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Elnawawy HM, Kutty MG, Yahya NA, Kasim NHA, Cooper PR, Camilleri J, Ahmed HMA. Chemical and physical properties of radiopaque Portland cement formulation with reduced particle size. Dent Mater J 2024; 43:672-682. [PMID: 39261022 DOI: 10.4012/dmj.2024-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
This study compared the chemical and physical properties of an experimental radiopaque white Portland cement (REPC) with reduced particle size to ProRoot white mineral trioxide aggregate (WMTA). The particle size distribution of experimental Portland cement (EPC) was examined, and then nano-zirconium oxide (nano-ZrO) was added to produce REPC. Chemical analysis, initial setting time, pH values, and push-out bond strength were evaluated. Results showed that REPC had smallest particle size (354.5±26.45 nm), while PC had the largest (1,309.67±60.54 nm) (p<0.05). Differences in chemical composition were observed. REPC exhibited shorter setting time (32.7±0.58 min) compared to WMTA (131.67±2.89 min) and PC (163.33±2.89 min) (p<0.05). All groups showed alkaline pH (p<0.05). REPC demonstrated the highest push-out bond strength (22.24±4.33 MPa) compared with WMTA (15.53±3.26 MPa) and PC (16.8±5.43 MPa) (p<0.05). This cost-effective PC formulation reduced the setting time and increased the push-out bond strength while maintaining the alkaline properties of the original cements.
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Affiliation(s)
| | | | - Noor Azlin Yahya
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya
| | | | - Paul Roy Cooper
- Sir John Walsh Research Institute, Department of Oral Sciences, University of Otago
| | - Josette Camilleri
- Division of Endodontology and Operative Dentistry, School of Health Sciences, College of Medicine and Health, University of Birmingham
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Botero T, Chrepa V, Shrestha A, Gibbs J, Al Hezaimi K, Law A, Sedgley C, Hargreaves KM. Web-Based Survey on Regenerative Endodontic Practices among Members of the American Association of Endodontists. J Endod 2024; 50:1281-1288. [PMID: 38906528 DOI: 10.1016/j.joen.2024.05.016] [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: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The American Association of Endodontics (AAE) Regenerative Endodontics Committee reports here the web-based survey data of regenerative endodontic procedures performed by the AAE members from 2008 to 2019. METHODS The web-based survey consisted of 2 questionnaires, a revascularization and a follow-up, including clinical and radiographic data at 3, 6, 12 or >12 months after treatment. Data from demographics, etiology, clinical protocols, radiographic, and clinical outcome as perceived by the clinicians were recorded. From 927 entries, 184 full cases were submitted and 126 were suitable for radiographic analysis. The data were divided into cases with 6-12 months and cases with >12 months recall time. Descriptive statistics and univariate analyses were performed. RESULTS Predominantly patients were male (63%), average 10 years-old with anterior teeth (77.2%) due to trauma (69.6%). A wide variation in regenerative endodontic procedures protocols was reported by the AAE members. The most common clinical protocols used minimal instrumentation (75.5%), 2.5% or higher concentrations of sodium hypochlorite (83.7%), and antibiotic paste as intracanal medication (58.7%). The majority reported blood clot formation (56%) and most common coronal capping material was white mineral trioxide aggregates (50.5%). Increases in radiographic root length, and radiographic root area were proportional to the time lapsed after treatment. Overall, case outcomes were categorized by clinicians as successful (54.3%), uncertain (23.9%), and unsuccessful (3.8%). CONCLUSIONS This web-based survey provides a valuable perspective on case selection, clinical protocols, and perceived outcomes for regenerative endodontic procedures and supports the need for future higher level evidence studies.
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Affiliation(s)
- Tatiana Botero
- Cariology, Restorative Sciences and Endodontics Department, School of Dentistry, University of Michigan, Ann Arbor, Michigan.
| | - Vanessa Chrepa
- Department of Endodontics, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Annie Shrestha
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Gibbs
- Division of Endodontics in Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mississippi
| | - Khalid Al Hezaimi
- Department of Endodontics and Periodontics, University of Southern California, Los Angeles, California
| | - Alan Law
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, Lake Elmo, Minnesota
| | - Christine Sedgley
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - Kenneth M Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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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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Sesen Uslu Y, Arıcan Alpay B, Sesen P, Özyürek T. The Efficacy of Different Laser Applications on Dentin Sealing in Preventing Discoloration Induced by Mineral Trioxide Aggregate. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1015. [PMID: 38473488 DOI: 10.3390/ma17051015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
The aim of this in vitro study was to evaluate the effect of the pre-application of a dentin-bonding agent and the application of different lasers on the prevention of tooth discoloration caused by mineral trioxide aggregate (MTA) in the presence of blood. Sixty extracted human anterior teeth were selected, with root lengths standardized to 10 mm and root canals shaped using Gates-Glidden drills #3 to #5. The samples were divided into six groups (n = 10): Group 1 with no surface treatment and Groups 2 to 6 with Optibond universal adhesive and Neodymium yttrium aluminum garnet (Nd:YAG), Erbium yttrium aluminum garnet (Er:YAG), Erbium-chromium-yttrium-scandium-gallium-garnet (Er:Cr:YSGG), and diode laser applications, respectively. Root canals were filled with fresh human blood, and ProRoot MTA and a collagen barrier were then placed. Color changes were measured with a spectrophotometer at 0, 7, 30, 90, and 180 days post MTA placement. Color differences (∆E) were analyzed using a two-factor mixed-design ANOVA with the Sidak method (p = 0.05). All treatment groups exhibited discoloration above the acceptability threshold. Although all treatment approaches exhibited less color change compared to the control group (p < 0.05), there was no significant difference among them in terms of preventing color change (p > 0.05). It was determined that none of the methods could guarantee 100% prevention of discoloration caused by MTA-blood contact.
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Affiliation(s)
- Yesim Sesen Uslu
- Department of Restorative Dentistry, School of Dental Medicine, Bahçeşehir University, Istanbul 34349, Turkey
| | - Burçin Arıcan Alpay
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul 34349, Turkey
| | - Pinar Sesen
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Kent University, Istanbul 34433, Turkey
| | - Taha Özyürek
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul 34349, Turkey
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Cho SY, Park S, Shin Y, Jung IY. Randomized clinical trial of pulpotomy using a premixed injectable calcium silicate cement on mature permanent teeth with reversible pulpitis. Sci Rep 2024; 14:2994. [PMID: 38316823 PMCID: PMC10844323 DOI: 10.1038/s41598-024-52818-6] [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: 07/30/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable calcium silicate cement, as compared to mineral trioxide aggregate in mature permanent premolar and molar teeth with reversible pulpitis. Included teeth were randomly divided into two groups according to pulpotomy material (ProRoot MTA [PMTA] group, Endocem MTA Premixed [EPM] group). After pulp exposure, the superficial pulp was either removed to a depth of 2 mm (partial pulpotomy) or completely amputated to the level of the root canal orifice (full pulpotomy). A 3-mm layer of either material was randomly placed over the pulp wound, followed by the application of a thin layer of a light-cured glass ionomer composite liner. The restoration procedure was then carried out during the same visit. After one year of treatment, the pulpotomy success rate was 94.4% (67/71), with no significant difference between the PMTA and EPM groups. The success rate was 93.9% in the PMTA group and 97.1% in the EPM group. There were no significant factors related to the procedures. EPM is a viable alternative to PMTA for single-visit pulpotomies of permanent premolars and molars.
