Mineral Trioxide Aggregate Research Articles

Impact of Acidic and Alkaline Environments on the Surface Morphology of Biodentine and White Mineral Trioxide Aggregate - An In-vitro Study.

The physical and chemical properties of calcium silicate cement might be affected due to exposure to acidic or alkaline conditions during clinical use. The present study aimed to evaluate the effect of acidic and alkaline environments on the surface morphology of biodentine (BD) and white mineral trioxide aggregate (wMTA). Disc-shaped specimens of BD (n = 30) and wMTA (n = 30) were prepared in a metal mould and wrapped in pieces of gauze. They were divided into three sub-groups according to the storage media: group A, soaked in sterile distilled water at a pH of 7.0; group B, exposed to butyric acid buffered at pH 4.0; and group C, exposed to calcium hydroxide solution buffered at pH 12.0. The specimens were incubated for 7 days at 37°C, followed by examination under scanning electron microscopy at 1000x and 5000x magnification to characterise the microstructural morphology. Definite changes were seen in the microstructure of BD and wMTA on exposure to acidic and alkaline pH. The microstructure of wMTA tends to exhibit reduced cohesion when exposed to an acidic environment, especially when compared to an alkaline pH. Acidic pH exerts a milder influence on the morphological structure of BD when contrasted with its effects on wMTA. Biodentine may emerge as a more prudent choice than wMTA for utilisation in inflamed periapical regions.

The Effect of Human Blood and Platelet-rich Fibrin on the Surface Microhardness of Hydraulic Calcium Silicate-based Cements

Objectives: This study aimed to compare the effect of human blood and platelet-rich fibrin (PRF) on the surface microhardness of hydraulic calcium silicate-based cements (OrthoMTA and RetroMTA). Materials and Methods: Two types of mineral trioxide aggregate, OrthoMTA and RetroMTA, were mixed and placed into cylindrical molds. The lower surfaces of all cements were exposed to saline. The upper surfaces of cements were exposed to human blood, PRF, or phosphate buffer saline (PBS). After storage for 7 days in fully saturated humidity at 37°C, the microhardness of cement surface exposed to blood, PRF, or PBS was measured using the Vickers microhardness test. The data were analyzed using two-way analysis of variance and post hoc Tamhane’s T2 test. The significance level was set at P<0.05. Results: Exposure to blood and PRF significantly decreased the surface microhardness of OrthoMTA and RetroMTA. The microhardness of PBS-contacted cements was significantly higher than that of blood or PRF groups (P<0.001). The microhardness values for OrthoMTA exposed to PRF were significantly higher than the blood group (P=0.020). There were no significant differences between RetroMTA contacted with blood or PRF groups (P=0.985). When exposed to blood or PBS, RetroMTA had a significantly higher microhardness than OrthoMTA (P<0.001 for blood, P=0.002 for PBS). Conclusion: Exposure to blood or PRF decreased the surface microhardness of both cements. Blood-contaminated RetroMTA showed significantly higher surface microhardness than OrthoMTA contacted with blood. No significant difference was found between PRF-contacted OrthoMTA and RetroMTA.

Investigation on structurally reinforced synthetic bone grafts via tricalcium silicate

AbstractTricalcium silicate (C3S) is one of the main components of mineral trioxide aggregates, which is used in dental endodontic treatment. C3S provides workable viscosity itself and fast hydration when water is added, and it is known to be nontoxic, noncarcinogenic, nongenotoxic, biocompatible, and insoluble in tissue fluids. In this study, C3S is added to synthetic bone‐graft materials from 30% to 60% to deliver viscosity to increase workability in the early stage of implant surgical procedure and to attain some degree of compressive strength after the hydration. Additionally, the porosity is not overly reduced to maintain the ability for bone regeneration. The porosity of the samples was confirmed to be 40%–50% with the formation of the C3S matrices. Simultaneously, the maximum compressive strength was ensured at 14.9 MPa within 24 h of curing time. The radiopacity required for post‐procedural diagnosis was evaluated. The radiopacity of the samples with 50% and 60% C3S was 1.0 mm Al and 1.1 mm Al, respectively. When ZrO2 was added, the radiopacity was enhanced to 1.6 mm Al. Overall, the experimental results showed that the bone‐graft added C3S would be suitable for alveolar bone support and rigid matrix formation in implant surgery.

