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Koçak Şahin T, Ünal M. Comparison of push-out bond strength and apical microleakage of different calcium silicate-based cements after using EDTA, chitosan and phytic acid irrigations. Microsc Res Tech 2024; 87:2072-2081. [PMID: 38661299 DOI: 10.1002/jemt.24589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/01/2024] [Accepted: 04/18/2024] [Indexed: 04/26/2024]
Abstract
This research was aimed to evaluate push-out bond strength and apical-microleakage after application of three different calcium silicate-based cements with irrigation solutions on simulated immature teeth. 40 maxillary permanent canine teeth were used for push-out bond strength test, and 120 maxillary permanent incisors were used for microleakage evaluation. 120 root slices were divided into four main groups (EDTA, Chitosan, Phytic acid, and Saline) and immersed these solutiouns according to irrigation procedures. Each irrigation group was divided into 3 subgroups (Biodentine, MTA Repair HP, and NeoPUTTY). The prepared teeth were divided into four groups according to irrigation procedure for microleakage test. EDTA irrigation with Biodentine group showed highest push-out bond strength value and saline group with Neoputty showed the lowest push-out bond strength value. The highest microleakage value was seen in saline group with MTA Repair HP, while the lowest microleakage value was observed chitosan with Biodentine group. Chitosan and phytic acid solutions can be recommended as an alternative irrigation solution to 17% EDTA in single-session apexification treatment, since they are non-toxic, naturally occurring materials, effectively remove the smear layer, and have a positive effect on bond strength and apical leakage. RESEARCH HIGHLIGHTS: One of the factors affecting the long-term success of root canal treatment is a hermetic seal. Non-hermetic or inadequate filling triggers a chronic inflammatory reaction in periapical tissues, causing fluids to enter the spaces and negatively affecting the success of the treatment. Therefore, this study will help clinicians choose the right biomaterial and irrigation solution that will affect the success of root canal treatment.
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Affiliation(s)
- Tutku Koçak Şahin
- Faculty of Dentistry, Department of Pediatric Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - Murat Ünal
- Faculty of Dentistry, Department of Pediatric Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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Vlajić Tovilović T, Petrović S, Lazarević M, Pavić A, Plačkić N, Milovanović A, Milošević M, Miletic V, Veljović D, Radunović M. Effect of Acetylsalicylic Acid on Biological Properties of Novel Cement Based on Calcium Phosphate Doped with Ions of Strontium, Copper, and Zinc. Int J Mol Sci 2024; 25:7940. [PMID: 39063181 PMCID: PMC11276672 DOI: 10.3390/ijms25147940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
This study aimed to compare the biological properties of newly synthesized cements based on calcium phosphate with a commercially used cement, mineral trioxide aggregate (MTA). Strontium (Sr)-, Copper (Cu)-, and Zinc (Zn)-doped hydroxyapatite (miHAp) powder was obtained through hydrothermal synthesis and characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive X-ray spectrometry (EDX). Calcium phosphate cement (CPC) was produced by mixing miHAp powder with a 20 wt.% citric acid solution, followed by the assessment of its compressive strength, setting time, and in vitro bioactivity. Acetylsalicylic acid (ASA) was added to the CPC, resulting in CPCA. Biological tests were conducted on CPC, CPCA, and MTA. The biocompatibility of the cement extracts was evaluated in vitro using human dental pulp stem cells (hDPSCs) and in vivo using a zebrafish model. Antibiofilm and antimicrobial effect (quantified by CFUs/mL) were assessed against Streptococcus mutans and Lactobacillus rhamnosus. None of the tested materials showed toxicity, while CPCA even increased hDPSCs proliferation. CPCA showed a better safety profile than MTA and CPC, and no toxic or immunomodulatory effects on the zebrafish model. CPCA exhibited similar antibiofilm effects against S. mutans and L. rhamnosus to MTA.
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Affiliation(s)
- Tamara Vlajić Tovilović
- School of Dental Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (T.V.T.); (S.P.); (M.L.)
| | - Sanja Petrović
- School of Dental Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (T.V.T.); (S.P.); (M.L.)
| | - Miloš Lazarević
- School of Dental Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (T.V.T.); (S.P.); (M.L.)
| | - Aleksandar Pavić
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11 000 Belgrade, Serbia; (A.P.); (N.P.)
| | - Nikola Plačkić
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11 000 Belgrade, Serbia; (A.P.); (N.P.)
| | - Aleksa Milovanović
- Faculty of Mechanical Engineering, University of Belgrade, 11 000 Belgrade, Serbia; (A.M.); (M.M.)
| | - Miloš Milošević
- Faculty of Mechanical Engineering, University of Belgrade, 11 000 Belgrade, Serbia; (A.M.); (M.M.)
| | - Vesna Miletic
- Faculty of Medicine and Health, Sydney Dental School, University of Sydney, Surry Hills, NSW 2010, Australia;
| | - Djordje Veljović
- Faculty of Technology and Metallurgy, University of Belgrade, 11 000 Belgrade, Serbia
| | - Milena Radunović
- School of Dental Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (T.V.T.); (S.P.); (M.L.)
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Kınay Taran P, Kara Ö. Prevention efficacy of dentin tubule sealing with Nd:YAG laser against tooth discoloration induced by vital pulp treatment. Int J Paediatr Dent 2024; 34:153-159. [PMID: 37649171 DOI: 10.1111/ipd.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The discoloration potential of dental materials and applications such as vital pulp therapy also cause discoloration due to the presence of blood. Dentin tubule sealing methods could be used for the prevention of discoloration. AIM The purpose of this study was to evaluate the effect of sealing pulp chamber walls with Nd:YAG laser against discoloration caused by tricalcium silicate-based materials in the presence and absence of blood contamination. DESIGN Eighty-one extracted human maxillary incisors were prepared and randomly divided into nine groups according to the Nd:YAG laser application, the cement to be used (NeoMTA Plus/Biodentine), and the presence or absence of blood. The color measurements were obtained with a spectrophotometer at baseline and then at the sixth (T1) and 12th (T2) months thereafter. RESULTS Sealing with Nd:YAG laser and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). Similarly, without sealing the cavity and placing NeoMTA Plus or Biodentine on human blood significantly increased discoloration at T1 and T2 (p < .05). CONCLUSION Regardless of sealing the dentin tubules with Nd:YAG laser, NeoMTA Plus and Biodentine caused more discoloration in the presence of blood contamination.
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Affiliation(s)
- Pınar Kınay Taran
- School of Dentistry, Department of Paediatric Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Özlem Kara
- School of Dentistry, Department of Prosthodontics, Bezmialem Vakif University, Istanbul, Turkey
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Thakur V. Modified single-step apexification and strengthening of thin dentinal walls with Biodentine. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:214-218. [PMID: 38463468 PMCID: PMC10923217 DOI: 10.4103/jcde.jcde_239_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/07/2023] [Accepted: 12/06/2023] [Indexed: 03/12/2024]
Abstract
Apexification is a technique used to create a mineralized barrier in a root having an open apex or to continue the apical growth of a root that is still not fully developed in teeth with necrotic pulps. Biodentine is a versatile material which can help in achieving apical closure as well as reinforcement of thin dentinal walls, thus improving the overall prognosis and preserving the natural dentition. In the present case, the radiographic evaluation showed thinner dentinal walls and an open apex with periapical radiolucency in relation to the upper right central incisor. The large open root apex and thin dentin walls of immature permanent teeth render them challenging to treat with root canal therapy. This case report describes a modified single-step apexification procedure and strengthening of the dentinal walls of the root canal using Biodentine.
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Affiliation(s)
- Vivek Thakur
- Department of Conservative Dentistry and Endodontics, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
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Ateş MO, Uğur Aydın Z. Evaluation of the effectiveness of different treatment approaches in preventing coronal discoloration caused by regenerative endodontic treatment. Clin Oral Investig 2023; 27:4595-4603. [PMID: 37243821 DOI: 10.1007/s00784-023-05085-0] [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] [Received: 01/18/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of Teethmate desensitizer, a dentin bonding agent (DBA), Nd:YAG laser, and Er:YAG laser, which provides dentin tubule occlusion in the pulp chamber with different mechanisms, in preventing tooth discoloration due to regenerative endodontic treatment. MATERIALS AND METHODS One hundred five extracted maxillary human incisors with single roots and single canals were included in the study. The apical third of each tooth was resected below the enamel-cementum junction (CEJ) to obtain a standard root length as 10 ± 1 mm. Root canal preparation was performed using the ProTaper Next files up to X5. Root canals were prepared with Gates Glidden (# 2-4) burs to simulate the immature root apex and an apical diameter of 1.1 ± 0.1 mm was obtained. The teeth were randomly divided into 7 groups (n = 15): DBA, Teethmate, Nd:YAG, Er:YAG, Biodentine, Blood, and Negative Control. Relevant dentin tubule occlusion methods were applied to DBA, Teethmate, Nd:YAG, and Er:YAG groups. Following dentin tubule occlusion procedures, Biodentine was placed on the blood clot after filling the root canals with blood up to 4 mm below the CEJ. No dentin tubule occlusion procedure was applied for Blood and Biodentine groups. Color measurement was performed with the spectrophotometer Vita Easyshade Advance before treatment, immediately after treatment, and at days 7, 30, and 90. Data were converted to L*a*b color values of Commission International de I'Eclairage (CIE L*a*b) and ΔE values were calculated. Two-way ANOVA and post hoc Tukey test (p = 0.05) were performed for statistical analysis. RESULTS A clinically detectable color change was observed in all groups except for the negative control (ΔE ≥ 3,3). It was observed that Biodentine used alone has a potential for discoloration. It was determined that as the contact time with blood increased, tooth discoloration increased. However, no significant difference was found between dentin tubule occlusion methods in preventing color change (p > 0.05). CONCLUSIONS It was determined that no dentin tubule occlusion method could 100% prevent discoloration caused by RET. CLINICAL RELEVANCE DBA and Teethmate, which do not have a significant difference in terms of preventing color change, are considered to be suitable for dentin tubule occlusion due to their ease of application and low cost compared to Nd:YAG laser and Er:YAG laser.
