Solubility of a new calcium silicate-based root-end filling material

Comparative evaluation of push-out bond strength and mode of failure of three different obturating materials: An in vitro study

Aim

This research aimed to assess the push-out bond strength (PBS) to dentin of three distinct obturation materials inside the root canal and identify the failure mechanism.

Materials and Methods

The research used 30 undamaged human mandibular premolars. The specimens were randomly assigned to three groups, each employing a different sealer (n = 10). Group 1 used AH Plus sealer, Group 2 used GuttaFlow-2 sealer, and Group 3 used bioceramic sealer (CeraSeal). The obturation procedure was performed utilizing the single-cone method with gutta-percha. The specimens were divided into sections and loaded using a universal testing machine. Following PBS testing, every sample underwent a stereomicroscope examination, and the specific failure mechanism was documented.

Results

The average PBS was greatest for AH Plus, followed by CeraSeal and Guttaflow-2. Notable disparities existed between the coronal and apical levels.

Conclusion

AH Plus exhibited superior PBS qualities to root dentin compared to other sealers.

Evaluation of the chemical, physical, and biological properties of a newly developed bioceramic cement derived from cockle shells: an in vitro study

BACKGROUND

Tricalcium silicate is the main component of commercial bioceramic cements that are widely used in endodontic treatment. Calcium carbonate, which is manufactured from limestone, is one of the substrates of tricalcium silicate. To avoid the environmental impact of mining, calcium carbonate can be obtained from biological sources, such as shelled mollusks, one of which is cockle shell. The aim of this study was to evaluate and compare the chemical, physical, and biological properties of a newly developed bioceramic cement derived from cockle shell (BioCement) with those of a commercial tricalcium silicate cement (Biodentine).

METHODS

BioCement was prepared from cockle shells and rice husk ash and its chemical composition was determined by X-ray diffraction and X-ray fluorescence spectroscopy. The physical properties were evaluated following the International Organization for Standardization (ISO) 9917-1;2007 and 6876;2012. The pH was tested after 3 h to 8 weeks. The biological properties were assessed using extraction medium from BioCement and Biodentine on human dental pulp cells (hDPCs) in vitro. The 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5[(phenylamino)carbonyl]-2 H-tetrazolium hydroxide assay was used to evaluate cell cytotoxicity following ISO 10993-5;2009. Cell migration was examined using a wound healing assay. Alizarin red staining was performed to detect osteogenic differentiation. The data were tested for a normal distribution. Once confirmed, the physical properties and pH data were analyzed using the independent t-test, and the biological property data were analyzed using one way ANOVA and Tukey's multiple comparisons test at a 5% significance level.

RESULTS

The main components of BioCement and Biodentine were calcium and silicon. BioCement's and Biodentine's setting time and compressive strength were not different. The radiopacity of BioCement and Biodentine was 5.00 and 3.92 mmAl, respectively (p < 0.05). BioCement's solubility was significantly higher than Biodentine. Both materials exhibited alkalinity (pH ranged from 9 to 12) and demonstrated > 90% cell viability with cell proliferation. The highest mineralization was found in the BioCement group at 7 days (p < 0.05).

CONCLUSIONS

BioCement exhibited acceptable chemical and physical properties and was biocompatible to human dental pulp cells. BioCement promotes pulp cell migration and osteogenic differentiation.

An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy

Regarding the common use of calcium silicate cements (CSCs) in root canal therapy, their position in the context of past and present dentistry agents can provide a better understanding of these materials for their further improvement. In this context, the present review article addresses a wide range of recent investigations in the field of CSC-based products and describes details of their composition, properties, and clinical applications. The need for maintaining or reconstructing tooth structure has increased in contemporary endodontic treatment approaches. This research thus discusses the attempts to create comprehensive data collection regarding calcium ion release, bond strength, alkalinizing activity and bioactivity, and the ability to stimulate the formation of hydroxyapatite as a bioactive feature of CSCs. Sealing ability is also highlighted as a predictor for apical and coronal microleakage which is crucial for the long-term prognosis of root canal treatment integrity. Other claimed properties such as radiopacity, porosity, and solubility are also investigated. Extended setting time is also mentioned as a well-known drawback of CSCs. Then, clinical applications of CSCs in vital pulp therapies such as pulpotomy, apexification, and direct pulp capping are reviewed. CSCs have shown their benefits in root perforation treatments and also as root canal sealers and end-filling materials. Nowadays, conventional endodontic treatments are replaced by regenerative therapies to save more dynamic and reliable hard and soft tissues. CSCs play a crucial role in this modern approach. This review article is an attempt to summarize the latest studies on the clinical properties of CSCs to shed light on the future generation of treatments.

Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements

Objectives

Materials and Methods

Results

Conclusions

Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material

Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.

A micro-computed tomographic study using a novel test model to assess the filling ability and volumetric changes of bioceramic root repair materials

Objectives

New premixed bioceramic root repair materials require moisture for setting. Using micro-computed tomography (micro-CT), this study evaluated the filling ability and volumetric changes of calcium silicate-based repair materials (mineral trioxide aggregate repair high-plasticity [MTA HP] and Bio-C Repair, Angelus), in comparison with a zinc oxide and eugenol-based material (intermediate restorative material [IRM]; Dentsply DeTrey).

Materials and Methods

Gypsum models with cavities 3 mm deep and 1 mm in diameter were manufactured and scanned using micro-CT (SkyScan 1272. Bruker). The cavities were filled with the cements and scanned again to evaluate their filling capacity. Another scan was performed after immersing the samples in distilled water for 7 days to assess the volumetric changes of the cements. The statistical significance of differences in the data was evaluated using analysis of variance and the Tukey test with a 5% significance level.

Results

Bio-C Repair had a greater filling ability than MTA HP (p < 0.05). IRM was similar to Bio-C and MTA HP (p > 0.05). MTA HP presented the largest volumetric change (p < 0.05), showing more volume loss than Bio-C and IRM, which were similar (p > 0.05).

Conclusions

Bio-C Repair is a new endodontic material with excellent filling capacity and low volumetric change. The gypsum model proposed for evaluating filling ability and volumetric changes by micro-CT had appropriate and reproducible results. This model may enhance the physicochemical evaluation of premixed bioceramic materials, which need moisture for setting.

Influence of Ultrasonic Activation on the Physicochemical Properties of Calcium Silicate-Based Cements

Purpose

To evaluate the influence of ultrasonic activation on the physicochemical properties of setting time (ST), flow (FL), dimensional change (DC), and solubility (SL) of the cements: MTA, MTA Repair HP, and Biodentine®.

Materials and Methods

Two experimental groups were formed according to the cement activation protocol: without ultrasonic activation and with ultrasonic activation. Cements were manipulated according to the manufacturers' instructions. Ultrasonic activation group was performed with an E1 insert at power 3 (24–32 kHz) for 30 s directly in the center of the cement mass. The molds for analysis of the physicochemical properties were filled out and evaluated according to specification No. 57 from ANSI/ADA. The results were analyzed using the ANOVA test (two-way), complemented by Tukey's test (α = 0.05). The distilled water used during the solubility test was submitted to spectrometry to verify the release of calcium ions. The morphologies of the external surface and the cross-section of the samples were analyzed by means of a scanning electron microscope (SEM).

Results

For the ST, ultrasonic activation reduced the values of MTA, MTA Repair HP, and Biodentine (P < 0.05). For the FL, ultrasonic activation did not alter the flow of MTA (P > 0.05); however, it increased the flow MTA Repair HP and Biodentine (P < 0.05). For the DC, the percentage values of dimensional change were higher when there was ultrasonic activation in all repair cements (P < 0.05). For SL, there was a reduction in the percentage of the values in MTA and MTA Repair HP (P < 0.05); however, there was no change in the values of Biodentine (P > 0.05). Ultrasonic activation favored the release of calcium ions from all cements. The SEM analysis showed, in general, that the ultrasonic activation reduced and altered the particle shape of the cement.

Conclusions

The ultrasonic activation interfered in the ST, DC, FL, ultrastructural morphology, and calcium release of the repair cements. However, it did not affect the solubility of Biodentine®.

Preserving pulp vitality: part one - strategies for managing deep caries in permanent teeth

This is the first article in a series reviewing the current literature surrounding the management of deep caries in permanent teeth. Approaches to caries management are continuing to evolve, with more conservative management increasingly favoured. This philosophy has never been more important than in managing the deep carious lesion. Evidence is emerging that the use of selective caries removal to reduce the risk of pulp exposure, in conjunction with calcium silicate cements, can be successful in maintaining pulp vitality, delaying the restorative cycle and prolonging the lifespan of the tooth.

