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Ismail HS, Morrow BR, Ali AI, Mehesen REE, Mahmoud SH, Garcia-Godoy F. Effect of different storage media on elemental analysis and microhardness of cervical cavity margins restored with a bioactive material. Restor Dent Endod 2024; 49:e6. [PMID: 38449501 PMCID: PMC10912542 DOI: 10.5395/rde.2024.49.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/26/2022] [Accepted: 01/12/2023] [Indexed: 03/08/2024] Open
Abstract
Objectives This study aimed to investigate the elemental analysis and microhardness of a bioactive material (Activa) and marginal tooth structure after storage in different media. Materials and Methods Fifteen teeth received cervical restorations with occlusal enamel and gingival dentin margins using the tested material bonded with a universal adhesive, 5 of them on the 4 axial surfaces and the other 10 on only the 2 proximal surfaces. The first 5 teeth were sectioned into 4 restorations each, then stored in 4 different media; deionized water, Dulbecco's phosphate buffered saline (DPBS), Tris buffer, and saliva. The storage period for deionized water was 24 hours while it was 3 months for the other media. Each part was analyzed by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) analysis for different substrates/distances and the wt% of calcium, phosphorus, silica, and fluoride were calculated. The other 10 teeth were sectioned across the restoration, stored in either Tris buffer or saliva for 24 hours or 3 months, and were evaluated for microhardness of different substrates/areas. Data were analyzed using analysis of variance and Tukey's post hoc test. Results Enamel and dentin interfaces in the DPBS group exhibited a significant increase in calcium and phosphorus wt%. Both silica and fluoride significantly increased in tooth structure up to a distance of 75 μm in the 3-month-media groups than the immediate group. Storage media did not affect the microhardness values. Conclusions SEM-EDS analysis suggests an ion movement between Activa and tooth structure through a universal adhesive while stored in DPBS.
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Affiliation(s)
- Hoda Saleh Ismail
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brian Ray Morrow
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ashraf Ibrahim Ali
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | | | - Salah Hasab Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
- The Forsyth Institute, Cambridge, MA, USA
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Wagih M, Hassanien E, Nagy M. Sealing Ability and Adaptability of Nano Mineral Trioxide Aggregate as a Root-End Filling Material. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Comparison between Nano MTA & MTA as a root-end filling materials regarding adaptability and sealing ability.
Materials and Methods: Forty extracted human maxillary incisors with straight roots were used. After root canals preparation and obturation, the apical 3 mm of each root was resected perpendicular to the long axis of the tooth. Root end cavities were prepared to a depth of 3mm parallel to the long axis of the tooth. The teeth were randomly divided into two main equal groups of 20 samples each according to the root-end filling material used either MTA or Nano MTA. Ten samples from each group were sectioned longitudinally into two equal halves to measure the sealing ability and another ten samples from each group were sectioned transversally to obtain 1 mm thick section to measure the adaptability of both materials. All samples were photographed under the SEM at three different magnifications (×1000). The gap thickness between the root end filling material and the retro cavity dentine walls were measured at seven selected points at the material-dentine interface in micrometers (µm).
Results: Nano MTA and MTA showed no statistically significant difference in the gap thickness between dentin-material interface in both longitudinal and transverse sections. Regarding the sealing ability, the mean value in MTA was (3.27±0.77), while the mean in Nano-MTA was (3.15±0.71). Regarding the adaptability, the mean value in MTA was (2.46±0.60), while the mean in Nano-MTA was (2.05±0.712). Both materials showed good sealing ability and good adaptation to the dentinal wall.
Conclusion: Nano MTA revealed good sealing ability and adaptability comparable to MTA when used as a retrograde filling material.
