ProRoot MTA Research Articles

In Vivo and In Vitro Response to a Regenerative Dental Scaffold

As dental pulp contains the stem cells necessary for regeneration, the tooth should hold the intrinsic capacity for self-repair. A triphasic hybrid dental biocomposite (3HB) composed of biocompatible biopolymers to provide strength, antibacterial properties and protein-based cell support could provide a conducive microenvironment for the regeneration of dental structures. 3HB was incorporated into Mineral Trioxide Aggregate (ProRoot MTA) to construct a malleable injectable implant. Human tooth pulp cells (hDPCs) significantly increased proliferation in the presence of 3HB+MTA compared to 3HB or MTA alone. Cell viability decreased with MTA alone but increased with 3HB and 3HB+MTA. 3HB+MTA was implanted into the residual tooth of drilled Wistar rat M2 molars for up to 45 days. Stereological analysis from micro-CT images showed the volume of the tooth remaining. Histologically, regenerative pulpal architecture was seen invading 3HB. A continuous odontoblastic profile lined a deposit of dentin-like material suggesting reparative dentinogenesis. Overall, no infection or encapsulation was seen. Immunohistochemically, odontoblasts were seen along the margins of the wounded tooth undergoing repair. Mesenchymal cells (MSCs) were seen at the base of the drilled tooth and by 21 days had translocated into the implant itself. Cells stimulating remineralization were highly expressed in the tooth undergoing repair. CD146-positive MSCs were seen in the center of the implant, possibly stimulating remineralization. In conclusion, behavior of 3HB+ in vitro and in vivo provided a promising start as 3HB+MTA may serve as a viable regenerative scaffold for pulp regeneration; however, this should be further studied before clinical use can be considered.

Clinical management of mandibular permanent premolars with periapical lesion and bilateral supernumerary teeth: A 7-years follow-up case report

Objectifs: This 7-years follow-up case report describes two diversified strategies for the management of bilateral mandibular permanent premolars associated with periapical lesion and unerupted supernumerary teeth. Case Report: A non-syndromic 9 years-old Asian female patient presented pain and swelling of the 35 in anatomical contiguity with an immature and unerupted supernumerary tooth. Clinical examination revealed an intraoral vestibular sinus tract related to the necrotic 35. Periapical radiography and CBCT showed that the 35 had an immature apex associated with a periapical lesion, and a supernumerary tooth in a lingual direction. Endodontic treatment of the 35 was performed by creating an apical plug with ProRoot MTA, while the supernumerary tooth was monitored radiographically with no intervention. Four years later, the 45 developed the same clinical condition of the left arch. Radiographic examination revealed a periapical lesion with massive periapical bone resorption, and a supernumerary tooth in normal alignment. The second premolar was herein extracted to allow for eruption of the supernumerary tooth. Outcomes: 3-years follow-up revealed continued root maturation and its spontaneous eruption in the dental arch. Proper healing of both mandibular lesions was monitored after 10 months, 3-years and 7-years revealing no recurrence on both sides.

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

Objective This study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) on ProRoot mineral trioxide aggregate (MTA) used for treating furcal perforations, compared to no solution application, using the dye penetration (DP) method. Materials and methods The study included 36 intact mandibular molars in the furcal area (FA) with well-spaced roots. Using dental operating microscopes, perforations were created at the FA of the molars with a 1.2 mm diameter. Subsequently, ProRoot MTA (Dentsply, Germany) was applied to seal the perforations. After 24 hours, the samples were randomly assigned to three groups: Group A (n = 12), irrigated with 5.25% NaOCl; Group B (n = 12), irrigated with 2% CHX; and Group C (n = 12), without irrigation (control group). Specimens' pulp chambers were immersed in 2% methylene blue for 24 hours. Buccal-lingual sections were performed, and the depth of marginal dye leakage was assessed using a stereomicroscope at 20x magnification. Data analysis employed the one-way analysis of variance (ANOVA) test and Bonferroni post-hoc test (α = 0.05). Results The study revealed significant differences in DP values between groups (p-value < 0.01). DP values in the control group (no irrigation) were lower than both NaOCl (p < 0.05) and CHX (p < 0.01) groups. Furthermore, DP values in the CHX group were higher than those in the NaOCl group (p < 0.01), suggesting the order: no irrigation < NaOCl < CHX (p < 0.05). Conclusions The sealing ability of MTA was compromised when irrigated with 2% CHX and 5.25% NaOCl. CHX significantly impacted the marginal leakage and sealing ability of MTA. Care should be taken when resuming endodontic treatment after the application of MTA in cases of furcal perforations as the use of CHX and NaOCl may affect the marginal leakage of MTA.

