Evaluation of physical and biologic properties of the mixture of mineral trioxide aggregate and 4-META/MMA-TBB resin

Physicochemical characterization of experimental resin-based materials containing calcium orthophosphates or calcium silicate

OBJECTIVE

To evaluate experimental dimethacrylate-based materials containing calcium orthophosphates or calcium silicate particles in terms of their optical, mechanical and Ca2+ release behaviour.

METHODS

Dicalcium phosphate dihydrate (DCPD), hydroxyapatite (HAp), beta-tricalcium phosphate (β-TCP) or calcium silicate (CaSi) particles were added to a photocurable BisGMA/TEGDMA resin (1:1 in mols) at a 30 vol% fraction. Materials containing silanized or non-silanized barium glass particles were used as controls. Degree of conversion (DC) at the top and base of 2-mm thick specimens was determined by ATR-FTIR spectroscopy (n = 5). Translucency parameter (TP) and transmittance (%T) were determined using a spectrophotometer (n = 3). Biaxial flexural strength (BFS) and flexural modulus (FM) were determined by biaxial flexural testing after 24 h storage in water (n = 10). Ca2+ release in water was determined during 28 days by inductively coupled plasma optical emission spectrometry (n = 3). Statistical analysis was performed using ANOVA/Tukey test (DC: two-way; TP, %T; BFS and FM: one-way; Ca2+ release: repeated measures two-way, α = 5 %).

RESULTS

CaSi and β-TCP particles drastically reduced DC at 2 mm, TP and %T (p < 0.001). Compared to both controls, all Ca2+-releasing materials presented lower BFS (p < 0.001) and only the material with DCPD showed significantly lower FM (p < 0.05). The material containing CaSi presented the highest Ca2+ release, while among materials formulated with calcium orthophosphates the use of DCPD resulted in the highest release (p < 0.001).

SIGNIFICANCE

CaSi particles allowed the highest Ca2+ release. Notwithstanding, the use of DCPD resulted in a material with the best compromise between optical behaviour, DC, strength and Ca2+ release.

Development of a novel direct dental pulp-capping material using 4-META/MMA-TBB resin with nano hydroxyapatite

In the case of dental pulp exposure, direct pulp capping is often performed to preserve vital dental pulp tissue. Numerous studies regarding the development of direct pulp-capping materials have been conducted, but materials with an appropriate sealing ability, which induce dense reparative dentin formation, have not been developed. Although nano hydroxyapatite (naHAp) is a bone-filling material with bioactivity and biocompatibility, the inductive effects of naHAp on reparative dentin formation remain unclear. In the present study, the effects of dental adhesive material 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate tri-n-butylborane [4-META/MMA-TBB or Super-bond (SB)], which included 10%, 30%, and 50% naHAp (naHAp/SB) on odontoblastic differentiation of dental pulp stem cells (DPSCs) and reparative dentin formation were investigated. Scanning electron microscopy (SEM) and energy dispersive X-ray spectrometer analysis were performed to verify the existence of naHAp particles on the surface of naHAp/SB discs. The tensile adhesive strength of naHAp/SB was measured using a universal testing machine. As a result, 10% naHAp/SB and 30% naHAp/SB showed almost the same tensile adhesive strength as SB but 50% naHAp/SB showed significantly lower than the other experimental group. WST-1 proliferation assay and SEM analysis revealed that naHAp/SB did not affect the proliferation of DPSCs. Calcium release assay, quantitative RT-PCR, and western blotting analysis demonstrated that naHAp/SB did not release calcium ion but 30% naHAp/SB increased the expression of calcium-sensing receptor (CaSR) in DPSCs. Additionally, quantitative RT-PCR, western blotting analysis, Alizarin Red S- and von Kossa staining revealed that 30% naHAp/SB induced odontoblastic differentiation of DPSCs, which was inhibited by a MEK/ERK inhibitor and CaSR antagonist. Furthermore, 30% naHAp/SB promoted dense reparative dentin formation in an experimentally-formed rat dental pulp exposure model. These findings suggest that 30% naHAp/SB can be used as an ideal direct pulp capping material.

Mineralization-inducing potentials of calcium silicate-based pulp capping materials in human dental pulp cells

Background

This study was performed to provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs).

Methods

Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials.

Results

BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05).

Conclusion

Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.

Sealing efficacy of mineral trioxide aggregate with and without nanosilver for root end filling: An in vitro bacterial leakage study

BACKGROUND

Various materials have been added to mineral trioxide aggregate to enhance its properties. This study was aimed to compare the sealing efficacy of MTA with and without nanosilver using bacterial leakage approach.

