Effect of acid etching procedures on the compressive strength of 4 calcium silicate-based endodontic cements

Comprehensive review of composition, properties, clinical applications, and future perspectives of calcium-enriched mixture (CEM) cement: a systematic analysis

This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.

Evaluation of the physical properties of bromelain-modified biodentine for direct pulp capping

BACKGROUND

This study aims to evaluate the compressive strength, solubility, radiopacity, and flow of Bromelain (BR)-modified Biodentine (BD) for direct pulp capping (DPC). This is suggested to determine the impact of BR on the physical properties of BD.

METHODS

Eighty samples were prepared according to the ISO and ADA specifications and evaluated for compressive strength, solubility, radiopacity, and flow. The compressive strength was evaluated at 24 h and 21 days via a universal testing machine. The solubility was determined by weight loss after 24-hours immersion in deionized water. Radiopacity was assessed via X-ray with aluminum step-wedges, and flow was measured by the diameter of the discs under a standard weight. Independent sample t-tests were used to statistically assess the data. A significance level of 5% was considered.

RESULTS

The compressive strength was 41.08 ± 1.84 MPa for BD and 40.92 ± 1.80 MPa for BR + BD after 24 h, and 88.93 ± 3.39 MPa for BD and 87.92 ± 3.76 MPa for BR + BD after 21 days, with no significant differences. Solubility was slightly greater in the BR + BD (2.75 ± 0.10%) compared to BD (2.62 ± 0.25%), but not significantly different. The radiopacity was similar between BD (2.82 ± 0.11 mm) and BR + BD (2.73 ± 0.10 mm). BR + BD resulted in significantly greater flow (9.99 ± 0.18 mm) than did BD (9.65 ± 0.27 mm) (p ≤ 0.05).

CONCLUSION

BR-modified BD maintains BD's physical properties, with improved flow, making it a promising DPC agent that warrants further study.

Evaluation of baghdadite (Ca3ZrSi2O9) cements for the application as novel endodontic filling materials

OBJECTIVES

Baghdadite (Ca3ZrSi2O9) cements of various composition have been investigated in this study regarding an application as endodontic filling materials.

METHODS

Cements were either obtained by mixing mechanically activated baghdadite powder with water (maBag) or by subsequently substituting the ß-tricalcium phosphate (ß-TCP) component in a brushite forming calcium phosphate cement. The cements were analyzed for their mechanical performance, injectability, radiopacity, phase composition and antimicrobial properties.

RESULTS

The cements demonstrated sufficient mechanical performance with a compressive strength of ∼1 MPa (maBag) and 2.3 - 17.4 MPa (substituted calcium phosphate cement), good injectability > 80 % depending on the powder to liquid ratio and an intrinsic radiopacity of 1.13 - 2.05 mm aluminum equivalent. Immersion in artificial saliva proved their bioactivity by the formation of calcium phosphate and calcium silicate precipitates on the cement surface. The bacterial activity of Staphylococcus aureus cultured on the surface of the cements was found to be similar compared to clinical standard ProRoot MTA cement or even reduced by a factor of 3 for Streptococcus mutans.

SIGNIFICANCE

In combination with their antibacterial properties, baghdadite cements are thought to have the potential to fulfil the clinical requirements for endodontic filling materials.

Effect of pH on the solubility and volumetric change of ready-to-use Bio-C Repair bioceramic material

Acidic pH can modify the properties of repair cements. In this study, volumetric change and solubility of the ready-to-use bioceramic repair cement Bio-C Repair (BCR, Angelus, Londrina, PR, Brazil) were evaluated after immersion in phosphate-buffered saline (PBS) (pH 7.0) or butyric acid (pH 4.5). Solubility was determined by the difference in initial and final mass using polyethylene tubes measuring 4 mm high and 6.70 mm in internal diameter that were filled with BCR and immersed in 7.5 mL of PBS or butyric acid for 7 days. The volumetric change was established by using bovine dentin tubes measuring 4 mm long with an internal diameter of 1.5 mm. The dentin tubes were filled with BCR at 37°C for 24 hours. Scanning was performed with micro-computed tomography (micro-CT; SkyScan 1176, Bruker, Kontich, Belgium) with a voxel size of 8.74 µm. Then, the specimens were immersed in 1.5 mL of PBS or butyric acid at and 37 °C for 7 days. After this period, a new micro-CT scan was performed. Bio-C Repair showed greater mass loss after immersion in butyric acid when compared with immersion in PBS (p<0.05). Bio-C Repair showed volumetric loss after immersion in butyric acid and increase in volume after immersion in PBS (p<0.05). The acidic pH influenced the solubility and dimensional stability of the Bio-C Repair bioceramic cement, promoting a higher percentage of solubility and decrease in volumetric values.

Evaluation of Surface Microstructure and Compressive Strength of Mineral Trioxide Aggregate and Biodentine in the Existence and Absence of Oral Tissue Fluids

Background

Calcium silicate cement like mineral trioxide aggregate (MTA) and Biodentine are known for their biocompatibility and are effectively used as retrograde filling materials. During their placement, the materials interact with oral tissue fluids like saliva and blood, so the aim of the present study was to assess the effect of distilled water, saline, and blood on the surface microstructure and compressive strength of MTA and Biodentine.

Materials and methods

In this experimental study, a total of 84 custom-made cylindrical molds were randomly allocated into two main cement groups (n = 42) MTA and Biodentine. Each group was further subdivided into three subgroups (n = 14) as per the testing conditions, that is, samples exposed to distilled water, saline, and fresh blood. Around 10 samples from each subgroup were tested for compressive strength using a universal testing machine (UTM), and the remaining four samples were used to examine the surface characteristics of MTA and Biodentine using a scanning electron microscope (SEM). One-way analysis of variance (ANOVA) and Tukey's post hoc tests were employed to calculate the mean compressive strength and standard deviation values.

Results

There was a significant difference in the compressive strength between MTA and Biodentine, especially in the presence of blood. During the SEM analysis, it was found that samples contaminated with blood or saline were devoid of acicular crystals in both groups. MTA group showed a more porous matrix with few hexagonal crystals than Biodentine.

