Comparative Evaluation of Shear Bond Strength of Resin-modified Glass Ionomer Cement with ProRoot MTA and MTA Angelus.

AIM: The aim of the present study was to evaluate the shear bond strength of resin-modified glass ionomer cement with two different types of mineral trioxide aggregate at different time intervals. MATERIALS AND METHODS: A total of 80 cylindrical blocks were prepared using a self-cure acrylic resin with a central cavity of 4 mm internal diameter and 2 mm height. The prepared samples were randomly divided into two groups (n = 40 each) according to the type of MTA cements used (ProRoot MTA and MTA Angelus). Two groups were further sub-divided into four sub-groups of 10 samples each according to the different time intervals. ProRoot MTA and MTA Angelus were placed in the prepared cavity and a wet cotton pellet was placed over the filled cavity. A hollow plastic tube was placed over the MTA surface and resin-modified glass ionomer cement (RMGIC) was placed into the hollow plastic tube and light-cured (Spectrum 800, Dentsply Caulk Milford, DE, USA) according to the time intervals decided. After light curing the plastic tubes were removed carefully and the specimens were stored at 37°C and 100% humidity for 24 hours to encourage setting of MTA. The specimens were mounted in a universal testing machine (ADMET) and a crosshead speed of 0.5 mm/min was applied to each specimen by using a knife-edge blade until the bond between the MTA and RMGIC failed. The data were statistically analyzed using ANOVA, post hoc Tukey's t-test and Fisher's t-test and p-value ≤ 0.5 was considered significant. RESULTS: For both ProRoot MTA and MTA Angelus there was no statistically significant difference between 45 minutes and 24 hours (p-value ≥ 0.8). For ProRoot MTA, shear bond strength value at 10 minutes were significantly lower than 45 minutes and 24 hours group. However, for MTA Angelus, shear bond strength value at 10 minute was not significantly different from 45 minutes group (p-value ≥ 0.3). For both ProRoot MTA and MTA Angelus shear bond strength value at 0 minute were the least and were significantly lower than 10 minutes, 45 minutes, and 24 hours, respectively (p-value ≥ 0.000). CONCLUSION: Resin-modified glass ionomer cement can be layered over MTA Angelus after it is allowed to set for 10 minutes. However, ProRoot MTA should be allowed to set for at least 45 minutes before the placement of RMGIC to achieve better shear bond strength. CLINICAL SIGNIFICANCE: Due to the variety of types of mineral trioxide aggregate cements available in dentistry, it is justifiable to emphasize on different time intervals as it may affect the shear bond strength of restorative cements. Such information is pivotal for the clinicians while using mineral aggregate-based cements that receive forces from the condensation of restorative materials or occlusion, as the compressive strength may be affected due to different time intervals. How to cite this article: Tyagi N, Chaman C, Anand S, et al. Comparative Evaluation of Shear Bond Strength of Resin-modified Glass Ionomer Cement with ProRoot MTA and MTA Angelus. J Contemp Dent Pract 2024;25(1):35-40.

Comparison of Marginal Adaptation, Surface Hardness and Bond Strength of Resected and Retrofilled Calcium Silicate-based Cements Used in Endodontic Surgery: An In Vitro Study.

AIMS: This study compared the effects of orthograde and retrograde methods on marginal adaptation, surface hardness, and push-out bond strength (POBS) of three calcium silicate-based used in endodontic surgery. MATERIALS AND METHODS: Ninety single-rooted human mandibular premolars were randomly assigned into six groups (n = 15/group): groups I and II, ProRoot mineral trioxide aggregate (MTA) with orthograde and retrograde methods; groups III and IV, Biodentine (BD) with orthograde and retrograde methods; groups V and VI, iRoot BP Plus (BP-RPM) with orthograde and retrograde methods. After obturation, the apical 3 mm of each root was sectioned into two 1-mm-thick root slices and evaluated for marginal adaptation using a scanning electron microscope, surface hardness using Vickers hardness tester and POBS using a universal testing machine. RESULTS: Orthograde placement had a higher maximum gap width than retrograde placement (p < 0.05), but there was no significant difference among the tested materials (p > 0.05). Biodentine exhibited lower surface hardness than ProRoot MTA and iRoot BP Plus (p < 0.05), but there was no significant difference between ProRoot MTA and iRoot BP Plus (p > 0.05). Orthograde placement had higher POBS compared with retrograde placement (p < 0.05). Biodentine had higher POBS than iRoot BP Plus (p < 0.05), but no significant difference from ProRoot MTA (p > 0.05). The failure mode was mainly mixed for all the tested materials regardless of material type or placement technique. CONCLUSION: The retrograde method had better marginal adaptation; however, the orthograde method provided better dislodgement resistance. Biodentine had lower surface hardness than MTA and iRoot BP Plus with both techniques, whereas iRoot BP Plus demonstrated lower dislodging resistance than BD. CLINICAL SIGNIFICANCE: The current findings suggest that orthograde technique, a simpler periapical surgery, with ProRoot MTA provides potentially better surface hardness and POBS than BD and iRoot BP Plus in single-canal teeth.

