MTA Angelus Research Articles

White MTA as a Material to Seal Iatrogenic Perforation for Furcation Teeth: A Case Report

Iatrogenic perforation is a common complication in endodontic treatment or restoration procedure. Recent developments in dentistry have improved tooth perforation prognosis. MTA (Mineral Trioxide Aggregate) is one of the chosen materials to seal tooth perforation. This case report discuss the management of an iatrogenic furcal perforation using White Angelus MTA to seal the furcal perforation on tooth 26 and its final restoration. Furcal perforation accured while removing the calcification in the mesio buccal canal using Protapper Next rotary file after sealing the perforation site, further root canal preparation was carried on, and root canals were medicated by Calcium Hydroxide. After 2 weeks root canal were obturated with Gutta Percha. After one week observation post obturation patient had no complain, and radiographic evaluation show good sealing by MTA. In Conclusion Angelus MTA have good sealing ability marginal adaptation, and the absence of calcium sulfate had reduced the setting time of the material. It is a suitable material to seal iatrogenic furcal perforation due to its biocompatibility, antimicrobial, good sealing ability, and low solubility.

Initial Cytotoxicity of Mineral Trioxide Aggregate (MTA) during Setting on Human Mesenchymal Stem Cells

Bone-marrow-derived human mesenchymal stem cells (hMSCs) which are important cell source for hard tissue regeneration stay near periapical lesions of tooth, playing an essential role in periodontal regeneration. Since the biomineralization process of MSCs is largely governed by the initial local environment, it is crucial to know the biological effects of dental bioceramic (mineral trioxide aggregate (MTA)) right after implantation. The purpose of this study was to evaluate the initial cytotoxicity of 4 different commercially available MTA materials (Endocem MTA, Ortho MTA, ProRoot MTA, and MTA Angelus) against hMSCs during or after setting using extracts of materials. The materials were mixed separately and placed into disk-shaped Teflon split molds (10 mm diameter and 2 mm thickness), and the sample discs were separated and eluted in the culture medium for 24 h. The extracts were exposed to hMSCs, and cytotoxicity was evaluated by the WST assay. In the present study, all 4 MTA products tested showed severe cytotoxicity at 100% and 50% extract, while 25% and 12.5% revealed 30∼100% depending on the MTA products. Endocem MTA showed severe cytotoxicity at 12.5% extract, while others showed relatively higher cell viability compared to Endocem MTA. Images of live and dead cells represented less live cells at 25% and 12.5%, confirming cell viability assay. Therefore, careful consideration of the concentration of MTA extracts is necessary, especially when applying MTA to the elderly patients to maintain the viability of hMSCs.

Effect of different surface treatment protocols on the shear bond strength of perforation repair materials to resin composite

The adhesion between the resin composite and perforation repair materials critically influences the treatment outcomes. This study aimed to investigate the effect of different surface treatment on the bond strength between the perforation repair materials and resin composite. Ninety blocks were prepared from Mineral trioxide aggregate (MTA) Angelus, EndoSequence (ERRM) and one experimental Nano-MTA (n = 30 each). Then, they were divided into two subgroups according to the surface treatment performed, which was either etching with phosphoric acid gel or air abrasion with Al2O3 particles. Adhesive system and resin composite were applied according to the manufacturers’ instructions. Specimens were tested for shear bond strength (SBS) tests using a universal testing machine. Failure modes were evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA and Tukey’s test. Perforation repair materials had a significant effect on SBS at p = 0.0008, while the surface treatment showed an insignificant effect on the SBS at p = 0.0612. After both surface treatment techniques; ERRM revealed the highest SBS mean values followed by MTA Angelus then Nano-MTA. There was no statistically significant difference between each of ERRM and MTA Angelus, and between MTA Angelus and Nano-MTA. Cohesive and mixed modes of failures were the most predominant failure modes in all groups. ERRM had the best bonding to resin composite. Both tested surface treatments performed similarly with ERRM and the experimental Nano-MTA regarding SBS to resin composite. Air abrasion surface treatment was considered more successful with MTA Angelus compared to phosphoric acid regarding SBS to resin composite. Abbreviation: MTA: Mineral trioxide aggregate; ERRM: EndoSequenceBC RRM-Fast Set Putty; SBS: shear bond strength; Nano-WMTA: Nano-white mineral trioxide aggregate; TEM: Transmission electron microscope

Effect of commonly used irrigants on the colour stabilities of two calcium-silicate based material.