Conclusion

Biodentine may be advantageous as a root-end filling or root repair material in the presence of blood.

How to cite this article

Bhullar KK, Gupta V, Sapra M, et al. Evaluation of Surface Microstructure and Compressive Strength of Mineral Trioxide Aggregate and Biodentine in the Existence and Absence of Oral Tissue Fluids. Int J Clin Pediatr Dent 2024;17(S-1):S1-S5.

The Effect of Charcoal-Based Dentifrice and Conventional Whitening Toothpaste on the Color Stability and Surface Roughness of Composite Resin: A Systematic Review of In Vitro Studies

The objective was to systematically review studies that evaluated the effect of charcoal-based dentifrices (CbDs) and conventional whitening toothpastes (CWTs) on the color stability (CS) and/or surface roughness (SR) of composite resin (CR). The question we focused on was "Do CbD and CWT affect the CS and/or SR of CR?" Indexed databases were searched without language and time restrictions up to and including May 2023 using different keywords. Original experimental studies were included. The risk of bias (RoB) was assessed using the Quality Assessment Tool for In Vitro Studies. Ten in vitro studies performed on CR were included. The number of CR samples assessed ranged between 18 and 200. In one study, CbDs altered the CS and SR of CR, whereas another study showed no difference in changes in the SR and CS of CR when CbDs were compared with CWTs. One study showed that compared with CWTs, CbDs caused changes in the CS of CR but changes in SR were similar between the two dentifrices. One study showed that CbDs and CWTs improved the overall color and enhanced the SR of CR. Three studies had a high RoB, five had a medium RoB, and two had a low RoB. Compared to CWTs, CbDs appeared to affect the CS of CR, but the SR of CR induced by both dentifrices remained consistent. Further well-designed and power-adjusted studies are needed.

Modern methods and materials used to treat root perforation: effectiveness comparison

This study aims to experimentally compare the efficacy of different endodontic materials (iRoot BP Plus, Biodentine, MTA, Rootdent, and Trioxide) in the treatment of pulpitis and perforations on extracted tooth specimens. Additionally, the study aims to investigate the influence of iRoot BP Plus endodontic material on the regenerative processes following pulp amputation in laboratory animals. The secondary goal is to evaluate the effect of iRoot BP Plus on the restoration process in laboratory animals after pulp removal. The study presents a micropermeability analysis of the selected biomaterials performed on a sample of 50 single-rooted apical teeth in 2022. All teeth underwent endodontic treatment. Changes in molar morphology were investigated with eight laboratory animals (rabbits, 3 months old, all males) after simulated pulp removal and subsequent treatment with the iRoot BP Plus biomaterials. iRoot BP Plus appeared to be more effective in retrograde apical root filling than other biomaterials, as evidenced by its higher sealing effect. An experiment involving animal participants revealed the presence of protective adaptive mechanisms, which manifested in the form of an inflammatory process within 6 weeks after the dental pulp was removed. The connective tissue replaced the necrosis, and new capillaries began to form intensively. These dental outcomes suggest that iRoot BP Plus enables hermetical sealing in tooth restoration with good adhesion. Thus, it may have the ability to promote more active tissue regeneration after pulp removal.

Clinical application of calcium silicate-based bioceramics in endodontics

Pulp treatment is extremely common in endodontics, with the main purpose of eliminating clinical symptoms and preserving tooth physiological function. However, the effect of dental pulp treatment is closely related to the methods and materials used in the process of treatment. Plenty of studies about calcium silicate-based bioceramics which are widely applied in various endodontic operations have been reported because of their significant biocompatibility and bioactivity. Although most of these materials have superior physical and chemical properties, the differences between them can also have an impact on the success rate of different clinical practices. Therefore, this review is focused on the applications of several common calcium silicate-based bioceramics, including Mineral trioxide aggregate (MTA), Biodentine, Bioaggregate, iRoot BP Plus in usual endodontic treatment, such as dental pulp capping, root perforation repair, regenerative endodontic procedures (REPs), apexification, root-end filling and root canal treatment (RCT). Besides, the efficacy of these bioceramics mentioned above in human trials is also compared, which aims to provide clinical guidance for their clinical application in endodontics.

Effect of incorporation of nano-graphene oxide on physicochemical, mechanical, and biological properties of tricalcium silicate cement

OBJECTIVE

Evaluation of setting time, compressive strength, pH, calcium ion release, and antibacterial activity of mineral trioxide aggregate (MTA) after modification with three different concentrations of nano-graphene oxide (GO) powder compared to unmodified Biodentine as a commercial control.

METHODS

GO powder, unhydrated and hydrated cements were characterized using Environmental Scanning Electron Microscope (ESEM) with Energy Dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), Raman Spectroscopy, and Fourier Transform Infrared spectroscopy (FTIR). GO was also analyzed using Scanning Transmission Electron Microscope (STEM) to determine average lateral dimensions. Specimens were prepared and grouped according to the concentration of GO added to Rootdent MTA (control, 1, 3, and 5 wt%) and the material used (MTA and unmodified Biodentine) into five groups. Setting time was evaluated using Gillmore penetrometer (n = 5). Compressive strength was evaluated using universal testing machine (n = 7). pH and calcium ion release were assessed using pH meter and Induced Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) at 1, 7, 14, and 28 days (n = 7). Antibacterial activity was evaluated against Streptococcus mutans using direct contact test (n = 7). One-way and repeated measures ANOVA followed by Tukey's post hoc test were used for data analysis with significance level set at p ≤ 0.05.

RESULTS

Addition of GO to MTA reduced both initial and final setting time. GO modified MTA groups and unmodified Biodentine showed significantly increased calcium ion release at 14 and 28 days. All cements showed alkaline pH of the storage media at all tested time intervals. 1 wt% GO recorded the highest compressive strength values in MTA modified groups. The increased concentration of GO from 1 to 5 wt% successively increased antibacterial activity of MTA, with Biodentine showing the lowest significant value.

CONCLUSION

Addition of 1 wt% GO can significantly improve the tested properties of tricalcium silicate-based cements without compromising their compressive strength.

