Ytterbium Oxide as Radiopacifier of Calcium Silicate-Based Cements. Physicochemical and Biological Properties.

This study evaluated physicochemical properties, cytotoxicity and bioactivity of MTA Angelus (MTA), calcium silicate-based cement (CSC) and CSC with 30% Ytterbium oxide (CSC/Yb2O3). Setting time was evaluated using Gilmore needles. Compressive strength was evaluated in a mechanical machine. Radiopacity was evaluated using radiographs of materials and an aluminum scale. Solubility was evaluated after immersion in water. Cell viability was evaluated by means of MTT assay and neutral red staining, and the mineralization activity by using alkaline phosphatase activity and Alizarin Red staining. The data were submitted to ANOVA, Tukey and Bonferroni tests (5% significance). The bioactive potential was evaluated by scanning electron microscopy. The materials presented similar setting time. MTA showed the lowest compressive strength. MTA and CSC/Yb2O3 presented similar radiopacity. CSC/Yb2O3 showed low solubility. Saos-2 cell viability tests showed no cytotoxic effect, except to 1:1 dilution in NR assay which had lower cell viability when compared to the control. ALP at 1 and 7 days was similar to the control. MTA and CSC had greater ALP activity at 3 days when compared to control. All the materials present higher mineralized nodules when compared with the control. SEM analysis showed structures suggesting the presence of calcium phosphate on the surface of materials demonstrating bioactivity. Ytterbium oxide proved to be a properly radiopacifying agent for calcium silicate-based cement since it did not affected the physicochemical and biological properties besides preserving the bioactive potential of this material.

Ytterbium oxide as radiopacifier of calcium silicate-based cements. physicochemical and biological properties

Abstract This study evaluated physicochemical properties, cytotoxicity and bioactivity of MTA Angelus (MTA), calcium silicate-based cement (CSC) and CSC with 30% Ytterbium oxide (CSC/Yb2O3). Setting time was evaluated using Gilmore needles. Compressive strength was evaluated in a mechanical machine. Radiopacity was evaluated using radiographs of materials and an aluminum scale. Solubility was evaluated after immersion in water. Cell viability was evaluated by means of MTT assay and neutral red staining, and the mineralization activity by using alkaline phosphatase activity and Alizarin Red staining. The data were submitted to ANOVA, Tukey and Bonferroni tests (5% significance). The bioactive potential was evaluated by scanning electron microscopy. The materials presented similar setting time. MTA showed the lowest compressive strength. MTA and CSC/Yb2O3 presented similar radiopacity. CSC/Yb2O3 showed low solubility. Saos-2 cell viability tests showed no cytotoxic effect, except to 1:1 dilution in NR assay which had lower cell viability when compared to the control. ALP at 1 and 7 days was similar to the control. MTA and CSC had greater ALP activity at 3 days when compared to control. All the materials present higher mineralized nodules when compared with the control. SEM analysis showed structures suggesting the presence of calcium phosphate on the surface of materials demonstrating bioactivity. Ytterbium oxide proved to be a properly radiopacifying agent for calcium silicate-based cement since it did not affected the physicochemical and biological properties besides preserving the bioactive potential of this material.

