The constitution, physical properties and biocompatibility of modified accelerated cement.

OBJECTIVES: The aim of this study was to determine constitution and physical properties of a prototype material based on Portland cement and assess biocompatibility compared with glass-ionomer cement by evaluating cell morphology. MATERIALS AND METHODS: Analysis of the material was performed using energy dispersive analysis (EDAX) and X-ray diffraction (XRD) analysis. Compressive strength and the effect of changing the mixing and curing conditions on the compressive strength of the materials were evaluated. Dimensional stability was evaluated by measuring water uptake of the materials. Biocompatibility was assessed at 1 and 28 days using a cell-culture technique and semi-quantitative cell morphological evaluation was performed by SEM. RESULTS: Analysis of the material showed that it was primarily composed of tricalcium silicate and dicalcium silicate. The compressive strength of the prototype cement and variants was comparable to Ketac Molar (47.98 N mm(-2) after 1 day, P>0.05). Vacuum mixing did not improve the compressive strength of the prototype cements at any age. Wet curing was detrimental to the neat cement at 1 day (35.98 N mm(-2), P=0.011) and 7 days (44.08 N mm(-2), P=0.025). The filler-replaced cement prototypes were more stable and less susceptible to changes in compressive strength by varying the curing method (P>0.05). The prototype material took up more water (0.9%) than glass-ionomer cement (1.7%) with P=0 after 1 day. Curing at 100% humidity resulted in a net loss of weight for all the materials tested. The test materials were less biocompatible than glass-ionomer cement at 1 day but their biocompatibility improved as the material aged. CONCLUSIONS: The constitution of the prototype material was broadly similar to that of mineral trioxide aggregate. The prototype cement could be a potential dental restorative material as its compressive strength compared well to an established restorative material. However, the material did not support cell growth, with biocompatibility being similar to that of glass-ionomer cement.

A study of periapical lesions correlating the presence of a radiopaque lamina with histological findings.

OBJECTIVE: To compare the presence or absence of a radiopaque lamina of 60 human periapical lesions with the histological findings from a case study in dental practice. STUDY DESIGN: Paralleling radiographs were taken of 60 teeth with periapical radiolucencies. The periapical radiographs were scanned, and standardized images were evaluated on a computer screen for the presence or absence of a radiopaque lamina by 2 calibrated observers according to agreed criteria. The serially sectioned histological specimens were obtained from the extraction of 13 endodontically treated teeth and 27 nontreated teeth, as well as 20 post-treatment teeth with apical periodontitis removed during periapical surgical procedure; the specimens were classified according to agreed criteria. The findings of the 2 evaluations were compared. RESULTS: Out of 57 electronic images that could be interpreted, 10 lesions had a radiopaque lamina, but of these only 3 were histologically diagnosed as cysts, while 7 were granulomas or abscesses. Out of 47 lesions without a radiopaque lamina, 40 were histologically diagnosed as granulomas or abscesses, while 7 were cysts. CONCLUSIONS: The diagnosis of periapical lesions cannot be made on the basis of the presence or absence of a radiopaque lamina, but requires histological examination of serial sections.

Epithelium and bacteria in periapical lesions.

OBJECTIVE: The purpose of this study was to evaluate 50 human periapical lesions for bacteria and epithelium in a case study in dental practice. STUDY DESIGN: Specimens were obtained from the extraction of 50 untreated teeth that had lesions attached to their apices. The specimens were histologically evaluated using serial sections. RESULTS: Bacteria were found in all teeth, colonizing necrotic tissue in the main canal, dentinal tubules, or apical ramifications, and in the body of the periapical lesion in 18 abscesses or cysts. Twenty-one lesions were epithelialized; 14 abscesses, 20 granulomas, and 16 cysts were distinguished. In 18 root canals inflamed tissue was found in the apical part of the canal. A single foramen was present in 13 cases while apical ramifications were found in 37 cases. CONCLUSIONS: Granulomas were most common, and most epithelialized lesions were cysts. Bacteria were only detected periapically in abscesses or cysts. Inflamed tissue was present in the apical root canal in one third of cases.

Characterization of Portland cement for use as a dental restorative material.

OBJECTIVES: The aim of this study was to evaluate the suitability of fast-setting cement formulations based on Portland cement as dental core build-up materials using two different methods of testing compressive strength and evaluation of setting times. METHODS: Four fast-setting cements based on Portland cement and their four respective densified with small particle (DSP) mortars were tested for setting time, constitution of cement by EDAX, and compressive strength using International and British Standards. Ordinary Portland cement (OPC) was used as a control. RESULTS: All the fast-setting cements had a similar elemental composition to OPC and the setting times were less than 7 min. The compressive strength of OPC was different between the two methods (P<0.001). All the fast-setting cements tested showed no difference in compressive strength regardless of the method of testing at 1 and 7 days (P>0.05), but the cylinders showed a lower compressive strength at 28 days (P<0.05). The OPC DSP mortar showed poorer compressive strength than OPC (P<0.01) at all times for cube testing but not for cylinder testing, where no difference was observed. The fast-setting DSP mortars had a lower compressive strength at 1 day (P<0.005) with both methods. At later times, there was no difference between the cements and DSP mortars for the cubes. SIGNIFICANCE: The pure fast-setting cements set in <7 min and were not susceptible to changes in the compressive strength testing procedure at 1 and 7 days but at 28 days all the fast-setting cements had a significantly higher strength with the test using cubes (P<0.05). A reduction in strength was observed at 28 days in cylinder testing. Most of the cements tested did not show encouraging strengths, however, one of the prototype cements tested could be a prospective dental restorative material.

The constitution of mineral trioxide aggregate.

OBJECTIVES: The aim of this study was to determine the constitution of a commercially available root-end filling material, mineral trioxide aggregate, (MTA) (ProRoot MTA, Tulsa Dental, Tulsa, OK, USA). The surface morphology of the material with various treatment conditions was also evaluated. METHODS: The constitution of two commercial versions of MTA was determined before and after mixing with water. The unset material was analysed using Energy Dispersive Analysis by X-ray (EDAX) in a scanning electron microscope (SEM) and X-ray diffraction (XRD). The first technique identified the constituent elements while XRD analysis identified the compounds or phases present. The set material was evaluated using EDAX. The surface morphology of the material stored under various conditions (100% humidity, immersion in water, or immersion in phosphate solution) was evaluated using SEM. RESULTS: The EDAX showed the white MTA to be composed primarily of calcium, silicon, bismuth and oxygen, with the gray MTA also having small peaks for iron and aluminum. The XRD analysis showed gray MTA to be composed primarily of tricalcium silicate and dicalcium silicate. The surface morphology of the materials differed under the various conditions, particularly following immersion in phosphate solution with crystal formation. SIGNIFICANCE: The commercial versions of MTA were shown to have broadly similar constitution to ordinary Portland cement except for the addition of bismuth compounds. The white MTA did not contain iron.