NeoMTA Plus Research Articles

Reinforcement of Teeth Having Reenacted Perforating Internal Resorption Cavities After Repair Using Different Calcium Silicate-based Cements and Backfilling Materials: An In vitro Study

ABSTRACT To evaluate the fracture resistance (FR) of the teeth having reenacted perforating internal resorption cavities repaired by distinctive calcium silicate-based cements (CSCs) specifically: Endocem MTA, Biodentine, NeoMTA Plus, and backfilling materials. Ninety-six freshly extracted human mandibular premolar teeth were selected. Twelve roots were used as the negative control group. Rotary files were used to complete the final irrigation and root canal preparation on the remaining teeth. Following that, burs were used to make standardized internal resorption chambers in the middle part of the roots. Twelve of these samples were used as positive control samples. The remaining 72 root canals were obturated in the apical 4 mm using a single-cone approach, and they were separated into 6 groups based on the CSCs used to fill voids and the materials used as backfilling. Group 1: Endocem MTA (resorption) + Endocem MTA (coronal), Group 2: Endocem MTA (resorption) + Gutta-percha/sealer (coronal), Group 3: Biodentine (resorption) + Biodentine (coronal), Group 4: Biodentine (resorption) + Gutta-percha/sealer (coronal), Group 5: NeoMTA Plus (resorption) + NeoMTA Plus (coronal), and Group 6: NeoMTA Plus (resorption) + Gutta-percha/sealer (coronal). Specimens were inserted in acrylic resin and then subjected to fracture testing. Fracture strength tests were performed using a Universal Testing Machine. The force was employed vertically with a consistent speed of 1 mm/minute. The results were analyzed with Variance and Bonferrini tests at P < 0.005. The mean force of fracture values were 447.00, 201.25, 318.75, 187.50, 596.58, 258.75, 347.50, and 298.75 N for Group 1, 2, 3, 4, 5, 6, 7, and 8, respectively. “There was a significant difference (P < 0.001) between the experimental groups and the control group”. Group 5 showed the highest FR as compared to other groups. Backfilling with CSCs appears to be a better material than a gutta-percha/sealer combination. Neo MTA plus furthermore appeared the highest fracture-resistant material, while Biodentine + Gutta percha/sealer showed the least FR.

The osteoinductive potential of different root-end filling materials in a rat femur model

In pediatric dentistry, the enduring success of root-end filling materials employed for the establishment of apical plugs in immature teeth undergoing endodontic intervention is contingent upon their possessing a robust osteoinductive capacity. Hence, the primary objective of this study was to histologically assess the osteoinductive potential of four distinct dental materials, specifically recommended for retrograde filling applications, utilizing an animal hard tissue model. Within the designed experimental model, two bone defects measuring 2 mm in diameter and 2 mm in depth were created in both femurs of a cohort comprising 21 male Wistar albino rats. The first defect in the right femur was left blank as the control group, and Neo MTA Plus was placed in the second defect. The EndoSequence BCRRM Fast Set Putty was placed in the first of the defects on the left femur, and Endo Repair was placed in the second defect. Subjects were sacrificed after 7, 14, and 28 days of follow-up, and sections were examined to assess the degree of inflammation, connective tissue formation, and new bone formation. The data were statistically evaluated with Kruskal‒Wallis and post hoc Dunn's tests using SPSS 12 software. The bone healing levels of the Neo MTA Plus group were significantly higher than those of the other groups in all periods (p < 0.05). Bone organization in all groups decreased over time, and fibrous tissue was enriched. The results of this study demonstrate that NeoMta Plus has superior osteoinductive properties compared to other materials but that EndoSequence and Endo Repair have the potential to be developed.

A paradigm shift from calcium hydroxide to bioceramics in direct pulp capping: A narrative review.

For many years, calcium hydroxide (CH) was the preferred material for direct pulp capping (DPC), occupying an elevated position. The collapse of this paradigm is due to the emergence of bioceramics with less pulpal inflammation and superior mineralization abilities than CH. The goal of the current article was directed to: (1) review the history of DPC "the idea of an exposed pulp as a hopeless organ has given way to one of healing and optimism," (2) classify the bioceramics in dentistry, and (3) explain and compare the mechanism by which dentin barriers for CH and bioceramics are formed. A comprehensive literature search of the database was conducted using PubMed, Google Scholar, and Scopus utilizing the following terms: Biodentine, calcium hydroxide, calcium aluminate, calcium phosphate, calcium silicate, direct pulp capping, NeoMTA Plus, Quick-Set2, and TotalFill. Reference mining of the selected publications was utilized to discover other studies and strengthen the results. Only works written in English were taken into consideration, and there were no restrictions on the year of publication. Bioceramic materials might be used as an intriguing substitute for CH. Compared to CH, they induced more positive pulpal reactions.

