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Asgary S, Aram M, Fazlyab M. Comprehensive review of composition, properties, clinical applications, and future perspectives of calcium-enriched mixture (CEM) cement: a systematic analysis. Biomed Eng Online 2024; 23:96. [PMID: 39294680 PMCID: PMC11409725 DOI: 10.1186/s12938-024-01290-4] [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: 02/07/2024] [Accepted: 09/07/2024] [Indexed: 09/21/2024] Open
Abstract
This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.
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Affiliation(s)
- Saeed Asgary
- Iranian Centre for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahtab Aram
- Sharif University of Technology, Tehran, Iran
| | - Mahta Fazlyab
- Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Nasiri K. Management of root resorption in dentistry. J Dent Sci 2023; 18:1427-1428. [PMID: 37404643 PMCID: PMC10316509 DOI: 10.1016/j.jds.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Indexed: 07/06/2023] Open
Affiliation(s)
- Kaveh Nasiri
- Corresponding author. Independent Researcher, Koenigraetzstrasse, Essen 45138, Germany.
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Mehta S, Ramugade M, Abrar S, Sapkale K, Giuliani V, Burbano Balseca MJ. Evaluation of coronal microleakage of intra-orifice barrier materials in endodontically treated teeth: A systematic review. J Conserv Dent 2022; 25:588-595. [PMID: 36591578 PMCID: PMC9795687 DOI: 10.4103/jcd.jcd_377_22] [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: 06/28/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 01/03/2023] Open
Abstract
Background Endodontic success depends on complete sealing of the root canal orifice to prevent re-infection and re-Contamination of the treated teeth through microleakage. Intra-orifice barrier material provides a seal against micro-organisms, its by-products thus, preventing microleakage and subsequent endodontic failure. Several studies have been done to evaluate microleakage after placing various materials as IOB, but still there is no standardization for the same. Thus, this systematic review was conducted to evaluate the microleakage associated with mineral trioxide aggregate (MTA), composite, and glass ionomer cement (GIC) when used as IOB material. Materials and Methods Protocol was formulated in accordance with PRISMA checklist 2020 and registered on PROSPERO (CRD42021226225). Electronic search from databases such as Medline/PubMed, Scopus, EBSCOhost, Embase, Google Scholar, and Cochrane were performed from the year 2000-2020. In vitro and ex vivo studies evaluating coronal microleakage after placing IOB material using methylene blue dye penetration test under a stereomicroscope were included. A total of 5 studies were included in the systematic review. After assessing the risk of bias using customized criteria referred from JBI critical appraisal tool, characteristics of the included studies, reason for exclusion of the studies, and data extraction sheet were prepared. Results All studies included in this systematic review reported that placement of an IOB material significantly reduces microleakage as compared to control groups. MTA used as an IOB showed less microleakage than composite and GIC. Conclusion MTA as IOB material demonstrated the least microleakage in vitro studies. However, in this systematic review, only in vitro studies were included. Thus, more studies in the form of randomized control trials are required to give a conclusive and definitive result.