Total Pulpotomy with MTA in Young Permanent Teeth: Case Series

Vital pulp therapy is a way to preserve the vitality and function of pulp damaged by trauma, caries or restorative procedures. Vital pulp therapy procedures include direct pulp capping, indirect pulp capping, partial and coronal pulpotomy treatments where diseased pulp tissue is removed. Over the years, the focus of vital pulp therapy has been on the preservation of the radicular pulp in immature permanent teeth to ensure the completion of root formation (apexogenesis). Today, it has been reported that vital pulp therapy can be considered as an alternative to root canal treatment, including in teeth with certain conditions that are considered to have irreversibly inflamed pulp. Coronal amputation therapy, a vital pulp treatment, involves complete removal of the coronal pulp, placement of a biologically acceptable material into the pulp chamber and restoration. The covering material must be able to relieve inflammation and initiate healing of the pulp tissue and allow new dentin tissue to form. The oldest material used in pulpotomy is calcium hydroxide. Mineral trioxide aggregate, which is a more recent material, is frequently preferred today due to its biocompatible and bioactive properties. In this case report, the results of 4 cases of coronal pulpotomy with mineral trioxide aggregate in young permanent teeth with a follow-up of 18 months are presented.

Effects of using different dentin conditioners on dentin regeneration.

This experiment aimed to evaluate the impact of several dentine etching and conditioning agents on growth factors (GFs) liberation from dentine slices. Eighteen dentine slices were obtained from nine premolars divided in to six groups, the slices immersed in one mL test solutions for 5 min; Group 1: white Mineral trioxide aggregate (MTA), Group 2: Phosphate buffered saline (PBS), Group 3: 37% phosphoric acid, Group 4: 17% Ethylenediaminetetraacetic Acid (EDTA), Group 5: 10% Maleic acid (MAc), and Group 6: 0.7% Fumaric acid. The solutions were removed and stored directly at for further detection and quantification of transforming GF beta 1 (TGF-b1), bone morphogenetic protein 2 (BMP2) and vascular endothelial growth factor (VEGF) by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA was used to compare the mean release and standard deviation between groups (α = 0.05). Tukey's post hoc applied for multiple comparisons. After five min conditioning of dentine slices, white MTA released the highest level of TGF-b1, BMP2 and VEGF among all groups, followed by 0.7% Fumaric acid with no significant difference between them, but compared to 37% phosphoric acid and PBS groups significant difference observed, which they released the least amount of GFs amongst all groups. Based on the results of this research the detectable release of TGF-b1, BMP2 and VEGF by 0.7% fumaric acid was comparable with white MTA from dentin slices.

How Irrigants Affect Mineral Trioxide Aggregate (MTA) Sealing in Furcal Perforations: An In Vitro Study

How Irrigants Affect Mineral Trioxide Aggregate (MTA) Sealing in Furcal Perforations: An In Vitro Study

Comparative evaluation of various biomaterials as pulpotomy agents in molars with symptomatic irreversible pulpitis: A randomized single-blinded single-center control trial

Abstract Introduction: Untreated tooth decay in mature permanent dentition is a prevalent global issue, affecting 34.1% of people with 2.5 billion cases annually. Extensive decay often leads to irreversible pulpitis, characterized by pulp inflammation and pain. Pulpectomy, the standard treatment, involves complex procedures with potential complications. Modern endodontics favors minimally invasive treatment such as pulpotomy, which preserves pulp vitality. This study aims to compare the clinical as well as radiographic outcomes of different pulpotomy agents: Biodentine, mineral trioxide aggregate (MTA), Bio-C repair, and Endosequence Bio-ceramic root repair material (BCRRM) in mature permanent molars. Methodology: This single-blind, single-center study involved 80 participants randomly assigned to four groups, each receiving one of the biomaterials. Ethical approval was obtained. Participants aged 14–60 years with symptomatic irreversible pulpitis were selected. Pulpotomy procedures were performed, and follow-up evaluations occurred at 24 h, 1 week, 4 weeks, 3, 6, and 12 months. Clinical success was measured by the absence of pain, sensitivity, and tenderness. Radiographic evaluation used the periapical index (PAI) scoring system. Results: Pulpotomy significantly reduced postoperative pain in all groups. Endosequence BCRRM showed the maximum pain reduction at 24 h with a statistically significant difference from all the groups (at 1% probability level), followed by Bio-C repair, Biodentine, and MTA. At 1 week, Bio-C repair led in pain reduction with statistically nonsignificant results. All groups reported no pain at 3, 6, and 12 months. Endosequence BCRRM had the highest improvement in periapical findings at 1 year. Sensitivity to hot and cold improved significantly in all groups, with Endosequence BCRRM performing best. Conclusion: Endosequence BCRRM provided the best overall outcomes, emphasizing the importance of material choice in pulpotomy treatments. Further research on biomaterials’ long-term clinical and radiographic outcomes is needed to enhance treatment efficacy.