The aim of present study was to evaluate the color stability of calcium-silicate based cements (CSC) Mineral Trioxide Aggregate (MTA) and BiodentineTM when exposed to endodontic irrigating solutions 5% Sodium hypochlorite (NaOCl) or 2% Chlorhexidine (CHX). A total of 60 (n=30) cylindrical samples (10 mm diameter, 2 mm height) were prepared by manipulating white MTA Angelus (Angelus, Londrina, PR, Brazil) and BiodentineTM (Septodent, Saint Maur, France) according to manufacturer's instructions. These samples were immersed in 5% sodium hypochlorite (Prime Dental Products Pvt. Ltd., Mumbai, India), 2% chlorhexidine gluconate (Dentochlor, Saronno VA, Italia), or distilled water for 24 hours. Color changes were measured using UV spectrophotometer (UV-1650, Shimadzu, Europe) and the values were tabulated. A significant difference was observed between group I and II with respect to both parameters A & B (p<0.05). Both the calcium-silicate-based materials exhibited significant discoloration when immersed in NaOCl and CHX. Distilled water did not cause clinically perceptible discoloration of any material. A significant discoloration was observed with a specific combination of calciumsilicate- based cement and irrigant. BiodentineTM exhibited significant discoloration with CHX whereas, MTA showed more discoloration with NaOCl.

Investigation of surface topography of different root-end filling materials: An in vitro study

Aim: Although there are many materials that can be used for retrograde filling in surgical endodontics, none of them can be regarded as an ideal material yet. The purpose of this study was to compare the surface topography of three different root-end filling materials.Methods: 36 extracted single rooted human incisor teeth were cleaned and decoronated to standardized 10 mm root lengths. The root segments were prepared and 2 mm apical resection were performed. The samples were randomly separeted to three groups (Group A: Ca(OH)2, Group B: MTA Angelus, Group C: ProRoot MTA), each comprised of 12 roots. Materials were placed as 2 mm apical barriers and obturated with guttapercha and AH-Plus sealer. Each group dimidiated two subgroups (A1,A2,B1,B2,C1,C2). Groups A1,B1,C1 were stored in normal saline (NS), groups A2,B2,C2 were stored in neutral phosphate buffer saline (NPBS) solution and samples were incubated at 370C for 2 weeks. Stereomicroscope (32X) was used to photograph the root-end filling.Results: All specimens demonstrated white crystals formation and sediment over the root-end filling materials and on the superficial border of the root-end cavities’ wall as a white plague. A2,B2,C2 samples have more crystal sediment on root-end fillings than samples A1,B1,C1. Dissolution and corrosion were observed in groups A1, A2.Conclusions: The results of this study revealed that calcium hydroxide is more resorbable than MTA Angelus and ProRoot MTA. The crystals formation and precipitation were observed in neutral phosphate buffer saline solution was more than normal saline solution for all groups as a hydroxiapatite crystals.

Cytotoxicity, Biocompatibility and Biomineralization of a New Ready-for-Use Bioceramic Repair Material.

New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and ¼ dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the ¼ dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials' cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

Effect of Er:YAG laser etching on topography, microstructure, compressive strength, and bond strength of a universal adhesive to calcium silicate cements