Radiopacity evaluation of calcium silicate cements.

BACKGROUND: The aim of this study was to compare the radiopacity of calcium silicate cements using a digital imaging method. METHODS: Four calcium silicate cements, NeoMTA 2, OrthoMTA, ProRoot MTA, and Biodentine, were used in this study. Disk-shaped samples were prepared from each material and placed on a plexiglass plate. An aluminum step-wedge was placed alongside the samples on a digital sensor and exposed to 70 kVp and 8 mA from 30 cm away for 0.32 s. The greyness values ​​of the tested materials were measured digitally with the system software and compared with those of the step-wedge to determine the equivalent aluminum thickness. RESULTS: The radiopacity values, expressed in equivalent millimetres of aluminum, of the studied materials ProRoot MTA, OrthoMTA, NeoMTA 2, and Biodentine were 4.32 ± 0.17 mm Al, 3.92 ± 0.09 mm Al, 3.83 ± 0.07 mm Al, and 2.29 ± 0.21 mm Al, respectively. Statistically significant differences were found between the mean radiographic density values of the tested materials (p < 0.05). CONCLUSION: ProRoot MTA was the most radiopaque root canal filling material among the tested materials. All materials, except Biodentine, were found to be compliant with the minimum radiopacity requirements of ISO 6876 and ADA 57 standards.

Evaluation of bacterial leakage and marginal adaptation of the bioceramics pulp dressing materials: an invitro study.

OBJECTIVE: To compare the sealing ability and marginal adaptation of three calcium silicate-based cement (Biodentine, Pro root MTA, MTA Angelus) using a bacterial leakage model and scanning electron microscope (SEM). METHODS: Recently extracted lower first premolars were randomly categorized into three experimental groups (n = 15 samples), positive control (n = 5 samples), and negative control group (n = 5 sample). Samples from the experimental groups and positive control group were subject to cavity Class I occlusal preparation followed by modified coronal pulpotomy. Different types of bioceramic dressing material were placed in 3 mm thickness accordingly, group 1 (Biodentine), group 2 (MTA Angelus), and group 3 (ProRoot MTA). No dressing material was placed in the positive control group (group 4). All samples were placed in the incubator for 24 h at 37℃, 100% humidity, for the materials to be completely set. The final restoration was placed using the Z350 resin composite. A double layer of nail varnish was applied over all the sample surfaces except the occlusal site. Whereas the samples' surfaces in the negative control, were completely covered. A 3 mm length was measured from the root apex of the samples from each group, before proceeding with the resection. The bacterial leakage test was performed using Enterococcus faecalis TCC 23,125, and a sample from each experimental group was randomly chosen for SEM. Data analysis was conducted under the One-way ANOVA test, completed by Tukey's post hoc test. RESULTS: There is a significant difference in sealing ability and marginal adaptation between the groups. (p < 0.05). The study showed that Pro Root MTA had the superior sealing ability and marginal adaptation compared to Biodentine and MTA Angelus. CONCLUSION: The ProRoot MTA as a coronal pulpotomy pulp dressing material, was found to have a better marginal adaptation and sealing ability compared to three other bioceramics materials. The material would be the better choice during clinical settings and procedures.

Ex Vivo Osteogenesis Induced by Calcium Silicate-Based Cement Extracts.