Microhardness and surface roughness of Biodentine exposed to mouthwashes

Aim:

This study evaluates Vickers microhardness and surface roughness in Biodentine cement (M1) and glass-ionomer cement Fuji IX (M2), both immersed in mouthwash.

Materials and Methods:

Fifty-four samples were randomly distributed in distilled water (S1), Listerine Cool Mint (S2), and Colgate Plax (S3). Each sample was put in a flask with mouthwash for 2 min, under vibration, twice a day for 21 days. Microhardness and surface roughness were assessed at 48 h (T0), 7 days (T1), 14 days (T2), and 21 days (T3).

Results:

For roughness: time (T), solution (S) and material (M), TxM, and SxM and for microhardness: M, TxS, TxM, and SxM were statistically significant. T3, M1, M1T3, and M1S1 presented the highest surface roughness. M2, M1T0, M1T1, M1T2, M1S1, and M1S2 presented higher microhardness.

Conclusion:

Biodentine showed higher surface roughness for T1, T2, and T3 and higher microhardness for T0, T1, and T2 against Fuji IX. Biodentine presented higher microhardness independently of solution.

Marginal adaptation, solubility and biocompatibility of TheraCal LC compared with MTA-angelus and biodentine as a furcation perforation repair material

BACKGROUND

This study evaluated the marginal adaptation, solubility and biocompatibility of TheraCal LC compared with mineral trioxide aggregate (MTA-Angelus) and Biodentine when used as a furcation perforation repair material.

METHODS

The marginal adaptation was assessed by scanning electronic microscope and presence of any gap between the dentin surface and filling material in each quadrant of the sample was analyzed at 1000 X magnification. The solubility was measured after one week by the ISO standard method. Biocompatibility was evaluated by the inflammatory response and radiography after one month and three months of repair of experimental furcation perforations in dog's teeth.

RESULTS

There were significant differences in the marginal adaptation, solubility and biocompatibility of the tested materials (P < 0.05). TheraCal LC showed the highest frequency distribution of gap presence that was followed by the MTA-Angelus then Biodentine. The least soluble material after one week was TheraCal LC that was followed by the MTA-Angelus and Biodentine. After one month and three months, TheraCal LC showed the highest inflammatory response and highest frequency distribution of radiolucency that was followed by the Biodentine then MTA-Angelus.

CONCLUSION

Unlike Biodentine, TheraCal LC is incapable of alternating the MTA in furcation perforation repair due to its poor biocompatibility and poor marginal adaptation.

The Effect of Biodentine Maturation Time on Resin Bond Strength When Aged in Artificial Saliva

Biodentine is a calcium silicate cement (CSC) that has been broadly applied in vital pulp therapy. The quality of the Biodentine-composite bond has a significant effect on the longevity of the definitive restoration. The aim of this study is to investigate the shear bond strength (SBS) between Biodentine and composite restoration at different maturation times of Biodentine aged in artificial saliva. Fifteen Biodentine discs were allocated into three groups (n = 5) based on the timeframe of performance of composite restoration: immediate (after 12  min), after 14 days, and after 28 days of Biodentine maturation. Total etch and rinse adhesive system and bulk-fill regular resin composite were used. The shear bond strength and the failure pattern were assessed. One-way ANOVA with the Bonferroni post hoc test was applied for statistical analysis at p < 0.05. The highest (32.47 ± 8.18 MPa) and the lowest (4.08 ± 0.81 MPa) SBS values were recorded for 14 days and 12 min groups, respectively. Significant statistical differences were reported among the groups, and a high statistically significant difference was found between the immediate group and the other groups. Adhesive failure patterns were evident in all groups. More clinically acceptable bond strength between the Biodentine and overlaid composite restoration is at 14 days after Biodentine maturation. Delaying the coverage of Biodentine later than 14 days may significantly reduce the SBS. Using the artificial saliva as an aging medium may affect the SBS between Biodentine and composite material.

