Radiopacity and Cytotoxicity of Portland Cement Containing Zirconia Doped Bismuth Oxide Radiopacifiers

Radiopaque Crystalline, Non-Crystalline and Nanostructured Bioceramics

Radiopacity is sometimes an essential characteristic of biomaterials that can help clinicians perform follow-ups during pre- and post-interventional radiological imaging. Due to their chemical composition and structure, most bioceramics are inherently radiopaque but can still be doped/mixed with radiopacifiers to increase their visualization during or after medical procedures. The radiopacifiers are frequently heavy elements of the periodic table, such as Bi, Zr, Sr, Ba, Ta, Zn, Y, etc., or their relevant compounds that can confer enhanced radiopacity. Radiopaque bioceramics are also intriguing additives for biopolymers and hybrids, which are extensively researched and developed nowadays for various biomedical setups. The present work aims to provide an overview of radiopaque bioceramics, specifically crystalline, non-crystalline (glassy), and nanostructured bioceramics designed for applications in orthopedics, dentistry, and cancer therapy. Furthermore, the modification of the chemical, physical, and biological properties of parent ceramics/biopolymers due to the addition of radiopacifiers is critically discussed. We also point out future research lacunas in this exciting field that bioceramists can explore further.

Energy-Dispersive X-Ray Spectrometry Analysis and Radiopacity of Five Different Root Canal Sealers

Root canal sealers should have optimum adhesion to the root dentin, low cytotoxicity, sufficient radiopacity and high dimensional stability, which depend mainly on their chemical composition. The aims of this study were to evaluate the chemical composition of Syntex (Cerkamed, Stalowa Wola, Poland), Adseal (Meta Biomed, Cheongju-si, Korea), Sealapex (SybronEndo, Scafati, Italy), MTA Fillapex (Angelus, Londrina, Brazil) and GuttaFlow Bioseal (Coltene/Whaledent, Altstätten, Switzerland) and to determine their radiopacity comparatively. Stainless steel molds with an inner diameter of 5 mm and a depth of 2 mm were constructed. Tested root-canal sealers were mixed and poured into the molds. Following setting, digital periapical radiographs of the specimens (n=12) were taken under standard exposure conditions and the mean gray-values of specimens were measured using a computer graphics program. Then the specimens were examined by scanning electron microscopy, and Energy-dispersive X-ray analysis was performed. The data were analyzed using One-way ANOVA followed by Holm-Sidak multi-comparison test (p = 0.05). Sealapex showed higher calcium peak than MTA Fillapex, GuttaFlow Bioseal, Adseal and Syntex sealers. MTA Fillapex contained a highest amount of tungstate. Sealapex presented the highest radiopacity value among the tested materials (p < 0.05), whereas MTA Fillapex was the least radiopaque material (p < 0.05). Each root canal sealer contains different compositions of radiopacifiers including bismuth oxide, calcium tungstate and zirconium oxide. The tested root canal sealers had radiopacity values above the ISO-specified limit. Sealapex was the most radiopaque root canal sealer followed by GuttaFlow Bioseal, Syntex, Adseal and MTA Fillapex.

Effect of Tantalum Pentoxide Addition on the Radiopacity Performance of Bi2O3/Ta2O5 Composite Powders Prepared by Mechanical Milling

Among the various phases of bismuth oxide, the high temperature metastable face-centered cubic δ phase attracts great attention due to its unique properties. It can be used as an ionic conductor or an endodontic radiopacifying material. However, no reports concerning tantalum and bismuth binary oxide prepared by high energy ball milling and serving as a dental radiopacifier can be found. In the present study, Ta₂O₅-added Bi₂O₃ composite powders were mechanically milled to investigate the formation of these metastable phases. The as-milled powders were examined by X-ray diffraction and scanning electron microscopy to reveal the structural evolution. The as-milled composite powders then served as the radiopacifier within mineral trioxide aggregates (i.e., MTA). Radiopacity performance, diametral tensile strength, setting times, and biocompatibility of MTA-like cements solidified by deionized water, saline, or 10% calcium chloride solution were investigated. The experimental results showed that subsequent formation of high temperature metastable β-Bi_7.8Ta_0.2O_12.2, δ-Bi₂O₃, and δ-Bi₃TaO₇ phases can be observed after mechanical milling of (Bi₂O₃)₉₅(Ta₂O₅)₅ or (Bi₂O₃)₈₀(Ta₂O₅)₂₀ powder mixtures. Compared to its pristine Bi₂O₃ counterpart with a radiopacity of 4.42 mmAl, long setting times (60 and 120 min for initial and final setting times) and 84% MG-63 cell viability, MTA-like cement prepared from (Bi₂O₃)₉₅(Ta₂O₅)₅ powder exhibited superior performance with a radiopacity of 5.92 mmAl (the highest in the present work), accelerated setting times (the initial and final setting time can be shortened to 25 and 40 min, respectively), and biocompatibility (94% cell viability).

