Investigation of mineral trioxide aggregate for root-end filling in dogs.

Numerous compounds have been used as root-end filling materials. Based on the results of in vitro and intraosseous implantation tests, mineral trioxide aggregate (MTA) seems to have potential as a root-end filling material. The purpose of this study was to examine the periradicular tissue response of dogs to MTA and amalgam. Lesions were developed in periradicular tissues of 46 roots in six beagle dogs. The canals on half of the roots were instrumented and obturated with gutta-percha and sealer, and their access cavities were sealed with MTA. The remaining root canals were instrumented and obturated with gutta-percha and sealer, and their access cavities were sealed with MTA. The remaining root canals were instrumented and obturated with gutta-percha without root canal sealer. The access cavities of the teeth in this group were left open to the oral cavity. After surgical resection of roots, half of the root-end cavities were filled with amalgam and the rest with MTA. The periradicular tissue response of the dogs was evaluated histologically 2 to 5 and 10 to 18 wk following periradicular surgery. Statistical analysis of the results showed less periradicular inflammation and more fibrous capsules adjacent to MTA, compared with amalgam. In addition, the presence of cementum on the surface of MTA was a frequent finding. The results show that MTA can be used as a root-end filling material.

Tissue reaction to implanted super-EBA and mineral trioxide aggregate in the mandible of guinea pigs: a preliminary report.

In vitro sealing ability and biocompatibility tests on mineral trioxide aggregate (MTA) have shown similar or better properties for this material than for existing root-end filling substances. The purpose of this study was to examine the tissue reaction of implanted Super-EBA and MTA in the mandibles of guinea pigs. After anesthetizing seven guinea pigs, raising a tissue flap and preparing two bony cavities, the test materials were placed in Teflon cups and implanted in the mandibles. Two bony cavities without implanted materials were left to heal and used as negative controls. The presence of inflammation, predominant cell type, and thickness of fibrous connective tissue adjacent to each implant was recorded. The tissue reaction to MTA implantation was slightly than that observed with Super-EBA implantation. Based on these results , it seems that both Super-EBA and MTA are biocompatible.

Cytotoxicity of four root end filling materials.

Leakage and scanning electron microscopic studies have shown that a mineral trioxide aggregate (MTA) used as root end filling material permits significantly less leakage and has better adaptation than other commonly used root end filling materials. Because these materials are in contact with the periradicular tissues, their cytotoxicity should be evaluated before in vivo tests. Using the agar overlay and radiochromium methods, the cytotoxicity of amalgam, Super EBA, IRM, and the MTA was evaluated. Statistical analysis of the data from the agar overlay technique shows that freshly mixed and set amalgam were significantly less toxic than the rest of tested materials (p< 0.00005). Fresh and set MTA ranked second when tested for cytotoxicity with this technique. Similar statistical tests revealed a significant statistical difference between the toxicity of freshly mixed and set materials after 24 h of incubation with radiochromium-labeled mouse L929 cells. The degree of cytotoxicity of fresh and set materials was MTA least toxic followed by amalgam, Super EBA, and IRM. Based on the results of the cell culture methods used in this study it appears that MTA is a potential root end filling material and warrants further in vivo evaluations.

Antibacterial effects of some root end filling materials.

