Mineral Trioxide Aggregate Research Articles

Comparative Evaluation of the Treatment Outcomes of Pulpotomy in Primary Molars Using Mineral Trioxide Aggregate and 3Mixtatin: A Randomized Clinical Trial.

To evaluate and compare the efficacy of 3Mixtatin and mineral trioxide aggregate (MTA) for pulpotomy in primary teeth by assessment of pre- and postoperative clinical and radiographic data. In this randomized clinical trial, 50 primary molars from 48 healthy children aged 3-8 years were randomly allocated into two groups. Deep dentinal caries approaching pulp in primary teeth were treated by pulpotomy using MTA and 3Mixtatin. Over the intervening period, restoration was done using glass ionomer cement (GIC) and composite, followed by stainless steel crown. Clinical and radiographic examinations were conducted at 3, 6, and 12 months after treatment. The data were compared using Chi-squared test at a significance level of 0.05. A total of 39 patients were available for follow-up study. By the end of 12 months, the overall success rates were 95.5% in MTA and 91.3% in 3Mixtatin. No statistically significant difference was found among the outcomes of MTA and 3Mixtatin groups (p > 0.05). Radiographic and clinical outcomes in MTA and 3Mixtatin group in this study show 3Mixtatin as a suitable alternative for pulpotomy medicament in primary teeth. Mushtaq A, Nangia T, Goswami M. Comparative Evaluation of the Treatment Outcomes of Pulpotomy in Primary Molars Using Mineral Trioxide Aggregate and 3Mixtatin: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(6):810-815.

Randomized clinical trial of pulpotomy using a premixed injectable calcium silicate cement on mature permanent teeth with reversible pulpitis

The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable calcium silicate cement, as compared to mineral trioxide aggregate in mature permanent premolar and molar teeth with reversible pulpitis. Included teeth were randomly divided into two groups according to pulpotomy material (ProRoot MTA [PMTA] group, Endocem MTA Premixed [EPM] group). After pulp exposure, the superficial pulp was either removed to a depth of 2 mm (partial pulpotomy) or completely amputated to the level of the root canal orifice (full pulpotomy). A 3-mm layer of either material was randomly placed over the pulp wound, followed by the application of a thin layer of a light-cured glass ionomer composite liner. The restoration procedure was then carried out during the same visit. After one year of treatment, the pulpotomy success rate was 94.4% (67/71), with no significant difference between the PMTA and EPM groups. The success rate was 93.9% in the PMTA group and 97.1% in the EPM group. There were no significant factors related to the procedures. EPM is a viable alternative to PMTA for single-visit pulpotomies of permanent premolars and molars.

Comparison of coronal sealing of flowable composite, resin-modified glass ionomer, and mineral trioxide aggregate in endodontically treated teeth: An in-vitro study

Background: Coronal seal is one of the essential factors that affects the success of endodontic treatment and reinforces the apical seal. The intra-orifice barrier is an efficient alternative approach to decrease coronal leakage in endodontically treated teeth and various materials have been used for this purpose. This study aimed to compare the coronal sealing of flowable composite, resin-modified glass ionomer (RMGI), and mineral trioxide aggregate (MTA) in endodontically treated teeth. Materials and Methods: In this in vitro study, 35 single-canal canine teeth were divided into five groups, including flowable composite, RMGI, MTA, positive control, and negative control groups. The teeth were filled with restorative materials according to the factory's instructions. Afterward, the samples were immersed in 2% methylene blue dye solution for 1 week at 37°C and 100% humidity condition. Finally, the teeth were sectioned longitudinally and dye penetration was measured using a stereomicroscope with ×10. Data were analyzed with Kolmogorov–Smirnov and Kruskal–Wallis tests (α = 0.05). Results: The positive control group showed the highest amount of dye penetration compared to other groups (12.34 ± 0.46). Dye penetration in the MTA group was significantly lower (4.25 ± 0.31) compared to the RMGI group (5.94 ± 0.24) (P = 0.02). Moreover, while the dye penetration in the MTA group was lower than in the flowable composite group (5.65 ± 0.26), the difference was not statistically significant (P = 0.12). Conclusion: MTA reduces the coronal leakage and provides an acceptable coronal seal in endodontically treated teeth, especially compared to RMGI, and therefore, using MTA as an intra-orifice barrier increases the endodontic treatment success rate.