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Affiliation(s)
- Sin-Yeon Cho
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-Do, Korea
| | - Seonghun Park
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Yooseok Shin
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Il-Young Jung
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea.
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Alharbi TM, Thabet AM, Alabbadi SH, Alhazmi MY, Khan HF, AlRasheed MA, Al-Twalbeh NA, Alsuhaim AS, Alqahtani NS. Unlocking the Potential of Cellular Guidance in Endodontics: Advancing the Process of Pulp Regeneration and Beyond. Cureus 2024; 16:e51651. [PMID: 38318576 PMCID: PMC10839349 DOI: 10.7759/cureus.51651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
Regenerative endodontics represents a paradigm shift in dental therapy, with the potential to not only restore damaged dental tissues but also to preserve the vitality of teeth. At the heart of this innovative approach is cell homing, a technique that harnesses the body's own healing mechanisms by recruiting endogenous stem cells to the site of dental injury for effective tissue regeneration. This review delves into the intricate processes of cell homing in the context of regenerative endodontics, particularly focusing on its application in immature teeth with open apices. It examines the role of bioactive molecules, scaffolds, and growth factors in orchestrating cell migration and differentiation within the root canal space. In addition, the review addresses the current limitations in clinical practice, such as the challenges in completely regenerating the pulp-dentin complex and the unpredictability in long-term outcomes. It also explores future possibilities, including the potential for more refined and effective regenerative strategies. By providing a comprehensive overview of the current state of cell homing in regenerative endodontics, this article aims to contribute to the ongoing development of advanced therapeutic techniques that could revolutionize endodontic treatment and improve patient care.
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Affiliation(s)
- Tariq M Alharbi
- Endodontics, King Fahad General Hospital, Medina, SAU
- Endodontics, Speciality Dental Center, Medina, SAU
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Chen CL, Chi CW, Lee CY, Tsai YL, Kasimayan U, K P O M, Lin HP, Chiang YC. Effects of surface treatments of bioactive tricalcium silicate-based restorative material on the bond strength to resin composite. Dent Mater 2024; 40:102-110. [PMID: 37919112 DOI: 10.1016/j.dental.2023.10.027] [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: 04/09/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES This study aimed to enhance the bond strength between Biodentine™ (BD), a bioactive tricalcium silicate (C3S) based material, and resin composite through various surface treatments. METHODOLOGY BD samples were immersed in either double distilled water or Hank's Balanced Salt Solution and analyzed using X-ray Diffraction (XRD). Shear bond strength (SBS) evaluations of BD were performed using Prime & Bond™ NT (PNT), Single Bond Universal (SBU), Xeno V (Xeno), and glass ionomer cement (GIC) following various etching durations (0 s/ 15 s/ 30 s/ 60 s with 37.5% phosphoric acid). Two primers, RelyX™ Ceramic Primer (RCP) and Monobond ™ Plus (MBP), were chosen to prime BD for SBS enhancement. Fractography and bonding interfaces were examined with energy dispersive X-ray spectroscopy (EDS)/ scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR). RESULTS XRD confirmed BD's main compositions as C3S, Ca(OH)2, CaCO3 and ZrO2 after 14 days crystal maturation. Etched BD did not improve SBS. GIC exhibited the lowest SBS (p < 0.05) among all adhesives, regardless of the etching mode (all < 1 MPa). The highest SBS (17.5 ± 3.6 MPa, p < 0.05) was achieved when BD primed with MBP followed by SBU application. FTIR and EDS showed γ-MPTS and10-MDP within the MBP primer interacted with C3S and ZrO2 of BD, achieving enhanced SBS. Most specimens exhibited mixed or cohesive failure modes. Significance BD's subpar mechanical properties and texture may contribute to its poor adhesion to resin composite. Pretreating BD with MBP primer, followed by SBU adhesive is recommended for improving bond strength.
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Affiliation(s)
- Che-Lun Chen
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan
| | - Chih-Wen Chi
- Department of Dentistry, National Taiwan University Hospital, Hsin-Chu Branch, No. 25, Ln. 442, Section 1, Jingguo Rd., North Dist., Hsinchu City 300195, Taiwan
| | - Chen-Yi Lee
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan
| | - Yi-Ling Tsai
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Uma Kasimayan
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Mahesh K P O
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Hong-Ping Lin
- Department of Chemistry, National Cheng Kung University. No.1, Daxue Rd., Tainan City 701, Taiwan
| | - Yu-Chih Chiang
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10016, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei 10617, Taiwan; School of Dentistry, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
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Song M, Lee SM, Bang JY, Kim RH, Kwak SW, Kim HC. Chemomechanical Properties and Biocompatibility of Various Premixed Putty-type Bioactive Ceramic Cements. J Endod 2023; 49:1713-1721. [PMID: 37734586 DOI: 10.1016/j.joen.2023.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION This study aimed to evaluate the chemomechanical properties and biocompatibility of recently introduced premixed putty-type bioactive ceramic cements (PPBCs). METHODS Including ProRoot MTA (PMTA) as a control, BC RRM fast-set putty (BCPT), Well-Root PT (WRPT), One-Fil PT (OFPT), and Endocem MTA premixed (ECPM) were compared to evaluate setting time, radiopacity, pH change, and microhardness. Biocompatibility on human dental pulp cells was compared using CCK-8 assay. Mineralization potential was evaluated using alkaline phosphatase activity, Alizarin Red S (ARS) staining, and quantitative real-time polymerase chain reaction with odontogenic gene marker. For data analysis, 1-way analysis of variance and Tukey's post hoc test were used at the significance level of 95%. RESULTS Among the PPBCs, BCPT presented the longest (552 ± 27) setting time (minutes) and others showed significantly shorter time than PMTA (334 ± 22) (P < .05). WRPT (6.20 ± 0.54) and OFPT (5.82 ± 0.50) showed significantly higher radiopacity values (mmAl) and others showed similar value compared with PMTA (P > .05). All PPBCs showed high alkaline pH from fresh materials and tended to increase according to time periods from 30 minutes to 12 hours. ECPM showed the highest value of microhardness (81.62 ± 5.90), WRPT showed similar, and others showed lower than PMTA (P < .05). All PPBCs showed biocompatibility in CCK-8 assay. All PPBCs showed similar or better value compared with PMTA in ALP and ARS staining, and ALP and DSPP marker expression (P < .05). CONCLUSIONS The PPBCs showed clinically acceptable chemomechanical properties and favorable mineralization potential.
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Affiliation(s)
- Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - So-Mang Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Ji-Young Bang
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Ruben H Kim
- UCLA Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Korea.
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Wang L, Konishi T, Inada M, Wada T, Uo M. Preparation and properties of the fine ground strontium-based endodontic cements. Dent Mater J 2023; 42:818-825. [PMID: 37821365 DOI: 10.4012/dmj.2023-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
In this study, fine powders of tristrontium aluminate (S3A) and distrontium cerate (S2Ce) cement were prepared using a dry grinding process, and their mechanical and ion dissolution properties were estimated. Fine cements showed the particles about 10 μm in diameter or smaller with sharp particle size distribution curves. The setting reaction of the fine cements was rapid; therefore, a 0.1% w/v of citric acid solution was used as the retarder. The compressive strengths of the fine cements were improved compared to those of the coarse cements at both 1 and 28 days after mixing at a water/powder ratio (W/P) of 0.4. The dissolution of Sr and Al ions from fine S3A cement was enhanced. However, the relative flowability decreases with fine grinding. Further studies on flowability, handling property are required. Additionally, the biological effects of endodontic cement should be studied both in vitro and in vivo.
