Metrologic Evaluation of the Surface of White MTA After the Use of Two Endodontic Irrigants

Removal efficiency of a fast setting pozzalan-based bioactive cement: a micro CT study

AIM

The aim of this study was to evaluate the removal efficiency of PRMTA and ECMPremixed applied to the coronal third according to the RET by UI and to examine the effect of different solutions on material removal.

MATERIALS AND METHODS

40 permanent upper central teeth were used to simulate immature teeth. The samples were irrigated with 1.5% NaOCl and calcium hydroxide was placed. Samples were incubated in PBS. Then irrigation was done with 17% EDTA, the samples were randomly divided into 2 groups (n = 20):Group 1: PRMTA, Group 2: ECM Premixed. The materials were placed in the samples. Then the samples were scanned with micro-CT. Materials were removed by UI. Micro-CT scan of the samples was performed. Each material group was divided into 2 subgroups (n = 10): Group1 was MTAD, group2 was irrigated with 10% CA; then micro-CT was performed. Obtained images were positioned in DataViewer and analyzed with CTAn. The obtained data were statistically analyzed in IBM SPSS 25. The significance level was determined as 5%.

RESULTS

There was no significant difference between the initial volumes of the materials (p > 0.05). The amount of the remaining material after UI was significantly higher in the PRMTA (0.7471%) group compared to the ECM Premixed (0.0093%). There was no significant difference in terms of remaining material after irrigation with MTAD and CA in both groups (p > 0.05).

CONCLUSION

A great deal of the materials were removed by UI under the operation microscope. ECM Premixed was removed more effectively compared to the PRMTA. And, acidic solutions did not provide any additional benefit in material removal.

Effect of different root canal irrigants on surface roughness and microhardness of Biodentine combined with triple antibiotic paste: An in vitro study

Background

Biodentine is widely used for endodontic applications; recently, it has been incorporated with triple antibiotic paste (TAP). The effect of endodontic irrigants on the physical characteristics of this new combination needs to be studied.

Aims

The aim of the study was to evaluate the surface roughness and microhardness of Biodentine incorporated with TAP subjected to various endodontic irrigants.

Materials and Methods

Hundred cylindrical discs (6 mm × 3 mm) were prepared by mixing the Biodentine with TAP (3:1). The specimens were subjected to different irrigating solutions for 5 min in 5 groups (n = 20): Group 1: distilled water (control), Group 2: 2.5% sodium hypochlorite, Group 3: 17% ethylenediaminetetraacetic acid, Group 4: 2% chlorhexidine (CHX), and Group 5: 2% chitosan nanoparticles (CSNs). Half of the specimens in each group were subjected to surface roughness (n = 10) and another half to microhardness (n = 10). Surface roughness was measured using a surface roughness tester, and digital Vickers microhardness testing was performed on each specimen.

Statistical Analysis

One-way ANOVA and post hoc Tukey's tests (P ≤ 0.05) were used.

Results

The highest microhardness was found with 2% CSN, whereas 2% CSN and 2% CHX had a minimal effect on the surface roughness of Biodentine incorporated with TAP (P ≤ 0.05).

Conclusion

The root canal irrigant 2% CSN exhibited the highest microhardness and least surface roughness of modified Biodentine with TAP.

The Washout Resistance of Bioactive Root-End Filling Materials

Fast-setting bioactive cements were developed for the convenience of retrograde fillings during endodontic microsurgery. This in vitro study aimed to investigate the effect of irrigation on the washout of relatively fast-setting materials (Biodentine, EndoCem Zr, and MTA HP) in comparison with MTA Angelus White and IRM in an apicectomy model. Washout resistance was assessed using artificial root ends. A total of 150 samples (30 for each material) were tested. All samples were photographed using a microscope, and half of them were also scanned. The samples were irrigated and immersed in saline for 15 min. Then the models were evaluated. Rinsing and immersing the samples immediately after root-end filling and after 3 min did not disintegrate the fillings made of all tested materials except Biodentine. Root-end fillings made of Biodentine suffered significant damage both when rinsing was performed immediately and 3 min after the filling. Quantitative assessment of washed material resulted in a slight loss of IRM, EndoCem MTA Zr, and MTA HP. MTA Angelus White showed a slightly greater washout. Rinsing and immersion of Biodentine restorations resulted in their significant destruction. Under the conditions of the current study, the evaluated materials, excluding Biodentine, showed good or relatively good washout resistance.

