Radiopacity of calcium hydroxide cement compared with human tooth structure

The Effect of Chitosan Incorporation on Physico-Mechanical and Biological Characteristics of a Calcium Silicate Filling Material

OBJECTIVES

A tricalcium silicate-based cement, Biodentine™, has displayed antibiofilm activity when mixed with chitosan powder. This study aimed to assess the effect of chitosan incorporation on the physico-mechanical and biological properties of Biodentine™.

METHODS

In this study, medium molecular weight chitosan powder was incorporated into Biodentine™ in varying proportions (2.5 wt%, 5 wt%, 10 wt%, and 20 wt%). The setting time was determined using a Vicat apparatus, solubility was assessed by calculating weight variation after water immersion, radiopacity was evaluated and expressed in millimeters of aluminum, the compressive strength was evaluated using an Instron testing machine, and the microhardness was measured with a Vickers microhardness tester. In addition, surface topography of specimens was analyzed using scanning electron microscopy, and the effect of chitosan on the viability of human embryonic kidney (HEK 293) cells was measured by a colorimetric MTT assay.

RESULTS

Incorporation of 2.5 wt% and 5 wt% chitosan powder delivered an advantage by speeding up the setting time of Biodentine material. However, the incorporation of chitosan compromised all other material properties and the crystalline structure in a dose-dependent manner. The chitosan-modified material also showed significant decreases in the proliferation of the HEK 293 cells, signifying decreased biocompatibility.

SIGNIFICANCE

Chitosan incorporation into calcium silicate materials adversely affects the physical and biological properties of the material. Despite the increased antimicrobial activity of the modified material, the diminution in these properties is likely to reduce its clinical value.

New-onset haemoptysis and associated lung mass in the setting of dental care avoidance during the COVID-19 pandemic

We present a case of new-onset haemoptysis and associated lung lesion on chest imaging in the setting of the COVID-19 pandemic. This was believed to be due to dental care avoidance after tooth fracture and long-term use of temporary dental filler, with subsequent aspiration and bronchial injury. Our patient underwent bronchoscopy due to persistent haemoptysis with findings of mild traumatic injury. She responded to conservative management with no pharmacologic intervention. With time, there was resolution of symptoms and radiographic improvement of the lung lesion. We include a brief discussion on the influence of the COVID-19 pandemic on healthcare avoidance, complications of tooth fracture and the differential diagnosis of a new solitary lung lesion on chest imaging.

Radiopacity evaluation of contemporary resin composites by digitization of images

OBJECTIVE

The aim of this study was to evaluate the radiopacity of different composite resins and compare the values to those of human enamel and dentine.

MATERIALS AND METHODS

Five specimens of each material with thicknesses of 2 mm were prepared and radiographed alongside aluminum step wedge and human enamel and dentin. Three occlusal radiographs for each material were taken and digitized using a desktop scanner. Mean gray values of the test materials were measured using Image J software. Then a conversion was performed according to establish the radiopacity of the test materials, in millimeters of equivalent Al. Data were analyzed using one-way analysis of variance and Duncan multiple range tests (P < 0.05).

RESULTS

The radiopacity values varied among the restorative materials (P < 0.05). The radiopacity values of the materials tested were, in decreasing order: Enamel Plus HRI > Z250 > Filtek Ultimate ≥ Z550 > Nexcomp ≥ Nanoceram Bright > enamel ≥ Estelite Sigma Quick > Clearfil Majesty Esthetic ≥ Reflexions XLS ≥ Aelite LS Posterior ≥ dentin ≥ 2 mm Al.

CONCLUSION

All resin composite materials investigated in this study presented different radiopacity values. However, all materials had radiopacity values greater than dentin and had sufficient radiopacity to meet International Organization for Standardization 4049 standard.

Comparative radiopacity of six current adhesive systems

BACKGROUND

The radiopacity of contemporary adhesive systems has been mentioned as the indication for replacement of restorations due to misinterpretation of radiographic images.

AIMS

This study aimed to evaluate the radiopacity of contemporary bonding agents and to compare their radiodensities with those of enamel and dentin.

