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Research Articles
Biomineralization of three calcium silicate-based cements after implantation in rat subcutaneous tissue
Ranjdar Mahmood Talabani, Balkees Taha Garib, Reza Masaeli, Kavosh Zandsalimi, Farinaz Ketabat
Restor Dent Endod 2021;46(1):e1.   Published online December 2, 2020
DOI: https://doi.org/10.5395/rde.2021.46.e1
AbstractAbstract PDFPubReaderePub
Objectives

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.

Materials and Methods

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%.

Results

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).

Conclusions

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.

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Comparative evaluation of the bond strength of self-adhering and bulk-fill flowable composites to MTA Plus, Dycal, Biodentine, and TheraCal: an in vitro study
Aakrati Raina, Asheesh Sawhny, Saurav Paul, Sridevi Nandamuri
Restor Dent Endod 2020;45(1):e10.   Published online January 8, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e10
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal.

Materials and Methods

Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance.

Results

A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal.

Conclusions

Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

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A micro-computed tomography evaluation of voids using calcium silicate-based materials in teeth with simulated internal root resorption
Vildan Tek, Sevinç Aktemur Türker
Restor Dent Endod 2020;45(1):e5.   Published online November 29, 2019
DOI: https://doi.org/10.5395/rde.2020.45.e5
AbstractAbstract PDFPubReaderePub
Objectives

The obturation quality of MTA, Biodentine, Total Fill BC root canal sealer (RCS), and warm gutta-percha (WGP) in teeth with simulated internal root resorption (IRR) was evaluated by using micro-computed tomography.

Materials and Methods

Standardized IRR cavities were created using 40 extracted maxillary central incisor teeth and randomly assigned into 4 groups (n = 10). IRR cavities were filled with MTA, Biodentine, Total Fill BC RCS (bulk-fill form) and WGP + Total Fill BC RCS. Percentage of voids between resorptive cavity walls and obturation material (external void), and inside the filling materials (internal voids) were measured.

Results

Total Fill BC sealer in the bulk-fill form presented significantly highest values of external and internal void percentages (p < 0.05). Biodentine showed a significantly lowest external void percentage (p < 0.05). WGP + Total Fill BC RCS presented significantly lower values of internal void percentages than all groups (p < 0.05), except Biodentine (p > 0.05).

Conclusion

None of the filling materials were created void-free obturation in resorption cavities. Biodentine may favor its application in teeth with IRR over Angelus MTA and bulk-fill form of Total Fill BC.

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The push-out bond strength of BIOfactor mineral trioxide aggregate, a novel root repair material
Makbule Bilge Akbulut, Durmus Alperen Bozkurt, Arslan Terlemez, Melek Akman
Restor Dent Endod 2019;44(1):e5.   Published online January 28, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e5
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this in vitro study was to evaluate the push-out bond strength of a novel calcium silicate-based root repair material-BIOfactor MTA to root canal dentin in comparison with white MTA-Angelus (Angelus) and Biodentine (Septodont).

Materials and Methods

The coronal parts of 12 central incisors were removed and the roots were embedded in acrylic resin blocks. Midroot dentin of each sample was horizontally sectioned into 1.1 mm slices and 3 slices were obtained from each root. Three canal-like standardized holes having 1 mm in diameter were created parallel to the root canal on each dentin slice with a diamond bur. The holes were filled with MTA-Angelus, Biodentine, or BIOfactor MTA. Wet gauze was placed over the specimens and samples were stored in an incubator at 37°C for 7 days to allow complete setting. Then samples were subjected to the push-out test method using a universal test machine with the loading speed of 1 mm/min. Data was statistically analyzed using Friedman test and post hoc Wilcoxon signed rank test with Bonferroni correction.

Results

There were no significant differences among the push-out bond strength values of MTA-Angelus, Biodentine, and BIOfactor MTA (p > 0.017). Most of the specimens exhibited cohesive failure in all groups, with the highest rate found in Biodentine group.

Conclusions

Based on the results of this study, MTA-Angelus, Biodentine, and BIOfactor MTA showed similar resistances to the push-out testing.

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Case Report
Fibre reinforcement in a structurally compromised endodontically treated molar: a case report
Renita Soares, Ida de Noronha de Ataide, Marina Fernandes, Rajan Lambor
Restor Dent Endod 2016;41(2):143-147.   Published online February 22, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.143
AbstractAbstract PDFPubReaderePub

The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment.

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Research Articles
Evaluation of reparative dentin formation of ProRoot MTA, Biodentine and BioAggregate using micro-CT and immunohistochemistry
Jia Kim, Young-Sang Song, Kyung-San Min, Sun-Hun Kim, Jeong-Tae Koh, Bin-Na Lee, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
Restor Dent Endod 2016;41(1):29-36.   Published online January 4, 2016
DOI: https://doi.org/10.5395/rde.2016.41.1.29
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to assess the ability of two new calcium silicate-based pulp-capping materials (Biodentine and BioAggregate) to induce healing in a rat pulp injury model and to compare them with mineral trioxide aggregate (MTA).

