The effect of acidity on the physicochemical properties of two hydraulic calcium silicate-based cements and two calcium phosphate silicate-based cements.

BACKGROUND: Bioceramic cements have been widely used in endodontic treatment. This study aimed to compare the microhardness, elastic modulus, internal microstructure and chemical compositions of Biodentine, WMTA, ERRM Putty, iRoot FS and IRM after exposure to PBS, butyric acid, and butyric acid followed by PBS. METHODS: Specimens of each material were prepared and randomly divided into 5 subgroups (n = 5): subgroup A: PBS (pH = 7.4) for 4 days, subgroup B: PBS (pH = 7.4) for 14 days, subgroup C: butyric acid (pH = 5.4) for 4 days, subgroup D: butyric acid (pH = 5.4) for 14 days, subgroup E: butyric acid for 4 days followed by 10 days in contact with PBS. The surface microhardness, elastic modulus, internal morphologic and chemical compositions of specimens were analyzed. RESULTS: The microhardness and elastic modulus values of all materials were significantly higher in the presence of PBS compared to exposure to butyric acid, with the same setting time (P < 0.01). After 4-day exposure to butyric acid followed by 10-day exposure to PBS, the microhardness values returned to the same level as 4-day exposure to PBS (P > 0.05). Biodentine showed significantly higher microhardness and elastic modulus values than other materials, while IRM displayed the lowest (P < 0.01). CONCLUSION: Biodentine seems the most suitable bioceramic cements when applied to an infected area with acidic pH. Further storage at neutral pH, e.g. PBS reverses the adverse effects on bioceramic cements caused by a low pH environment.

Physical properties and hydration behavior of a fast-setting bioceramic endodontic material.

BACKGROUND: To investigate the physical properties and the hydration behaviour of the fast-setting bioceramic iRoot FS Fast Set Root Repair Material (iRoot FS) and three other endodontic cements. METHODS: iRoot FS, Endosequence Root Repair Material Putty (ERRM Putty), gray and white mineral trioxide aggregate (G-MTA & W-MTA), and intermediate restorative material (IRM) were evaluated. The setting time was measured using ANSI/ADA standards. Microhardness was evaluated using the Vickers indentation test. Compressive strength and porosity were investigated at 7 and 28 days. Differential scanning calorimetry (DSC) was employed for the hydration test. RESULTS: iRoot FS had the shortest setting time of the four bioceramic cements (p < .001). The microhardness values of iRoot FS, ERRM Putty and MTA increased at different rates over the 28 days period. At day one, ERRM Putty had the lowest microhardness of the bioceramic cements (p < .001), but reached the same level as MTA at 4, 7 and 28 days. The microhardness of iRoot FS was lower than that of W-MTA at 7 and 28 days (p < .05). The porosity of the materials did not change after 7 days (p < .05). The compressive strength values at 28 days were significantly greater for all bioceramic groups compared to those at 7 days (p < .01). ERRM Putty had the highest compressive strength and the lowest porosity of the evaluated bioceramic cements (p < .05), followed by iRoot FS, W-MTA, and G-MTA, respectively. DSC showed that iRoot FS hydrated fastest, inducing an intense exothermic reaction. The ERRM Putty did not demonstrate a clear exothermic peak during the isothermal calorimetry test. CONCLUSIONS: iRoot FS had a faster setting time and hydrating process than the other bioceramic cements tested. The mechanical properties of iRoot FS, G-MTA and W-MTA were relatively similar.

Quantitative Assessment of Dimensional Evaluation and Artefacts from Filling Materials with CBCT Using Standard Phantom Roots.

OBJECTIVE: To investigate the accuracy of dimensional evaluation and representation of artefacts generated by different gutta-percha (GP) cones with or without sealer with CBCT using a reproducible, standardised phantom root methodology. METHODS: The reproducible artificial phantom roots with six root canal sizes from #25 to #50 and 0.04 taper were aligned according to the jaw curvature in a stone model for dimensional measurements. Each root was scanned while empty and filled with four types of filling materials. The specimens were scanned using the CS 9300 3D (Carestream Dental, Rochester, NY, USA) (at two different resolutions), 3D Accuitomo (J Morita, Kyoto, Japan) and NewTom VGi (Verona, Italy) CBCT systems. The hyperdense and hypodense axial slice artefacts from root canal sizes #40, #45 and #50 were recorded. RESULTS: Dimensions were significantly smaller and more accurate with CS 9300/0.09 mm voxel size than with other protocols. The hypodense band was found mostly in the CS 9300 3D system with 0.18 mm voxel size, especially in the buccal-lingual (95%) and coronal (64%) sections. The 3D Accuitomo CBCT system showed the lowest presence of the hypodense band. Areas of both light and dark artefacts were significantly larger in the coronal third than in the apical and middle thirds. CONCLUSION: Artefacts in the coronal locations and in buccal-lingual sections were more evident in the CS 9300 3D system with a 0.18-mm voxel size.