The Management of Root Perforation: A Review of the Literature.

Root canal perforation is defined as an opening or communication of the root to the outer oral tissue that occurs either accidentally during root canal therapy or due to unknown pathological causes, which generally result in complications in patientsdue to the passage of microorganisms to the surrounding tissues. These complications may necessitate extraction of the affected tooth. In this literature review, 42 articles were reviewed initially; 33 of them were included in the final analysis based on exclusion and inclusion criteria. Root perforation may occur due to caries, external and internal resorption, trauma, as well as iatrogenic causes. Many studies have suggested that perforation can be identified by radiographs, unexpected bleeding and pain during instrumentation, blood on paper points, electronic apex locator, and dental operating microscope. Several materials have been used in endodontic perforation repairs, such as indium foil, super 2-ethoxybenzoic acid (super EBA), as well as bioceramic materials like mineral trioxide aggregate (MTA) and biodentine. These materials must achieve biocompatibility, bacteriostatic ability, and radio-opacity. Many studies have reported the superior properties of MTA in comparison with other materials. Based on our literature review, management of root perforation should be performed based on multiple significant factors. Clinicians must possess a comprehensive understanding of tooth anatomy to prevent perforation occurrence. Furthermore, clinical management and prognosis of root perforation have been enhanced by the availability of advanced materials and sealing techniques.

Clinical and Cost-effectiveness of Allium sativum oil versus Mineral Trioxide Aggregate in primary molars pulpotomy in a group of Egyptian children: A Randomised Clinical Pilot Study.

Clinical and Cost-effectiveness of Allium sativum oil versus Mineral Trioxide Aggregate in primary molars pulpotomy in a group of Egyptian children: A Randomised Clinical Pilot Study.

Effect of lateral extent of pulp tissue removal on the outcome of partial pulpotomy for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis: A randomized clinical trial.

The aim of this study is to compare the outcomes of restricted partial pulpotomy (R-PP) versus extended partial pulpotomy (E-PP) for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis (SIP). This double-arm, parallel designed randomized clinical trial was registered at clinicaltrials.gov (registration number: NCT05406557). Following random allocation, 43 participants of each group received the designated intervention. In the R-PP group, 2-3 mm of superficial pulp tissue was removed only from the exposure site, while chamber was completely de-roofed and 2-3 mm of superficial pulp tissue from entire chamber was removed in the E-PP group. Haemostasis was achieved using 3% sodium hypochlorite-soaked cotton pellets. Upon haemostasis, ProRoot mineral trioxide aggregate (ProRoot MTA) was placed over the pulpal wound, overlaid with a resin-modified glass ionomer liner, and restored with composite resin in the same visit. Outcome measures included clinical and radiographic success evaluation at 6 and 12 months, and pain assessment using the visual analogue scale pre-operatively and daily for 7 post-operative days. Nonparametric tests were used for variables including patient's age, pain intensities, mean analgesic consumption, and haemostasis time. Categorical variables including gender, caries type, analgesic intake, hard tissue barrier formation, clinical and radiographic success, and pulp sensibility responses were assessed using Chi-square or Fisher's exact test. Tooth survival was analysed using Kaplan-Meier analysis. A total of 81 cases were analysed at 12 months follow-up. Comparable success was observed in both groups (97.6% in E-PP & 97.5% in R-PP; p > .05). The R-PP group reported significantly lower pain scores on the 1st and 2nd post-operative days than E-PP (p < .05) and required significantly less analgesic intake (p < .05). Hard tissue barrier formation was significantly lower in the R-PP group (p < .05). No significant differences were observed between groups regarding haemostasis time, pulp sensibility responses, and tooth survival (p > .05). Both the PP approaches exhibited comparable success for managing cariously exposed mature permanent molars with SIP. Given the conservative nature of R-PP, it may be used as preferred PP approach for managing such cases. Being the first study of this kind, further work is necessary to draw definitive conclusions.