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Affiliation(s)
- Liwei Wang
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tomoya Konishi
- Department of Creative Engineering, National Institute of Technology, Anan College
| | - Miki Inada
- Center of Advanced Instrumental Analysis, Kyushu University
| | - Takahiro Wada
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Motohiro Uo
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Castelo-Baz P, Gancedo-Gancedo T, Pereira-Lores P, Mosquera-Barreiro C, Martín-Biedma B, Faus-Matoses V, Ruíz-Piñón M. Conservative management of dens in dente. AUST ENDOD J 2023; 49 Suppl 1:481-487. [PMID: 37154212 DOI: 10.1111/aej.12763] [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: 06/28/2022] [Revised: 04/02/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023]
Abstract
Dens Invaginatus (DI) or dens in dente is an uncommon anomaly which mostly affects permanent lateral incisors, and it is very rare in molars. This article presents the conservative endodontic management of four different cases of DI and a discussion of the endodontic literature for this malformation. Three upper lateral incisors Type II, IIIa and IIIb, and an upper first molar Type II are shown. The most conservative approach possible was carried out. Three of the cases were obturated using the continuous wave technique. In one of the cases, it was possible to treat only the invagination with MTA and preserve the pulp vitality of the main canal. To make a correct diagnosis and to treat in the most conservative way possible, a DI is necessary to know its classification and use tools such as CBCT and magnification.
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Affiliation(s)
- Pablo Castelo-Baz
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Tania Gancedo-Gancedo
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Pereira-Lores
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carolina Mosquera-Barreiro
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Benjamín Martín-Biedma
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Manuel Ruíz-Piñón
- Department of Endodontics, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Jang YJ, Kim YJ, Vu HT, Park JH, Shin SJ, Dashnyam K, Knowles JC, Lee HH, Jun SK, Han MR, Lee JH, Kim JS, Kim JB, Lee JH, Shin JS. Physicochemical, Biological, and Antibacterial Properties of Four Bioactive Calcium Silicate-Based Cements. Pharmaceutics 2023; 15:1701. [PMID: 37376149 DOI: 10.3390/pharmaceutics15061701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Calcium silicate-based cement (CSC) is a pharmaceutical agent that is widely used in dentistry. This bioactive material is used for vital pulp treatment due to its excellent biocompatibility, sealing ability, and antibacterial activity. Its drawbacks include a long setting time and poor maneuverability. Hence, the clinical properties of CSC have recently been improved to decrease its setting time. Despite the widespread clinical usage of CSC, there is no research comparing recently developed CSCs. Therefore, the purpose of this study is to compare the physicochemical, biological, and antibacterial properties of four commercial CSCs: two powder-liquid mix types (RetroMTA® [RETM]; Endocem® MTA Zr [ECZR]) and two premixed types (Well-Root™ PT [WRPT]; Endocem® MTA premixed [ECPR]). Each sample was prepared using circular Teflon molds, and tests were conducted after 24 h of setting. The premixed CSCs exhibited a more uniform and less rough surface, higher flowability, and lower film thickness than the powder-liquid mix CSCs. In the pH test, all CSCs showed values between 11.5 and 12.5. In the biological test, cells exposed to ECZR at a concentration of 25% showed greater cell viability, but none of the samples showed a significant difference at low concentration (p > 0.05). Alkaline phosphatase staining revealed that cells exposed to ECZR underwent more odontoblast differentiation than the cells exposed to the other materials; however, no significant difference was observed at a concentration of 12.5% (p > 0.05). In the antibacterial test, the premixed CSCs showed better results than the powder-liquid mix CSCs, and ECPR yielded the best results, followed by WRPT. In conclusion, the premixed CSCs showed improved physical properties, and of the premixed types, ECPR exhibited the highest antibacterial properties. For biological properties, none of these materials showed significant differences at 12.5% dilution. Therefore, ECPR may be a promising material with high antibacterial activity among the four CSCs, but further investigation is needed for clinical situations.
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Affiliation(s)
- Yu-Ji Jang
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Yu-Jin Kim
- Department of Biomaterials Science, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Huong Thu Vu
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Jeong-Hui Park
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Seong-Jin Shin
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Khandmaa Dashnyam
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Drug Research Institute, Mongolian Pharmaceutical University & Monos Group, Ulaanbaatar 14250, Mongolia
| | - Jonathan C Knowles
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- UCL Eastman-Korea Dental Medicine Innovation Centre, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Cell & Matter Institute, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Division of Biomaterials and Tissue Engineering, Eastman Dental Institute, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK
- Department of Dental Hygiene, Hanseo University, 46 Hanseo 1ro, Seosan 31962, Republic of Korea
| | - Hae-Hyoung Lee
- Department of Biomaterials Science, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- UCL Eastman-Korea Dental Medicine Innovation Centre, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Soo-Kyung Jun
- Department of Biomaterials Science, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
| | - Mi-Ran Han
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Joon-Haeng Lee
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Jong-Soo Kim
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Jong-Bin Kim
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
| | - Jung-Hwan Lee
- Department of Biomaterials Science, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- UCL Eastman-Korea Dental Medicine Innovation Centre, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Cell & Matter Institute, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
| | - Ji-Sun Shin
- Department of Pediatric Dentistry, College of Dentistry, Dankook University, 119 Dandaero, Cheonan 31116, Republic of Korea
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
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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: 41] [Impact Index Per Article: 20.5] [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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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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Al-Ali M, Camilleri J. The scientific management of deep carious lesions in vital teeth using contemporary materials—A narrative review. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.1048137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AimThe aim of this article is to review the scientific evidence for deep caries removal in permanent vital teeth and the choice of dentine replacement material and restoration of the teeth to maintain long term tooth vitality and function.MethodThe two position statements namely the European Society of Endodontology and the American Association of Endodontists position statements on vital pulp therapy will be scrutinized and compared with regards to the deep caries removal strategy and assessed for evidence of best practice. The properties of materials used to manage vital pulps and the best way to restore the teeth will be reviewed and guidance on the full management of vital teeth will be suggested.ConclusionsPromoting new treatment modalities for reversible and irreversible pulpitis allowing for pulp preservation should be considered. Although debatable, cases with deep caries should be managed by complete non-selective caries removal which will allow for pulpal management if needed and a more predictable outcome can be expected when using the new materials and treatment modalities of vital pulp therapy.