MATERIAL AND METHODS

Seventy canine teeth were prepared and obturated. Then, after apical resection, the root-end cavities were prepared by ultrasonic retrotips. Teeth were randomly divided into 4 groups containing two experimental groups (n=30) and two negative and positive controls (n=5). In group 1 and 2, root-end cavities were respectively filled with MTA and MTA with nanosilver (by 1% weight). Leakage assessment was carried out by bacterial leakage apparatus with Enterococcus faecalis species. Leakage comparison between experimental groups was done using Mann-Whitney test by Spss 16 software at significancy level of 0.05.

RESULTS

The median bacterial leakages for MTA and MTA with nanosilver were 19 and 2, respectively. The mean bacterial leakages for MTA and MTA with nanosilver were 30.06±28.67 and 9.66±14.25, respectively. Mann-Whitney test indicated that there was a significant difference in bacterial leakage day between two experimental groups (P=0.002).

CONCLUSIONS

Based on the findings of this in-vitro bacterial leakage study, adding nanosilver to MTA decreased its sealing ability. Key words:Root canal therapy, root canal obturation, root canal filling materials, nanosilver, MTA.

Push-out bond strength of MTA with antiwashout gel or resins

AIM

Assessment of the push-out bond strength of four MTA-based formulations for use as root-end filling materials.

METHODOLOGY

MTA Plus mixed with (i) water ('MTA-W'); (ii) a proprietary water-based antiwashout gel ('MTA-AW'); (iii) Superbond C&B chemically curing resin ('MTA-Chem'); and (iv) Heliobond light-curing resin ('MTA-Light') was tested. Root slices 3 mm thick human had a 1.5 mm diameter hole drilled centrally and were treated with 17% EDTA for 60s. Forty specimens divided into groups 1-4 were prepared and filled with MTA-W, MTA-AW, MTA-Chem and MTA-Light, respectively. Groups 3 and 4 were etched with 37% phosphoric acid for 60s, and bonding agent was applied to the dentine surface. Specimens were stored for 28 days in Hanks' Balanced Salt Solution at 37 °C. Push-out strength was tested with a punch and die (punch diameter 1.3 mm, die diameter 2.0 mm, punch speed 1 mm min(-1)). Stereomicroscopy was used to classify failure mode (adhesive, cohesive or mixed type).

RESULTS

The resulting push-out strengths were 5.1 MPa (MTA-W), 4.3 MPa (MTA-AW), 4.7 MPa (MTA-Chem) and 11.0 MPa (MTA-Light). MTA-W had higher push-out strength than MTA-AW (P = 0.022). The same was noted for MTA-Light relative to the other materials (P < 0.05). All materials exhibited adequate push-out strengths compared with MTA-W. Failure was predominantly mixed, except for MTA-Chem (predominantly adhesive).

CONCLUSIONS

All materials exhibited adequate push-out strength. Previous studies have shown the new formulations have additional advantages including increased washout resistance and faster setting time, making them promising for future dental applications.

The chemical properties of light- and chemical-curing composites with mineral trioxide aggregate filler

OBJECTIVE

One of the challenges encountered with composite restorations is their inability to prevent secondary caries. Alternative fillers that initiate remineralization have been proposed but poor mechanical strength limits their use to lining and support materials. Mineral trioxide aggregate (MTA) is a material with many dental applications including root-end filling and pulp capping. MTA is capable of encouraging remineralization by leaching calcium in solution, and has the ability to form apatite in physiological solution. The aim of this study was to characterize and investigate the chemical properties of MTA-filled composite resins.

METHODS

Composite resins composed of light-cured (Heliobond) and chemical-cured (Superbond) dental resins filled with MTA Plus (MTA-Light, MTA-Chem) respectively, and MTA Plus mixed with water (MTA-W), were investigated. Un-hydrated and set materials were characterized by scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, X-ray diffraction (XRD) analysis and Fourier transform infrared (FT-IR) spectroscopy after being stored dry or immersed in Hank's balanced salt solution (HBSS). The chemical properties of the set materials were then investigated.

RESULTS

XRD and FT-IR analyses revealed that MTA powder remains unhydrated within the composite, even after 28 days of immersion in HBSS. Furthermore neither resin appeared to chemically react with the MTA. EDX revealed minimal diffusion of bismuth oxide through the polymer network. Apatite formation on the material surfaces was demonstrated by SEM. Significantly less apatite deposition was exhibited on the composites compared to MTA-W. All materials leached calcium and produced an alkaline pH in physiological solution. The pH at 28 days was: MTA-W 12.7, MTA-Light 11.4, and MTA-Chem 10.8. Calcium ion concentration followed the same trend, with MTA-W>MTA-Light>MTA-Chem.

SIGNIFICANCE

The novel composites exhibited calcium ion release, alkalinizing pH and formation of apatite, although in each case not as strongly as the control (MTA-W). MTA-Chem fared less favorably than MTA-Light in these aspects. Thus they are recommended for applications where bioactivity is desirable but not critical, and only they have a significant advantage over ordinary MTA in some other aspect.