Comparative Evaluation of the Push-Out Bond Strength of Glass Ionomer Cement, Mineral Trioxide Aggregate, Biodentine, and Endosequence Root Repair Material in Repair of Furcation Perforations: An In Vitro Study

ABSTRACT Introduction: An in vitro comparative analysis was performed to calculate the push-out bond strength of commercially existing root repairing cements like glass ionomer cement (GIC), biodentine, mineral trioxide aggregate (MTA), and endosequence root repair material (RRM) employed in furcation perforation, with or without blood contamination present. Materials and Methods: Eighty molars were selected and subjected to furcal perforations. They were categorized based on the cement used for repair (GIC, MTA, biodentine, and endosequence RRM); furthermore, they were sub-divided into two sub-groups, that is, blood contaminated and non-contaminated. For 24 hours, all the samples were kept in an incubator till the materials were fully set. Then these samples were examined for push-out bond strength measurement. Results: The 24-hour push-out bond strength of was the highest in biodentine and the lowest in glass ionomer cement. The push-out bond strength of endosequence RRM, MTA, and GIC was influenced by blood contamination. Conclusion: The push-out bond strength of biodentine was the highest as compared to endosequence RRM, MTA angelus, and GIC. The push-out bond strength of endosequence RRM and MTA angelus after 24 hours with or without blood contamination showed insignificant differences. Group 1A (GIC contaminated with blood) displayed the least push-out bond strength among other groups.

Antibacterial Efficacy of Mineral Trioxide Aggregate, Bioactive Glass and Epoxy-Resin Based Sealer: An In-Vitro Interventional Study.

The aim and objective of this in vitro study was to evaluate the antibacterial efficacy of mineral trioxide aggregate, bioactive glass sealer, and epoxy-resin-based sealer. In the present study, 22 Mueller Hinton agar (MH agar) plates were employed and equally divided into two groups. Three holes were made by removal of agar at equidistant points and filled with root canal sealers. The strains of the bacteria used in this study were S. aureus (ATCC 6538) and C. albicans (ATCC 10231) and were divided into two groups and root canal sealers were divided into three subgroups: mineral trioxide aggregate (MTA) fillapex Sealer, Nishika Bioactive Glass sealer, and Syntex Epoxy Resin base sealer. For Staphylococcus aureus, peptone water was placed in a 2 mL test tube and bacteria were extracted from blood agar plates using a nichrome wire loop and poured into the peptone water-containing test tube and incubated for 2 hours and for C. albicans, fungi were grown at 37°C for 24 hours in MH Broth and seeded into MH agar to produce turbidity of 0.5 on the McFarland scale, which corresponds to a concentration of 108 CFU/mL. This MH broth was used as a second layer. The seeded agar was then added over the plates immediately after the insertion of sealer cement. After incubation, the diameters of zones of inhibition around the plates were measured. The results of this study showed that the highest inhibition was recorded in Syntex sealer against Staphylococcus aureus followed by MTA fillapex sealer and Nishika sealer, whereas MTA fillapex showed the highest inhibition against C. albicans followed by Syntex sealer and Nishika sealer. Syntex sealer exhibits better antibacterial efficacy against Staphylococcus aureus and MTA fillapex exhibit better antibacterial efficacy against C. albicans.

Partial pulpotomy success in primary molars followed up for 24 months: A randomized controlled clinical trial using mineral trioxide aggregate, biodentine, and acemannan.

Finding the best treatment approach and suitable capping materials in primary molars with deep carious lesions remains unresolved. To compare the success rates of partial pulpotomy in deep caries lesions in primary molars treated with mineral trioxide aggregate (MTA), biodentine, or acemannan for 6-24 months. A parallel-design, non-inferiority randomized controlled clinical trial was performed. Ninety mandibular primary molars from 65 children meeting the criteria, aged 3-8 years, were included. After inflamed pulp tissue removal and hemostasis, each tooth was randomly allocated into the MTA control group, or the biodentine or acemannan experimental group (N = 30 per group). All teeth were restored with a stainless steel crown. The outcomes were evaluated for 6-24 months. A generalized estimating equation model was used to compare the overall success rate in each group. After 24 months, 58 children (83 teeth) were available for evaluation. The results indicated that the success rate in the MTA, biodentine, and acemannan groups was 83.3%, 76.9%, and 74.1%, respectively. No significant difference in success rates among groups, however, was observed at the 6- to 24-month follow-ups (at 24th month, p = .30). There was no statistically significant difference between MTA, biodentine, or acemannan in the partial pulpotomy success after 24 months.