CLINICAL SIGNIFICANCE

GO is a promising modification for tricalcium silicate cements to improve setting time, compressive strength, and antibacterial activity to provide a variety of materials for different clinical situations. This in turn can reduce the risk of reinfection and allow placement of the final restoration in a single visit.

Strength of a cement-based dental material: Early age testing and first micromechanical modeling at mature age

The compressive strength evolution of 37 centigrade-cured Biodentine, a cement-based dental material, is quantified experimentally by crushing cylindrical specimens with length-to-diameter ratios amounting to 1.84 and 1.34, respectively, at nine different material ages ranging from 1 h to 28 days. After excluding strength values significantly affected by imperfections, formulae developed for concrete are i) adapted for inter- and extrapolation of measured strength values, and ii) used for quantification of the influence of the slenderness of the specimens on the compressive strength. The microscopic origin of the macroscopic uniaxial compressive strength of mature Biodentine is investigated by means of a micromechanics model accounting for lognormal stiffness and strength distributions of two types of calcite-reinforced hydrates. The following results are obtained: The material behavior of Biodentine is non-linear in the first few hours after production. After that, Biodentine behaves virtually linear elastic all the way up to sudden brittle failure. The strength evolution of Biodentine can be well described as the exponential of a function involving the square root of the inverse of the material age. The genuine uniaxial compressive strength evolution can be quantified using a correction formula taken from a standard for testing of concrete, which accounts for length-to-diameter ratios of cylindrical samples deviating from 2. Multiscale modeling suggests that 63% of the overall material volume, occupied by dense calcite-reinforced hydration products, fail virtually simultaneously. This underlines the highly optimized nature of the studied material.

Fracture Resistance of Molars With Simulated Strip Perforation Repaired With Different Calcium Silicate-Based Cements

Background and aims A root perforation is a connection between the root canal system and the external supportive tissues. Strip perforation (SP), occurring within root canals in a strip, can worsen the prognosis of a treated tooth, reduce its mechanical resistance, and impair the tooth structure. One of the suggested methods to treat SP is to seal it with a bio-material such as calcium silicate cement. Therefore, this in vitro study aimed to assess the molar structure impairment due to SP, which requires studying the fracture resistance, and the ability of mineral trioxide aggregate (MTA), bioceramic, and calcium-enriched mixture (CEM) to repair this perforation. Materials and methods Seventy-five molars were instrumented to size #25 and taper 4%, irrigated with sodium hypochlorite and ethylenediaminetetraacetic acid (EDTA), dried, and then divided randomly into five groups (G1-G5): in G1, root canals were filled with gutta-percha and sealer (negative control sample), whereas the rest of the groups (G2-G5) had a manual simulated SP made with Gates Glidden drill at the mesial root of the extracted molar, and filled with gutta-percha and sealer up to their perforation area; in G2, SP was filled with gutta-percha and sealer (positive control sample); G3 used MTA to repair the SP; G4 used bioceramic putty; and G5 used CEM. Fracture resistance tests of the molars were conducted in the crown-apical direction using a universal testing machine. One-way ANOVA test and Bonferroni test were used to study the significance of the differences in the mean values of the tooth fracture resistance, where statistical significance was set at 0.05. Results The ANOVA test showed that there were statistically significant differences between the fracture resistance (in newtons) values among groups (p = 0.000). The Bonferroni test showed that G2 had a smaller fracture resistance mean than the other four study groups (656.53 N; p = 0.000), and that of G5 was smaller than G1, G3, and G4 (794.40 N, 1083.73 N, 1025.20 N, and 1034.20 N, respectively; p = 0.000 in each pairwise comparison). Conclusion SP reduced the fracture resistance of endodontically treated molars. SP restored using MTA and bioceramic putty was better than that treated with CEM and similar to molars without SP. Moreover, MTA and bioceramic putty enhanced the fracture resistance of endodontically treated teeth to levels similar to molars without SP.

Effect of nanosized bioactive glass addition on some physical properties of biodentine

The aim of this in vitro study was to investigate some physical properties of Biodentine (BD) (Septodont, France) that has been modified by adding nanosized bioactive glass (nBG) particles to it in different ratios. The cement was modified by adding 1% (7 mg) and 2% (14 mg) nBG powder to BD. BD was used as the control group in its commercial form. A total of 240 cement samples (n = 80) were prepared according to the standard measurements for each test. Subsequently, tests to determine compressive strength, microhardness, initial setting time, and solubility of the samples were performed. The obtained data were statistically analyzed using one-way ANOVA and Tukey's HDS tests, and the significance level was found to be 0.05. The compressive strength values of the samples modified with 1% and 2% nBG were higher than those of the unmodified BD; however, no statistically significant difference was found between them [BD + nBG (2 wt%) ⩾ BD+nBG (1 wt%) ⩾ control BD], (p > 0.05). The microhardness values of the samples modified with 1% and 2% nBG were found to be significantly higher than those of the control group [BD + nBG (2 wt%) > BD+nBG (1 wt%) > control BD], p < 0.05. Initial setting times were determined as 14 min for unmodified BD, 13 min for BD + nBG (1 wt%), and 12 min for BD + nBG (2 wt%). The addition of nBG to BD significantly reduced the initial setting time of BD (p < 0.05). A significant decrease was observed in the solubility of the BD modified with nBG samples compared to that of the control group [control BD > BD+nBG (1 wt%) >BD+nBG (2 wt%)], p < 0.05. Within the limitations of this study, it was found that the addition of certain amounts of nBG to BD positively affected some physical properties of the cement. Future in vitro and in vivo studies should be performed to prove the clinical applicability of the cements used in this study.

Resistance to fracture of simulated external cervical resorption cavities repaired with different materials

The aim of the study was to evaluate the fracture resistance (FR) of teeth with simulated external cervical resorption (ECR) cavities repaired with different materials. Following the shaping of the 80 human permanent maxillary central incisors, standard ECR cavities were prepared and restored with a nanohybrid composite resin; a high viscosity GIC Equia Forte Fill; Biodentine; Biodentine + nanohybrid composite resin; MTA BIOREP; MTA BIOREP + nanohybrid composite resin. Then, the root canals were obturated with AH Plus and gutta-percha. The roots were embedded acrylic resin blocks and fracture strength test was applied. The highest FR was observed in the Biodentine group, while the lowest was in Equia group (p < 0.05). No significant results were observed among composite, Biodentine + composite, MTA BIOREP + composite and MTA BIOREP (p > 0.05). Biodentine may be a preferable material for repairing ECR cavities. Adding a composite layer on MTA BIOREP and Biodentine did not improve the FR of these materials.