Antifungal Effectiveness between Tricalcium Silicate-White Portland Cements Added Bi2O3 and Mineral Trioxide Aggregate Against Candida albicans

Background

Candida albicans is the most dominant fungus found in root canal reinfection cases. This microorganism can withstand extreme pH, low oxygen levels, lack of nutrients, and penetrate the dentinal tubules so that it can resist the intracanal medicament. Root canal cement helps prevent microorganisms and causing root canal reinfection. MTA is one of the root canals cement which is widely used and has an excellent antifungal activity, but it is less beneficial economically. Tricalcium silicate-white Portland cement (WPC) has a similar main composition as MTA, except there is no Bi2O3 content that functions as a radiopacifier.

Objectives:

To fabricate a mixture of tricalcium silicate-WPC with Bi2O3 through a simple solution method and investigate antifungal activity's effectiveness between tricalcium silicate-WPC added Bi2O3 and MTA to C. albicans.

Materials and Methods:

The 80 g of tricalcium silicate-WPC was mixed with 20 g of Bi2O3 through the simple solution method using 99.9% isopropanol as a solution. This sample solution is stirred until homogeneous, then centrifuged. The precipitate was dried until a dry powder was obtained. The powder was analyzed using X-Ray fluorescence spectrometry to identify its chemical composition and concentration. A total of 30 samples were divided into two experimental groups of tricalcium silicate-WPC added Bi2O3 and ProRoot MTA. The vials, which contain cement and C. albicans, respectively, were incubated at 37°C for 24 hours and diluted to obtain a suspension 104, 106 (0.5 in McFarland’s nephelometer) and then inoculated with sterile cotton swabs onto Saboroud Dextrose Agar Plates. The plates were incubated at 37°C for 24 hours. The measurement of colony number of C. albicans was counted by colony counter (CFU/ml).

Results:

The Bi2O3 was revealed in tricalcium silicate-WPC based on XRF characterization, and the antifungal test showed that both materials were effective against C. albicans. There was no statistically significant difference in the number of C. albicans colonies between tricalcium-WPC added Bi2O3 and MTA (p>0.05).

Conclusion:

The mixture of Bi2O3 in tricalcium silicate-WPC was successfully fabricated through a simple solution method, and both samples were effective against the C. albicans.

The versatile biomedical applications of bismuth-based nanoparticles and composites: therapeutic, diagnostic, biosensing, and regenerative properties

Studies of nanosized forms of bismuth (Bi)-containing materials have recently expanded from optical, chemical, electronic, and engineering fields towards biomedicine, as a result of their safety, cost-effective fabrication processes, large surface area, high stability, and high versatility in terms of shape, size, and porosity. Bi, as a nontoxic and inexpensive diamagnetic heavy metal, has been used for the fabrication of various nanoparticles (NPs) with unique structural, physicochemical, and compositional features to combine various properties, such as a favourably high X-ray attenuation coefficient and near-infrared (NIR) absorbance, excellent light-to-heat conversion efficiency, and a long circulation half-life. These features have rendered bismuth-containing nanoparticles (BiNPs) with desirable performance for combined cancer therapy, photothermal and radiation therapy (RT), multimodal imaging, theranostics, drug delivery, biosensing, and tissue engineering. Bismuth oxyhalides (BiO_x, where X is Cl, Br or I) and bismuth chalcogenides, including bismuth oxide, bismuth sulfide, bismuth selenide, and bismuth telluride, have been heavily investigated for therapeutic purposes. The pharmacokinetics of these BiNPs can be easily improved via the facile modification of their surfaces with biocompatible polymers and proteins, resulting in enhanced colloidal stability, extended blood circulation, and reduced toxicity. Desirable antibacterial effects, bone regeneration potential, and tumor growth suppression under NIR laser radiation are the main biomedical research areas involving BiNPs that have opened up a new paradigm for their future clinical translation. This review emphasizes the synthesis and state-of-the-art progress related to the biomedical applications of BiNPs with different structures, sizes, and compositions. Furthermore, a comprehensive discussion focusing on challenges and future opportunities is presented.

Sintering Pmperature-Dependence on Radiopacity of Bi(2-x) ZrxO(3+x/2) Powders Prepared by Sol-Gel Process

Bismuth oxide (Bi₂O₃) is an effective additive used to enhance radiography resolution for dental materials. However, there are potential concerns regarding its biocompatibility and connection to tissue discoloration. In the present study, we modified the radiopacity properties of Bi₂O₃ with zirconium oxide (ZrO₂) using a sol-gel process and investigated the composition, as well as the effects of heat treatment temperature using Thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and X-ray diffraction (XRD). The harvested Bi2-xZrxO3+x/2 particles showed that the dominant phase transferred from α-Bi₂O₃ to β-Bi7.38Zr0.62O12.31 after a heat treatment of over 750 °C for 2 h. As the x values of Bi2-xZrxO3+x/2 increased from 0.2 to 1.0, more zirconium oxide precipitated onto the particle surface, thus enhancing the surface roughness of particles. For sol-gel Bi1.8Zr0.2O3.1 powders (x = 0.2), the radiopacity values became 4.90 ± 0.23 and 5.83 ± 0.22 mmAl after a heat treatment of 500 °C and 750 °C, respectively.