Calcium silicate-based cements are used in a variety of clinical conditions affecting the pulp tissue, relying on their inductive effect on tissue mineralization. This work aimed to evaluate the biological response of calcium silicate-based cements with distinct properties-the fast-setting Biodentine™ and TotalFill® BC RRM™ Fast Putty, and the classical slow-setting ProRoot® MTA, in an ex vivo model of bone development. Briefly, eleven-day-old embryonic chick femurs were cultured for 10 days in organotypic conditions, being exposed to the set cements' eluates and, at the end of the culture period, evaluated for osteogenesis/bone formation by combining microtomographic analysis and histological histomorphometric assessment. ProRoot® MTA and TotalFill® extracts presented similar levels of calcium ions, although significantly lower than those released from BiodentineTM. All extracts increased the osteogenesis/tissue mineralization, assayed by microtomographic (BV/TV) and histomorphometric (% of mineralized area; % of total collagen area, and % of mature collagen area) indexes, although displaying distinct dose-dependent patterns and quantitative values. The fast-setting cements displayed better performance than that of ProRoot® MTA, with BiodentineTM presenting the best performance, within the assayed experimental model.

Fast-Setting Calcium Silicate-Based Pulp Capping Cements-Integrated Antibacterial, Irritation and Cytocompatibility Assessment.

Calcium silicate-based cements (CSCs) are endodontic materials widely used in vital pulp-capping approaches. Concerning the clinical application, the reduced set time and pre-mixed formulations are relevant characteristics during the operative management of pulpal exposure, aiming to optimise the work time and improve cross-infection/asepsis control. Additionally, clinical success seems to be greatly dependent on the biological performance of the materials that directly contact the living pulp. As such, this work approaches an integrative biological characterisation (i.e., antibacterial, irritation, and cytocompatibility assays) of three fast-setting CSCs-BiodentineTM, TotalFill® BC RRM™ Fast Putty, and Theracal LC®. These cements, after setting for 24 h, presented the expected topography and elemental composition (assessed by scanning electron microscopy, coupled with EDS analysis), in accordance with the information of the manufacturer. The set cements displayed a significant and similar antibiofilm activity against S. mutans, in a direct contact assay. Twenty-four-hour eluates were not irritant in the standardised CAM assay, but elicited distinct dose- and time-dependent cytotoxicity profiles on fibroblastic cells-i.e., Biodentine was devoid of toxicity, TotalFill presented a slight dose-dependent initial toxicity that was easily overcome, and Theracal LC was deleterious at high concentrations. When compared to long-setting ProRoot MTA cement, which highlighted the pursued integrative approach, Biodentine presented a similar profile, but TotalFill and Theracal LC displayed a poorer performance regarding antibiofilm activity/cytocompatibility features, and Theracal LC suggested eventual safety concerns.

The Evaluation of the Antibacterial and Antifungal Efficacy of Novel Kids Mineral Trioxide Aggregate (e-MTA) With ProRoot MTA and Glass Ionomer Cement.

Background Most pulpal and periapical problems could be treated nonsurgically. However, in cases of infections, certain operations must be performed that require using materials with good antibacterial and antifungal efficacy. ProRoot mineral trioxide aggregate (MTA) was marketed as gray- and white-colored preparations, composed of 75% Portland cement, 20% bismuth oxide, and 5% gypsum by weight. MTA, composed of powder and liquid as distilled water, formed a colloidal gel that further solidified and formed a hard cement within approximately four hours. The new endodontic material Kids e-MTA (Kids-e-dental, Mumbai, India) was introduced recently. It was also available as powder and liquid. It was a bioactive cement consisting of very fine hydrophilic particles of several mineral oxides. Aim This study compares the antimicrobial and antifungal efficacy of e-MTA (mineral trioxide aggregate) (Kids-e-dental, Mumbai, India), ProRoot MTA (Dentsply Sirona, Tulsa Dental, OK, USA), and glass ionomer cement (GIC) (GC Asia Dental Pte Ltd, Singapore). Materials and methods The agar diffusion method was used to test the materials. e-MTA, ProRoot MTA, and GIC were tested for their antibacterial efficacy against Enterococcus faecalis and antifungal efficacy against Candida albicans. The zone of inhibition was calculated and measured using a precision ruler. The collected data was put through Student's unpaired t-test. Results and conclusions On conducting the tests and comparing the results, it was found that e-MTA had a slightly better antibacterial efficacy and almost similar antifungal efficacy compared to ProRoot MTA but significantly superior properties compared to GIC.

