Calcium Silicate-based Cements Research Articles

Morphological and Chemical Analysis of Different Types of Calcium Silicate-Based Cements.

Objectives Particle size and shape can influence the properties of materials. However, to improve the physicochemical and biological properties of mineral trioxide aggregate (MTA), silicate-based hydraulic cements were introduced. This study aimed to evaluate and compare the major constituents and crystalline structures along with the surface morphology of different types of calcium silicate-based cement (CSC). Materials and Methods Six different types of CSC (white Portland cement, white ProRoot MTA, white MTA Angelus, Biodentine, and Endosequence, both putty and paste) were used in this study. Five samples of each material were analyzed in both uncured and cured cement using scanning electron microscopy/energy-dispersive X-ray (SEM/EDX), X-ray diffraction (XRD), and Fourier transform-infrared spectroscopy (FTIR). Results SEM analysis showed that the surfaces of all materials consisted of particle sizes ranging from 0.194 μm to approximately 51.82 μm. The basic elements found in both uncured and cured cement of all tested materials using EDX were carbon, calcium, silicon, and oxygen. A difference was observed in the presence or absence of magnesium, aluminum, bismuth, zirconium, and tantalum. XRD showed that all tested materials were composed mainly of tricalcium silicate and dicalcium silicate, which are the main components of Portland cement. FTIR analysis showed aromatic rings, phosphine PH, alkyl halides, and alcohol O-H groups in all tested materials but at different wavenumbers. Conclusions The different types of CSCs tested in this study were primarily modified types of Portland cement with the addition of radiopacifiers. ProRoot MTA and MTA Angelus contained bismuth oxide, Biodentine contains zirconium oxide, whereas Endosequence root repair materials (both putty and paste) contained zirconium oxide and tantalum oxide. Endosequence root repair materials showed smaller particle sizes than the other groups. White PC had the most irregular and large particle sizes. CSC had a smaller particle size, except for MTA Angelus. Clinical Relevance. The composition of CSC has a direct influence on the properties of these cements, which may affect the clinical outcome of the treatment.

Bond Strength of Adhesive Systems to Calcium Silicate-Based Materials: A Systematic Review and Meta-Analysis of In Vitro Studies.

Since the adhesion of resin composites to calcium silicate-based cement is considered challenging. Therefore, the best adhesion strategy should be indicated. This review aimed to assess the effect of different adhesive systems on the bond strength of resin composite to calcium silicate-based cement through a systematic review and meta-analysis. The subsequent PICOS framework used was: population, calcium silicate-based cement; intervention, use of self-etch adhesive systems; control, use of total-etch adhesive systems; outcome, bond strength; study design, in vitro studies. The literature search was conducted independently by two reviewers up to 18 February 2021. Electronic databases (PubMed, ISI Web of Science, SciELO, Scopus, and Embase) were searched for applicable articles. In vitro manuscripts studying the effect of adhesive systems on the bond strength of calcium silicate-based cement were considered. The meta-analyses were performed using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Bond strength comparisons were made considering the type of calcium silicate-based cement (Mineral Trioxide Aggregate (MTA), Biodentine™, or TheraCal LC®). A p-value < 0.05 was considered statistically significant. A total of 7321 studies were retrieved in databases searched. After full-text evaluation, 37 eligible papers were assessed for qualitative analysis, leaving a total of 22 papers for the quantitative analysis. According to the meta-analysis, the bond strength values of resin composite materials to MTA and TheraCal LC® cement were favored when a total-etch adhesive system was used (p ≤ 0.02). On the other hand, the meta-analysis of the bond strength of resin-based materials to Biodentine™ calcium silicate-based cement was similar between both approaches (p = 0.12). The in vitro evidence suggests that the bond strength of resin-based materials to both MTA and TheraCal LC® cement was preferred by using the total-etch adhesive strategy. However, when bonding to Biodentine™, the use of self-etch or total-etch strategies displayed promising results. Given the lack of evidence related to the chemical interaction of self-etch adhesive materials with the bioceramics, if self-etch adhesives are used for bonding resin-based restorations to calcium silicate-based cement, a pretreatment with phosphoric acid could be recommended.