Physicochemical and Biological Evaluation of Endodontic Filling Materials for Primary Teeth.

This study assessed the pH, radiopacity, antimicrobial effect, cytotoxicity and biocompatibility of endodontic filling materials for primary teeth. Zinc oxide eugenol (ZOE), Vitapex and Calen paste thickened with zinc oxide (ZO) were evaluated in comparison to an experimental MTA-based material. Radiopacity was tested using a graduated aluminum stepwedge with a digital sensor (n=5). The materials pH was recorded at 1, 4, 12 h; 1, 3, 7, 15 and 30 days (n=5). Direct contact test was used to assess the antimicrobial efficacy against Enterococcus faecalis after 1, 4, 12, 24 h (n=5). Cytotoxicity assay used MTT test for cell viability after incubation for 1, 3 and 7 days (n=5). For biocompatibility test, Wistar rats had received implants containing each material (n=5). The biopsied tissues were histologically analyzed after 15, 30 and 60 days. The results of radiopacity, pH, antimicrobial capacity and cytotoxicity were analyzed using ANOVA and Tukey tests. The histological data were submitted to Kruskal-Wallis test. The experimental material presented the lowest radiopacity (3.28 mm Al) and had a pH>12.0 throughout the test period. The experimental material showed the highest antibacterial effect, killing over 99.97% bacteria in 4 h. Vitapex presented the highest cell viability. Initially, biocompatibility test showed moderate to severe inflammation in all groups. After 60 days, Calen+ZO group showed moderate inflammation, while the others showed predominantly mild inflammatory reaction. The present results demonstrated that the experimental MTA-based material exhibited satisfactory behavior regarding the studied properties. Additional in vivo studies are necessary for a better evaluation of the material.

Fatigue Resistance of a 3-dimensional Conforming Nickel-Titanium Rotary Instrument in Double Curvatures.

INTRODUCTION: Fatigue resistance of ProFile, Vortex Blue, and TRUShape files in artificial single curvature and in 2 different artificial double curvature canals was evaluated. METHODS: Three files (ProFile, Vortex Blue [size 20/.06], and TRUShape [size 20/.06v]) were subjected to fatigue tests in a single curvature (group 1: 60° curvature) and 2 different double curvatures (group 2: 60° and 30° curvatures; group 3: two 60° curvatures). The time to fracture and the total number of cycles to failure were recorded. The fracture surfaces of the fragments were examined with a scanning electron microscope. RESULTS: All files had significantly higher fatigue resistance in a single curvature canal than in the double curvature canals. In a single curvature group, the time to fracture of TRUShape and ProFile was longer than in Vortex Blue files. In both double curvature groups, TRUShape had the longest time to fracture among all files. The fatigue resistance (the time to fracture and number of cycles to failure) of ProFile and Vortex Blue was lower in group 3 than in group 2 (P < .05). However, there was no significant difference in fatigue resistance of TRUShape in the double curvature groups. The length of the fragment of TRUShape was longer than in Vortex Blue and ProFile files in group 3 (P < .05). CONCLUSIONS: The fatigue performance of TRUShape is different in double curvature canals, compared with conventional nickel-titanium rotary files. The fatigue resistance of TRUShape was superior to ProFile and Vortex Blue in double curvature canals.

Phase Transformation Behavior and Resistance to Bending and Cyclic Fatigue of ProTaper Gold and ProTaper Universal Instruments.