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Primus CM, Tay FR, Niu LN. Bioactive tri/dicalcium silicate cements for treatment of pulpal and periapical tissues. Acta Biomater 2019; 96:35-54. [PMID: 31146033 PMCID: PMC6717675 DOI: 10.1016/j.actbio.2019.05.050] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 12/11/2022]
Abstract
Over 2500 articles and 200 reviews have been published on the bioactive tri/dicalcium silicate dental materials. The indications have expanded since their introduction in the 1990s from endodontic restorative and pulpal treatments to endodontic sealing and obturation. Bioactive ceramics, based on tri/dicalcium silicate cements, are now an indispensable part of the contemporary dental armamentarium for specialists including endodontists, pediatric dentists, oral surgeons andfor general dentists. This review emphasizes research on how these materials have conformed to international standards for dental materials ranging from biocompatibility (ISO 7405) to conformance as root canal sealers (ISO 6876). Potential future developments of alternative hydraulic materials were included. This review provides accurate materials science information on these important materials. STATEMENT OF SIGNIFICANCE: The broadening indications and the proliferation of tri/dicalcium silicate-based products make this relatively new dental material important for all dentists and biomaterials scientists. Presenting the variations in compositions, properties, indications and clinical performance enable clinicians to choose the material most suitable for their cases. Researchers may expand their bioactive investigations to further validate and improve materials and outcomes.
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Affiliation(s)
- Carolyn M Primus
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA.
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA
| | - Li-Na Niu
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Hena, China
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Ranjkesh B, Isidor F, Kraft DCE, Løvschall H. In vitro cytotoxic evaluation of novel fast-setting calcium silicate cement compositions and dental materials using colorimetric methyl-thiazolyl-tetrazolium assay. J Oral Sci 2018; 60:82-88. [PMID: 29576580 DOI: 10.2334/josnusd.16-0751] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
A novel fast-setting calcium silicate cement with fluoride (CSC) has been developed for potential application in tooth crowns. This study compared the cytotoxicity of CSC compositions and a variety of dental materials. We tested CSC compositions (Protooth), MTA, Biodentine, Ketac Molar, Fuji II LC, Vitrebond, DeTrey Zinc, Dycal, and IRM, DMEM (negative control) and 1% NaOCl (positive control). After setting of cements for 24 h, specimens were immersed in DMEM for 24 h to obtain material elutes. The elutes were serially diluted in serum-free DMEM to obtain three dilutions. L929 mouse fibroblast cells (1 × 104 cells per well) were treated for 24 h with elute dilutions (n = 3). Cytotoxicity was determined using methyl-thiazolyl-tetrazolium assay in triplicate. CSC compositions, MTA, and Biodentine showed no significant reduction in cell viability compared to DMEM. There was no significant difference in cell viability, at any of three dilutions, between CSC compositions and either MTA or Biodentine. Cytotoxicity was significantly lower for CSC compositions than for Vitrebond, DeTrey Zinc, Dycal, IRM, and 1% NaOCl, at all three dilutions, and undiluted Fuji II LC elute. In contrast to resin-modified glass ionomers, zinc phosphate cements, Dycal, and IRM, the CSC compositions showed no cytotoxic potential.
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Cechella B, de Almeida J, Kuntze M, Felippe W. Analysis of sealing ability of endodontic cements apical plugs. J Clin Exp Dent 2018; 10:e146-e150. [PMID: 29670732 PMCID: PMC5899792 DOI: 10.4317/jced.54186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/05/2017] [Indexed: 11/05/2022] Open
Abstract
Background It is unknown whether the bioactivity of Biodentine characterized by the precipitation of hydroxyapatite and formation of tags into the dentinal tubules improve its sealing ability as an apical plug. Aim: To evaluate the sealing ability provided by Biodentine and mineral trioxide aggregate (MTA) apical plugs, with or without phosphate-buffered saline (PBS) intracanal dressing, using a glucose leakage method. Material and Methods The space of the canal of 100 root segments with about 12 mm long was shaped using Gates-Glidden. After created an apical retrograde cavity, the root segments were randomly divided into 4 groups (n = 25): G1 - Biodentine; G2 - Biodentine + PBS intracanal dressing; G3 - MTA and G4 - MTA + PBS intracanal dressing. All access openings were filled with temporary cement and all root segments were introduced in floral foams moistened with PBS. After 2 months, all root segments were prepared to evaluate the glucose leakage. The amount of glucose leakage was quantified by a spectrophotometer and the data were analyzed using chi-square test (p<0.05). Results Traces of the glucose were observed in a higher of samples that received Biodentine apical plug (p<0.05). The exposure to intracanal PBS did not influence the sealing provided by Biodentine and MTA. Conclusions The Biodentine had lower sealing ability than MTA. The interaction with PBS intracanal dressing did not improve the sealing ability provided by sealers. Key words:Apexification, dental cements, dental leakage, glucose, pressure.
