Bio-active cements-Mineral Trioxide Aggregate based calcium silicate materials: a narrative review.

Recent advances in the field of endodontics have greatly improved the outcome and success rate of dental materials. For last three decades, there has been great interest in the development of bioactive dental material with the ability to interact and induce surrounding dental tissues to promote regeneration of pulpal and periradicular tissues. As these bioactive materials are mainly based on calcium silicates, they are also referred to as Calcium Silicate materials. The first material introduced was Mineral Tri-oxide Aggregate, which, due to its favourable biological properties, gained importance initially. However, later, due to its drawbacks, liked is colouration, long setting time and difficult manipulation, several modifications were done and newer bioactive materials, such as Biodentine, BioAggregate, Endosequence, Calcium-Enriched Mixture etc., were developed. The main applications of these materials are for pulp capping (direc t/indirec t), pulpotomy, perforation repair, resorption defects, apexogenesis and as retrograde filling materials, apexification and endodontic sealers. This review discusses the various types of bioactive materials, their composition, setting mechanism, and literature evidence for current applications.

Resistencia a la fractura in vitro de incrustaciones cerámicas usando dos materiales como bases cavitarias / in vitro fractures strength of ceramic inlays, using two types of cavity bases

Las bases cavitarias son usadas en odontología restauradora,varios materiales se recomiendan como base cavitaria en incrustaciones cerámicas. Objetivo: Comparar la resistencia a la fractura in vitro de una cerámica (disilicato de litio) como material restaurativo usando diferentes bases cavitarias en inlays en premolares. Material y métodos: Se elaboraron cavidades estandarizadas para inlays cerámicas MOD en 30 premolares. Se asignaron aleatoriamente tres grupos (n = 10): grupo 1: sin base cavitaria; grupo 2: base ionómero de vidrio reforzado con resina (VitrebondTM, 3M); grupo 3: base resina compuesta (FiltekTM Z350 XT, 3M). Las incrustaciones fueron fabricadas con disilicato de litio (IPS e.max®, Ivoclar) cementadas con (RelyXTM, 3M) y almacenadas en agua bidestilada (37 oC por 24 horas). Semidió la resistencia a la fractura en una máquina universal de pruebas mecánicas (MTS® Alliance RT/30) a una velocidad de 0.5 mm/minuto,fracturadas las muestras se registró bajo microscopia estereoscópica elmodo de fallo. Los datos se analizaron usando ANOVA de una vía y comparaciones post hoc con la prueba Scheffé. (Programa IBM SPSS STATISTICS 21.0). Resultados: El grupo control (sin base) obtuvo la media más alta (105.16 Kgf ± 11.41) siendo estadísticamente significativa con relación al grupo 2 (77.04 ± 19.69). El grupo 3 obtuvo una media (94.81 ± 10.65) siendo estadísticamente diferente del grupo 2 (p = .001). El modo de fallo más común fue el patrón IV (60 por ciento). Conclusiones: La resistencia a la fractura de inlays cerámicas de disilicato de litio es mayor en cavidades sin base cavitaria...

Risk assessment due to environmental exposures to fibrous particulates associated with taconite ore.

In the early 1970s, it became a concern that exposure to the mineral fibers associated taconite ore processed in Silver Bay, Minnesota would cause asbestos-related disease including gastrointestinal cancer. At that time data gaps existed which have now been significantly reduced by further research. To further our understanding of the types of airborne fibers in Silver Bay we undertook a geological survey of their source the Peter Mitchell Pit, and found that there are no primary asbestos minerals at a detectable level. However we identified two non-asbestos types of fibrous minerals in very limited geological locales. Air sampling useful for risk assessment was done to determine the type, concentrations and size distribution of the population of airborne fibers around Silver Bay. Approximately 80% of the airborne fibers have elemental compositions consistent with cummingtonite-grunerite and the remaining 20% have elemental compositions in the tremolite-actinolite series. The mean airborne concentration of both fiber types is less than 0.00014 fibers per milliliter that is within the background level reported by the World Health Organization. We calculate the risk of asbestos-related mesothelioma and lung cancer using a variety of different pessimistic assumptions. (i) that all the non-asbestos fibers are as potent as asbestos fibers used in the EPA-IRIS listing for asbestos; with a calculated risk of asbestos-related cancer for environmental exposure at Silver Bay of 1 excess cancer in 28,500 lifetimes (or 35 excess cancers per 1,000,000 lifetimes) and secondly that taconite associated fibers are as potent as chrysotile the least potent form of asbestos. The calculated risk is less than 0.77 excess cancer case in 1,000,000 lifetimes. Finally, we briefly review the epidemiology studies of grunerite asbestos (amosite) focusing on the exposure conditions associated with increased risk of human mesothelioma.

Indices of fiber biopersistence and carcinogen classification for synthetic vitreous fibers (SVFs).

It is generally accepted that the biopersistence of a synthetic vitreous fiber (SVF) is an important determinant of its biological activity. Experimental protocols have been developed to measure the biopersistence of an SVF from short-term inhalation experiments with rats. Clearance kinetics of long (>20 microm) fibers (those believed to have greatest biological activity) have been approximated by one- or two-pool models. Several measures or indices of biopersistence have been proposed in the literature of which three, the weighted half-time (WT(1/2)), the time required to clear 90% of long fibers (T(0.9)), and the so-called slow-phase half-time (T(2)), have been investigated in some detail. This paper considers both one- and two-pool models for long fiber clearance, characterizes the properties of these candidate indices of fiber biopersistence, identifies measures with potentially superior statistical properties, suggests possible cutoff values based on the relation between biopersistence and the outcome of chronic bioassays, and offers comments on the selection of efficient experimental designs. This analysis concludes that WT(1/2) and T(0.9) are highly correlated, are efficient predictors of the outcome of chronic bioassays, and have reasonable statistical properties. T(2), although perhaps attractive in principle, suffers from some statistical shortcomings when estimated using present experimental protocols. The WT(1/2) is shown to be directly proportional to the cumulative exposure (fiber days) after the cessation of exposure and also the mean residence time of these fibers in the lung.