Antimicrobial Action, Genotoxicity, and Morphological Analysis of Three Calcium Silicate-Based Cements.

This study is aimed at evaluating five mineral oxides (5MO), mineral trioxide aggregate repair high plasticity (MTA HP), and mineral trioxide aggregate (MTA) in relation to the antimicrobial action over Porphyromonas gingivalis, Porphyromonas endodontalis, Parvimonas micra, Fusobacterium nucleatum, and Prevotella intermedia; the genotoxicity over mouse macrophage (RAW 264.7) and osteoblast (Mg-63) cultures; and the morphological analysis using scanning electron microscopy (SEM) analysis (50 k and ×100 k). Sodium hypochlorite (NaOCl), calcium hydroxide, and saline solution were used as control groups in the different analysis. All data were submitted to a normality test and then analyzed with one-way ANOVA, Tukey, and Kruskal-Wallis and Dunn tests, considering α ≤ 0.05 significance level. It was found that over P. gingivalis and P. endodontalis, there was no a significant difference between the calcium silicate-based cements (CSC) and the control group of saline solution, and only 5MO was similar to the NaOCl group. However, over P. micra, all groups were effective and showed a statistically significant difference compared to the saline solution group. Conversely, none of the groups were effective over F. nucleatum and P. intermedia, except of the NaOCl group. There was a significant difference between 5MO and MTA groups in comparison with NaOCl and MTA HP over osteoblasts and macrophages after 24 hours. SEM images showed small irregular particles interspersed with some elongated needle-like particles and small irregular particles with some larger particles as well as elongated particles. It was concluded that 5MO, MTA, and MTA HP have effective antimicrobial action over P. micra. However, only 5MO is effective over P. gingivalis and P. endodontalis. Besides, 5MO and MTA are not genotoxic over mouse macrophage (RAW 264.7) and osteoblast (Mg-63) cultures.

Physicochemical and biological properties of four calcium silicate-based endodontic cements

Background/purposeSeveral brands of calcium silicate-based cements (CSBCs) are currently marketed. Here we compared physicochemical and biological properties of new products Ortho MTA (BioMTA), Retro MTA (BioMTA), and EZ-Seal (Ezekiel) to widely used ProRoot MTA (Dentsply Tulsa). Materials and methodsCSBCs were analyzed by X-ray diffractometry and examined by scanning electron microscopy. Elemental composition was determined by energy dispersive spectroscopy. Particle size was measured by particle size analyzer. Human stem cells from apical papilla (SCAPs) were incubated with eluates from CSBCs. Survival of SCAP cells was evaluated with MTT assay. The Alizarin red S stain was used to identify calcified nodules formed in SCAP cultures. The effects of CSBC eluates on SCAP proliferation and migration were examined using an in-vitro scratch “wound-healing” assay. ResultsAll CSBC specimens showed similar X-ray diffraction patterns. The average particle size of EZ-Seal was smaller than ProRoot MTA, Ortho MTA, and Retro MTA (P < 0.001). The least cytotoxicity of eluates was found for EZ-Seal. In the Alizarin red S staining test, calcified nodules were observed in cultures with ProRoot MTA, Ortho MTA, and Retro MTA, however, no calcified nodules were observed in cultures with EZ-Seal. SCAP proliferation and migration capacity in presence of EZ-Seal was higher than with ProRoot MTA, Ortho MTA, and Retro MTA (P < 0.001). ConclusionEZ-Seal has a smaller average particle size and a better cytocompatibility than all other examined CSBCs.

