with adhesive systems or liners used before restorative procedures
Calcium hydroxide deposition formed as a by-product of the hydration reaction of hydraulic calcium silicate-based materials is crucial, since it serves as a chemical mediator in tertiary dentinogenesis after vital pulp treatments.[1,2,5]
Summary
Vital pulp therapy techniques and the use of adequate biomaterials can establish predictable, minimally invasive biological therapies with high success rates. Materials used in vital pulp treatments should ideally possess physicochemical properties, such as flow and consistency that facilitate their insertion in cavities, short setting time to allow restoration in the same operative session, antimicrobial effect, and compatibility with adhesive systems or liners used before restorative procedures These materials should be radiopaque, so that they can be visible in prospective clinical follow-ups, provide an alkaline environment, and deposit calcium hydroxide to induce the formation of dentin bridges, which potentially maintain pulp vitality after the application of these materials in definitive restorations.[3,4] Calcium hydroxide deposition formed as a by-product of the hydration reaction of hydraulic calcium silicate-based materials is crucial, since it serves as a chemical mediator in tertiary dentinogenesis after vital pulp treatments.[1,2,5]
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