Search Results (11)

When performing an apicoectomy avoiding the microleakage is desired. That is why materials used for this procedure should be resistant to washout. Washout refers to the tendency of freshly prepared materials to disintegrate upon contact with fluids. Background/Objectives: The aim of this paper is to provide a literature review on the washout resistance of bioactive root-end filling materials. Methods: This systematic review was conducted following the PRISMA 2020 guidelines. International databases (PubMed, Google Scholar, ScienceDirect, and Wiley Online Library) were searched, and articles published in the last 20 years were selected for analysis. The following keywords were used “antiwashout”, “washout resistance”, “washout in dentistry”, “root-end filling materials”, “calcium silicate-based cements”, “bioceramic materials”. A total of 6 in vitro studies that met all the inclusion criteria were included in the analysis. The overall risk of bias was low in all six studies. Results: Most tested bioceramic materials are Endocem, Capasio, and Ceramicrete-D. Generex-A, MTA-Plus, MTA-AW, Bioaggregate, and MTA HP usually demonstrate very good washout resistance. ProRoot and MTA Angelus performed differently depending on the test; however, generally they showed good washout resistance. The Biodentine material showed significant washout, and requires further research. There is still a lack of a unified method for washout evaluation in dentistry, which makes it difficult to compare different studies. Conclusions: The study the confirmed excellent washout resistance of EndoCem, Capasio, Ceramicrete-D, Generex-A, Bioaggregate, MTA-Plus, and MTA HP. ProRoot, MTA-Angelus, and MTA Angelus White exhibited lower washout resistance. Biodentine shows poor washout resistance, and requires further research. A unified method for assessing washout would be beneficial for comparing different studies. Full article

Objective. In this study, the biological effect of MTA Repair HP (Mineral Trioxide Aggregate Repair High Plasticity) and Biodentine have been tested on a stabilized fibroblast cell line NCTC clone 929. Materials and Methods. We assessed quantitative and qualitative parameters related to cytotoxic effect of the investigated products. The experimental period was 96 hours. Statistical analysis was performed with Kruskal-Wallis and Wilcoxon tests. Results. The detached cells test showed no statistically significant difference on cell culture for Biodentine and MTA Repair HP, while for the cellular density assay we found the same biological effect on the tested fibroblasts in the first 24 and 48 h, but a significant different cellular response for the investigated pulp capping materials for the next 48 h of the experiment. Conclusions. The results demonstrated that the materials presented a very low level of cytotoxicity. Biodentine showed in all parameters better biological effects than MTA Repair HP, expressed by lower and limited cellular damage and a higher cell density. Full article

The present study evaluated the cytocompatibility of three endodontic bioceramics in human periodontal-ligament-derived cells (hPDLCs): MTA Repair HP (HP), MTA Flow White (F), and Nishika Canal Sealer BG multi (BG). In addition, we also evaluated the effect of the powder–liquid (paste) ratio of F and BG on cytocompatibility. Discs of endodontic bioceramics (diameter = 8 mm, thickness = 1 mm) were prepared with HP, F, and BG. hPDLCs obtained from extracted teeth and cultured for three to five passages were used in the experiment. The prepared discs were placed at the bottom of a 48-well plate, seeded with hPDLCs at 100,000 cells/well, cultured for 7 or 28 days, and subjected to a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. hPDLCs cultured without any discs were used as a negative control (NC) group. Discs made of F or BG mixed in three different consistencies were also used in this experiment. The absorbance values at days 7 and 28 were high in the order of HP > NC > BG > F. Furthermore, F or BG with higher consistency showed higher absorbance values. MTA Repair HP had the highest cytocompatibility among the three materials. Furthermore, it also showed that higher consistency improved cytocompatibility. Full article

Fast-setting bioactive cements were developed for the convenience of retrograde fillings during endodontic microsurgery. This in vitro study aimed to investigate the effect of irrigation on the washout of relatively fast-setting materials (Biodentine, EndoCem Zr, and MTA HP) in comparison with MTA Angelus White and IRM in an apicectomy model. Washout resistance was assessed using artificial root ends. A total of 150 samples (30 for each material) were tested. All samples were photographed using a microscope, and half of them were also scanned. The samples were irrigated and immersed in saline for 15 min. Then the models were evaluated. Rinsing and immersing the samples immediately after root-end filling and after 3 min did not disintegrate the fillings made of all tested materials except Biodentine. Root-end fillings made of Biodentine suffered significant damage both when rinsing was performed immediately and 3 min after the filling. Quantitative assessment of washed material resulted in a slight loss of IRM, EndoCem MTA Zr, and MTA HP. MTA Angelus White showed a slightly greater washout. Rinsing and immersion of Biodentine restorations resulted in their significant destruction. Under the conditions of the current study, the evaluated materials, excluding Biodentine, showed good or relatively good washout resistance. Full article