To evaluate the effect of Er:YAG etching on topography, microstructure, compressive strength, and shear bond strength (SBS) of All-Bond Universal adhesive to mineral trioxide aggregate-Angelus (AMTA) and Biodentine (BD). Sixty cylindrical specimens of each cement (AMTA and BD) in five groups were prepared and stored for 72h. The control groups were non-etched, and four other groups were acid-etched and laser-etched with a pulse energy of 60, 80, or 100mJ, followed by compressive strength testing. Surface micromorphology and topography were evaluated. Similar groups were bonded using All-Bond Universal with self-etch and etch-and-rinse (acid-etch) approaches, and laser-etch 60, 80, and 100mJ, and SBS was tested. Data were analyzed using two-way and one-way ANOVA and the Bonferroni post hoc tests (α = 0.05). BD had a significantly higher compressive strength and SBS (except for laser-etch 100) compared to AMTA, regardless of the etching method (p < 0.001). Acid etching and laser etching 100 of both cements and laser etching 80 of BD alone produced a significantly lower compressive strength than that for the other groups. Contrary to BD, for AMTA, all the treatments significantly increased SBS compared to that of the self-etch group. Etching of AMTA was needed for stronger bonding; laser etching with 60 or 80mJ without compromising compressive strength was recommended. Etching not only did not improve bonding ability of BD, but it also negatively affected the strength of BD. To achieve successful combined calcium silicate cement-resin material restoration, an adequate bond between the materials is mandatory. This might be provided with the ultramild adhesive through laser etching without compromising compressive strength, depending on cement composition and laser energy level used.

The effects of sodium hypochlorite and ethylenediaminetetraacetic acid on the microhardness of Mineral Trioxide Aggregate and TotalFill Bioceramic Putty.

This study aimed to evaluate the effects of 5% NaOCl and 17% EDTA on the Vickers microhardness of Mineral Trioxide Aggregate, MTA Angelus (MTAA), and TotalFill Bioceramic Putty (BCP) after 24h and 8days. Twenty-four samples of MTAA and BCP were tested for baseline microhardness at 24h. They were divided into four subgroups (5% NaOCl or 17% EDTA, 24h, 5% NaOCl or 17% EDTA at 8days) and microhardness was evaluated at different time-points. Results were recorded and analysed statistically via one-way anova Kruskal-Wallis test and post hoc uncorrected Dunn's multiple comparison test. MTAA had a higher baseline microhardness than BCP. NaOCl reduced the microhardness of MTAA but increased that of BCP. EDTA reduced the microhardness for both materials at 24h. At 8days, EDTA reduced the microhardness of MTAA, while BCP exhibited an increase in microhardness. Enabling these materials to set for a week prior to exposure to irrigants improves their microhardness.

Influence of ultrasonic agitation on bond strength, marginal adaptation, and tooth discoloration provided by three coronary barrier endodontic materials.

The effect of ultrasonic agitation (UA) on bond strength and adaptation of cervical plugs prepared with MTA Angelus (MTA), MTA Repair HP (MTAHP), and Biodentine (BIO) was evaluated. Dentin discoloration caused by the materials/treatment was also assessed. Seventy-two single rooted teeth were divided into six groups depending on the materials/treatment. After cervical plug preparation, dentin discs were excised for the push-out test; additional discs were analyzed under the confocal microscope to determine adaptation (gaps occurrence). For dentin discoloration analysis (ΔE), blocks of bovine incisors had cavities prepared and filled with the materials/treatment (from 7 to 180days). Both bond strength and adaptation were positively influenced by UA (P < 0.05). Comparison between materials showed an advantage for BIO when compared to MTAHP (P < 0.05). The best and worst results were provided by BIO/UA (12.66MPa and 1.87%) and MTAHP (2.54MPa and 28.58%), respectively. For ΔE, significant differences were observed throughout the periods. Just the MTA without UA exhibited noticeable discoloration at 180days (P < 0.05). UA favored a better adaptation of the materials to the dentin root, resulting in higher bond strength and adaptation of the materials to the root canal walls. Moreover, UA reduced MTA discoloration, keeping it imperceptible over the period evaluated. The better adaptation and higher bond strength provided by UA can be considered clinically relevant due to the importance of maintaining blood clot integrity and the possible esthetic compromise provided by reparative materials when used as coronary barrier in regenerative procedures.

