Addition of MTA in a salicylate-based resin root canal sealer to retrograde root-end filling

Aim To evaluate the flow, pH and calcium release of white MTA (WMTA), salicylate-based resin root canal sealer (Sealapex; SEAL) and SEAL containing 10 (SE10) or 20% (SE20) (w/w) of MTA. Methodology Flow test was realized according to ISO 6876 specification. The sealers samples (n= 10) were placed in polyethylene tubes and immersed in deionized water. After 24 hours and 7, 14, and 28 days, the water pH was determined with a pH meter, and calcium release was assessed by atomic absorption spectrophotometry. Results SEAL and WMTA showed respectively the highest and lowest flow rate when compared with the other materials (P<0.05). SE20 showed the highest pH value only in 24h and 7 days periods (p<0.05). In 14- and 28-days periods, SEAL showed the lowest pH value (p<0.05), but there are no differences between other groups (p>0.05). In all periods, WMTA and SEAL respectively showed the highest and lowest calcium release (p<0.05). Conclusions SE20 proves to be an association with better flow and handling than WMTA, with satisfactory potential for alkalinization and calcium release.

Marginal gaps and internal voids after root-end filling using three calcium silicate-based materials: A Micro-CT analysis

Abstract This study evaluated the 3D quality of root-end filling, assessing the presence (volume and percentage) of marginal gaps and internal voids formed after retro-filling with three calcium silicate-based materials: MTA Angelus (Angelus Soluçoes Odontologicas, Londrina, PR, Brazil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, France) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Florida, US). Thirty human, extracted, single rooted teeth were used. Orthograde root canal treatment, root resection (3mm shorter than the apex) and retrograde cavity preparation with ultrasonic tips were performed. Teeth were divided into 3 groups (n =10 each) following a stratified randomization according to the initial volume of the root-end cavity. After retrofilling, samples were stored for 7 days. Then, two rounds of micro-CT scans were performed: soon after root-end preparation (with the cavity still empty) and 7 days after root-end filling. Marginal gaps, internal voids volume (mm3 and %), as well as, the overall defects (sum of gaps and voids) were evaluated. Statistics compared the three groups in relation to those defects. There was not statistical difference between groups regarding the marginal gaps (P≥ 0.05), the internal voids (P≥ 0.05), and the overall defects (P≥ 0.05). Median (mm3) and % of overall air-entrapment defects (gaps and/or voids) was: 0.004mm3 and 1.749% for MTA Angelus, 0.018mm3 and 6.660% for Biodentine, and 0.012mm3 and 4.079% for Neo MTA Plus. All materials had gaps and/or voids. No differences were found between MTA Angelus, Biodentine and Neo MTA Plus.

Resumo Este estudo avaliou a qualidade 3D de retro-obturações, avaliando a presença (volume e percentagem) de "gaps" marginais e "voids" internos formados a partir da retro-obturação com três materiais à base de silicato de cálcio: MTA Angelus (Angelus Soluções Odontológicas, Londrina, PR, Brasil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, França) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Flórida, US). Trinta dentes humanos unirradiculares extraídos foram usados. Após tratamento de canal ortrógrado, resecção radicular (3 mm apicais), o prepare da cavidade retrógrada com pontas ultrassônicas foi realizado. Os dentes foram divididos em três grupos (n= 10 cada) seguindo uma randomização estratificada, de acordo com o volume inicial da cavidade retrógrada. Depois da retro-obturação as amostras foram armazenadas por 7 dias. Duas rodadas de escaneamento de micro-CT foram realizadas: logo após o preparo retrógrado (com a cavidade ainda vazia) e 7 dias após a retro-obturação. O volume de "gaps" marginais e de "voids" internos (mm3 e %), bem como, os defeitos totais (soma de "gaps" e "voids") foram avaliados. Não houve diferença estatística entre os grupos em relação aos "gaps" marginais (P≥ 0,05), "voids" internos (P≥ 0,05), e aos defeitos totais (P≥ 0,05). A mediana (mm3) e porcentagem dos defeitos totais de aprisionamento de ar foi 0,004mm3 e 1,749% para o MTA Angelus, 0,018mm3 e 6,660% para o Biodentine, e 0,012mm3 e 4,079% para o Neo MTA Plus. Todos os materiais tiveram defeitos ("gaps"e/ou "voids"). Não houve diferença entre MTA Angelus, Biodentine e Neo MTA Plus.