Subcutaneous tissue reaction and gene expression of inflammatory markers after Biodentine and MTA implantation

Abstract The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice exposed to tricalcium silicate (Biodentine) and aggregated mineral trioxide (ProRoot MTA). A total of 120 mice were divided into 4 groups in 3 different experimental periods (7, 21 and 63 days): Biodentine; Pro-Root MTA; zinc oxide-eugenol and; Negative control - Sham. After the experimental periods microscopic descriptive, semi-quantitative and quantitative analysis of the inflammatory process were analyzed on H&E sections and evaluation of the gene expression of Il10, Infg, Il6, Il1r1 and Tnf (qRT-PCR) were performed. The data obtained were analyzed using the chi-square test and two-way analysis of variance (ANOVA) followed by the Bonferroni post-test (5% significance level). Results: In the microscopic analysis, a slight inflammatory infiltrate was observed, with a predominance of sparse macrophages and polymorphonuclear cells, slight tissue fibrosis, regular fibrous capsule and with dystrophic calcifications, in all groups that received the materials (Biodentine and Pro-Root MTA). In parallel, all materials modulated the gene expression of the different cytokines and receptors evaluated. Conclusion: Pro-Root MTA and Biodentine showed a tissue compatibility, mediated inflammation, with increased fibrous tissue and production of pro- and anti-inflammatory cytokines.

Resumo Objetivo: Avaliar a resposta do tecido conjuntivo subcutâneo de camundongos isogênicos expostos à Biodentine™ e ao Trióxido Mineral Agregado (MTA). Métodos: Um total de 120 camundongos foram divididos em 4 grupos e 3 períodos experimentais diferentes (7, 21 e 63 dias): Biodentine™ (Septodont, Saint Maur des Fosses, França); Pro-Root MTA (Dentsplay, Tulsa, EUA); óxido de zinco eugenol (Biodinâmica Química e Farmacêutica LTDA., Ibiporã, PR - Brasil); e controle negativo - Sham. Após os períodos experimentais, análises microscópicas descritivas, semiquantitativas e quantitativas do processo inflamatório foram analisadas nos cortes de H&E e ainda, foi realizada a avaliação da expressão gênica de Il10, Infg, Il6, Il1r1 e Tnf (qRT-PCR). Os dados obtidos foram analisados por meio do teste do qui-quadrado e da análise de variância (ANOVA) two-way, seguido do pós-teste de Bonferroni (nível de significância de 5%). Resultados: Na análise microscópica observou-se discreto infiltrado inflamatório, com predomínio de macrófagos esparsos e polimorfonucleares, leve fibrose tecidual, cápsula fibrosa regular e com calcificações distróficas, em todos os grupos que receberam os materiais (Biodentine ™ e Pro-Root MTA). Paralelamente, todos os materiais modulam a expressão gênica das diferentes citocinas e receptores avaliados. Conclusão: Pro-Root MTA e Biodentine™ mostraram compatibilidade tecidual, inflamação mediada, com aumento do tecido fibroso e produção de citocinas pró- e antiinflamatórias.

Evaluation of Endosequence Root Repair Material and Endocem MTA as direct pulp capping agents: An in vivo study.

The study aimed to assess the human pulpal response to direct pulp capping using Endosequence Root Repair Material (ERRM) and Endocem MTA against ProRoot MTA as control. Intentional direct pulp capping was done using the three materials in 30 caries-free human premolars. After 30 days, the teeth were extracted, fixed and decalcified. Sections were prepared for histologic examination using light microscopy. Thickness and quality of dentine bridge formed and level of inflammation were evaluated. Difference between dentine bridge thickness of the three groups was statistically significant. Mean thickness of dentine bridges formed in ProRoot MTA group was greater than other two groups, and difference was statistically significant. Difference in dentine bridge thickness between ERRM and Endocem MTA was statistically significant. No significant difference was observed between the 3 groups with respect to inflammation. Results indicate ProRoot MTA performed best with ERRM giving better results than Endocem MTA.

Comparative study of pulpal responses to ProRoot MTA, Vitapex, and Metapex in canine teeth.