Impact of different disinfection protocols on the bond strength of NeoMTA 2 bioceramic sealer used as a root canal apical plug (in vitro study)

IntroductionTreatment of an immature permanent tooth required a special disinfection protocol due to the presence of thin radicular walls, which are prone to fracture. Mineral Trioxide Aggregate (MTA) has been proposed as a root repair material for root canal treatment. The aim of this in vitro study was to compare the push-out bond strength of conventional White MTA cements and second generation NeoMTA 2 in imitated immature roots treated with different disinfection protocols, which are 5.25% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA), and NaOCl, followed by 20% etidronic acid (HEBP).MethodsThe root canals of freshly extracted single-root teeth were manually prepared until 90 K-file to imitate immature roots. Roots were randomly divided into four groups (G) according to the disinfection protocol (n = 15 per group). where G1 (NaOCl + EDTA + White MTA) and G2 (NaOCl + EDTA + NeoMTA 2) While G3 (NaOCl + HEBP + White MTA) and G4 (NaOCl + HEBP + NeoMTA 2) All groups were activated with manual agitation. All specimens were incubated for 48 h. The apical third of each root was perpendicularly sectioned to attain a slice of 3 mm thickness. Push-out bond strength values were assessed using a two-way ANOVA and a Student’s t test.ResultsG3 and G4 that were treated with HEPB showed higher significant push-out bond strength mean values than G1 and G2 treated with an EDTA chelating agent. Irrespective of the chelating agent used, it was found that both NeoMTA 2 and White MTA had no significant influence on push-out bond strength mean values (p ≤ 0.05).ConclusionThe combined use of 5.25% NaOCl and 20% HEBP increased the push-out strength values of both NeoMTA 2 and White MTA, rendering them suitable to be used as an alternative chelating agent to EDTA.

Re-evaluation of Microhardness of Mineral Trioxide Aggregate and Biodentine After Removal From Root Using Different Types of Solvents: An In Vitro Study.

Objective This study aimed to evaluate the effects of different solvents on the microhardness of mineral trioxide aggregate (MTA) and Biodentine, which are used in endodontic therapy for their biocompatibility and ability to create a hermetic seal. Methods A total of 150 extracted human single-rooted teeth were selected and sectioned into 4 mm slices. The samples were divided into two groups according to the material used: MTA and Biodentine. Then the samples were incubated at 37°C and 100% humidity for 28 days. After that, 15 MTA and Biodentinesampleseach were sent for microhardness test and the remaining samples were subdivided into four subgroups according to the solvent used, i.e., treated with normal saline, 5.25% sodium hypochlorite, 10% citric acid, or 40% hydrofluoric acid. The microhardness of the upper and lower surfaces of the samples was measured using a Vickers microhardness tester. Results The average microhardness values for Biodentine and MTA were found to be 74.4 HV and 69.9 HV, respectively. Treatment with sodium hypochlorite, citric acid, and hydrofluoric acid significantly reduced the microhardness of both materials. Hydrofluoric acid had the most pronounced effect, followed by citric acid and sodium hypochlorite. Statistical analysis using one-way analysis of variance (ANOVA) 'F' test showed highly significant differencesbetween the groups. Discussion The study demonstrated that solvents such as hydrofluoric acid, citric acid, and sodium hypochlorite effectively reduced the microhardness of MTA and Biodentine, facilitating their removal during retreatment. This reduction in microhardness is attributed to the chemical interactions of the solvents with the materials, leading to disintegration and reduced structural integrity. Conclusion Biodentine had greater microhardness compared to MTA, and hydroflouric acid reduced the microhardness to a greater extentcompared to other solvents.

