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Shancy Merlin AR, Ravindran V, Jeevanandan G, Eswaramoorthy R, Arthanari A. Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates. Cureus 2024; 16:e56320. [PMID: 38629015 PMCID: PMC11019474 DOI: 10.7759/cureus.56320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
Background The challenges associated with incorporating antimicrobial agents, such as the potential diminishment of the cement's physical properties, highlight the need for comprehensive evaluations. Balancing antimicrobial efficacy with the maintenance of structural integrity is a crucial aspect of material development. The acknowledgment of cytotoxic properties associated with tricalcium aluminate, a major constituent in conventional mineral trioxide aggregate (MTA), is critical in terms of long-term evaluation of treatment procedures. The primary focus of the push-out test is to evaluate the resistance of the tested material to dislodgement. Greater push-out strength implies stronger adhesion between the tested material and the tooth surface. Aim This study aims to evaluate the push-out bond strength of two antibacterial-enhanced MTAs with conventional MTA and Biodentine. Material and methods A total of five materials were tested: a) modified MTA, b) doxycycline-enhanced MTA, c) metronidazole-enhanced MTA, d) conventional MTA, and e) Biodentine. All the materials were mixed based on a predetermined powder:liquid ratio and then carried using a plastic instrument to the desired experimental design. Single-rooted permanent teeth, preferably incisors, were used in the present study. Teeth were embedded vertically in a rubber mold, and sectioning of the tooth was performed. A single operator instrumented the canal space in each slice using Gates-Glidden burs, and the mixed cements were placed in the respective groups and stored for 72 hours. A push-out test was carried out using a universal testing machine. Following the bond failure, the slices were examined under a stereomicroscope to determine the nature of the bond failure. The collected data was subjected to a one-way analysis of variance test, post hoc test, and chi-square test for statistical analysis. Results The mean push-out bond strength was found to be the highest for Biodentine (43.25 ± 0.62 megapascals (MPa)), followed by doxycycline- and metronidazole-enhanced MTAs (39.54 ± 0.65 MPa and 39.29 ± 0.16 MPa, respectively), modified MTA formulation (37.75 ± 0.73 MPa), and the lowest for conventional MTA (25.93 ± 0.7 MPa). Conventional MTA samples had an adhesive failure (89.4%), while Biodentine samples had a cohesive failure (80.3%). Mixed failures were noticed with the samples containing modified MTA formulation (71.3%), doxycycline-enhanced MTA (76.6%), and metronidazole-enhanced MTA (78.0%). Conclusion Despite not surpassing Biodentine in bond strength, antibacterial-enhanced MTAs are considered potential alternatives to conventional MTA in day-to-day clinical practice.
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Affiliation(s)
- Arokia Rajkumar Shancy Merlin
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Vignesh Ravindran
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rajalakshmanan Eswaramoorthy
- Center of Molecular Medicine and Diagnostics, Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Abirami Arthanari
- Department of Forensic Odontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Merlin AR, Ravindran V, Jeevanandan G, Maganur PC, Panda S, Syed AA, Kalagi S, AlShehri A, Khanagar S, Vishwanathaiah S. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024; 25:168-173. [PMID: 38514415 DOI: 10.5005/jp-journals-10024-3638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine. MATERIALS AND METHODS Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed. RESULTS The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures. CONCLUSION Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties. CLINICAL SIGNIFICANCE Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.
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Affiliation(s)
- Arokia Rs Merlin
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Vignesh Ravindran
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9789934476, e-mail:
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Orcid: https://orcid.org/0000-0003-3631-6982
| | - Prabhadevi C Maganur
- Department of Preventive Dental Sciences and Department of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Suman Panda
- Department of Preventive Dental Sciences and Department of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Ather A Syed
- Department of Preventive Dental Sciences and Department of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Sara Kalagi
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Aram AlShehri
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Sanjeev Khanagar
- Department of Preventive Dental Sciences and Department of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan; King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Satish Vishwanathaiah
- Department of Preventive Dental Sciences and Department of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Ravindran V, Jeevanandan G. Comparative Evaluation of the Physical and Antimicrobial Properties of Mineral Trioxide Aggregate, Biodentine, and a Modified Fast-Setting Mineral Trioxide Aggregate Without Tricalcium Aluminate: An In Vitro Study. Cureus 2023; 15:e42856. [PMID: 37664390 PMCID: PMC10473445 DOI: 10.7759/cureus.42856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Background Tricalcium aluminate, one of the major constituents of mineral trioxide aggregate (MTA), has been shown to have cytotoxic properties. Mineral trioxide aggregate has moderate to low antimicrobial activity against the most common endodontic pathogen, Enterococcus faecalis. Aim To assess the physical and antimicrobial properties of a newly modified formulation of mineral trioxide aggregate. Materials & methods The final setting time, compressive strength, and antimicrobial properties were tested for three groups of materials. The material used for Group 1 was mineral trioxide aggregate (white MTA, Angelus, Londrina, Brazil); the material for Group 2 was Biodentine (Septodont, Saint Maur des Fossés, France); and for Group 3, a modified MTA formulation was used. Results Group 1 had the longest setting time, and Group 2 had the shortest setting time. Group 3's material was set at 83.65 ± 0.28 minutes. This difference among the groups was statistically significant (p < 0.05). The highest mean compressive strength during all the time periods was seen in Group 2, followed by Group 3, and the least in Group 1. This difference in compressive strength was statistically significant (p=0.001). The largest zone of inhibition against Enterococcus faecalis, Candida albicans, and Streptococcus mutans was seen in Group 3, followed by Group 2 and Group 1. Conclusion Under the limitations of the present study, the newly modified MTA could serve as an alternative to the conventional MTA in terms of faster setting, higher strength, and better antimicrobial properties.