Effect of Trichloroacetic Acid on the Bond Strength of Calcium Silicate-Based Cements: A Modified Push-Out Test

Effect of Trichloroacetic Acid on the Bond Strength of Calcium Silicate-Based Cements: A Modified Push-Out Test

Vital Pulp Therapy in Permanent Teeth

This review article aimed to evaluate the outcome of vital pulp therapy procedures including indirect pulp capping (IDPC), direct pulp capping (DPC), miniature pulpotomy (MP), partial pulpotomy (PP) and full pulpotomy (FP) in permanent teeth even with signs of reversible and irreversible pulpitis. Instead of complete pulp tissue removal by pulpectomy, vital pulp therapy has been considered as an alternative approach. Articles published after 2000 were searched in PubMed and GoogleScholar online databases according to PRISMA guidelines. Forty articles were selected according to the inclusion and exclusion criteria. Eighty-five cases from case series and case report studies and also results of 20 clinical articles were included in this study. The success rate of partial and full pulpotomy in permanent teeth with signs of reversible and irreversible pulpitis was 98.8%. The success rate for both partial and full pulpotomies with mineral trioxide aggregate and calcium silicate-based cements in the current review of clinical studies was 84.6%-100% and 78.9%-100%. Partial and full pulpotomies demonstrated favourable outcomes and a high success rate in treating permanent teeth. So the vital pulp therapy procedures in permanent teeth with signs of pulpitis can be more successful, cost-effective and time-saving compared to traditional root canal treatment. However further well-designed studies with longer follow-up periods are required to validate these findings.

Push-out bond strength of the calcium silicate-based endodontic cements in the presence of blood: A systematic review and meta-analysis of in vitro studies.

ObjectivesThe push‐out bond strength (POBS) of calcium silicate‐based cements (CSCs) to the dentinal wall is considered one of the essential physical properties for clinical success. The presence of blood in the treatment area affects the POBS of these types of cement. This study aimed to evaluate the impact of blood contamination on the bond strength of CSCs and dentinal walls.Material and MethodsThis systematic review was performed by searching electronic databases (MEDLINE‐PubMed, Scopus, and EMBASE) to include relevant in vitro studies published between 1992 and April 2020. Two reviewers independently evaluated the selected studies and extracted data on the type of studied CSCs, evaluated area of the teeth, sample size, the dimension of a prepared area, slice thickness, storage duration, the setting of the universal testing machine (UTM), effects of blood contamination on POBS of CSCs and their failure modes. The bond strength of evaluated CSCs in studies was used for network meta‐analysis.ResultsInitial searches identified 292 articles, while only 13 articles met the inclusion criteria. Full texts of these articles were evaluated, and data extraction was performed. The effect of blood contamination on bond strength to the dentinal wall was assessed in various CSCs such as PMTA, Biodentine, and AMTA. The network meta‐analysis results showed that the bond strength of Biodentine was significantly higher than other types of cement in blood presence (p < .05).ConclusionsBased on the current systematic review, despite controversies among the result of the different articles and the lack of data for some CSCs like bioaggregate, it could be concluded that the bond strength of Biodentine to the dentinal wall is better than other evaluated CSCs in the presence of blood.

Effectiveness of Three Agents in Pulpotomy Treatment of Permanent Molars with Incomplete Root Development: A Randomized Controlled Trial.

The aim of this study was to investigate and compare, radiographically and clinically, the impacts of calcium-silicate based-cement (CSBC), nano-hydroxyapatite and platelet-rich fibrin (PRF) as pulpotomy agents in permanent immature molars with incomplete root development. Sixty-three participants (63 permanent immature molars) were included in this study. The patients were randomly divided into three equal groups. Fast setting MTA (MM-MTA), nano-hydroxyapatite and platelet-rich fibrin were used as pulpotomy agents. The teeth were evaluated clinically and radiographically after 6 and 12 months by two blinded examiners. Apical closure and pulp canal obliteration percentages were recorded. The in vitro reaction of the tested materials after a 7-day immersion period of the different materials in phosphate-buffered solution was analyzed using scanning electron microscopy to associate the in vitro mineralization with in vivo pulp canal obliteration percentages. Data were analyzed using Chi-square and ANOVA tests (α = 0.05). No significant difference was found between the three tested groups in terms of clinical and radiographic success (p > 0.05). All cases demonstrated evidence of root growth, including complete apical closure or continued apical closure. At 12 months, complete apical closure was found among the MM-MTA group (50%), nano-hydroxyapatite group (55%) and platelet-rich fibrin group (60%) (p > 0.05). After 12 months, pulp canal obliteration was more observed in the MM-MTA and nano-hydroxyapatite groups than in the PRF group (p < 0.05). MM-MTA (auto-mixed), NHA (hand-mixed) and PRF (autologous) could be used as pulpotomy agents since they exhibit comparable high clinical and radiographic success rates. However, the fact that the groups managed with MM-MTA and NHA have a higher tendency to canal obliteration might indicate that PRF should be considered the first choice material as pulpotomy agent, as it would make retreatment considerably easier.

