The Effect of Different Mixing Methods on Working Time, Setting Time, Dimensional Changes and Film Thickness of Mineral Trioxide Aggregate and Calcium-Enriched Mixture.

INTRODUCTION: The aim of the present study was to evaluate the effect of different mixing techniques (conventional, amalgamator and ultrasonic mixing) on the physical properties the working time (WT), setting time (ST), dimensional changes (DC) and film thickness (FT)] of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA). METHODS AND MATERIALS: The mentioned physical properties were determined using the ISO 6786:2001 specification. Six samples of each material were prepared for three mixing techniques (totally 36 samples). Data were analyzed using descriptive statistics, two-way ANOVA and Post Hoc Tukey's tests. The level of significance was defined at 0.05. RESULTS: Irrespective of mixing technique, there was no significant difference between the WT and FT of the tested materials. Except for the DC of MTA and the FT of the all materials, other properties were significantly affected with mixing techniques (P<0.05). The ultrasonic technique decreased the ST of MTA and CEM cement and increased the WT of CEM cement (P<0.05). CONCLUSION: The mixing technique of the materials had no significant effect on the dimensional changes of MTA and the film thickness of both materials.

The Effect of Different Mixing Methods on the pH and Solubility of Mineral Trioxide Aggregate and Calcium-Enriched Mixture.

INTRODUCTION: The aim of this study was to evaluate the effect of different mixing techniques on the pH and solubility of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM). METHODS AND MATERIALS: Five samples were prepared from each biomaterial with different mixing techniques including hand-, amalgamator- or ultrasonic-mixing and were then placed in pre-weighted plastic tubes to determine their pH values. Each tube was then incubated in 10 mL deionized distilled water for 1 h at 37(º)C. An electrode was placed in the fluid in each flask at 24(º)C and the pH was recorded. In the next stage, six samples from each mixing technique/material were separately placed in glass bottles containing 50 mL of distilled water at 37(º)C for 1 h and were let dry for 1 h at 37(º)C. The samples' weights were measured and recorded twice. The procedure was repeated at 1-, 7- and 21-day intervals. Data were analyzed with the repeated measures ANOVA (for solubility) and two-way ANOVA (for pH) and then the post-hoc Tukey's test was done. RESULTS: The pH of the materials was not significantly affected by mixing methods. (P=0.8 for CEM and P=0.1 for MTA). The solubility of all test groups was within the acceptable range (=3%). However, the solubility of CEM at 1- and 21-day intervals was significantly different (P=0.03 for 1 day and P=0.001 for 21 days). Different mixing techniques had significant effects on the solubility of MTA at the three time points (P=0.004, 0.003 and 0.002 for 1-, 7- and 21-day intervals, respectively). CONCLUSION: The pH of biomaterials was not influenced by the mixing technique and their solubility was within the acceptable range.

The effect of different mixing methods on the flow rate and compressive strength of mineral trioxide aggregate and calcium-enriched mixture.

INTRODUCTION: Flow rate (FR) and compressive strength (CS) are important properties of endodontic biomaterials that may be affected by various mixing methods. The aim of this experimental study was to evaluate the effect of different mixing methods on these properties of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement. MATERIALS AND METHODS: Hand, amalgamator and ultrasonic techniques were used to mix both biomaterials. Then 0.5 mL of each mixture was placed on a glass slab to measure FR. The second glass slab (100 g) was placed on the samples and 180 sec after the initiation of mixing a 100-g force was applied on it for 10 min. After 10 min, the load was removed, and the minimum and maximum diameters of the sample disks were measured. To measure the CS, 6 sample of each group were placed in steel molds and were then stored in distilled water for 21 h and 21 days. Afterwards, the CS test was performed. Data were analyzed with multi-variant ANOVA and post hoc Tukey tests. The level of significance was set at 0.05. RESULTS: There were significant differences in FR of MTA and CEM cement with different mixing techniques (P<0.05). In the MTA group, none of the mixing techniques exhibited a significant effect on CS (P>0.05); however, in CEM group the CS at 21-h and 21-day intervals was higher with the hand technique (P<0.05). CONCLUSION: Mixing methods affected the flowability of both biomaterials and compressive strength of CEM cement.