INTRODUCTION: The purpose of this study was to compare the flexibility and cyclic fatigue resistance of ProTaper Universal (PTU; Dentsply Tulsa Dental Specialities, Tulsa, OK) and ProTaper Gold (PTG; Dentsply Tulsa Dental Specialities, Tulsa, OK) instruments in relation to their phase transformation behavior. METHODS: Sizes S1, S2, F1, F2, and F3 of PTU and PTG instruments were subjected to rotational bending at a curvature of 40° and a radius of 6 mm. The number of cycles to fracture (NCF) was recorded. The fracture surface of all fragments was examined with a scanning electron microscope. Flexibility was determined by 45° bending tests according to the ISO 3630-1 specification. Unused and fractured instruments were examined by differential scanning calorimetry. RESULTS: PTG had a cyclic fatigue resistance superior to PTU in all sizes (P < .001). The NCF of the nickel-titanium files of sizes S1 and S2 was significantly higher than those of sizes F1 to F3 (P < .001). No significant difference in the NCF of PTU instruments was detected between F1 and F2. The fractured files of both PTU and PTG showed the typical fracture pattern of fatigue failure. The bending load values were significantly lower for PTG than for PTU (P < .05). The differential scanning calorimetry analyses showed that each segment of the PTG instruments had a higher austenite finish temperature (50.1°C ± 1.7°C) than the PTU instruments (21.2°C ± 1.9°C) (P < .001). PTG instruments had a 2-stage transformation behavior. There was no significant difference in the austenite finish between unused files and instruments subjected to the fatigue process. CONCLUSIONS: PTG files were significantly more flexible and resistant to fatigue than PTU files. PTG exhibited different phase transformation behavior than PTU, which may be attributed to the special heat treatment history of PTG instruments. PTG may be more suited for preparing canals with a more abrupt curvature.

In vitro cytotoxicity of calcium silicate-containing endodontic sealers.

INTRODUCTION: The cytotoxicity of 2 novel calcium silicate-containing endodontic sealers to human gingival fibroblasts was studied. METHODS: EndoSequence BC (Brasseler, Savannah, GA), MTA Fillapex (Angelus Indústria de Produtos Odontológicos S/A, Londrina, PR, Brazil) and a control sealer (AH Plus; Dentsply DeTrey GmbH, Konstanz, Germany) were evaluated. Human gingival fibroblasts were incubated for 3 days both with the extracts from fresh and set materials in culture medium and cultured on the surface of the set materials in Dulbecco-modified Eagle medium. Fibroblasts cultured in Dulbecco-modified Eagle medium were used as a control group. Cytotoxicity was evaluated by flow cytometry, and the adhesion of the fibroblasts to the surface of the set materials was assessed using scanning electron microscopy. The data of cell cytotoxicity were analyzed statistically using a 1-way analysis of variance test at a significance level of P < .05. RESULTS: Cells incubated with extracts from BC Sealer showed higher viabilities at all extract concentrations than cells incubated with extracts from freshly mixed AH Plus and fresh and set MTA Fillapex, esspecially for the high extract concentrations (1:2 and 1:8 dilutions). Extracts from set MTA Fillapex of 2 weeks and older were more cytotoxic than extracts from freshly mixed and 1-week-old cement. With extract concentrations of 1:32 and lower, MTA Fillapex was no longer cytotoxic. After setting, AH Plus was no longer cytotoxic, and the fibroblast cells grew on set AH Plus equally as well as on BC Sealer. CONCLUSIONS: BC Sealer and MTA Fillapex, the 2 calcium silicate-containing endodontic sealers, exhibited different cytotoxicity to human gingival fibroblasts.

Cyclic Fatigue of ProFile Vortex and Vortex Blue Nickel-Titanium Files in Single and Double Curvatures.

INTRODUCTION: The aims of this study were to determine the flexibility of ProFile Vortex (VX) and Vortex Blue (VB) files (Dentsply Tulsa Dental Specialties, Tulsa, OK) and then to evaluate and compare their fatigue resistance in artificial single curvature and 2 different artificial double curvature canals. METHODS: Flexibility of the files (size 25/.04) in bending was assessed according to ISO 3630-1. Both files were subjected to fatigue tests inside artificial canals with a single curvature (group 1: 60° curvature, 5-mm radius) and with 2 different double curvatures (group 2: first [coronal] curve of 60° curvature and 5-mm radius and the second one [apical] of 30° curvature and 2-mm radius and group 3: first curve of 60° curvature and 5-mm radius and the second one of 60° curvature and 2-mm radius). The number of cycles to fracture (NCF) was recorded, and the fracture surface of all fragments was examined with a scanning electron microscope. RESULTS: The bending load was significantly lower for VB files than VX files (P < .05), and the 2 types of files followed different trajectories in identical canals. In group 1, the 2 files had significantly higher NCF than in groups 2 and 3 (P < .05). Both files had significantly higher NCF in group 2 than in group 3 (P < .05). In group 1, VB files had fatigue resistance superior to VX files (P < .05), whereas in groups 2 and 3 their fatigue resistance was not statistically different from each other. The crack initiation of a vast majority of files that fractured in double curvature canals (groups 2 and 3) was localized on either 1 of 2 of the 3 cutting edges. CONCLUSIONS: Double curvature canals represent a much more stressful and challenging anatomy than single curvature canals, and, in them, fatigue resistance may be affected by the degrees and the radii of curvatures as well as by the bending properties of the files.