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Affiliation(s)
- Melis Oya Ateş
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Zeliha Uğur Aydın
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
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Hu X, Li Y, Xu J, Li Q, Wang R. Immature permanent incisors with complicated crown fractures treated with partial pulpotomy using white mineral trioxide aggregate and IRoot BP plus-a retrospective long-term study. Dent Traumatol 2023; 39:165-172. [PMID: 36409268 DOI: 10.1111/edt.12804] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS Calcium silicate cements have been widely used for pulpotomies in immature permanent teeth with complicated crown fractures due to their superior properties. However, few studies have evaluated the long-term outcomes of white mineral trioxide aggregate (WMTA) and iRoot BP Plus for partial pulpotomies. The aim of this study was to investigate the long-term clinical and radiographic outcomes of WMTA and iRoot BP Plus for partial pulpotomies in immature permanent incisors with complicated crown fractures. MATERIALS AND METHODS Children who had partial pulpotomies of immature permanent incisors with complicated crown fractures using WMTA or iRoot BP Plus as capping agents were enrolled. Eighty immature permanent incisors in 68 children (aged 8-13 years) were included. They were divided into two groups (WMTA and iRoot BP Plus) according to the capping agents. Clinical and radiographic information was collected during a 5-year follow-up period. Study data were analyzed using Chi-square tests or Fisher exact tests. RESULTS The clinical and radiographic success rates in the WMTA (n = 36) and iRoot BP Plus groups (n = 44) were 94.4% versus 97.7% and 88.9% versus 97.7%, respectively (both p < .05). The average observation period was 74.5 ± 13.2 months and 61.9 ± 1.6 months in the WMTA and iRoot BP Plus groups, respectively (p < .01). Five cases presented with periapical radiolucencies. The WMTA group had four cases of pulp canal calcification (11.1%), while the iRoot BP Plus group had two cases (4.6%). There was crown discolouration in all cases in the WMTA group, but none in the iRoot BP Plus group. CONCLUSION Both WMTA and iRoot BP Plus had favorable outcomes in promoting physiological development and maintaining the basic functions of immature permanent incisors with complicated crown fractures. As a partial pulpotomy material, iRoot BP Plus may be more suitable for the esthetic zone than WMTA.
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Affiliation(s)
- Xiaoyan Hu
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Yuexiang Li
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Jianguang Xu
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Quanli Li
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Run Wang
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
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Durán CR, Gancedo-Caravia DL, González VV, Losada CG. Push out bond strength of hydraulic cements used at different thicknesses. BMC Oral Health 2023; 23:81. [PMID: 36750823 PMCID: PMC9906962 DOI: 10.1186/s12903-023-02758-w] [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: 11/05/2022] [Accepted: 01/22/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The aim of this study was to compare the pushout bond strength (POBS) of three hydraulic cements, when used at thicknesses of 3 and 5 mm. METHODS 78 root slices of 3 and 5 mm of thickness were obtained from human teeth. Cylindrical cavities of 1.4 mm of diameter were drilled and filled with Biodentine (BD), Totalfill Root Repair paste (TF) or ProRoot MTA White (PMTA). Pushout tests were performed 21 days later. The fracture pattern of each sample was also analyzed. POBS data were analyzed with Welch and Brown-Forsythe and Tamhane's post hoc tests and a Weibull analysis was also performed. RESULTS In the 3 mm group, TF showed significantly lower bond strength than BD and PMTA. In the 5 mm group, BD showed significantly higher bond strength than TF. Both BD and TF showed higher bond strength when the thickness of the sample increased, while PMTA did not. CONCLUSIONS TF and BD achieve higher pushout bond strength resistance when used at a thickness of 5 mm than at 3 mm, while the mean resistance of PMTA is less influenced by the thickness. At 5 mm of thickness, BD and PMTA exhibit similar resistance to displacement. However, the behavior of BD is more predictable than that of its predecessor. BD is a reliable hydraulic cement for clinical situations where thick cavities need to be filled and displacement resistance plays an important role. Clinicians need to consider choosing specific hydraulic cements according to the thickness of material to be used.
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Affiliation(s)
- C. Ruiz Durán
- grid.4795.f0000 0001 2157 7667Department of Consevative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza de Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - Dra L. Gancedo-Caravia
- grid.4795.f0000 0001 2157 7667Department of Consevative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza de Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - V. Vera González
- grid.4795.f0000 0001 2157 7667Department of Consevative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza de Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - C. González Losada
- grid.4795.f0000 0001 2157 7667Department of Consevative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza de Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain
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Llena C, Herrero A, Lloret S, Barraza M, Sanz JL. Effect of calcium silicate-based endodontic sealers on tooth color: A 3-year in vitro experimental study. Heliyon 2023; 9:e13237. [PMID: 36755620 PMCID: PMC9900268 DOI: 10.1016/j.heliyon.2023.e13237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/13/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
Objective To analyze the change in tooth color produced by two hydraulic and one resin-based sealers by means of spectrophotometry for 3 years. Methods Forty maxillary anterior teeth were selected (n = 10 per group). Root canals were prepared by rotary instrumentation and irrigation was performed with NaOCl, which was also used in the final irrigation, followed by saline and activated with Endoactivator. Root canals were then filled using single cone technique. Negative control (NC): gutta-percha filling; Positive control: gutta-percha and AH Plus; experimental groups: gutta-percha and Bioroot RCS/TotalFill BC Sealer. Gutta-percha was cut 2 mm below the cementoenamel junction, the pulp chamber was sealed with flowable composite. The teeth were kept in PBS. Color was measured in the cervical and incisal halves before root canal treatment (RCT), one and six months after RCT, and after one, two and three years, with the Vita EasyShade spectrophotometer; positioned using an individualized splint. ΔEab and ΔE00 were calculated. Two-way ANOVA repeated measures test followed by Bonferroni post-test were performed to analyze the ΔL, Δa*, Δb*, ΔEab, and ΔE00, considering treatment groups and evaluation periods. Statistical significance was set at p < 0.05. Results In the incisal half, in decreasing order of darkening, the groups at three years were ordered according to the ΔEab: AH Plus > NC > TotalFill > Bioroot. ΔE00 values were: 1.38 ± 0.61 NC, 2.37 ± 0.70 AH Plus, 1.86 ± 0.60 BioRoot and 1.53 ± 0.85 TotalFill. In the cervical half, the ΔEab values, showed the same descending order, except for Bioroot and TotalFill which alternated the order. The ΔE00 values were 1.86 ± 0.61 NC, 3.01 ± 0.70 AH Plus,1.89 ± 0.58 Bioroot and 1.65 ± 0.41 TotalFill, with no significant differences between groups and times in both locations. Conclusions All groups presented some degree of discoloration. Lightness and b* component were the most influential. Calcium silicate-based cements (Bioroot RCS and TotalFill BC Sealer) produced acceptable levels of discoloration at the end of follow-up.
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Jesus LSD, Reis TLDS, Machado BGMDM, Costa ALMD, Savaris JM, Volpato CAM, Bortoluzzi EA, Teixeira CDS, Fernandes PCDSV, Garcia LDFR. Dental and composite resin discoloration induced by different hydraulic calcium silicate-based cements: two-year in vitro assessment. J Appl Oral Sci 2023; 31:e20220444. [PMID: 37132699 PMCID: PMC10159045 DOI: 10.1590/1678-7757-2022-0444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/12/2023] [Indexed: 05/04/2023] Open
Abstract
Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.
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Affiliation(s)
- Lucas Santos de Jesus
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departmento de Odontologia - Endodontia, Florianópolis, SC, Brasil
| | | | | | | | - Julia Menezes Savaris
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departmento de Odontologia - Endodontia, Florianópolis, SC, Brasil
| | - Claudia Angela Maziero Volpato
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departmento de Odontologia - Endodontia, Florianópolis, SC, Brasil
| | - Eduardo Antunes Bortoluzzi
- University of Louisville, Department of Diagnosis & Oral Health - Endodontics Division, Louisville, KY, USA
| | - Cleonice da Silveira Teixeira
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departmento de Odontologia - Endodontia, Florianópolis, SC, Brasil
| | | | - Lucas da Fonseca Roberti Garcia
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departmento de Odontologia - Endodontia, Florianópolis, SC, Brasil
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Expert consensus on regenerative endodontic procedures. Int J Oral Sci 2022; 14:55. [PMID: 36450715 PMCID: PMC9712432 DOI: 10.1038/s41368-022-00206-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 12/05/2022] Open
Abstract
Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
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Mousivand S, Sheikhnezami M, Moradi S, Koohestanian N, Jafarzadeh H. Evaluation of the outcome of apexogenesis in traumatised anterior and carious posterior teeth using mineral trioxide aggregate: a 5-year retrospective study. AUST ENDOD J 2022; 48. [PMID: 34699673 DOI: 10.1111/aej.12583] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/02/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to evaluate the outcome of apexogenesis with mineral trioxide aggregate (MTA) in traumatised anterior and carious posterior teeth over 5 years. A comprehensive chart review was performed to obtain a retrospective of sequential previously completed cases with recalls. Clinical and radiographic data were collected for 97 vital immature teeth (40 traumatised anterior and 57 carious posterior teeth) pulpotomised (partial or full pulpotomy) using MTA with an average follow-up time of 5 years. Chi-squared test and Fisher's exact test were implemented to analyse data. The success rate in anterior teeth and posterior teeth was 82.5% and 96.4% respectively. Crown discolouration was observed in 25 (62.5%) anterior teeth. There was a significant difference between the number of successful and unsuccessful cases (P < 0.05) and there was no correlation between type of treatment and success/failure (P > 0.05). The success rate of apexogenesis using MTA in immature teeth was relatively high.