Effect of smear layer on the push-out bond strength of two endodontic biomaterials to radicular dentin.

INTRODUCTION: This in vitro study was designed to evaluate the effect of smear layer removal on push-out bond strength of white mineral trioxide aggregate (WMTA) and calcium-enriched mixture cement (CEM). MATERIALS AND METHODS: Dentin discs with 3 mm thicknesses were divided into 4 groups (n=15): group 1: irrigation of the canal with normal saline and filling with WMTA; group 2: irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), and then filling with WMTA; group 3: same as group 1 but the lumens were filled with CEM; group 4: same as group 2 but the lumens filled with CEM. The samples were incubated at 37(°)C for 3 days after wrapping in gauze pieces moistened with distilled water. The push-out bond strengths were then measured by the universal testing machine and the failure modes were examined under a stereomicroscope at 40× magnification. Data were analyzed using two-way ANOVA and post-hoc Tukey's test for bond strength. Statistical significance was set at P<0.05. RESULTS: The greatest and lowest mean standard deviation for push-out bond strength were observed for groups 4 (3.13±1.46 MPa) and group3 (1.44±0.96 MPa), respectively. The effect of smear layer removal on push-out bond strength of CEM was significant (P=0.01), however, it was not significant for WMTA (P=0.52). The failure mode for all the groups was of mixed type. CONCLUSION: Under the limitations of this study, smear layer removal is recommended for CEM in order to gain higher push-out strength.

Effect of smear layer on the push-out bond strength of two different compositions of white mineral trioxide aggregate.

INTRODUCTION: The aim of this in vitro study was to evaluate the effect of smear layer on the push-out bond strength of white mineral trioxide aggregate (WMTA) with and without disodium hydrogen phosphate (Na2HPO4). MATERIALS AND METHODS: Dentin discs with standard cavities were obtained from extracted human single-rooted teeth and divided to 4 groups (n=15) according to the irrigation regimen and the canal filling material. In groups 1 and 3, canals were irrigated with normal saline; in groups 2 and 4, irrigation method included sodium hypochlorite (NaOCl) and then ethylenediaminetetra-acetic acid (EDTA). The canals were filled with WMTA in first and second groups and with WMTA+Na2HPO4; in groups 3 and 4. The samples were wrapped in wet gauze and incubated in 37°C for 3 days. The push-out bond strength was then measured by means of the Universal Testing Machine and the failure modes were examined under stereomicroscope at 40× magnification. Tow-way ANOVA was used to evaluate the effect of material type and smear layer removal. Post hoc Tukey test was used for the two-by-two comparison of the groups. RESULTS: The greatest and lowest mean±standard deviation for push-out bond strength were observed in groups 4 (4.54±1.14 MPa) and 1 (1.44±0.96 MPa), respectively. The effect of removing the smear layer on the push-out bond strength of WMTA+Na2HPO4 was significant (P=0.01), but not for WMTA (P=0.52). Interestingly, there was significant difference between groups 1, 3 and 2, 4 (P<0.05). The failure mode for all experimental groups was of mixed type. CONCLUSION: Under circumstances of this in vitro study, removal of smear layer increases push-out bond strength when Na2HPO4 is added to WMTA.

Effect of blood contamination on the retention characteristics of two endodontic biomaterials in simulated furcation perforations.