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.

Evaluation and comparison of four types of bio-ceramic materials AGM MTA, Ortho MTA, pro root MTA and Cem cement in oral and dental health

Background and objectivesMineral Trioxide Aggregate (MTA) is one of the main retrograde filling materials that is used today as a root end filling material and perforation repair material. This study was conducted with the aim of investigating the antibacterial and antifungal properties of four types of bio-ceramic materials, AGM MTA, Ortho MTA, Pro root MTA and Cem cement for oral and dental health.MethodsIn this study, the antibacterial activity of four types of bio-ceramic materials against two bacterial strains of Enterococcus faecalis (ATTC 29212), Escherichia coli (ATTC 35318) and antifungal activity against Candida albicans (ATTC 10231) were investigated using the well diffusion method.ResultsIn the context of the relationship between the type of microorganism and the diameter of the growth inhibitory zone for each type of bio-ceramic material, there was no significant difference for Enterococcus faecalis, and a significant difference was observed for Escherichia coli and Candida albicans (p < 0.05).ConclusionThe results show that each of the bio-ceramic materials AGM, Pro root, Cem cement and Ortho have antibacterial and antifungal properties. AGM MTA bio-ceramic material on Candida albicans fungus and Ortho MTA bio-ceramic material had the most effect on Escherichia coli bacteria. Therefore, the mentioned bio-ceramic materials can play a significant role in oral and dental health by providing a suitable material for restoration.

The comparative evaluation of cell viability, inflammatory response, and antimicrobial activity of calcium hydroxide-bovine dentin grain

Abstract Objectives Dentin tissue can act as a reservoir for bioactive molecules that create signals for cellular proliferation and differentiation to initiate tissue regeneration. Therefore, the aim of this study is to compare the cell viability, inflammatory response, and antimicrobial activity of bovine dentin grain-added calcium-hydroxide (CH-BDG) with different pulp-capping materials. Methods ProRoot MTA, Biodentine, Dycal, TheraCal-LC, and an experimental material, CH-BDG, were examined. Cell viability was determined via the WST-1 assay. The inflammatory response was analysed by the monocyte chemoattractant protein-1 (MCP-1/CCL2) and macrophage inflammatory protein-1α (MIP-1α/CCL3) levels. The antimicrobial activity was evaluated by agar-diffusion. Results The cell viability of CH-BDG was analogous with Biodentine and control at 24 h. The cell viability of CH-BDG decreased at 48 h, but the rate was higher than ProRoot MTA and Dycal (p&lt;0.05). For MCP-1 and MIP-1α values, there was no significant difference between the control and CH-BDG. The MCP-1 level of CH-BDG was lower compared to other pulp-capping materials (p&lt;0.05). The MIP-1α level of CH-BDG was lower compared to ProRoot MTA, Biodentine, and TheraCal-LC (p&lt;0.05). No inhibition zone was detected against oral microorganisms for CH-BDG. Conclusions The experimentally developed CH-BDG showed competing properties and additional advantages compared to the existing pulp-capping materials.

Evaluation of peroxide release during nonvital bleaching using three different coronal barriers: An in vitro study.