BACKGROUND/PURPOSE: ProRoot MTA, Vitapex, and Metapex are widely used for pulp treatment of primary tooth. The aim of this study was to compare the pulpal responses to ProRoot MTA, Vitapex, and Metapex in a canine model of pulpotomy. MATERIALS AND METHODS: Pulpotomy procedure was performed to 34 teeth (21 incisors and 13 premolars) and ProRoot MTA, Vitapex or Metapex was applicated to artificially exposed pulp tissues. After 13 weeks, the teeth were extracted and processed with hematoxylin-eosin staining for histologic evaluation. All specimens were evaluated in several categorys related to calcific barrier, inflammatory responses and the area of calcific barrier formation was measured. RESULTS: Most of the specimens in the ProRoot MTA group developed a calcific barrier at the pulp amputation site and showed a low level of inflammatory response. However, in comparison to ProRoot MTA group, a small amount of calcific barrier formed in Vitapex and Metapex groups. CONCLUSION: This in vivo study found that Vitapex and Metapex induced similar pulpal responses but showed poor outcomes compared with using ProRoot MTA. Vitapex and Metapex are therefore not good substitutes for ProRoot MTA in direct pulp capping and pulpotomy.

Comparing Bacterial Leakage of Three Intraorifice Barrier Sealing Materials against Enterococcus faecalis and Proteus vulgaris.

AIM: The purpose of this in vitro study was to evaluate the intraorifice sealing ability of light-cured glass-ionomer cement (LC-GIC), Tetric N-Flow, and ProRoot mineral trioxide aggregate (MTA) against Enterococcus faecalis and Proteus vulgaris. MATERIALS AND METHODS: Crowns of the eighty human mandibular teeth were decapitated. Working length determination was performed, after which cleaning and shaping were carried out. A uniform orifice diameter of 1.3 mm, at its widest point, was made. Once instrumentation was completed, the canals were irrigated and then obturated. A heat carrier was used to remove gutta-percha to the depth of 3.5 mm. Samples were then divided into a control group (Group 1) with no barrier, and three groups, namely, Group 2, Group 3, and Group 4, were restored with the LC-GIC, Tetric N-Flow, and ProRoot MTA, respectively. The groups were further subdivided into Subgroup A for checking bacterial leakage against E. faecalis and Subgroup B, against P. vulgaris. All samples were subjected to the bacterial leakage test and observed daily for the appearance of turbidity after which statistical analysis was performed. RESULTS: Group 1 showed leakage in, as early as, 3 days. The longest time for the turbidity to appear was shown by Group 4 with an average of 31 days. The mean number of days for turbidity to appear in Group 2 and Group 3 was 23 and 24 days, respectively. Group 4 showed the best intraorifice sealing ability with a significant difference. CONCLUSION: The teeth with an intraorifice coronal seal had better protection against microbial leakage. Among all materials used, the ProRoot MTA showed the best intraorifice sealing ability. CLINICAL SIGNIFICANCE: Use of the ProRoot MTA promises long-term results in the endodontically treated teeth as compared with other materials.

Reinforcement effect of intra-orifice barrier materials in teeth treated with regenerative endodontic procedure: Research article.

Background. Regenerative endodontic treatment (RET) is a clinically advanced procedure for necrotic immature teeth. However, root canal walls of these teeth are brittle especially in the cervical region and need reinforcement. This in vitro study is conducted to evaluate the effect of intra-orifice barrier materials on the fracture resistance of immature teeth treated with regenerative procedure. Methods. Forty-eight maxillary central incisors were used. Twelve intact teeth were selected for the control group. Remained teeth were prepared using peeso drills to simulate immature teeth and assigned into three groups according to the intra-orifice barrier material placed over MTA (n = 12); Composite resin (CR), ProRoot MTA and Resin-modified glass ionomer cement (RMGIC). Fracture strength test was applied using a universal testing machine. One-way ANOVA and Tukey post hoc tests were used at P = 0.05. Results. A significant difference was obtained among groups (P < 0.05). MTA showed the lowest fracture resistance (P < 0.05). However, no significant difference was found among RMGIC, CR, and control groups (P > 0.05). Conclusion. Intra-orifice restorative materials have reinforcement affect in immature teeth treated with regenerative endodontic procedure. RMGIC or CR can be regarded as a viable choice to reduce the occurrence of cervical root fracture of immature teeth treated with a regenerative therapy.

Evaluation of Sealing Potential of Different Repair Materials in Furcation Perforations Using Dye Penetration: An In Vitro Study.