Gallic acid–coated nanolayer on mineral trioxide aggregate for regulating the inflammatory and differentiation cellular response profile of human dental pulp stem cells

Mineral trioxide aggregate (MTA) is a biomaterial used in endodontics due to its high bioactivity, antibacterial behaviors, and good biocompatibility. However, it has several disadvantages related to certain physical properties, including a long setting time and poor mechanical properties. Therefore, we hypothesized that coating MTA with gallic acid (GA) would regulate physical properties and lead to enhanced adhesion, proliferation, and secretion of angiogenic- and odontogenic-related proteins. This study examined whether MTA can be modified with GA to form GAMTA cement and evaluated its physicochemical and biological behaviors and immune suppression, angiogenesis, and odontogenesis capabilities. We soaked MTA in Tris buffer containing different concentrations of GA to coat the MTA powders. X-ray diffraction (XRD) and diametral tensile strength analyses were conducted to assess the physical characteristics of GAMTA. Then, we immersed GAMTA cement in simulated body fluid to evaluate its hydroxyapatite precipitation capabilities and silicon ion release profile. We used human dental pulp stem cells to assess the cell responses and the immunosuppressive, angiogenic, and odontogenic capabilities of GAMTA. The XRD results showed that GA was successfully coated onto MTA without the disruption or loss of MTA’s advantageous original structural properties. GAMTA demonstrated excellent physicochemical and biological properties, improving hydroxyapatite formation and angiogenic, odontogenic, and anti-inflammatory properties compared with MTA alone. Our results indicate that the GAMTA cement is a useful dental material for future tissue engineering and clinical applications.

Efficacy of Mineral Trioxide Aggregate (MTA) as a Reparative Material in Iatrogenic Furcal Perforations in Mandibular Molars.

Mineral trioxide aggregate (MTA) is widely recognized as one of the most biocompatible materials for perforation repairs during root canal treatment (RCT). Experimental evidence has consistently demonstrated MTA's superior sealing ability and biocompatibility compared to various dental materials, including amalgam, intermediate restorative material, zinc oxide eugenol cement, and resin-modified glass ionomer cement. This study aimed to assess the efficacy of MTA as a reparative material in iatrogenic furcal perforations during RCT. A descriptive cross-sectional study was conducted from May 18, 2021, to November 17, 2021, at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Seventy-six patients aged 18-60 years, of both genders, who developed iatrogenic furcal perforations during procedures were included. Patients with fractures or endo-perio lesions identified during clinical and radiographic examinations were excluded. Isolation was achieved using a rubber dam. The perforation site was cleaned and irrigated with 1% sodium hypochlorite to control hemorrhage and enhance visualization. Following the manufacturer's recommendations, the perforation site was sealed with MTA mixed with sterile saline. The age range in this study was 18 to 60 years, with a mean age of 42.09 ± 9.69 years. Most patients (56.78%) were between 41-60 years old. Out of the 76 patients, 46 (60.53%) were male, and 30 (39.47%) were female, resulting in a male-to-female ratio of 1.5:1. The study found that MTA's efficacy as a reparative material in iatrogenic furcal perforations was observed in 61 (80.26%) patients. A 6-month follow-up revealed no periodontal ligament breakdown, demonstrating the efficacy of MTA as a reparative material in iatrogenic furcal perforations. This study concludes that the efficacy of MTA as a reparative material in iatrogenic furcal perforations is remarkable and significant.