Resumo Este estudo avaliou as propriedades físico-químicas, citotoxicidade e bioatividade do MTA Angelus (MTA), cimento à base de silicato de cálcio (CSC) e CSC com 30% de óxido de itérbio (CSC/Yb2O3). O tempo de presa foi avaliado usando agulhas Gilmore. A resistência à compressão foi avaliada em uma máquina mecânica. A radiopacidade foi avaliada utilizando radiografias dos materiais e uma escala de alumínio. A solubilidade foi avaliada após imersão em água. A viabilidade celular foi avaliada por meio do ensaio MTT e coloração de vermelho neutro (NR), e a atividade de mineralização por meio da atividade da fosfatase alcalina e a coloração com Vermelho de Alizarina. Os dados foram submetidos aos testes ANOVA, Tukey e Bonferroni (5% de significância). O potencial bioativo foi avaliado por microscopia eletrônica de varredura. Os materiais apresentaram tempo de presa semelhante. O MTA mostrou menor resistência à compressão. MTA e CSC/Yb2O3 apresentaram radiopacidade semelhante. CSC/Yb2O3 apresentou menores valores de solubilidade. A viabilidade celular realizada pelos ensaios de MTT e NR não revelaram efeitos ctotóxicos em todas as diluições, exceto na diluição 1:1 no NR, o qual mostrou baixa viabilidade celular (p<0.05) em todos materiais testados quando comparado ao controle. A atividade de ALP em 1 e 7 dias foi similar ao controle (p>0.05). MTA e CSC tiveram significante aumento na atividade de ALP aos 3 dias quando comarados ao controle (p>0.05). Todos os materiais apresentaram grande produção de nódulos mineralizados quando comparados ao controle (P<0.05). A análise da SEM mostrou estruturas que sugerem a presença de depósitos de fosfato de cálcio na superfície dos materiais demonstrando bioatividade. O Yb2O3 mostrou ser um agente radiopacificador adequado em cimentos à base de silicato de cálcio uma vez que não afetou as propriedades físico-químicas e biológicas e ainda preservou o potencial bioativo desse material.

Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report.

This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional.

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.

Push-out Bond Strength of Root-end Filling Materials.

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.

Effect of zirconium oxide and zinc oxide nanoparticles on physicochemical properties and antibiofilm activity of a calcium silicate-based material.

The aim of the present study was to evaluate the antibiofilm activity against Enterococcus faecalis, compressive strength. and radiopacity of Portland cement (PC) added to zirconium oxide (ZrO2), as radiopacifier, with or without nanoparticulated zinc oxide (ZnO). The following experimental materials were evaluated: PC, PC + ZrO2, PC + ZrO2 + ZnO (5%), and PC + ZrO2 + ZnO (10%). Antibiofilm activity was analyzed by using direct contact test (DCT) on Enterococcus faecalis biofilm, for 5 h or 15 h. The analysis was conducted by using the number of colony-forming units (CFU/mL). The compressive strength was performed in a mechanical testing machine. For the radiopacity tests, the specimens were radiographed together with an aluminium stepwedge. The results were submitted to ANOVA and Tukey tests, with level of significance at 5%. The results showed that all materials presented similar antibiofilm activity (P > 0.05). The addition of nanoparticulated ZnO decreased the compressive strength of PC. All materials presented higher radiopacity than pure PC. It can be concluded that the addition of ZrO2 and ZnO does not interfere with the antibiofilm activity and provides radiopacity to Portland cement. However, the presence of ZnO (5% or 10%) significantly decreased the compressive strength of the 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. .

Radiopacity, pH and antimicrobial activity of Portland cement associated with micro- and nanoparticles of zirconium oxide and niobium oxide.

The aim of this study was to evaluate some properties of the calcium silicate materials Mineral Trioxide Aggregate (MTA) and Portland cement (PC) with microparticulated (micro) and nanoparticulated (nano) zirconium oxide (ZrO2) or niobium oxide (Nb2O5). The experimental materials: White PC (PC), MTA-Angelus(®) (MTA), PC+ZrO2micro, PC+ZrO2nano, PC+Nb2O5micro and PC+Nb2O5nano were submitted to radiopacity and pH evaluations. Furthermore, the antimicrobial activity against different microorganisms was assessed by agar diffusion test. MTA presented higher radiopacity than other materials. However, all materials except PC presented higher radiopacity than recommended by ISO/ADA. MTA promoted higher pH values in all analyzed periods (p≤0.05). At the initial periods, PC and PC+ZrO2micro showed pH similar to MTA. All materials showed antimicrobial activity against the evaluated microorganisms. In conclusion, ZrO2 and Nb2O5 could be alternative radiopacifiers to be added to calcium silicate materials.