AIM: The present study aimed to assess the sealing ability of various repair materials in furcation perforations using dye penetration. MATERIALS AND METHODS: A total of 80 human first molars from mandible with unbroken enamel surfaces, which were extracted completely for periodontal reasons, were chosen. All extracted teeth were kept in a sterile solution up until further use. Endo-access bur was used to prepare endodontic access cavity, and a high-speed long shank round bur was used to create a planned perforation on the floor of pulp. All the specimens were randomly grouped (20 teeth in each group): Group I: control; group II: Pro-Root MTA; group III: resin-modified glass-ionomer cement (RM GIC); and group IV: Biodentin. After placement of repair materials in perforated furcation, the chamber of each tooth was accessed with 2% methylene blue dye. Later, a diamond disk was used to split the teeth buccolingually. A stereomicroscope (10×) was used to visualize the highest dye penetration. RESULTS: The least penetration was seen in teeth repaired by Biodentin group (0.88 ± 0.02), next by Pro-Root MTA group (1.24 ± 0.13) and resin-modified glass ionomer cement group (3.62 ± 0.46). A statistically significant difference was seen among different perforation repair materials by analysis of variance. A statistically significant difference (p value < 0.05) was found between each group, excluding group II v/s group IV. CONCLUSION: This study concluded that reduced dye penetration in perforation repair along the furcations and improved sealing ability are shown by biodentine group in comparison to Pro-Root MTA and resin-modified glass-ionomer cement group. CLINICAL SIGNIFICANCE: Root perforations along the furcation that develop due to the endodontic procedures have a remarkable damaging effect on prognosis and frequently result in loss of secondary periodontal attachment, thus resulting in early loss of the involved tooth. Therefore, the selection of biocompatible repair material aids to enhance the treatment prognosis.

Alterations of mitochondrial dynamics, inflammation and mineralization potential of lipopolysaccharide-induced human dental pulp cells after exposure to N-acetyl cysteine, Biodentine or ProRoot MTA.

AIM: To investigate the effects of N-acetyl cysteine (NAC), Biodentine, ProRoot MTA and their combinations, on cell viability, mitochondrial reactive oxygen species (mtROS) production, mineralization and on the expression of genes related to inflammatory cytokine production, mitochondrial dynamics and cell apoptosis of lipopolysaccharide (LPS)-induced human dental pulp cells (hDPCs). METHODOLOGY: Isolated hDPCs were exposed to 20 µg mL-1 of Escherichia coli (E. coli) LPS for 24 h, before the experiment, except for the control group. Eight experimental groups were assigned: (i) control (hDPCs cultured in regular medium), (ii) +LPS (hDPCs cultured in LPS medium throughout the experiment), (iii) -LPS/Media, (iv) -LPS/BD, (v) -LPS/MTA, (vi) -LPS/NAC, (vii) -LPS/BD + NAC and (viii) -LPS/MTA + NAC. Cell viability was measured using Alamar blue assay at 24 and 48 h. Production of mtROS was evaluated at 6 and 24 h by MitoSOX Red and MitoTracker Green. The expressions of IL-6, TNF-α, Bcl-2, Bax, Mfn-2 and Drp-1 genes were investigated at 6 h using reverse transcriptase-polymerase chain reaction (RT-PCR). For differentiation potential, cells were cultured in the osteogenic differentiation media and stained using Alizarin red assay at 14 and 21 days. The Kruskal-Wallis test, Mann-Whitney U test and one-way anova were performed for statistical analysis. RESULTS: NAC was associated with significantly greater LPS-induced hDPC viability (P < 0.05). Both Biodentine and MTA extracts promoted cell survival, whereas the combination of NAC to these material extracts significantly increased the number of viable cells at 24 h (P < 0.05). Biodentine, MTA or NAC did not alter the mtROS level (P > 0.05). NAC supplementation to the MTA extract significantly reduced the level of IL-6 and TNF-α expression (P < 0.05). Regarding mitochondrial dynamics, the use of NAC alone promoted significant Mfn-2/Drp-1 expression (P < 0.05). Most of the groups exhibited a level of Bcl-2/Bax gene expression similar to that of the control group. The increases in mineralization productions were observed in most of the groups, except the LPS group (P < 0.05). CONCLUSIONS: The antioxidant effect of NAC was not evident under the LPS-induced condition in DPC in vitro. NAC combined either with Biodentine or MTA improved LPS-induced hDPCs survival at 24 h. The combination of NAC with MTA promoted mineralization.

Physicochemical, antimicrobial, and biological properties of White-MTAFlow.