In addition to having good sealing ability, root end filling materials should "ideally" have some antibacterial activity to prevent bacterial growth. This investigation compared the antibacterial effects of amalgam, zinc oxide-eugenol, Super EBA and a mineral trioxide aggregate on nine facultative bacteria Streptococcus fecalis, Streptococcus mitis, Streptococcus mutans, Streptococcus salivarius, Lactobacillus species, Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, and Escherichia coli B and seven strict anaerobic bacteria, Prevotella (Bacteroides) buccae, Bacteroides fragilis, Prevotella (Bacteroides) intermedia, Prevotella (Bacteroides) melaninogenica, Fusobacterium necrophorum, Fusobacterium nucleatum, and Peptostreptococcus anaerobius. After growing these bacteria on solid media, freshly mixed and 24-h set test materials were placed on the surface of these inoculated media and incubated in the appropriate atmosphere for 24 to 48 h at 37 degrees C. Impregnated discs with the Super EBA liquid were used as positive controls. The antibacterial effects of each material were measured in millimeters and the data were analyzed using one-way and two-way analysis of variance and Scheffé tests to determine the statistical differences between the antibacterial effects of the test materials. Impregnated discs with Super EBA liquid caused varying degrees of growth inhibition for both facultative and strict anaerobic bacteria. Both types of amalgam had no antibacterial effect against any of the bacteria tested in this study. Mineral trioxide aggregate had an antibacterial effect on some of the facultative bacteria and no effect on any of the strict anaerobic bacteria. Zinc oxide-eugenol and Super EBA pastes had some antibacterial effects on both types of bacteria tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Physical and chemical properties of a new root-end filling material.

This study determined the chemical composition, pH, and radiopacity of mineral trioxide aggregate (MTA), and also compared the setting time, compressive strength, and solubility of this material with those of amalgam, Super-EBA, and Intermediate Restorative Material (IRM). X-ray energy dispersive spectrometer in conjunction with the scanning electron microscope were used to determine the composition of MTA, and the pH value of MTA was assessed with a pH meter using a temperature-compensated electrode. The radiopacity of MTA was determined according to the method described by the International Organization for Standardization. The setting time and compressive strength of these materials were determined according to methods recommended by the British Standards Institution. The degree of solubility of the materials was assessed according to modified American Dental Association specifications. The results showed that the main molecules present in MTA are calcium and phosphorous ions. In addition, MTA has a pH of 10.2 initially, which rises to 12.5 three hours after mixing. MTA is more radiopaque than Super-EBA and IRM. Amalgam had the shortest setting time (4 min) and MTA the longest (2 h 45 min). At 24 h MTA had the lowest compressive strength (40 MPa) among the materials, but it increased after 21 days to 67 MPa. Finally, except for IRM, none of the materials tested showed any solubility under the conditions of this study.

Use of mineral trioxide aggregate for repair of furcal perforations.

The histologic response to intentional perforation in the furcations of 28 mandibular premolars in seven dogs was investigated. In half the teeth, the perforations were repaired immediately with either amalgam or mineral trioxide aggregate; in the rest the perforations were left open to salivary contamination before repair. All repaired perforations were left for 4 months before histologic examination of vertical sections through the site. In the immediately repaired group, all the amalgam specimens were associated with inflammation, whereas only one of six with mineral trioxide aggregate was; further, the five noninflamed mineral trioxide aggregate specimens had some cementum over the repair material. In the delayed group, all the amalgam specimens were associated with inflammation; in contrast only four of seven filled with the aggregate were inflamed. On the basis of these results, it appears that mineral trioxide aggregate is a far more suitable material than amalgam for perforation repair, particularly when used immediately after perforation.

Apical marginal adaptation of orthograde and retrograde root end fillings: a dye leakage and scanning electron microscopic study.

A few studies have attempted to examine the correlation between clinical success of root canal therapy and in vitro examinations. In this case report we examined the apical adaptation of three orthograde fillings and four retrograde amalgam root end fillings from four radiographically successful teeth and one unsuccessful case by using dye leakage and scanning electron microscopic methods. Despite the radiographic appearance of successful root canal therapy, these examinations showed penetration of methylene blue dye through the apical foramina to the levels of the root canal filling materials in the roots treated nonsurgically and the presence of small gaps between filling materials and the dentinal walls. The methylene blue dye also penetrated through the interface between amalgam and root end cavities, and there were varying size gaps between the root end cavities and amalgam. Similar examinations on the radiographically unsuccessful retrograde filling showed the presence of gaps between the amalgam and the root end cavity preparation and complete penetration of methylene blue dye between amalgam, root canal filling materials, and the dentinal walls.