Comparative evaluation of blood contamination on the push-out bond strength of mineral trioxide aggregate, Biodentine, and bone cement in furcation perforation repair: An in vitro study

ABSTRACT Aim: This in vitro study was designed to compare the effect of blood contamination on the push-out bond strength of mineral trioxide aggregate (MTA), Biodentine, and bone cement. Materials and Methods: Seventy-eight human mandibular molars with furcation were selected and decoronated at the cementoenamel junction. The samples were mounted 3 mm below the furcation area into the acrylic resin. A perforation in the center of the furcation was made using a round carbide bur size 3 with a diameter of 1.2 mm. Then, the perforation was enlarged up to a standardized diameter of 1.3 mm using a size 5 Gates-Glidden drill. The samples were randomly divided into three groups. Based on blood contamination status, each group (n = 26) was further subdivided into two subgroups (n = 13). Whole fresh human blood was obtained from the principal investigator of the research group. A 27-gauge syringe was used to inject blood into the perforated furcal area. A piece of gelatin was packed under the furcal area using a condenser. MTA, Biodentine, and bone cement were mixed according to the manufacturer’s recommendations and compacted into the perforation. A universal testing machine was used to evaluate the push-out bond strength. Statistical Analysis: The results were analyzed using one-way analysis of variance followed by Tukey’s post hoc test (P &lt; 0.05). Results: In the experimental groups with blood contamination, Group 2A exhibited statistically significant push-out bond strength values compared with Group 1A and Group 3A. In the groups without blood contamination, Group 2B showed statistically significant push-out bond strength values compared with Group 1B and Group 3B. Irrespective of the blood contamination status, Group 3 exhibited higher push-out bond strength values than Group 1, with no statistically significant difference between the groups. No significant difference was observed within the groups. Conclusion: Biodentine showed promising results as a better perforation repair material irrespective of the status of blood contamination. Bone cement can be a viable alternative material for furcation perforation repair compared with MTA.

Evaluation of microleakage of mineral trioxide aggregate and biodentine as apical barriers in simulated young permanent teeth

BackgroundApexification is a procedure that promotes apical closure by forming mineralized tissue in the apex region of a nonvital young permanent tooth. Calcium silicate-based cement like Mineral trioxide aggregate (MTA) and Biodentine are commonly employed as apical barriers to facilitate this process. Microleakage, defined as the leakage along the junction between the canal wall and filling material, is a crucial aspect to assess in MTA and Biodentine applications as apical barriers, as it directly impacts the prevention of bacterial seepage and maintenance of structural integrity. The current study aims to assess the microleakage of MTA and Biodentine when used as apical barriers in simulated young permanent teeth.MethodsFrom a total of 128 extracted teeth, 114 were selected for the study and randomly allocated into three groups: G1 (MTA), G2 (Biodentine), and G3 (Control), with 38 teeth per group. After excluding 5 teeth from each group due to issues such as canal calcification, breakage during sectioning, and procedural errors, 33 teeth were analyzed to ensure equal distribution. To simulate young permanent teeth, samples were instrumented using a person-reamer with a diameter of 1.7 mm. A 4 mm thick apical plug of MTA and Biodentine was placed in G1 and G2, respectively, while G3 was the control group. Apical microleakage in all experimental groups was assessed using a dye penetration method. Specimens were longitudinally sectioned and examined under a stereomicroscope with graded eyepiece.ResultsThe Kruskal-Wallis test revealed variations in mean apical microleakage among the groups: G1 recorded 0.67, G2–0.16, and G3–1.62, with G2 showing the lowest value and G3 group exhibiting the highest.ConclusionsBiodentine was found to excel in its ability to create a secure seal and function effectively as an apical barrier in simulated young permanent teeth. These results underscore its potential as a highly efficient material for dental applications, particularly in scenarios requiring reliable sealing and barrier formation in the root canal system of developing permanent teeth.

Biocompatibility and antimicrobial effect of demineralised dentin matrix hydrogel for dental pulp preservation.

Regeneration of dentin and preserving pulp vitality are essential targets for vital pulp therapy. Our study aimed to evaluate a novel biomimetic pulp capping agent with increased dentin regenerative activities. To produce demineralised dentin matrix (DDM) particles, human extracted teeth were ground and treated with ethylene diamine tetra-acetic acid solution. DDM particles were added to sodium alginate and this combination was dripped into a 5% calcium chloride to obtain DDM hydrogel (DDMH). The eluants of both DDMH and mineral trioxide aggregate (MTA) were tested using an MTT assay to detect their cytotoxic effect on dental pulp stem cells (DPSC). Collagen-I (COL-I) gene expression was analysed on DPSC exposed to different dilutions of pulp capping material eluants by real-time quantitative polymerase chain reaction. Acridine orange staining was used to monitor the cell growth over the tested materials. Agar diffusion assay was utilised to test the antibacterial effect of DDMH and MTA compared to controls. MTT assay revealed that neat eluates of DDMH promoted DPSC viability. However, neat eluates of MTA were cytotoxic on DPSC after 72h of culture. Moreover, DPSC were capable of growth and attached to the surface of DDMH, while they showed a marked reduction in their number when cultured on the MTA surface for one week, as shown by the acridine orange stain. In DPSC cultured with DDMH eluates, the COL-I gene was overexpressed compared to those cultured with MTA eluants. DDMH had significant antimicrobial activity in comparison to MTA after 24h incubation. This in vitro study showed that DDMH could be an alternative pulp capping agent for regenerative endodontics.