OBJECTIVES: To evaluate a new material containing tantalum oxide as an alternative radiopacifier, and a water-based gel for hydration, in comparison with two calcium silicate-based cement: ProRoot MTA and Biodentine. MATERIALS AND METHODS: ProRoot MTA (Dentsply), Biodentine (Septodont), and a new hydraulic calcium silicate cement White-MTAFlow (Ultradent) (in 'thin' consistency) were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS). The interaction with dentin was also assessed using SEM and EDS. Physical and chemical properties radiopacity, setting time, linear flow, volumetric central filling, and lateral flow, pH, and volume change were investigated together with the color luminosity (L) and color change (ΔE). The agar diffusion and direct contact antimicrobial activity, and methylthiazolyldiphenyl-tetrazolium-bromide (MTT) cytotoxicity using human fibroblast cells were also evaluated. Data were statistically analyzed at a 5% significance level. RESULTS: All materials were composed of tricalcium and dicalcium silicate but had different radiopacifiers, and calcium hydroxide (portlandite) deposition was detected in XRD analysis. White-MTAFlow exhibited radiopacity values in accordance with ISO standard, and the longest setting time. The water-based gel provided the highest linear flow, a comparable cavity central filling, and the highest groove-lateral flow in the volumetric flow analysis. White-MTAFlow exhibited an alkalinity reduction, and Biodentine, a progressive increase of pH values after 28 days. However, similar volume loss for White-MTAFlow was assessed in comparison to Biodentine after the 28-day immersion. White-MTAFlow showed the highest L value (91.5), and ProRoot MTA the lowest (78.1) due to dentin staining caused by bismuth migration. None of the materials exhibited inhibition halos against the tested bacteria, and similar turbidity values were obtained after 48 h in direct contact with E. faecalis, indicating an upregulation to bacterial growth. White-MTAFlow showed MTT cytocompatibility similarly to the control group. CONCLUSIONS: White-MTAFlow in 'thin' consistency presents comparable physicochemical, biological, and antimicrobial properties to ProRoot MTA and Biodentine, and does not cause color alteration in dentin. CLINICAL RELEVANCE: White-MTAFlow is a suitable material for use as reparative endodontic cement. Further studies considering its biocompatibility are necessary.

Effects of different pulp-capping materials on cell death signaling pathways of lipoteichoic acid-stimulated human dental pulp stem cells.

PURPOSE: This study aimed to evaluate the response of dental pulp stem cells (DPSCs) cultured with and without lipoteichoic acid (LTA) to different pulp-capping materials. METHODS: The cells were cultured and seeded in 6-well plates and exposed to 1% LTA solution. Dycal, ProRoot MTA and Biodentine materials were applied on cells and all groups were evaluated by cell proliferation, viability, cell cycle and cell death signaling pathways for 24 and 72 h. RESULTS: LTA + Dycal treatment significantly inhibited the proliferation of DPSCs and increased the apoptosis rate of cells more than the other groups at 72 h. Compared to other groups, LTA + Dycal treatment significantly increased the levels of Caspase-3 and AKT and decreased the levels of p-AKT. CONCLUSIONS: The results of this study revealed that all tested materials caused apoptosis in DPSCs via an extrinsic apoptotic pathway. The DPSCs showed an early apoptosis response to the Dycal and a late apoptosis response to the ProRoot MTA and Biodentine treatments. LTA led autophagy and inhibited the proliferation of DPSCs. ProRoot MTA and Biodentin eliminated the LTA's bioactivity with higher efficiency than Dycal.

Shear Bond Strength of a Resin Composite to Six Pulp Capping Materials Used in Primary Teeth.

AIM: The purpose of this in vitro study was to assess the shear bond strength (SBS) and bond failure types of a resin-composite to six pulp-capping materials used in primary teeth. STUDY DESIGN: Eight-disc specimens from each pulp-capping material (6 groups) to bond to Filtek™ Z350 XT Flowable using a standard PVC tube (2×2mm). All groups were prepared according to the instruction of the manufacturer. The SBS was measured with a crosshead speed of 0.5 mm/min using a universal testing machine. Failure mode evaluation was completed using Digital Microscope by two independent examiners. RESULTS: Urbical LC® showed the highest SBS (Mean±SD) followed by ProRoot® MTA and TheraCal LC® (35.422±2.910, 22.114±2.515, and 21.175±1.983) respectively. ANOVA showed significant differences between all groups (P=0.0001). Urbical LC® and Photac™ Fil QuickAplicap™ were statistically significant different from all other pulp-capping materials groups. ProRoot® MTA was statistically significant different than Biodentine® (P=0.0001) and Photac™ Fil (P=0.0001). The total number of bond failure was recorded for cohesive B failure/cohesive in the pulp-capping material (14) and adhesive failure (14). CONCLUSION: Most of the tested pulp-capping materials bonded to Filtek™ Z350 XT demonstrated clinically acceptable and high SBS. Urbical LC showed the highest SBS while Biodentine® showed the lowest SBS.