Bioactivity and pH of Nano-White MTA Versus NeoMTA(TM) Plus® and MTA Angelus® as Root Repair Materials: An “In Vitro” Study

Objective: This study compared the bioactivity and pH of Nano-white mineral trioxide aggregate (NWMTA), Neo-mineral trioxide aggregate plus (NeoMTA Plus), and Mineral trioxide aggregate angelus (MTA-A) as root repair materials. Methods: A total of 60 discs made from the three materials (20 discs each) were prepared accord ing to the manufacturer’s instructions. These discs were packed into plastic molds and allowed to set before testing. For bioactivity study, ten discs of each material were immersed in Hanks’ Balanced Salt Solution (HBSS) for 28 days, and analyzed with scanning electron microscope with energy dispersive X-ray (SEM/EDX). Ten discs of each material were used to assess the pH chang es by the pH meter at 3 h, 24 h, 72 h, and 168 h. All data were statistically analyzed. Results: After 28 days of immersing in HBSS, the crystals of Nano WMTA, NeoMTA Plus and MTA were covered with calcium phosphate precipitates with no statistically significant difference (P=0.908). The three tested materials induced alkalization of the deionized water after 3 h of immersion and started to decrease at 3 days continuing until the last test at 7 days. Conclusion: The Nano WMTA, NeoMTA Plus and MTA have similar bioactivity and strong alkalizing activity. Keywords: Apatite-forming ability, MTA angelus, Nano-White MTA, Neo-MTA plus, Root perforations

Interfacial adaptation of NeoMTA Plus, BioRoot RCS and MTA in root-end cavities: A micro-CT study.

This study aimed to use the micro-computed tomography to evaluate the interfacial adaptation and the presence of gaps of NeoMTA Plus, BioRoot RCS, and MTA in the root-end cavities. Thirty standardized bovine roots measuring 15 mm in length were selected. Chemical-mechanical preparation was performed up to instrument #80 and obturation with the cold lateral compaction technique with cement based on zinc oxide and eugenol. The roots were kept at 37°C for 7 days. Afterward, apicectomy of the apical 3 mm and a root-end filling cavity was performed at 3 mm depth. Micro-computed tomography (micro-CT) was performed to measure the volume of the retroactivity. The roots were divided by stratified randomization into three groups according to the retro-end filling material: NeoMTA Plus, BioRoot RCS, and MTA. A new micro-CT was performed to assess the presence of voids in the root-end filling material and between it and the canal wall. One-way ANOVA and Tukey tests were performed using the BioEstat 4.0 program. There was no difference in the initial volume values of the root-end cavities (p > .05). After the insertion of root-end filling materials, the most significant volumes of voids were observed in the NeoMTA Plus group (p < .05), with no difference for the BioRoot RCS and MTA Angelus groups (p > .05). Micro-computed tomography showed that MTA and BioRoot RCS have better interfacial adaptation and presented fewer number of gaps than NeoMTA Plus when used as root-end filling materials. Micro-computed tomography evaluation of different root-end fillings materials.

Histological evaluation of tissue reaction and new bone formation of different calcium silicate-based cements in rats.

The purpose of this study was to evaluate the local reactions and new bone formation of rat subcutaneous and bone tissue to different calcium silicate cements. In this study, 80 rats were divided into five groups as control, BIOfactor MTA (BIO), NeoMTA Plus (NEO), MTA Repair Hp (REP), Biodentine (DENT) and then into two subgroups according to sacrification times (7, 30 days; n = 8). Polyethylene tubes filled with appropriate materials (test groups); empty tubes (control group) were implanted into the dorsum of each rat subcutaneously. For intraosseous implantation, materials were placed in the cavities created in tibia of rats. Subcutaneous tissue and tibia samples were stained with haematoxylin-eosin and subjected to histopathological analysis. A score (0-3) was used to grade inflammatory reaction and new bone formation. Data were analysed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Inflammatory reaction observed in subcutaneous and intraosseous tissues for 7 days decreased significantly in all groups over time (P < 0.05). It was determined that there was significant increase in new bone formation in REP, BIO, DENT groups over time (P < 0.05). Four contemporary bioceramic materials induced local inflammation and tissues changes shortly after subcutaneous implantation, which were reduced over time. In ıntraosseous implantation, all materials induced new bone formation over time. ADJ-03-23-0134. © 2023 Australian Dental Association.