An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy

Regarding the common use of calcium silicate cements (CSCs) in root canal therapy, their position in the context of past and present dentistry agents can provide a better understanding of these materials for their further improvement. In this context, the present review article addresses a wide range of recent investigations in the field of CSC-based products and describes details of their composition, properties, and clinical applications. The need for maintaining or reconstructing tooth structure has increased in contemporary endodontic treatment approaches. This research thus discusses the attempts to create comprehensive data collection regarding calcium ion release, bond strength, alkalinizing activity and bioactivity, and the ability to stimulate the formation of hydroxyapatite as a bioactive feature of CSCs. Sealing ability is also highlighted as a predictor for apical and coronal microleakage which is crucial for the long-term prognosis of root canal treatment integrity. Other claimed properties such as radiopacity, porosity, and solubility are also investigated. Extended setting time is also mentioned as a well-known drawback of CSCs. Then, clinical applications of CSCs in vital pulp therapies such as pulpotomy, apexification, and direct pulp capping are reviewed. CSCs have shown their benefits in root perforation treatments and also as root canal sealers and end-filling materials. Nowadays, conventional endodontic treatments are replaced by regenerative therapies to save more dynamic and reliable hard and soft tissues. CSCs play a crucial role in this modern approach. This review article is an attempt to summarize the latest studies on the clinical properties of CSCs to shed light on the future generation of treatments.

Effect of Different Adhesive Strategies on the Microshear Bond Strength of Calcium-Silicate-Based Materials

Aim:

To evaluate the microshear bond strength (µSBS) of mineral trioxide aggregate and Biodentine to various resin-based materials using different adhesive strategies.

Materials and Methods:

Three resin-based materials—a self-adhering resin composite with or without acid etching (Vertise flow; Kerr, Orange, CA, USA), a conventional flowable composite with a total-etch adhesive (Filtek Ultimate Flowable; 3M ESPE, St. Paul, MN, USA), and a flowable resin-modified glass ionomer cement (RMGIC) without any surface modification (Ionoseal; VOCO GmbH, Cuxhaven, Germany)—and two calcium-silicate-based materials—Biodentine and BIOfactor mineral trioxide aggregate (MTA)—were tested. A total of 100 cylindrical acrylic molds were prepared. Biodentine and BIOfactor MTA were prepared and placed into the central holes on the molds. Specimens were divided into two main groups according to materials and into five subgroups ( n = 10). µSBS were evaluated using a µSBS testing device. The failure modes were examined under a stereomicroscope with magnification. They were categorized as adhesive, cohesive, or mixed. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey test. The significance level was taken as α = 0.05.

Results:

It was observed that both calcium-silicate-based material type and resin-based material type influenced the µSBS significantly according to two-way ANOVA. Biodentine exhibited higher bond strength values than MTA. However, no statistically significant interaction was demonstrated between these factors ( P = .396). The µSBS values of intermediate materials to Biodentine and MTA were listed from the lowest to the highest as follows: RMGIC < Acid Etch + RMGIC < SARC (self-adhering resin composite) < FC (flowable composite) < Acid Etch + SARC.

Conclusion:

Self-adhering composites can be used on calcium-silicate-based materials in vital pulp treatments because of their mechanical properties. Acid-etching ensures high µSBS values. Although the µSBS of Biodentine were higher than MTA according to this study’s results, there was no statistically significant difference in µSBS of FC and acid-etched SARC to MTA.

Compressive strength, surface roughness, and surface microhardness of principle tricalcium silicate-based endodontic cements after universal adhesive application

Aims and Background

It was aimed to evaluate compressive strength (CS), surface roughness, and microhardness of mineral trioxide aggregate (ProRoot MTA) and Biodentine (BD) after adhesive application.

Materials and Methods

Tests was carried out according to international ISO standard. ProRoot MTA and BD were prepared in Teflon molds according to manufacturer's instructions: n = 210 for CS; n = 210 for microhardness. Samples were incubated for 7 days at 37°C in 100% humidity. Surfaces were smoothed with up to 2000 grits of silicon-carbide sandpaper on abrasive device at 150 rpm, randomly divided into seven groups (n = 15). Clearfil Universal Bond, All Bond Universal, and Single Bond Universal (SBU) were applied in both total-etch and self-etch (SE) modes. Adhesives were applied according to manufacturers' recommendations (no adhesive used in control). CS was performed at speed of 1 mm/min, microhardness at 100 gr for 15 s. The surface roughness of the samples was analyzed with atomic force microscopy. Two-way analysis of variance and post hoc Tukey tests were used for the evaluation of the data.

Results

Man CS and microhardness values between ProRoot MTA and BD were as follows: 24.9 N, 72.6 HV; 59.8 N, 59.0 HV, respectively. In CS, BD was higher than ProRoot MTA (P < 0.05). In other comparisons except for SBU SE group (P < 0.05), BD and ProRoot MTA showed similar results (P > 0.05). However, ProRoot MTA was found higher than BD regarding microhardness (P < 0.05). As a result of the adhesive application in both BD and ProRoot MTA groups, a decrease in surface roughness was observed compared to the control group.

Conclusion

BD exhibited better results than ProRoot MTA regarding CS. However, ProRoot MTA was found to be more successful than BD in terms of microhardness. BD and ProRoot MTA showed similar physical properties in terms of surface roughness. To improve regenerative procedures, besides the selection of bioceramic cements, the interaction between cements and materials applied during coronal restoration should be considered.

Are resin-containing pulp capping materials as reliable as traditional ones in terms of local and systemic biological effects?