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Lin HN, Wang LC, Chen MS, Chang PJ, Lin PY, Fang A, Chen CY, Lee PY, Lin CK. Discoloration Improvement by Mechanically-Milled Binary Oxides as Radiopacifier for Mineral Trioxide Aggregates. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7934. [PMID: 36431419 PMCID: PMC9695230 DOI: 10.3390/ma15227934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Mineral trioxide aggregates (MTA) have been widely used in endodontic treatments, but after some time, patients suffer tooth discoloration due to the use of bismuth oxide (Bi2O3) as a radiopacifier. Replacement of Bi2O3 with high energy ball-milled single (zirconia ZrO2; hafnia, HfO2; or tantalum pentoxide, Ta2O5) or binary oxide powder was attempted, and corresponding discoloration improvement was investigated in the present study. Bi2O3-free MTA is expected to exhibit superior discoloration. The radiopacity, diametral tensile strength, and discoloration of MTA-like cements prepared from the as-milled powder were investigated. Experimental results showed that MTA-like cements prepared using Ta2O5 exhibited a slightly higher radiopacity than that of HfO2 but had a much higher radiopacity than ZrO2. Milling treatment (30 min to 3 h) did not affect the radiopacities significantly. These MTA-like cements exhibited superior color stability (all measured ΔE00 < 1.0) without any perceptible differences after UV irradiation. MTA-like cements prepared using ZrO2 exhibited the best color stability but the lowest radiopacity, which can be improved by introducing binary oxide. Among the investigated samples, MTA-like cement using (ZrO2)50(Ta2O5)50 exhibited excellent color stability and the best overall performance with a radiopacity of 3.25 mmAl and a diametral tensile strength of 4.39 MPa.
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Affiliation(s)
- Hsiu-Na Lin
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Ling-Chi Wang
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Center of Dental Technology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - May-Show Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Pei-Jung Chang
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Pin-Yu Lin
- Department of Optoelectronics and Materials Technology, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Alex Fang
- Department of Engineering Technology and Industrial Distribution, Texas A & M University, College Station, TX 77843, USA
| | - Chin-Yi Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Materials Science and Engineering, Feng Chia University, Taichung 407, Taiwan
| | - Pee-Yew Lee
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Optoelectronics and Materials Technology, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Chung-Kwei Lin
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
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Eskandari F, Razavian A, Hamidi R, Yousefi K, Borzou S. An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy. Int J Dent 2022; 2022:6858088. [PMID: 36349079 PMCID: PMC9637478 DOI: 10.1155/2022/6858088] [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: 08/24/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Fateme Eskandari
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Razavian
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rozhina Hamidi
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadije Yousefi
- Department of Dental Materials and Biomaterials Research Center, Shiraz Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Susan Borzou
- University of Pennsylvania, College of Dentistry, Philadelphia, PA, USA
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Evaluation of the Effectiveness of Laser-Assisted Bleaching of the Teeth Discolored due to Regenerative Endodontic Treatment. Int J Dent 2022; 2022:3589609. [PMID: 35847349 PMCID: PMC9279097 DOI: 10.1155/2022/3589609] [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: 04/22/2022] [Revised: 06/04/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Regenerative endodontic treatments (RETs) as a valuable treatment option to save the immature necrotic teeth, have been reported to be associated with discoloration which is an inevitable unfavorable outcome. The present study aimed to compare three laser-assisted protocols with conventional walking bleaching in terms of bleaching efficacy. Seventy-two human incisor teeth underwent regenerative treatment. A triple antibiotic paste containing minocycline, ciprofloxacin, and metronidazole was used as an intracanal medicament. A human blood clot was applied as a scaffold and capped by a hydraulic calcium silicate-based cement. Ten weeks after the RET procedure, a four-session bleaching course started. Teeth were assigned to four groups: (1) 35% hydrogen peroxide gel, (2) 35% hydrogen peroxide gel + Nd: YAG laser, (3) 35% hydrogen peroxide gel + 980 nm diode laser, and (4) 35% hydrogen peroxide gel + 810 nm diode laser. The color changes (ΔE) were measured before and after bleaching sessions. The data were analyzed using Kruskal-Wallis nonparametric test. The statistical significance level was set at 0.05. Significant discoloration, exceeding the perceptibility threshold (ΔE > 3.7) was observed in all of the samples ten weeks after RET. There was no significant difference between groups in terms of RET-induced discoloration values (p > 0.05). Bleaching either by using 35% hydrogen peroxide or 35% hydrogen peroxide activated by different lasers used in this study resulted in significant tooth whitening (p < 0.05). There was no statistically significant difference among the groups in terms of bleaching efficacy (p > 0.05). Internal bleaching by using 35% hydrogen peroxide is as effective as laser-assisted protocols for correction of crown discoloration in teeth that have undergone RET.
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Deniz-Sungur D, Onur MA, Akbay E, Tan G, Daglı-Comert F, Sayın TC. Effects of calcium silicate cements on neuronal conductivity. Restor Dent Endod 2022; 47:e18. [PMID: 35692227 PMCID: PMC9160757 DOI: 10.5395/rde.2022.47.e18] [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: 11/27/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives This study evaluated alterations in neuronal conductivity related to calcium silicate cements (CSCs) by investigating compound action potentials (cAPs) in rat sciatic nerves. Materials and Methods Sciatic nerves were placed in a Tyrode bath and cAPs were recorded before, during, and after the application of test materials for 60-minute control, application, and recovery measurements, respectively. Freshly prepared ProRoot MTA, MTA Angelus, Biodentine, Endosequence RRM-Putty, BioAggregate, and RetroMTA were directly applied onto the nerves. Biopac LabPro version 3.7 was used to record and analyze cAPs. The data were statistically analyzed. Results None of the CSCs totally blocked cAPs. RetroMTA, Biodentine, and MTA Angelus caused no significant alteration in cAPs (p > 0.05). Significantly lower cAPs were observed in recovery measurements for BioAggregate than in the control condition (p < 0.05). ProRoot MTA significantly but transiently reduced cAPs in the application period compared to the control period (p < 0.05). Endosequence RRM-Putty significantly reduced cAPs. Conclusions Various CSCs may alter cAPs to some extent, but none of the CSCs irreversibly blocked them. The usage of fast-setting CSCs during apexification or regeneration of immature teeth seems safer than slow-setting CSCs due to their more favorable neuronal effects.
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Affiliation(s)
- Derya Deniz-Sungur
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mehmet Ali Onur
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Esin Akbay
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Gamze Tan
- Department of Biology, Faculty of Science and Letters, Aksaray University, Aksaray, Turkey
| | - Fügen Daglı-Comert
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Adult Restorative Dentistry and Endodontics, Oman Dental College, Muscat, Oman
| | - Taner Cem Sayın
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Private Practice, Fort Lauderdale, FL, USA
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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: 42] [Impact Index Per Article: 21.0] [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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Eren SK, Örs SA, Aksel H, Canay Ş, Karasan D. Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements. Restor Dent Endod 2022; 47:e10. [PMID: 35284325 PMCID: PMC8891465 DOI: 10.5395/rde.2022.47.e10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives Materials and Methods Results Conclusions
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Affiliation(s)
- Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli Örs
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Hacer Aksel
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Şenay Canay
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Duygu Karasan
- Division of Prosthodontics, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
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Dumrongvute K, Adel S, Wada T, Kawashima N, Piyachon C, Watanabe H, Kurabayashi T, Okiji T, Uo M. Distrontium Cerate as a Radiopaque Component of Hydraulic Endodontic Cement. MATERIALS (BASEL, SWITZERLAND) 2021; 15:284. [PMID: 35009428 PMCID: PMC8746137 DOI: 10.3390/ma15010284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to synthesize distrontium cerate (2SrO·CeO2: S2Ce) and evaluate its properties as an alternative component of the endodontic cement. S2Ce cement was prepared through calcination of strontium hydroxide and cerium carbonate. Subsequently, the crystal phase was confirmed using X-ray diffraction. S2Ce cement exhibited a rapid setting time (121 min) and achieved a high compressive strength (72.1 MPa) at 1 d after mixing, comparable to the compressive strength of a commercial mineral trioxide aggregate (MTA) cement (ProRoot MTA) after 28 d post mixing. However, the compressive strength decreased after 28 d of storage when the W/P ratio was 0.30-0.40 (p < 0.05). Ion dissolution test of the S2Ce cement showed that strontium ions were released after immersion in water (5.27 mg/mL after 1 d), whereas cerium dissolution was not detected. S2Ce exhibited approximately three times higher radiopacity (9.0 mm aluminum thickness equivalent) compared to the commercial MTA (p < 0.05). These findings suggest that S2Ce is a possible component for hydraulic endodontic cement that demonstrates a rapid setting and high radiopacity.