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Affiliation(s)
| | - Mahshid Sheikhnezami
- Dental Trauma Center, Academic Center for Education, Culture and Research, Mashhad, Iran
| | - Saeed Moradi
- Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamid Jafarzadeh
- Dental Trauma Center, Academic Center for Education, Culture and Research, Mashhad, Iran.,Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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12
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Coronal discoloration induced by calcium silicate-based cements used in full pulpotomy in mature permanent molars: a randomized clinical trial. Clin Oral Investig 2022; 27:1723-1730. [PMID: 36445467 DOI: 10.1007/s00784-022-04799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/17/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVES This study aimed to randomly compare in vivo coronal discoloration at 6 and 12 months after full pulpotomy in mature permanent molars using MTA, Biodentine, and TotalFill and to investigate the effect of variables such as remaining buccal wall thickness and time to achieve hemostasis. MATERIALS AND METHODS One hundred eight teeth that met the inclusion criteria received full pulpotomy and were randomly divided into 3 groups via a block randomization technique according to the calcium silicate cement (CSC): ProRoot WMTA, TotalFill, or Biodentine. Assessment of tooth color was carried out using a spectrophotometric device (VITA Easyshade Compact) after composite placement (T0), at 6- and 12-month follow-up. Buccal wall thickness and time to hemostasis were recorded. The primary outcome measure (color change ΔE) was calculated, and the results were analyzed by three-way ANOVA and crosstabulations in relation to material type and effect of variables. RESULTS Four cases were excluded after pulpotomy failure; 81 teeth were evaluated at 6 months and 95 teeth at 12 months. All CSCs caused tooth discoloration (defined as ΔE > 3.7); MTA significantly caused the highest color change at 6- and 12-month follow-up (76% (19/25) and 87.5% (28/32), respectively) compared to Biodentine (41% (9/22), 48% (13/27)) and TotalFill (44% (15/34), 53% (19/53)) (p = 0.022, p = 0.002), while no significant difference was found between the Biodentine and TotalFill groups (p = 0.813, p = 0.8). Buccal wall thickness (above or below 2.7 mm) had a significant effect on the degree of discoloration (p = 0.004). CONCLUSIONS The 3 CSCs caused tooth discoloration based on the threshold of ΔE > 3; the remaining buccal wall thickness was a significant factor. The use of Biodentine and TotalFill instead of MTA is encouraged to minimize discoloration. CLINICAL RELEVANCE While experimental studies report coronal discoloration after CSCs use, clinical data is lacking. This study assessed discoloration using a spectrophotometric device. The use of materials with lower discoloration potential in pulpotomy is encouraged. TRIAL REGISTRATION The study was registered with clinical trial registration number: NCT04346849 on 14.4.2020.
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Hassan T, Qiu Y, Hasan MR, Saito T. Effects of Dentin Phosphophoryn-Derived RGD Peptides on the Differentiation and Mineralization of Human Dental Pulp Stem Cells In Vitro. Biomedicines 2022; 10:2781. [PMID: 36359301 PMCID: PMC9687143 DOI: 10.3390/biomedicines10112781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 10/12/2023] Open
Abstract
The purposes of this study were to investigate the in vitro effects of arginine-glycine-aspertic acid (RGD) peptides derived from human dentin phosphophoryn (DPP) on human dental pulp stem cell-proliferation, differentiation and mineralization, and to explore the mechanism of the peptides' function. The 1 M concentration of soluble DPP-derived RGD peptides, RGD-1, RGD-2 and RGD-3 were coated onto non-tissue-culture polystyrene plates, and human dental pulp stem cells (hDPSCs) were cultured on them to examine the effects of the peptides on hDPSCs. In addition, 1 M arginine-alanine-aspertic acid (RAD) peptides were used as the control. Cell proliferation of hDPSCs was promoted by all three RGD peptides. All three RGD peptides had significantly higher alkaline phosphatase (ALP) activity compared to the control. RGD-3 induced the highest ALP activity compared to the control. RGD-3 also significantly promoted the mRNA expression of the following genes: 1.69-fold in dentine matrix protein-1 (DMP-1), 1.99-fold in dentine sialophosphoprotein (DSPP), 1.51-fold in ALP, and 2.31-fold in bone sialoprotein (BSP), as compared to the control group. Mineralization of hDPSCs was accelerated by all three RGD peptides, RGD-3 in particular. The MAPK p38 inhibitor SB202190 inhibited the effect of RGD-3 to a level comparable to the control, observed in both ALP activity assay and Arizarin red S (ARS) staining. It suggests that the p38 pathway may be responsible for eliciting the differentiation and mineralization effects of DPP-derived RGD peptides in the hDPSCs. The mRNA expression levels of the integrins ITGA1-5, ITGA7, ITGB1 and ITGB3 were significantly upregulated. Among them, expression of ITGA5 was promoted 1.9-fold, ITGA7 1.58-fold, ITGB1 1.75-fold and ITGB3 1.9-fold compared to the control. It suggests the possible involvement of these integrin channels in different subunit combinations facilitating signal transduction for differentiation of hDPSCs into odontoblasts. As conclusions, human DPP-derived RGD peptides RGD-1, RGD-2 and RGD-3 promoted the proliferation, differentiation and mineralization of hDPSCs in vitro. Among the three peptides, RGD-3 had the most significant effects. It is also suggested that RGD-3 binds to integrin receptors on the surface of hDPSCs and regulates the odontogenic gene expression and differentiation via activation of p38 of MAPK pathway. DPP-derived RGD-3 may be a promising choice in the formulation of a novel material for vital pulp therapy to induce dental pulp stem cells into odontoblasts and form reparative dentin on the exposed pulp tissue.
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Affiliation(s)
- Tubayesha Hassan
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Hokkaido, Japan
| | - Youjing Qiu
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361008, China
| | - Md Riasat Hasan
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Hokkaido, Japan
| | - Takashi Saito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Hokkaido, Japan
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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15
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Matoug‐Elwerfelli M, ElSheshtawy A, Duggal M, Tong H, Nazzal H. Vital pulp treatment for traumatised permanent teeth: a systematic review. Int Endod J 2022; 55:613-629. [DOI: 10.1111/iej.13741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - A.S. ElSheshtawy
- Department of Endodontics Faculty of Dentistry Cairo University Egypt
| | - M. Duggal
- College of Dental Medicine QU Health Qatar University Doha Qatar
| | - H.J. Tong
- Discipline of Orthodontics and Paediatric Dentistry Faculty of Dentistry National University of Singapore Singapore
| | - H. Nazzal
- Dentistry Department Hamad Dental Centre Hamad Medical Corporation Doha Qatar
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16
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Portland Cement: An Overview as a Root Repair Material. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3314912. [PMID: 35036431 PMCID: PMC8758263 DOI: 10.1155/2022/3314912] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/08/2021] [Indexed: 01/08/2023]
Abstract
Portland cement (PC) is used in challenging endodontic situations in which preserving the health and functionality of pulp tissue is of considerable importance. PC forms the main component of mineral trioxide aggregate (MTA) and demonstrates similar desirable properties as an orthograde or retrograde filling material. PC is able to protect pulp against bacterial infiltration, induce reparative dentinogenesis, and form dentin bridge during the pulp healing process. The biocompatibility, bioactivity, and physical properties of PC have been investigated in vitro and in animal models, as well as in some limited clinical trials. This paper reviews Portland cement's structure and its characteristics and reaction in various environments and eventually accentuates the present concerns with this material. This bioactive endodontic cement has shown promising success rates compared to MTA; however, considerable modifications are required in order to improve its characteristics and expand its application scope as a root repair material. Hence, the extensive chemical modifications incorporated into PC composition to facilitate preparation and handling procedures are discussed. It is still important to further address the applicability, reliability, and cost-effectiveness of PC before transferring into day-to-day clinical practice.