Materials and Methods

Eighteen rats were anesthetized, cavities were prepared and the pulp was capped with either of ProRoot MTA, Biodentine, or BioAggregate. The specimens were scanned using a high-resolution micro-computed tomography (micro-CT) system and were prepared and evaluated histologically and immunohistochemically using dentin sialoprotein (DSP).

Results

On micro-CT analysis, the ProRoot MTA and Biodentine groups showed significantly thicker hard tissue formation (p < 0.05). On H&E staining, ProRoot MTA showed complete dentin bridge formation with normal pulpal histology. In the Biodentine and BioAggregate groups, a thick, homogeneous hard tissue barrier was observed. The ProRoot MTA specimens showed strong immunopositive reaction for DSP.

Conclusions

Our results suggest that calcium silicate-based pulp-capping materials induce favorable effects on reparative processes during vital pulp therapy and that both Biodentine and BioAggregate could be considered as alternatives to ProRoot MTA.

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Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth
Bharti Kusum, Kumar Rakesh, Khanna Richa
Restor Dent Endod 2015;40(4):276-285.   Published online September 9, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.276
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically.

Materials and Methods

A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system.

Results

The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively.

Conclusions

Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.

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In vitro cytotoxicity of four calcium silicate-based endodontic cements on human monocytes, a colorimetric MTT assay
Sedigheh Khedmat, Somayyeh Dehghan, Jamshid Hadjati, Farimah Masoumi, Mohammad Hossein Nekoofar, Paul Michael Howell Dummer
Restor Dent Endod 2014;39(3):149-154.   Published online April 30, 2014
DOI: https://doi.org/10.5395/rde.2014.39.3.149
AbstractAbstract PDFPubReaderePub
Objectives

This study was performed to evaluate the cytotoxicity of four calcium silicate-based endodontic cements at different storage times after mixing.

Materials and Methods

Capillary tubes were filled with Biodentine (Septodont), Calcium Enriched Mixture (CEM cement, BioniqueDent), Tech Biosealer Endo (Tech Biosealer) and ProRoot MTA (Dentsply Tulsa Dental). Empty tubes and tubes containing Dycal were used as negative and positive control groups respectively. Filled capillary tubes were kept in 0.2 mL microtubes and incubated at 37℃. Each material was divided into 3 groups for testing at intervals of 24 hr, 7 day and 28 day after mixing. Human monocytes were isolated from peripheral blood mononuclear cells and cocultered with 24 hr, 7 day and 28 day samples of different materials for 24 and 48 hr. Cell viability was evaluated using an MTT assay.

Results

In all groups, the viability of monocytes significantly improved with increasing storage time regardless of the incubation time (p < 0.001). After 24 hr of incubation, there was no significant difference between the materials regarding monocyte viability. However, at 48 hr of incubation, ProRoot MTA and Biodentine were less cytotoxic than CEM cement and Biosealer (p < 0.01).

Conclusions

Biodentine and ProRoot MTA had similar biocompatibility. Mixing ProRoot MTA with PBS in place of distilled water had no effect on its biocompatibility. Biosealer and CEM cement after 48 hr of incubation were significantly more cytotoxic to on monocyte cells compared to ProRoot MTA and Biodentine.

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Cytotoxicity and physical properties of tricalcium silicate-based endodontic materials
Young-Eun Jang, Bin-Na Lee, Jeong-Tae Koh, Yeong-Joon Park, Nam-Eok Joo, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
Restor Dent Endod 2014;39(2):89-94.   Published online March 21, 2014
DOI: https://doi.org/10.5395/rde.2014.39.2.89
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the cytotoxicity, setting time and compressive strength of MTA and two novel tricalcium silicate-based endodontic materials, Bioaggregate (BA) and Biodentine (BD).

Materials and Methods

Cytotoxicity was evaluated by using a 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-((phenylamino)carbonyl)-2H-tetrazolium hydroxide (XTT) assay. Measurements of 9 heavy metals (arsenic, cadmium, chromium, copper, iron, lead, manganese, nickel, and zinc) were performed by inductively coupled plasma-mass spectrometry (ICP-MS) of leachates obtained by soaking the materials in distilled water. Setting time and compressive strength tests were performed following ISO requirements.

Results

BA had comparable cell viability to MTA, whereas the cell viability of BD was significantly lower than that of MTA. The ICP-MS analysis revealed that BD released significantly higher amount of 5 heavy metals (arsenic, copper, iron, manganese, and zinc) than MTA and BA. The setting time of BD was significantly shorter than that of MTA and BA, and the compressive strength of BA was significantly lower than that of MTA and BD.