Push-out Bond Strength of Root-end Filling Materials

Abstract The aim of this study was to evaluate the bond strength of root-end filling materials. Forty 2-mm-thick slices were obtained from human single-rooted teeth. After root canal preparation using a 1.5 mm diameter cylindrical drill, the dentinal walls were prepared by diamond ultrasonic tip (CVD T0F-2). The specimens were divided according the material (n=10): MTA Angelus (MTAA), MTA Sealer (MTAS, experimental), Sealer 26 (S26) and zinc oxide and eugenol cement (ZOE). The push-out test was performed in a mechanical test machine (EMIC DL 2000) at 1 mm/min speed. The failure type was evaluated by stereomicroscopy. The results were subjected to ANOVA and Tukey test, at 5% significance level. MTAA (19.18 MPa), MTAS (19.13 MPa) and S26 (15.91 MPa) showed higher bond strength (p<0.05). ZOE (9.50 MPa) showed the least bond strength values (p<0.05). Adhesive failure was prevalent in all groups, except for ZOE, which showed mixed failures. It was concluded that root-end filling materials MTA Angelus, MTA Sealer and Sealer 26 showed higher bond strength to dentinal walls than zinc oxide and eugenol cement after retrograde preparation.

Resumo O objetivo deste estudo foi avaliar a resistência de união de materiais retrobturadores. Quarenta fatias de 2 mm de espessura foram obtidas a partir de dentes unirradiculares humanos. Após o preparo do canal radicular usando uma broca cilíndrica de 1,5 mm de diâmetro, as paredes de dentina foram preparadas usando uma ponta de ultra-som diamantada (CVD T0F-2). As amostras foram divididas de acordo com os materiais (n=10): MTA Angelus (MTAA), MTA Sealer (MTAS, experimental), Sealer 26 (S26) e óxido de zinco e eugenol (ZOE). O teste de push-out foi realizado utilizando uma máquina de ensaios mecânicos (EMIC DL 2000) com velocidade de 1 mm/min. O tipo de falha foi avaliado em estereomicroscópio. Os resultados foram submetidos a ANOVA e teste de Tukey, com níveis de variância de 5%. MTAA (19,18 MPa), MTAS (19,13 MPa) e S26 (15,91 MPa) apresentaram os maiores valores de resistência de união (p<0,05). ZOE (9,50 MPa) apresentou os menores valores de resistência de união (p<0,05). A falha adesiva foi prevalente em todos os grupos, com exceção do ZOE, que apresentou falhas mistas. Concluiu-se que os materiais retrobturadores MTA Angelus, MTA Sealer e Sealer 26 apresentam maior resistência de união às paredes dentinárias que o óxido de zinco e eugenol após o preparo retrógrado.

New Methodology to Evaluate Bond Strength of Root-End Filling Materials

This study evaluated the bond strength of root-end filling materials to root-end cavities using a new methodology. Twenty maxillary central incisors were subjected to biomechanical preparation (#80 hand file) and sectioned transversally 2 mm short of the apex and 4 mm coronally to this point. The root cylinders were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. Two groups (n=10) were formed according to the root-end filling material: MTA and Super EBA. A gutta-percha cone (#80) was tug-backed at the limit between the canal and the root-end cavity. The cavity was filled and the gutta-percha cone was removed after complete setting of the sealer. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and run at a crosshead speed of 1.0 mm/min for pushing out the root-end filling material. Data were analyzed by ANOVA (α=5%). Super EBA (6.03±1.31) presented higher bond strength (MPa) than MTA (1.81±0.45) (p>0.05). There was a predominance of cohesive failures for Super EBA and mixed for MTA. The protocol of specimen preparation is effective and introduces a specific methodology for assessing bond strength of root-end filling materials to dentin. Among the materials, Super EBA presented the highest bond strength.