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Affiliation(s)
- Bruna Cechella
- DDS, MSc, Department of Endodontics, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Josiane de Almeida
- DDS, MSc, PhD, Professor of Endodontics, University of Southern Santa Catarina, Palhoça, Brazil
| | - Morgane Kuntze
- DDS, MSc, PhD student in Endodontics, Department of Endodontics, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Wilson Felippe
- DDS, MSc, PhD, Associate Professor of Endodontics, Department of Endodontics, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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6
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Ranjkesh B, Ding M, Dalstra M, Nyengaard JR, Chevallier J, Isidor F, Løvschall H. Calcium phosphate precipitation in experimental gaps between fluoride-containing fast-setting calcium silicate cement and dentin. Eur J Oral Sci 2018; 126:118-125. [PMID: 29334137 DOI: 10.1111/eos.12399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A novel fast-setting calcium silicate cement containing fluoride (novel-CSC) has been developed for applications in tooth crowns. The aim of this study was to assess the ability of the novel-CSC to close the experimental gaps at the dentin-cement interface. The novel-CSC was tested against Vitrebond and GC Fuji II LC. Experimental gaps of 50 or 300 μm width were created between the materials and dentin. Specimens with the 300-μm-wide gap were immersed in phosphate-buffered saline and the closed gap area was measured during 96 h. All specimens with 50 or 300 μm gap width were analyzed by scanning electron microscopy equipped with energy dispersive X-ray spectroscopy (SEM/EDX) to assess the morphology and chemical composition of the precipitates after 96 h immersion in phosphate-buffered saline. High-resolution micro-computed tomography (μCT) was used to evaluate the integrity and continuity of the precipitiates after 96 h and 180 d. In all novel-CSC samples, precipitates closed the gap area completely after 96 h. The SEM/EDX revealed that the globular precipitates closing the gap area were mainly composed of calcium and phosphorus. After 180 d, μCT indicated thicker precipitates compared with initial precipitates only in the novel-CSC group, whereas no precipitates were observed in resin-modified glass ionomers. Novel-CSC promoted continuous precipitation of calcium phosphate, including apatite, and closed the experimental gaps.
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Affiliation(s)
- Bahram Ranjkesh
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ming Ding
- Department of Orthopedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michel Dalstra
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory Centre for Stochastic Geometry and Advanced Bioimaging, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Flemming Isidor
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Henrik Løvschall
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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7
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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: 201] [Impact Index Per Article: 28.7] [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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Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J 2017; 51:177-205. [PMID: 28836288 DOI: 10.1111/iej.12841] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/21/2017] [Indexed: 01/09/2023]
Abstract
Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new BECs have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, NeoMTA Plus, OrthoMTA, Quick-Set, RetroMTA, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, the chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and VPT applications of BECs had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term 'bioactive endodontic cements (BECs)', which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used MTA for VPT. In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.