Effect of various calcium hydroxide removal protocols on the dislodgement resistance of biodentine in an experimental apexification model

Background/purpose

Residual calcium hydroxide (CH) in the root canal dentine walls may influence the adhesion of tricalcium silicate-based materials. The aim of this study is to evaluate the effect of various CH removal protocols on the dislodgement resistance of biodentine from simulated immature root canals in an experimental apexification model.

Materials and methods

CH was applied to 120 simulated immature root canals. The samples were divided into 12 experimental groups (n = 10) according to the applied irrigation protocols used for the removal of CH: Group 1: Sodium hypochlorite (NaOCl), Conventional needle irrigation (CNI); Group 2: NaOCl, EndoActivator; Group 3: NaOCl, XP-endo Finisher; Group 4: NaOCl- Ethylenediaminetetraacetic acid (EDTA), CNI; Group 5: NaOCl-EDTA, EndoActivator; Group 6: NaOCl-EDTA, XP-Endo Finisher; Group 7: NaOCl+etidronic acid (HEBP), CNI; Group 8: NaOCl+HEBP, EndoActivator; Group 9: NaOCl+HEBP, XP-endo Finisher; Group 10: NaOCl- Peracetic acid (PAA), CNI; Group 11: NaOCl-PAA, EndoActivator; Group 12: NaOCl-PAA, XP-endo Finisher; Control Group: CH was not applied. Biodentine was placed at the apical thirds of 130 immature root canals. Vertical loading was applied to biodentine fillings inside the dentin discs. Maximum force to dislodge the material was statistically analyzed with ANOVA.

Results

The control, NaOCl+HEBP (CNI, EndoActivator, XP-endo Finisher) and NaOCl-PAA (EndoActivator, XP-endo Finisher) groups exhibited the lowest dislodgement resistance values (p < 0.001). When used CNI, irrigation with NaOCl+HEBP resulted in lower resistance to dislodgement of biodentine compared to NaOCl, and NaOCl-EDTA (p < 0.001).

Conclusion

Adhesion of apical barrier materials to root canal dentine can be influenced by the irrigation protocols used for CH removal.

Mineralogical and Microstructural Characteristics of Two Dental Pulp Capping Materials

This paper aims to investigate the composition, surface, and microstructural characteristics, and bioactivity of two commercially available pulp capping materials known as TheraCal LC and BIO MTA+. The materials were prepared as cylindrical samples and assessed by X-ray diffraction (XRD) and complex thermal analysis for mineralogical characterization, and by scanning electron microscopy (SEM) coupled with energy dispersive of X-ray (EDX), Fourier-Transformed Infrared Spectroscopy (FT-IR), and atomic force microscopy (AFM) for microstructural and surface characteristics. The in vitro bioactivity was highlighted by surface mineralization throughout SEM coupled with EDX and FT-IR analysis. XRD analysis performed on both materials showed calcium silicate phases and different radiopacifying compounds. AFM measurements indicated a smoother and more homogenous surface with a lower average roughness for TheraCal LC due to the resin matrix from its composition. FT-IR analysis displayed bands for several compounds in both materials. Both materials exhibited bioactive properties showing surface mineralization after being immersed in solution similar to the human physiological environment. However, the MTA cement showed a better mineralization due to the anhydrous and hydrated phases.

Surface and vertical dimensional changes of mineral trioxide aggregate and biodentine in different environmental conditions

OBJECTIVES

Surface changes in biological environments are critical for the evaluation of physical and biological activity of biomaterials. Objective: This study investigated surface alterations of calcium silicate-based cements after exposure to different environments.

MATERIAL AND METHODS

Material and Methods: Forty-eight cylindrical cavities were prepared on root surfaces. The cavities were filled using ProRoot MTA or Biodentine and assigned to four subgroups (n=6): dry, wet, acidic, and blood. Surface topographies were evaluated using an optical profilometer for 28 days, and the roughness of the material surfaces was quantified. Vertical dimensional change was measured by determining the height difference between the material surface and the flat tooth surface. Data were compared with a two-way repeated measures ANOVA and Bonferroni tests.