ROOT CANAL FILLING WITH NEOMTA PLUS IN SECOND PRIMARY MOLAR TEETH WITH MISSING SUCCESSOR: TWENTY-FOUR MONTHS OF FOLLOW-UP

Hypodontia of the mandibular second premolar teeth is one of the most frequent anomalies of tooth development, which reveals a unique hardship for clinicians. Retaining the primary second molars helps to maintain arch integrity until facial growth is complete. This case series investigates the potential improvement and longevity of retained primary mandibular second molars obturation of the root canal system using a mineral trioxide aggregate when successors are missing. Neo MTA Plus (Avalon Biomed Inc, Bradenton, FL) recently introduced calcium silicate-based cement that may have some potential as a root canal obturating material. Nevertheless, no study using Neo MTA Plus as a root canal filling material was found in the literature. Five female patients with a decayed, necrotic second primary molar tooth without a successor were selected and performed a root canal treatment with Neo MTA Plus. Patients were scheduled for clinical and radiographic evaluation at 6, 12, 18, and 24 months. They were followed up for twenty-four months. According to the present study, it can be concluded that NeoMTA Plus maybe a proper material for use in the root canal treatment of primary molars with a missing successor.

Outcomes of endodontic microsurgery with retrofilling of calcium silicate cements with or without calcium chloride accelerator: A randomized controlled clinical trial

Introduction: Calcium silicate-based cement (CSC) with calcium chloride (CaCl2) accelerator sets faster than the cement without accelerator. For endodontic microsurgery, CSC with the accelerator tends to be less soluble in tissue fluid that may improve clinical outcome. This study aimed to evaluate the outcome of endodontic microsurgery by retrofilling with CSC containing accelerator (Bio-MA) compared to the original CSC (ProRoot® mineral trioxide aggregate [MTA]).Materials and Methods: Forty-eight teeth required surgical root canal retreatment was included according to the eligible criteria. Endodontic microsurgery with standardized protocol was performed under the dental operating microscope. Bio-MA or ProRoot® MTA was randomly selected for retrofilling. At recall visit, treatment outcomes were evaluated as “healed,” “healing” or “diseased,” based on clinical and radiographic assessments. The Chi-square test and Fisher's exact test were used in the statistical analysis of the outcome.Results: Seven teeth were excluded because of vertical root fracture detected in surgery (n = 5) and inadequate retrofilling depth (n = 2). Two cases were lost to follow-up. For thirty-nine teeth with 14.9 ± 5.2 months recall, “healed” rates were 85% in Bio-MA and 84.2% in ProRoot® MTA, and “healing” rates was 15% in Bio-MA and 15.8% in ProRoot® MTA. None of “disease” was observed. No significant difference in the clinical outcome was observed between groups of Bio-MA and ProRoot® MTA (P = 1.00).Conclusions: The endodontic microsurgery outcome of Bio-MA containing CaCl2 accelerator was similar to that of ProRoot® MTA without accelerator.

Antibacterial ability and osteogenic activity of polyphenol-tailored calcium silicate bone cement.

