Hydration characteristics of zirconium oxide replaced Portland cement for use as a root-end filling material

Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: a scanning electron microscopy study

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.

Microparticulated and nanoparticulated zirconium oxide added to calcium silicate cement: Evaluation of physicochemical and biological properties

The physicochemical and biological properties of calcium silicate-based cement (CS) associated to microparticulated (micro) or nanoparticulated (nano) zirconium oxide (ZrO2 ) were compared with CS and bismuth oxide (BO) with CS. The pH, release of calcium ions, radiopacity, setting time, and compression strength of the materials were evaluated. The tissue reaction promoted by these materials in the subcutaneous was also investigated by morphological, immunohistochemical, and quantitative analyses. For this purpose, polyethylene tubes filled with materials were implanted into rat subcutaneous. After 7, 15, 30, and 60 days, the tubes surrounded by capsules were fixed and embedded in paraffin. In the H&E-stained sections, the number of inflammatory cells (ICs) in the capsule was obtained. Moreover, detection of interleukin-6 (IL-6) by immunohistochemistry and number of IL-6 immunolabeled cells were carried out. von Kossa method was also performed. The differences among the groups were subjected to Tukey test (p ≤ 0.05). The solutions containing the materials presented an alkaline pH and released calcium ions. The addition of radiopacifiers increased setting time and radiopacity of CS. A higher compressive strength in the CS + ZrO2 (micro and nano) was found compared with CS + BO. The number of IC and IL-6 positive cells in the materials with ZrO2 was significantly reduced in comparison with CS + BO. von Kossa-positive structures were observed adjacent to implanted materials. The ZrO2 associated to the CS provides satisfactory physicochemical properties and better biological response than BO. Thus, ZrO2 may be a good alternative for use as radiopacifying agent in substitution to BO.

Effect of bismuth oxide on white mineral trioxide aggregate: chemical characterization and physical properties

AIM

To assess the effect of bismuth oxide (Bi2 O3 ) on the chemical characterization and physical properties of White mineral trioxide aggregate (MTA) Angelus.

METHODOLOGY

Commercially available White MTA Angelus and White MTA Angelus without Bi2 O3 provided by the manufacturer especially for this study were subjected to the following tests: Rietveld X-ray diffraction analysis (XRD), energy-dispersive X-ray analysis (EDX), scanning electron microscopy (SEM), compressive strength, Vickers microhardness test and setting time. Chemical analysis data were reported descriptively, and physical properties were expressed as means and standard deviations. Data were analysed using Student's t-test and Mann-Whitney U test (P = 0.05).

RESULTS

Calcium silicate peaks were reduced in the diffractograms of both hydrated materials. Bismuth particles were found on the surface of White MTA Angelus, and a greater amount of particles characterized as calcium hydroxide was observed by visual examination on White MTA without Bi2 O3 . The material without Bi2 O3 had the shortest final setting time (38.33 min, P = 0.002), the highest Vickers microhardness mean value (72.35 MPa, P = 0.000) and similar compressive strength results (P = 0.329) when compared with the commercially available White MTA Angelus containing Bi2 O3 .

CONCLUSION

The lack of Bi2 O3 was associated with an increase in Vickers microhardness, a reduction in final setting time, absence of Bi2 O3 peaks in diffractograms, as well as a large amount of calcium and a morphology characteristic of calcium hydroxide in EDX/SEM analysis.

Chemical characteristics of mineral trioxide aggregate and its hydration reaction

Mineral trioxide aggregate (MTA) was developed in early 1990s and has been successfully used for root perforation repair, root end filling, and one-visit apexification. MTA is composed mainly of tricalcium silicate and dicalcium silicate. When MTA is hydrated, calcium silicate hydrate (CSH) and calcium hydroxide is formed. Formed calcium hydroxide interacts with the phosphate ion in body fluid and form amorphous calcium phosphate (ACP) which finally transforms into calcium deficient hydroxyapatite (CDHA). These mineral precipitate were reported to form the MTA-dentin interfacial layer which enhances the sealing ability of MTA. Clinically, the use of zinc oxide euginol (ZOE) based materials may retard the setting of MTA. Also, the use of acids or contact with excessive blood should be avoided before complete set of MTA, because these conditions could adversely affect the hydration reaction of MTA. Further studies on the chemical nature of MTA hydration reaction are needed.

The impact of zirconium oxide radiopacifier on the early hydration behaviour of white Portland cement

Zirconium oxide has been identified as a candidate radiopacifying agent for use in Portland cement-based biomaterials. During this study, the impact of 20 wt.% zirconium oxide on the hydration and setting reactions of white Portland cement (WPC) was monitored by powder X-ray diffraction (XRD), (29)Si and (27)Al magic angle spinning nuclear magnetic resonance spectroscopy (MAS NMR), transmission electron microscopy (TEM) and Vicat apparatus. The presence of 20 wt.% zirconium oxide particles in the size-range of 0.2 to 5 μm was found to reduce the initial and final setting times of WPC from 172 to 147 min and 213 to 191 min, respectively. Zirconium oxide did not formally participate in the chemical reactions of the hydrating cement; however, the surface of the zirconium oxide particles presented heterogeneous nucleation sites for the precipitation and growth of the early C-S-H gel products which accelerated the initial setting reactions. The presence of zirconium oxide was found to have little impact on the development of the calcium (sulpho)aluminate hydrate phases.

Dentin-cement interfacial interaction: calcium silicates and polyalkenoates

The interfacial properties of a new calcium-silicate-based coronal restorative material (Biodentine™) and a glass-ionomer cement (GIC) with dentin have been studied by confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), micro-Raman spectroscopy, and two-photon auto-fluorescence and second-harmonic-generation (SHG) imaging. Results indicate the formation of tag-like structures alongside an interfacial layer called the "mineral infiltration zone", where the alkaline caustic effect of the calcium silicate cement's hydration products degrades the collagenous component of the interfacial dentin. This degradation leads to the formation of a porous structure which facilitates the permeation of high concentrations of Ca(2+), OH(-), and CO(3) (2-) ions, leading to increased mineralization in this region. Comparison of the dentin-restorative interfaces shows that there is a dentin-mineral infiltration with the Biodentine, whereas polyacrylic and tartaric acids and their salts characterize the penetration of the GIC. A new type of interfacial interaction, "the mineral infiltration zone", is suggested for these calcium-silicate-based cements.