Addition of phosphates and chlorhexidine to resin‐modified MTA materials

To evaluate the properties of experimental mineral trioxide aggregate (MTA) resin-modified materials for root-end filling procedures, varying their compositions regarding the addition of hydroxiapatite (HA) or dicalcium phosphate dihydrate, with or without chlorhexidine digluconate. White MTA (Angelus, Londrina, Brazil) was used as a reference material. Degree of conversion (DC) was evaluated by Fourier transformed infrared (FTIr) spectroscopy (n = 5). Flowability (n = 3) and radiopacity (n = 3) were evaluated following ISO 6876:2001 methods. For splitting tensile strength analysis, cylindrical samples (n = 10) were subjected to compressive load using a universal testing machine (Instron Corporation, Norwood, MA). Water sorption and solubility tests were performed according to ISO 4049:2009 methods. Calcium ion release and pH analysis (n = 10) were evaluated using a pH meter (Orion, Watsonville, CA). Cytotoxicity (n = 8) of materials extracts was evaluated as cell viability percentage. Statistical analysis was performed using Kolmogorov-Smirnov for normal distribution and data was subjected to one-way ANOVA and Tukey test (α = 0.05). Addition of chlorhexidine digluconate reduced DC mean values for experimental materials (<50%). White MTA demonstrated lower flowability (5.3 mm) and higher radiopacity (9.8 mm Al), splitting tensile strength (9.1 MPa), solubility (8.2 μg/mm3 ), calcium ion release (~26.5 ppm), cytotoxicity (55.2%), and pH mean values (10.8), when compared to experimental materials. All groups demonstrated a decrease in calcium release (<85%) and pH (<13%). Formulation containing HA demonstrated similar pH values after 28 days when compared to white MTA. Evaluated experimental resin-modified MTA based materials without chlorhexidine digluconate showed satisfactory results for all physico-chemical properties tested and cytotoxicity. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2195-2201, 2019.

Evaluation of color stability of different repairing materials

Evaluate the potential for dental color alteration of high-plasticity cements, MTA HP and MTA Flow, in comparison with MTA Angelus with calcium tungstate as radiopacifier; and alternative the formulations proposed, MTA Flow + 5% zinc oxide (ZnO) and an Experimental cement (powder of tricalcium silicate, bismuth oxide, ZnO and liquid of distilled water and water-soluble polymer). Thirty-five bovine teeth were prepared and filled with the cements (n=5). Triple antibiotic paste and unfilled samples were the positive and negative controls, respectively. The specimens were immersed in water and the color assessed with a spectrophotometer: before filling (B), 24 hours (24h), 28 days (28d) and 90 days after filling. The color change (ΔE) and the luminosity (*L) were calculated. The statistical analysis was performed using nonparametric Kruskal-Wallis and Dunn test (p &lt; 0.05). The analysis of delta E values showed that all the materials presented color alteration after the evaluated periods. High *L values were found for MTA HP and Experimental, with statistical difference in relation to MTA Flow at 90d (p &gt; 0.05). The addition of ZnO inhibited dental staining of MTA Flow after 90d of contact with dentine. The MTA Flow presented potential for dental discoloration, which is inhibited by the addition of zinc oxide. The experimental cement presented similar luminosity values than that presented by MTA and MTA HP.

Comparison of cytotoxic effects of calcium silicate-based materials on human pulp fibroblasts Mehmet.

Background. This study aimed to compare the in vitro cytotoxicity of Theracal LC, BiodentineTM, iRoot BP Plus, and MTA Angelus on human pulp fibroblasts (HPF). Methods. Fifteen discs from each calcium silicate-based material were prepared in sterile Teflon molds. After setting, the fabricated discs were eluated with a culture medium for 24 h. HPF cells were plated onto 24-well plates at 5×103 cells/well, and the cells were exposed to the material eluates. The cell viability was evaluated with MTT assay at three different times (24, 48, and 72 h). Data were statistically analyzed. The apoptotic/necrotic status of HPF cells exposed to material eluates was determined by flow cytometry. Results. The differences between the effects of Theracal LC, BiodentineTM, MTA Angelus, and iRoot BP Plus on HPF cells were found to be statistically significant (P<0.05). Theracal LC was found to be more cytotoxic considering other vital pulp capping materials at 24- (28.3%), 48- (44.9%), and 72-hour (49.2%) intervals. On the other hand, BiodentineTM showed the least cytotoxic effects (97.1%, 130.0%, and 103.7%, respectively) According to flow cytometry results, Theracal LC material increased apoptosis/necrosis ratios compared to the other materials. Conclusion. Based on the results of the present study, BiodentineTM, MTA Angelus, and iRoot BP Plus can be classified as biocompatible materials in vital endodontic treatments. However, the Theracal LC materials should be used carefully due to their cytotoxic effects.