Este estudo avaliou a resistência de união de materiais retrobturadores a cavidades retrógradas, usando uma nova metodologia. Vinte incisivos centrais superiores foram submetidos ao preparo biomecânico (lima manual #80) e seccionadas transversalmente a 2 mm do ápice e a 4 mm do primeiro corte. Os cilindros de raízes foram incluídos em resina acrílica e posicionado a 45° em relação ao plano horizontal para confecção das retrocavidades com ponta ultrassônica diamantada. Dois grupos (n = 10) foram formados de acordo com os cimentos utilizados: MTA e Super EBA. Um cone de guta-percha (#80) foi travado no limite da retrocavidade com o canal radicular. A retrocavidade foi preenchida e, após o tempo de endurecimento do cimento utilizado, o cone de guta-percha foi removido. Os espécimes foram fixados na máquina universal de ensaios Instron com a retrobturação voltada para baixo. A haste empregada para pressionar o cimento retrobturador no teste de push-out foi inserida no espaço anteriormente ocupado pela guta-percha e acionada com velocidade de cruzeta de 1,0 mm/min, para extrusão do material retroburador. Os dados foram analisados por meio do teste ANOVA (α=5%). O cimento Super EBA (6,03 ± 1,31) apresentou maior resistência de união (MPa) comparado ao cimento MTA (1,81 ± 0,45) (p> 0,05). Houve predomínio de falhas coesivas para o cimento Super EBA e falhas mistas para o MTA. O protocolo de preparação das amostras é eficaz e apresenta uma metodologia específica para avaliação da resistência de união de materiais retrobturadores à dentina. Dentre os materiais testados, o cimento Super EBA apresentou a maior resistência de união.

Comparison of physical and mechanical properties of mineral trioxide aggregate and Biodentine.

Background: Mineral trioxide aggregate (MTA) fulfills many of the ideal properties of the root‑end filling material. However, its low cohesive property often makes it difficult to handle. Biodentine, new calcium‑silicate‑based cement has been developed to improve some MTA drawbacks such as its difficult handling property and long‑setting time. Aim: The objective of this study was to compare at different times the microleakage of roots filled with Biodentine and white MTA (WMTA)‑Angelus and to investigate their setting time, handling properties and compressive strength. Materials and Methods: Root canals of single‑rooted teeth were instrumented, filled with either Biodentine or WMTA‑Angelus (n = 15 each) with two positive and two negative control roots and stored at 37°C. Sealing was assessed at 4, 24 h, 1, 2, 4, 8, and 12 weeks by a fluid filtration method. The initial setting time, handling properties, and compressive strength of the test groups were investigated by a vicat needle, questionnaire of operational hand feel, and universal instron machine, respectively. Results: Significant differences in microleakage were found between two groups at 4‑h and 24 h (P < 0.05) and no difference at 1, 2, 4, 8, and 12 weeks. No significant difference was seen in the setting time of MTA‑Angelus and Biodentine, though latter was found to have better handling consistency. Compressive strength of Biodentine was significantly higher than MTA‑Angelus. Conclusions: The results suggest that the new calcium‑silicate‑based endodontic cement provides improvement in sealing ability as well as clinical manageability of dental filling materials.

Análise físico-química do MTA e do cimento Portland associado a quatro diferentes radiopacificadores / Physicochemical analysis of MTA and Portland cement associated with four different radiopacifiers