Calcium silicate-based cement (CSC) has attracted much interest because of its favourable osteogenic effect that supports its clinical use. Although CSC has antibacterial activity, this activity still needs to be improved when used in an infected bone defect. Natural polyphenols have been considered antimicrobial reagents. To this end, three different types of polyphenols (gallic acid (GA), pyrogallol (PG) and tannic acid (TA)) with different concentrations as a liquid phase were mixed with bioactive calcium silicate to enhance the antibacterial activity of CSC. The setting time, antibacterial activity, and osteogenic activity of CSC were studied. Evaluation of antibacterial ability and reactive oxygen species (ROS) was performed using Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus) bacteria, while a human osteoblast-like cell line (MG63) was used to examine osteogenic activity. The experimental results showed that the addition of polyphenols did not remarkably affect the phase composition and morphology of CSC, but changed the setting time and diametral tensile strength. At the same concentration of 1 wt%, the setting time of TA (21 min) was significantly shorter than that of PG (26 min) and GA (68 min), and was indistinguishable from the control cement (20 min). GA had a significantly higher antioxidant activity than PG and TA. As expected, higher concentrations of polyphenols had a more positive impact on ROS generation. More importantly, the incorporation of polyphenols greatly enhanced the antibacterial activity of CSC against E. coli and S. aureus, but had little effect on the in vitro osteogenic activity of MG63 cells and the cytotoxicity of L929 cells. It was concluded that among the three phenolic compounds, the optimal concentration of the liquid phase in the hybrid cement was 5 wt% TA in terms of setting time, strength, antibacterial activity and in vitro osteogenic activity.

Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements.

ObjectivesThis study aimed to investigate the color stability, solubility, and surface characteristics of 3 calcium silicate-based cements (CSCs) after immersion in different solutions.Materials and MethodsProRoot white mineral trioxide aggregate (MTA), Biodentine, and Endosequence Root Repair Material (ERRM) were placed in cylindrical molds and stored at 37°C for 24 hours. Each specimen was immersed in distilled water, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine, or 0.1% octenidine hydrochloride (OCT) for 24 hours. Color changes were measured with a spectrophotometer. Solubility was determined using an analytical balance with 10−5 g accuracy. The surface characteristics were analyzed using scanning electron microscopy and energy-dispersive spectroscopy. Data were analyzed using 2-way analysis of variance, the Tukey test, and the paired t-test.ResultsMTA exhibited significant discoloration in contact with NaOCl (p < 0.05). White precipitation occurred on the surfaces of Biodentine and ERRM after contact with the solutions, and none of the materials presented dark brown discoloration. All materials showed significant solubility after immersion in the solutions (p < 0.05), irrespective of the solution type (p > 0.05). The surface topography and elemental composition of the samples showed different patterns of crystal formation and precipitation depending on the solution type.ConclusionsAll materials presented some amount of solubility and showed crystal precipitation after contact with the solutions. Biodentine and ERRM are suitable alternatives to ProRoot MTA as they do not exhibit discoloration. The use of OCT can be considered safe for CSCs.

Comparative evaluation of shear bond strength of a bioactive material to composite resin using three different universal bonding agents: An in vitro study.

Background:Calcium silicate-based cements or bioceramics have revolutionized and simplified pulp-capping procedures due to its versatility and accessibility.Aim:This study aimed to assess the shear bond strength (SBS) of a bioceramic material to composite resin at two aging periods and with three universal adhesives.Materials and Methods:Forty-eight samples of Biodentine with a height of 2 mm and internal diameter of 4 mm were prepared. After 12 min of mixing, 24 samples were randomly selected and divided into four subgroups: Group I: Single Bond Universal, Group II: Palfique Universal Bond, Group III: G-Premio BOND, and Group IV: Control. Composite resin was restored over Biodentine after the application of universal adhesives using a cylindrical plastic mold of 2 mm height and 2 mm internal diameter. This process was repeated 24 h after mixing on the remaining 24 samples of Biodentine. The universal testing machine was used to measure the SBS of the fractured specimens, followed by stereomicroscopic evaluation. One-way ANOVA test and Bonferroni post hoc test were used to statistically analyze the data.Results:Highest SBS values were observed in Group III at 12 min and 24 h of the setting of Biodentine.Conclusions:Compared to the 12-min group, SBS was higher at 24 h. Group III exhibited higher bond strength than other subgroups.

