Effect of acidic solutions on the microhardness of dentin and set OrthoMTA and their cytotoxicity on murine macrophage

Effect of Various Acid Solutions as an Aid in Removing the OrthoMTA-Based Root Canal Filling

The objectives of this study were to compare the effects of various acid solutions combined with ultrasonics as an aid to remove mineral trioxide aggregate (MTA)-based root canal filling and to assess their effect on the surface topography and microhardness of root canal dentin.

MATERIALS AND METHOD

Fifty human permanent single rooted and single canaled freshly extracted teeth were decoronated and sectioned apically to prepare the middle third of root sections of 5 mm length. The canals were prepared in a step-back manner. OrthoMTA was packed throughout the prepared canals. These root sections were incubated for one week and subsequently randomly allocated to five groups (n = 10) according to the OrthoMTA removal method: No treatment (NT); 5% glycolic acid + ultrasonics (5% GA+U); 10% glycolic acid + ultrasonics (10% GA+U); 10% citric acid + ultrasonics (10% CA+U); Distilled water + ultrasonics (DW+U). A 1 mm deep well was created within the coronal end of the set OrthoMTA. Wells were filled with each respective test solution and left for 5 min. Thereafter, further removal of OrthoMTA used a specific ultrasonic tip. Finally, the canals were flushed using 1 mL of the respective test solutions and activated with a Controlled Memory ultrasonic tip for two cycles of 20 s each followed by flushing with 1 mL of distilled water and paper point drying of the canals. Then, specimens were longitudinally split into two halves and examined under a scanning electron microscope (1000×) to assess the residual OrthoMTA and surface topography of root canal dentin. The Vickers surface microhardness of treated radicular dentin was measured using the HMV-2 microhardness tester.

RESULT

Data were analysed using one-way ANOVA followed by Tukey's post hoc test. Significant differences for residual OrthoMTA were observed between (10% GA+U) with (5% GA+U), (10% CA+U), (DW+U) and (NT) (p value < 0.01). In the context of microhardness, (5% GA+U) and (10% GA+U) showed statistically significant difference compared to (NT), (10% CA+U) and (DW+U) (p value < 0.01).

CONCLUSION

10% GA+U was superior to other tested groups in removing OrthoMTA, but it substantially reduced dentin microhardness.

Influence of Acidic Environmental Conditions on Push-Out Bonding Strength of Four Calcium Silicate-Based Materials to Root Dentin

Introduction. Calcium silicate-based cements (CSCs) are frequently used in various endodontic procedures such as perforation repair, vital pulp therapy, regenerative treatments, or apexification. One of their areas of use, treatment of perforations, can be challenging in clinical practice. Selection of stable, durable, and compatible material with structural and biological alterations is a must in such situations. Aim. This study aimed to compare the dislocation resistance of various calcium-silicate-containing materials used in endodontic treatment exposed to various environmental conditions in a push-out study model. Methods. Selected ninety-six human mandibular premolars with single root canals were cut from the middle portion to obtain dentin slices of 2 mm thickness (n = 192). Then, the canal lumen was enlarged by using #4Gates-Glidden drills. Specimens for each repair material (MTA, Angelus, Endosequence RRM (ERRM), Biodentine, BioMTA) were placed in shaped lumens, wrapped in pieces of gauze, and randomly divided into four groups (n = 48) according to the storage time and media: group A: 4 days in phosphate-buffered saline (PBS), group B: 4 days in acetic acid (pH = 4.4), group C: 34 days in PBS, and group D: 4 days in acetic acid (pH = 4.4) followed by exposure to PBS for 30 days. A universal testing machine measured the dislodgement resistance followed by scanning electron microscopy imaging to evaluate the material-dentin interface. Results. ERRM showed the highest dislocation resistance in all test groups ( $p<0.05$ ). The greatest bonding strength was observed (13,54 ± 5,56 MPa) after exposure to 34 days in PBS (pH = 7.2). The values for ERRM decreased in contact with acetic acid (pH = 4.4) and increased when placed in PBS ( $p>0.05$ ). Conclusion. All repair materials showed a higher dislocation resistance when stored in PBS regardless of storage time. However, the improved pH of the surrounding media was not successful in reversing the deteriorating effect caused by lower pH in relation to dislocation resistance in all tested materials except for ERRM.

Calcium hydroxide and niobium pentoxide treatment effects before MTA placement

The aim of this study was to evaluate the effect of calcium hydroxide (CH) and niobium pentoxide (NP) pretreatment on pH, dentin microhardness and sealing of Mineral Trioxide Aggregate (MTA; Angelus). The pH of CH, NP and CH-NP (3:1) was evaluated in neutral and acidic simulated tissue fluid over 28 days. The Vickers microhardness was measured in forty 4 mm coronal root slices filled with pretreatment materials stored in medium for 1, 7, 28 days. Forty 10 mm roots were packed with pretreatment materials, irrigated after 24 h, then a 3 mm MTA plug was placed. Sealing ability was evaluated after 7 days using fluid filtration method. Statistics was performed using ANOVA and post hoc Tukey HSD tests. Addition of NP to CH maintained the alkalinity of CH, increased the microhardness of root dentin and reduced the microleakage. CH-NP can be effectively used as a pretreatment medicament in root canals requiring placement of MTA under acidic conditions.