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Affiliation(s)
- M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Saghiri MA, Shabani A, Asatourian A, Sheibani N. Storage Medium Affects the Surface Porosity of Dental Cements. J Clin Diagn Res 2017; 11:ZC116-ZC119. [PMID: 28969288 DOI: 10.7860/jcdr/2017/28657.10517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/15/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Calcium silicate-based cements physical properties is influenced by environmental changes. AIM Here, we intended to evaluate the effect of storage medium on surface porosity of root Mineral Trioxide Aggregate (MTA) and Biodentine cement. MATERIALS AND METHODS A total of 40 polyethylene tubes were selected and divided into two groups: Group A (MTA) and Group B (Biodentine). Each group was subdivided into two subgroups (n=10). In subgroups A1 and B1, tubes were transferred to Distilled Water (DW), while samples of subgroup A2 and B2 were transferred to Synthetic Tissue Fluid (STF) as storage medium and samples were stored for three days. All specimens were then placed in a desiccator for 24 hours and then subject to surface porosity evaluation by Scanning Electron Microscopy (SEM) at ×500, ×1000, ×2000 and ×5000 magnifications. The number and the surface porosities were determined by Image J analysis. Data were analyzed by ANOVA at level of significance of p<0.05. RESULTS The lowest surface porosity was observed in MTA samples stored in STF and the highest was in Biodentine samples stored in DW. Significant differences were noted between groups and subgroups of each group (p< 0.05). MTA samples stored in DW and STF showed significantly lower surface porosities compared to Biodentine samples (p < 0.05). CONCLUSION Storage medium can drastically affect the surface porosity of tested calcium silicate-based cements. However, MTA showed lower surface porosity compared to Biodentine cement, which can result in lower microleakage in applied area.
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Affiliation(s)
- M Ali Saghiri
- Department of Dental Materials, Dental Material Research Center, Azad University, Tehran Branch, Tehran, Iran; Departments of Ophthalmology and Visual Sciences, Biomedical Engineering and Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Asal Shabani
- Department of Dental Materials, Azad University, Tehran Branch, Tehran, Iran
| | - Armen Asatourian
- Angiogenesis Regenerative Medicine Sector, Dr. H. Afsar Lajevardi Research Cluster, Shiraz, Iran
| | - Nader Sheibani
- Department of Ophthalmology and Visual Sciences, Biomedical Engineering and Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Abazarpour R, Parirokh M, Farhadi A, Jalali Z, Kheirabadi N. Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus. IRANIAN ENDODONTIC JOURNAL 2017; 12:390-395. [PMID: 28808472 PMCID: PMC5527221 DOI: 10.22037/iej.v12i3.16559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/03/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023]
Abstract
Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.
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Affiliation(s)
| | - Masoud Parirokh
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran;
| | - Aida Farhadi
- Endodontic Department, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
| | - Zahra Jalali
- Restorative Department, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nasir Kheirabadi
- Endodontic Department, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
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Parirokh M, Farzaneh S, Hallajmofrad AR. Conservative Management of Unset Mineral Trioxide Aggregate Root-End Filling: A Case Report. IRANIAN ENDODONTIC JOURNAL 2016; 11:241-5. [PMID: 27471540 PMCID: PMC4947853 DOI: 10.7508/iej.2016.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/25/2016] [Accepted: 05/10/2016] [Indexed: 11/30/2022]
Abstract
This case report presents conservative management of unset mineral trioxide aggregate (MTA) after being placed as a root-end filling material following periapical surgery. Periapical surgery was indicated for a maxillary lateral incisor of a 15-year-old male due to persistent exudate and a large periapical lesion. During surgery Angelus MTA was placed as root-end filling. The next session it was noticed that MTA had failed to completely set. In an orthograde approach, calcium-enriched mixture (CEM) cement was used to obturate the root canal space. The patient was followed up for 27 months and did not exhibit any clinical signs and symptoms. Radiographic images showed complete healing of the lesion.
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Affiliation(s)
- Masoud Parirokh
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Farzaneh
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
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12
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Prasad A, Pushpa S, Arunagiri D, Sawhny A, Misra A, Sujatha R. A comparative evaluation of the effect of various additives on selected physical properties of white mineral trioxide aggregate. J Conserv Dent 2015; 18:237-41. [PMID: 26069412 PMCID: PMC4450532 DOI: 10.4103/0972-0707.157263] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/13/2015] [Accepted: 03/16/2015] [Indexed: 11/28/2022] Open
Abstract
Aims: This study examined the setting time, compressive strength, and pH of white mineral trioxide aggregate (MTA) mixed with various additives: Calcium chloride (CaCl2), calcium formate (CaF), disodium hydrogen orthophosphate (Na2HPO4). Materials and Methods: Group 1 (Control) was obtained by mixing MTA with distilled water. In Groups 2 and 3, MTA containing 10% CaCl2 and 20% CaF, respectively, was mixed with distilled water. In Group 4, MTA was mixed with 15% Na2HPO4. Setting time, compressive strength, and pH of each group were examined. Statistical Analysis Used: Analysis was done using Statistical Package for Social Sciences (SPSS) version 14. A P-value < 0.05 was considered statistically significant. Comparison of mean values was done using analysis of variance (ANOVA) with post-hoc Games-Howell test. Results: The setting time of test groups were significantly shorter than that of control group (P < 0.001). The compressive strengths of test groups were lower than that of control group (P < 0.001). The pH value obtained for Groups 3 and 4 were higher than that of the control group (P < 0.001). Conclusions: Study result showed that additives significantly reduced the setting time of MTA and also maintained the pH at a high value. However, there was not much improvement in the compressive strength of the material.