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Affiliation(s)
- Kunlanun Dumrongvute
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (K.D.); (S.A.); (N.K.); (T.O.)
- Department of Conservative Dentistry and Prosthetics, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Bangkok 10110, Thailand;
| | - Sherif Adel
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (K.D.); (S.A.); (N.K.); (T.O.)
- National Research Centre of Egypt, Department of Restorative Dentistry and Dental Materials, Oral and Dental Research Division, El Buhouth Street, Dokki, Cairo 12622, Egypt
| | - Takahiro Wada
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Nobuyuki Kawashima
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (K.D.); (S.A.); (N.K.); (T.O.)
| | - Chinalai Piyachon
- Department of Conservative Dentistry and Prosthetics, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Bangkok 10110, Thailand;
| | - Hiroshi Watanabe
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.W.); (T.K.)
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.W.); (T.K.)
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (K.D.); (S.A.); (N.K.); (T.O.)
| | - Motohiro Uo
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
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22
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Reis MDS, Scarparo RK, Signor B, Bolzan JT, Steier L, Figueiredo JAPD. Pulp capping with mineral trioxide aggregate or Biodentine: a comparison of mineralized barrier formation and inflammatory and degenerative events. Braz Oral Res 2021; 35:e118. [PMID: 34878073 DOI: 10.1590/1807-3107bor-2021.vol35.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Biodentine in endodontic practice has been widely investigated, but comprehensive histological descriptions of degenerative and inflammatory responses are not covered in most of the studies that compare pulp capping materials. This study aimed to evaluate pulpal responses to mineral trioxide aggregate (MTA Angelus) and Biodentine, focusing on mineralized barrier formation and on inflammatory and degenerative events. 80 male Wistar rats were assigned to 5 groups, according to the materials used for pulp capping and coronal sealing (n=8 per group/period). The lower first molars were mechanically exposed, capped with either MTA or Biodentine, and restored with silver amalgam. In an additional test group, the teeth were capped and sealed with Biodentine. The teeth capped with gutta-percha and restored with silver amalgam served as positive control, whereas untreated teeth served as negative control. Pulpal responses and coronal sealing were evaluated after 14 or 21 days. Data was statistically analyzed by the Kruskal-Wallis and Dunn's post hoc tests (p<0.05). Biodentine and MTA presented satisfactory results, showing a milder inflammatory response (p<0.0001) and more pronounced formation of mineralized barrier (p<0.0001) compared to the teeth capped with gutta-percha. As a restorative material, Biodentine kept coronal sealing in only 37.5% of the samples. Biodentine showed favorable properties in vital pulp therapy, being similar to MTA. However, it was not effective in protecting dental pulp from microleakage during the experimental period.
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Affiliation(s)
- Magda de Sousa Reis
- Universidade de Santa Cruz do Sul - Unisc, Department of Health Sciences, Santa Cruz do Sul, RS, Brazil
| | - Roberta Kochenborger Scarparo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Bruna Signor
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Juliana Troglio Bolzan
- Pontifícia Universidade Católica do Riio Grande do Sul - PUCRS, Clinical Department, Porto Alegre, RS, Brazil
| | - Liviu Steier
- University of Pennsylvania, School of Dental Medicine, Division of Restorative Dentistry, Philadelphia, PA, USA
| | - José Antonio Poli de Figueiredo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, 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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Vital Pulp Therapy in Aesthetic Zone-Identifying the Biomaterial That Reduces the Risk of Tooth Discolouration. MATERIALS 2021; 14:ma14206026. [PMID: 34683617 PMCID: PMC8539990 DOI: 10.3390/ma14206026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
Calcium silicate-based cements are biocompatible materials for vital pulp therapy. However, they discolour the tooth tissue, which is important for the aesthetics of the anterior teeth. The aim of this study was to investigate the effect of calcium silicate-based cements on tooth discolouration. The study included 70 extracted bovine incisors. The crown of the tooth was cut off from the root, 2 mm below the cement-enamel junction. The pulp tissue was removed via a cervical cut with a barbed broach. The teeth were randomly divided into five experimental, one positive, and one negative control groups. The evaluated materials included Biodentine, Ortho MTA, Retro MTA, MTA Plus, MTA Repair HP, and in the positive group, ProRoot MTA. A VITA Easyshade Compact 5.0 spectrophotometer was used before the application, after 1 week, 1 month, 3 months, and 6 months. The significance levels were set at p < 0.05. All materials significantly changed the teeth colour (p < 0.05). However, Ortho MTA, ProRoot MTA, MTA Plus, and Biodentine (ΔE > 6) caused maximum colour change after 6 months. While the ProRoot MTA, Ortho MTA, and MTA Plus caused grey discolouration, Biodentine darkened the shade of the base colour. Thus, Retro MTA and MTA Repair HP can be safely used in the aesthetic dentition zone. According to these clinical results, the possibility of using Biodentine, due to its lack of gray discoloration, can be considered.
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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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Spectrophotometric Analysis of Coronal Discolouration Induced by ProRoot MTA, Biodentine and MTA Repair HP Used for Pulpotomy Procedures. Eur Endod J 2021; 6:189-196. [PMID: 34650014 PMCID: PMC8461484 DOI: 10.14744/eej.2021.66375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess and quantify coronal tooth discolouration by ProRoot MTA, Biodentine and MTA repair HP as pulpotomy agents and to identify colour stability of these materials in presence of blood contamination. METHODS 120 human premolar teeth were used in the study. The teeth were sectioned horizontally 1 mm apical to the cementoenamel junction. A retrograde cavity extending within 2 mm of the incisal edge was prepared. The specimens were randomly distributed as; Control: Group 1, ProRoot MTA: Group 2, Biodentine: Group 3 and MTA repair HP: Group 4. The groups werefurther subdivided on basis of exposure to saline (subgroup A) or blood (subgroup B). The access was sealed with light cured Glass ionomer cemet and the specimens were stored in artificial saliva at 37°C. The Colour change was evaluated with a spectrophotometer at: day 0 (T0), day 1 (T1), day 7 (T7), 1 month (T30), 2 months (T60), and 6 months (T180). The colour measurements were recorded using the Commission Internationale de l'Eclairage L*a*b* value. RESULTS For all groups, there was a sharp increase in L* parameter at T1. At 6 months, Group 1B (Control + blood) showed maximum decrease in luminosity followed by Group 2A (ProRoot + saline) > Group 4B (MTA repair HP + blood) > Group 2B (ProRoot + blood). Group 3A (Biodentine + saline) showed the least amount of decrease in luminosity followed by Group 4A (MTA repair HP + saline) and Group 3B (Biodentine + blood). No significant difference was found in ∆E change between any of the groups from baseline to 180 days (P>0.05). CONCLUSION Relative to L* parameter, it was possible to observe a statistically significant decrease in luminosity in the Group1B (Control + blood) followed by ProRoot MTA (Group 2A and 2B) and MTA repair HP (Group 4A and 4B). Biodentine (Group 3A and 3B) showed least tooth discolouration in terms of L* parameter.