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17
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Dželetović B, Milanović I, Antonijević Đ, Badnjar J, Petrov Z, Antić S, Ležaja-Zebić M. Radiopacity of premixed and two-component Calcium silicate-based Root Canal sealers. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm2203161d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background/Aim: Radiopacity enables radiographic visualization, which is significant in diagnostic procedures and assessment of the quality of endodontic filling. It is important to compare newly developed endodontic sealers with materials that are already in clinical use in order to promote evidence-based dentistry. The aim of our study was to evaluate radiopacity of different calcium silicate-based sealers in comparison with control, epoxy resin-based sealer. The null hypothesis was that there were no statistically significant differences in radiopacity of the tested sealers. Material and Methods: Premixed (TotalFill BC Sealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer), two-component (BioRoot RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal) calcium silicate-based sealers and AH Plus, as a control, were used. Specimens were radiographed using a Radiovisiography (RVG-4) CCD (charge-coupled devices)-based digital sensor. Results: Ceraseal had the highest, while Bioceramic Root Canal Sealer had the lowest radiopacity. Bioceramic Root Canal Sealer and MTA Fillapex had radiopacity significantly lower than all other sealers. Radiopacity level of AH Plus, was similar to premixed and significantly higher than radiopacities of all two-component endodontic sealers. Conclusions: Calcium silicate-based sealers radiopacity ranged from slightly above minimal required value (3mm), to a value higher than control sealer. Premixed endodontic sealers showed similar radiopacity as AH Plus which suggests that their clinical performance, in terms of visibility on dental radiograms, should be similar
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18
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Silva RAB, Gaton-Hernandez P, Pucinelli CM, Silva FWGDPE, Lucisano MP, Consolaro A, de Sá RC, Araujo LDC, Sousa-Neto MD, Silva LAB. Subcutaneous tissue reaction and gene expression of inflammatory markers after Biodentine and MTA implantation. Braz Dent J 2022; 33:41-56. [PMID: 35262553 PMCID: PMC9645138 DOI: 10.1590/0103-6440202203562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/20/2020] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice exposed to tricalcium silicate (Biodentine) and aggregated mineral trioxide (ProRoot MTA). A total of 120 mice were divided into 4 groups in 3 different experimental periods (7, 21 and 63 days): Biodentine; Pro-Root MTA; zinc oxide-eugenol and; Negative control - Sham. After the experimental periods microscopic descriptive, semi-quantitative and quantitative analysis of the inflammatory process were analyzed on H&E sections and evaluation of the gene expression of Il10, Infg, Il6, Il1r1 and Tnf (qRT-PCR) were performed. The data obtained were analyzed using the chi-square test and two-way analysis of variance (ANOVA) followed by the Bonferroni post-test (5% significance level). Results: In the microscopic analysis, a slight inflammatory infiltrate was observed, with a predominance of sparse macrophages and polymorphonuclear cells, slight tissue fibrosis, regular fibrous capsule and with dystrophic calcifications, in all groups that received the materials (Biodentine and Pro-Root MTA). In parallel, all materials modulated the gene expression of the different cytokines and receptors evaluated. Conclusion: Pro-Root MTA and Biodentine showed a tissue compatibility, mediated inflammation, with increased fibrous tissue and production of pro- and anti-inflammatory cytokines.
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Affiliation(s)
- Raquel Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | - Patrícia Gaton-Hernandez
- Department of Integrated Paediatric Dentistry, School of Dentistry,
University of Barcelona, Barcelona, Spain
| | - Carolina Maschietto Pucinelli
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | | | - Marília Pacífico Lucisano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | - Alberto Consolaro
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil, Department of Oral Pathology, Bauru Dental School, University of
Sao Paulo, São Paulo, SP, Brazil
| | - Rafaela Cardoso de Sá
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | - Lisa Danielly Curcino Araujo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of
Ribeirão Preto, University of Sao Paulo, São Paulo, SP, Brazil
| | - Léa Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão
Preto, University of Sao Paulo, São Paulo, SP, Brazil
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Slaboseviciute M, Vasiliauskaite N, Drukteinis S, Martens L, Rajasekharan S. Discoloration Potential of Biodentine: A Systematic Review. MATERIALS 2021; 14:ma14226861. [PMID: 34832263 PMCID: PMC8619462 DOI: 10.3390/ma14226861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
The aim of this systematic review is to investigate the teeth discoloration potential of Biodentine. An electronic search in six databases (PubMed, Cochrane Library, LILACS, SCIELO, Web of Science, and Scopus) was conducted by three independent reviewers to identify eligible articles. The following search terms were used: ((discolo*, staining potential, color, colour, or spectrophotomet*), (teeth or tooth), and (Biodentine)). Methodology following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was adopted for this investigation. At the end of the selection process, 30 articles were identified as eligible, of which 14 in vitro studies were included in this systematic review. Nine of the included studies evaluated the discoloration potential of Biodentine in the presence of blood. Within the limitations of this review, teeth discoloration using Biodentine is highly expected when material is placed in direct contact with blood during dental procedures. In the absence of blood, Biodentine causes less teeth color changes than MTA-based materials, but it is still unclear what clinically relevant results could be expected regarding the discoloration frequency and intensity induced by Biodentine.
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Affiliation(s)
- Monika Slaboseviciute
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Neringa Vasiliauskaite
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
| | - Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania; (M.S.); (N.V.)
- Correspondence: ; Tel.: +370-610-41808
| | - Luc Martens
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry, Ghent University School of Oral Health Sciences, B-9000 Ghent, Belgium; (L.M.); (S.R.)
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Cardoso PDC, Chaves GS, Decurcio DDA, Decurcio RDA, Rossi-Fedele G, de Magalhães APR. Late discolouration of root-treated teeth and subsequent restorative retreatment: three case reports. AUST ENDOD J 2021; 48:179-186. [PMID: 34637558 DOI: 10.1111/aej.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/30/2022]
Abstract
Root-filled teeth that receive ceramic veneers may experience subsequent coronal discolouration, which will likely negatively affect the quality of life of patients and their relationship with the clinician. This manuscript describes three cases of this undesirable aesthetic consequence in anterior teeth of young patients and the subsequent restorative reintervention, with satisfactory results. In all three reports, the root canal filling was performed using cements containing bismuth oxide that likely disassociated into reduced metallic crystals when in contact with LED light. The discolouration observed after veneer cementation was most likely caused by the accumulation of these bismuth metallic crystals. These cases highlight the importance of preventing this undesirable complication, which may also result in the potential subsequent further sacrifice of sound coronal dental structure, and the role of recall in aesthetically demanding clinical cases.
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Affiliation(s)
- Paula de Carvalho Cardoso
- Department of Restorative Dentistry and Esthetic, Brazilian Dentistry Association - Section of Goiás, Goiânia, Brazil
| | - Gustavo Silva Chaves
- Department of Endodontics, Dentistry School, Federal University of Goiás, Goiânia, Brazil
| | | | - Rafael de Almeida Decurcio
- Department of Restorative Dentistry and Esthetic, Brazilian Dentistry Association - Section of Goiás, Goiânia, Brazil
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21
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Colorimetric Comparison of Internal Bleaching with and without Removing Mineral Trioxide Aggregate (MTA) on Induced Coronal Tooth Discoloration by MTA. Int J Dent 2021; 2021:8319986. [PMID: 34621316 PMCID: PMC8492271 DOI: 10.1155/2021/8319986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective. This study aimed to colorimetric comparison of internal bleaching with and without removing mineral trioxide aggregate (MTA) on induced coronal tooth discoloration by MTA cement. In this experimental study, twenty human teeth were prepared. An OrthoMTA barrier was placed 1 mm below the CEJ. The teeth were restored with composite resin and were placed in the aging accelerator machine. Then, the specimens were divided into two groups (n = 10); in group A, part of the OrthoMTA was removed and the glass ionomer was placed on the OrthoMTA, and in group B, the OrthoMTA remained intact. Internal bleaching was performed 5 times in 6-day intervals using 37% carbamide peroxide gel. Color determination was performed in 5 stages: baseline, after OrthoMTA discoloration, before OrthoMTA removal, after OrthoMTA removal, and after bleaching treatment sessions. In group A, 8 specimens reached to ∆E < 3.3 after 2 times internal bleaching treatment, and in group B, 5 specimens reached to ∆E < 3.3 with almost 3 bleaching sessions (p > 0.05). Additionally, 5 specimens reached to the initial color (baseline) after bleaching treatment, 4 specimens in group A and 1 specimen in group B. After OrthoMTA removal, 2 specimens in group A reached to ∆E < 3.3. There was no significant difference between groups with or without OrthoMTA removal (p=0.06). Although, the specimens with OrthoMTA removal required fewer bleaching treatment sessions, and the mean value of ∆E was lower in this group.
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Al-Hiyasat AS, Ahmad DM, Khader YS. The effect of different calcium silicate-based pulp capping materials on tooth discoloration: an in vitro study. BMC Oral Health 2021; 21:330. [PMID: 34215230 PMCID: PMC8254364 DOI: 10.1186/s12903-021-01677-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Variation in the composition of calcium silicate-based pulp capping materials could influence the discoloration potential of some of these materials, thus affecting the color and aesthetic appearance of the coronal tooth structure. Furthermore, contact with blood if hemostasis is not fully achieved may enhance this discoloration for some materials. Therefore the aim of this study was to evaluate in vitro the color change of coronal tooth structure after placing various calcium silicate-based materials in the pulp chamber in the presence or absence of blood. Mehtods Maxillary extracted premolars (n = 144) were sectioned and the crowns were separated from the roots. Pulp chambers were prepared to a standard size and then the tested materials (GMTA Angelus, ProRoot WMTA, Biodentine, TheraCal, and TotalFill) were placed with saline or with blood. Color change was assessed by spectrophotometry; prior to and after material placement at different time intervals of 24 h, 1 week, 1 month, 3 months, and 6 months. Color change (ΔE) values were calculated and statistically analyzed. Results In the saline groups, Biodentine caused the least color change, while GMTA and WMTA caused the highest color change which were significantly different from the others (p < 0.001), TotalFill and TheraCal caused moderate changes. Adding blood increased the ΔE overall the tested materials to various degrees. Biodentine was the most affected by the blood, while MTA groups were the least affected, followed by TotalFill and then TheraCal. The increase in ΔE was significant over time up to 3 months, after which the increase was not significant. Conclusions Overall, WMTA and GMTA caused the most severe discoloration. In saline, Biodentine caused the least discoloration, but it was the most affected by the presence of blood, although it still caused the least discoloration similar to that observed with TotatFill. TheraCal caused moderate discoloration but more than that caused by Biodentine and TotalFill.