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Affiliation(s)
- Anushree Prasad
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Shankarappa Pushpa
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Doraiswamy Arunagiri
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Asheesh Sawhny
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Abhinav Misra
- Department of Conservative Dentistry and Endodontics, Rama Dental College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Ramamurthy Sujatha
- Department of Microbiology, Rama Medical College-Hospital and Research Centre, Kanpur, Uttar Pradesh, India
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Asgary S, Eghbal MJ, Mehrdad L, Kheirieh S, Nosrat A. Surgical management of a failed internal root resorption treatment: a histological and clinical report. Restor Dent Endod 2014; 39:137-42. [PMID: 24790928 PMCID: PMC3978105 DOI: 10.5395/rde.2014.39.2.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 02/12/2014] [Indexed: 11/29/2022] Open
Abstract
This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Eghbal
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leili Mehrdad
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sanam Kheirieh
- Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Ali Nosrat
- Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Anand S, Taneja S, Kumari M. Effect of accelerants on the immediate and the delayed sealing ability of mineral trioxide aggregate when used as an apical plug: An in vitro study. J Conserv Dent 2014; 17:45-8. [PMID: 24554860 PMCID: PMC3915385 DOI: 10.4103/0972-0707.124134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/22/2013] [Accepted: 10/17/2013] [Indexed: 11/24/2022] Open
Abstract
Aim: To evaluate and compare the influence of various accelerators, 15% disodium hydrogen phosphate (Na2HPO4), 10% calcium chloride (CaCl2) and 23.1 wt% calcium lactate gluconate (CLG), on the immediate (after 72 h) and delayed (after 2 months) sealing ability of white ProRoot mineral trioxide aggregate (WMTA) when it is used as an apical plug. Materials and Methods: Eighty, single-rooted mandibular premolars were instrumented and standardized artificial open apices were created. The samples were then randomly assigned into four experimental groups and two control groups. WMTA was mixed with the respective accelerators and an apical plug of 4-mm thickness was fabricated. The remaining canal spaces were then backfilled. The samples were stored for the stipulated time periods and then immersed in 0.2% Rhodamine B solution for 72 h. Dye leakage was analyzed using a stereomicroscope. Results: Mean microleakage values of all experimental groups revealed that MTA + 23.1 wt% CLG showed the least leakage, followed by MTA + 15% Na2HPO4 and MTA + 10% CaCl2 with MTA + deionized water showing the maximum leakage at both the time intervals (P < 0.001). All the samples stored for a period of 2 months showed less leakage as compared with the samples stored for 72 h (P < 0.05). Conclusions: It was found that all three accelerators significantly accelerated the set of WMTA, of which 23.1 wt% CLG showed the best results, followed by 15% Na2HPO4 and 10% CaCl2. The sealing ability of all the experimental groups was significantly superior after 2 months as compared with that after 72 h.