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

Single-burn clinkering of endodontic calcium silicate-based cements: Effects of ZnO in the C3S phase formation and hydration rate

Calcium silicate-based cements were synthesized with 1–4 wt% ZnO at 1300 and 1500 °C. Powder and in-situ XRD tests were conducted in anhydrous and hydrating samples. Results showed that ZnO addition significantly increased the alite (C3S) content into cements, thus allowing the single-burn clinkering of cement with over 80 wt% C3S. ZnO incorporation progressively reduced the relative content of triclinic C3S while increasing the monoclinic C3S content. No significant hydration delays were observed when ZnO was added up to 1 and 3 wt% for the cement synthesized at 1300 and 1500 °C, respectively. ZnO proved to be an efficient mineralizer even in a single-burn step and does not seem to retard the C3S hydration when incorporated into its structure.

Characterisation of the calcium silicate-based cement-composite interface and the bonding strength with total-etch or single/two-stage self-etch adhesive systems.

Due to favourable biological and physical properties, calcium silicate-based cements (CSCs) are biocompatible materials used widely for vital pulp therapies. Sealing efficacy between the adhesive system and CSC determines the clinical success of treatment. This study aimed to evaluate the shear bond strength (SBS) of CSC to composite resin with different adhesive systems and to analyse the CSC-composite interface. Mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (Septodont, Saint-Maur-des-Fossés, France) and NeoMTA Plus (Avalon Biomed Inc., Bradenton, FL) samples (n = 90) were placed in the cavities and divided into three subgroups according to the adhesive family (n = 10). SBSs were measured using a universal testing machine. The interfaces were examined using a scanning electron microscope (SEM) (×1000). NeoMTA Plus showed significantly higher SBS values than MTA and Biodentine (P < 0.0001). The application of total-etch adhesive system over Biodentine and NeoMTA Plus provided the statistically highest bond strength (P < 0.05). However, when the SBS values of MTA subgroups were compared, different adhesive families applied over MTA did not make a significant difference in SBS values (P > 0.05). Based on SEM analyses, the specimens exhibit no gaps, cracks or delamination within the adhesive layer, which indicates a good adhesion between the CSC-composite interface in all subgroups. In conclusion, the different adhesive families used over CSC did not influence interfacial gap formation.

Biocompatibility and Osteogenic Potential of Calcium Silicate-Based Cement Combined with Enamel Matrix Derivative: Effects on Human Bone Marrow-Derived Stem Cells.

The characteristics of retrograde filling material are important factors that can affect the long-term success of apical microsurgery. Various calcium silicate-based cements (CSC) were introduced to overcome drawbacks of mineral trioxide aggregate (MTA), while Emdogain is known to be effective in the regeneration of periodontal tissues. The aim of this study is to evaluate the biocompatibility and osteogenic potential of various CSCs combined with Emdogain on human bone marrow-derived mesenchymal stem cells. Experimental groups were classified into eight groups depending on the material and the presence of Emdogain. In the cell-counting kit test, all experimental groups combined with Emdogain showed higher cell viability compared with those without Emdogain at days 1 and 2. In the wound-healing assay, cell migration increased significantly over time, with or without Emdogain. In the alkaline phosphatase assay, all groups treated with Emdogain showed higher activity compared with those without Emdogain at day 3 (p < 0.05). Using alizarin red S staining, all groups treated with Emdogain showed greater calcium nodule formation compared with those without Emdogain at days 7 and 14 (p < 0.05). In conclusion, using CSCs as retrograde filling materials and the application of additional Emdogain will increase bone regeneration and improve the prognosis of apical microsurgery.

Evaluation of pH, Calcium Ion Release, and Dimensional Stability of an Experimental Silver Nanoparticle-Incorporated Calcium Silicate-Based Cement.

An experimental calcium silicate-based root-end filling material incorporated with silver nanoparticles intended for use in periapical surgeries was developed with the purpose to overcome the drawbacks of existing materials and to satisfy the ideal requirements of root-end filling materials. This study was designed to evaluate the physicochemical properties, pH, calcium ion release, and dimensional stability of the experimental cement, and compare the results with commercially available ProRoot MTA (Dentsply). An independent sample test was used to analyze the data. Mean initial pH (immediately after mixing) of the experimental cement was 10.42 ± 0.04 which was higher than that of MTA. However, there was a significant increase in pH of MTA at 1 day, 2 days, and 7 days. Presence of calcium chloride favored the release of calcium ions which was significantly increased in the experimental group at 24 hours. At the end of 30 days, MTA showed a significant expansion when compared to the experimental cement (p < 0.001). In conclusion, the experimental nanoparticle-incorporated calcium silicate-based cement showed clinically acceptable physicochemical properties.