Categorization and nomenclature of vitreous silicate wools.

There is substantial interest among government agencies in categorizing fibers for hazard classification purposes, particularly the commercially important synthetic vitreous fibers (e.g., rock wool, slag wool, glass wool, and refractory ceramic fibers). The intent of this categorization is to partition the population of fibers into distinct categories, which are mutually exclusive, collectively exhaustive, easy to understand and implement, and homogeneous with respect to potential biological activity. This paper identifies criteria for categorization, summarizes historical systems for categorization (e.g., by origin, chemistry and structure, physical form and morphology, and application), analyzes the current categorization schemes used by the European Community (EC) and the International Agency for Research on Cancer (IARC), and proposes an improved partitioning method based upon biopersistence/durability. The proposed basis for categorization incorporates the best features of the EC and IARC methods, eliminates some of their inconsistencies, exploits available knowledge of fiber toxicology (much of which was developed in recent years), and is practical to implement.

Synthetic vitreous fibers: a review of toxicology research and its impact on hazard classification.

Because the inhalation of asbestos, a naturally occurring, inorganic fibrous material, is associated with lung fibrosis and thoracic cancers, concerns have been raised about the possible health effects of synthetic vitreous fibers (SVFs). SVFs include a very broad variety of inorganic fibrous materials with an amorphous molecular structure. Traditionally, SVFs have been divided into three subcategories based on composition: fiberglass, mineral wool (rock, stone, and slag wools), and refractory ceramic fiber. For more than 50 years, the toxicologic potential of SVFs has been researched extensively using human epidemiology and a variety of laboratory studies. Here we review the research and its impact on hazard classification and regulation of SVFs. Large, ongoing epidemiology studies of SVF manufacturing workers have provided very little evidence of harmful effects in humans. Several decades of research using rodents exposed by inhalation have confirmed that SVF pulmonary effects are determined by the "Three D's", fiber dose (lung), dimension, and durability. Lung dose over time is determined by fiber deposition and biopersistence in the lung. Deposition is inversely related to fiber diameter. Biopersistence is directly related to fiber length and inversely related to fiber dissolution and fragmentation rates. Inhaled short fibers are cleared from the lung relatively quickly by mobile phagocytic cells, but long fibers persist until they dissolve or fragment. In contrast to asbestos, most of the SVFs tested in rodent inhalation studies cleared rapidly from the lung (were nonbiopersistent) and were innocuous. However, several relativley biopersistent SVFs induced chronic inflammation, lung scarring (fibrosis), and thoracic neoplasms. Thus, biopersistence of fibers is now generally recognized as a key determinant of the toxicologic potential of SVFs. In vitro dissolution of fibers in simulated extracellular fluid correlates fairly well with fiber biopersistence in the lung and pulmonary toxicity, but several exceptions suggest that biopersistence involves more than dissolution rate. Research demonstrating the relationship between biopersistence and SVF toxicity has provided a scientific basis for hazard classification and regulation of SVFs. For a nonhazardous classification, legislation recently passed by the European Union requires a respirable insulation wool to have a low lung-biopersistence or be noncarcinogenic in laboratory rats. U.S. fiberglass and mineral wool industries and the Occupational Health and Safety Administration (OSHA) have formed a voluntary Health and Safety Partnership Program (HSPP) that include: a voluntary permissible exposure level (PEL) in the workplace of 1 fiber/cc, a respiratory protection program for specified tasks, continued workplace air monitoring, and, where possible, the development of fiber formulations that do not persist in the lung. RCF manufacturers have implemented a Product Stewardship Program that includes: a recommended exposure guideline of 0.5 fibers/cc; a 5-year workplace air monitoring program; and research into the development of high-temperature-resistant, biosoluble fibers.

A science-based paradigm for the classification of synthetic vitreous fibers.

Synthetic vitreous fibers (SVFs) are a broad class of inorganic vitreous silicates used in a large number of applications including thermal and acoustical insulation and filtration. Historically, they have been grouped into somewhat artificial broad categories, e.g., glass, rock (stone), slag, or ceramic fibers based on the origin of the raw materials or the manufacturing process used to produce them. In turn, these broad categories have been used to classify SVFs according to their potential health effects, e.g., the International Agency for Research on Cancer and International Programme for Chemical Safety in 1988, based on the available health information at that time. During the past 10-15 years extensive new information has been developed on the health aspects of these fibers in humans, in experimental animals, and with in vitro test systems. Various chronic inhalation studies and intraperitoneal injection studies in rodents have clearly shown that within a given category of SVFs there can be a vast diversity of biological responses due to the different fiber compositions within that category. This information has been further buttressed by an in-depth knowledge of differences in the biopersistence of the various types of fibers in the lung after short-term exposure and their in vitro dissolution rates in fluids that mimic those found in the lung. This evolving body of information, which compliments and explains the results of chronic animal studies clearly show that these "broad" categories are somewhat archaic, oversimplistic, and do not represent current science. This new understanding of the relation between fiber composition, solubility, and biological activity requires a new classification system to more accurately reflect the potential health consequences of exposure to these materials. It is proposed that a new classification system be developed based on the results of short-term in vivo in combination with in vitro solubility studies. Indeed, the European Union has incorporated some of this knowledge, e.g., persistence in the lung into its recent Directive on fiber classification.