Quality of the calcium-enriched mixture apical plug in simulated apexification model; Effect of different mixing and placement methods

Effect of three intracanal medicaments used in pulp regeneration on the push-out bond strength of mineral trioxide aggregate and calcium-enriched mixture: An in vitro study

Background. The bond strength of the materials used as a cervical barrier in the pulp regeneration is essential for the success of treatment. This study aimed to evaluate the effects of triple antibiotic paste (TAP), double antibiotic paste (DAP), and simvastatin as intracanal medicaments on the dislodgement resistance of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM). Methods. A total of 160 extracted human single-rooted teeth were selected, and root canal preparation was carried out. The teeth in each group were randomly divided into four subgroups: TAP, DAP, simvastatin, and the control group (without intracanal medicament). Four weeks after placing the medicaments, it was removed by sodium hypochlorite, and MTA and CEM were placed in the coronal third of the root canals. After a week, 2-mm-thick dentin disks were prepared from the coronal third of the roots, and the push-out test was performed using a universal testing machine. The data were analyzed using two-way ANOVA and independent t-test at a significance level of 0.05. Results. Regardless of the intracanal medicament, there was no significant difference between the overall bond strength of MTA (59.3±10 MPa) and CEM (55.8±11 MPa) (P=0.6). Furthermore, there were no significant differences in bond strength between the two intracanal medicament groups and the control group (P>0.05). Conclusion. Under the limitations of the current study, DAP, simvastatin, and TAP, as intracanal medicaments, did not adversely affect the push-out bond strength of CEM and MTA.

The Effect of Different Mixing Methods on the Properties of Calcium-enriched Mixture Cement: A Systematic Review of in Vitro Studies

Introduction

It has been shown that the mechanical and physical properties of Calcium Enriched Mixture (CEM) cement are influenced by the mixing methods. Despite several studies conducted on different mixing methods of CEM cement, there is no systematic review to summarize the results. This systematic review was conducted to investigate the effect of different mixing techniques on mechanical and physical characteristics of CEM cement.

Methods and Materials

A professional librarian with skills in informatics conducted a systematic search by searching electronic databases PubMed/MEDLINE, Scopus and Ovid for English language peer-reviewed articles published between 1992 and April 2019.

Results

Initial searches from all sources identified 1175 references. Two of the authors examined the titles, abstracts of these articles and the full reports of 20 studies were obtained, and data extraction was performed. Seven studies satisfied the eligibility criteria for the review. The effect of different mixing methods was investigated on bacterial microleakage, push-out bond strength, flow rate, compressive strength, solubility, pH, film thickness, dimensional changes, working time, setting time and quality of the apical plug.

Conclusion

Based on the results of this systematic review, some of the important properties of CEM cement were affected by different mixing methods. Although none of these mixing methods could improve all the properties, mechanical and manual methods were more effective compared to ultrasonic method.