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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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Biocompatibility Study of a New Dental Cement Based on Hydroxyapatite and Calcium Silicates: Focus on Liver, Kidney, and Spleen Tissue Effects. Int J Mol Sci 2021; 22:ijms22115468. [PMID: 34067318 PMCID: PMC8196841 DOI: 10.3390/ijms22115468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The effects of a new material based on hydroxyapatite and calcium silicates, named ALBO-MPCA, were investigated on the liver, kidney and spleen. The material was administrated orally for 120 days in an in vivo model in Wistar rats, and untreated animals served as a control. Hematological and biochemical blood parameters were analyzed. Qualitative histological analysis of tissues, change in mitotic activity of cells, and histological characteristics was conducted, as well as quantitative stereological analysis of parenchymal cells, blood sinusoids, and connective tissues. Additionally, the protein expressions of Ki67 and CD68 markers were evaluated. Histological analysis revealed no pathological changes after the tested period. It showed the preservation of the architecture of blood sinusoids and epithelial cells and the presence of mitosis. Additionally, the significantly increased number of the Ki67 in the presence of ALBO-MPCA confirmed the proliferative effect of the material noticed by stereological analysis, while immunoreactive CD68 positive cells did not differ between groups. The study showed non-toxicity of the tested material based on the effects on the hematological, biochemical, and observed histological parameters; in addition, it showed evidence of its biocompatibility. These results could be the basis for further steps toward the application of tested materials in endodontics.
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Marques Junior RB, Baroudi K, Santos AFCD, Pontes D, Amaral M. Tooth Discoloration Using Calcium Silicate-Based Cements For Simulated Revascularization in Vitro. Braz Dent J 2021; 32:53-58. [PMID: 33914003 DOI: 10.1590/0103-6440202103700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 02/26/2023] Open
Abstract
The endodontic revascularization may be an alternative treatment for necrotic immature teeth, however, several treatment steps may cause tooth discoloration. This study evaluated the use of three calcium silicate-based cements with different radiopacifying agents on the color alteration (∆E) of extracted premolars after simulation of revascularization. Forty single rooted extracted premolars were shaped with #1-6 gates Glidden drills, rinsed with sodium hypochlorite, and filled with fresh human blood. Three calcium silicate-based cements with different radiopacifying agents (bismuth oxide - CSBi, calcium tungstate - CSW, and zirconium oxide - CSZr) were applied over the blood clot (n=10). The control group received the application of a temporary zinc oxide-based cement (TFZn) (n=10). ∆E was measured with a spectrophotometer, using the L*a*b* color system of the International Commission on Illumination (CIELab), in different times: prior to the preparation of the access cavity (t0); right after treatment (t1); and after one (t2), two (t3), three (t4) and four (t5) months. The tooth site for color evaluation was standardized by silicon matrix, the color reading was performed 3 times per tooth, and the teeth were stored in 37º water between evaluations. ∆E, whiteness (WID index) and yellowness (b*) were evaluated. Data were subjected to one-way ANOVA and repeated measures ANOVA, followed by Tukey's post hoc test (α=0.05). All groups were similar in ∆E1 (t0-t1). The ∆E was the lowest and constant in the control group. In all evaluation times, CSBi presented the highest ∆E (p<0.01). CSW and CSZr were similar in all evaluated times and presented intermediate ∆E values. WID index from CSBi and CSW presented more distancing from 'white' reference. CSBi presented the greatest decrease in yellowness (b* value). The cement containing bismuth oxide presented the highest color alteration values. All tested calcium silicate-based cements presented clinically perceptible discoloration. Calcium tungstate and zirconium oxide may be used as alternative radiopacifiers to decrease tooth discoloration after endodontic tooth revascularization.
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Affiliation(s)
| | - Kusai Baroudi
- Postgraduate Program in Dentistry, School of Dentistry, University of Taubaté, Taubaté, Brazil
| | | | - Denise Pontes
- Postgraduate Program in Dentistry, School of Dentistry, University of Taubaté, Taubaté, Brazil
| | - Marina Amaral
- Postgraduate Program in Dentistry, School of Dentistry, University of Taubaté, Taubaté, Brazil
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Kang TY, Choi JW, Seo KJ, Kim KM, Kwon JS. Physical, Chemical, Mechanical, and Biological Properties of Four Different Commercial Root-End Filling Materials: A Comparative Study. MATERIALS 2021; 14:ma14071693. [PMID: 33808262 PMCID: PMC8036496 DOI: 10.3390/ma14071693] [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: 03/03/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
Commercial mineral trioxide aggregate (MTA) materials such as Endocem MTA (EC), Dia-Root Bio MTA (DR), RetroMTA (RM), and ProRoot MTA (PR) are increasingly used as root-end filling materials. The aim of this study was to assess and compare the physicochemical and mechanical properties and cytotoxicity of these MTAs. The film thicknesses of EC and DR were considerably less than that of PR; however, RM’s film thickness was greater than that of PR. In addition, the setting times of EC, DR, and RM were shorter than that of PR (p < 0.05). The solubility was not significantly different among all groups. The three relatively new MTA groups (EC, DR, and RM) exhibited a significant difference in pH variation and calcium ion release relative to the PR group (p < 0.05). The radiopacity of the three new MTAs was considerably less than that of PR. The mechanical strength of RM was not significantly different from that of PR (p > 0.05); however, the EC and DR groups were not as strong as PR (p < 0.05). All MTA groups revealed cytocompatibility. In conclusion, the results of this study confirmed that EC, RM, DR, and PR exhibit clinically acceptable physicochemical and mechanical properties and cell cytotoxicity.
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Affiliation(s)
- Tae-Yun Kang
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (T.-Y.K.); (J.-W.C.); (K.-J.S.); (K.-M.K.)
| | - Ji-Won Choi
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (T.-Y.K.); (J.-W.C.); (K.-J.S.); (K.-M.K.)
- BK21 FOUR Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Kyoung-Jin Seo
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (T.-Y.K.); (J.-W.C.); (K.-J.S.); (K.-M.K.)
- BK21 FOUR Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Kwang-Mahn Kim
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (T.-Y.K.); (J.-W.C.); (K.-J.S.); (K.-M.K.)
- BK21 FOUR Project, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Korea; (T.-Y.K.); (J.-W.C.); (K.-J.S.); (K.-M.K.)