Peroxide from bleaching agents can cause external cervical resorption. An intracoronal barrier is used to prevent leakage of bleaching agents into the periradicular space. This study aims to determine and compare the amount of peroxide released, during non vital bleaching at the end of 1st and 3rd day using Glass ionomer cement (GIC), Mineral Trioxide aggregate (ProRoot MTA) and Biodentine as intracoronal barriers. Forty-five single-rooted teeth were selected for the study and root canal therapy was performed. Three millimeters of the coronal gutta-percha were removed and according to the coronal barrier placed, samples were divided into Group A: GIC, Group B: ProRoot MTA, and Group C: Biodentine. Nonvital bleaching was done using sodium perborate and 30% H2O2. Peroxide released at the end of the 1st and 3rd day was analyzed using potassium iodide and ultraviolet spectrophotometer. This was done using the Wilcoxon matched pair test and the Kruskal-Wallis test. No significant difference in intergroup comparison at the end of 1st and 3rd day, respectively (P > 0.05), a significant difference was found in the MTA group at follow-up dates (P < 0.05). All the three tested materials (GIC, MTA, and Biodentine) may be preferred as intracoronal barrier for nonvital bleaching.

Effects of Three Retrograde Filling Materials on Production of Inflammatory Cytokines and Resorbing Mediators

: Root-end filling materials are typically used following endodontic surgeries, and due to their different chemical compositions, they have varying effects on the survival and differentiation of tissues around the root apex. The purpose of this in vitro study was to evaluate the effects of three retrograde filling materials—ProRoot MTA, Super ethoxy benzoic acid (EBA), and Geristore—on the production of pro-inflammatory and resorptive cytokines (RANK, RANK-L, OPG, IL-1β, and TNF-α). After mixing and setting, the experimental materials were exposed to UV rays and then applied to the prepared cells. This study used osteoblast (MG-63) and THP-1 monocyte cell lines, as well as peripheral blood monocytes (PBM). The evaluation times for RANK-L and OPG were 24 and 48 hours, while IL-1β and tumor necrosis factor (TNF-α) were evaluated at 24 hours. The RANK levels were measured using flow cytometry, and monocyte survival was assessed at different times using the MTT assay. The results were analyzed using Minitab statistical software, which indicated that the type of material significantly affected cytokine production. Exposure of monocytes to EBA resulted in a decrease in TNF-α and IL-1β secretion compared to the other groups. However, in the THP-1 cell line, there was no significant difference in the release of pro-inflammatory cytokines between the groups. Conversely, Geristore induced the highest level of RANK-L and the lowest level of OPG in cultures with the MG-63 cell line. According to the MTT assay, the viability order of the materials from early to late was Geristore &lt; EBA &lt; MTA.

Calcium Silicate-Based Cements in Restorative Dentistry: Vital Pulp Therapy Clinical, Radiographic, and Histological Outcomes on Deciduous and Permanent Dentition-A Systematic Review and Meta-Analysis.

Vital pulp therapy aims to preserve the vitality of dental pulp exposed due to caries, trauma, or restorative procedures. The aim of the present review was to evaluate the clinical, radiographic, and histological outcomes of different calcium silicate-based cements used in vital pulp therapy for both primary and permanent teeth. The review included 40 randomized controlled trials from a search across PubMed, LILACS, and the Cochrane Collaboration, as well as manual searches and author inquiries according to specific inclusion and exclusion criteria. A critical assessment of studies was conducted, and after data extraction the results were submitted to a quantitative statistical analysis using meta-analysis. The studies, involving 1701 patients and 3168 teeth, compared a total of 18 different calcium silicate-based cements in both dentitions. The qualitative synthesis showed no significant differences in short-term outcomes (up to 6 months) between different calcium silicate-based cements in primary teeth. ProRoot MTA and Biodentine showed similar clinical and radiographic success rates at 6 and 12 months. In permanent teeth, although the global results appeared to be well balanced, ProRoot MTA generally seemed to perform better than other calcium silicate-based cements except for Biodentine, which had comparable or superior results at 6 months. Meta-analyses for selected comparisons showed no significant differences in clinical and radiographic outcomes between ProRoot MTA and Biodentine over follow-up periods. The present review highlights the need for standardized definitions of success and follow-up periods in future studies to better guide clinical decisions. Despite the introduction of new calcium silicate-based cements aiming to address limitations of the original MTA. ProRoot MTA and Biodentine remain the most used and reliable materials for vital pulp therapy, although the results did not deviate that much from the other calcium silicate-based cements. Further long-term studies are required to establish the optimal CSC for each clinical scenario in both dentitions.

Effect of four direct pulp capping agents on human dental pulp tissue.