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Affiliation(s)
- Ahmad S Al-Hiyasat
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
| | - Dana M Ahmad
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Yousef S Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Krug R, Ortmann C, Reich S, Hahn B, Krastl G, Soliman S. Tooth discoloration induced by apical plugs with hydraulic calcium silicate-based cements in teeth with open apices-a 2-year in vitro study. Clin Oral Investig 2021; 26:375-383. [PMID: 34151389 PMCID: PMC8791895 DOI: 10.1007/s00784-021-04009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/20/2021] [Indexed: 11/10/2022]
Abstract
Objectives To assess tooth discoloration induced by different hydraulic calcium silicate-based cements (HCSCs), including effects of blood and placement method. Materials and methods Eighty bovine teeth cut to a length of 18 mm (crown 8 mm, root 10 mm) were randomly assigned to 10 groups (n = 8), receiving orthograde apical plug treatment (APT). Apical plugs were 4 mm in length and made of ProRoot MTA (Dentsply), Medcem MTA (Medcem), TotalFill BC RRM Fast Set Putty (Brasseler), or Medcem Medical Portland Cement (Medcem) plus bismuth oxide (Bi2O3) with and without bovine blood. Further, orthograde (with or without preoperative adhesive coronal dentin sealing) and retrograde APT were compared. Teeth were obturated with gutta-percha and sealer, sealed with composite and stored in distilled water. Tooth color was measured on apical plug, gutta-percha/sealer, and crown surface before treatment versus 24 h, 1, 3, 6, 12, and 24 months after treatment by spectrophotometry. Color difference (ΔE) values were calculated and analyzed by Shapiro–Wilk test, ANOVA with post hoc tests, Friedman test, t test, and post hoc tests with Bonferroni correction (α = .05). Results Tooth discoloration occurred in all groups with no significant differences between HCSCs (p > .05). After 24 months, color changes were prominent on roots but insignificant on crowns. Blood contamination induced a significantly decreased luminescence (p < .05). Blood had a stronger impact on tooth color than Bi2O3. No relevant effects of retrograde placement (p > .05) or preoperative dentin sealing (p > .05) were detected. Conclusions Apical plugs of the tested HCSCs cause discoloration of bovine roots, but not discoloration of bovine tooth crowns within a 24-month period. Clinical relevance APT should be performed carefully while avoiding direct contact with the coronal dentin, and in that case no aesthetic impairments occur.
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Affiliation(s)
- Ralf Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | | | | | - B Hahn
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - G Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - S Soliman
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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de Jesus LS, Volpato CAM, Bortoluzzi EA, da Silveira Teixeira C, Rossetto HL, de Carvalho Panzeri Pires-de-Souza F, da Fonseca Roberti Garcia L. Tooth discoloration induced by the different phases of a calcium aluminate cement: One-year assessment. J ESTHET RESTOR DENT 2021; 33:999-1009. [PMID: 33929073 DOI: 10.1111/jerd.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/16/2021] [Accepted: 04/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the discoloration of teeth treated with the different phases of calcium aluminate cement (CAC), in comparison with the conventional CAC and mineral trioxide aggregate (MTA). MATERIALS AND METHODS Fifty bovine incisors were prepared and filled. Two millimeters of the filling was removed to fabricate a cervical plug with the following cements (n=10): CA(CaO.Al2 O3 ); CA2 (CaO.2Al2 O3 ); C12 A7 (12CaO.7Al2 O3 ); CAC and MTA. The initial color measurement was performed and after 7, 15, 30, 45, 90, 180, and 365 days new color measurements were performed to determine the color (ΔE00 ), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and the whiteness index (WID ). RESULTS ΔE00 was significant for groups (p = 0.036) and periods (p < 0.05). The greater ΔE00 was observed after 365 days for CAC (12.8). C12 A7 (7.2) had the smallest ΔE00 . ΔL' and ΔC' were significant for groups and periods (p < 0.05). ΔH' was significant for periods (p < 0.05). After 365 days, significant reduction in lightness was observed for all groups. For CA, CA2 , CAC, and MTA groups, the WID values decreased over time (p < 0.05). CONCLUSIONS The tested cements changed the color behavior of the samples, resulting in greater teeth darkening over time. CLINICAL SIGNIFICANCE There is no long-term study assessing the discoloration induced by the different phases of CAC.
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Affiliation(s)
- Lucas Santos de Jesus
- Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Eduardo Antunes Bortoluzzi
- Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Pulpal Response to the Combined Use of Mineral Trioxide Aggregate and Iloprost for Direct Pulp Capping. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: The present study aims to assess the combined effects of mineral trioxide aggregate (MTA) and iloprost when used as a pulp capping material on pulpal inflammation and tertiary dentin formation compared with MTA and iloprost alone in rat molar teeth. Methods: Eighty maxillary first molar rat teeth were exposed and capped with iloprost solution, MTA, or MTA mixed with iloprost (MTA-iloprost). The cavities were then filled with resin-modified glass ionomer. The cavity was restored with glass ionomer without the use of pulp capping agent in the control group. The rats were sacrificed after one and four weeks. Block sections of the molar specimens were prepared and subjected to hematoxylin and eosin staining for evaluation. Statistical analysis was done using the Kruskal–Wallis test, followed by Dunnett’s test. Results: At week one, the control group showed significantly more severe pulpal inflammatory reactions than the iloprost (p = 0.00), MTA (p = 0.04), and MTA-iloprost (p = 0.00) groups. Hard tissue formation was commonly found in the iloprost, MTA, and MTA-iloprost groups. After four weeks, pulpal tissue degeneration was observed in the control group. Complete hard tissue barriers were found in 50%, 72.7%, and 77.8% of the specimens in iloprost, MTA, and MTA-iloprost groups, respectively, with no significant differences among the experimental groups. The dentinal tubule patterns were mostly regular in the MTA-iloprost group and irregular in the iloprost and MTA groups. Conclusions: The application of iloprost, MTA, and MTA-iloprost as a pulp capping material resulted in similar pulpal responses in the mechanically exposed pulp of rat molars. Therefore, mixing MTA with iloprost might not be clinically significant.
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Effect of different manipulations on the physical, chemical and microstructural characteristics of Biodentine. Dent Mater 2021; 37:e399-e406. [PMID: 33863567 DOI: 10.1016/j.dental.2021.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/27/2021] [Accepted: 03/28/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The water to powder ratio and method of mixing is important for the properties of hydraulic cements. For this purpose a number of clinicians prefer premixed materials. Dental manufacturing companies provide predosed materials, however the manufacturer instructions are not always adhered to. The aim of this research is to investigate physical and chemical alterations of the tricalcium silicate-based cement Biodentine when manipulated according to the manufacturer's instructions (control) or changing the doses and mixing of the material components. METHODS 6 groups were constituted according to different mixing and dosing of powder and liquid. The hydrated cements were characterized using scanning electron microscopy (SEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR). Calcium ion concentration of the leachate was also investigated. Assessment of the physical characteristics included setting time and microhardness. RESULTS Microstructural differences were visible only in the Biodentine mixed manually with water, in which early hydration rate was also affected, with lower calcium ion release. Increase of Biodentine liquid increased the calcium ion release, but also increased the setting time. Manual manipulation required more liquid (both water and Biodentine liquid) added to the mixture to guarantee a similar consistency to the control. A decrease in setting time was also noted. All groups showed higher values of microhardness at 24 h compared to the freshly set materials. In the freshly set materials, there was an overall decrease in microhardness in all groups when compared to group control, particularly significant when increasing the dosage of Biodentine liquid. SIGNIFICANCE When mixing Biodentine, altering the mixing procedure in terms of type and amount of liquid added to the powder and mixing device chosen has an effect on the physical, chemical and mechanical characteristics and surface topography of the material, when compared to Biodentine mixed according to the manufacturer's recommendations. Hence, the manufacturer's instructions should be strictly followed.
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Arandi NZ, Thabet M. Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5569313. [PMID: 33884264 PMCID: PMC8041541 DOI: 10.1155/2021/5569313] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/03/2021] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Abstract
Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.
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Affiliation(s)
- Naji Ziad Arandi
- Department of Conservative Dentistry and Prosthodontics, Arab American University, Jenin, State of Palestine
| | - Mohammad Thabet
- Department of Orthodontics and Pediatric Dentistry, Arab American University, Jenin, State of Palestine
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Moazzami F, Sahebi S, Shirzadi S, Azadeh N. Comparative in vitro Assessment of Tooth Color Change under the Influence of Nano Fast Cement and MTA. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:48-52. [PMID: 33718530 PMCID: PMC7921768 DOI: 10.30476/dentjods.2020.85057.1113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Tooth color changes followed by treatment with bioceramic materials are always a matter of concern. Purpose The aim of the present in vitro study was to compare tooth discoloration that occurs in human teeth filled with ProRoot WMTA (DENTSPLY Tulsa Dental Specialties, Tulsa, OK) and those filled with Nano Fast Cement (NFC) over the course of 3 months. Materials and Method In this experimental study, Thirty human intact premolars were obtained. The roots of all teeth were removed by a horizontal cut about 2 mm below the cementoenamel junction. The pulp tissues were removed using a barbed broach (Mani, Tokyo, Japan).The teeth were randomly divided to 3 groups (n= 10) including the control (no material), ProRoot WMTA and NFC. The experimental materials were condensed into the crowns and the teeth ends were sealed with light-cure glass ionomer cement (GC Corporation, Tokyo, Japan). The color was assessed at TBL (baseline; after preparation of the cavities but before placement of the materials), TPO (immediately after placement of the filling material and provisional restoration), T4 (after 4weeks of storage), and T12 (after 12weeks) of storage. Results The discoloration was evident in all teeth, immediately (TPO) after applying MTA and NFC. The highest ΔΕ was noted in WMTA at 12 weeks, followed by NFC; however, there was no significant difference between the discolorations induced by these two materials. Conclusion Similar levels of clinically observable tooth discoloration were detected by using either WMTA or NFC.