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Affiliation(s)
- Surbhi Anand
- Department of Conservative Dentistry and Endodontics, I.T.S. Centre for Dental Studies and Research Delhi-Merrut Road, Ghaziabad, Uttar Pradesh, India
| | - Sonali Taneja
- Department of Conservative Dentistry and Endodontics, I.T.S. Centre for Dental Studies and Research Delhi-Merrut Road, Ghaziabad, Uttar Pradesh, India
| | - Manju Kumari
- Department of Conservative Dentistry and Endodontics, I.T.S. Centre for Dental Studies and Research Delhi-Merrut Road, Ghaziabad, Uttar Pradesh, India
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15
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Almeida JD, Alves AMH, Melo RFD, Felippe MCS, Bortoluzzi EA, Teixeira CDS, Felippe WT. The sealing ability of MTA apical plugs exposed to a phosphate-buffered saline. J Appl Oral Sci 2014; 21:341-5. [PMID: 24037073 DOI: 10.1590/1678-775720130023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 06/20/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of exposure of the mineral trioxide aggregate (MTA) - with and without calcium chloride (CaCl2) - to phosphate-buffered saline (PBS) on the apical microleakage using a glucose leakage system. MATERIAL AND METHODS Sixty root segments were randomly divided into 4 experimental groups (n=15). After resecting the apical segments and enlarging the canals with Gates-Glidden drills, the apical cavities were filled with MTA with or without CaCl2 and the root canals were dressed with a moistened cotton pellet or PBS, as follows: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. All root segments were introduced in floral foams moistened with PBS. After 2 months, all root segments were prepared to evaluate the glucose leakage along the apical plugs. The amount of glucose leakage was measured following an enzymatic reaction and quantified by a spectrophotometer. Four roots were used as controls. The data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05). RESULTS There were no differences between groups 1 and 2 (p>0.05), and 3 and 4 (p>0.05). The addition of CaCl2 to the MTA significantly decreased its sealing ability (p<0.05). CONCLUSION The interaction with PBS did not improve the MTA sealing ability. The addition of CaCl2 to the MTA negatively influenced the apical seal.
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Affiliation(s)
- Josiane de Almeida
- Department of Endodontics, School of Dentistry, Federal University of Santa Catarina, FlorianópolisSC, Brazil
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16
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Salem Milani A, Rahimi S, Froughreyhani M, Vahid Pakdel M. Effect of Blood Contamination on Marginal Adaptation and Surface Microstructure of Mineral Trioxide Aggregate: A SEM Study. J Dent Res Dent Clin Dent Prospects 2013; 7:157-63. [PMID: 24082987 PMCID: PMC3779375 DOI: 10.5681/joddd.2013.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 06/11/2013] [Indexed: 11/17/2022] Open
Abstract
Background and aims In various clinical situations, mineral trioxide aggregate (MTA) may come into direct contact or even be mixed with blood. The aim of the present study was to evaluate the effect of exposure to blood on marginal adaptation and surface microstructure of MTA.
Materials and methods Thirty extracted human single-rooted teeth were used. Standard root canal treatment was carried out. Root-ends were resected, and retrocavities were prepared. The teeth were randomly divided into two groups (n = 15): in group 1, the internal surface of the cavities was coated with fresh blood. Then, the cavities were filled with MTA. The roots were immersed in molds containing fresh blood. In group 2, the aforementioned procedures were performed except that synthetic tissue fluid (STF) was used instead of blood. To assess the marginal adaptation, “gap perimeter” and “maximum gap width” were measured under scanning electron microscope. The surface microstructure was also examined. Independent samples t-test and Mann-Whitney U test were used to analyze the data.
Results Maximum gap width and gap perimeter in the blood-exposed group were significantly larger than those in the STF-exposed group (p < 0.01). In the blood-exposed group, the crystals tended to be more rounded and less angular compared with the STF-exposed group, and there was a general lack of needle-like crystals.
Conclusion Exposure to blood during setting has a negative effect on marginal adaptation of MTA, and blood-exposed MTA has a different surface microstructure compared to STF-exposed MTA.