Sealing Ability of MTA vs Portland Cement in the Repair of Furcal Perforations of Primary Molars: A Dye Extraction Leakage Model-An In Vitro Study.

ABSTRACTAimThe purpose of this present study is to compare the ability of MTA and Portland cement to seal furcal perforations in extracted primary molars using the dye extraction leakage model.Materials and methodsSixty primary molars were selected and randomly divided into four groups after access openings and furcal perforations were created in the pulp chamber floor. Group I (n = 20) in which perforations were repaired with MTA (ProRoot MTA, MTA-Angelus), group II (n = 20) in which perforations were repaired with the Portland cement, group III (n = 10) in which perforations were left unsealed (positive control), and group IV (n = 10) without perforations (negative control). All samples were subjected to 1% of basic fuchsin dye challenge followed by dye extraction with 65 wt% of nitric acid. Samples were analyzed using the automatic microplate spectrophotometer 545 nm and the readings were statistically analyzed.ResultsThere was no statistically significant difference in the microleakage between MTA and Portland cement repair groups.ConclusionPortland cement provides an effective seal for primary teeth furcal perforations and can be considered a more economic substitute for MTA as a repair material enhancing the prognosis of perforated primary teeth that would otherwise be extracted.How to cite this articleReddy NV, Srujana P, et al. Sealing Ability of MTA vs Portland Cement in the Repair of Furcal Perforations of Primary Molars: A Dye Extraction Leakage Model—An In Vitro Study. Int J Clin Pediatr Dent 2019;12(2):83–87.

Comparative Study of the Antibacterial effect of MTA, Nano-MTA, Portland cement, AND Nano-Portland cement

The root end filling materials antibacterial properties is a must nowadays as there is none of the available root canal filling materials can provide a hermetic seal.The aim of the current study isto compare the antibacterial effect of Gray Portland cement and white MTA angelus in the conventional and nano-particle forms. Agar diffusion test was used to examine the tested materials, where Enterococcus faecalis ATCC29212 (American Type Culture Collection 29212) cultured in agar BHI (brain heart infusion) in anaerobic condition at 37oCfor 72 hours.Then, the agar was added to 12 sterile petri plates and the prepared bacterial suspension was inoculated. Punch holes of 6 mm diameter were formed on each agar plate and each 3 plates were filled with the materials tested (Portland cement, Nano-Portland cement, MTA angelus, and Nano-MTA angelus). The results showed that conventional Portland cement has the highest antibacterial property, followed by Nano-Portland cement, MTA angelus, Nano-MTA angelus respectively with significant difference according to Kruskal Wallis ANOVA test followed by Mann-Whitney U test.

Assessment of tooth discoloration induced by biodentine and white mineral trioxide aggregate in the presence of blood

Introduction:In clinical dental application, using silicate-based cements is extremely popular. These materials come into direct contact with blood during or after placement and may cause tooth discoloration.Objectives:The purpose of this study was to compare the coronal tooth discoloration induced by white mineral trioxide aggregate (MTA) and biodentine in the presence of blood.Materials and Methods:Seventy specimens were chemomechanically prepared and divided into four experimental and two control groups. In the experimental groups, the pulp chambers were filled with white MTA angelus or biodentine. Blood or saline saturated cotton pellets were placed within the canals. Saline or blood alone was used in the control groups. Color was assessed with a spectrophotometer at baseline, 1 week, and 1 and 3 months, and color change values were calculated. Tukey's honestly significant difference and Sidak tests were used for statistical analysis.Results:The color change was significantly less with biodentine/saline than MTA/saline and MTA/blood (P < 0.05). Regardless of the material type and blood presence, discoloration increased after 3 months (P < 0.05).Conclusion:Discoloration induced by biodentine/saline may not be clinically noticeable and it was less than MTA-containing groups. Irrespective of blood presence or absence, MTA caused perceptible color change.