Development and evaluation of reparative tricalcium silicate-ZrO2 -Biosilicate composites

Biosilicate is a bioactive glass-ceramic used in medical and dental applications. This study evaluated novel reparative materials composed of pure tricalcium silicate (TCS), 30% zirconium oxide (ZrO₂ ) and 10 or 20% biosilicate, in comparison with Biodentine. Setting time was evaluated based on ISO 6876 standard, radiopacity by radiographic analysis, solubility by mass loss, and pH by using a pH meter. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and NR assays. Alkaline phosphatase (ALP) activity and alizarin red were used to evaluate cell bioactivity. Antimicrobial activity was assessed on Enterococcus faecalis by the direct contact test. The data were submitted to analysis of variance (ANOVA)/Tukey; Bonferroni and Kruskal-Wallis, and Dunn tests (α = 0.05). The association of Biosilicate with TCS + ZrO₂ had appropriate setting time, radiopacity, and solubility, alkaline pH, and antimicrobial activity. TCS and Biodentine showed higher ALP activity in 14 days than the control (serum-free medium). All cements produced mineralized nodules. In conclusion, Biosilicate + TCS ZrO₂ decreased the setting time and increased the radiopacity in comparison to TCS. Biosilicate + TCS ZrO2 presented lower solubility and higher radiopacity than Biodentine. In addition, these experimental cements promoted antimicrobial activity and mineralization nodules formation, suggesting their potential for clinical use.

Solubility of Calcium Silicate Based Cements – a Comparative Study

Calcium silicate based cement is a group of biomaterials, based on Portland cement. Its physicochemical properties such as solubility are of the utmost importance. It should have low solubility in tissue fluid since the dissolution of materials may lead to treatment failure.

The aim of this study is to evaluate the solubility of five calcium silicate cements after being placed in distilled water for a period of 28 days.

Material and methods: The purpose of this study was to compare solubility of a four new calcium silicate-based cements, such as: gray MTA Angelus; white MTA Angelus; BioAggregate and Biodentine with conventional mineral trioxide aggregate White ProRoot. Solubility is evaluated using standardized samples of materials, which are weighed before and after 28-day immersion in distilled water.

Results: The lowest solubility is found at White ProRoot and the significantly highest solubility – at Biodentine.

Micro-computed tomography high resolution evaluation of dimensional and morphological changes of 3 root-end filling materials in simulated physiological conditions

The aim of this study was to evaluate volumetric and morphological stability of 3 root-end filling materials in addition to porosity and interface voids, using micro-computed tomography (µCT) in high resolution and a highly accurate approach for image analysis. Following root-end resection and apical preparation, two-rooted maxillary premolars were divided into three groups, according to the filling materials: White MTA Angelus, Biodentine, and IRM. Samples were scanned by µCT at 5 µm after the setting time and at time intervals of 7 and 30 days after immersion in phosphate-buffered saline (PBS). Volumetric and morphological changes besides material porosity and interface voids were evaluated by comparing initial values and those obtained after immersion. Data were analyzed statistically, using ANOVA and t-tests (α = 0.05). All materials showed volumetric stability. Regarding the morphological changes, Biodentine had a significant thickness reduction after storage in PBS when compared with MTA. Biodentine also showed an increase in porosity, as well as in percentage and thickness of voids after 30 days of immersion. In conclusion, µCT in high resolution and an accurate image analysis approach may be used to evaluate morphological changes of endodontic materials. Although Biodentine showed suitable adaptability and lower values of porosity than MTA, after PBS immersion there was a dimensional reduction of this material, besides an increase in porosity and interface voids.

Addition of zirconium oxide to Biodentine increases radiopacity and does not alter its physicochemical and biological properties

Objectives:

To evaluate the radiopacity of Biodentine (BD) and BD associated with 15% calcium tungstate (BDCaWO₄) or zirconium oxide (BDZrO₂), by using conventional and digital radiography systems, and their physicochemical and biological properties.

Materials and Methods:

Radiopacity was evaluated by taking radiographs of cement specimens (n=8) using occlusal film, photostimulable phosphor plates or digital sensors. Solubility, setting time, pH, cytocompatibility and osteogenic potential were also evaluated. Data were analyzed using one-way ANOVA and Tukey post-test or two-way ANOVA and Bonferroni post-test (α=0.05).

Results:

BD radiopacity was lower than 3 mm Al, while BD ZrO₂ and BD CaWO₄ radiopacity was higher than 3 mm Al in all radiography systems. The cements showed low solubility, except for BDCaWO₄. All cements showed alkaline pH and setting time lower than 34 minutes. MTT and NR assays revealed that cements had greater or similar cytocompatibility in comparison with control. The ALP activity in all groups was similar or greater than the control. All cements induced greater production of mineralized nodules than control.