In vitro cytotoxicity evaluation of a novel root repair material.

INTRODUCTION: This study examined the effect of a new bioactive dentin substitute material (Biodentine) on the viability of human gingival fibroblasts. METHODS: Biodentine, White ProRoot mineral trioxide aggregate (MTA), and glass ionomer cement were evaluated. Human gingival fibroblasts were incubated for 1, 3, and 7 days both in the extracts from immersion of set materials in culture medium and directly on the surface of the set materials immersed in culture medium. Fibroblasts cultured in Dulbecco modified Eagle medium were used as a control group. Cytotoxicity was evaluated by flow cytometry, and the adhesion of human gingival fibroblasts to the surface of the set materials was assessed by using scanning electron microscopy. The data of cell cytotoxicity were analyzed statistically by using a one-way analysis of variance test at a significance level of P< .05. RESULTS: Cells exposed to extracts from Biodentine and MTA showed the highest viabilities at all extract concentrations, whereas cells exposed to glass ionomer cement extracts displayed the lowest viabilities (P< .05). There was no significant difference in cell viabilities between Biodentine and MTA during the entire experimental period (P> .05). Human gingival fibroblasts in contact with Biodentine and MTA attached to and spread over the material surface after an overnight culture and increased in numbers after 3 and 7 days of culture. CONCLUSIONS: Biodentine caused gingival fibroblast reaction similar to that by MTA. Both materials were less cytotoxic than glass ionomer cement.

[Effects of three at-home bleaching agents on enamel structure and structure-related mechanical properties].

OBJECTIVE: To investigate the effects of three differently concentrated at-home bleaching agents on the structure and the structure-related mechanical properties of human enamel. METHODS: Sixty enamel specimens were randomly divided into four groups and treated with 10% carbamide peroxide (CP), 15% CP, 20% CP and distilled water, respectively. The bleaching process was 8 h/day for 14 consecutive days. Baseline and final atomic force microscopy (AFM) surface detection, Raman spectroscopy, attenuated total reflectance-infrared spectroscopy (ATR-IR), microhardness and fracture toughness (FT) measurements were carried out before and after bleaching experiments. RESULTS: CP didn't change the morphology of enamel. Meanwhile, the three bleached groups and the control group had no significant difference in root mean square detection (P = 0.774), ν(2)CO(3)(2-) : ν(1)ν(3)PO(4)(3-) (P = 0.263) and microhardness (P = 0.829). The percentage of relative Raman intensity in the three bleached groups and the control group were (105.74 ± 11.34)%, (104.46 ± 8.83)%, (99.52 ± 9.32)% and (97.62 ± 7.46)%, respectively. There was no significant difference among them (P = 0.062). However, the percentage of laser-induced fluorescence in the three bleached groups and the control group were (20.86 ± 7.23)%, (22.14 ± 7.34)%, (21.10 ± 7.59)% and (100.78 ± 3.70)%, respectively. There was significant difference between either of the bleached groups and the control group (P < 0.001). Moreover, FT declined significantly in the three groups (P = 0.024, P = 0.005, P = 0.013) when compared with the control group. CONCLUSIONS: Under in vitro condition, three differently concentrated at-home bleaching agents wouldn't induce the demineralization and the decline of microhardness on enamel. However, the decrease of FT on enamel seemed to be inevitable after bleaching.