Introdução: O Mineral Trióxido Agregado (MTA) é composto por cimento Portland (CP) e um radiopacificador (óxido de bismuto). Objetivo: Avaliar tempo de presa, solubilidade, pH, liberação de íons Cálcio e radiopacidade do cimento Portland puro ou associado a quatro radiopacificadores (sulfato de bário, carbonato de bismuto, óxido de bismuto e iodofórmio), comparados ao MTA branco (Angelus, Londrina, Brasil). Material e Método: A proporção empregada CP/radiopacificador foi de 4:1 em peso, (80% de cimento Portland e 20% de radiopacificador). A especificação 57 da ADA foi usada para avaliação do tempo de presa. A solubilidade foi analisada segundo a especificação ISO 6876/2001. A avaliação do pH foi realizada com peagâmetro digital e a liberação de íons Ca++foi verificada por meio de espectrofotômetro de absorção atômica. A radiopacidade foi determinada em milímetros de alumínio (mm/Al). Os resultados foram submetidos aos testes de Análise de Variância e Tukey, nível de significância 5%. Resultado: O sulfato de bário não alterou o tempo de presa final do CP. Radiopacidade inferior ao mínimo recomendado pelas normas da ADA nº 57 e ISO 6876/2001 foi observada para CP e CP associado com sulfato de bário. O CP associado ao iodofórmio apresentou solubilidade acima dos 3% recomendados pela ISO 6876/2001. Todos os materiais proporcionaram alcalinização do meio e promoveram liberação de íons cálcio. Conclusão: Carbonato de bismuto ou óxido de bismuto proporcionaram tempo de presa inicial, solubilidade, pH, liberação de íons Cálcio e radiopacidade adequados quando associados ao CP. .

Introduction: Mineral Trioxide Aggregate (MTA) is composed of Portland cement (PC), and a radiopacifier (bismuth oxide). Objective: To evaluate the setting time, solubility, pH, calcium ion release and radiopacity of pure Portland cement and its association to four radiopacifiers, (Barium sulfate, bismuth carbonate, bismuth oxide and iodoform), and White MTA (Angelus, Londrina, Brazil). Material and Method: The ratio CP/radiopacifier used was 4:1 by weight (80% Portland cement and 20% radiopacifier). The setting time was evaluated according the specification ADA 57. The solubility was analyzed according to ISO 6876/2001 specification. The pH was evaluated using a digital pHmeter and the release of Ca++ ions by atomic absorption spectrophotometer. The radiopacity was measured in millimeters of aluminum (mm/Al). The results were submitted to ANOVA and Tukey tests using 5% of significance level. Result: Barium sulfate did not alter the final setting time of the PC. Observed radiopacity was less than the minimum recommended by ADA 57 and ISO 6876/2001 for CP and CP associated with barium sulfate. The PC associated with iodoform showed solubility above the 3% recommended by ISO 6876/2001. All materials provided alkalinization and promoted calcium ion release. Conclusion: Bismuth carbonate and bismuth oxide provided proper initial setting time, solubility, pH, calcium ion release and radiopacity when combined with CP. .

Cytotoxicity of newly developed pozzolan cement and other root-end filling materials on human periodontal ligament cell

OBJECTIVES: The purpose of this study was to evaluate in vitro cytotoxicity of the pozzolan cement and other root-end filling materials using human periodontal ligament cell. MATERIALS AND METHODS: Endocem (Maruchi), white ProRoot MTA (Dentsply), white Angelus MTA (Angelus), and Super EBA (Bosworth Co.) were tested after set completely in an incubator at 37degrees C for 7 days, Endocem was tested in two ways: 1) immediately after mixing (fresh specimens) and 2) after setting completely like other experimental materials. The methods for assessment included light microscopic examination, cell counting and WST-1 assay on human periodontal ligament cell. RESULTS: In the results of microscopic examination and cell counting, Super EBA showed significantly lower viable cell than any other groups (p < 0.05). As the results of WST-1 assay, compared with untreated control group, there was no significant cell viability of the Endocem group. However, the fresh mixed Endocem group had significantly less cell viability. The cells exposed to ProRoot MTA and Angelus MTA showed the highest viability, whereas the cells exposed to Super EBA displayed the lowest viability (p < 0.05). CONCLUSIONS: The cytotoxicity of the pozzolan cement (Endocem) was comparable with ProRoot MTA and Angelus MTA. Considering the difficult manipulation and long setting time of ProRoot MTA and Angelus MTA, Endocem can be used as the alternative of retrofilling material.

Comparing the sealing properties of mineral trioxide aggregate and an experimental ceramic based root end filling material in different environments.