Biocompatibility Investigation of New Endodontic Materials Based on Nanosynthesized Calcium Silicates Combined with Different Radiopacifiers

INTRODUCTION

The aim of this article was to analyze biocompatibility and bioactivity of new endodontic materials on the basis of nanosynthesized calcium silicates (ALBO-MPCA₁ and ALBO-MPCA₂) combined with different radiopacifiers in comparison with MTA⁺.

METHODS

Morphology of the samples was studied by scanning electron microscopy, and the pH and ion release analysis were also assessed. Biocompatibility of materials' eluates (24-hour, 7-day, and 21-day) was conducted by using MTT test. Twelve New Zealand white rabbits were used for intraosseous implantation. Four calvarial defects per animal were created and filled with freshly prepared investigated materials.

RESULTS

Samples mostly consisted of agglomerates built up from nanoparticles, preferably spherical and rod-like. There was no significant difference among pH values of materials' eluates after 24 hours (P > .05). The amount of calcium and aluminum ion release decreased, whereas the amount of magnesium and bismuth (ALBO-MPCA₁, MTA⁺) and barium (ALBO-MPCA₂) increased during 21-day period. The metabolic activity of cells increased after the extraction time, except in case of undiluted elutes of ALBO-MPCA₂ and ALBO-MPCA₁ (21-day). Histologic analysis of the samples revealed newly formed bone tissue with moderate inflammation for all investigated materials, which subsided during 90-day period to mild. Both MTA⁺ and ALBO-MPCA₁ were in direct contact with the newly formed bone tissue. After 90 days, statistically significant difference in hard tissue formation was observed in comparison of MTA⁺ and ALBO-MPCA₁ with control group (P < .05).

CONCLUSIONS

Experimental materials ALBO-MPCA₁ and ALBO-MPCA₂ possess both biocompatibility and bioactivity. Because ALBO-MPCA₁ provokes favorable biological response, it is especially good candidate for further clinical investigations.

Effect of incorporation of a new antimicrobial nanomaterial on the physical-chemical properties of endodontic sealers

OBJECTIVES

The objective of the study is to incorporate the nanostructured silver vanadate (AgVO3) decorated with silver nanoparticles at endodontic sealers AH Plus, Sealapex, Sealer 26, and Endofill, at concentrations of 2.5%, 5%, and 10%, and to evaluate physical-chemical properties.

MATERIALS AND METHODS

The study was to evaluate the radiopacity using digital radiography (n = 5), the tooth color change in 48 incisors (n = 3) for 7, 30, 90, and 180 days in a spectrophotometer, and the topographic distribution in a confocal laser (n = 5). The radiopacity was analyzed by Kruskal-Wallis test and the permutation (α = 0.05) and the color and topographical distribution by descriptive statistical analysis.

RESULTS

The AgVO3 had no effect on the radiopacity of Endofill and Sealapex (P > 0.05) and at 2.5% concentrations increased the radiopacity of Sealer 26 and AH Plus (P < 0.05). The Endofill 10% showed less color change, and the major changes were the modified groups in 180 days. The AgVO3 showed a circular topographic distribution in areas of the sealers.

CONCLUSION

It was found that the addition of AgVO3 did not affect the radiopacity of Endofill and Sealapex however, increased the radipacity of Sealer 26 and AH Plus. For modified groups, the greatest color change was promoted after 180 days, except for Endofill with 10%. Topographic distribution of nanomaterial affected the color change of theevaluated sealers.

In vitro biocompatibility of nanostructured endodontic materials using SCAP cells

Background/Aim: Lately, fully innovative sol-gel method with high-temperature self-propagating reaction was used for the synthesis of new nanostructured endodontic materials, in combination with different radiopacifiers: bismuth (ALBO-MPCA1) and barium (ALBO-MPCA2). The aim of this study was to investigate the biocompatibility of nanostructured endodontic materials based on highly active calcium silicates and mixed with different radiopacifiers in comparison to MTA+ using human stem cells from the apical papilla- SCAP cells. Material and Methods: Morphology of the samples was studied by SEM. The tested materials were mixed with distilled water in a ratio 2:1 (m/m). Fifteen minutes after the preparation, samples were used in the experiment. The biocompatibility of fresh materials, after 3h and 7 days, was tested using 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide- MTT test. Results: Samples mostly consisted of spherical and rode-like. The relative viability of cells increased following the exposure time. Conclusion: The biocompatibility of synthesized materials is comparable to the control material MTA+, and therefore these materials can be recommended for further clinical studies.