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Affiliation(s)
- Fariborz Moazzami
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sareh Shirzadi
- Dept. of Endodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloufar Azadeh
- Dept. of Orthodontic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Mehta DL, Abraham S, Kamble AB, Vaswani SD, Najan HB, Mehta PL. Spectrophotometric analysis of the color stability of white mineral trioxide aggregate in contact with four different irrigating solutions - An in vitro study. J Conserv Dent 2021; 23:377-383. [PMID: 33623240 PMCID: PMC7883782 DOI: 10.4103/jcd.jcd_412_20] [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: 08/19/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 11/04/2022] Open
Abstract
Aims This study aims to compare the color stability of white mineral trioxide aggregate (wMTA) in contact with four irrigating solutions. Settings and Design Original research study. Subjects and Methods Fifty cylindrical discs of wMTA, 10 mm in diameter and 2 mm in height were prepared using a mold. Samples were incubated at a temperature of 37°C and at 100% humidity for the material to reach its optimal mechanical properties. The samples were divided into 6 groups: Group A: dry (n = 5); Group B: distilled water (DW) (n = 5); Group C: 5% sodium hypochlorite (NaOCl) (n = 10); Group D: 2% chlorhexidine gluconate (CHX) (n = 10); Group E: 17% aqueous ethylene diamine tetra-acetic acid (EDTA) (n = 10); Group F: 0.2% Chitosan (n = 10) Each disc was immersed into the irrigating solution for a period of 24 h. All the specimens were photographed using a digital camera before and after immersion. The assessment of color change of each disc of wMTA was conducted by a spectrophotometer. The Commission Internationale de l'eclairage system was used to calculate the differences in color. Statistical Analysis Used Statistical Package for the Social Sciences version 16.0 (Chicago, IL, USA) at a significance level of P < 0.05 was used. Results All groups except group A exhibited discoloration of wMTA. The mean values for change in color was highest with Group D, followed by Group C, F, E, B, and group A. Only Group B when compared to group A did not show any statistically significant difference (P = 0.948) whereas all the other four groups showed a highly statistically significant difference (P < 0.001). Conclusions 2% CHX causes maximum discoloration of wMTA followed by 5% NaOCl, 0.2% Chitosan and least discoloration with 17% aqueous EDTA and DW.
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Affiliation(s)
- Disha Lalit Mehta
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sathish Abraham
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Aradhana Babu Kamble
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sneha Dhruvkumar Vaswani
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Harshal B Najan
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Puneet Lalit Mehta
- Department of Periodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
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Camilleri J, Borg J, Damidot D, Salvadori E, Pilecki P, Zaslansky P, Darvell BW. Colour and chemical stability of bismuth oxide in dental materials with solutions used in routine clinical practice. PLoS One 2020; 15:e0240634. [PMID: 33176336 PMCID: PMC7657490 DOI: 10.1371/journal.pone.0240634] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/29/2020] [Indexed: 11/19/2022] Open
Abstract
Bismuth(III) oxide is included as a radio-opacifier in dental materials, including hydraulic silicate cements, the material of choice for several endodontic procedures. It has been implicated in tooth discoloration after contact with endodontic irrigants, in particular NaOCl solution, To date, there has been no work on the chemistry: all reports have been of clinical findings only. The purpose now was to report the reactions leading to colour change from Bi2O3 in contact with solutions used in routine endodontic practice. Ten-gram portions of Bi2O3 were immersed in either water, NaOH, NaCl, NaOCl or HCl solution, either in the dark or exposed to visible light, and samples retrieved at 1, 4, 12 and 24 weeks. After washing, these were exposed to either added CO2 or not, for 1 week while drying, and under the same dark or light conditions. Changes in appearance were monitored by photography and colour measurement, and chemically by X-ray diffraction and Fourier-transform infrared spectroscopy. 24-week material was studied using electron paramagnetic resonance and Raman spectroscopy; NaOCl-treated material was also examined by scanning electron microscopy. With water, NaCl and NaOH, bismuth subcarbonate was formed. With or without added carbon dioxide, discoloration occurred from pale yellow to light brown when exposed to light, and to a lesser extent in the dark, intensifying with time. In contrast, exposure to NaOCl rapidly formed a dark brown-black sodium bismuthate. With HCl, white BiOCl was formed. Bi2O3 is not at all inert in this context as is commonly believed, denying its principle of use. Previously unreported solution-mediated reaction occurs readily even in water and NaCl solution, forming new compounds that discolour. In contact with NaOCl sodium bismuthate is formed; severe darkening occurs rapidly. The reactivity is such that Bi2O3 is not indicated for dental materials and should be withdrawn from use.
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Affiliation(s)
- Josette Camilleri
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Joseph Borg
- Systems Engineer, Triq L-Uqija Ta L-Ibrag, Is-Swieqi, Malta
| | - Denis Damidot
- Department of Civil and Structural Engineering, Faculty of Civil Engineering, Ecole de Mines, LGCgE-GCE, Douai, France
| | | | - Peter Pilecki
- Imaging and Microscopy, King’s College London, London, United Kingdom
| | - Paul Zaslansky
- Department for Operative and Preventive Dentistry, Centrum für Zahn-, Mund- und Kieferheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Brian W. Darvell
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
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Tripathi R, Cohen S, Khanduri N. Coronal Tooth Discoloration After the Use of White Mineral Trioxide Aggregate. Clin Cosmet Investig Dent 2020; 12:409-414. [PMID: 33061653 PMCID: PMC7533229 DOI: 10.2147/ccide.s266049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
Mineral trioxide aggregate (MTA) has been used in regenerative procedures but observations have indicated that with its use there is dark staining of the tooth structure. This case report describes the treatment of tooth discoloration caused by white mineral trioxide aggregate (WMTA). Revascularization was performed with the use of WMTA in the upper left central incisor. Grayish discoloration appeared 9 months later, the tooth necessitating internal bleaching of the tooth. A significant improvement was observed in the crown after internal bleaching. The choice of material should not rely solely on biological and functional aspects, but aesthetic considerations should also be taken into account. The patient needs to be advised of risks, benefits, and alternatives to internal bleaching, eg, a veneer or a crown. Coronal discoloration is a significant distraction and embarrassment for many people in achieving an aesthetic smile; thus, it must be corrected at the earliest possible stage of discoloration.
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Affiliation(s)
- Rupam Tripathi
- Department of Conservative Dentistry and Endodontics, UCMS College of Dental Surgery, Bhairahawa, Nepal
| | - Stephen Cohen
- American Board of Endodontics, San Francisco, CA, USA
| | - Nitin Khanduri
- Department of Pedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
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Chen SJ, Karabucak B, Steffen JJ, Yu YH, Kohli MR. Spectrophotometric Analysis of Coronal Tooth Discoloration Induced by Tricalcium Silicate Cements in the Presence of Blood. J Endod 2020; 46:1913-1919. [PMID: 32949559 DOI: 10.1016/j.joen.2020.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION New tricalcium silicate cements have been shown to induce less coronal discoloration. The purpose of this in vitro study was to evaluate the degree of color change induced by various silicate materials in the presence and absence of blood. METHODS One hundred human extracted anterior single-canal teeth were sectioned to standardized root lengths, accessed, and instrumented. Eight random experimental groups and 2 control groups were created wherein specimens were filled with experimental materials below the buccal cementoenamel junction as follows: EndoSequence RRM putty (Brasseler USA, Savannah, GA), EndoSequence RRM fast set putty (Brasseler USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), and white mineral trioxide aggregate (Dentsply Sirona, York, PA) either with the presence or absence of blood. Blood-only and saline-only samples were used for the positive and negative controls. After incubation in 100% humidity at 37°C, color changes were evaluated with a spectrophotometer (Ocean Optics, Dunedin, FL) on days 0, 30, 60, and 180 after material placement. Data were transformed into Commission International de I'Eclairage's L∗a∗b color values, and corresponding ΔE values were calculated. The 1-way analysis of variance test was performed for statistical analysis. RESULTS Discoloration was observed in all specimens in the presence of blood. There was no statistical significance when comparing different materials in contact with blood. Intragroup observation at various time points, Biodentine, and EndoSequence RRM fast set putty showed significant difference between the presence and absence of blood at 180 days (P < .05). CONCLUSIONS Contamination with blood of tricalcium silicate materials has the potential to cause coronal tooth discoloration.
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Affiliation(s)
- Stephanie J Chen
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Bekir Karabucak
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania.
| | - Joshua John Steffen
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Ya-Hsin Yu
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Meetu R Kohli
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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Haikal L, Ferraz dos Santos B, Vu DD, Braniste M, Dabbagh B. Biodentine Pulpotomies on Permanent Traumatized Teeth with Complicated Crown Fractures. J Endod 2020; 46:1204-1209. [DOI: 10.1016/j.joen.2020.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/26/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
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Tooth discoloration and the effects of internal bleaching on the novel endodontic filling material SavDen® MTA. J Formos Med Assoc 2020; 120:476-482. [PMID: 32600866 DOI: 10.1016/j.jfma.2020.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND/PURPOSE Mineral trioxide aggregate (MTA) was widely used in endodontic therapy as bioceramic material. Although MTA has high biocompatibility, it may lead to tooth discoloration. The aim of this study was to investigate the discoloration of two different bioceramic materials and the effects of internal bleaching. METHODS Thirty single-canal mandibular premolars were extracted and randomly assigned to three groups (n = 10), white ProRoot® MTA, SavDen® MTA and a control group. Endodontic access opening, cleaning and shaping were performed, then the teeth were obturated using the two bioceramic materials. Tooth color was recorded at baseline, day 1, and 1, 2, 4, 6, 8, 12, 16, and 24 weeks after treatment. At the end of 24 weeks, sodium perborate was used to perform internal bleaching. Tooth color was recorded at 1, 2, and 6 weeks subsequently. Teeth were measured using a DeguDent® spectrophotometer, and data were transformed into Commission Internationale de l'Eclairage (CIE) L∗a∗b∗ system. RESULTS Teeth treated with white ProRoot® MTA showed significant color change and decrease in L∗ value. Internal bleaching leaded to decrease of the ΔE∗ value for all three groups and increase in the L∗ value. There was no difference in tooth discoloration between SavDen® MTA and the control group after obturation and internal bleaching. CONCLUSION In terms of visual perception, white ProRoot® MTA tends to cause black and blue discoloration. SavDen® MTA, formulated with calcium lactate gluconate, could be used to reduce tooth discoloration in endodontic treatment.