Prevention efficacy of dentin tubule sealing with Nd:YAG laser against tooth discoloration induced by vital pulp treatment.

The discoloration potential of dental materials and applications such as vital pulp therapy also cause discoloration due to the presence of blood. Dentin tubule sealing methods could be used for the prevention of discoloration. The purpose of this study was to evaluate the effect of sealing pulp chamber walls with Nd:YAG laser against discoloration caused by tricalcium silicate-based materials in the presence and absence of blood contamination. Eighty-one extracted human maxillary incisors were prepared and randomly divided into nine groups according to the Nd:YAG laser application, the cement to be used (NeoMTA Plus/Biodentine), and the presence or absence of blood. The color measurements were obtained with a spectrophotometer at baseline and then at the sixth (T1) and 12th (T2) months thereafter. Sealing with Nd:YAG laser and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). Similarly, without sealing the cavity and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). Regardless of sealing the dentin tubules with Nd:YAG laser, NeoMTA Plus and Biodentine caused more discoloration in the presence of blood contamination.

Systemic effect of calcium silicate-based cements with different radiopacifiers-histopathological analysis in rats.

This in vivo study aimed to examine the systemic effects of contemporary calcium silicate cements (CSC) contain different radiopacifiers in rats. Polyethylene tubes filled with BIOfactor MTA (BIO), Neo MTA Plus (NEO), MTA Repair HP (REP), Biodentine (DENT) and empty tubes (control group) were implanted into the subcutaneous tissues of 80 male Spraque Dawley rats for 7 and 30 days (n=8). After 7 and 30 day, samples of liver and kidney tissues were submitted to histopathological analysis. Blood samples were collected to evaluate changes in hepatic and renal functions of rats. Wilcoxon and post hoc Dunn Bonferroni tests were used to compare between the 7th and 30th days in order to evaluate the histopathological data. Paired-sample t-test was used to compare laboratory values between the 7th and 30th days, ANOVA analysis and a post hoc Tukey test were used to compare values between groups (p<0.05). On the 7th day, REP, BIO and NEO groups were statistically similar in kidney tissue and the degree of inflammation was found to be significantly higher in these groups compared to the control and DENT groups. On the 30th day, the degree of inflammation of the REP and NEO groups in the kidney tissue was found to be significantly higher than the control, BIO and DENT groups. Although the inflammation in the liver was moderate and mild on the 7th and 30th days, no statistically significant difference was observed between the groups. Vascular congestion was evaluated as mild and moderate in kidney and liver in all groups, and no statistically significant difference was observed between the groups. While there was no statistically significant difference between the groups in the 7th day AST, ALT and urea values, when the creatinine values were compared, the DENT and NEO groups were found to be statistically similar and significantly lower than the control group. On the 30th day, ALT values were statistically similar between the groups. The AST values of the BIO group were found to be significantly higher than the DENT group. While BIO, DENT, NEO and control groups had statistically similar urea values, the REP group was found to be significantly higher than the other groups. The creatinine value of the REP group was significantly higher than the groups other than the control group (p<0.05). CSCs with different radiopacifiers had similar and acceptable effects on the histological examination of the kidneys and liver systemically, and serum ALT, AST, urea, creatinine levels.

Outcome of Regenerative Endodontic Procedures in Nonvital Immature Permanent Teeth Using 2 Intracanal Medications: A Prospective Randomized Clinical Study

IntroductionThis randomized clinical trial aimed to assess and compare the long-term clinical and radiographic outcomes of regenerative endodontic procedures (REPs) in treating nonvital immature permanent teeth using 2 intracanal medicaments. MethodsForty-five patients yielding a total of 50 anterior and posterior nonvital immature teeth were randomly divided into 2 groups. REPs using either nonsetting calcium hydroxide (Ca[OH]2) (n = 25) or modified triple antibiotic paste (TAP) (n = 25) as intracanal medicaments were performed. NeoMTA Plus (Avalon Biomed Inc) was applied for coronal sealing. Cases were followed up clinically and radiographically for 36 months. The survival rate, success rate, and clinical outcome measures were analyzed. Preoperative and recall radiographs were evaluated for dimensional changes in root length, dentin thickness, apical diameter, and periapical radiolucency. ResultsAt the 36-month follow-up, the success and survival rates were 81.6% and 100%, respectively, in which 79.4% of cases showed complete resolution of periapical radiolucency with no significant difference between the nonsetting Ca(OH)2 and modified TAP groups (P > .050). The cumulative changes in root length, root dentin thickness, and apical diameter throughout the study period were observed in 47.9%, 77.1%, and 89.6% of cases, respectively, with no significant differences between groups (P ≥ .39). Intracanal calcifications were detected in 60% of cases with no significant difference between groups (P = .77). ConclusionsREPs, using either nonsetting Ca(OH)2 or modified TAP as the intracanal medicament, exhibited high success and survival rates over a follow-up period of 36 months with equally favorable clinical and radiographic outcome data.