- BK21 FOUR Project, Yonsei University College of Dentistry, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3081
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Elnaghy AM, Mandorah A, Hassan AH, Elshazli A, Elsaka S. Effect of surface treatments on push-out bond strength of calcium silicate-based cements to fiber posts. BMC Oral Health 2021; 21:131. [PMID: 33740953 PMCID: PMC7977572 DOI: 10.1186/s12903-021-01518-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the effect of surface treatments on the push-out bond strength of Biodentine (BD) and white mineral trioxide aggregate (WMTA) to fiber posts. METHODS Two brands of fiber posts were used: Reblida post; RP and RelyX post; RX. Each type of post (n = 80/group) was divided into four groups (n = 20/group) and exposed to surface treatment as follows: Control (no treatment), sandblasting (SB), hydrofluoric acid (HF), and TiF4 4 wt/v%. Each group was further subdivided into two subgroups (n = 10/subgroup) based on the type of CSCs used as follows: Subgroup A: BD and Subgroup B: WMTA. Push-out bond strength of BD and WMTA to glass fiber posts was assessed. Data were statistically analyzed using three-way ANOVA and Tukey's test. A Weibull analysis was performed on the push-out bond strength data. RESULTS BD showed higher bond strength than WMTA (P < 0.001). The push-out bond strength for posts treated with TiF4 4 wt/v% showed greater bond strength than the other surface treatments (P < 0.05). The BD/RP-TiF4 4 wt/v% showed the greater characteristic bond strength (σ0) (15.93) compared with the other groups. Surface treatments modified the surface topography of glass fiber posts. CONCLUSIONS The BD/RP-TiF4 4 wt/v% showed greater bond strength compared with the other groups. The TiF4 4 wt/v% surface treatment enhanced the bond strength of BD and WMTA to glass fiber posts than the other treatments. Surface treatment of fiber post with TiF4 4 wt/v% could be used to improve the bond strength with calcium silicate-based cements.
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Affiliation(s)
- Amr M Elnaghy
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Ayman Mandorah
- Department of Restorative and Dental Materials, Faculty of Dentistry, Taif University P.O Box 11099, Taif, 21944, Saudi Arabia
| | - Ali H Hassan
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Restorative Dental Sciences, Vision Colleges, Jeddah, Saudi Arabia
| | - Alaa Elshazli
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Shaymaa Elsaka
- Department of Restorative Dental Sciences, Vision Colleges, Jeddah, Saudi Arabia.,Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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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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Fagogeni I, Falgowski T, Metlerska J, Lipski M, Górski M, Nowicka A. Efficiency of Teeth Bleaching after Regenerative Endodontic Treatment: A Systematic Review. J Clin Med 2021; 10:jcm10020316. [PMID: 33467092 PMCID: PMC7829849 DOI: 10.3390/jcm10020316] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 01/13/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this review is to evaluate of effectiveness of bleaching procedures used to treat discolored teeth subsequent to regenerative endodontic procedures (REPs) based on the review of in vitro and in vivo studies. This literature review was carried out according to the PRISMA guidelines. Four databases (PubMed, Scopus, the Cochrane Library, and Web of Science databases) were searched electronically, until 30 January 2020 without a year limit. The quality of studies was assessed using a modified methodological index for non-randomized studies. After analyzing 1405 studies, 6 in vitro and 9 in vivo studies were eligible for this review. In in vitro studies, effectiveness of bleaching was assessed in teeth discolored by antibiotic pastes, blood, and barrier materials in various combinations. In all analyzed studies, bleaching was effective in teeth discolored by antibiotic pastes as well as by blood and barrier materials. Of 26 treated teeth in the in vivo studies, 17 teeth were bleached successfully. In six cases, there was improvement of the shade. In three cases, bleaching was not sufficient. Bleaching material, techniques, and times differed between studies. Whitening of discolored teeth after REPs is achievable. However, to establish precise guidelines, further long-term clinical studies should be performed.
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Affiliation(s)
- Irini Fagogeni
- Doctoral Studies of the Faculty of Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (I.F.); (J.M.)
| | - Tomasz Falgowski
- General, Minimally Invasive and Gastrointestinal Surgery Department, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Joanna Metlerska
- Doctoral Studies of the Faculty of Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (I.F.); (J.M.)
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Maciej Górski
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- Correspondence: ; Tel.: +48-91-466-16-48
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Sharma A, Thomas MS, Shetty N, Srikant N. Evaluation of indirect pulp capping using pozzolan-based cement (ENDOCEM-Zr®) and mineral trioxide aggregate - A randomized controlled trial. J Conserv Dent 2020; 23:152-157. [PMID: 33384487 PMCID: PMC7720766 DOI: 10.4103/jcd.jcd_367_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 11/04/2022] Open
Abstract
Background Pulp capping should always be considered as the primary treatment of choice for teeth without irreversible pulpitis in lesions approaching dental pulp. The predictability of vital pulp therapy has improved with the introduction of newer bioceramic materials. Aim The purpose of this randomized controlled trial was to compare the outcomes of mineral trioxide aggregate (MTA) (Angelus, Londrina, Brazil) and a pozzolan-based cement (ENDOCEM-Zr® [Maruchi, Wonju, Korea]) as an indirect pulp capping (IPC) material. Materials and Methods IPC was performed in forty patients who were randomly divided into ENDOCEM-Zr® and MTA groups. The outcome was assessed using clinical and radiographic tests at different time intervals. The prognostic factors on the outcome of IPC were also evaluated. Results and Conclusions The success rate of ENDOCEM-Zr® and MTA groups was 94.7% and 89.4%, respectively. The results were not statistically significant. Binary logical regression showed that the age of the patient and the status of the pulp before treatment were deciding variables for the outcome of the study. Therefore, it was concluded from the study that the evaluated pozzolan-based cement could be used as an alternative to MTA because of its faster setting time and lower discoloration potential. In addition, pulp capping should be performed with caution in individuals above 40 years and in teeth with reversible pulpitis.
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Affiliation(s)
- Ankita Sharma
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Manuel S Thomas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Neeta Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - N Srikant
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
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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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Adel S, Wada T, Kawashima N, Abdou A, Watanabe H, Kurabayashi T, Okiji T, Uo M. Preparation and properties of tristrontium aluminate as an alternative component of mineral trioxide aggregate (MTA) cement. Dent Mater J 2020; 40:184-190. [PMID: 32999218 DOI: 10.4012/dmj.2019-414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated tristrontium aluminate (S3A) and its viability as a component for tricalcium silicate (C3S) cements. The properties of S3A, C3S, and S3A/C3S mixtures were evaluated in terms of setting time, compressive strength, flowability, and radiopacity. X-ray diffraction (XRD) pattern verified the powder synthesized in the laboratory as S3A, consequently, confirming the preparation method. S3A exhibited the lowest setting time, followed by C3S and S3A/C3S mixtures. Compressive strength of C3S was significantly higher than S3A. The S3A/C3S mixture showed comparable compressive strength to C3S for 1-day post initial mixing. There was no significant difference in flowability between S3A/C3S and mineral trioxide aggregate (MTA). S3A showed comparable radiopacity to MTA, whereas that of the S3A/C3S mixture was significantly lower comparatively; however, it achieved sufficient radiopacity (3 mm aluminum thickness equivalent). Further studies are needed to improve the manufacturing process of S3A and evaluate the bioactive effect of strontium.
