Novel Fast-Setting Mineral Trioxide Aggregate: Its Formulation, Chemical-Physical Properties, and Cytocompatibility

Discoloration Improvement by Mechanically-Milled Binary Oxides as Radiopacifier for Mineral Trioxide Aggregates

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.

Bio-C Repair - A New Bioceramic Material for Root Perforation Management: Two Case Reports

These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.

Inorganic Porous Bulk Discs as a Matrix for Thin-Layer Chromatography and Translucent Hard Composite Materials

Magnesium-stabilized amorphous calcium carbonate (Mg-ACC), amorphous magnesium calcium silicate hydrate (MCSH), and hydroxyapatite (HAp) are prepared by a precipitation method. By cold-pressing these particles, it is possible to produce porous bulk discs with a narrow pore size distribution. These porous inorganic discs (Mg-ACC, MCSH, and HAp) are investigated as stationary phases to study the chromatographic behavior and adsorption ability of rhodamine B, methylene blue, and ribonuclease. The adsorption affinities of different biomolecules can be easily observed and evaluated through this method. Furthermore, by infiltrating fabricated opaque porous discs with benzyl ether, which has a similar refractive index as the used inorganic particles (Mg-ACC, MCSH, and HAp), their optical properties significantly change and the discs become translucent. Moreover, by infiltrating the MCSH discs with a light-curing polymer, translucent composites with good surface hardness are fabricated. By doping particles with ions such as Ni²⁺, Co²⁺, Fe³⁺, and Eu³⁺, the color and UV-visible spectrum of the bulk discs can be adjusted. Typically, by using iron-doped MCSH particles as the inorganic matrix, nanocomposites, which show a steep UV-absorption edge at 400 nm, are fabricated. Our work provides a simple and economical method to evaluate the affinity of biomolecules to inorganic materials and a novel way to fabricate translucent hard composite materials. The fabricated nanocomposite discs show a great UV shielding effect and superior surface hardness compared to polymethyl methacrylate and commercial sunglasses, suggesting their potential as new sunglass materials.

Biological Effects of New Hydraulic Materials on Human Periodontal Ligament Stem Cells

Background: The aim of this study was: to evaluate the biological properties of new hydraulic materials: Bio-C Repair and Bio-C Sealer. Methods: Periodontal ligament stem cells were exposed to several dilutions of Bio-C Repair and Bio-C Sealer. The ion release profile and pH were determined. Metabolic activity, cell migration and cell survival were assessed using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), wound-healing assays and Annexin assays, respectively. Cells were cultured in direct contact with the surface of each material. These were then analyzed via scanning electron microscopy (SEM) and energy dispersive X-ray (EDX). Statistical differences were assessed using a two-way ANOVA (α < 0.05). Results: Similar pH was observed in these cements. Bio-C Sealer released significantly more Ca and Si ions (p < 0.05) in comparison with Bio-C Repair. Undiluted Bio-C Sealer induced a significant reduction on cellular viability, cell survival and cell migration when compared to the control (p < 0.05). Moreover, SEM showed abundant cells adhered on Bio-C Repair and a moderate number of cells attached on Bio-C Sealer. Finally, EDX analysis identified higher percentages of Ca and O in the case of Bio-C repair than with Bio-C sealer, while other elements such as Zr and Si were more abundant in Bio-C sealer. Conclusions: Bio-C Repair displayed higher cell viability, cell adhesion and migration rates than Bio-C Sealer.

A novel, doped calcium silicate bioceramic synthesized by sol-gel method: Investigation of setting time and biological properties