Dental and composite resin discoloration induced by different hydraulic calcium silicate-based cements: two-year in vitro assessment.

Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.

Biocompatibility and mineralization potential of new calcium silicate cements

Background/purposeAs calcium silicate cements (CSCs) have been successfully used in various types of vital pulp therapy, many new CSC products have been developed. The aim of this study was to evaluate the biocompatibilities and mineralization potential of new CSC. The experimental materials were NeoMTA Plus and EndoSequence Root Repair Material-Fast Set Putty (ERRM-FS) which were compared to ProRoot MTA. Materials and methodsIn vitro, the effects of the new CSC on stem cells were evaluated. Each CSC was prepared for cell viability testing, alkaline phosphatase (ALP) assay, and calcium ion release assay. In vivo, the exposed pulp model was used for the partial pulpotomy procedure. Thirty-six teeth were treated with three materials: ProRoot MTA, NeoMTA Plus, or ERRM-FS. After four weeks, the teeth were extracted and processed for histologic analysis. Dentin bridge formation, pulp inflammation, and odontoblastic cell layer were evaluated and the area of newly formed calcific barrier of each group was measured. ResultsThree CSCs demonstrated similar cell viability on stem cells and the levels of ALP and calcium release were not significantly different between tested materials. ProRoot MTA and ERRM-FS showed better tissue healing process than NeoMTA Plus after partial pulpotomy, in terms of quality of calcific barrier and pulp inflammation. The outcomes from measuring newly formed calcific area demonstrated no significant differences between the materials. ConclusionNeoMTA Plus and ERRM-FS displayed similar biocompatibilities and mineralization potential compared to ProRoot MTA. Therefore, these new CSCs can be used as desirable alternatives to ProRoot MTA.

Effect of Additional Apical Preparation on Retreatment of Curved Root Canals Filled with Different Sealers.

This study assessed the influence of additional apical preparation on material removal during retreatment of curved root canals filled with different sealers. Twelve mesial roots of mandibular molars with two separate canals and curvature between 25 and 35 degrees were selected. The working length was established 1-mm short of the apical foramen, and all the root canals were prepared using ProDesign R (PDR) 25/0.06. After preparation, the root canals were divided in two groups (n = 12) and filled by continuous wave condensation technique with NeoMTA Plus or AH Plus. All the root canals were retreated using rotary ProDesign Logic RT 25/0.08, reciprocating PDR 25/0.06 and apical preparation with PDR 35/0.05. Additional apical preparation was performed with ProDesign Logic (PDL) 50/0.01. The samples were scanned using a Skycan 1176 micro-computed tomography (micro-CT), voxel size 8.74 µm, before and after the retreatment procedures. Percentages of remaining filling material were evaluated. The data were submitted to paired and unpaired t-tests (α = 0.05). Percentage of remaining filling material was similar between the root canals filled with NeoMTA Plus or AH Plus sealer after retreatment using PDR 35/0.05, and after additional apical preparation using PDL 50/0.01 (p > 0.05). However, PDL 50/0.01 significantly decreased the percentage of remaining filling material in the apical third after the additional apical preparation for both sealers (p < 0.05). NeoMTA Plus or AH Plus did not influence the retreatment of curved root canals. ProDesign Logic 50/0.01 promoted greater filling material removal in the apical third.