INTRODUCTION: The aim of the present study was to compare the effect of blood contamination on retention characteristics of white mineral trioxide aggregate (WMTA) and calcium-enriched mixture (CEM) in reconstructions of the furcation area. METHODS: Furcal perforations, measuring 1.3 mm in diameter and 2 mm in height, were produced in 180 human mandibular first molars. The teeth were divided into 12 groups of 15. WMTA and CEM were used in groups 1-6 and 7-12, respectively, for perforation repair. In groups 1, 3, 5, 7, 9, and 11 the walls of the perforated area were contaminated with blood; normal saline was injected in the remaining groups. Push-out test was carried out in groups 1, 2, 7, and 8 after 24 hours, in groups 3, 4, 9, and 10 after 72 hours, and in the remaining groups 7 days after placement of the materials by using a Universal test machine. To evaluate the failure modes, the samples were sectioned at furcation floor area, divided in two in the vertical direction, and evaluated under a stereomicroscope at × 40 magnification. Data were analyzed with multivariate analysis of variance and post hoc Tukey tests. RESULTS: The highest (6.75 MPa) and lowest (1.77 MPa) bond strength values were recorded in groups CEM/no blood contamination at 7 days and MTA/blood contamination at 24 hours, respectively. There were no statistically significant differences in bond strength between MTA and CEM (P < .05). However, there were significant differences in bond strength between blood-contaminated and uncontaminated groups in both materials (P < .05); time had exerted a significant effect on the bond strength of the study groups (P < .05). Failure patterns were of the mixed type in all the samples. CONCLUSIONS: Resistance of both WMTA and CEM to displacement was similar, and elapse of time from 24 hours to 7 days and contamination resulted in an increase and decrease in bond strength of these 2 materials to dentin, respectively.

The effect of composite fiber insertion along with low-shrinking composite resin on cuspal deflection of root-filled maxillary premolars.

AIM: The aim of the present study was to evaluate the effect of three methods of composite fiber placement along with siloranebased composite resin on cuspal deflection and fracture strength of root-filled maxillary premolars. MATERIALS AND METHODS: Mesio-occluso-distal cavities were prepared in 60 extracted premolars subsequent to endodontic treatment. The remaining thickness of buccal and lingual walls at height of contour was 2.5 ± 0.2 mm and the gingival cavosurface margin was 1.5 mm coronal to cementoenamel junction. Subsequent to measurement of primary intercuspal distances, the teeth were randomly divided into four groups. In group 1, the cavities were only filled with Filtek Silorane composite resin. In the other three groups, preimpregnated glass fibers were placed at gingival, middle and occlusal thirds respectively, and the cavities were restored similar to the group 1. Cuspal deflection was recorded in micrometer using a stereomicroscope. Fracture strength of the samples was measured in Newton subsequent to thermocycling. Data was analyzed using Kruskal-Wallis, Mann-Whitney U, one-way ANOVA and post-hoc Tukey tests at a significance level of p < 0.05. RESULTS: The highest cuspal deflection was recorded in the group 1, and the difference between group 1 and other groups was significant (p < 0.001). Fracture resistance in group 4 was significantly higher than that in other groups (p < 0.001). CONCLUSION: In restoring root-filled premolars with siloranebased composite resins, cuspal deflection decreased with the use of preimpregnated glass fibers. CLINICAL SIGNIFICANCE: Using preimpregnated glass fibers along with silorane-based composite resin may lead to better results in cuspal deflection and fracture resistance of endodonticallytreated maxillary premolars.

Effect of aluminum chloride hemostatic agent on microleakage of class V composite resin restorations bonded with all-in-one adhesive