Preventive Effects of Laser Irradiation and Dentin Bonding Agent Application on Tooth Discoloration Induced by Mineral Trioxide Aggregate

The aim of the present study was to evaluate the effect of the pre-application of dentin bonding agent and laser application on the prevention of tooth discoloration caused by (MTA) in the presence of blood. Fifty extracted human anterior teeth were prepared by standardizing root lengths to 10 mm and shaping root canals. Specimens were divided into five groups (n = 10) based on the treatment applied to the pulp chamber dentin wall: Group 1/no surface treatment; Group 2/Optibond FL; Group 3/Clearfil SE; Group 4/Optibond Universal adhesive application; Group 5/Nd:YAG laser application. Root canals were filled with fresh human blood below the cemento-enamel junction (CEJ), followed by ProRoot MTA, and collagen barrier placement. Color changes were monitored using a spectrophotometer at 0, 7, 30, 90, and 180 days post MTA placement. Color differences (∆E) were calculated and analyzed using two-factor mixed-design ANOVA with Sidak adjustment at p = 0.05. The degree of coloration increased with time within each group (p < 0.05). No significant differences were observed between Optibond FL and Optibond Universal within each time interval, or between Clearfill SE Bond and the control group (p > 0.05). When compared to the control group, the Nd YAG group exhibited the least degree of discoloration in all time intervals (p < 0.05). Although the Nd:YAG laser had promising results, none of the methods can guarantee a 100% prevention of discoloration resulting from tooth discoloration caused by MTA-blood contact.

Improvement of the setting properties of mineral trioxide aggregate cements using cellulose nanofibrils.

Cellulose nanofibrils (CNFs) exhibit excellent mechanical properties and are used to reinforce various composites. The effects of incorporating CNFs into commercial mineral trioxide aggregate (MTA) cements (NEX MTA (NEX) and ProRoot® MTA (PR)) on the underwater setting properties, compressive strength, and flowability were estimated in this study. NEX mixed without CNFs disintegrated after water immersion. NEX mixed with CNF-suspended solutions showed good setting properties under water immersion and a similar compressive strength, which was kept in air (100% relative humidity). PR did not degrade after water immersion, regardless of the presence of CNFs, and no significant difference in the compressive strength caused by CNFs incorporation was detected. The relative flowability of the NEX mixture decreased with increasing CNFs content up to 1.0 w/v%. The application of CNF-incorporated MTA in various dental cases is promising because CNFs prevent the water-immersion-dependent collapse of some MTA cements immediately after mixing.

Thermophysical properties and bonding with composite resin of premixed mineral trioxide aggregate for use as base material.

Dental bases require low thermal conductivity and good mechanical properties, such as bonding with composite resins. This study aims to elucidate the physicochemical properties of premixed mineral trioxide aggregate (MTA) for its suitability as a dental base and to explore the optimal adhesive strategy with composite resin. The thermal conductivity and compressive strength of this premixed MTA are 0.12 W/(m•K) and 93.76 MPa, respectively, Which are deemed adequate for its application as dental base. When bonded to composite resin, the use of 37% phosphoric acid etching before applying the Clearfil SE bond significantly reduced the bonding strength between composite resin and premixed MTA. This was because the compressive strength and Vickers hardness of premixed MTA decreased, and tricalcium silicate was dissolved from the surface during acid etching. Therefore, it is recommended to avoid using 37% phosphoric acid etching when bonding premixed MTA and composite resin as a dental base.

Evaluating the Sealing Ability of MTA as a Root Canal Sealing Material

This study was to evaluate the potential of using mineral trioxide aggregate (MTA) as a root canal sealing material via comparing its apical sealing ability with that of the most commonly used root canal sealer (Dorifill) zinc oxide based sealer , twenty-eight extracted human single rooted teeth were selected for use in this study . All teeth were prepared in standard manner using hand instruments, randomly divided into two groups of twelve teeth each and a control group of four teeth. Root canals in the two experimental groups were filled laterally condensed gutta percha and either MTA or zinc oxide based (Dorifill) sealer. After sealers had set, the root surfaces were coated with nail varnish except 1 mm at the apex of the root . Positive controls had no root filling and were coated with nail varnish in the same manner, while the negative controls were sealed only entirely with nail varnish. The teeth were immersed into 1% methylene blue dye for 72 hours. The teeth were cleared and the linear extent of dye penetration was measured with a stereomicroscope. Group (MTA) showed significantly less apical dye penetration than group 2 . Positive controls had total leak age and negative controls had no leakage. The study demonstrate that MTA provide an apical seal that is superior to that of zinc o xide based root canal sealer (Dorifill).

Dislodgement resistance and structural changes of tricalcium silicate-based cements after exposure to different chelating agents.