Conclusions

BA and BD were biocompatible, and they did not show any cytotoxic effects on human periodontal ligament fibroblasts. BA showed comparable cytotoxicity to MTA but inferior physical properties. BD had somewhat higher cytotoxicity but superior physical properties than MTA.

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Case Reports
Biodentine-a novel dentinal substitute for single visit apexification
Gurudutt Nayak, Mohammad Faiz Hasan
Restor Dent Endod 2014;39(2):120-125.   Published online March 21, 2014
DOI: https://doi.org/10.5395/rde.2014.39.2.120
AbstractAbstract PDFPubReaderePub

Use of an apical plug in management of cases with open apices has gained popularity in recent years. Biodentine, a new calcium silicate-based material has recently been introduced as a dentine substitute, whenever original dentine is damaged. This case report describes single visit apexification in a maxillary central incisor with necrotic pulp and open apex using Biodentine as an apical barrier, and a synthetic collagen material as an internal matrix. Following canal cleaning and shaping, calcium hydroxide was placed as an intracanal medicament for 1 mon. This was followed by placement of small piece of absorbable collagen membrane beyond the root apex to serve as matrix. An apical plug of Biodentine of 5 mm thickness was placed against the matrix using pre-fitted hand pluggers. The remainder of canal was back-filled with thermoplasticized gutta-percha and access cavity was restored with composite resin followed by all-ceramic crown. One year follow-up revealed restored aesthetics and function, absence of clinical signs and symptoms, resolution of periapical rarefaction, and a thin layer of calcific tissue formed apical to the Biodentine barrier. The positive clinical outcome in this case is encouraging for the use of Biodentine as an apical plug in single visit apexification procedures.

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Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report
Cyril Villat, Brigitte Grosgogeat, Dominique Seux, Pierre Farge
Restor Dent Endod 2013;38(4):258-262.   Published online November 12, 2013
DOI: https://doi.org/10.5395/rde.2013.38.4.258
AbstractAbstract PDFPubReaderePub

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

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Research Article
Effects of dentin moisture on the push-out bond strength of a fiber post luted with different self-adhesive resin cements
Sevinç Aktemur Türker, Emel Uzunoğlu, Zeliha Yılmaz
Restor Dent Endod 2013;38(4):234-240.   Published online November 12, 2013
DOI: https://doi.org/10.5395/rde.2013.38.4.234
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the effects of intraradicular moisture on the pushout bond strength of a fibre post luted with several self-adhesive resin cements.

Materials and Methods

Endodontically treated root canals were treated with one of three luting cements: (1) RelyX U100, (2) Clearfil SA, and (3) G-Cem. Roots were then divided into four subgroups according to the moisture condition tested: (I) dry: excess water removed with paper points followed by dehydration with 95% ethanol, (II) normal moisture: canals blot-dried with paper points until appearing dry, (III) moist: canals dried by low vacuum using a Luer adapter, and (IV) wet: canals remained totally flooded. Two 1-mm-thick slices were obtained from each root sample and bond strength was measured using a push-out test setup. The data were analysed using a two-way analysis of variance and the Bonferroni post hoc test with p = 0.05.

Results

Statistical analysis demonstrated that moisture levels had a significant effect on the bond strength of luting cements (p < 0.05), with the exception of G-Cem. RelyX U100 displayed the highest bond strength under moist conditions (III). Clearfil SA had the highest bond strength under normal moisture conditions (II). Statistical ranking of bond strength values was as follows: RelyX U100 > Clearfil SA > G-Cem.

Conclusions

The degree of residual moisture significantly affected the adhesion of luting cements to radicular dentine.

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Original Article
The effects of the fluoride concentration of acidulated buffer solutions on dentine remineralization
Won-Sub Han, Chan-Young Lee
J Korean Acad Conserv Dent 2009;34(6):526-536.   Published online November 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.6.526
AbstractAbstract PDFPubReaderePub

The aim of this vitro-study is to evaluate the effects of fluoride on remineralization of artificial dentine caries. 10 sound permanent premolars, which were extracted for orthodontic reason within 1 week, were used for this study. Artificial dentine caries was created by using a partially saturated buffer solution for 2 days with grounded thin specimens and fractured whole-body specimens. Remineralization solutions with three different fluoride concentration (1 ppm, 2 ppm and 4 ppm) were used on demineralized-specimens for 7 days. Polarizing microscope and scanning electron microscope were used for the evaluation of the mineral distribution profile and morphology of crystallites of hydroxyapatite.

The results were as follows :

When treated with the fluoride solutions, the demineralized dentine specimens showed remineralization of the upper part and demineralization of the lower part of the lesion body simultaneously.

As the concentration of fluoride increased, the mineral precipitation in the caries dentine increased. The mineral precipitation mainly occurred in the surface layer in 1 and 2 ppm-specimens and in the whole lesion body in 4 ppm-specimens.

When treated with the fluoride solution, the hydroxyapatite crystals grew. This crystal growth was even observed in the lower part of the lesion body which had shown the loss of mineral.

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