Effect of intracanal medications on the interfacial properties of reparative cements.

ObjectivesThe purpose of the present study was to evaluate the effect of calcium hydroxide with 2% chlorhexidine gel (HCX) or distilled water (HCA) compared to triple antibiotic paste (TAP) on push-out bond strength and the cement/dentin interface in canals sealed with White MTA Angelus (WMTA) or Biodentine (BD).Materials and MethodsA total of 70 extracted human lower premolars were endodontically prepared and randomly divided into 4 groups according to the intracanal medication, as follows: group 1, HCX; group 2, TAP; group 3, HCA; and group 4, control (without intracanal medication). After 7 days, the medications were removed and the cervical third of the specimens was sectioned into five 1-mm sections. The sections were then sealed with WMTA or BD as a reparative material. After 7 days in 100% humidity, a push-out bond strength test was performed. Elemental analysis was performed at the interface, using energy-dispersive spectroscopy. The data were statistically analyzed using analysis of variance and the Tukey test (p < 0.05).ResultsBD presented a higher bond strength than WMTA (p < 0.05). BD or WMTA in canals treated with calcium hydroxide intracanal medications had the highest bond strength values, with a statistically significant difference compared to TAP in the WMTA group (p < 0.05). There were small amounts of phosphorus in samples exposed to triple antibiotic paste, regardless of the coronal sealing.ConclusionsThe use of intracanal medications did not affect the bond strength of WMTA and BD, except when TAP was used with WMTA.

Antibacterial activity of newly synthesized endodontic nanomaterial based on calcium aluminate

Introduction Materials used for root canal obturation and root perforation are expected to have, in addition to preventing apical, lateral and coronary leakage, antimicrobial effects on microorganisms that are not accessible to chemomechanical instrumentation and intra-canal medications. The aim of this study was to evaluate the antimicrobial effect of a novel calcium aluminate-based endodontic nanostructured biomaterial (ALBO-MCCA) using agar diffusion test. Material and methods the two materials were tested in the study. The nanostructured calcium aluminate was synthesized by the hydrothermal sol-gel method from individual components of calcium aluminate (CaOxAl2 O3 ), calcite (CaCO3 ) and barium sulfate (BaSO4 ) as radiocontrast agent in the ratio of 2:2:1 according to V. Jokanovic's recipe. The other used material was calcium silicate MTA Angelus (Londrina, Brazil). The antimicrobial effect was assessed using agar diffusion test. Standard strains of Enterococcus faecalis, Escherichia coli, Staphylococcus aureus, cultured on blood Mueller-Hinton agar and Candida albicans cultivated on Sabouraud Dextrose Agar, were used as test microorganisms. Results the best antimicrobial effect after 24 h both materials showed against S. aureus. The mean values of the growth inhibition zone for ALBO MCCA were 5.7 ± 0.25 mm and MTA 6.2 ± 0.4 mm. The ALBO MCCA material showed slightly stronger antibacterial effect against E. coli compared to MTA (p < 0.05), whereas none of the materials showed antibacterial effect against E. faecalis. Conclusion the ALBO MCCA material showed certain antibacterial effect on Escherichia coli, Staphylococcus aureus and Candida albicans that was comparable to antibacterial effect of MTA.

Physical and Biological Properties of a High-Plasticity Tricalcium Silicate Cement.