Direct pulp capping (DPC) is a vital pulp therapy, wherein accidental or carious pulp exposures can be capped with various materials to induce reparative dentine formation. One of the major factors that determine the success of direct pulp capping procedures is the material used. Therefore, it is of interest to evaluate and compare the efficacy of a new material, Tristrontium aluminate in comparison with the widely used materials such as ProRoot MTA, Biodentine & TheraCal LC. Hence, 40 premolars scheduled for extraction for orthodontic treatment, were equally divided into 4 groups and iatrogenic DPC was done using one of the study materials. The premolars were then extracted after 90 days & assessed for the formation of Dentine Bridge and pulpal response elicited by the materials using CBCT and histopathological analysis. All the materials tested in the study were successful in inducing dentine bridge formation & maintaining pulp vitality. Thus, the novelty of Tristrontium aluminate for potential applications in future is eminent.

Evaluation of baghdadite (Ca3ZrSi2O9) cements for the application as novel endodontic filling materials

ObjectivesBaghdadite (Ca3ZrSi2O9) cements of various composition have been investigated in this study regarding an application as endodontic filling materials. MethodsCements were either obtained by mixing mechanically activated baghdadite powder with water (maBag) or by subsequently substituting the ß-tricalcium phosphate (ß-TCP) component in a brushite forming calcium phosphate cement. The cements were analyzed for their mechanical performance, injectability, radiopacity, phase composition and antimicrobial properties. ResultsThe cements demonstrated sufficient mechanical performance with a compressive strength of ∼1 MPa (maBag) and 2.3 – 17.4 MPa (substituted calcium phosphate cement), good injectability > 80 % depending on the powder to liquid ratio and an intrinsic radiopacity of 1.13 – 2.05 mm aluminum equivalent. Immersion in artificial saliva proved their bioactivity by the formation of calcium phosphate and calcium silicate precipitates on the cement surface. The bacterial activity of Staphylococcus aureus cultured on the surface of the cements was found to be similar compared to clinical standard ProRoot MTA cement or even reduced by a factor of 3 for Streptococcus mutans. SignificanceIn combination with their antibacterial properties, baghdadite cements are thought to have the potential to fulfil the clinical requirements for endodontic filling materials.

Effect of Blood Contamination on Vickers Microhardness and Surface Morphology of Mineral Trioxide Aggregate

This study aimed to investigate the effects of blood contamination on the Vickers hardness and the surface morphology of premixed MTA and compare them with the effects on conventional MTA. The Vickers microhardness of Endocem MTA Premixed Regular (EP) and ProRoot MTA (PM) was assessed after immersion in fetal bovine serum (FBS) and saline. Stem cells from human exfoliated deciduous teeth (SHED) were seeded on MTA after immersion in FBS, saline, and deionized water (DW). Cell adhesion patterns and surface morphology were visualized via scanning electron microscopy (SEM). The surface microhardness of EP and PM in FBS was lower than in saline. However, short-term exposure of PM to FBS did not reduce the microhardness compared to saline. Angular crystals formed in water, while rounded crystals with more air voids appeared in FBS. Favorable SHED attachment occurred in all groups. Overall, the surface hardness of EP and PM decreased after FBS exposure, although PM was less influenced. We suggest minimizing the amount of bleeding when using MTA clinically; nevertheless, PM remains an option with more expected blood contamination than EP. In summary, exposure to FBS decreased mechanical performance but allowed cell adhesion for both MTAs, with PM being more resistant to these changes.

Leaching and cytotoxicity of bismuth oxide in ProRoot MTA - A laboratory investigation.