A Silk Fibroin Based Hydration Accelerator for Root Canal Filling Materials.

Mineral trioxide aggregate (MTA) is widely used in various dental endodontic applications such as root-end filling, furcal perforation repair, and vital pulp therapy. In spite of many attempts to improve handling properties and reduce the discoloration of MTA, the ideal root canal filling material has yet to be fully developed. The objective of this study was to investigate the setting time, mechanical properties, and biocompatibility of MTA set by a silk fibroin solution. A 5 wt% silk fibroin (SF) solution (a novel hydration accelerant) was used to set SavDen® MTA and ProRoot® white MTA (WMTA). Changes in setting time, diametral tensile strength (DTS), material crystallization, in vitro cell viability, and cell morphology were assessed by Vicat needle measurement, a universal testing machine, scanning electron microscopy (SEM), and WST-1 assay, respectively. The initial setting time of ProRoot® MTA and SavDen® MTA experienced a drastic decrease of 83.9% and 42.1% when deionized water was replaced by 5 wt% SF solution as the liquid phase. The DTS of SavDen® MTA showed a significant increase after set by the SF solution in 24 h. A human osteoblast-like cell (MG-63)-based WST-1 assay revealed that both ProRoot® MTA and SavDen® MTA hydrated using SF solution did not significantly differ (p > 0.05) in cell viability. MG-63 cells with pseudopodia attachments and nuclear protrusions represent a healthier and more adherent status on the surface of MTA when set with SF solution. The results suggest that the 5 wt% SF solution may be used as an alternative hydration accelerant for MTA in endodontic applications.

Bio-Inductive Materials in Direct and Indirect Pulp Capping-A Review Article.

The article is aimed at analyzing the available research and comparing the properties of bio-inductive materials in direct and indirect pulp capping procedures. The properties and clinical performances of four calcium-silicate cements (ProRoot MTA, MTA Angelus, RetroMTA, Biodentine), a light-cured calcium silicate-based material (TheraCal LC) and an enhanced resin-modified glass-ionomer (ACTIVA BioACTIVE) are widely discussed. A correlation of in vitro and in vivo data revealed that, currently, the most validated material for pulp capping procedures is still MTA. Despite Biodentine's superiority in relatively easier manipulation, competitive pricing and predictable clinical outcome, more long-term clinical studies on Biodentine as a pulp capping agent are needed. According to available research, there is also insufficient evidence to support the use of TheraCal LC or ACTIVA BioACTIVE BASE/LINER in vital pulp therapy.

Direct Pulp Capping With ProRoot MTA Alone and in Combination With Er:YAG Laser Irradiation: A Clinical Trial.

Background: Due to the complications of root canal treatment, conservative modalities to preserve pulp vitality are favorable. Direct pulp capping (DPC) refers to the coverage of the pulp tissue exposed by a biocompatible agent that can improve the prognosis of the tooth by 44% to 95%. Some recent studies have reported more predictable results (a success rate of about 90%) for DPC with laser and regenerative materials such as mineral trioxide aggregate (MTA). This study aimed to clinically compare DPC with ProRoot MTA alone and in combination with Er:YAG (erbium-doped yttrium aluminium garnet) laser irradiation (2940 nm). Methods: This clinical trial was conducted on 26 patients with a mean age of 29 years (in the range of 17 to 46 years) who required DPC following pulp exposure during deep caries removal. The teeth were divided into two groups. In the control group, the teeth underwent DPC with ProRoot MTA while in the test group, the teeth were first irradiated with a 2940 nm Er:YAG laser and then underwent DPC with ProRoot MTA. The patients were recalled at one, 3 and 6 months for the follow-up (clinical and radiographic examinations). The data were analyzed using Fisher exact test. Results: The success rate was 75% in the laser group and 93% in the control group. The groups were not significantly different (P>0.05). Conclusion: No significant difference was found in terms of the success rate of DPC with ProRoot MTA alone and in combination with Er:YAG laser irradiation.