Background: An apical seal is an important factor in achieving success in surgical endodontics. Aim: The purpose of this study was to compare the sealing properties of mineral trioxide aggregate (MTA) with a new ceramic based root end filling material (Cold Ceramic) in different environments. Materials and Methods: One hundred teeth were selected. The root canals were instrumented and obturated. Except for the apical 2 mm, the root surfaces were sealed. After root resection, 3 mm depth root-end cavities were prepared. For each material, roots were divided into 3 equal subgroups and the root-end filling was done in different environments (dry, saliva contaminated, blood contaminated). Five roots served as positive and 5 roots as negative controls. Samples were immersed in 2% methylene blue dye. Roots were sectioned longitudinally and examined under stereomicroscope to record the extension of dye penetration. Results: All experimental groups demonstrated dye penetration. The lowest linear leakage was seen in Cold Ceramic blood contaminated group while the highest leakage was observed in MTA blood contaminated group. The linear dye penetration of both MTA and Cold Ceramic (CC) groups did not show any significant differences among different environments. Also, the difference between MTA and CC was not significant in dry and saliva contaminated subgroups. Only the difference between dye penetration of MTA and CC in blood contaminated subgroups showed significant difference ( P = 0.008). Conclusion: The sealing property of this ceramic based root end filling material (Cold Ceramic) is better than MTA in blood contaminated condition and at least similar to MTA in other conditions.

Similar Sealability Between Bioceramic Putty Ready-To-Use Repair Cement and White MTA

This study was designed to assess the ability to prevent glucose penetration of a bioceramic putty ready-to-use repair cement comparing to white mineral trioxide aggregate (WMTA). After root canal instrumentation, the apical 3 mm of maxillary incisors were resected and root-end cavities with depth of 3 mm were prepared with ultrasound and filled with the tested materials (15 roots per group). All roots were mounted in a double chamber system to assess glucose penetration using 15 psi pressure application. After 1 h, glucose concentrations in the lower chamber were measured following an enzymatic reaction. Four roots were used as controls. The Mann-Whitney test verified differences in glucose leakage between groups and the Tukey's test was used for multiple comparisons. Significance level was set at 5%. There was no significant difference in glucose leakage between iRoot BP Plus and White MTA groups. iRoot BP Plus had a similar ability to that of white MTA in preventing glucose leakage as a root-end filling material.

Este estudo foi desenhado para avaliar a capacidade de impedir a infiltração de glicose de um cimento reparador biocerâmico pronto para o uso, em comparação com o agregado trióxido mineral (MTA) branco. Após a instrumentação do canal radicular, os 3 mm apicais de incisivos superiores foram removidos, e retropreparos com 3 mm de profundidade foram realizados com ultra-som. As cavidades retrógradas foram preenchidas com os materiais testados (15 raízes por grupo). Todas as raízes foram montadas em um sistema de câmara dupla para avaliar a infiltração de glicose utilizando a aplicação de pressão de 15 psi. Depois de 1 h, concentrações de glicose na câmara inferior foram medidas seguida de uma reação enzimática. Quatro raízes foram usadas como controle. O teste de Mann-Whitney verificou diferenças na infiltração de glicose entre os grupos e o teste de Tukey realizou comparações múltiplas. A significância foi estabelecida em α= 5%. Não houve diferença significante entre a média e a mediana comparando-se os grupos do iRoot BP Plus e o MTA branco. iRoot BP Plus teve uma capacidade semelhante ao do MTA branco na prevenção da infiltração de glicose como material retroobturador.

Sealing ability of white and gray mineral trioxide aggregate mixed with distilled water and 0.12% chlorhexidine gluconate as a root end filling material: An ex vivo evaluation.

Aim: The aim of this study was to evaluate the sealing ability of white and gray mineral trioxide aggregate (MTA) mixed with distilled water and 0.12% chlorhexidine (CHX) gluconate when used as a root-end filling material using the dye-penetration technique. Materials and Methods: A total of 48 single-rooted human teeth were cleaned, shaped, and obturated with gutta-percha and AH Plus sealer. The apical 3 mm of each root was resected, and 3-mm deep root-end cavity preparations were made. The teeth were randomly divided into 4 experimental groups, each containing 8 teeth, and 2 negative and positive control groups, each containing 8 teeth. Root-end cavities in the experimental groups were filled with the experimental materials. After application of nail polish, the teeth were exposed to India ink for 72 h and longitudinally sectioned, and the extent of dye penetration was measured with a stereomicroscope. Results : No statistically significant differences were observed in the sealing ability of gray and white MTA mixed with distilled water and 0.12% CHX. Conclusion : CHX appears to be a good alternative to replace distilled water, as a solution to be mixed with MTA.