This study aimed to evaluate the dislodgement resistance and structural changes of different mineral trioxide aggregate cements (MTA) like Pro-Root MTA, Ortho MTA, and Retro MTA after exposure to sodium hypochlorite (NaOCl), NaOCl-Ethylenediaminetetraacetic acid (EDTA), 1-hydroxyethylidene-1, 1-bisphosphonate (Dual Rinse HEDP), and NaOCl-Maleic acid (MA). The root canal spaces of 150 dentine slices were obturated using tricalcium silicate cements and divided into 3 groups (n = 50): Group1: ProRoot MTA, Group2: Retro MTA, and Group3: Ortho MTA. The samples in each group were further subdivided into four experimental (n = 10) and one control groups (n = 10): 2.5% NaOCl-17% EDTA, Dual Rinse HEDP, 2.5% NaOCl-7% Maleic acid, 2.5% NaOCl, distilled water (control). The dislodgement resistance and structural changes of cements were measured. Use of DR HEDP resulted in higher dislodgement resistance compared to17% EDTA and 7% MA in the samples obturated with Ortho MTA and Pro-Root MTA (p<0.001). In Retro MTA group, samples treated with DR HEDP and 17% EDTA had higher dislodgment resistance compared to 7% MA (p<0.001). On microstructural and elemental analysis of all the three MTA cements, samples treated with 17% EDTA and 7% MA were more amorphous and granular when compared to DR HEDP, which was pettle shaped. Calcium level was decreased more in samples treated with 17% EDTA and 7% MA when compared to DR HEDP.

Comparative Evaluation of Shear Bond Strength of Tricalcium Silicate-based Materials to Composite Resin with Two Different Adhesive Systems: An In Vitro Study.

Establishing a strong bond between the pulp capping agent and the restorative material is crucial to the success of the procedure. Without this bond, there is a risk of bacterial infiltration into the pulp, leading to treatment failure. In the past, calcium hydroxide was commonly used for such treatments, but it faced challenges, including poor adhesion to dentin, dissolution over time, and the development of multiple tunnel defects. Mineral trioxide aggregate (MTA), introduced to dentistry in 1993, offered an alternative but came with drawbacks like challenging handling and extended setting times. However, in recent times, several new calcium silicate-based materials have emerged to address MTA's limitations. Two notable examples are Biodentine and MTA Plus. Biodentine, for instance, exhibits excellent sealing ability, while MTA Plus distinguishes itself with a finer particle size compared to traditional MTA. These innovative materials offer promising solutions to enhance the efficacy of pulp capping procedures. Therefore, in this research, we conducted a comparative analysis of the shear bond strength (SBS) between composite resin and three materials-MTA, MTA Plus, and Biodentine. We examined the effects of applying two distinct adhesive systems in order to evaluate their influence on the bond strength. A total of 60 acrylic blocks were evenly distributed into three groups, each containing 20 blocks-group I received Biodentine, group II was assigned MTA, and group III received MTA Plus. The respective test materials were compacted into the holes within the blocks. Following this, the samples were incubated for a period of 72 hours. Subsequently, the samples were divided into two subgroups, each consisting of 10 blocks-the self-etch and the total-etch subgroup. The SBS values were then carefully measured for analysis. The SBS of the Biodentine group demonstrated a significantly higher value when compared to the other groups. It's worth noting that when the self-etch adhesive system was employed, the SBS of all the groups experienced a significant reduction. Biodentine cement proves to be an effective choice for pulp capping procedures, regardless of the specific adhesive system employed. Notably, the total-etch adhesive system consistently yields higher bond strength when compared to the self-etch adhesive system. Kumar V, Showkat I, Manuja N, et al. Comparative Evaluation of Shear Bond Strength of Tricalcium Silicate-based Materials to Composite Resin with Two Different Adhesive Systems: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-3):S272-S277.

Effects of mineral trioxide aggregate and methyl sulfonyl methane on pulp exposure via RUNX2 and RANKL pathways.