Objectives: Since hemostatic agents can induce changes on enamel and dentin surfaces and influence composite resin adhesion, the aim of the present study was to evaluate the effect of the aluminum chloride hemostatic agent on the gingival margin microleakage of class V (Cl V) composite resin restorations bonded with all-in-one adhesive. Study design: Cl V cavities were prepared on the buccal surfaces of 60 sound bovine permanent incisors. Gingival margins of the cavities were placed 1.5 mm apical to the cemento-enamel junction (CEJ). The teeth were randomly divided into two groups of 30. In group 1, the cavities were restored without the application of a hemostatic agent; in group 2, the cavities were restored after the application of the hemostatic agent. In both groups all-in-one adhesive and Z250 composite resin were used to restore the cavities with the incremental technique. After finishing and polishing, the samples underwent a thermocycling procedure, followed by immersion in 2% basic fuschin solution for 24 hours. The samples were sectioned and gingival microleakage was evaluated under a stereomicroscope. The non-parametric Mann-Whitney U test was used to compare microleakage between the two groups. Statistical significance was defined at P<0.05. Results: A statistically significant difference was observed in microleakage between the two groups (P<0.001). Conclusions: Contamination of Cl V composite resin restorations bonded with all-in-one adhesive with aluminum chloride hemostatic agent significantly increases restoration gingival margin microleakage (AU)

Effect of aluminum chloride hemostatic agent on microleakage of class V composite resin restorations bonded with all-in-one adhesive.

OBJECTIVES: Since hemostatic agents can induce changes on enamel and dentin surfaces and influence composite resin adhesion, the aim of the present study was to evaluate the effect of the aluminum chloride hemostatic agent on the gingival margin microleakage of class V (Cl V) composite resin restorations bonded with all-in-one adhesive. STUDY DESIGN: Cl V cavities were prepared on the buccal surfaces of 60 sound bovine permanent incisors. Gingival margins of the cavities were placed 1.5 mm apical to the cemento-enamel junction (CEJ). The teeth were randomly divided into two groups of 30. In group 1, the cavities were restored without the application of a hemostatic agent; in group 2, the cavities were restored after the application of the hemostatic agent. In both groups all-in-one adhesive and Z250 composite resin were used to restore the cavities with the incremental technique. After finishing and polishing, the samples underwent a thermocycling procedure, followed by immersion in 2% basic fuschin solution for 24 hours. The samples were sectioned and gingival microleakage was evaluated under a stereomicroscope. The non-parametric Mann-Whitney U test was used to compare microleakage between the two groups. Statistical significance was defined at P<0.05. RESULTS: A statistically significant difference was observed in microleakage between the two groups (P<0.001). CONCLUSIONS: Contamination of Cl V composite resin restorations bonded with all-in-one adhesive with aluminum chloride hemostatic agent significantly increases restoration gingival margin microleakage.

Effects of surface treatments of conventional glass-ionomer on shear bond strength to giomer.

BACKGROUND: An appropriate bond between glass-ionomer and the superficial resin materials is very important for the success of sandwich technique. The aim of the present in vitro study was to evaluate the effect of three surface treatments of conventional glass-ionomer on its shear bond strength to giomer. MATERIALS AND METHODS: Sixty cylindrical specimens of a conventional glass-ionomer (GC Fuji II) were prepared and randomly divided into three groups (n = 20). The specimens in groups 1 and 2 were treated with total-etch adhesive resin (Single Bond) along with acid etching, and self-etch adhesive resin (FL-Bond II) on the set glass-ionomer, respectively. Specimens in group 3 were treated with self-etch adhesive resin (FL-Bond II) before initial setting of the glass-ionomer was complete. Then a giomer restorative (Beautifil II) was added to the specimens. Subsequent to thermocycling, the specimens were subjected to shear bond strength test. Failure modes were evaluated under a stereomicroscope. Data were analyzed by one-way analysis of variance and a post hoc Tukey test at a significance level of P < 0.05. RESULTS: There were statistically significant differences in bond strengths between the groups (P < 0.0005). Differences in bond strengths between group 2 and other groups were significant (P < 0.0005) while the differences between groups 1 and 3 were not significant. Failures were predominantly of the cohesive type in all the groups. CONCLUSION: Based on the results of this study, the use of self-etch adhesive resin (FL-Bond II) on the set glass-ionomer yielded the highest bond strength in the glass-ionomer/giomer sandwich technique.