Advancements in bio-ceramic technology has revolutionised endodontic material science by enhancing the treatment outcome for patients. This class of dental materials conciliates excellent biocompatibility with high osseoconductivity that render them ideal for endodontic care. Few recently introduced bio-ceramic materials have shown considerable clinical success over their early generations in terms of good handling characteristics. Calcium enriched mixture (CEM) cement, Endosequence sealer, and root repair materials, Biodentine and BioAggregate are the new classes of bio-ceramic materials. The aim of this literature review is to present investigations regarding properties and applications of CEM cement in endodontics. A review of the existing literature was performed by using electronic and hand searching methods for CEM cement from January 2006 to December 2013. CEM cement has a different chemical composition from that of mineral trioxide aggregate (MTA) but has similar clinical applications. It combines the biocompatibility of MTA with more efficient characteristics, such as significantly shorter setting time, good handling characteristics, no staining of tooth and effective seal against bacterial leakage.

The purpose of this study was to evaluate the physical properties of different self-adhesive resin cements and their shear bond strength on dentin and lithium disilicate ceramic and compare these result with that of conventional resin cement. For this study, four self-adhesive resin cements (Rely-X Unicem, Embrace Wetbond, Mexcem, BisCem), one conventional resin cement (Rely-X ARC) and one restorative resin composite (Z-350) were used. In order to evaluate the physical properties, compressive strength, diametral tensile strength and flexural strength were measured. To evaluate the shear bond strength on dentin, each cement was adhered to buccal dentinal surface of extracted human lower molars. Dentin bonding agent was applied after acid etching for groups of Rely-X ARC and Z-350. In order to evaluate the shear bond strength on ceramic, lithium disilicate glass ceramic (IPS Empress 2) disks were prepared. Only Rely-X ARC and Z-350 groups were pretreated with hydrofluoric acid and silane. And then each resin cement was adhered to ceramic surface in 2 mm diameter. Physical properties and shear bond strengths were measured using a universal testing machine.

Results were as follows

1. BisCem showed the lowest compressive strength, diametral tensile strength and flexural strength. (P<0.05)

2. Self-adhesive resin cements showed significantly lower shear bond strength on the dentin and lithium disilicate ceramic than Rely-X ARC and Z-350 (P<0.05)

In conclusion, self-adhesive resin cements represent the lower physical properties and shear bond strength than a conventional resin cement.

The purposes of this study were firstly to identify the microbial species on gutta-percha (GP) cones exposed at clinics using polymerase chain reaction, and secondly to evaluate the short-term sterilization effect of three chemical disinfectants. It also evaluated the alteration of surface texture and physical properties of GP cones after 5-min soaking into three chemical disinfectants. 150 GP cones from two endodontic departments were randomly selected for microbial detection using PCR assay with universal primer. After inoculation on the sterilized GP cones with the same microorganism identified by PCR assay, they were soaked in three chemical disinfectants: 5% NaOCl, 2% Chlorhexidine, and ChloraPrep for 1, 5, 10, and 30 minutes. The sterilization effect was evaluated by turbidity and subculture. The change of surface textures using a scanning electron microscope and the tensile strength and elongation rate of the GP cones were measured using an Instron 5500 (Canton). Statistical analysis was performed.

Four bacterial species were detected in 29 GP cones (19.4%), and all the species belonged to the genus Staphylococcus. All chemical disinfectants were effective in sterilization with just 1 minute soaking. On the SEM picture of NaOCl-soaked GP cone, a cluster of cuboidal crystals was seen on the cone surface. The tensile strength of NaOCl-soaked group was significantly higher than the other groups (p < 0.05). Also, all disinfectants significantly increased the elongation rate of GP cones compared to the fresh GP cone (p < 0.05). Present data demonstrate that three chemical disinfectants are useful for rapid sterilization of GP cone just before obturation.