Comparative cytocompatibility of the new calcium silicate-based cement NeoPutty versus NeoMTA Plus and MTA on human dental pulp cells: an in vitro study

ObjectivesThe aim of the present in vitro study is to determine the cytocompatibility of the recently introduced NeoPutty in contact with human dental pulp cells compared with its precursor NeoMTA Plus and the classic gold standard MTA Angelus.Materials and methodsSample disks were obtained for each of the tested materials (5 mm diameter; 2 mm thickness; n = 30), along with 1:1, 1:2, and 1:4 material eluents. HDPCs were extracted and cultured with the tested materials (test groups) or in unconditioned medium (control group), and the following biocompatibility assays were performed: MTT assay, scratch wound assay, cell cytoskeleton staining assays, and cell attachment assessment via SEM. Additionally, material ion release and surface element composition were evaluated via ICP-MS and SEM–EDX, respectively. Each experimental condition was carried out three times and assessed in three independent experiments. Statistical significance was established at p < 0.05.Results1:2 dilutions of all the tested materials exhibited a comparable cell viability to that of the control group at 48 and 72 h of culture (p < 0.05). The same was observed for 1:4 dilutions of the tested materials at 24, 48, and 72 h of culture (p > 0.05). All the tested materials exhibited adequate cytocompatibility in the remaining biocompatibility assays. MTA exhibited a significantly higher calcium ion release compared to NeoPutty and NeoMTA Plus (p < 0.05).ConclusionThe results from the present work elucidate the adequate cytocompatibility of NeoPutty, NeoMTA Plus, and MTA Angelus towards human dental pulp cells.Clinical relevanceWithin the limitations of the present in vitro study, our results may act as preliminary evidence for its use in vital pulp therapy as a pulp capper. However, results need to be interpreted with caution until further clinical supporting evidence is reported.

Influence of acidic pH on antimicrobial activity of different calcium silicate based-endodontic sealers.

To investigate the antibacterial activity of calcium silicate-based sealers (CSBSs) against Enterococcus faecalis biofilm in a neutral or acidic condition. Dentin cylinders (4 mm length) were prepared and infected with 3-week-old E. faecalis. The samples were filled with BioRoot RCS (BR), EndoSequence BC (ES), and NeoMTA Plus (NMTA) and incubated in either neutral or acidic conditions for 7 days (n=10/group). Sterile or infected samples alone were used as the positive and negative control. The root canal sealers were removed after 7 days, and the remaining bacteria on dentinal walls were determined by colony-forming units (CFUs/ml), and three samples from each group were visualized under a confocal laser scanning microscope (CLSM). The pH was also measured (n=3/group) after 4 h and 7 days of incubation at 37°C in both conditions. In the neutral condition, all sealers significantly decreased the log-CFU values (p<0.05), while in the acidic condition, the log-CFU reduction was less for ES and NMTA, but a higher reduction was observed in BR (p<0.05). The antibacterial activity of CSBSs was similar in neutral conditions (p>0.05), and BR showed a greater antibacterial effect than ES andNMTA in the acidic condition (p<0.05). The pH of BR, ES, and NMTA ranged from 8.2 to 8.8 in the neutral condition in the presence of dentin after 7 days. However, acidic conditions reduced the pH values to 7.8 for BR, 6.0 for ES, and 5.8 for NMTA. All CSBSs showed similar antibacterial activity in neutral conditions, while acidic pH had a reducing antibacterial effect on CSBSs. Inflammatory pH decreased the antibacterial properties of CSBSs depending on the sealer type.

Effects of calcium silicate-based cements on odonto/osteogenic differentiation potential in mesenchymal stem cells.

The objective of this study was to evaluate the biological effects and odonto/osteogenic differentiation potential of Biodentine, NeoMTA Plus and TheraCal LC in tooth germ-derived stem cells (TGSCs). TGSCs were exposed to the material extracts. Biocompatibility was tested with MTS cell proliferation assay. Odonto/osteogenic differentiation was assessed with alkaline phosphatase (ALP) activity and mRNA gene expressions (RUNX2, DSPP and DMP-1). Scanning electronic microscopy/energy-dispersive X-ray (SEM/EDX) analysis and pH analysis were also performed for the materials. Data were evaluated using the one-way ANOVA and Tukey's tests. TGSCs remained viable after 7days of incubation with all tested materials. Biodentine and NeoMTA Plus showed high ALP activity and increased expression of RUNX2, DSPP and DMP-1 compared to that of TheraCal LC. All materials can induce odonto/osteogenic differentiation of MSCs in various levels. Biocompatibility and odonto/osteogenic differentiation potential of Biodentine and NeoMTA Plus are similar and superior to that of TheraCal LC.

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.