METHODS AND MATERIALS

To measure the radiopacity, eight specimens were fabricated from Clearfil SE Bond (CF), Xeno V (XE), Adper SE Bond (ASE), Magic Bond (MB), Single Bond 2 (SB), Scotchbond Multipurpose (SM), and gutta-percha (positive control). The optical densities of enamel, dentin, the bonding agents, gutta-percha, and an aluminium (Al) step wedge were obtained from radiographic images using image analysis software.

STATISTICAL ANALYSIS

The radiographic density data were analyzed statistically by analysis of variance and Tukey's test (α =0.05).

RESULTS

Significant differences were found between ASE and all other groups tested and between XE and CF. No statistical difference was observed between the radiodensity of 1 mm of Al and 1 mm of dentin, between 2 mm of Al and enamel, and between 5 mm of Al and gutta-percha. Five of the six adhesive resins had radiopacity values that fell below the value for dentin, whereas the radiopacity of ASE adhesive was greater than that of dentin but below that of enamel.

CONCLUSION

This investigation demonstrates that only ASE presented a radiopacity within the values of dentin and enamel. CF, XE, MB, SB, and SM adhesives are all radiolucent and require alterations to their composition to facilitate their detection by means of radiographic images.

In vitro and in vivo degradation evaluation of novel iron-bioceramic composites for bone implant applications

Biodegradable metals such as magnesium, iron and their alloys have been known as potential materials for temporary medical implants. However, most of the studies on biodegradable metals have been focusing on optimizing their mechanical properties and degradation behavior with no emphasis on improving their bioactivity behavior. We therefore investigated the possibility of improving iron biodegradation rate and bioactivity by incorporating various bioactive bioceramics. The iron-based bioceramic (hydroxyapatite, tricalcium phosphate and biphasic calcium phosphate) composites were prepared by mechanical mixing and sintering process. Degradation studies indicated that the addition of bioceramics lowered the corrosion potential of the composites and slightly increased their corrosion rate compared to that of pure iron. In vitro cytotoxicity results showed an increase of cellular activity when rat smooth muscle cells interacted with the degrading composites compared to pure iron. X-ray radiogram analysis showed a consistent degradation progress with that found in vivo and positive tissue response up to 70 days implantation in sheep animal model. Therefore, the iron-based bioceramic composites have the potential to be used for biodegradable bone implant applications.

Study of the radio-opacity of base and liner dental materials using a digital radiography system

OBJECTIVES

This study investigated the radio-opacity of commercially available glass ionomer cements (GICs), flowable resin composites (FRCs) and calcium hydroxide cements (CHCs) and compared this with the radio-opacity of enamel, dentine and aluminium stepwedge. 16 GICs, 8 FRCs and 4 CHCs were analysed.

METHODS

Three sets of three samples were prepared: 1 mm, 2 mm and 3 mm thickness for GIC and FRC and 1 mm thickness for CHC. Specimens of enamel and dentine with the same thicknesses were obtained. As a control, an aluminium stepwedge was used. Radiographs were taken with a digital Kodak RVG 5000 (0.32 s, 30 cm). The images were analysed using the Image Tool(®) program (v. 2.00; The University of Texas Health Science Center, San Antonio, TV) to obtain the mean grey values.

RESULTS

Analysis of variance was used to investigate the significance of differences among the groups. For pairwise comparisons, the Tukey test was applied (p < 0.05). The GICs Ionomaster (Wilcos, Petrópolis, Brazil), Maxxion (FGM, Joinville, Brazil), Bioglass R (Biodinâmica, Ibiporã, Brazil), Bioglass F (Biodinâmica), Vidrion R (SS White, Rio de Janerio, Brazil) and Vidrion F (SS White), presented radio-opacity lower than that of dentine. All FRCs and CHCs studied showed radio-opacity higher than that of dentine. Vitro Fil (DFL, Rio de Janeiro, Brazil), Magic Glass (Vigodent, Rio de Janeiro, Brazil), Vitrebond (3M, Sumaré SP, Brazil), Riva Self Cure (SDI, Victoria, Australia), Riva Light Cure (SDI), Fill Magic (Vigodent), Opallis (FGM, Joinville, Brazil), Surefil SDR (Dentsply, Milford, DE), Tetric N (Ivoclar Vivadent, Schaan, Lichtenstein), Tetric (Ivoclar Vivadent), Hydro C (Dentsply, Petrópolis, Brazil), Hydcal (Technew, Madalena, Portugal) and Liner (Vigodent) showed radio-opacity similar to or greater than that of enamel for all thicknesses.