RESULTS

Results: In dry condition, the surface roughness of MTA or Biodentine was constant up to 3 days (p>0.05) but decreased after 28 days (p<0.05). In dry condition, ProRoot MTA presented constant surface level through time, while Biodentine showed decreased surface level after 28 days. In wet condition, the roughness and the surface levels of both materials increased after 1 day (p<0.05). Neither the surface roughness nor the levels of the materials showed significant changes in acidic conditions (p>0.05). Both materials showed the highest roughness in blood conditions on the 1st day (p<0.05), while the surface roughness in blood decreased dramatically after 28 days. The roughness of Biodentine was higher in wet conditions up to 3 days compared with ProRoot MTA (p<0.05). Likewise, in blood condition, Biodentine showed higher roughness on the 28th day than ProRoot MTA (p<0.05).

CONCLUSIONS

Conclusions: Dry, wet, and blood conditions had a time-dependent effect on the surface roughness and vertical dimensional changes of the materials. However, acidic conditions did not affect the roughness and the surface level of the materials.

Effect of root canal irrigation protocols on the dislocation resistance of mineral trioxide aggregate-based materials: A systematic review of laboratory studies

The aim of this systematic review was to address the question: Do different irrigating protocols have an impact on the dislocation resistance of mineral trioxide aggregate (MTA)-based materials? The review was performed using a well-defined search strategy in three databases (PubMed, Scopus, Web of Science) to include laboratory studies performed between January 1995 and May 2017, in accordance with PRISMA guidelines. Two reviewers analysed the papers, assessed the risk of bias and extracted data on teeth used, sample size, size of root canal preparation, type of MTA-based material, irrigants, canal filling method, storage method and duration, region of roots and the parameters of push-out testing (slice thickness, plunger dimensions and plunger loading direction), the main results and dislocation resistance values (in MPa). From 255 studies, 27 were included for full-text analysis. Eight papers that met the inclusion criteria were included in this review. There was a wide variation in dislocation resistance due to differences in irrigation sequence, time and concentration of irrigants, storage method and duration, and the parameters of push-out bond strength testing. A meta-analysis was not done but qualitative synthesis of the included studies was performed. No definitive conclusion could be drawn to evaluate the effect of irrigation protocols on dislocation resistance of MTA-based materials. Recommendations have been provided for standardized testing methods and reporting of future studies, so as to obtain clinically relevant information and to understand the effects of irrigating protocols on root canal sealers and their interactions with the dentine walls of root canals.

Bond strength of composite resin to white mineral trioxide aggregate: Effect of different surface treatments

Background:

The main aim of restorative dentistry is to restore and preserve dental health with the use of appropriate restorative modalities to protect the pulp and restore its function. This study compared the effect of different surface treatments of mineral trioxide aggregate (MTA) on the bond strength of composite resin to MTA.

Materials and Methods:

Forty cylindrical acrylic blocks with a hole were prepared and filled by ProRoot MTA. The samples were assigned to four groups: Group 1 – no surface treatment; Group 2 – phosphoric acid etching; Group 3 – sandblasting; and Group 4 – hydrofluoric acid (HF) etching, rinsing, and silane application. OptiBond Solo Plus adhesive was utilized in all the groups. Then, composite resin cylinders were bonded to sample surfaces. The samples were thermocycled and tested for microshear bond strength using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with Kruskal–Wallis and Mann–Whitney tests. Scanning electron microscopy images were prepared for each study group after surface treatments.

Results:

Means and standard deviations of bond strength values in study groups 1–4 were 14.83 ± 7.76, 21.85 ±7.99, 6.48 ± 3.89, and 26.01 ± 11.09 Mpa, respectively.

Conclusions:

Within the limitations of this study, phosphoric acid etching or HF etching plus silanization was preferred to surface treatment of MTA before composite resin bonding.

Effect of novel chelating agents on the push-out bond strength of calcium silicate cements to the simulated root-end cavities

To compare the effects of different chelating agents on the push-out bond strength of calcium silicate-based cements to the simulated root-end cavities. Root-end cavities were prepared on the roots of fifty extracted maxillary anterior teeth. The specimens were then randomly divided into 5 groups (n = 10) based on the final irrigation regimen: Group 1: 17% EDTA, Group 2: 7% maleic acid, Group 3: QMix, Group 4: 2.25% peracetic acid (PAA), Group 5: 0.9% saline. Then, the samples from each group were subdivided into two groups (n = 5) based on the apical filling material. In group 1, root-end cavities of all samples were filled with Biodentine and in group 2, with MTA. Each sample was horizontally sectioned to produce two discs of ∼1 mm thick per specimen. The maximum load required for the dislodgement of 100 retrofillings was recorded. The specimens were examined under scanning electron microscope after debonding to assess the type of bond failure. Data were statistically analyzed using Kruskal Wallis and Mann Whitney U tests. Irrigation with saline resulted in higher bond strength compared to the other irrigants in the retrograde cavities obturated with MTA or Biodentine (p < .05). In MTA group, there was no significant difference between the test irrigants (p > .05). EDTA and PAA groups showed higher dislodgement resistance values than the other test irrigants, when Biodentine was used as a filling. The type of irrigation solution influences the bond strength of the root-end fillings.