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Affiliation(s)
- Vignesh Ravindran
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Pushpalatha C, Dhareshwar V, Sowmya SV, Augustine D, Vinothkumar TS, Renugalakshmi A, Shaiban A, Kakti A, Bhandi SH, Dubey A, Rai AV, Patil S. Modified Mineral Trioxide Aggregate—A Versatile Dental Material: An Insight on Applications and Newer Advancements. Front Bioeng Biotechnol 2022; 10:941826. [PMID: 36017346 PMCID: PMC9395930 DOI: 10.3389/fbioe.2022.941826] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Mineral Trioxide Aggregate (MTA) has been a material of revolution in the field of dentistry since its introduction in the 1990s. It is being extensively used for perforation repairs, apexification, root-end filling, obturation, tooth fracture repair, regenerative procedures, apexogenesis, pulpotomies, and as a pulp-capping material because of its desired features such as biocompatibility, bioactivity, hydrophilicity, sealing ability, and low solubility. Even though its application is wide, it has its own drawbacks that prevent it from reaching its full potential as a comprehensive replacement material, including a long setting time, discoloration, mud-like consistency, and poor handling characteristics. MTA is a material of research interest currently, and many ongoing studies are still in process. In this review, the newer advancements of this versatile material by modification of its physical, chemical, and biological properties, such as change in its setting time, addressing the discoloration issue, inclusion of antimicrobial property, improved strength, regenerative ability, and biocompatibility will be discussed. Hence, it is important to have knowledge of the traditional and newer advancements of MTA to fulfill the shortcomings associated with the material.
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Affiliation(s)
- C. Pushpalatha
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Vismaya Dhareshwar
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - S. V. Sowmya
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Dominic Augustine
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Apathsakayan Renugalakshmi
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Amal Shaiban
- Department of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ateet Kakti
- Department of Pediatric Dentistry, Preventive Division, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Shilpa H. Bhandi
- Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Alok Dubey
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Amulya V. Rai
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- *Correspondence: Shankargouda Patil, , orcid.org/0000-0001-7246-5497
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Lim M, Yoo S. The antibacterial activity of mineral trioxide aggregate containing calcium fluoride. J Dent Sci 2022; 17:836-841. [PMID: 35756781 PMCID: PMC9201925 DOI: 10.1016/j.jds.2021.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/01/2021] [Indexed: 01/12/2023] Open
Abstract
Background/purpose Because complete microbial elimination of the infected root canal system is nearly impossible to achieve, the use of root canal fillings with antibacterial effects may help to minimize intracanal infections. Our previous study, MTA modified by CaF2 addition, improved the biocompatibility and mineralization potential of human dental pulp cells without adverse effect on the physical properties. In this study, the antibacterial effect of MTA after CaF2 addition was evaluated for use as a root canal sealer. The objective of this study was to evaluate the antibacterial activity of MTA after the addition of CaF2. Materials and methods The antibacterial activities of MTA and MTA–CaF2 mixture against Enterococcus faecalis (E. faecalis), Porphyromonas endodontalis (P. endodontalis), and Porphyromonas gingivalis (P. gingivalis) were investigated with MTA-CaF2 powder and eluates. The bacterial growth was measured by optical density using a spectrophotometer and the bacterial colony counting. Results MTA inhibited the growth of E. faecalis, P. endodontalis, and P. gingivalis, and the addition of CaF2 improved this antibacterial effect in a concentration dependent manner (p < 0.05). E. faecalis was more resistant to MTA-CaF2 than the other groups of bacteria. Conclusion The addition of more than 5% CaF2 to MTA can increase the antibacterial activity.
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Affiliation(s)
- Miyoung Lim
- Department of Conservative Dentistry, Dankook University College of Dentistry Jukjeon Hospital, Yongin, South Korea
| | - Seunghoon Yoo
- Songha Yoo Seunghoon Pediatric Dentistry, Cheonan, South Korea
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