Marginal adaptation of customized gutta percha cone with calcium silicate based sealer versus MTA and biodentine apical plugs in simulated immature permanent teeth (an in vitro study)

BackgroundThis study aimed to compare the marginal adaptation of a single customized gutta percha cone with calcium silicate-based sealer versus mineral trioxide aggregate (MTA) and Biodentine apical plugs in simulated immature permanent teeth.MethodsThirty-nine extracted human maxillary anterior teeth were selected, prepared to simulate immature permanent teeth with an apical diameter 1.1 mm, placed in moist foam and divided into three groups. Group 1: Obturation with a single customized gutta percha cone and calcium silicate sealer. Group 2: MTA apical plug. Group 3: Biodentine apical plug. After incubation, teeth were horizontally sectioned at 1 mm and 3 mm from the apex and marginal adaptation was evaluated using scanning electron microscope (SEM).ResultsBiodentine showed the least mean gap size at both 1 and 3 mm from the apex with no statistically significant differences compared to MTA (p > 0.05). The single customized cone with calcium silicate based sealer showed the greatest mean gap size at both 1 and 3 mm from the apex with a statistically significant difference compared to the other groups (p < 0.001).ConclusionBiodentine and MTA apical plugs provide a significantly better marginal adaptation to the dentinal walls than a single customized gutta percha cone with calcium silicate based sealer in simulated immature permanent teeth.

Comparing the technical quality and clinical outcomes of root canal treatment on immature permanent incisors in children: a retrospective evaluation of three bioceramic plug materials.

To assess the technical quality and clinical outcomes of non-surgical endodontic treatment of immature permanent incisor teeth with three different bioceramic plug materials and highlight variables which may influence treatment and quality outcomes. This cross-sectional analysis forms part of a retrospective service evaluation of the technical quality and clinical outcome of orthograde root canal treatment carried out in the Paediatric Dentistry Department of Charles Clifford Dental Hospital (United Kingdom). Twenty-five cases were identified chronologically, using the electronic patient record system, for three bioceramic plug materials: Mineral Trioxide Aggregate (MTA), Biodentine, and TotalFill Putty. All radiographs were analysed using standard conditions. Intra- and inter-examiner agreement was calculated using Kappa and weighted Kappa tests. Data were collected using a data collection tool, entered into Microsoft Excel, and analysed using descriptive statistics, exploratory analysis with Chi-squared tests, and multivariable analyses (logistic regression). At 12-month review, the success rate for each apexification material was MTA (84%), Biodentine (88%), and TotalFill Putty (92%). MTA had the highest frequency of post-operative coronal discolouration, with Biodentine most associated with apical extrusion. A number of variables and trends that affect the clinical outcome were identified, including the presence of pre-operative resorption, the number of operators involved in treatment, the number of appointments to complete treatment, as well as how non-use of local anaesthetic during apical plug placement had no adverse effect on technical quality or clinical outcome. MTA, Biodentine, and TotalFill Putty are highly effective apexification materials which produce excellent clinical outcomes. As such, logistical and situational factors, such as continuity of care from operators with increased levels of experience, skill and ability, rather than material choice, may be more prognostic regarding the technical quality and clinical outcome of immature endodontic treatment. Further high-quality evidence is required.