Biocompatibility of root-end filling materials: recent update

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials.

Avaliação do selamento proporcionado pelo cimento MTA e pasta LC em retro-obturações / Sealing evaluation of mineral trioxide aggregate and pasta LC in retrofilling

Este estudo teve por objetivo avaliar o selamento proporcionado por dois materiais em retro-obturações. Trinta e três dentes humanos permanentes não vivos cujos canais radiculares foram retro-obturados, foram utilizados e divididos aleatoriamente em três grupos iguais, de acordo com o material empregado: G1 = Pasta LC, G2 = MTA e G3 = LC+MTA. As amostras foram impermeabilizadas, imersas em soro fetal bovino por 48 horas e, a seguir, clivados longitudinalmente para medir a infiltração por meio de escores. O resultado dos três grupos foi semelhante depois de submetidoà análise estatística por meio do teste de Kruskal-Wallis.

The purpose of this study was to evaluate the apical sealing of two materials in root-end filling. For this, thirty-three permanent human teeth were root-end prepared divided in three groups randomly, with eleven teeth in each one. The following materials were used: G1 = Pasta LC, G2 = MTA and G3 = LC+MTA. The samples were waterproofed and immersed in fetal bovine serum for 48 hours. After, the roots were separated longitudinally for measuring the infiltration by scores. The results were similar among the groups after submitted to the analysis statistics using the test of Kruskal-Wallis.

Avaliação da radiopacidade de diferentes materiais utilizados como retrobturadores / Evaluation of radiopacity of different used as root-end filling materials

Objetivo: O presente estudo tem como objetivo avaliar a radiopacidade de três materiais utilizados como retrobturadores. Métodos: Foram avaliados a radiopacidade de três cimentos: Sealer 26, Cimento Portland e Fillapex associado com 50% de cimento Portland.Para a determinação da radiopacidade, foram confeccionados corpos de provas cilíndricos de 10 mm de diâmetro e 1 mm de altura com os cimentos em teste e cilindros de dentina de mesma espessura, de acordo com a norma ISO 6876:2001. Após a sensibilização e processamento das películas, as imagens foram digitalizadas e analisadas quanto a densidade radiográfica no programa Digora 1.51. O valor da radiopacidade foi determinado em densidade radiográfica que foi, também, convertida em milímetros de alumínio (mm Al). Resultados: Os resultados demonstraram que o Sealer 26 possui maior radiopacidade, seguido pelo Fillapex associado com 50% de Cimento Portland e o cimento Portland. Conclusão: Conclui-se que todos os materiais apresentaram radiopacidade maior que a dentina e as normas da ISO, com exceção do cimento Portland.

Aim: The present study aims to evaluate the radiopacity of three used as root-end filling materials. Methods: To evaluated the radiopacity of three cement: Sealer 26, Fillapex associated with 50% of Portland cement and Portland cement. For the determination of radiopacity, cylindrical specimens with 10 mm in diameter and 1mm in thickness were made with the cements under test and dentin cylinders of equal thickness, according to ISO 6876:2001. After the raising and processing of films, the images were digitized andanalyzed for the radiographic density in Digora 1.51. The value of radiopacity was determined in radiographic density that was also converted into millimetres of aluminium (mm Al). Results: The results showed that the Sealer 26 has greater radiopacity, followed by Fillapex associated with 50% of Portland cement and Portland cement. Conclusion: It is concluded that all materials presented radiopacity is greater than the dentin and the ISO standards, with the exception of Portland cement.

Root - End Filling Materials - A Review.

When non-surgical root canal treatment fails to resolve periradicular lesions of endodontic origin or if retreatment is not feasible surgical intervention is recommended. Management of root end during endodontic surgery involves apical resection,retropreparation and retrofilling to seal the root canal. Numerous materials have been suggested and the newer ones like MTA, Castor Oil Polymer and calcium phosphate have shown promising results . This article is a review of literature on the suitability of various root end filling materials based on their leakage assessment, marginal adaptation, cytotoxicity and usage tests in experimental animals and humans.