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Affiliation(s)
- Amin Salem Milani
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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17
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Shokouhinejad N, Razmi H, Fekrazad R, Asgary S, Neshati A, Assadian H, Kheirieh S. Push-out bond strength of two root-end filling materials in root-end cavities prepared by Er,Cr:YSGG laser or ultrasonic technique. AUST ENDOD J 2012; 38:113-7. [PMID: 23211070 DOI: 10.1111/j.1747-4477.2010.00264.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study compared the push-out bond strength of mineral trioxide aggregate (MTA) and a new endodontic cement (NEC) as root-end filling materials in root-end cavities prepared by ultrasonic technique (US) or Er,Cr:YSGG laser (L). Eighty single-rooted extracted human teeth were endodontically treated, apicectomised and randomly divided into four following groups (n = 20): US/MTA, US/NEC, L/MTA and L/NEC. In US/MTA and US/NEC groups, root-end cavities were prepared with ultrasonic retrotip and filled with MTA and NEC, respectively. In L/MTA and L/NEC groups, root-end cavities were prepared using Er,Cr:YSGG laser and filled with MTA and NEC, respectively. Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine. Then, all slices were examined to determine the mode of bond failure. Data were analysed using two-way anova. Root-end filling materials showed significantly higher bond strength in root-end cavities prepared using ultrasonic technique (US/MTA and US/NEC) (P < 0.001). The bond strengths of MTA and NEC did not differ significantly. The failure modes were mainly adhesive for MTA, but cohesive for NEC. In conclusion, bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities.
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Affiliation(s)
- Noushin Shokouhinejad
- Department of Endodontics, School of Dentistry/Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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18
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Nosrat A, Asgary S, Eghbal MJ, Ghoddusi J, Bayat-Movahed S. Calcium-enriched mixture cement as artificial apical barrier: A case series. J Conserv Dent 2012; 14:427-31. [PMID: 22144818 PMCID: PMC3227296 DOI: 10.4103/0972-0707.87218] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 02/03/2011] [Accepted: 06/12/2011] [Indexed: 11/30/2022] Open
Abstract
In comparison to the conventional apexification using calcium hydroxide, artificial apical barrier technique is more valuable and less time consuming. This article describes successful use of calcium-enriched mixture (CEM) cement as an artificial apical barrier in open apices. In this study, 13 single-rooted teeth with necrotic pulps and open apices were treated non-surgically. After copious irrigation of the root canals with NaOCl 5.25% and gentle filing, based on need for interappointment dressing, treatments were followed by CEM cement (BioniqueDent, Tehran, Iran) apical plug insertion in the first or second appointment. All cases were then permanently restored. All subjects were followed until radiographic evidence of periradicular healing was seen (mean 14.5 months). Clinically, all cases were functional and asymptomatic and complete osseous healing was observed in all the teeth. Considering the biological properties of CEM cement, this new endodontic biomaterial might be appropriate to be used as artificial apical barrier in the open apex teeth.
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Affiliation(s)
- Ali Nosrat
- Department of Endodontics, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Kerman, Iran
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19
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Asgary S, Nosrat A, Homayounfar N. Periapical Healing After Direct Pulp Capping With Calcium-enriched Mixture Cement: A Case Report. Oper Dent 2012; 37:571-5. [DOI: 10.2341/11-417-s] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This article describes a successful direct pulp capping of a mature symptomatic mandibular second molar in a 14-year-old girl. The patient was referred with sensitivity to cold beverages and pain on chewing on the second left mandibular molar. Clinical examinations revealed extensive coronal caries and sensitivity to percussion. Radiographically, the tooth was mature and had a widened apical periodontal ligament (PDL) and a narrow periapical lesion. The concluding diagnosis was symptomatic irreversible pulpitis with symptomatic apical periodontitis. Treatment included caries removal under rubber dam isolation, capping of exposure sites with calcium-enriched mixture (CEM) cement, and permanent coronal restoration. At three-, 10-, and 15-month follow-up, the tooth was functional, had normal response to cold test, and did not have sensitivity to percussion. The PDL space regained its normal width, and the periapical lesion healed.