Pre-application of dentin bonding agent prevents discoloration caused by mineral trioxide aggregate

BACKGROUND

To evaluate tooth discoloration by newly developed calcium silicate-based materials, and to examine the pre-application of dentin bonding agent (DBA) for preventing discoloration caused by mineral trioxide aggregate (MTA).

METHODS

The roots of 50 premolars were randomly divided into five groups (n = 10) and cavities were prepared from resected root surfaces. MTA was placed in the cavities of teeth belonging to the ProRoot MTA (MTA) and RetroMTA (RMTA) groups. For teeth belonging to the ProRoot + DBA (MTA-B) and RetroMTA + DBA (RMTA-B) groups, DBA was first applied to the cavities prior to the addition of MTA. Teeth in the control group were restored with composite resin only (i.e., without MTA). After 12 weeks, MTA was removed from the MTA and RMTA groups and bleaching agents were applied for 3 additional weeks. Color assessments were recorded at baseline, and 1, 4, and 12 weeks, as well as after bleaching. A one-way ANOVA was performed to assess the differences between the two types of MTAs and color changes following DBA pre-application in each MTA group. A p-value of < 0.05 was considered indicative of statistical significance.

RESULTS

Following 12 weeks of MTA treatment, there was a significant difference between the discoloration in the MTA and RMTA groups (p < 0.05). However, no significant difference was observed between the RMTA and RMTA-B groups (p > 0.05). Following bleaching, the color changes (ΔE values) of the MTA group were not significantly different from those of the MTA-B group (p > 0.05). The difference of ΔE between the RMTA group after internal bleaching and the RMTA-B group was also not significant (p > 0.05).

CONCLUSIONS

RetroMTA caused significantly less discoloration than ProRoot MTA. Pre-application of DBA reduced discoloration caused by ProRoot MTA. MTA discoloration was improved equally well between DBA pre-application and post-bleaching.

The effects of sodium hypochlorite and ethylenediaminetetraacetic acid on the microhardness of Mineral Trioxide Aggregate and TotalFill Bioceramic Putty

This study aimed to evaluate the effects of 5% NaOCl and 17% EDTA on the Vickers microhardness of Mineral Trioxide Aggregate, MTA Angelus (MTAA), and TotalFill Bioceramic Putty (BCP) after 24 h and 8 days. Twenty-four samples of MTAA and BCP were tested for baseline microhardness at 24 h. They were divided into four subgroups (5% NaOCl or 17% EDTA, 24 h, 5% NaOCl or 17% EDTA at 8 days) and microhardness was evaluated at different time-points. Results were recorded and analysed statistically via one-way anova Kruskal-Wallis test and post hoc uncorrected Dunn's multiple comparison test. MTAA had a higher baseline microhardness than BCP. NaOCl reduced the microhardness of MTAA but increased that of BCP. EDTA reduced the microhardness for both materials at 24 h. At 8 days, EDTA reduced the microhardness of MTAA, while BCP exhibited an increase in microhardness. Enabling these materials to set for a week prior to exposure to irrigants improves their microhardness.

Effect of the Bone Graft on the Surface Microhardness of Endodontic Biomaterials

Introduction

During periapical surgery, using of bone products in large endodontic lesions, is a treatment option that could affect the properties of the retro-filling endodontic material. The aim of present study was to evaluate the effect of Osteon II bone powder on the surface microhardness of calcium-enriched mixture (CEM) and mineral trioxide aggregate (MTA).

Methods and Materials

Each material was mixed and carried into 40 sterile custom-made plastic cylinders. Half of the samples in each group were exposed to Osteon II. All cylinders were submerged in simulated tissue fluid and incubated at 37^°C and 100% relative humidity for 7 days. Surface microhardness values of each study group was attained using Vickers microhardness test. The data were analyzed statistically using two-way ANOVA and independent t-test at a significance level of 0.05.

Results

The highest and lowest microhardness values were recorded in the MTA/without Osteon and MTA/with Osteon groups, respectively. Irrespective of the presence or absence of bone powder, the overall microhardness of CEM cement and MTA was not significantly different. In the MTA group, the presence of the powder resulted in a significant decrease (P<0.05) of the microhardness; however, its effect on CEM cement was not significant (P>0.05).

Conclusion

Under the limitations of the present in vitro study, the presence of Osteon bone powder had no negative effect on the microhardness of CEM cement, contrary to its effect on MTA.