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Affiliation(s)
- Shaili Mehta
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Manoj Ramugade
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Sayed Abrar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Kishor Sapkale
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Valentina Giuliani
- Department of Experimental and Clinical Medicine, University of Florence, Italy
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Tu Y, Deng S, Wang Y, Lin X, Yang Z. Adhesive Ability of Different Oral Pathogens to Various Dental Materials: An In Vitro Study. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:9595067. [PMID: 35959001 PMCID: PMC9359852 DOI: 10.1155/2022/9595067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022]
Abstract
Introduction In dental treatments, the reason for secondary caries and the failure of root canal treatment is the microbial infection, which concerns most dentists. The challenge of how to reduce the number of bacteria at the filling materials and the number of residual bacteria in the root canal has become a research hotspot. In this study, the bacterial adhesion properties of several common dental materials were compared to provide a theoretical basis for the selection of antibacterial properties of dental materials. Methodology. Three commonly used dental restorative materials and five sealers in root canal treatment were selected. Each material block was immersed in the corresponding supragingival (Streptococcus mutans and Actinomyces viscosus) or subgingival (Porphyromonas gingivalis and Enterococcus faecalis) bacterial solution and cultured under anaerobic conditions at 37°C for 2, 4, 6, 8, 12, 16, 20, and 24 h. The adhesion of bacteria was observed, and the number of different bacteria adhering to various material model disks was calculated at different time intervals under a scanning electron microscope. The adherent CFU load of the materials was determined by colony counting. Results Streptococcus mutans and Actinomyces viscosus exhibited the strongest adhesion ability to the resin material blocks. Porphyromonas gingivalis and Enterococcus faecalis exhibited the highest adhesion ability to the AH-Plus sealer block. Conclusions In dental treatments, dental materials should be selected based on the chemical, physical, and biological properties of materials. In addition, it is necessary to develop new antibacterial dental materials.
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Affiliation(s)
- Yan Tu
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Shuli Deng
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Yuan Wang
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Xiaolong Lin
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Zhenyu Yang
- Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
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Asgary S, Eghbal MJ, Shahravan A, Saberi E, Baghban AA, Parhizkar A. Outcomes of root canal therapy or full pulpotomy using two endodontic biomaterials in mature permanent teeth: a randomized controlled trial. Clin Oral Investig 2022; 26:3287-3297. [PMID: 34854987 PMCID: PMC8636579 DOI: 10.1007/s00784-021-04310-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/20/2021] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth. MATERIALS AND METHODS A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal-Wallis. RESULTS At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544). CONCLUSION In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results. CLINICAL RELEVANCE Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, 1983963113, Tehran, Iran.
| | - Mohammad Jafar Eghbal
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, 1983963113, Tehran, Iran
| | - Arash Shahravan
- Endodontology Research Center, Endodontic Department, Dental School, Kerman University of Medical Sciences, 7618751689, Kerman, Iran
| | - Eshaghali Saberi
- Endodontic Department, Oral and Dental Diseases Research Center, Dental School, Zahedan University of Medical Sciences, 9816743463, Zahedan, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, 1971653313, Tehran, Iran
| | - Ardavan Parhizkar
- Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, 1983963113, Tehran, Iran
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Influence of intracoronal bleaching agents on the bond strength of MTA cements to composite resin and their surface morphology. Odontology 2022; 110:148-156. [PMID: 34370134 DOI: 10.1007/s10266-021-00650-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/06/2021] [Indexed: 12/31/2022]
Abstract
The objective of the present in vitro study was to evaluate micro-tensile bond strength (µSBS) of MTA cements to composite resin using a universal adhesive after internal bleaching procedure, and to examine surface characteristics of MTA cements exposed to bleaching agents. MTA specimens were divided into three subgroups according to the bleaching agent used which were, 37% carbamide peroxide (CP), 35% hydrogen peroxide (HP), and no exposure as a control group (n = 12). After exposure to bleaching agent, composite resins were applied to MTA surfaces using a universal adhesive in self-etch mode. The specimens were exposed to a shear force until failure to evaluate bond strength. MTA surfaces were investigated using scanning electron microscopy (SEM) to observe the effects of the bleaching agents. Differences between groups were analyzed using two-way ANOVA test and intergroup comparisons were assessed with Tukey test (p < 0.05). Although there was a slight difference in bond strength between bleaching agents (CP and HP), no significant difference was found, irrespective of MTA cement. After the HP application, the bond strength values decreased approximately by half compared with the controls. SEM results demonstrated distinct morphological differences between the intact MTA surface (control) and treated MTA surface. Distinct micro-cracks, surface irregularities, and capillary voids formed due to the superficial dissolution caused by peroxides. Exposure to the intra-coronal bleaching agents had a negative influence on the surface morphology of MTA cements and their bond strength to composite resin.
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