Effect of Smear Clear and Some Other Commonly Used Irrigants on dislodgement resistance of Mineral Trioxide Aggregate to Root Dentin

Background

This study aimed to assess the push-out bond strength of mineral trioxide aggregate (MTA) to root canal dentin after irrigation with Smear Clear in comparison with 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) and saline as commonly used root canal irrigants.

Material and Methods

The coronal and mid-root areas of maxillary anterior teeth were horizontally sectioned into one-millimeter thick slices. The root canal lumen of dentinal slices was dilated using a diamond bur with 1.3 mm diameter. After the application of MTA, the samples were incubated in 100% humidity for 10 minutes and were then randomly divided into four groups (n=20) and immersed in Smear Clear, 2.5% NaOCl, 2% CHX and saline for 30 minutes. No irrigant was used for the control group (n=20). A wet cotton pellet was placed on the samples and after 48 hours of incubation, push-out bond strength was measured using a universal testing machine. The samples were evaluated under a stereomicroscope to determine the mode of failure. One-way ANOVA was used to assess statistical differences among the groups.

Results

The control group showed the highest bond strength with significant differences with other groups (P<0.05). Among the experimental groups, the saline group had no significant difference with CHX (P=0.09) but it had significant differences with Smear Clear and NaOCl groups (P<0.05). No significant difference in bond strength to MTA was noted after irrigation with Smear Clear, CHX and NaOCl (P>0.05). Other pairwise comparisons showed no significant difference (P>0.05).

Conclusions

Irrigation with Smear Clear, CHX and NaOCl did not cause a significant change in bond strength of MTA to dentin.

Key words:Root Canal Irrigants, push-out, Mineral Trioxide Aggregate, dentin.

Calcium silicate-based cements and functional impacts of various constituents

Calcium silicate-based cements have superior sealing ability, bioactivity, and marginal adaptation, which make them suitable for different dental treatment applications. However, they exhibit some drawbacks such as long setting time and poor handling characteristics. To overcome these limitations calcium silicates are engineered with various constituents to improve specific characteristics of the base material, and are the focus of this review. An electronic search of the PubMed, MEDLINE, and EMBASE via OVID databases using appropriate terms and keywords related to the use, application, and properties of calcium silicate-based cements was conducted. Two independent reviewers obtained and analyzed the full texts of the selected articles. Although the effects of various constituents and additives to the base Portland cement-like materials have been investigated, there is no one particular ingredient that stands out as being most important. Applying nanotechnology and new synthesis methods for powders most positively affected the cement properties.

In Vitro Evaluation of Different Solvents for Retrieval of Mineral Trioxide Aggregate and Calcium-Enriched Mixture

Introduction:

The purpose of this study was to evaluate the effect of different solvents; carbonic acid (H₂CO₃), hydrochloric acid (HCl), chlorhexidine (CHX) and sodium hypochlorite (NaOCl) on the surface hardness of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement.

Methods and Materials:

Plexiglass molds were prepared and filled with Angelus MTA or CEM cement and then exposed to 2% carbonic acid, 37% hydrochloric acid, 2% chlorhexidine, 5.25% sodium hypochlorite and normal saline at intervals of 1 and 21 days, respectively (n=4). Surface microhardness of all specimens was analyzed by a universal testing machine and an electron microscope for some selected samples. Data were analyzed using the three-way ANOVA. Subgroup analysis was performed by Student’s t-test, One-way ANOVA and Tukey’s tests. The level of significance was set at 0.05.

Results:

On the first day, all solvents and on 21^st day HCl, and H₂CO₃ were more effective in reducing the microhardness of MTA compared to CEM cement (P<0.05).

Conclusion:

The two experimental cements were differently affected by the solvents at specific time intervals. The solvents were more effective on MTA.