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Pre-application of dentin bonding agent prevents discoloration caused by mineral trioxide aggregate. BMC Oral Health 2020; 20:163. [PMID: 32493290 PMCID: PMC7268677 DOI: 10.1186/s12903-020-01151-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate tooth discoloration by newly developed calcium silicate-based materials, and to examine the pre-application of dentin bonding agent (DBA) for preventing discoloration caused by mineral trioxide aggregate (MTA). METHODS The roots of 50 premolars were randomly divided into five groups (n = 10) and cavities were prepared from resected root surfaces. MTA was placed in the cavities of teeth belonging to the ProRoot MTA (MTA) and RetroMTA (RMTA) groups. For teeth belonging to the ProRoot + DBA (MTA-B) and RetroMTA + DBA (RMTA-B) groups, DBA was first applied to the cavities prior to the addition of MTA. Teeth in the control group were restored with composite resin only (i.e., without MTA). After 12 weeks, MTA was removed from the MTA and RMTA groups and bleaching agents were applied for 3 additional weeks. Color assessments were recorded at baseline, and 1, 4, and 12 weeks, as well as after bleaching. A one-way ANOVA was performed to assess the differences between the two types of MTAs and color changes following DBA pre-application in each MTA group. A p-value of < 0.05 was considered indicative of statistical significance. RESULTS Following 12 weeks of MTA treatment, there was a significant difference between the discoloration in the MTA and RMTA groups (p < 0.05). However, no significant difference was observed between the RMTA and RMTA-B groups (p > 0.05). Following bleaching, the color changes (ΔE values) of the MTA group were not significantly different from those of the MTA-B group (p > 0.05). The difference of ΔE between the RMTA group after internal bleaching and the RMTA-B group was also not significant (p > 0.05). CONCLUSIONS RetroMTA caused significantly less discoloration than ProRoot MTA. Pre-application of DBA reduced discoloration caused by ProRoot MTA. MTA discoloration was improved equally well between DBA pre-application and post-bleaching.
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Khoshkhounejad M, Shokouhinejad N, Alikhasi M, Pirmoazen A. Effect of irrigation solutions on the coronal discoloration induced by mineral trioxide aggregate cements containing different radiopacifiers. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.302894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wadhwa H, Mahajan P, Monga P, Mukheja A, Dhillon J, Bajaj N. Comparative evaluation of push-out bond strength of root-end filling materials in root-end cavities prepared by laser or ultrasonic technique: An in vitro study. J Conserv Dent 2019; 22:396-400. [PMID: 31802827 PMCID: PMC6873595 DOI: 10.4103/jcd.jcd_545_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Context: The use of mineral trioxide aggregate (MTA) and Biodentine as a root-end filling materials used in the root-end cavities prepared by laser or ultrasonic technique is a current topic in the branch of dentistry and push-out bond strength is used to measure the adhesiveness provided by the root-end filling materials. Aim: The aim of this study is to evaluate the push-out bond strength of MTA and Biodentine in root-end cavities prepared by erbium:yttrium-aluminium-garne (Er:YAG) laser and ultrasonic retrotip. Materials and Methods: A total of 40 extracted maxillary central incisors and canines were selected. Chemomechanical preparation and obturation were done. Root-end resections were performed followed by the root-end cavity preparation and root-end filling. Specimens were divided into four groups. Root-end cavities prepared by Er:YAG laser and filled with MTA, root-end cavities prepared by Er:YAG laser and filled with Biodentine, root-end cavities prepared by ultrasonic retrotip and filled with MTA and root-end cavities prepared by ultrasonic retrotip and filled with Biodentine, respectively. The apical end was again sectioned perpendicular to the long axis. The push-out bond strength was evaluated using a universal testing machine. Statistical Analysis Used: The data were analyzed using the analysis of variance and post hoc Tukey test. Results: Difference between push-out bond strength of root-end filling materials to root-end cavity walls prepared by laser and ultrasonic retrotips was statistically nonsignificant. Push-out bond strength of MTA and Biodentine did not differ significantly. Conclusion: Difference between push-out bond strength of MTA and Biodentine to root-end cavity walls prepared by Er:YAG Laser or ultrasonic retrotip were statistically nonsignificant.
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Affiliation(s)
- Harshita Wadhwa
- Department of Conservative Dentistry and Endodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Pardeep Mahajan
- Department of Conservative Dentistry and Endodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Prashant Monga
- Department of Conservative Dentistry and Endodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Ashish Mukheja
- Department of Prosthodontics, Private Practice, Smile Care Dental Clinic and Implant Centre, Nabha, Punjab, India
| | - Jaidev Dhillon
- Department of Conservative Dentistry and Endodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Nitika Bajaj
- Department of Pedodontics and Preventive Dentistry, Dasmesh Institute of Dental Sciences and Research, Faridkot, Punjab, India
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Jiménez-Sánchez MDC, Segura-Egea JJ, Díaz-Cuenca A. Physicochemical parameters - hydration performance relationship of the new endodontic cement MTA Repair HP. J Clin Exp Dent 2019; 11:e739-e744. [PMID: 31598203 PMCID: PMC6776399 DOI: 10.4317/jced.56013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/04/2019] [Indexed: 12/18/2022] Open
Abstract
Background To characterize the chemical composition and textural parameters of the MTA Repair HP precursor powder and their influence to hydration performance. Material and Methods Un-hydrated precursor material was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), X-ray fluorescence (XRF), laser diffraction (LD), N2 physisorption and field emission gun scanning electron microscopy (FEG-SEM). Setting time was assessed according to ASTM specification C 266. Hydrated material was analysed by XRD, FT-IR, energy dispersive X-ray (EDX) analysis and FEG-SEM. Results Ca3SiO5 and Ca2SiO4, in addition to CaWO4 as radiopacifier are the main compositional phases. Other measured parameter indicates high specific surface area of 4.8 m2 g-1, high aluminium content of 1.7 wt.% and low initial and final setting times of 12 and 199 min, respectively. Singular microstructural features consisting of high aspect ratio nanoparticles are main constituents of un-hydrated precursor. Besides, FEM-SEM observation shows notably growth of hexagonal shaped plate-like morphologies homogeneously distributed along the sample during hydration process. Conclusions The short setting time measured for HP Repair, is correlated with high surface area of precursor powder, high Al content and the absence of compositional sulphate phases. Key words:Bioactive endodontic cements, hydration performance, MTA HP Repair, physicochemical parameters.
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Affiliation(s)
- María Del Carmen Jiménez-Sánchez
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain.,Materials Science Institute of Sevilla (ICMS), Joint CSIC-University of Sevilla Center, Sevilla, Spain
| | - Juan-José Segura-Egea
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain
| | - Aránzazu Díaz-Cuenca
- Materials Science Institute of Sevilla (ICMS), Joint CSIC-University of Sevilla Center, Sevilla, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
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Aly MM, Taha SEED, El Sayed MA, Youssef R, Omar HM. Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non-vital immature permanent anterior teeth (randomized clinical study). Int J Paediatr Dent 2019; 29:464-473. [PMID: 30702789 DOI: 10.1111/ipd.12474] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/12/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To asses clinically and radiographically the effect of using two types of coronal plug materials in revascularization of non-vital immature teeth. METHODS A total of 26 necrotic immature permanent anterior teeth were enrolled for pulp revascularization using a double antibiotic mix for root canal disinfection. They were randomly divided into the following based on coronal plug materials used: Biodentine (Group I) and white Mineral Trioxide Aggregate (Group II; n = 13). Clinical and radiographic assessments were performed after 3, 6, 9, and 12 months. RESULTS When comparing the overall clinical successes and percentage of increase in root length between the two groups, there was no statistically significant difference (P > 0.05). There was a significant difference in the distribution of discoloration between the two groups. One case was reported in Group I, and seven cases were reported in Group II (P = 0.01). CONCLUSIONS Both Biodentine and Mineral Trioxide Aggregate were successful clinically regarding the resolution of signs and symptoms associated with the necrotic teeth.
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Affiliation(s)
- Mariam Mohsen Aly
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Sherine Ezz El-Din Taha
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Manal Ahmed El Sayed
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Randa Youssef
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Giza, Egypt
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Adl A, Javanmardi S, Abbaszadegan A. Assessment of tooth discoloration induced by biodentine and white mineral trioxide aggregate in the presence of blood. J Conserv Dent 2019; 22:164-168. [PMID: 31142987 PMCID: PMC6519179 DOI: 10.4103/jcd.jcd_466_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: In clinical dental application, using silicate-based cements is extremely popular. These materials come into direct contact with blood during or after placement and may cause tooth discoloration. Objectives: The purpose of this study was to compare the coronal tooth discoloration induced by white mineral trioxide aggregate (MTA) and biodentine in the presence of blood. Materials and Methods: Seventy specimens were chemomechanically prepared and divided into four experimental and two control groups. In the experimental groups, the pulp chambers were filled with white MTA angelus or biodentine. Blood or saline saturated cotton pellets were placed within the canals. Saline or blood alone was used in the control groups. Color was assessed with a spectrophotometer at baseline, 1 week, and 1 and 3 months, and color change values were calculated. Tukey's honestly significant difference and Sidak tests were used for statistical analysis. Results: The color change was significantly less with biodentine/saline than MTA/saline and MTA/blood (P < 0.05). Regardless of the material type and blood presence, discoloration increased after 3 months (P < 0.05). Conclusion: Discoloration induced by biodentine/saline may not be clinically noticeable and it was less than MTA-containing groups. Irrespective of blood presence or absence, MTA caused perceptible color change.