CONCLUSIONS

The increased thickness of the materials studied increases their radio-opacity. Some commercially available GICs used as a base and liner for restorations have a very low radio-opacity (Ionomaster, Maxxion, Bioglass R, Bioglass F, Vidrion R and Vidrion F).

Radiopacity evaluation of Portland and MTA-based cements by digital radiographic system

OBJECTIVE

The aim of the present study was to evaluate the radiopacity of Portland and MTA-based cements using the Digora TM digital radiographic system.

MATERIAL AND METHODS

The performed tests followed specification number 57 from the American National Standard Institute/American Dental Association (2000) for endodontic sealing materials. The materials were placed in 5 acrylic plates, especially designed for this experiment, along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The set was radiographed at a 30 cm focus-object distance and with 0.2 s exposure time. After the radiographs were taken, the optical laser readings of radiographs were performed by Digora TM system. Five radiographic density readings were performed for each studied material and for each step of the aluminum scale.

RESULTS

White ProRoot MTA (155.99±8.04), gray ProRoot MTA (155.96±16.30) and MTA BIO (143.13±16.94) presented higher radiopacity values (p<0.05), while white non-structural Portland (119.76±22.34), gray Portland (109.71±4.90) and white structural Portland (99.59±12.88) presented lower radiopacity values (p<0.05).

CONCLUSIONS

It was concluded that MTA-based cements were the only materials presenting radiopacity within the ANSI/ADA specifications.

A descriptive study of the radiographic density of implant restorative cements

STATEMENT OF PROBLEM

Cementation of implant prostheses is a common practice. Excess cement in the gingival sulcus may harm the periodontal tissues. Identification of the excess cement may be possible with the use of radiographs if the cement has sufficient radiopacity.

PURPOSE

The purpose of this study was to compare the radiographic density of different cements used for implant prostheses.

MATERIAL AND METHODS

Eight different cements were compared: TempBond Original (TBO), TempBond NE (TBN), Fleck's (FL), Dycal (DY), RelyX Unicem (RXU), RelyX Luting (RXL), Improv (IM), and Premier Implant Cement (PIC). Specimen disks, 2 mm in thickness, were radiographed. Images were made using photostimulable phosphor (PSP) plates with standardized exposure values. The average grey level of the central area of each specimen disk was selected and measured in pixels using a software analysis program, ImageTool, providing an average grey level value representative of radiodensity for each of the 8 cements. The radiodensity was determined using the grey level values of the test materials, which were recorded and compared to a standard aluminum step wedge. An equivalent thickness of aluminum in millimeters was calculated using best straight line fit estimates. To assess contrast effects by varying the exposure settings, a second experiment using 1-mm-thick cement specimens radiographed at both 60 kVp and 70 kVp was conducted. The PSP plates with specimens were measured for a grey level value comparison to the standard aluminum step wedge, using the same software program.

RESULTS

The highest grey level values were recorded for the zinc cements (TBO, TBN, and FL), with the 1-mm specimen detectable at both 60- and 70-kVp settings. A lower grey level was recorded for DY, indicative of a lower radiodensity compared to the zinc cements, but higher than RXL and RXU. The implant-specific cements had the lowest grey level values. IM could only be detected in 2-mm-thick sections with a lower aluminum equivalence value than the previously mentioned cements. PIC could not be detected radiographically for either the 1-mm or 2-mm thicknesses at either of the kVp settings.

CONCLUSIONS

Some types of cement commonly used for the cementation of implant-supported prostheses have poor radiodensity and may not be detectable following radiographic examination.