Sealing ability, marginal adaptation and their correlation using three root-end filling materials as apical plugs

OBJECTIVE: This study used dye leakage assay and scanning electron microscopy to evaluate, respectively, the sealing ability and marginal adaptation of three root-end filling materials used as apical plugs, as well as the possible correlation between these properties. MATERIAL AND METHODS: Ninety-eight single-rooted human teeth were prepared to simulate an open apex. The teeth were allocated to three experimental groups (n = 30), which received a 5-mm thick apical plug of (1) gray MTA AngelusTM, (2) CPM TM and (3) MBPc, and two controls groups (n = 4). After immersion in 0.2 percent Rhodamine B solution for 48 h, the teeth were sectioned longitudinally and analyzed by Image Tool 3.0 software. The marginal adaptation between apical plugs and the root canal walls were analyzed by SEM. RESULTS: MBPc had significantly less (p<0.05) apical leakage than the other materials. Regarding marginal adaptation, CPM TM showed the best numerical results, though without statistical significance from the other materials (p<0.05). There was no correlation between the two properties. CONCLUSIONS: When used as apical plugs, the tested root-end filling materials had similar marginal adaptation to the dentin walls, but MBPc had the best sealing ability, as demonstrated by the least apical leakage from all tested materials.

Propriedades e aspectos biológicos do agregado trióxido mineral: revisão da literatura / Properties and biological aspects of mineral trioxide aggregate: literature review

O material obturador ideal deve apresentar características específicas, como biocompatibilidade, selamento marginal adequado, capacidade de permitir ou induzir o reparo ósseo e facilidade de manipulação e inserção. O agregado trióxido mineral (MTA) foi desenvolvido como um material para obturação retrógrada com melhores propriedades químicas, físicas e biológicas do que os materiais existentes na época, como amálgama, material restaurador intermediário (IRM) e SuperEBA. Atualmente, o MTA é usado como material de preenchimento radicular no selamento apical, no reparo de perfurações e como agente de capeamento pulpar, além de ser usado como material de obturação retrógrada. O objetivo deste artigo foi realizar uma revisão da literatura acerca do agregado trióxido mineral, comparando-o com os principais cimentos endodônticos e materiais obturadores retrógrados disponíveis no mercado para a retrobturação do sistema de canais radiculares, analisando suas propriedades e características biológicas. Concluiu-se que o MTA é um material obturador retrógrado bastante satisfatório do ponto de vista químico-físico-biológico, especialmente por sua biocompatibilidade e seu potencial de ação osteocondutora, osteoindutora e cementocondutora.

The ideal root canal sealer should present specific characteristics, as biological compatibility, appropriate marginal sealing, ability to allow or induce bone repair, and ease of manipulation and insertion. Mineral trioxide aggregate (MTA) was developed such a retro-sealer with better chemistry, physics and biological properties than materials that exist at the time, as amalgam, intermediate restorative material (IRM), and SuperEBA. Actually, MTA is used such a canal filling material to seal root apical, at drilling repair, and as a pulp capping agent; in addition, it is used as a filling retrograde material. The purpose of this study was a literature review about mineral trioxide aggregate, comparing it to the main endodontic cements and retro-sealer materials available at market for root canal filling retrograde filling, analyzing its properties and biological characteristics. It was concluded MTA is a quite satisfactory retro-sealer material, in terms of its chemical-physical-biological properties, especially due to its biocompatibility, and potential actions do conduce and induce the repair of bone and cementum.