The aim of this study was to compare the local and systemic effects of current pulp capping materials containing resin with those of traditional materials in an animal study. A total of 48 rats were used: a control group (n=12) (sub-control and negative control), a resin-containing group (n=18) (Calcimol LC, Theracal LC, Activa-BioActive Base/Liner), and a traditional group (n=18) (Biodentine, ProRoot MTA, Dycal). The materials which had been placed in polyethylene tubes were implanted in subcutaneous pockets. The rats were sacrificed at 1, 2, or 4 weeks. Evaluations were made of subcutaneous connective tissue, the left kidney, liver, and blood samples. Of all the study groups, MTA demonstrated biocompatibility at a level close to that of the control groups. Inflammation was observed to be more severe in resin-containing materials, but Activa Base/Liner showed a more successful local and systemic tissue response.

Effect of different manipulations on the physical, chemical and microstructural characteristics of Biodentine

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.

Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material

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.

A 3D finite element analysis of stress distribution on different thicknesses of mineral trioxide aggregate applied on various sizes of pulp perforation

OBJECTIVES

The aim of this study was to evaluate the stress distribution on different thicknesses of mineral trioxide aggregate (MTA) placed on various widths of pulp perforations during the condensation of the composite resin material.

MATERIALS AND METHODS

The mandibular molar tooth was modeled by COSMOSWorks program (SolidWorks, Waltham, MA). Three finite elemental analysis models representing 3 different dimensions of pulp perforations, 1, 2, and 3 mm in diameter, were created. The perforation area was assumed as filled with MTA with different thicknesses, 1, 2, and 3 mm for each pulp perforation width, creating a total of 9 different models. Then, a composite resin material was layered on MTA for each model. A 66.7 N load was applied and an engineering simulation program (ANSYS, Canonsburg, US) was used for the analysis. Results were presented considering von Mises stress criteria.

RESULTS

As MTA thickness increased, the stress values recorded within the area between pulp and MTA decreased. Strain was decreased when the thickness of MTA increased.

CONCLUSIONS

Stresses at MTA-pulp interface and strain on MTA decreased with the increase in MTA thickness.

CLINICAL RELEVANCE

In clinical practice, when MTA is required for pulp capping, using a thick layer of the material seems to be a better option in order to reduce the stress under forces of hand condensation of overlying restorative materials.

Calcium silicate cement interface with restorative materials through layering after different time intervals

The aim was to evaluate the interfacial characteristics of Biodentine, CEM Cement, and ProRoot MTA when restored with different final restorative materials after different time intervals. Biodentine, CEM Cement and ProRoot MTA were layered with amalgam, composite resin or light cure glass ionomer cement. Layering was done either immediately, 24 or 72 h after cement placement. The interface of cements with restorative materials was characterized using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) after separation. Vickers surface microhardness test was also performed on the interface. Statistical analysis included two-way Anova, Dunnett T3, and Tukey HSD. The significance level was set at P < 0.05. The highest microhardness values were seen when restorative materials were layered after 24 h in the case of Biodentine, and after 72 h in the case of CEM Cement and ProRoot MTA. In ProRoot MTA no significant difference was seen in the microhardness when layered with different restorative materials regardless of the time of layering. In immediate layering, Biodentine exhibited the highest microhardness values. Both immediate and delayed layering resulted in element transfer between calcium silicate cements (CSCs) and restorative materials. Deposition and depletion of element occurs subsequent to layering of restorative materials on CSCs. When immediate layering is necessary, Biodentine may be a better option compared to other CSCs evaluated.

Evaluation of the properties of Mineral Trioxide Aggregate mixed with Zinc Oxide exposed to different environmental conditions

Addition of zinc oxide (ZnO) to Mineral Trioxide Aggregate (MTA) has been shown to rectify tooth discoloration caused by Angelus MTA. This study evaluated the microhardness, compressive strength, calcium ion release and crystalline structures of MTA mixed with ZnO in different environmental conditions. Molds with a diameter of 4 mm and a height of 6 mm were used for compressive strength, calcium ion release and X-ray diffraction (XRD) evaluations. Molds with 6 mm diameter and 4 mm height were used for surface microhardness evaluations. Cements evaluated include Angelus MTA (Angelus, Brail), Angelus MTA + ZnO, ProRoot MTA (Dentsply Tulsa Dental, OK), and ProRoot MTA + ZnO. Each group was divided into 3 subgroups according to exposure conditions: normal saline (NS), phosphate buffered saline (PBS) or blood. After 7 days incubation, surface microhardness, compressive strength and XRD analysis was performed. Calcium ion release was evaluated after 3, 24 and 168h incubation using atomic absorption spectrophotometry. Data were analyzed by One Way Anova followed by the Tukey HSD Post hoc tests and T-Test. The significance level was set at 0.05. Addition of ZnO to Angelus and ProRoot MTA significantly decreased the compressive strength of these cements regardless of the environmental conditions (P < 0.001); however, it had no significant effect on their microhardness or calcium ion release. In conclusion, adding ZnO to Angelus and ProRoot MTA can adversely affect the compressive strength of Angelus and ProRoot MTA.

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Addition of ZnO can prevent tooth discoloration caused by MTA.

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Mixing 5% ZnO with ProRoot and Angelus MTA decreases the compressive strength of the cement.

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Calcium ion release also decreases with the addition of ZnO although this decrease is not statistically significant.

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It seems that mixing ZnO with MTA can initially impair the hydration of this cement.

The role of calcium ion release on biocompatibility and antimicrobial properties of hydraulic cements

Tricalcium silicate (TCS)-based materials produce calcium hydroxide as a byproduct of their hydration reaction. The present study investigated whether calcium ion release (CIR) affects their biological and antimicrobial properties when used as pulp protection materials. The effect of incorporation of micro-silica and calcium phosphate monobasic to radiopacified TCS-based materials was investigated. The commercial TCS-based Biodentine, Bio-C Pulpo, TotalFill Root Repair Material, TheraCal LC and a base/liner- ACTIVA BioACTIVE (Activa) were also evaluated. The hydration and CIR were monitored and correlated with biocompatibility and antimicrobial assessment of eluates. Overall, the additives altered the hydration and leaching profile of the prototype cements. The micro-silica inclusion resulted in a decreased long-term calcium hydroxide formation which was associated with neutralised cytotoxicity and antibacterial activity. Calcium phosphate did not alter the leaching profile, although a stronger antibacterial effect was induced. The commercial materials also had different CIR profiles. The water-based ones had higher CIR, and this was associated with stronger antimicrobial effect but not enhanced biological activity. Both TheraCal LC and Activa exhibited poor degree of conversion, low CIR, acceptable biocompatibility and moderate antibacterial activity. A positive correlation of CIR with antibacterial effectiveness was observed (0.3 < r < 0.49; p = 0.021, p = 0.011 for the two test bacterial cultures). No relation was shown between CIR and cytotoxicity (0.3 < r < 0.49; p = 0.150, p = 0.068 for the two cell cultures studied). The additives modified the CIR. The antimicrobial properties were dependent on the CIR; the cytotoxicity of the materials was unaffected.