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Affiliation(s)
- Sherif Adel
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Restorative and Dental Materials, Oral and Dental research division, National Research Centre of Egypt
| | - Takahiro Wada
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Nobuyuki Kawashima
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Ahmed Abdou
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Biomaterials, Faculty of Oral and Dental Medicine, Modern University for Technology and Information
| | - Hiroshi Watanabe
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Motohiro Uo
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Materials Engineering, Graduate School of Engineering, The University of Tokyo
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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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Bolhari B, Meraji N, Rezazadeh Sefideh M, Pedram P. Evaluation of the properties of Mineral Trioxide Aggregate mixed with Zinc Oxide exposed to different environmental conditions. Bioact Mater 2020; 5:516-521. [PMID: 32322762 PMCID: PMC7170961 DOI: 10.1016/j.bioactmat.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 12/28/2022] Open
Abstract
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. Addition of ZnO can prevent tooth discoloration caused by MTA. Mixing 5% ZnO with ProRoot and Angelus MTA decreases the compressive strength of the cement. Calcium ion release also decreases with the addition of ZnO although this decrease is not statistically significant. It seems that mixing ZnO with MTA can initially impair the hydration of this cement.
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Affiliation(s)
- B Bolhari
- Department of Endodontics, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - N Meraji
- Department of Endodontics, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - M Rezazadeh Sefideh
- Department of Endodontics, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - P Pedram
- Department of Dental Materials, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
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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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Fagogeni I, Metlerska J, Lipski M, Falgowski T, Maciej G, Nowicka A. Materials used in regenerative endodontic procedures and their impact on tooth discoloration. J Oral Sci 2019; 61:379-385. [PMID: 31378754 DOI: 10.2334/josnusd.18-0467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
There is some evidence of tooth discoloration after regenerative endodontic procedures. The aim of this review is to determine which materials used in regenerative procedures induce tooth discoloration. The authors searched six digital databases in February 2018: PubMed, Google Scholar, the Cochrane Library, Scopus, Web of Science, and Lilacs. As a result, 353 studies were found. Eleven studies that met the established criteria were selected. Analysis of the selected studies showed that most materials used in regenerative endodontic procedures have the potential to stain tooth tissues. To decrease tooth discoloration, sealing dentin with a dentin-bonding agent before the placement of a disinfectant paste and barrier materials should be considered. Only a small number of in vitro studies have been performed; therefore, further studies on this topic are warranted.
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Affiliation(s)
- Irini Fagogeni
- Faculty of Dentistry, Pomeranian Medical University in Szczecin
| | | | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics,Pomeranian Medical University in Szczecin
| | | | - Górski Maciej
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin
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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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Alvandifar S, Madani Z, Bizhani A. Evaluation of tooth discoloration after treatment with mineral trioxide aggregate, calcium-enriched mixture, and Biodentine® in the presence and absence of blood. Dent Res J (Isfahan) 2019. [DOI: 10.4103/1735-3327.270787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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45
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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: 41] [Impact Index Per Article: 6.8] [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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Ashofteh Yazdi K, Ghabraei S, Bolhari B, Kafili M, Meraji N, Nekoofar MH, Dummer PMH. Microstructure and chemical analysis of four calcium silicate-based cements in different environmental conditions. Clin Oral Investig 2018; 23:43-52. [PMID: 29603021 DOI: 10.1007/s00784-018-2394-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 02/15/2018] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- K Ashofteh Yazdi
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sh Ghabraei
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - B Bolhari
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Kafili
- Department of Endodontics, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - N Meraji
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - M H Nekoofar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. .,School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Management of dens invaginatus in a maxillar lateral incisor with open apex and persistent sinus tract: A case report. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: Dens invaginatus is a developmental anomaly of teeth. The endodontic treatment of these teeth may be difficult because of adversity in accessing the root canals and also complicated variations of internal structure. In this case, the report is presented the nonsurgical management and follow-up of a tooth with class II dens invaginatus with an open apex and sinus tract. Case Report: In the radiographic examination, there are two root canals; a primary (main) canal and an invaginated canal. The main canal wide-open at the portal of exit and associated with a large chronic periapical lesion extending to the apex of the maxillary left central incisor. An invaginated canal was not reaching the apex. In a clinical examination, a sinus tract was detected in the labial gingiva. After apexification with using MTA was applied, the endodontic treatment was completed. In 12 month recall, a gray discoloration was detected and internal bleaching with 35% hydrogen peroxide was applied. Finally, the tooth was restored using composite resin. 12 months follow-up radiographs revealed resolution of periapical radiolucency, trabecular bone formation, and closure of the root apex with the totally asymptomatic tooth. Conclusions: The case report shows that tooth with DI that has wide apex and sinus tract can be treated with non-surgical methods, such as immature tooth without anomalies.
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Lipski M, Nowicka A, Kot K, Postek-Stefańska L, Wysoczańska-Jankowicz I, Borkowski L, Andersz P, Jarząbek A, Grocholewicz K, Sobolewska E, Woźniak K, Droździk A. Factors affecting the outcomes of direct pulp capping using Biodentine. Clin Oral Investig 2017; 22:2021-2029. [PMID: 29234957 PMCID: PMC5945752 DOI: 10.1007/s00784-017-2296-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
Introduction This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal. Methods Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2–3 months and 1–1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1–1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05. Results Eighty-six teeth were available for 1–1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome. Conclusions A patient’s age influenced the outcome of direct pulp capping using this new calcium silicate cement. Clinical relevance Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.
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Affiliation(s)
- Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University of Szczecin, Al. Powstańców Wlkp. 72, 70-111, Szczecin, Poland.
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland.
| | - Katarzyna Kot
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University of Szczecin, Al. Powstańców Wlkp. 72, 70-111, Szczecin, Poland
| | | | | | - Lech Borkowski
- Department of Pediatric Dentistry, Silesian Medical University, Zabrze, Poland
| | | | - Anna Jarząbek
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Katarzyna Grocholewicz
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Ewa Sobolewska
- Department of Gerodontology, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Agnieszka Droździk
- Department of General Dentistry, Pomeranian Medical University of Szczecin, Szczecin, Poland
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Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin Oral Investig 2017; 22:1725-1731. [PMID: 29090391 DOI: 10.1007/s00784-017-2266-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/24/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of this study was to assess the effect of sealing the pulp chamber walls with a dentin-bonding agent (DBA) on prevention of discoloration induced by regenerative endodontic procedures (REPs) in an ex vivo model. MATERIALS AND METHODS Ninety-six bovine incisors were prepared and randomly divided into two groups. In one group, the pulp chamber walls were sealed with DBA before placement of triple antibiotic paste (TAP) containing minocycline inside the root canals, but in the other group, DBA was not applied. After 4 weeks, the root canals were filled with human blood and each group was then randomly divided into four subgroups (n = 12) according to the endodontic cements placed over the blood clot (ProRoot MTA, OrthoMTA, RetroMTA, or Biodentine). The color changes (∆E) were measured at different steps. The data were analyzed using t test and two-way ANOVA. RESULTS The specimens in which dentinal walls of pulp chamber were sealed with DBA showed significantly less coronal discoloration at each step of regenerative treatment (p < 0.001). However, application of DBA did not completely prevent the clinically perceptible coronal color change. Sealing the blood clot with different endodontic cements did not result in significant difference in coronal discoloration (p > 0.05). CONCLUSIONS Sealing the pulp chamber walls before insertion of TAP decreased coronal discoloration following REP using different endodontic cements but did not prevent it. CLINICAL RELEVANCE Discoloration of teeth undergoing REPs is an unfavorable outcome. Considering the significant contribution of TAP containing minocycline to the coronal tooth discoloration even after sealing the pulp chamber walls, the revision of current guidelines in relation to the use of TAP with minocycline might need to be revised.
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 214] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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