Comparative evaluation of the effect of cold ceramic and MTA-Angelus on cell viability, attachment and differentiation of dental pulp stem cells and periodontal ligament fibroblasts: an in vitro study

BackgroundBiocompatibility and induction of mineralized tissue formation are the properties expected from a material used in vital pulp therapy and repair of perforations. Cold ceramic (SJM, Iran; CC) is a newly introduced calcium silicate-based cement for above mentioned therapeutic applications. This in-vitro study aimed to compare the effect of CC and White MTA-Angelus (MTA) on cell viability, attachment, odontogenic differentiation, and calcification potential of human dental pulp stem cells (DPSCs) and periodontal ligament fibroblasts (PDLFs).MethodsCell viability of DPSCs and PDLFs was assessed using MTT on days 1, 3, 7, and 14 (n = 9) in contact with freshly mixed and set states of CC and MTA. Field emission scanning electron micrographs (FESEM) were taken to evaluate cell-bioceramic interaction (n = 6). Gene expression levels of osteo/odontogenic markers (Dentin sialophosphoprotein, Dentin matrix protein 1, Collagen type I alpha 1, and Alkaline phosphatase (DSPP, DMP1, COL 1A1, and ALP, respectively) (n = 8) were assessed using qrt-PCR. ALP enzymatic activity was evaluated to assess the mineralization potential. A two-way ANOVA test was applied, and p < 0.05 was considered to be statistically significant.ResultsThe effect of freshly mixed and set MTA and CC on the survival of DPSCs and PDLFs in all study groups was statistically similar and comparable to the positive control group (p > 0.05); the only exception was for the viability of PDLFs in contact with freshly mixed cements on day 1, showing a more significant cytotoxic effect compared to the control and the set state of materials (p < 0.05). PDLFs attached well on CC and MTA. The spread and pseudopodium formation of the cells increased on both samples from day 1 to day 14. Contact of MTA and CC with DPSCs similarly increased expression of all dentinogenesis markers studied on days 7 and 14 compared to the control group (p < 0.001), except for DSPP expression on day 7 (p = 0.46 and p = 0.99 for MTA and CC, respectively).ConclusionsWithin the limitation of this in-vitro study, cold ceramic and MTA-Angelus showed high biocompatibility and induced increased expression of osteo/dentinogenic markers. Therefore, cold ceramic can be a suitable material for vital pulp therapy and the repair of root perforations.

Effect of exposure to etidronic acid on the bond strength of calcium silicate-based cements after 1 and 21\xa0days: an in vitro study

BackgroundAfter reparation of root perforations with calcium silicate-based cements (CSBC), the surface of the material is expected to be exposed to root canal irrigants (RCI) while resuming the root canal treatment.MethodsThe aim of this study was to compare the effect of exposure to a mixture of sodium hypochlorite (NaOCl) and etidronic acid (HEBP) or other irrigants on the Push Out Bond Strength (POBS) of CSBC after two different setting times. 240 root slices 1 mm thick were obtained from single-rooted human teeth. A 1.4 mm diameter perforation was performed on each slice and filled with Biodentine (BD) or ProRoot MTA (PMTA). After 1 or 21 days they were exposed to 17% ethylenediaminetetraacetic acid, 5.25% NaOCl, a mixture of 5.25% NaOCl and 9% HEBP (NaOCl + HEBP) or saline (n = 15) and submitted to a push-out test. POBS results were analysed with ANOVA and Tukey tests.ResultsBD showed higher POBS than PMTA after 1 day (p < .05). After 21 days no differences were found between materials. After 1 day exposure to NaOCl + HEBP resulted in higher POBS, compared to the other irrigants (p < .05).ConclusionPOBS results are influenced by the cement, the setting time and the exposure to irrigants.