The present study examined the leaching and cytotoxicity of bismuth from ProRoot MTA and aimed to identify whether bismuth leaching was affected by the cement base and the immersion regime used. The leaching profile of bismuth was examined from ProRoot MTA and compared with hydroxyapatite containing 20% bismuth oxide as well as hydroxyapatite and tricalcium silicate to investigate whether bismuth release changed depending on the cement base. Bismuth leaching was determined after 30 and 180 days of ageing immersed in Dulbecco's modified Eagle's medium (DMEM) using mass spectroscopy (ICP-MS). The media were either unchanged or regularly replenished. The pH, surface microstructure and phase changes of aged materials were assessed. Wistar rat femoral bone marrow stromal cells (BMSCs) and cutaneous fibroblasts were isolated, cultured and seeded for cell counting (trypan blue live/dead) after exposure to non-aged, 30- and 180-days-aged samples in regularly replenished DMEM. Aged DMEM in contact with materials was also used to culture BMSCs to investigate the effect of material leachates on the cells. Gene expression analysis was also carried out after direct exposure of cells to non-aged materials. Differences between groups were statistically tested at a significance level of 5%. All materials exhibited alterations after immersion in DMEM and this increased with longer exposure times. The bismuth leached from ProRoot MTA as detected by ICP-MS. Aged ProRoot MTA samples exhibited a black discolouration and surface calcium carbonate deposition. ProRoot MTA influenced cell counts after direct exposure and its 180-days leachates reduced BMSC viability. After direct BMSC contact with non-aged ProRoot MTA an upregulation of metallothionein (MT1 and MT2A) expression and down-regulation of collagen-1a (Col-1a) and bone sialoprotein (BSP) expression was identified. Bismuth leaching was observed throughout 180-days observation period from all materials containing bismuth oxide. This negatively influenced cell viability and gene expression associated with bismuth exposure. This is the first study to report that metallothionein gene expression was influenced by exposure to ProRoot MTA.

A Study on Nanoleakage of Apical Retrograde Filling of Premixed Calcium Silicate-Based Cement Using a Lid Technique.

This study aimed to compare the nanoleakage of retrograde fillings with premixed calcium silicate-based putty and mineral trioxide aggregate (MTA), using two different techniques (traditional and Lid). Sixty-four extracted human teeth were decoronated, then root canals and ends were instrumented for retrograde filling and divided into four groups according to the retrograde filling technique: the traditional and the Lid technique. Each group (n = 15) was filled with Ceraseal + Well-Root putty, Well-Root putty, Ceraseal + ProRoot MTA, and ProRoot MTA. The nanoleakage was evaluated using the Nanoflow device (IB Systems) on days 1, 3, 7, 15 and 30. Data were collected twice per second at the nanoscale (nL/s) and calculated after archiving the stabilization of fluid flow. The Kruskal-Wallis and Mann-Whitney U-tests were used for statistical analysis. All groups showed enhanced sealing ability over time. Regardless of filling materials, the Well-Root putty, Ceraseal+Well-Root putty, and Ceraseal+ProRoot MTA groups indicated less nanoleakage than the ProRoot MTA group in the first week of evaluation (p < 0.05). Although all groups did not show significant differences after 2 weeks, the Ceraseal+ProRoot MTA group leaked less than ProRoot MTA on Days 3 and 7 (p < 0.05). The scanning electron microscopic examined good adaptation to the cavity wall, which was similar to nanoleakage results. Premixed calcium silicate-based putty retrograde filling material alone and using the "lid technique" were shown to be faster and less prone to nanoleakage when compared to MTA.

Fracture Resistance of Simulated Immature Teeth Filled with Three Types of Calcium Silicate Cement after Intracanal Medication with Ca(OH)2: An Ex Vivo Study.

The aim of this study was to evaluate the 1-day fracture resistance of simulated immature teeth with an apical plug with ProRoot MTA, MTA Angelus, and RetroMTA after calcium hydroxide intracanal medication. Sixty extracted, single-rooted human mandibular premolars were randomly divided into six groups of 10 teeth each. Firstly, to standardize the 9 mm root length, the crowns were cut off at and 9 mm below the cementoenamel junction transversely. Simulations for immature apices were carried out by using No. 1-6 Peeso reamers to pass through the apex to obtain a diameter of 1.7 mm at the apical opening. One group served as a negative control without any treatment, while the other groups received 30 days of calcium hydroxide intracanal medication. Four groups were plugs with 4 mm of ProRoot MTA, MTA Angelus, RetroMTA, and gutta-percha, respectively. The last one was served as a positive control group without filling inside. After 1 day of incubation, specimens were vertically loaded in a universal testing machine at a crosshead speed of 1 mm/min until fracture occurred. The peak load to fracture (Newton) and fracture pattern were recorded. A one-way analysis of variance (ANOVA) followed by Tukey's HSD test was used for data analysis. The highest mean load to fracture was shown in the negative control group (543.33 ± 37.17 N), followed by ProRoot MTA (432.82 ± 68.06 N), MTA Angelus (396.92 ± 59.93 N), RetroMTA (389.08 ± 56.25 N), and gutta-percha (283.28 ± 43.40 N), and the lowest belonged to the positive control group (239.98 ± 27.19 N). The significant differences were found between both the control and experimental groups with an apical plug with calcium silicate cement (p < 0.05). There were no significant differences among those three apical plugs (p > 0.05). Apical plugs with ProRoot MTA, MTA Angelus, and RetroMTA had an immediate strengthening effect on simulated immature teeth after calcium hydroxide intracanal medication had been used.