The aim of this study was to determine the therapeutic effects of mineral trioxide aggregate (MTA) and methyl sulfonyl methane (MSM) on pulp damage due to pulp exposure through the RUNX2 and RANKL pathways. Seventy-two male Sprague-Dawley rats aged 4-6months and weighing 250-300g were divided into healthy, control, MTA, and MSM groups. After experimental applications, all rats at 2, 4, and 8 weeks were killed anesthetically with xylazine hydrochloride (Rompun, Bayer) 30mg/kg and ketamine hydrochloride (Ketalar, Pfizer) 50mg/kg injections (i.p.). We observed that necrotic odontoblasts, edema, inflammation, and vascular congestion findings were reduced from week 2 to week 8 in the MSM treatment group after pulp capping compared to the control group and MTA group. Similarly, we found a decrease in RUNX2 and RANKL levels in the MSM application group compared to the control and MTA groups (p < 0.05). MSM material has shown therapeutic effects on pulp capping treatment-induced pulp injury via increased RUNX2 ve RANKL expression.

Management of Failed Regenerative Endodontic Treatment of a Necrotic Immature Molar: A Case Report With 12-Month Follow Up

Introduction: Management of necrotic immature permanent teeth has always posed a challenge to clinicians. Regenerative endodontic procedures (REPs) have been proposed as an alternative to apexification to treat necrotic immature teeth. However, few failed cases of REPs have been presented in the literature with different successful retreatment approaches. Case presentation: An eight-year-old boy reported spontaneous pain in the right permanent mandibular first molar. Regenerative endodontic treatment using platelet-rich fibrin (PRF) was the treatment method due to the open apices. At the 9-month follow-up, there was a periapical lesion around the distal root. Hence, apexification with Mineral trioxide aggregate (MTA) was carried out. In the twelve-month follow-up, the periapical lesion healed radiographically. Conclusions: MTA and bioceramic-based root canal sealers yielded satisfactory outcomes in lesion healing. Little is known about the biological and clinical aspects of regenerative endodontic treatment. Moreover, there are still unknown factors that govern the success of REPs.

Evaluation of the Marginal Adaptation of Two Hydraulic Calcium Silicate Cements Used in Apical Plugs: An In Vitro Study

Background: The emergence of new hydraulic calcium silicate cements has revolutionized endodontics, addressing the limitations of mineral trioxide aggregate (MTA). The aim of this study is to assess and compare the marginal adaptation of two calcium silicate-based cements (White ProRoot MTA® and TotalFill® BC RRM Fast Set PuttyTM), when creating apical plugs for teeth with open apices. Methods: twenty-four single-rooted teeth were divided into two groups—GMTA (plug with MTA®) and GTBC (plug with TotalFill® BC RRM Fast Set PuttyTM)—and were sectioned at 1 mm and 2 mm from the apex. The transverse sections were analyzed with scanning electron microscopy and the marginal adaptation of the cements was measured with ImageJ® 1.3 software. Statistical analysis (IBM® SPSS® statistics software version 27) was performed and statistical significance was set at 0.05 (p &lt; 0.05). Results: There was a significant difference in the apical region, favoring White ProRoot MTA®, with a lower percentage of marginal adaptation failure (1.32 ± 4.47), presenting a statistically significant difference in the apical region (p = 0.029) but not in the cervical region of the apical plugs (p = 0.774). Conclusions: White ProRoot MTA® showed superior marginal adaptation in the apical section compared to TotalFill® BC RRM Fast Set PuttyTM.

In vitro and in vivo evaluation of iRoot BP Plus as a coronal sealing material for regenerative endodontic procedures