Comparative evaluation of sealing ability and microstructure of MTA and Biodentine after exposure to different environments

OBJECTIVES

The aim of this study was to evaluate the sealing ability and morphological microstructure of Biodentine in comparison to ProRoot mineral trioxide aggregate (MTA) after storage in an acidic environment.

MATERIALS AND METHODS

Biodentine and ProRoot MTA were prepared and packed into the canal lumen of dentin disks. Twenty specimens of each material were further randomly divided into two groups according to the storage media: group A: materials with saline as storage medium; group B: materials with citric acid buffered at pH 5.4 as storage medium. The sealing ability was evaluated at 1, 3, 6, and 24 h and 1 or 3 months, using a fluid transport model for quantitative analysis of endodontic microleakage. The morphological microstructures of the materials were also evaluated using scanning electron microscopy.

RESULTS

During the first 24 h, MTA showed greater fluid transport values than Biodentine in both environments. At the 3-month measurement, when the materials were stored in saline, MTA showed greater ability to prevent fluid movement than Biodentine (p < 0.0001). However, when the materials were stored in an acidic environment, no statistical significant difference was found after 3 months. After storage in saline, both materials showed an uneven crystalline surface with similar hexagonal crystals. The microstructure of Biodentine changed after exposure to citric acid, showing a relatively smooth surface with more spheroidal crystals.

CONCLUSIONS

The exposure to an acidic environment, within the limits of this study, seems to result in morphological changes of Biodentine in a different manner than MTA. MTA shows good ability to prevent fluid movement over time, in both environments. The ability of Biodentine to prevent fluid movement over time was enhanced in the acidic environment.

CLINICAL RELEVANCE

The findings of the present study could imply that both materials are indicated for use in an acidic environment.

Effect of mineral trioxide aggregate surface treatments on morphology and bond strength to composite resin

INTRODUCTION

The aim of this study was to evaluate the micromorphologic changes that accompany different surface treatments on mineral trioxide aggregate (MTA) and their effect on the bond strength to the composite resin with 4 adhesive systems.

METHODS

Three types of MTA cement, ProRoot MTA (WMTA) (Dentsply, Tulsa, OK), MTA Angelus (AMTA) (Angelus, Londrina, PR, Brazil), and Endocem MTA (EMTA) (Maruchi, Wonju, Korea), were prepared and stored for a week to encourage setting. Surface treatment was performed using phosphoric acid or self-etch primer, and an untreated MTA surface was prepared as a control. The surface changes were observed using scanning electron microscopy. MTA surfaces were bonded with 4 adhesive systems, including Scotchbond Multipurpose (3M ESPE, St Paul, MN), Single Bond 2 (3M ESPE), Clearfil SE BOND (Kuraray, Osaka, Japan), and AdheSE One F (Ivoclar Vivadent, Schaan, Liechtenstein), to evaluate the adhesive effectiveness of MTA followed by composite resin restoration. The shear bond strength of the polymerized specimens was tested.

RESULTS

For WMTA and AMTA, untreated surfaces showed an irregular crystalline plate with clusters of globular aggregate particles. For EMTA, the untreated surface presented a reticular matrix with acicular crystals. After surface treatment, superficial crystalline structures were eroded regardless of the MTA cement and adhesive system used. WMTA bonded significantly more strongly than AMTA and EMTA, regardless of the adhesive system used. In the WMTA and AMTA groups, AdheSE One F showed the highest bond strength to the composite. For EMTA, no significant differences were found across adhesive systems.

CONCLUSIONS

Acidic treatment of the MTA surface affected the micromorphology and the bond strength to the composite. Within the limitations of this study, using a 1-step self-etch adhesive system might result in a strong bond to WMTA when the composite resin restoration is required over MTA cement.