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Affiliation(s)
- S Asgary
- Saeed Asgary, DDS, MS, professor, Iranian Center for Endodontic Research, Dental Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Nosrat
- Ali Nosrat, DDS, MS, assistant professor, Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - N Homayounfar
- Negar Homayounfar, DDS, MS, graduate student, Department of Oral Biology, School of Dentistry, University of Washington, Seattle, WA, USA
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20
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Lotfi M, Vosoughhosseini S, Saghiri MA, Rahimi S, Zand V, Reyhani MF, Samiei M, Ghasemi N, Mehrvarzfar P, Azimi S, Shokohinejad N. Effect of Synthetic Tissue Fluid on Microleakage of Grey and White Mineral Trioxide Aggregate as Root-End Filling Materials: An in vitro study. Sultan Qaboos Univ Med J 2012; 12:323-9. [PMID: 22912925 DOI: 10.12816/0003146] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 01/08/2012] [Accepted: 05/02/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The success of endodontic surgery has been shown to depend partly on the apical seal. Grey mineral trioxide aggregate (GMTA) produces hydroxyapatite twice as often as white mineral trioxide aggregate (WMTA) when suspended in a phosphate buffered saline (PBS) solution. The aim of this in vitro study was to compare the microleakage phenomenon of gray and white mineral trioxide aggregates as root-end filling materials after immersion in synthetic tissue fluid (STF). METHODS 55 single-rooted extracted maxillary anterior human teeth were divided into two experimental groups of 20 teeth each, plus 3 groups of 5 teeth each as two negative and one positive control groups. The root canals were cleaned, shaped, and laterally compacted with gutta-percha. The root ends were resected and 3 mm deep cavities were prepared. The root-end preparations were filled with GMTA or WMTA in the experimental groups. Leakage was determined using a dye penetration method. Data were analysed using analysis of variance (ANOVA) at the 0.05 level of significance. RESULTS The mean dye leakage was 0.40 ± 0.1 mm for GMTA and 0.50±0.1 mm for WMTA groups, respectively. There was no significant difference between the two experimental groups (P = 0.14). CONCLUSION Despite the different properties and behaviours of GMTA and WMTA in STF, there were no significant differences in microleakage when using GMTA or WMTA.
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Affiliation(s)
- Mehrdad Lotfi
- Research Center of Pharmaceutical Nano Technology, Tabriz University (Medical Sciences), Tabriz, Iran
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21
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Nosrat A, Nekoofar MH, Bolhari B, Dummer PMH. Unintentional extrusion of mineral trioxide aggregate: a report of three cases. Int Endod J 2012; 45:1165-76. [DOI: 10.1111/j.1365-2591.2012.02082.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 05/04/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - P. M. H. Dummer
- Endodontology Research Group; School of Dentistry, Cardiff University; Cardiff; UK
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22
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Nekoofar MH, Davies TE, Stone D, Basturk FB, Dummer PMH. Microstructure and chemical analysis of blood-contaminated mineral trioxide aggregate. Int Endod J 2011; 44:1011-8. [PMID: 21718336 DOI: 10.1111/j.1365-2591.2011.01909.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To test the hypothesis that blood contamination has a detrimental effect on the chemical properties of Mineral trioxide aggregate (MTA). METHODOLOGY The effects of whole, fresh human blood on the microstructure and elemental chemistry of MTA were evaluated using scanning electron microscopy and energy-dispersive X-ray analysis, respectively. The phase compositions of contaminated and uncontaminated MTA were also analysed using X-ray diffraction analysis. RESULTS The hydration state of specimens partially mixed with blood were more complete than those mixed entirely with blood and less than those entirely mixed with water. Acicular crystals, characteristic of ettringite, were abundant in specimens mixed entirely with water and absent from specimens mixed partially or entirely with blood. Calcium hydroxide crystals were absent in specimens contaminated entirely with blood and the unhydrated MTA powder, but present in the other groups. CONCLUSION Mixing MTA with blood resulted in the lack of formation of the crystalline calcium hydroxide in the early stage of the hydration process.
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Affiliation(s)
- M H Nekoofar
- Endodontology Research Group, School of Dentistry, Cardiff University, Cardiff, UK.
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HAN L, OKIJI T, OKAWA S. Morphological and chemical analysis of different precipitates on mineral trioxide aggregate immersed in different fluids. Dent Mater J 2010; 29:512-7. [DOI: 10.4012/dmj.2009-133] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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