Evaluation of subcutaneous and alveolar implantation surgical sites in the study of the biological properties of root-end filling endodontic materials

OBJECTIVE: The aim of this study was to compare two methodologies used in the evaluation of tissue response to root-end filling materials in rats. MATERIAL AND METHODS: Forty rats were divided into 4 groups: in Groups I and II (control groups), empty polyethylene tubes were implanted in the extraction site and in the subcutaneous tissue, respectively; in Groups III and IV, polyethylene tubes filled with ProRoot MTA were implanted in the extraction site and in the subcutaneous tissue, respectively. The animals were killed 7 and 30 days after tube implantation, and the hemi-maxillas and the capsular subcutaneous tissue, both with the tubes, were removed. Specimens were processed and evaluated histomorphologicaly under light microscopy. The scores obtained were analyzed statistically by the Kruskal-Wallis test (p<0.05). RESULTS: There were no statistically significant differences between the implantation methods (p=0.78033, p=0.72039). It was observed that the 30-day groups presented a more mature healing process due to smaller number of inflammatory cells. CONCLUSIONS: The present study showed no differences in tissue responses as far as the implantation site and the studied period were concerned. Alveolar socket implantation methodology represents an interesting method in the study of the biological properties of root-end filling endodontic materials due to the opportunity to evaluate bone tissue response.

The effect of several root-end filling materials on MG63 osteoblast-like cells / 대한치과보존학회지

The purpose of this study was to compare mineral trioxide aggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK, USA), which is widely used as root-end filling material, with DiaRoot BioAggregate (DB; Innovative BioCaramix Inc, Vancouver, BC, Canada), newly developed product, by using MG63 osteoblast-like cells. MTA, DB, and Intermediate Restorative Material (IRM; Dentsply Caulk, Milford, DE, USA) were used for root-end filling material while tissue culture plastic was used for control group. Each material was mixed and, the mixtures were left to set for 24 hours. MG63 cells were seeded to each group and then they were cultured for attachment for 4 hours. Following the attachment of cells to the root-end filling material, early cellular response was observed. After another 12 hours'culture, the level of attachment between cells and material was observed and in order to identify the effect of each material to bone formation, transforming growth factor beta1 (TGFbeta1) and osteocalin (OC) were estimated by using enzyme-linked immunosorbent assay (ELISA), and the amount of alkaline phosphatase (ALP) was also measured. The data were analyzed using one-way ANOVA. As a result, only at OC and the number of cells which were attached to materials, there was no statistical difference between MTA and DB. At other items, there was statistically significant difference in all groups. Although DB has not shown exactly the same cellular response like that of MTA, the number of attached cells shows that biocompatibility of the material and OC indicates bone formation rate. Therefore, if DB is used for root end filling material, it is expected to lead to similar results to MTA.

Mineral trioxied aggregate and its substitutes / 대한치과보존학회지

Since its introduction in 1993, Mineral Trioxide Aggregate (MTA) has been shown to be superior to others in sealing, biocompatibility, and many other aspects of clinical endodontics. MTA is primarily Portland cement with bismuth oxide as a radiopacitifier. Although some studies suggested that the reasonable-priced Portland cement could be used instead of MTA, but MTAs are different from Portland cement in its composition, especially in heavy metal contents. Therefore, clinicians should be meticulous adapting the Portland cement as a MTA substitute.

Sealing ability of castor oil polymer as a root-end filling material

OBJECTIVE: The purpose of this study was to evaluate the sealing ability of castor oil polymer (COP), mineral trioxide aggregate (MTA) and glass ionomer cement (GIC) as root-end filling materials. Forty-five single-rooted human teeth were cleaned and prepared using a step-back technique. The apical third of each root was resected perpendicularly to the long axis direction. All teeth were obturated with gutta-percha and an endodontic sealer. After, a root-end cavity with 1.25-mm depth was prepared using a diamond bur. The specimens were randomly divided into three experimental groups (n=15), according to the root-end filling material used: G1) COP; G2) MTA; G3) GIC. The external surfaces of the specimens were covered with epoxy adhesive, except the root-end filling. The teeth were immersed in rhodamine B dye for 24 hours. Then, the roots were sectioned longitudinally and the linear dye penetration at the dentin/material interface was determined using a stereomicroscope. ANOVA and Tukey's tests were used to compare the three groups. The G1 group (COP) presented smaller dye penetration, statistically different than the G2 (MTA) and G3 (GIC) groups (p<0.05). No statistically significant difference in microleakage was observed between G2 and G3 groups (p>0.05). The results of this study indicate that the COP presented efficient sealing ability when used as a root-end filling material showing results significantly better than MTA and GIC.