Effect of Chelating Agents on Push-Out Bond Strength of NeoMTA Plus to Root Canal Dentin

Objective To evaluate and compare the effect of 17% Ethylenediaminetetraacetic Acid (EDTA), 9% Etidronic acid (HEDP), and 7% Maleic acid (MA) on the push-out bond strength of NeoMTA Plus sealer to the coronal, middle, and apical thirds of root canal dentin. Material and Methods Forty single-rooted human maxillary central incisors were selected and decoronated to 12 mm long root fragments. Working length was established and root canals were then enlarged up to rotary Protaper F3. After each instrumentation, the root canal was irrigated with 2.5% NaOCl. For the final irrigation regimen, the specimens were divided into 4 groups (n=10) and treated with EDTA, HEDP, MA or Saline. Root canals were coated with NeoMTA Plus sealer, and obturation was done with single cone obturation technique. Subsequently, three horizontal sections were taken from the coronal, middle and apical thirds of each specimen, and POBS was measured using a universal testing machine. The type of bond failures was assessed under a stereomicroscope. Statistical analysis was done with One-way ANOVA with Tukey’s Post hoc analysis. Results MA and EDTA showed the highest POBS. There was no significant difference in bond strength between MA and EDTA (p>0.05). HEDP and Saline showed lower POBS. Among all the four groups, the coronal third showed the highest values, followed by middle and apical thirds. Conclusion The type of chelating agent used during the root canal treatment significantly affects the bond strength of NeoMTA Plus to the root canal dentin.

Hydration reaction analysis of calcium-silicatebased materials using scanning electron microscopy and X-ray diffraction method

Background/Aim: The components of calcium silicate-based materials can be identified through X-Ray Diffraction Analysis. This study aimed to determine the hydration reactions and particle size of MTA Angelus, Biodentine, and NeoMTA Plus as calcium-silicate-based materials. Material and Methods: The powder and set cement samples using divergence and scatter slits of 1○ and a receiver slit of 0.10 mm. The scanning range was set at 5○ to 70○, and ongoing scans for the theta-2theta range was performed with a scan speed of 2○/minute (-1). The patterns obtained were analyzed using search-match software. The three most substantial peaks were used to identify hydration reactions and major crystalline structures. Also, Scanning Electron Microscope (SEM) analysis was performed and the particle size of set materials were determined using an image analysis software. Results: According to X-Ray Diffraction Analysis, the main components were determined as tricalcium silicate and dicalcium silicate in the three calcium silicate-based materials. We determined that the main components of the materials were similar. We also identified the extensive presence of tricalcium aluminate in MTA Angelus, calcium carbonate in Biodentine, and calcium phosphate salts in NeoMTA Plus. Furthermore, the results of the present particle analysis show that the calcium-silicate-based materials' distribution of particle count and size varies. Biodentine has the widest, and MTA Angelus has the narrowest particle size distribution range. NeoMTA Plus has the largest number of fine, large-sized particles (p &lt; 0.0001), while MTA Angelus and Biodentine have a more homogeneous and nonstatistically significant particle distribution range (p &gt; 0.05). Conclusions: The present findings provide insight into variations in performance between different calcium-silicate-based materials.

Hydration reaction analysis of calcium-silicatebased materials using scanning electron microscopy and X-ray diffraction method

Background/Aim: The components of calcium silicate-based materials can be identified through X-Ray Diffraction Analysis. This study aimed to determine the hydration reactions and particle size of MTA Angelus, Biodentine, and NeoMTA Plus as calcium-silicate-based materials. Material and Methods: The powder and set cement samples using divergence and scatter slits of 1○ and a receiver slit of 0.10 mm. The scanning range was set at 5○ to 70○, and ongoing scans for the theta-2theta range was performed with a scan speed of 2○/minute (-1). The patterns obtained were analyzed using search-match software. The three most substantial peaks were used to identify hydration reactions and major crystalline structures. Also, Scanning Electron Microscope (SEM) analysis was performed and the particle size of set materials were determined using an image analysis software. Results: According to X-Ray Diffraction Analysis, the main components were determined as tricalcium silicate and dicalcium silicate in the three calcium silicate-based materials. We determined that the main components of the materials were similar. We also identified the extensive presence of tricalcium aluminate in MTA Angelus, calcium carbonate in Biodentine, and calcium phosphate salts in NeoMTA Plus. Furthermore, the results of the present particle analysis show that the calcium-silicate-based materials' distribution of particle count and size varies. Biodentine has the widest, and MTA Angelus has the narrowest particle size distribution range. NeoMTA Plus has the largest number of fine, large-sized particles (p &lt; 0.0001), while MTA Angelus and Biodentine have a more homogeneous and nonstatistically significant particle distribution range (p &gt; 0.05). Conclusions: The present findings provide insight into variations in performance between different calcium-silicate-based materials.

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.