This study was designed to evaluate the parameters of bonding performance to root dentin, including push-out bond strength and dentinal tubular biomineralization, of a hydraulic bioceramic root-end filling material premixed with dimethyl sulfoxide (Endocem MTA Premixed) in comparison to a conventional powder-liquid–type cement (ProRoot MTA).

The root canal of a single-rooted premolar was filled with either ProRoot MTA or Endocem MTA Premixed (n = 15). A slice of dentin was obtained from each root. Using the sliced specimen, the push-out bond strength was measured, and the failure pattern was observed under a stereomicroscope. The apical segment was divided into halves; the split surface was observed under a scanning electron microscope, and intratubular biomineralization was examined by observing the precipitates formed in the dentinal tubule. Then, the chemical characteristics of the precipitates were evaluated with energy-dispersive X-ray spectroscopic (EDS) analysis. The data were analyzed using the Student’s t-test followed by the Mann-Whitney U test (p < 0.05).

No significant difference was found between the 2 tested groups in push-out bond strength, and cohesive failure was the predominant failure type. In both groups, flake-shaped precipitates were observed along dentinal tubules. The EDS analysis indicated that the mass percentage of calcium and phosphorus in the precipitate was similar to that found in hydroxyapatite.

Regarding bonding to root dentin, Endocem MTA Premixed may have potential for use as an acceptable root-end filling material.

The aim of this study was to evaluate the dystrophic mineralization deposits from 3 calcium silicate-based cements (Micro-Mega mineral trioxide aggregate [MM-MTA], Biodentine [BD], and EndoSequence Root Repair Material [ESRRM] putty) over time after subcutaneous implantation into rats.

Forty-five silicon tubes containing the tested materials and 15 empty tubes (serving as a control group) were subcutaneously implanted into the backs of 15 Wistar rats. At 1, 4, and 8 weeks after implantation, the animals were euthanized (n = 5 animals/group), and the silicon tubes were removed with the surrounding tissues. Histopathological tissue sections were stained with von Kossa stain to assess mineralization. Scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDX) were also used to assess the chemical components of the surface precipitates deposited on the implant and the pattern of calcium and phosphorus distribution at the material-tissue interface. The calcium-to-phosphorus ratios were compared using the non-parametric Kruskal-Wallis test at a significance level of 5%.

The von Kossa staining showed that both BD and ESRRM putty induced mineralization starting at week 1; this mineralization increased further until the end of the study. In contrast, MM-MTA induced dystrophic calcification later, from 4 weeks onward. SEM/EDX showed no statistically significant differences in the calcium- and phosphorus-rich areas among the 3 materials at any time point (p > 0.05).

After subcutaneous implantation, biomineralization of the 3-calcium silicate-based cements started early and increased over time, and all 3 tested cements generated calcium- and phosphorus-containing surface precipitates.