Introduction Mineral Trioxide Aggregate (MTA) is a tricalcium-based silicate, dicalcium silicate matrix. Despite its good biologic properties, some clinicians still claim to have difficulties in handling MTA after its preparation due to its sandy consistency. The aim of the present study was to evaluate the physicochemical properties and cytotoxicity of MTA Repair HP (Angelus, Londrina, PR, Brazil) compared with MTA Angelus (Angelus, Londrina, PR, Brazil). Materials and Method The properties assessed were particle size, setting time, flow, film thickness, radiopacity, water solubility, compressive strength, and cytotoxicity. Statistical analysis was performed considering p < 0.05 as statistically significant. Results For radiopacity, water absorption and solubility MTA Repair HP were statistically similar to MTA Angelus. The MTA Angelus had statistically different film thickness values, higher than MTA Repair HP (p < 0.05). Besides, MTA Angelus showed a lower and statistically different compressive strength after 28 days than MTA Repair HP (p<0.05). Additionally, MTA Repair HP set more slowly (p < 0.05). Relative to cell viability, MTA Repair HP was statistically similar to MTA Angelus after 24 and 48 h in cell viability. Conclusions The MTA Repair HP presented similar cell viability, lower film thickness, higher flow, setting time, and compressive strength values after 28 days than MTA Angelus. In general, the MTA Repair HP presented physicochemical and biological properties similar to the MTA Angelus.

Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial

IntroductionMineral trioxide aggregate (MTA) has been used in pulp capping of cariously exposed mature permanent teeth with promising results. The search for alternative materials that seal better and set faster than MTA and do not stain is ongoing. Biodentine (Septodont, St Maur-des-Fossés, France) exhibits these advantages but has not been tested yet for a prolonged duration in mature teeth. This study aimed to evaluate the clinical performance of Biodentine and white MTA (Angelus, Londrina, Brazil) in cariously exposed mature permanent teeth. MethodsThis was a prospective longitudinal randomized controlled study of 68 vital permanent teeth with deep caries. Patients were randomly allocated into 2 study arms: Biodentine and MTA. Teeth were assessed clinically and radiographically before the procedure. Caries were excavated under local anesthesia; hemostasis was achieved after pulp exposure using sodium hypochlorite and capped with Biodentine or MTA. Clinical and radiographic follow-ups were performed by a blinded calibrated evaluator after 6 months and 1, 2, and 3 years. ResultsThere were no significant differences in the overall success rate between Biodentine and MTA; it was 93.3% (Biodentine = 93.1% and MTA = 93.5%) at 6 months. The overall success rate increased to 96.2% (Biodentine = 96.0% and MTA = 100%) at 1 year and to 100% at 2 years. At the 3-year follow-up, it decreased to 93.8% (Biodentine = 91.7% and MTA = 96.0%). ConclusionsBiodentine and MTA have favorable and comparable success rates when used as direct pulp capping or pulpotomy material in permanent mature teeth with carious exposure. The remaining tooth structure and durability of coronal restoration might affect significantly the long-term success of vital pulp therapy.

Ytterbium Oxide as Radiopacifier of Calcium Silicate-Based Cements. Physicochemical and Biological Properties.

This study evaluated physicochemical properties, cytotoxicity and bioactivity of MTA Angelus (MTA), calcium silicate-based cement (CSC) and CSC with 30% Ytterbium oxide (CSC/Yb2O3). Setting time was evaluated using Gilmore needles. Compressive strength was evaluated in a mechanical machine. Radiopacity was evaluated using radiographs of materials and an aluminum scale. Solubility was evaluated after immersion in water. Cell viability was evaluated by means of MTT assay and neutral red staining, and the mineralization activity by using alkaline phosphatase activity and Alizarin Red staining. The data were submitted to ANOVA, Tukey and Bonferroni tests (5% significance). The bioactive potential was evaluated by scanning electron microscopy. The materials presented similar setting time. MTA showed the lowest compressive strength. MTA and CSC/Yb2O3 presented similar radiopacity. CSC/Yb2O3 showed low solubility. Saos-2 cell viability tests showed no cytotoxic effect, except to 1:1 dilution in NR assay which had lower cell viability when compared to the control. ALP at 1 and 7 days was similar to the control. MTA and CSC had greater ALP activity at 3 days when compared to control. All the materials present higher mineralized nodules when compared with the control. SEM analysis showed structures suggesting the presence of calcium phosphate on the surface of materials demonstrating bioactivity. Ytterbium oxide proved to be a properly radiopacifying agent for calcium silicate-based cement since it did not affected the physicochemical and biological properties besides preserving the bioactive potential of this material.