ObjectivesTo investigate in vitro effects of a nanoparticle bioceramic material, iRoot BP Plus, on stem cells from apical papilla (SCAP) and in vivo capacity to induce pulp-dentin complex formation. Materials and methodsThe sealing ability of iRoot BP Plus was measured via scanning electron microscopy (SEM). SCAP were isolated and treated in vitro by iRoot BP Plus conditioned medium, with mineral trioxide aggregate (MTA) conditioned medium and regular medium used as controls, respectively. Cell proliferation was assessed by BrdU labeling and MTT assay and cell migration was evaluated with wound healing and transwell assays. Osteo/odontogenic potential was evaluated by Alizarin red S staining and qPCR. Pulp-dentin complex formation in vivo was assessed by a tooth slice subcutaneous implantation model.ResultsiRoot BP Plus was more tightly bonded with the dentin. There was no difference in SCAP proliferation between iRoot BP Plus and control groups (P > 0.05). iRoot BP Plus had a greater capacity to elevated cell migration (P < 0.05) and osteo/odontogenic marker expression and mineralization nodule formation of SCAP compared with MTA groups (P < 0.05). Furthermore, the new continuous dentine layer and pulp-like tissue was observed in the iRoot BP Plus group in vivo.ConclusionsiRoot BP Plus showed excellent sealing ability, promoted the migration and osteo/odontogenesis of SCAP and induced pulp-dentin complex formation without affecting the cell proliferation, which indicated iRoot BP Plus was a promising coronal sealing material in REPs.Clinical relevanceThe coronal sealing materials play crucial roles for the outcomes of REPs. This study showed that iRoot BP Plus has good coronal sealing and promote pulp-dentin complex formation compared with MTA, providing experimental evidences for the clinical application of iRoot BP Plus as a promising coronal seal material in REPs.

Effects of Thai propolis mixed in mineral trioxide aggregate on matrix metalloproteinase-2 expression and activity in inflamed human dental pulp cells.

This study sought to determine effects of Thai propolis extract mixed in mineral trioxide aggregate (MTA) on matrix metalloproteinase-2 (MMP-2) expression and its activity in inflamed human dental pulp cells (HDPCs). Interleukin-1β-primed HDPCs were treated with either the eluate of MTA mixed with distilled water, of MTA mixed with 0.75 mg/ml of the propolis extract, or of Dycal®, 0.75 mg/ml of the propolis extract, or 0.2% (v/v) of chlorhexidine for 24 or 72 h. The viability of HDPCs was determined by the PrestoBlue® cytotoxic assay. HDPCs' lysates were analyzed for MMP-2 mRNA expression by RT-qPCR, while their supernatants were measured for MMP-2 activity by gelatin zymography. At 24 and 72 h, a non-toxic dose of the propolis extract at 0.75 mg/ml by itself or mixed in MTA tended to reduce MMP-2 expression upregulated by MTA, while it further decreased the MMP-2 activity as compared to that of MTA mixed with distilled water. The MMP-2 activity of interleukin-1β-primed HDPCs treated with the eluate of the propolis extract mixed in MTA was significantly lower than that of interleukin-1β-primed HDPCs at 24 h (p=0.012). As a control, treatment with chlorhexidine significantly inhibited MMP-2 expression induced by MTA and MMP-2 activity enhanced by interleukin-1β (p<0.05). Treatment with Dycal® caused a significant increase in HDPC's death, resulting in a significant decrease in MMP-2 expression and activity (p<0.05). MTA mixed with Thai propolis extract can reduce MMP-2 mRNA expression and activity when compared to MTA mixed with distilled water in inflamed HDPCs.

Influence of azathioprine on healing of exposed dogs' dental pulp capped with three different materials.

Azathioprine is one of the earliest immunosuppressants prescribed for several autoimmune diseases. Yet there is a lack of research on the impact of azathioprine on pulp healing following the pulp capping procedure. This study aimed to investigate the effect of azathioprine on the healing ability of mechanically exposed dogs' dental pulps following direct pulp capping with mineral trioxide aggregate (MTA), bio-aggregates (BA), and Calcium hydroxide (Ca(OH)2). Four mongrel dogs were randomly assigned to two groups (two dogs/30 teeth in each group): immunosuppressed (group I) and control (group II). Group I received azathioprine for two months before surgical treatments and until the dogs were euthanized. Fifteen class V buccal cavities were performed in each dog. Each group was randomly divided into three subgroups (10 teeth each) based on the pulp capping substance. The pulps in subgroups A, B, and C were immediately capped with MTA, BA, and Ca(OH)2, respectively. Inflammation and dentine bridge development were histopathologically evaluated and scored at one and two months. The data were statistically analyzed. The immunosuppressed group exhibited statistically greater inflammatory cell count and decreased dentine bridge thickness, compared to the control group in all subgroups (p < 0.05). Azathioprine has an adverse effect on the healing of exposed dogs' dental pulp following direct pulp capping with MTA, BA, and Ca(OH)2. Therefore, patients using azathioprine as an immunosuppressive medication may experience delayed healing of mechanically exposed pulps following capping with MTA, BA, or Ca(OH)2.