Conclusions:

Addition of 15% ZrO₂ or CaWO₄ was sufficient to increase the radiopacity of BD to values higher than 3 mm Al. BD associated with radiopacifiers showed suitable properties of setting time, pH and solubility, except for BDCaWO₄, which showed the highest solubility. All cements had cytocompatibility and potential to induce mineralization in Saos-2 cells. The results showed that adding 15% ZrO₂ increases the radiopacity of BD, allowing its radiography detection without altering its physicochemical and biological properties.

The Chemical and Morphological Study of Calcium Silicate-Based Material (Biodentine®) and Glass Ionomer Cement (GIC®)

Background:

Attention was paid to the chemical properties of bioactive materials, and the reaction that could occur on their surface.

Objective:

The evaluation of the chemical properties includes the solubility, water sorption, pH changes and calcium release of two dental materials (BD and GIC). In addition, the morphological structure of each material was studied after its immersion in two different solutions,i.e.deionized water and phosphate solution.

Methods:

The chemical study was carried out for two sets of samples; 28 samples of each material. Samples were immersed in 10 mL of deionized water and stored at 37 °C for different times. The morphological structure and elemental analysis of BD and GIC samples were studied after immersion in the two solutions for 1, 7, 14 and 28 days.

Results:

Solubility of BD increased with time reaching a maximum value after 60 days (13.63 ± 2.08%). The solubility of GIC was negatively correlated with time, with a maximum value of 4.11 ± 0.47% for 3 h. The released Ca+2ions varied between 1.0 ± 0.3 mg (3 h) and 5.3 ± 0.8 mg (60 days) for BD. However, calcium was not detected in the GIC samples. The formation of calcium hydroxy-fluorapatites and strontium-fluoro-alumino-silicate, on the surface of BD and GIC, respectively, was clarified for the first time in this study.

Conclusion:

A comparative study was carried out revealing the difference in the chemical properties and the morphological structure between the two studied materials. The results confirmed the biointeractivity and the bioactivity of BD and GIC.

Effects of a New Bioceramic Material on Human Apical Papilla Cells

BACKGROUND

The development of materials with bioregenerative properties is critically important for vital pulp therapies and regenerative endodontic procedures. The aim of this study was to evaluate the cytocompatibility and cytotoxicity of a new endodontic biomaterial, PulpGuard, in comparison with two other biomaterials widely used in endodontic procedures, ProRoot Mineral Trioxide Aggregate (MTA) and Biodentine.

METHODS

Apical papilla cells (APCs) were isolated from third molars with incomplete rhizogenesis from patients with orthodontic indication for dental extraction. Cultured APCs were incubated for 24, 48, or 72 h with different dilutions of eluates prepared from the three materials. Cellular viability, mobility, and proliferation were assessed in vitro using the Alamar Blue assay and a wound-healing test. The cells were also cultured in direct contact with the surface of each material. These were then analyzed via Scanning Electron Microscopy (SEM), and the surface chemical composition was determined by Energy-Dispersive Spectroscopy (EDS).

RESULTS

Cells incubated in the presence of eluates extracted from ProRoot MTA and PulpGuard presented rates of viability comparable to those of control cells; in contrast, undiluted Biodentine eluates induced a significant reduction of cellular viability. The wound-healing assay revealed that eluates from ProRoot MTA and PulpGuard allowed for unhindered cellular migration and proliferation. Cellular adhesion was observed on the surface of all materials tested. Consistent with their disclosed composition, EDS analysis found high relative abundance of calcium in Biodentine and ProRoot MTA and high abundance of silicon in PulpGuard. Significant amounts of zinc and calcium were also present in PulpGuard discs. Concerning solubility, Biodentine and ProRoot MTA presented mild weight loss after eluate extraction, while PulpGuard discs showed significant water uptake.

CONCLUSIONS

PulpGuard displayed a good in vitro cytocompatibility profile and did not significantly affect the proliferation and migration rates of APCs. Cells cultured in the presence of PulpGuard eluates displayed a similar profile to those cultured with eluates from the widely used endodontic cement ProRoot MTA.

Effect of pH on solubility of white Mineral Trioxide Aggregate and Biodentine: An in vitro study

Background. The aim of this study was to evaluate the effect of acidic, neutral and alkaline environments on the solubility of white mineral trioxide aggregate (WMTA) and Biodentine (BD).