Physicochemical and Biological Evaluation of Endodontic Filling Materials for Primary Teeth

Abstract This study assessed the pH, radiopacity, antimicrobial effect, cytotoxicity and biocompatibility of endodontic filling materials for primary teeth. Zinc oxide eugenol (ZOE), Vitapex and Calen paste thickened with zinc oxide (ZO) were evaluated in comparison to an experimental MTA-based material. Radiopacity was tested using a graduated aluminum stepwedge with a digital sensor (n=5). The materials pH was recorded at 1, 4, 12 h; 1, 3, 7, 15 and 30 days (n=5). Direct contact test was used to assess the antimicrobial efficacy against Enterococcus faecalis after 1, 4, 12, 24 h (n=5). Cytotoxicity assay used MTT test for cell viability after incubation for 1, 3 and 7 days (n=5). For biocompatibility test, Wistar rats had received implants containing each material (n=5). The biopsied tissues were histologically analyzed after 15, 30 and 60 days. The results of radiopacity, pH, antimicrobial capacity and cytotoxicity were analyzed using ANOVA and Tukey tests. The histological data were submitted to Kruskal-Wallis test. The experimental material presented the lowest radiopacity (3.28 mm Al) and had a pH>12.0 throughout the test period. The experimental material showed the highest antibacterial effect, killing over 99.97% bacteria in 4 h. Vitapex presented the highest cell viability. Initially, biocompatibility test showed moderate to severe inflammation in all groups. After 60 days, Calen+ZO group showed moderate inflammation, while the others showed predominantly mild inflammatory reaction. The present results demonstrated that the experimental MTA-based material exhibited satisfactory behavior regarding the studied properties. Additional in vivo studies are necessary for a better evaluation of the material.

Resumo Este estudo avaliou o pH, radiopacidade, efeito antimicrobiano, citotoxicidade e biocompatibilidae de materiais obturadores de dentes decíduos. Foram avaliados o cimento de óxido de zinco e eugenol (OZE), Vitapex e pasta Calen espessada com óxido de zinco (OZ), comparativamente a um material experimental à base de MTA. A radiopacidade foi testada usando uma escala milimetrada de alumínio, com um sensor digital. O pH dos materiais também foi avaliado nos períodos de 1, 4, 12 h; 1, 3, 7, 15, e 30 dias (n=5). O teste de contato direto foi utilizado para avaliação da atividade antimicrobiana dos materiais conta uma cepa de Enterococcus faecalis após incubação por 1, 4, 12, e 24 h (n=5). Para avaliação da citotoxicidade foi utilizado o teste de MTT para avaliação da viabilidade celular. No teste de biocompatibilidade, ratos Wistar receberam implantes subcutâneos contendo cada material obturador (n=5). Após biópsia, os tecidos foram submetidos à avaliação histológica em períodos de 15, 30 e 60 dias. Os resultados de radiopacidade, pH, ação antimicrobiana e citotoxicidade foram analisados usando os testes ANOVA e Tukey. Os dados histológicos foram submetidos ao teste de Kruskal-Wallis. O material experimental apresentou a menor radiopacidade (3.28 mm Al) e apresentou um pH superior a 12,0 durante todo o período experimental. O material experimental apresentou o maior efeito antimicrobiano, eliminando mais de 99,97% das bactérias em um período de 4 h. O Vitapex permitiu uma maior viabilidade celular em comparação aos demais materiais avaliados. Inicialmente, os testes de biocompatibilidade demonstraram inflamação de moderada a severa em todos os grupos. Após 60 dias, apenas o grupo Calen+ OZ apresentou inflamação moderada, enquanto os outros materiais demonstraram predominantemente a indução de inflamação leve. Os resultados demonstraram que o material experimental à base de MTA exibiu comportamento satisfatório com relação às propriedades avaliadas. Estudos adicionais, in vivo, são necessários para uma melhor avaliação do material.

[The preparation of nano-hydroxyapatite and preliminary observation on its effects on the occlusion of dentinal tubule].

OBJECTIVE: To synthesize nano-hydroxyapatite (nano-HA) and evaluate its effect on the occlusion of dentinal tubules in vitro, and therefore provide evidence for the clinical application. METHODS: (NH(4))(2)HPO(4) and Ca(NO3)2 were used to form nano-HA, which was characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectrometer (FTIR) and X-ray diffractometer (XRD) respectively. Twenty-four dentin slabs were obtained from 8 healthy third molars and randomly divided into 3 groups, which were control group, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group, and nano-HA group. After the CPP-ACP and nano-HA were topically applied to the slabs of two study groups twice a day for 7 days, the surface of slab dentin was observed using SEM. RESULTS: SEM, TEM, FTIR, and XRD tests showed that nano-HA was synthesized successfully. SEM observations revealed that the sealing of dentinal tubules of nano-HA group was extremely high when compared with those of control and CPP-ACP group. CONCLUSIONS: In comparison with CPP-ACP, nano-HA could occlude dentinal tubules more effectively in vitro.