Discolouration resulting from regenerative endodontic procedures may have a negative impact on the quality of life of treated patients; therefore, it is recommended to minimize this risk by selecting appropriate scaffolds and barrier materials, and if discolouration occurs, the use of a simple, cost-effective and minimally invasive technique, such as whitening, should be considered. This in vitro study aimed to evaluate tooth discolouration after two- and single-visit regenerative endodontic procedures and the effectiveness of subsequent whitening procedures with carbamide peroxide. Two hundred bovine incisors were included in this study and divided into twenty groups based on the tested material combinations. Two groups were control groups, one with saline and the other group with blood. In the 12 groups, the experiment was designed to be consistent with the two-visit regenerative endodontic procedures. Triple antibiotic paste or calcium hydroxide were placed in the root canal, and then scaffolds (e.g., blood or platelet-rich fibrin) and barrier materials (Biodentine, OrthoMTA or MTA Repair HP) were applied after rinsing the disinfectant pastes. In the six groups that corresponded to the single-visit regenerative endodontic procedure, the use of a disinfectant paste was omitted. Subsequently, the specimens were bleached twice with carbamide peroxide at a 7-day interval. Colour change measurements were performed using a spectrophotometer (VITA Easyshade Compact 5.0, VITA Zahnfabrik, Bad Säckingen, Germany). Statistical analysis was performed with the Kruskal–Wallis H test, the independent t-test and t-test for related samples. Tooth discolouration was noticed after two- and single-visit regenerative endodontic procedures, except for the platelet-rich fibrin+MTA Repair HP group. After the first and second whitening procedures, all of the tested two- and single-visit regenerative endodontic procedures groups showed a change in the colour of the crown, which was noticeable to the naked eye (∆E > 3.3). When analysing the ∆E value between the first and second bleaching procedures, no changes in the colour of teeth were visually noticed in the calcium hydroxide and platelet-rich fibrin +MTA Repair HP groups (∆E < 3.3). Single-visit regenerative endodontic procedures are suggested if possible; however, if two-visit regenerative endodontic procedures are performed, it is recommended to use calcium hydroxide as the disinfectant paste because of the lower staining potential. In the context of discolouration, platelet-rich fibrin is advisable for use as a scaffold. The whitening procedure is worth considering, but does not guarantee a return to the original tooth colour, especially when triple antibiotic paste is used. Full article

Calcium silicate-based cements are biocompatible materials for vital pulp therapy. However, they discolour the tooth tissue, which is important for the aesthetics of the anterior teeth. The aim of this study was to investigate the effect of calcium silicate-based cements on tooth discolouration. The study included 70 extracted bovine incisors. The crown of the tooth was cut off from the root, 2 mm below the cement-enamel junction. The pulp tissue was removed via a cervical cut with a barbed broach. The teeth were randomly divided into five experimental, one positive, and one negative control groups. The evaluated materials included Biodentine, Ortho MTA, Retro MTA, MTA Plus, MTA Repair HP, and in the positive group, ProRoot MTA. A VITA Easyshade Compact 5.0 spectrophotometer was used before the application, after 1 week, 1 month, 3 months, and 6 months. The significance levels were set at p < 0.05. All materials significantly changed the teeth colour (p < 0.05). However, Ortho MTA, ProRoot MTA, MTA Plus, and Biodentine (ΔE > 6) caused maximum colour change after 6 months. While the ProRoot MTA, Ortho MTA, and MTA Plus caused grey discolouration, Biodentine darkened the shade of the base colour. Thus, Retro MTA and MTA Repair HP can be safely used in the aesthetic dentition zone. According to these clinical results, the possibility of using Biodentine, due to its lack of gray discoloration, can be considered. Full article

Bioactive calcium silicate cement Mineral Trioxide Aggregate (MTA) has been used for years as a gold standard in intravital pulp treatment and specialist endodontic procedures. Owing to flaws of the material, the manufacturers have been trying to enhance and produce materials showing improved physical, chemical and biological parameters. One of the new calcium-silicate cements based on mineral trioxide aggregate, however without some flaws exhibited by the cement, is Mineral Trioxide Aggregate Repair High Plasticity (MTA HP). The aim of the present paper was a systematic literature review concerning the MTA HP material used nowadays in dentistry, as a review of its specific features. The present paper is the first article providing a systematic literature review on MTA HP. The aim of the present article is the better understanding of MTA HP properties, which can aid the decision-making process in endodontic treatment. Full article