Biocompatibility of Mineral Trioxide Aggregate with TiO2 Nanoparticles on Human Gingival Fibroblasts

Background

The New compositions of white mineral trioxide aggregate (WMTA) or use of various additives like nanoparticles might affect MTA’s ideal characteristics This study was performed to evaluate the cytotoxicity of WMTA and WMTA with Titanium dioxide (TiO2) nanoparticles (1% weight ratio) at different storage times after mixing on human gingival fibroblasts (HGFs).

Material and Methods

HGFs were obtained from the attached gingiva of human premolars. HGFs were cultured in Dulbecco’s Modified Eagle medium, supplemented with 10% fetal calf serum, penicillin and streptomycin. The cells were exposed to WMTA (groups 1 and 2) and WMTA+TiO2 (groups 3 and 4). The fifth and sixth groups served as controls. Each group contained 15 wells. After 24h (groups 1, 3 and 5) and 48 h (groups 2, 4 and 6) of exposure, HGF viability was determined by Mosmann’s tetrazolium toxicity (MTT) assay. Statistical analysis of the data was performed by using one-way analysis of variance and Tukey post hoc test, with significance of p < 0.05.

Results

With both materials, the viability of HGFs significantly decrased with increasing the incubation time from 24h to 48 h (P<0.05). There was no significant difference between the materials regarding HGF viability (P>0.05).

Conclusions

Under the limitations of the present study, incorporation of TiO2 nanoparticles into MTA at 1 wt% had no negative effect on its biocompatibility.

Key words:Cytotoxicity, fibroblast, MTA, MTT assay, nanoparticle, TiO2.

Push-Out Bond Strength and Surface Microhardness of Calcium Silicate-Based Biomaterials: An in vitro Study

OBJECTIVE

This was an in vitro evaluation of push-out bond strength and surface microhardness of calcium silicate-based biomaterials in coronal and apical root dentin.

MATERIALS AND METHODS

Ninety sections (2 mm thick) of coronal and apical root dentin were obtained from roots of 60 extracted teeth; the canals were enlarged to a standardized cavity diameter of 1.3 mm. Sections were randomly divided into 6 groups (n = 15 per group), and cavities were filled with Biodentine™, BioAggregate, or ProRoot mineral trioxide aggregate (MTA), according to the manufacturers' instructions. Push-out bond strength values were measured using a universal testing machine under a compressive load at a speed of 1 mm/min. Samples were analyzed under a light microscope to determine the nature of bond failure. Ten samples (2 mm thick) were prepared for all the materials, and Vickers microhardness was determined using a digital hardness tester. Data were analyzed using one-way analysis of variance and Tukey-Kramer multiple comparison tests at a significance level of p < 0.05.

RESULTS

Biodentine (42.02; 39.35 MPa) and ProRoot MTA (21.86; 34.13 MPa) showed significantly higher bond strengths than BioAggregate (6.63; 10.09 MPa) in coronal and apical root dentin, respectively (p < 0.05). Biodentine also differed significantly from ProRoot MTA in coronal dentin. Bond failure was predominantly adhesive in Biodentine and ProRoot MTA, while BioAggregate showed predominantly mixed failure. ProRoot MTA (158.52 HV) showed significantly higher microhardness and BioAggregate (68.79 HV) showed the lowest hardness.

CONCLUSION

Biodentine and ProRoot MTA showed higher bond strength and microhardness compared to BioAggregate.

Carbohydrate-electrolyte drinks exhibit risks for human enamel surface loss

Objectives

The aim of this investigation was to give insights into the impact of carbohydrate-electrolyte drinks on the likely capacity of enamel surface dissolution and the influence of human saliva exposure as a biological protective factor.

Materials and Methods

The pH, titratable acidity (TA) to pH 7.0, and buffer capacity (β) of common beverages ingested by patients under physical activity were analyzed. Then, we randomly distributed 50 specimens of human enamel into 5 groups. Processed and natural coconut water served as controls for testing three carbohydrate-electrolyte drinks. In all specimens, we measured surface microhardness (Knoop hardness numbers) and enamel loss (profilometry, µm) for baseline and after simulated intake cycling exposure model. We also prepared areas of specimens to be exposed to human saliva overnight prior to the simulated intake cycling exposure. The cycles were performed by alternated immersions in beverages and artificial saliva. ANOVA two-way and Tukey HDS tests were used.

Results

The range of pH, TA, and β were 2.85 - 4.81, 8.33 - 46.66 mM/L and 3.48 - 10.25 mM/L × pH, respectively. The highest capacity of enamel surface dissolution was found for commercially available sports drinks for all variables. Single time human saliva exposure failed to significantly promote protective effect for the acidic attack of beverages.

Conclusions

In this study, carbohydrate-electrolyte drinks usually consumed during endurance training may have a greater capacity of dissolution of enamel surface depending on their physicochemical proprieties associated with pH and titratable acidity.