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Affiliation(s)
- Alireza Adl
- Biomaterials Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Javanmardi
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Jiménez-Sánchez MDC, Segura-Egea JJ, Díaz-Cuenca A. MTA HP Repair stimulates in vitro an homogeneous calcium phosphate phase coating deposition. J Clin Exp Dent 2019; 11:e322-e326. [PMID: 31110610 PMCID: PMC6522111 DOI: 10.4317/jced.55661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/13/2019] [Indexed: 12/04/2022] Open
Abstract
Background To study the mineralization capacity in vitro of the bioceramic endodontic material MTA HP Repair. Material and Methods Bioactivity evaluation in vitro was carried out, by soaking processed cement disk in simulated body fluid (SBF) during 168 h. The cement surface was studied by Fourier transform infrared spectroscopy (FT-IR), field emission gun scanning electron microscopy (FEG-SEM) and energy dispersive X-ray analysis (EDX). Release to the SBF media of ionic degradation products was monitored using inductively coupled plasma atomic emission spectroscopy (ICP-AES). Results FT-IR showed increasing formation of phosphate phase bands at 1097, 960, 607 and 570 cm-1 with prolonged SBF soaking. FEG-SEM analysis reveals that HP produces a effectively surface covering consisting in homogeneous spherical phosphate phase aggregates with an average diameter of 0.5-1.0 µm. EDX analysis comparing un-treated (hydrated), 24 h and 72 h SBF treated surfaces of MTA HP Repair revealed phosphate deposition after 24 h, with high phosphorous/silicon element ratio signal measured after 24 h, indicating a very high phosphate phase deposition for this material. Conclusions The study shows that MTA HP Repair produces a quick and effective bioactive response in vitro in terms of crystalline calcium phosphate surface coating formation. The high bioactive response of MTA HP Repair makes it an interesting candidate for endodontic use as repair cement. Key words:Bioactive endodontic cements, bioactive response, MTA HP Repair.
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Affiliation(s)
- María Del Carmen Jiménez-Sánchez
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain.,Materials Science Institute of Sevilla (ICMS), Joint CSIC-University of Sevilla Center, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain
| | - Aránzazu Díaz-Cuenca
- Materials Science Institute of Sevilla (ICMS), Joint CSIC-University of Sevilla Center, Sevilla, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
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Regenerative Endodontic Procedures Using Contemporary Endodontic Materials. MATERIALS 2019; 12:ma12060908. [PMID: 30893790 PMCID: PMC6471897 DOI: 10.3390/ma12060908] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/28/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022]
Abstract
Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application.
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Six-Month Color Stability Assessment of Two Calcium Silicate-Based Cements Used in Regenerative Endodontic Procedures. J Funct Biomater 2019; 10:jfb10010014. [PMID: 30823393 PMCID: PMC6462979 DOI: 10.3390/jfb10010014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 02/07/2023] Open
Abstract
AIM The purpose of the present study is to assess the color stability of two calcium silicate-based cements (CSCs) used in regenerative endodontic procedures (REPs). METHODS A total of 40 acrylic single-rooted transparent teeth, with immature apex, were used. Root canals were filled up to 3 mm below the level of the cementoenamel junction, with either saline solution (Mineral Trioxide Aggregate (MTA)/saline and Biodentine/saline) or blood (MTA/blood and Biodentine/blood). Subsequently, ProRoot MTA® or BiodentineTM was placed in the root canal to create a cervical barrier. Color measurement was carried out at four different evaluation periods (3 h, 72 h, 7 days, and 6 months). Shade analysis within the L* a* b* color space was performed and color variation (∆E) calculated. The significance level for statistical analysis was set at p < 0.05. RESULTS The four groups showed a significant decrease in L* values over time. The ΔE value increased over time for all groups but was not statistically significant for the Biodentine/blood group. Two-way ANOVA showed no interaction between the CSC and treatment (contact with saline solution or blood). CSC used was the factor responsible for ΔE over time, inducing statistically significant color variations from T3H to T7D (p = 0.04) and T3H to T6M (p < 0.01). After 6 months, MTA/saline had 5.08 (p = 0.001) higher ΔE than Biodentine/Saline and the MTA/blood had 3.65 (p = 0.009) higher than Biodentine/blood. CONCLUSIONS After 6 months, regardless of blood exposure, Biodentine exhibits superior color stability compared to MTA. Biodentine might be a suitable alternative to MTA as a cervical barrier material in REPs.
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Jiménez-Sánchez MDC, Segura-Egea JJ, Díaz-Cuenca A. Higher hydration performance and bioactive response of the new endodontic bioactive cement MTA HP repair compared with ProRoot MTA white and NeoMTA plus. J Biomed Mater Res B Appl Biomater 2019; 107:2109-2120. [PMID: 30637928 DOI: 10.1002/jbm.b.34304] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/19/2018] [Indexed: 12/31/2022]
Abstract
The aim of this study was to characterize the hydration performance and the bioactive response of the new bioactive endodontic cement MTA HP repair (HP), comparing its physicochemical parameters with those of ProRoot MTA White (Pro) and NeoMTA Plus (Neo). Un-hydrated precursor materials were characterized by X-ray fluorescence, laser diffraction, N2 physisorption and field emission gun scanning electron microscopy (FEG-SEM). Setting time was assessed according to ASTM specification C 266. Hydrated materials were analyzed by X-ray diffraction, Fourier transform infrared spectroscopy (FT-IR) and (FEG-SEM). Bioactivity evaluation in vitro was carried out, by soaking processed cement disk in simulated body fluid (SBF) during 168 h. The cements surface was studied by FT-IR, FEG-SEM, and energy dispersive X-ray. Release to the SBF media of ionic degradation products was monitored using inductively coupled plasma atomic emission spectroscopy. HP showed shorter initial setting time compared to Pro and Neo and produce a quick and effective bioactive response in vitro in terms of phosphate phase surface coating formation. This higher bioactive response for HP is correlated with increasing calcium aluminate content, increasing surface area of un-hydrated powder precursor and the increasing release capacity of Si ionic products of the final hydrated product. The higher bioactive response of MTA HP repair highlights this material, as very interesting to further investigate its performance to improve the outcome of vital pulp therapy procedures. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2109-2120, 2019.
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Affiliation(s)
- María Del Carmen Jiménez-Sánchez
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain.,Materials Science Institute of Seville (ICMS), Joint CSIC-University of Seville Center, Sevilla, Spain
| | - Juan José Segura-Egea
- Department of Stomatology, Faculty of Dentistry, University of Sevilla, Sevilla, Spain
| | - Aránzazu Díaz-Cuenca
- Materials Science Institute of Seville (ICMS), Joint CSIC-University of Seville Center, Sevilla, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
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Careddu R, Duncan HF. How does the pulpal response to Biodentine and ProRoot mineral trioxide aggregate compare in the laboratory and clinic? Br Dent J 2018; 225:sj.bdj.2018.864. [PMID: 30337724 DOI: 10.1038/sj.bdj.2018.864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Affiliation(s)
- R Careddu
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
| | - H F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland
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Meschi N, EzEldeen M, Torres Garcia AE, Jacobs R, Lambrechts P. A Retrospective Case Series in Regenerative Endodontics: Trend Analysis Based on Clinical Evaluation and 2- and 3-dimensional Radiology. J Endod 2018; 44:1517-1525. [DOI: 10.1016/j.joen.2018.06.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/09/2018] [Accepted: 06/15/2018] [Indexed: 12/17/2022]
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Emara R, Elhennawy K, Schwendicke F. Effects of calcium silicate cements on dental pulp cells: A systematic review. J Dent 2018; 77:18-36. [DOI: 10.1016/j.jdent.2018.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 02/03/2023] Open
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Espona J, Roig E, Durán-Sindreu F, Abella F, Machado M, Roig M. Invasive Cervical Resorption: Clinical Management in the Anterior Zone. J Endod 2018; 44:1749-1754. [PMID: 30243659 DOI: 10.1016/j.joen.2018.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/04/2023]
Abstract
According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.
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Affiliation(s)
- José Espona
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elena Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Francesc Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Manoel Machado
- Department of Endodontics, Universidade de São Paulo, São Paulo, Brazil
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
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Song M, Yu B, Kim S, Hayashi M, Smith C, Sohn S, Kim E, Lim J, Stevenson RG, Kim RH. Clinical and Molecular Perspectives of Reparative Dentin Formation: Lessons Learned from Pulp-Capping Materials and the Emerging Roles of Calcium. Dent Clin North Am 2018; 61:93-110. [PMID: 27912821 DOI: 10.1016/j.cden.2016.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The long-term use of calcium hydroxide and the recent increase in the use of hydraulic calcium-silicate cements as direct pulp-capping materials provide important clues in terms of how reparative dentin may be induced to form a "biological seal" to protect the underlying pulp tissues. In this review article, we discuss clinical and molecular perspectives of reparative dentin formation based on evidence learned from the use of these pulp-capping materials. We also discuss the emerging role of calcium as an odontoinductive component in these pulp-capping materials.
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Affiliation(s)
- Minju Song
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA; Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Bo Yu
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Sol Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA; Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Marc Hayashi
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Colby Smith
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Suhjin Sohn
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry, 50 Yonsei-Ro, 03772, Seoul, Korea
| | - James Lim
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Richard G Stevenson
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Reuben H Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA; Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
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