Effect of commonly used irrigants on the colour stabilities of two calcium-silicate based material

Purpose:

The aim of present study was to evaluate the color stability of calcium-silicate based cements (CSC) Mineral Trioxide Aggregate (MTA) and BiodentineTM when exposed to endodontic irrigating solutions 5% Sodium hypochlorite (NaOCl) or 2% Chlorhexidine (CHX).

Materials and methods:

A total of 60 (n=30) cylindrical samples (10 mm diameter, 2 mm height) were prepared by manipulating white MTA Angelus (Angelus, Londrina, PR, Brazil) and BiodentineTM (Septodent, Saint Maur, France) according to manufacturer's instructions. These samples were immersed in 5% sodium hypochlorite (Prime Dental Products Pvt. Ltd., Mumbai, India), 2% chlorhexidine gluconate (Dentochlor, Saronno VA, Italia), or distilled water for 24 hours. Color changes were measured using UV spectrophotometer (UV-1650, Shimadzu, Europe) and the values were tabulated.

Results:

A significant difference was observed between group I and II with respect to both parameters A & B (p<0.05). Both the calcium-silicate-based materials exhibited significant discoloration when immersed in NaOCl and CHX. Distilled water did not cause clinically perceptible discoloration of any material.

Conclusion:

A significant discoloration was observed with a specific combination of calciumsilicate- based cement and irrigant. BiodentineTM exhibited significant discoloration with CHX whereas, MTA showed more discoloration with NaOCl.

Effect of Er:YAG laser etching on topography, microstructure, compressive strength, and bond strength of a universal adhesive to calcium silicate cements

OBJECTIVE

To evaluate the effect of Er:YAG etching on topography, microstructure, compressive strength, and shear bond strength (SBS) of All-Bond Universal adhesive to mineral trioxide aggregate-Angelus (AMTA) and Biodentine (BD).

METHODS AND MATERIALS

Sixty cylindrical specimens of each cement (AMTA and BD) in five groups were prepared and stored for 72 h. The control groups were non-etched, and four other groups were acid-etched and laser-etched with a pulse energy of 60, 80, or 100 mJ, followed by compressive strength testing. Surface micromorphology and topography were evaluated. Similar groups were bonded using All-Bond Universal with self-etch and etch-and-rinse (acid-etch) approaches, and laser-etch 60, 80, and 100 mJ, and SBS was tested. Data were analyzed using two-way and one-way ANOVA and the Bonferroni post hoc tests (α = 0.05).

RESULTS

BD had a significantly higher compressive strength and SBS (except for laser-etch 100) compared to AMTA, regardless of the etching method (p < 0.001). Acid etching and laser etching 100 of both cements and laser etching 80 of BD alone produced a significantly lower compressive strength than that for the other groups. Contrary to BD, for AMTA, all the treatments significantly increased SBS compared to that of the self-etch group.

CONCLUSIONS

Etching of AMTA was needed for stronger bonding; laser etching with 60 or 80 mJ without compromising compressive strength was recommended. Etching not only did not improve bonding ability of BD, but it also negatively affected the strength of BD.

CLINICAL RELEVANCE

To achieve successful combined calcium silicate cement-resin material restoration, an adequate bond between the materials is mandatory. This might be provided with the ultramild adhesive through laser etching without compromising compressive strength, depending on cement composition and laser energy level used.

The effect of bleaching agents on the compressive strength of calcium silicate-based materials

The present study aimed to evaluate the effect of sodium perborate on the compressive strength of calcium silicate-based materials. ProRoot wMTA, MTA Plus, NeoMTA Plus and Biodentine discs with 5 mm thickness and 4 mm diameter were prepared. Thirty discs from each material were used for compressive strength testing and divided into two groups: control and bleaching (n = 15). The sodium perborate was mixed with 30% hydrogen peroxide in a creamy consistency and placed on the surface of the specimens. Specimens were tested in an Instron machine, and compressive strength values were recorded and compared. The data were analysed using one-way anova and post hoc Tukey tests. Compressive strength of all tested materials significantly decreased after bleaching (P < 0.05). SEM examination revealed deterioration on materials' surfaces after bleaching. Application of sodium perborate and hydrogen peroxide reduced the compressive strength of ProRoot wMTA, MTA Plus, NeoMTA Plus and Biodentine.

Effect of reducing acid-etching duration time on compressive strength and bonding of a universal adhesive to calcium silicate cements

AIM

To assess the effect of acid-etching duration time on the compressive strength, microstructure and shear bond strength of All-Bond Universal adhesive to MTA-Angelus (AMTA), and Biodentine (BD).

METHODOLOGY

Forty-eight cylindrical specimens (4 mm in diameter, 6 mm in height) of AMTA in four groups and 48 specimens of BD in four groups (n = 12) were prepared and stored for 72 h. The control groups were unetched whilst the three experimental groups were acid-etched for 5, 10 and 15 s, respectively, followed by compressive strength testing. The effect of the various acid-etching times on surface micromorphology was evaluated under a scanning electron microscope. Similar groups were bonded using All-Bond Universal and Aelite Flo and shear bond strength was tested. Data were analysed using two-way ANOVA and Tukey tests.