Interferometric microscopy study of the surface roughness of Portland cement under the action of different irrigants

Objectives: Some investigations suggested common Portland cement (PC) as a substitute material for MTA for endodontic use; both MTA and PC have a similar composition. The aim of this study was to determine the surface roughness of common PC before and after the exposition to different endodontic irrigating solutions: 10% and 20% citric acid, 17% ethylenediaminetetraacetic (EDTA) and 5% sodium hypochlorite. Study Design: Fifty PC samples in the form of cubes were prepared. PC was mixed with distilled water (powder/liquid ratio 3:1 by weight). The samples were immersed for one minute in 10% and 20% citric acid, 17% EDTA and 5% sodium hypochlorite. After gold coating, PC samples were examined using the New View 100 Zygo interferometric microscope. It was used to examine and register the surface roughness and the profile of two different areas of each sample. Analysis of variance (ANOVA) was carried out, and as the requirements were not met, use was made of the Kruskal-Wallis test for analysis of the results obtained, followed by contrasts using Tukey’s contrast tests. Results: Sodium hypochlorite at a concentration of 5% significantly reduced the surface roughness of PC, while 20% citric acid significantly increased surface roughness. The other evaluated citric acid concentration (10%) slightly increased the surface roughness of PC, though statistical significance was not reached. EDTA at a concentration of 17% failed to modify PC surface roughness. Irrigation with 5% sodium hypochlorite and 20% citric acid lowered and raised the roughness values, respectively. Conclusions: The surface texture of PC is modified as the result of treatment with different irrigating solutions commonly used in endodontics, depending on their chemical composition and concentration.

Key words:MTA, Portland cement, citric acid, ethylenediaminetetraacetic acid, sodium hypochlorite, surface roughness.

In-vitro evaluation of various solvents for retrieval of mineral trioxide aggregate and their effect on microhardness of dentin

AIM

Organic acids have the potential to decrease the strength of mineral trioxide aggregate (MTA) during retreatment. However, this might cause alterations in dentin composition and structure. The aim of this study was to assess the efficacy of chemicals on surface microhardness of white MTA (WMTA) and dentin.

MATERIALS AND METHODS

White MTA-Angelus(®) was mixed and packed into tooth molds. Six experimental groups (n = 15) were formed and exposed to 2% carbonic acid, 2% chlorhexidine gluconate, 5.25% sodium hypochlorite, 10% citric acid, 20% tartaric acid, and normal saline for 10 min and 20 min intervals on 1 and 21 days of setting, respectively. Vickers microhardness of WMTA and dentin for each specimen was measured before and after exposure. Data were subjected to repeated-analysis of variance (ANOVA) and post-hoc tests.

RESULTS

Carbonic acid was effective in significantly reducing the surface hardness of WMTA on both 1 and 21 days; followed by citric and tartaric acid (P < 0.05). Two percent chlorhexidine gluconate and NaOCl were effective on 1-day set WMTA. All chemicals, except 2% chlorhexidine, decreased microhardness of dentin significantly (P < 0.05) at 20 min interval.

CONCLUSION

Cautious use of these chemicals not exceeding 10 min is mandatory to prevent significant alterations in mechanical properties of tooth during MTA retrieval.

Scanning electron microscopic evaluation of the material interface of adjacent layers of dental materials

OBJECTIVE

Many dental materials are used in contact with each other in sandwich techniques. Liners, bases and permanent restorative materials are placed adjacent to each other and allowed to set under the same conditions. The same applies for endodontic materials where irrigating solutions and root canal dressings come in contact with root canal obturating materials and root-end fillers. The aim of this research was to investigate the material interface of mineral trioxide aggregate (MTA) in contact with non-setting calcium hydroxide paste (CH), glass ionomer cement (GIC) and intermediate restorative material (IRM).

METHODS

All materials were mixed according to manufacturer's instructions. Freshly mixed MTA (Dentsply) was placed in a plastic container and another dental material was compacted on it while still unset. These materials included GIC (Fuji IX), non-setting calcium hydroxide (Calasept) and IRM (Dentsply). The materials were allowed to set for 28 days at 37°C and 100% humidity. The layered materials were sectioned longitudinally embedded in resin and polished to expose the interface between the two materials. Scanning electron microscopy (SEM) was performed of the interface and X-ray energy dispersive analysis (EDX) was conducted at 50 μm intervals to establish elements present at specific distances from the material interface.

RESULTS

The calcium hydroxide paste did not affect the hydration of MTA. Migration of silicon, aluminum and bismuth from the MTA to the CH occurred. The GIC exhibited a high degree of micro-cracking and some porosity in the interfacial region. Strontium from the GIC was detected at 200 μm within the MTA. The zinc from the IRM cement was detected at 100 μm within the MTA. The zinc affected the hydration of the MTA leading to retardation of setting and increased porosity.