The aim of the current study was to synthesize a fast-setting ion-doped calcium silicate bioceramic by the sol-gel method and to characterize its in vitro apatite-forming ability and cell viability. Calcium silicate (CS), doped calcium silicate with zinc and magnesium, with Ca/Zn molar ratios of 6.7:1 (DCS1), and 4.5:1 (DCS2), were synthesized by the sol-gel method. Matreva white MTA (WMTA, Matreva, CA, Egypt) was used as a control. The synthesized powders were characterized by x-ray diffraction. Setting time was measured using the Gilmore needle indentation technique. The in vitro apatite-forming ability of the materials was evaluated by scanning electron microscope and energy dispersive X-ray. NIH3T3-E1 cells viability was tested using MTT assay. The ion release of Ca, Si, Zn, and Mg was measured using inductive coupled plasma-optical emission spectroscopy (ICP-OES). One-way ANOVA was used to analyze setting time results. The Tukey's HSD post hoc test was used to establish significance (p < 0.001). For nonparametric data, the Kruskal-Wallis H test with Dunn's correction for post hoc comparison was used (p < 0.05). CS, DCS1, and DCS2 showed a significant decrease in setting time 33 ± 1.63 min, 28 ± 1.63 min, and 41.75 ± 2.87 min, respectively, compared to WMTA 91 ± 3.16 min (p < 0.001). DCS1 showed the highest apatite-forming ability and cell viability compared to the other groups. Ca and Si ions release decreased in both DCS1 and DCS2. The physical and biological properties of CS can be successfully improved by the sol-gel synthesis and ions doping. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:56-66, 2020.

Biological effects of acid-eroded MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells

OBJECTIVE

The aim of this study was to analyze the biological effects of MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells (hPDLSCs) after exposure to acidic and neutral environments.

MATERIALS AND METHODS

Discs of each material (n = 30) were exposed to phosphate buffered saline (pH = 7.4) or butyric acid (pH = 5.2) for 7 days, and biological testing was carried out in vitro on hPDLSCs. Cell viability and apoptosis assays were performed using eluates of each root-end filling material. To evaluate cell attachment to the different materials, hPDLSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. The chemical composition of the root-end filling materials was determined by energy-dispersive x-ray and eluates were analyzed by inductively coupled plasma-mass spectrometry. Statistical differences were assessed by ANOVA and Tukey test (p < 0.05).

RESULTS

Under an acidic environment, both materials displayed similar ion release abilities, with the increased release of Si and Ca ions. Substantial changes in microstructure were observed for both materials after exposure to acidic pH. In addition, material exposure to an acidic environment showed a similar degree of cell adherence, and, surprisingly, MTA Repair HP exhibited higher cell viability rates at pH 5.2 than ProRoot MTA.

CONCLUSIONS

Exposure to an acidic environment promoted Si and Ca ion release from ProRoot MTA and MTA Repair HP. Moreover, we observed optimal biological properties of ProRoot MTA and MTA Repair HP in terms of cell viability, cell death, and cell attachment in both environments.

CLINICAL RELEVANCE

These results may suggest that MTA Repair HP and ProRoot exhibited optimal biological properties in terms of cell viability, cell death and cell attachment in acidic environment, being considered as materials for root-end filling and perforations.

Does Adding Various Accelerators to Mineral Trioxide Aggregate Have a Negatively Effect on Push-Out Bond Strength?

OBJECTIVE

This study compares the effect of the white mineral trioxide aggregate (WMTA) accelerators, including disodium hydrogen orthophosphate (Na2HPO4; 2.5 wt%), calcium chloride (CaCl2; 5 and 10 wt%), and KY jelly, on the push-out bond strength of WMTA. The null hypothesis was that the WMTA accelerators would not affect the push-out bond strength of WMTA.

MATERIALS AND METHODS

Slices (2-mm-thick) were obtained from 75 human mandibular molar distal roots. The slices were enlarged up to size 6 Gates-Glidden burs to obtain a 1.5-mm canal diameter. The slices were randomly divided into 4 experimental groups and a control group (n = 15 in each group). Freshly prepared WMTA mixture was placed into the root slices and stored at 37°C in a 100% humidified atmosphere for 60 days. The force required to dislodge the WMTA cement from the root slice was determined using a universal testing machine. The push-out bond strength was calculated.

RESULTS

Push- out bond strength of 5- and 10-wt% CaCl2, and 2.5-wt% Na2HPO4 WMTA groups was significantly lower than in the KY-jelly and control groups (p < 0.05). The mean push-out bond strength of KY jelly was lower than in the control group but not statistically significant.

CONCLUSION

The addition of KY jelly to WMTA did not have an adverse effect on the push-out bond strength of WMTA, in contrast to the other accelerators, including Na2HPO4 and CaCl2, which reduced the push-out bond strength.