Methods. Thirty-nine ring molds were randomly divided into three groups of A, B, and C (n = 12) with pH values of 7.4, 4.4 and 10.4, respectively, and an empty mold was used as a control. Each group was further divided into two subgroups (1 and 2) according to the material studied. The samples in groups A, B and C were transferred into synthetic tissue fluid buffered at pH values of 7.4, 4.4 and 10.4, respectively, and kept in an incubator at 37°C with 100% humidity. Daily solubility at 1-, 2-, 5-, 14-, 21-, and 30-day intervals and cumulative solubility up to 5-, 14-, and 30-day intervals were calculated. Statistical analysis was carried out with independent-samples t-test, two-way ANOVA and post hoc Tukey tests using SPSS 18. Statistical significance was set at P<0.05.

Results. Both WMTA and BD exhibited the highest solubility in acidic pH with 5.4235±0.1834 and 10.7516±0.0639 mean cumulative solubility values at 30-day interval, respectively. At all exposure times, BD was significantly more soluble than WMTA (P<0.001).

Conclusion. Acidic periapical environment jeopardized the solubility of both WMTA and BD, affecting their sealing characteristics in clinical applications like perforation repair procedures and blunderbuss canals.

Physicochemical properties of calcium silicate-based formulations MTA Repair HP and MTA Vitalcem

Objective

This study aimed to analyze the following physicochemical properties: radiopacity, final setting time, calcium release, pH change, solubility, water sorption, porosity, surface morphology, and apatite-forming ability of two calcium silicate-based materials.

Material and methods

We tested MTA Repair HP and MTA Vitalcem in comparison with conventional MTA, analyzing radiopacity and final setting time. Water absorption, interconnected pores and apparent porosity were measured after 24-h immersion in deionized water at 37°C. Calcium and pH were tested up to 28 d in deionized water. We analyzed data using two-way ANOVA with Student-Newman-Keuls tests (p<0.05). We performed morphological and chemical analyses of the material surfaces using ESEM/EDX after 28 d in HBSS.

Results

MTA Repair HP showed similar radiopacity to that of conventional MTA. All materials showed a marked alkalinizing activity within 3 h, which continued for 28 d. MTA Repair HP showed the highest calcium release at 28 d (p<0.05). MTA Vitalcem showed statistically higher water sorption and solubility values (p<0.05). All materials showed the ability to nucleate calcium phosphate on their surface after 28 d in HBSS.

Conclusions

MTA Repair HP and MTA Vitalcem had extended alkalinizing activity and calcium release that favored calcium phosphate nucleation. The presence of the plasticizer in MTA HP might increase its solubility and porosity. The radiopacifier calcium tungstate can be used to replace bismuth oxide.

Biodentine™ material characteristics and clinical applications: a 3 year literature review and update

INTRODUCTION

Biodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry.

AIM

To provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™.

STUDY DESIGN

A comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language.

CONCLUSIONS

The enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.

Evaluation of physicochemical properties of root-end filling materials using conventional and Micro-CT tests

Objective

To evaluate solubility, dimensional stability, filling ability and volumetric change of root-end filling materials using conventional tests and new Micro-CT-based methods.

Material and Methods

7.

Results

The results suggested correlated or complementary data between the proposed tests. At 7 days, BIO showed higher solubility and at 30 days, showed higher volumetric change in comparison with MTA (p<0.05). With regard to volumetric change, the tested materials were similar (p>0.05) at 7 days. At 30 days, they presented similar solubility. BIO and MTA showed higher dimensional stability than ZOE (p<0.05). ZOE and BIO showed higher filling ability (p<0.05).

Conclusions

ZOE presented a higher dimensional change, and BIO had greater solubility after 7 days. BIO presented filling ability and dimensional stability, but greater volumetric change than MTA after 30 days. Micro-CT can provide important data on the physicochemical properties of materials complementing conventional tests.

A novel technique of sculpting Biodentine in the restoration of iatrogenic dentin loss

Excessive tooth structure loss is a common iatrogenic error encountered during endodontic practice. Conservative treatment planning is essential to maintain the structural integrity in such teeth. This case report elucidates a novel approach in sculpting Biodentine as a dentin substitute followed by internal bleaching and restoration with fiber-reinforced composite.