CONCLUSIONS

MTA interacts with other dental materials with resultant elemental migration in adjacent materials. Zinc oxide eugenol based cements should be avoided in the presence of MTA as zinc causes retardation of cement hydration with increased porosity. Glass ionomer cements absorb the water of hydration from the MTA also resulting in increased porosity and incomplete hydration of MTA.

"MTA"-an Hydraulic Silicate Cement: review update and setting reaction

OBJECTIVES

To review the current status and understanding of Portland cement-like endodontic materials commonly referred to by the trade designation "MTA" (alias "Mineral Trioxide Aggregate"), and to present an outline setting reaction scheme, hitherto unattempted.

METHOD

The literature was searched using on-line tools, overlapping an earlier substantial review to pick up any omissions, including that in respect of ordinary Portland cement (OPC), with which MTA shares much. The search was conducted for the period January 2005 to December 2009 using 'MTA', 'GMTA', 'WMTA', and 'mineral AND trioxide AND aggregate' as keywords, with various on-line search engines including ScienceDirect (http://www.sciencedirect.com), SAGE Journals Online (http://online.sagepub.com), Wiley Online Library (http://onlinelibrary.wiley.com), SciELO Scientific electronic library online (http://www.scielo.br/scielo.php), JSTOR (http://www.jstor.org), and Scopus (http://www.scopus.com). References of articles found were cross-checked where appropriate for missed publications. Manufacturers' and related websites were searched with Google Search (http://www.google.com.hk).

RESULTS

A generic name for this class of materials, Hydraulic Silicate Cement (HSC), is proposed, and an outline reaction scheme has been deduced. HSC has distinct advantages apparent, including sealing, sterilizing, mineralizing, dentinogenic and osteogenic capacities, which research continues to demonstrate. However, ad hoc modifications have little supporting justification.

SIGNIFICANCE

While HSC has a definite place in dentistry, with few of the drawbacks associated with other materials, some improvements in handling and other properties are highly desirable, as are studies of the mechanisms of the several beneficial physiological effects. Reference to the extensive, but complex, literature on OPC may provide the necessary insight.

Dentin treatment effects on the bonding performance of self-adhesive resin cements

The effects of dentin surface treatments on the microtensile bond strengths and on the interfacial characteristics of self-adhesive resin cements were investigated. Flat dentin surfaces were obtained from human molars and were treated as follows: (i) no treatment of dentin; (ii) 0.1 M EDTA scrubbed for 60 s; or (iii) 10% polyacrylic acid applied for 30 s. Three self-adhesive cements were used to lute composite overlays on deep-coronal dentin surfaces in the presence of simulated pulpal pressure (15 cm of H(2)O). Bonded specimens were cut into beams 1 mm thick and stressed in tension until failure. Fractured sticks were examined under a scanning electron microscope. Additional specimens were stained with Masson's trichrome and observed under light microscopy for interfacial evaluations. The bond strength to dentin of the hydrophobic and solvent-free cement (RelyX Unicem) was unaffected by the tested dentin treatments. The bond strength of the 2-hydroxyethyl methacrylate (HEMA)-based cement (Bis-Cem) decreased after treatment of dentin with EDTA and/or polyacrylic acid. The hydrophilic and water-containing cement (G-Cem) attained a higher bond strength when luted on polyacrylic acid-conditioned dentin. In conclusion, smear layer removal, opening of dentinal tubules, and the water content of dentin differently influence the bond strengths and the interfacial characteristics of self-adhesive cement-dentin interfaces.

New Portland cement-based materials for endodontics mixed with articaine solution: a study of cellular response

The biocompatibility of innovative tetrasilicate cements proposed for root-end filling restorations was tested. White ProRoot-MTA and AH Plus were used as control. The new cements were mixed with a local anesthetic solution (4% articaine) to form a paste. Human osteoblast-like cells Saos-2 were challenged in short-term cultures (72 hours) with solid materials and with material extracts prepared in culture medium. Cell growth and viability, cellular attachment, and morphologic features were assessed to verify cell/material interactions. No acute toxicity was exerted by the experimental cements in the assay systems. On solid samples Saos-2 adhered and proliferated on all the experimental cements and on MTA. The ultrastructural findings revealed that Saos-2 were able to adhere and to spread. The maintenance of the osteoblastic phenotype on the innovative cements was confirmed by the alkaline phosphatase assay. All experimental cements prepared with articaine supported the growth of bone-like cells, showing suitable properties to be used as canal sealers and root-end filling materials.