Antibacterial, biocompatible, and mineralization-inducing properties of calcium silicate-based cements.

Different pulp capping materials have different origins and compositions, require different preparations, and may vary in their bioactive properties. The purpose of this study was to evaluate the antibacterial activity, biocompatibility, and mineralization-inducing potential of calcium silicate-based pulp capping materials. Six contemporary calcium silicate-based cements, ProRoot MTA, MTA Angelus, Biodentine, EndoSequence, NeoMTA 2, and NeoPutty, were evaluated. The antibacterial effects of these materials against Streptococcus mutans UA159 and Enterococcus faecalis ATCC 29212 were determined by the agar diffusion assay and the direct culture test. The biocompatibility and mineralization-inducing potential of these materials in preodontoblastic 17IIA11 cells were evaluated by the MTT assay and by Alizarin Red S staining, respectively. In agar diffusion test, only Biodentine showed distinct antibacterial effects against S. mutans. All the tested materials, however, showed antibacterial effects against S. mutans and E. faecalis in the direct culture test, with Biodentine showing the strongest growth inhibition against both S. mutans and E. faecalis. All the tested materials showed acceptable biocompatibility and mineralization-supporting potential in our experimental conditions. In summary, ProRoot MTA, MTA Angelus, Biodentine, EndoSequence, NeoMTA 2, and NeoPutty demonstrated acceptable invitro antimicrobial, biocompatible, and mineralization-supporting properties.

Cytotoxicity and Alkaline Phosphatase Activity of Curcumin, Aloin and MTA on Human Dental Pulp Cells.

The objective of this in-vitro study was to assess the cytotoxicity and alkaline phosphatase (ALP) activity of curcumin and aloin extracted from Curcuma longa and Aloe vera , and mineral trioxide aggregate (MTA) on human dental pulp stem cells. Human dental pulp stem cells (Lonza Group, Switzerland), curcumin (Sigma-Aldrich, USA), aloin (Sigma-Aldrich, USA), and ProRoot MTA (Dentsply, USA) were used in the study. 2.5-6.75-12.5-25-50 μg/ml of curcumin and aloin, 25%-50%-75%-100% of MTA were prepared; pulp cells unincubated with a material were assessed as controls. Cytotoxicity of all doses/concentrations of materials was analysed on days of 1, 2, 3, and 7 by WST-1 test. 2.5-6.75 μg/ml of curcumin and aloin, 25%-50% of MTA incubated with cells for 7-14 days were evaluated for ALP activity by ELISA test. Data was statistically analysed by One Way ANOVA, Tukey, and Sidak tests at GraphPad Prism 6. The findings have shown that 2.5 μg/ml of curcumin, all doses of aloin, 25% and 50% of MTA increased cell proliferation significantly on day 1 ( P < 0.05). Curcumin, aloin, and MTA decreased the cell viability as dose/concentration and exposure time increased. All materials have shown no significant increases in ALP activity ( P > 0.05) on 7 and 14 days. Data of this study revealed that 2.5 - 6.75 μg/ml of curcumin/aloin, 25%-50% of MTA have promoted cell viability and proliferation of human dental pulp cells; and none of the materials have significantly increased the ALP activity at 7-14 days.

Evaluation of Antimicrobial Properties, Cell Viability, and Metalloproteinase Activity of Bioceramic Endodontic Materials Used in Vital Pulp Therapy.