The aim of the present in vitro study was to investigate the effects of 10% and 40% citric acid (CA) on the color of calcium silicate–based cements (CSCs) in comparison to the effects of common root canal irrigants. Samples of six CSCs (n = 6)—ProRoot MTA (Dentsply, Tulsa, OK, USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), MTA Plus (Avalon Biomed Inc, by Prevest Denpro Limited, Jammu, India), MTA Repair HP (Angelus, Londrina, PR, Brazil), Ortho MTA (BioMTA, Seoul, Korea), and Retro MTA (BioMTA, Seoul, Korea)—were immersed in 10% and 40% CA as well as 15% EDTA, 2% NaOCl, 2% CHX, and 0.9% NaCl for 15 min, 1 h, and 24 h. ΔE values, representing the difference between the final and baseline values of the color components, were then determined using a VITA Easyshade Compact 5.0 spectrophotometer. Naked-eye evaluation of the changes in color and structures of the materials was performed using our own scale. Upon immersion of the materials in both 10% and 40% CA, there were statistically significant differences between spectrophotometric color measurement results for all CSCs (P < 0.05). However, CA does not cause dark discoloration, observable with the naked eye, of any of the materials, such as NaOCl and CHX. Significant statistical differences were also found between all CSCs in terms of submersion duration (P < 0.05). CA, which could be an alternative to EDTA use, caused greater CSCs discoloration and changed some of their structures. Unless required by the therapeutic procedure, clinicians should pay attention to the fact that the irrigant may affect the CSCs discoloration and minimize the contact time of irrigant with CSCs. Full article

The aim of the present study was to investigate the new silicate cement mineral trioxide aggregate (MTA Repair HP) with respect to its effect on the inflammation process involving the tooth and periodontal tissues. The composition of MTA Repair HP was supplemented with plasticizer agents which can have a negative effect on the modulation of tooth inflammation. The silicate-based material in question is widely used in regeneration of the pulp-dentin complex, treatment of perforations of various locations in the tooth, as well as in surgical treatment of the complications of periapical tissue. The improved bioceramic restorative cement can affect the expression of metalloproteinases MMP-2 and MMP-9 in monocytes/macrophages involved in modulation of inflammation and regenerative processes of the tooth and periodontal tissues. The novel aspect of the present study lies in the application of the model of THP-1 monocyte/macrophage and applying the biomaterial in direct contact with the cells. Hence, it provides a representation of clinical conditions with respect to regenerative pulp and periodontal treatment with the use of MTA Repair HP. A lack of macrophage activation (as measured with flow cytometry) was found. Moreover, the study identified a lack of expression stimulation of the studied metalloproteinases (with the use of Western blotting and fluorescent microscopy). Similarly, no increase in MMP-2 and MMP-9 concentration was found (measured by ELISA method) in vitro when incubated with MTA Repair HP. Based on the results it can be concluded that new MTA Repair HP does not increase the inflammatory response in monocytes/macrophages associated with the activity of the described enzymes. It can also be speculated that they do not affect the process of dentin regeneration in which MMP-2 and MMP-9 play significant roles. Full article

There are limited data regarding the potential effect of erbium, chromium: yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser-activated irrigation (LAI) on the microleakage qualities of calcium silicate-based cements. The objective of the present study was to assess the effect of LAI on the microleakage qualities of MTA Repair HP (MTA-HP) and NeoMTA Plus (Neo) used in root-end filling and to compare the antimicrobial effectiveness of MTA- HP. Two experimental sets were conducted: antimicrobial activity (agar diffusion test/at 24, 48 h) and microleakage (glucose leakage model/at 1st, 10th, 20th days). Antimicrobial activities of MTA-HP, Neo, Biodentine, ProRoot and MTA Angelus were evaluated, and inhibition zones were observed not only against a range of Gram-positive and Gram-negative bacteria but also against yeast at 48h. For microleakage evaluation, fifty teeth were prepared to simulate the clinical situation where the root-tips (apex) are open, and randomly divided into two experimental groups (n = 20/group) according to the cement type (MTA-HP and Neo), and two control (n = 5/group) groups. Each experimental group was further divided into two subgroups (n = 10/group) with respect to LAI: MTA-HP, L-HP, Neo, L-Neo. A statistical difference was only detected between Neo and L-HP groups on day 1. Subsequently, MTA-HP exhibited superior microleakage quality compared to Neo in the short-term. Er,Cr:YSGG laser-activated irrigation could be used as a reliable technique without creating adverse effects on the sealing abilities of MTA Repair HP and NeoMTA Plus. Full article

Mineral trioxide aggregate (MTA) is considered a bioactive endodontic material, which promotes natural mineralization at the material-tooth tissue interface. MTA Repair HP stands out because of the short setting time and the quick and effective bioactive response in vitro. The bioactivity, depens on material composition and microstructure. This work is devoted to analyze MTA Repair HP microstructural features, of both the powder precursor and set material, to get insights into the material physicochemical parameters—functionality performance relationships. Transmission electron microscopy (TEM), and field emission gun scanning electron microscopy (FEG-SEM) coupled with energy-dispersive X-ray (EDX) analyses were performed. X-ray diffraction (XRD) measurements were carried out at different times to investigate setting process. Bioactivity evaluation in vitro was carried out by soaking the processed cement disk in simulated body fluid (SBF). The presented results point out those MTA Repair HP precursor material characteristics of tricalcium silicate particles of nanometric size and high aspect ratio, which provide an elevated surface area and maximized components dispersion of calcium silicate and very reactive calcium aluminate. The MTA Repair HP precursor powder nanostructure and formulation, allows a hydration process comprising silicate hydrate structures, which are very effective to achieve both fast setting and efficient bioactive response. Full article