Influence of early mineral deposits of silicate- and aluminate-based cements on push-out bond strength to root dentine.

AIM: To evaluate mineral trioxide aggregate (MTA), Biodentine and several formulations of calcium aluminate cements (CACb) in terms of their ability to release calcium ions (Ca2+ ) and form apatite-like precipitates after short-term immersion in phosphate-buffered saline (PBS) and its influence on the bond strength to the root-end cavity. METHODOLOGY: Ten samples of MTA, Biodentine, CACb and calcium-enriched aluminate cement (CACb+) were placed in contact with PBS or deionized water for 14 days. The cement surfaces were analysed using SEM, EDS-X and FTIR. Eighty standardized root-end cavities filled with the cements (ten samples of each cement) were immersed in PBS or deionized water for 14 days, and the bond strengths were measured. Data from the push-out test were analysed using two-way ANOVA and Tukey's tests (α = 0.05). RESULTS: A gradual decrease was observed in Ca2+ concentrations and pH of all solutions. FTIR bands of different phases of hydroxyapatite were identified. Crystalline formation was observed on the surface of all cements after immersion in PBS. No significant difference was observed in the bond strength of the test materials (P > 0.05); however, all cements without contact with the solution revealed significantly lower bond strength values than those in contact with the solution (P < 0.05). CONCLUSION: MTA, Biodentine, CACb e CACb+ were associated with precipitation of crystals after being in contact with PBS for 14 days, indicated by different phases of hydroxyapatite crystalline formation, which also increased dislodgment resistance of the material from root-end cavities. The CACb+ had similar bond strengths and precipitation of crystals to existing materials.

Calcium chloride-enriched calcium aluminate cement promotes in vitro osteogenesis.

AIM: To evaluate the effects of 2.8% or 10% calcium chloride (CaCl2 ) in calcium aluminate cement (CAC) with either bismuth oxide (Bi2 O3 ) or zinc oxide (ZnO) as radiopacifiers on the progression of osteogenic cell cultures. METHODOLOGY: Rat calvaria-derived cells were grown on Thermanox® coverslips for 24 h and exposed to samples of (i) CACb: with 2.8% CaCl2 and 25% Bi2 O3 ; (ii) CACb+: with 10% CaCl2 and 25% Bi2 O3 ; (iii) CACz: with 2.8% CaCl2 and 25% ZnO; or (iv) CACz+: with 10% CaCl2 and 25% ZnO, placed on inserts. Nonexposed cultures served as the control. Calcium and phosphorus contents in culture media were quantified. The effects of the cements on cell apoptosis, cell viability and acquisition of the osteogenic cell phenotype were evaluated. Data were compared by Kruskal-Wallis test (α = 5%). RESULTS: CACb+ promoted the highest levels of calcium in the culture media; CACz+, the lowest levels of phosphorus (P < 0.05). CACz+ and CACb increased cell apoptosis (P < 0.05). CACb reduced cell viability (P < 0.05) and the expression of the osteoblastic phenotype. CACz+ and CACb+ promoted greater cell differentiation and matrix mineralization compared to CACz and CACb (P < 0.05). CONCLUSION: For CAC with the lower CaCl2 content, the use of Bi2 O3 was detrimental for osteoblastic cell survival and differentiation compared to ZnO, while CAC with the higher CaCl2 content supported the acquisition of the osteogenic cell phenotype in vitro regardless of the radiopacifier used. Thus, CAC with 10% CaCl2 would potentially promote bone repair in the context of endodontic therapies.

Osteogenic cell response to calcium aluminate-based cement.

AIM: To evaluate the effect of a calcium aluminate-based cement (CAC+) on the development of the osteogenic phenotype in vitro. METHODOLOGY: Rat calvaria-derived cells were grown on Thermanox® coverslips for 24 h and then exposed to either samples (4-h set) of CAC+ or mineral trioxide aggregate (MTA) placed on Transwell® inserts for periods of up to 14 days. Nonexposed cultures were used as the controls. The comparisons were made using the nonparametric Kruskal-Wallis test, followed by the Student-Newman-Keuls post hoc test when appropriate. RESULTS: The results showed that proximity to MTA or CAC+ samples inhibited cell growth, whereas at a distance, viable and proliferative cells adhered to and spread on the Thermanox® , expressing osteoblast differentiation markers prior to mineralization of the extracellular matrix. Compared with MTA, the osteogenic cell cultures exposed to CAC+ exhibited significantly greater cell viability, alkaline phosphatase (ALP) activity and expression of runt-related transcription factor 2, osterix, ALP, bone sialoprotein and osteocalcin (P < 0.05 for all). For the osteogenic cell cultures exposed to CAC+, the quantification of matrix mineralization was not altered (P > 0.05). CONCLUSIONS: CAC+ supported the acquisition of the osteogenic cell phenotype in vitro, rendering this novel material a potential alternative to MTA in endodontic procedures. Further in vivo studies are needed to verify if the beneficial in vitro effects of CAC+ on osteoblastic cells correspond to an increase and/or acceleration of bone repair in the periapical region.