This study aimed to evaluate the antimicrobial properties, cell viability, and matrix metalloproteinase (MMP) inhibition capacity of several endodontic materials aimed at vital pulp therapy: Pro Root MTA®, EndoSequence®, Biodentine®, MTA Angelus®, TheraCal LC®, and BioC Repair®. The materials were prepared according to the manufacturer's instructions. Antimicrobial tests were conducted using a microcosm biofilm model, cell viability was assessed using murine fibroblasts (L929), and MMP activity was analyzed through electrophoresis. The results showed that BioC Repair®, Biodentine®, and EndoSequence® exhibited similar antimicrobial properties, while MTA Angelus® and ProRoot MTA® had inferior results but were comparable to each other. In terms of cell viability, no significant differences were observed among the materials. EndoSequence® demonstrated the highest MMP inhibition capacity. In conclusion, BioC Repair®, Biodentine®, EndoSequence®, and TheraCal® showed better antimicrobial properties among the tested materials. The materials did not exhibit significant differences in terms of cytotoxicity. However, EndoSequence® displayed superior MMP inhibition capacity.

Evaluation of biocompatibility and bioactive potential of Well-Root PT by comparison with ProRoot MTA and Biodentine

Background/purposeWell-Root PT is a novel bioceramic material developed to overcome limitations of conventional calcium silicate cements. The purpose of this study was to assess the biocompatibility and bioactivity of a premixed putty-type cement, Well-Root PT. Materials and methodsIdentical cylindrical samples were prepared from ProRoot MTA, Biodentine, and Well-Root PT. In vitro calcium weight volume and calcium ion release from the materials were evaluated with scanning electron microscopy and energy-dispersive spectroscopy and inductively coupled plasma-optical emission spectroscopy. An in vivo rat direct pulp capping model was implemented with the materials (n = 14 per material). The rats were sacrificed at 7 or 28 days. Hematoxylin and eosin and immunohistochemical analyses were performed. ResultsIn vitro calcium weight volume was 42.83 ± 8.82 % in ProRoot MTA, 47.05 ± 8.83 % in Biodentine, and 29.99 ± 4.94 % in Well-Root PT. Calcium ion releases from Well-Root PT after 7 and 28 days were similar with those from ProRoot MTA, but lower than those from Biodentine (P = 0.001 after 7 and 28 days equally). In an in vivo rat model, hematoxylin and eosin analysis showed no significant differences in inflammatory infiltration (P = 0.393) and hard tissue formation scores among the materials (P = 0.905). Also, both CD68 and DSPP expression showed similar results, with no significant differences among the materials (equally P = 0.874 for both markers). ConclusionWithin the limits of this study, Well-Root PT was comparable to ProRoot MTA and Biodentine in terms of biocompatibility and bioactivity.

The Efficacy of Different Laser Applications on Dentin Sealing in Preventing Discoloration Induced by Mineral Trioxide Aggregate.

The aim of this in vitro study was to evaluate the effect of the pre-application of a dentin-bonding agent and the application of different lasers on the prevention of tooth discoloration caused by mineral trioxide aggregate (MTA) in the presence of blood. Sixty extracted human anterior teeth were selected, with root lengths standardized to 10 mm and root canals shaped using Gates-Glidden drills #3 to #5. The samples were divided into six groups (n = 10): Group 1 with no surface treatment and Groups 2 to 6 with Optibond universal adhesive and Neodymium yttrium aluminum garnet (Nd:YAG), Erbium yttrium aluminum garnet (Er:YAG), Erbium-chromium-yttrium-scandium-gallium-garnet (Er:Cr:YSGG), and diode laser applications, respectively. Root canals were filled with fresh human blood, and ProRoot MTA and a collagen barrier were then placed. Color changes were measured with a spectrophotometer at 0, 7, 30, 90, and 180 days post MTA placement. Color differences (∆E) were analyzed using a two-factor mixed-design ANOVA with the Sidak method (p = 0.05). All treatment groups exhibited discoloration above the acceptability threshold. Although all treatment approaches exhibited less color change compared to the control group (p < 0.05), there was no significant difference among them in terms of preventing color change (p > 0.05). It was determined that none of the methods could guarantee 100% prevention of discoloration caused by MTA-blood contact.