Comparative Evaluation of the Effect of Various Irrigating Solutions on the Push-Out Bond Strength of Biodentine and Mineral Trioxide Aggregate: An In Vitro Study

Introduction: A successful endodontic treatment is ba¬sed on combination of adequate instrumentation, irrigation and obturation of canal system. The objectives of endodontic irrigants are lubrication of root canal, removal of microorganisms, pulp, dentinal remnants and dissolution of tissues. The objective of root-end filling is establishment of proper apical hermetic seal. Aim: To evaluate and compare the effect of various irrigating solutions on push-out bond strength of Biodentine and Mineral trioxide aggregate (MTA). Materials and Method: Sixty-four extracted human single rooted teeth were decoronated 1.5-2 mm coronal to cemento-enamel junction. The root canals were prepared and divided into four groups (n=16): Group I- Normal Saline (Control group), Group II- Triple antibiotic solution, Group III- 2% Chlorhexidine, Group IV- Morinda citrifolia solution. Mid root dentin was sectioned horizontally and irrigated further with respective irrigating solutions for 5 minutes and divided into 2 subgroups: Subgroup A- Biodentine and Subgroup B- MTA. The root-end filling material was incrementally placed and embedded in acrylic blocks. Samples were tested for push-out bond strength using universal testing machine. Results: The highest push-out bond strength was shown by 2% Chlorhexidine group when used with Biodentine and lowest when normal saline was used with Biodentine. Conclusion: All experimental irrigating solutions increased the push-out bond strength of MTA and Biodentine.

Effect of calcium hydroxide and calcium hydroxide nanoparticles used as intracanal drugs after manual and ultrasonic removal on the bond strength of a new sealer with a pozzolan base (Endoseal mineral trioxide aggregate)

ABSTRACT Aim: The adhesion ability of filling materials to the root canal wall can be affected by the intracanal medicaments. The present study investigated the effect of pretreatment with nano-calcium hydroxide and calcium hydroxide on the bond strength of Endoseal mineral trioxide aggregate (MTA) to root canal dentin. Materials and Methods: Fifty maxillary incisor teeth were randomly divided into two experimental groups (n = 20) and a control group (n = 10) after decoronation near the cementoenamel junction and root canal instrumentation according to the type of intracanal medicament (calcium hydroxide and nano-calcium hydroxide). Each experimental group was divided into two subgroups based on manual and ultrasonic drug removal methods. After removing intracanal medicaments and irrigating them, all the groups were obturated with gutta-percha and Endoseal MTA sealer. Then, the samples were sectioned into cross-sections with a thickness of 2 mm using a diamond disc, and the push-out bond strength test was performed on them. Results: The results showed no significant difference in the mean Endoseal MTA bond strength in terms of the type of intracanal medicament and the method used to remove it from the canal (P &gt; 0.05). Conclusion: Using the ultrasonic method compared to the manual method in removing intracanal medicament resulted in no significant difference in the strength of the Endoseal MTA bond. Furthermore, the effect of nanoparticle calcium hydroxide on Endoseal MTA bond strength was not different compared to the conventional type of this medication.

Comparative Analysis of Calcium and Hydroxyl Ion Release from Pulp Dressing Materials in Pulpotomized Premolars.

BACKGROUND The aim of this study was to evaluate the time-dependent release of calcium (Ca⁺⁺) and hydroxyl (OH⁻) ions from 3 different pulp dressing materials used to cap root canal orifices in pulpotomized premolars. MATERIAL AND METHODS Freshly extracted (n=40) premolars were subjected to standardized pulpotomy procedure and finally restored in 5 groups using resin-modified glass ionmmer liner (RMGI) and bonded resin composite directly against the pulp chamber's floor (Control, G2) and over 3 different orifices' capping materials - Dycal (G3), Endo Sequence root repair material (ESRRM, G4), and mineral trioxide aggregate (MTA) Angelus (G5). Another 10 sound premolars served as the Reference group (G1). The restored teeth were incubated at 37±1°C in sealed containers filled with deionized water to assess Ca⁺⁺ and OH⁻ ions release after 24 h and at 1, 4, and 8 weeks. Two-way ANOVA and Tukey's comparisons at alpha=0.05 were used to statistically analyze the collected data. RESULTS Two-way ANOVA revealed significant differences in Ca⁺⁺ ions between test groups at different testing time intervals (P<0.05). Despite the constant (Tukey's, P<0.05) pH levels (OH⁻ release), Group 5 specimens exhibited higher Ca⁺⁺ ion release in comparison to Groups 4 and 3 at different testing timepoints (Tukey's, P<0.05). CONCLUSIONS Although all the assessed pulp dressing materials had equivalent and stable pH levels, ESRRM and MTA-Angelus had the highest Ca⁺⁺ ion release at the assessment intervals.