RESULTS

10-s and 15-s acid-etching reduced the compressive strength of AMTA and BD (P < 0.001), while 5-s etching did not (P ≤ 0.86). In all the groups, BD had greater compressive strength compared to AMTA. Contrary to BD, the three etched AMTA groups had significantly higher shear bond strength compared to the control group (P < 0.001), with no significant differences between them. The etched groups of AMTA had shear bond strengths comparable to all the BD groups. Scanning electron microscope observations indicated variable surface morphologies such as remnant crystals and cracking/eroding in all our groups of AMTA; though these differences were less prominent for BD.

CONCLUSIONS

Shortening the acid-etching time to 5 s resulted in a beneficial effect in terms of resin bonding for AMTA while preventing the detrimental effect of 10-s and 15-s etching on the compressive strength of AMTA and BD. However, the three etching times had no effect on resin-BD bond.

Microstructure and chemical analysis of four calcium silicate-based cements in different environmental conditions

OBJECTIVE

The objective of this study was to analyze the microstructure and crystalline structures of ProRoot MTA, Biodentine, CEM Cement, and Retro MTA when exposed to phosphate-buffered saline, butyric acid, and blood.

METHODS AND MATERIALS

Mixed samples of ProRoot MTA, Biodentine, CEM Cement, and Retro MTA were exposed to either phosphate-buffered saline, butyric acid, or blood. Scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopic (EDX) evaluations were conducted of specimens. X-ray diffraction (XRD) analysis was also performed for both hydrated and powder forms of evaluated calcium silicate cements.

RESULTS

The peak of tricalcium silicate and dicalcium silicate detected in all hydrated cements was smaller than that seen in their unhydrated powders. The peak of calcium hydroxide (Ca(OH)₂) in blood- and acid-exposed ProRoot MTA, CEM Cement, and Retro MTA specimens were smaller than that of specimens exposed to PBS. The peak of Ca(OH)₂ seen in Biodentine™ specimens exposed to blood was similar to that of PBS-exposed specimens. On the other hand, those exposed to acid exhibited smaller peaks of Ca(OH)₂.

CONCLUSION

Exposure to blood or acidic pH decreased Ca(OH)₂ crystalline formation in ProRoot MTA, CEM Cement and Retro MTA. However, a decrease in Ca(OH)₂ was only seen when Biodentine™ exposed to acid.

CLINICAL RELEVANCE

The formation of Ca(OH)₂ which influences the biological properties of calcium silicate cements was impaired by blood and acid exposures in ProRoot MTA, CEM Cement, and Retro MTA; however, in the case of Biodentine, only exposure to acid had this detrimental effect.

Biodentine™ material characteristics and clinical applications: a 3 year literature review and update

INTRODUCTION

Biodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry.

AIM

To provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™.

STUDY DESIGN

A comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language.

CONCLUSIONS

The enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.

Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2)

Introduction

The preservation of the integrity and health of primary teeth and their supporting tissues is of great importance in maintaining arch length space, mastication, speech, and esthetics. A pulpotomy is a common therapy performed on a primary tooth presenting reversible pulpitis or a traumatic pulp exposure, allowing its conservation on the arch until its loss.

Aim

The study aims to clinically and radiographically evaluate the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on deciduous molars with complete roots formation (stage 2).

Materials and methods

A total number of 75 primary molars in stage 2 of formation were selected to undergo pulpotomy treatment. All teeth were restored with a stainless-steel crown.The clinical success was evaluated at 1, 3, 6 and 12-month intervals. The radiographic follow-up evaluations were at 6 and 12 months. The resulting data were tabulated and statistically analyzed.

Results

Among the 75 teeth treated with Biodentine™, one tooth revealed abnormal mobility and tenderness to percussion at the end of the 1st month. PLS widening and the bone lesion was not seen in any of the 74 remaining cases. Forty teeth (54.1%) showed pulp canal obliteration (PCO), and none of the cases developed a draining sinus or had increased mobility. At the end of the 1-year follow-up, the clinical and radiographic success rates were 98.7% and 100%, respectively.

Conclusion

Pulpotomies performed with Biodentine™ on stage 2 primary molars were generally very satisfactory and fulfilled all requirements, covering all needs. This innovative bioactive medicament seems to be a "heroic" material. The excellent outcomes of the present study are indicative that Biodentine™ is a promising biomaterial to promote pulp repair after pulpotomy in clinical practice.

How to cite this article

Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2). Int J Clin Pediatr Dent 2018;11(6):496-504.

Effect of Different Water-to-Powder Ratios on the Compressive Strength of Calcium-enriched Mixture Cement

INTRODUCTION

Calcium-enriched Mixture (CEM) cement is an endodontic reparative material available in the form of powder and liquid. The purpose of this in vitro study was to determine the effect of different water-to-powder (WP) proportions on the compressive strength (CS) of the cement.

METHOD MATERIALS AND

One gram of CEM cement powder was mixed with either 0.33 g, 0.4 g or 0.5 g CEM liquid. The mixture was transferred to metallic cylindrical molds (n=10) with internal dimensions of 6±0.1 mm height and 4 ±0.1 mm diameter. After 4 days, the specimens were subjected to compressive strength tests using a universal testing machine. The data were analyzed by One-way ANOVA and Tukey's tests at a significance level of 0.05.

RESULTS

Statically significant difference was found among experimental groups (P<0.05). The 0.33 WP ratio showed significantly greater CS value compared to 0.4 and 0.5 proportions (P=0.012 and P=0.000, respectively). The CS of 0.4 WP ratio was also significantly higher than that of 0.5 WP ratio (P=0.014).

CONCLUSION

According to the results, higher WP ratios results in lower CS of the cement.

Antimicrobial and biological activity of leachate from light curable pulp capping materials

OBJECTIVES

Characterization of a number of pulp capping materials and assessment of the leachate for elemental composition, antimicrobial activity and cell proliferation and expression.

METHODOLOGY

Three experimental light curable pulp-capping materials, Theracal and Biodentine were characterized by scanning electron microscopy, energy dispersive spectroscopy and X-ray diffraction. The elemental composition of the leachate formed after 24h was assessed by inductively coupled plasma (ICP). The antimicrobial activity of the leachate was determined by the minimum inhibitory concentration (MIC) against multispecies suspensions of Streptococcus mutans ATCC 25175, Streptococcus gordonii ATCC 33478 and Streptococcus sobrinus ATCC 33399. Cell proliferation and cell metabolic function over the material leachate was assessed by an indirect contact test using 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.

