The mineralizing effect of zinc oxide-modified hydroxyapatite-based sealer on radicular dentin.

OBJECTIVE: The aim of this study was to evaluate the remineralization ability of three endodontic sealer materials at different root dentin regions. MATERIAL AND METHODS: Cervical, medial, and apical root dentin surfaces were treated with two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite); an epoxy resin-based canal sealer, AH Plus; and gutta-percha. Remineralization, at the inner and outer zones of dentin disk surfaces, was studied by nanohardness (Hi) and Raman analysis. Nanoroughness and collagen fibrils width measurements were performed. Numerical data, at 24 h or 12 m, were analyzed by ANOVA and Student-Newman-Keuls (p < 0.05). RESULTS: At the outer and inner zones of the cervical dentin treated with oxipatite, the highest Hi after 12 m of immersion was achieved. The same group showed the highest intensity of phosphate peak, markers for calcification and crystallinity. Nanoroughness was lower and fibril diameter was higher at the inner zone of the dentin treated with oxipatite. Dentin mineralization occurred in every region of the root dentin treated with oxipatite and calcypatite, especially at the inner zone of the dentin after 12 m. CONCLUSIONS: Oxipatite reinforced the inner root zone at any third of the radicular dentin, by increasing both nanohardness and remineralization. When using calcypatite, the highest nanohardness was found at the apical third of the inner root dentin, but the lowest mechanical performance was obtained at the cervical and the medial thirds of the roots. Therefore, application of oxipatite as sealing cement of root canals is recommended. CLINICAL RELEVANCE: Oxipatite, when used as an endodontic sealing material, strengthens radicular dentin.

Hydroxyapatite-based cements induce different apatite formation in radicular dentin.

OBJECTIVE: To investigate crystallinity and ultrastructure of the formed hydroxyapatite at radicular cervical and apical dentin after being treated with three different canal sealers. METHODS: Cervical and apical root dentin surfaces were treated with two experimental hydroxyapatite-based sealers, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite) and an epoxy resin-based canal sealer (AH Plus); gutta-percha without sealer was included as control. Dentin surfaces were studied by X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-field imaging after 24h and 12m of storage. RESULTS: Root cervical dentin treated with calcypatite and oxipatite produced poor crystallinity of new minerals, wide amorphous phase and non-stoichiometry. Reflections at the 002 plane and the corresponding diffraction rings attained lower values in the Scherrer equation and the Scherrer-Wilson equation in samples treated with both HAp-based sealers than in specimens without sealer or with AH Plus. At root cervical dentin treated with calcypatite, shorter and wider crystallite size formations and lower crystals grain size were found, if compared to those encountered at oxipatite treated dentin. Oxipatite attained improved crystallographic atomic order and less structural variation in both distances and angles. Apical dentin treated with oxipatite attained preferred grain orientation with polycrystalline lattices. SIGNIFICANCE: The immature crystallites formed in dentin treated with calcypatite and oxipatite will account for high hydroxyapatite solubility and remineralizing activity. New polycrystalline formations encountered in apical dentin treated with oxipatite may also produce high mechanical performance.

A zinc oxide-modified hydroxyapatite-based cement favored sealing ability in endodontically treated teeth.

OBJECTIVES: To evaluate the effectiveness of different endodontic canal sealers for dentin permeability reduction and to determine the viscoelastic performance of root dentin after their application. METHODS: Cervical, medial and apical root dentin surfaces were treated with two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite); an epoxy resin- based canal sealer, AH Plus; and gutta-percha. Root dentin was evaluated for fluid filtration. Field emission scanning electron microscopy, energy dispersive analysis, AFM, Young's modulus and Nano-DMA analysis were also performed, at the inner and outer zones of dentin. RESULTS: Dentin treated with oxipatite showed the lowest microleakage among groups with hermetically sealed tubules and zinc-based salt formations. Samples treated with oxipatite showed the highest Ei at the cervical dentin third among groups, at 6 m of storage. Oxipatite promoted the highest complex modulus and tan delta values at the inner zone of both cervical and medial root dentin. Calcypatite favored the lowest tan delta outcomes at the inner zone of apical dentin at 6 m. CONCLUSIONS: Specimens treated with oxipatite showed the highest sealing ability, based on the highest Young's modulus and dentin mineralization, achieved by closing dentinal tubules, voids and pores that reinforced the inner zone of root dentin. The homogeneity of viscoelastic properties among the different root dentin thirds favored the energy dissipation without creating zones of stress concentration and micro-cracking which would have challenge micropermeability. Thereby, among the tested materials oxipatite is proposed as canal filling material and sealer in endodontics. CLINICAL SIGNIFICANCE: Oxipatite could be considered a good candidate for root canal filling material and sealer due to its improved long-term sealing ability and to the advanced remineralization, and so to the enhanced energy dissipation achieved at the inner zone of the radicular dentin.

A zinc-doped endodontic cement facilitates functional mineralization and stress dissipation at the dentin surface

BACKGROUND: The purpose of this study was to evaluate nanohardness and viscoelastic behavior of dentin surfaces treated with two canal sealer cements for dentin remineralization. MATERIAL AND METHODS: Dentin surfaces were subjected to: I) 37% phosphoric acid (PA) or II) 0.5 M ethylenediaminetetraacetic acid (EDTA) conditioning prior to the application of two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite), respectively. Samples were stored in simulated body fluid during 24 h or 21 d. The intertubular and peritubular dentin were evaluated using a nanoindenter to assess nanohardness (Hi). The load/displacement responses were used for the nano-dynamic mechanical analysis to estimate complex modulus (E*) and tan delta (δ). The modulus mapping was obtained by imposing a quasistatic force setpoint to which a sinusoidal force was superimposed. AFM imaging and FESEM analysis were performed. RESULTS: After 21 d of storage, dentin surfaces treated with EDTA+calcypatite, PA+calcypatite and EDTA+oxipatite showed viscoelastic discrepancies between peritubular and intertubular dentin, meaning a risk for cracking and breakdown of the surface. At both 24 h and 21 d, tan δ values at intertubular dentin treated with the four treatments performed similar. At 21 d time point, intertubular dentin treated with PA+oxipatite achieved the highest complex modulus and nanohardness, i.e., highest resistance to deformation and functional mineralization, among groups. CONCLUSIONS: Intertubular and peritubular dentin treated with PA+oxipatite showed similar values of tan δ after 21 d of storage. This produced a favorable dissipation of energy with minimal energy concentration, preserving the structural integrity at the dentin surface