RESULTS

The hydration behavior of the test materials varied with Biodentine being the most reactive and releasing the highest amount of calcium ions in solution. All materials tested except the unfilled resin exhibited depletion of phosphate ions from the solution indicating interaction of the materials with the media. Regardless the different material characteristics, there was a similar antimicrobial activity and cellular activity. All the materials exhibited no antimicrobial activity and were initially cytotoxic with cell metabolic function improving after 3days.

CONCLUSIONS

The development of light curable tricalcium silicate-based pulp capping materials is important to improve the bonding to the final resin restoration. Testing of both antimicrobial activity and biological behavior is critical for material development. The experimental light curable materials exhibited promising biological properties but require further development to enhance the antimicrobial characteristics.

Effect of Oral Tissue Fluids on Compressive Strength of MTA and Biodentine: An In vitro Study

INTRODUCTION

Over the past many years various root end filling materials have been used which have been tested for their physical properties but each of them had certain limitations. In clinical practice, root end filling materials are exposed to oral tissue fluids which may compromise their longevity.

AIM

The aim of this study was to investigate the effects of oral tissue fluids on compressive strength of Mineral Trioxide Aggregate (MTA) and biodentine.

MATERIALS AND METHODS

MTA and biodentine cylinders measuring 6 mm × 4 mm were prepared using acrylic blocks. They were divided into six groups; (Group 1) (MTA) (n=3), (Group 2) MTA contaminated with saliva, (MTA-S) (n=3), Group 3: MTA contaminated with blood, MTA-B (n=3), Group 4: Biodentine (BD), Group 5: Biodentine contaminated with saliva (BD-S) (n=5), Group 6: Biodentine contaminated with blood (BD-B) (n=5). The mould was contaminated with saliva and blood and incubated at 37°C at 100% humidity for three days and compressive strength (MPa) was measured using universal testing machine and the data was analyzed statistically using one-way ANOVA test.

RESULTS

There was no significant difference in the compressive strength between the three groups i.e., MTA, MTA-S, MTA-B (p > 0.05). However, there was higher compressive strength in the MTA-B group when compared to MTA and MTA-S. Also, there was no statistical significant difference between BD, BD-S, BD-B (p>0.05).

CONCLUSION

This study showed that the compressive strength of MTA and biodentine was not adversely affected by contamination with oral tissue fluids like blood and saliva.

Effect of the TiO2 nanoparticles on the selected physical properties of mineral trioxide aggregate

Background

Some of the efforts to improve the properties of Mineral Trioxide Aggregate (MTA) include incorporation of some nanoparticles such as Titanium dioxide (TiO2). The aim of this study was to evaluate the effect of TiO2 nanoparticles on the setting time, working time, push-out bond strength and compressive strength of MTA.

Material and Methods

The physical properties to be evaluated were determined using the ISO 6786:2001 and 9917 specifications. Fifteen samples of each material (MTA or MTA with 1% weight ratio of TiO2 Nanoparticles) were prepared for any evaluated physical property. Data were analyzed using descriptive statistics and T-test. Statistical significance was set at P<0.05.

Results

There was the significant effect of the material type (presence and absence of TiO2 nanoparticles) on the push-out bond strength, compressive strength, working time and setting time, with significantly higher values achieved in the group with TiO2 nanoparticles than the group without these particles (P=0.01 for the setting time and compressive strength, P=0.03 for the working time and P=0.001 for the bond strength).

Conclusions

Based on the findings of this in vitro study, incorporation of the TiO2 nanoparticles with weight ratio of 1% increased the setting time, working time, compressive strength and push out bond strength of MTA.

Key words:Mineral trioxide aggregate, nanoparticles, physical properties, titanium dioxide.

Calcium silicate-based cements: composition, properties, and clinical applications

Mineral trioxide aggregate (MTA) is a calcium silicate-based cement (CSC) commonly used in endodontic procedures involving pulpal regeneration and hard tissue repair, such as pulp capping, pulpotomy, apexogenesis, apexification, perforation repair, and root-end filling. Despite the superior laboratory and clinical performance of MTA in comparison with previous endodontic repair cements, such as Ca(OH)₂ , MTA has poor handling properties and a long setting time. New CSC have been commercially launched and marketed to overcome the limitations of MTA. The aim of the present review was to explore the available literature on new CSC products, and to give evidence-based recommendations for the clinical use of these materials. Within the limitations of the available data in the literature regarding the properties and performance of the new CSC, the newer products could be promising alternatives to MTA; however, further research is required to support this assumption.

The effects of acid etching time on surface mechanical properties of dental hard tissues

The objective of this study was to evaluate the effect of etching time on the surface properties of dental hard tissues including enamel and dentin. For this purpose, samples were prepared using extracted human teeth and treated with 37% phosphoric acid for various length of time using the set protocol. The effects of etching time on surface roughness were assessed using non-contact surface roughness profilometer and surface hardness was measured using nanoindentation technique. All results were analyzed statistically using SPSS computer software. Within the limitation of this study, it was concluded that etching time influences on the surface properties of dental hard tissues particularly the enamel. Enamel surface properties such as roughness and hardness can be altered remarkable as a matter of few seconds. Prolonged etching time than recommended is likely to increase the surface roughness and decrease surface hardness; compromising the bond strength of adhesive materials in clinical applications.

A review on biodentine, a contemporary dentine replacement and repair material

Biodentine is a calcium-silicate based material that has drawn attention in recent years and has been advocated to be used in various clinical applications, such as root perforations, apexification, resorptions, retrograde fillings, pulp capping procedures, and dentine replacement. There has been considerable research performed on this material since its launching; however, there is scarce number of review articles that collates information and data obtained from these studies. Therefore, this review article was prepared to provide the reader with a general picture regarding the findings about various characteristics of the material. The results of a PubMed search were classified and presented along with some critical comments where necessary. The review initially focuses on various physical properties of the material with subheadings and continues with biocompatibility. Another section includes the review of studies on Biodentine as a vital pulp treatment material and the article is finalized with the summary of some case reports where the material has been used.