Nanomodification of mineral trioxide aggregate for enhanced physiochemical properties

Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

This systematic review evaluated the effects of nano-sized cement particles on the properties of calcium silicate-based cements (CSCs). Using defined keywords, a literature search was conducted to identify studies that investigated properties of nano-calcium silicate-based cements (NCSCs). A total of 17 studies fulfilled the inclusion criteria. Results indicated that NCSC formulations have favourable physical (setting time, pH and solubility), mechanical (push out bond strength, compressive strength and indentation hardness) and biological (bone regeneration and foreign body reaction) properties compared with commonly used CSCs. However, the characterization and verification for the nano-particle size of NCSCs were deficient in some studies. Furthermore, the nanosizing was not limited to the cement particles and a number of additives were present. In conclusion, the evidence available for the properties of CSC particles in the nano-range is deficient-such properties could be a result of additives which may have enhanced the properties of the material.

Nanotechnology for Dentistry: Prospects and Applications

In the XXI century, application of nanostructures in oral medicine has become common. In oral medicine, using nanostructures for the treatment of dental caries constitutes a great challenge. There are extensive studies on the implementation of nanomaterials to dental composites in order to improve their properties, e.g., their adhesive strength. Moreover, nanostructures are helpful in dental implant applications as well as in maxillofacial surgery for accelerated healing, promoting osseointegration, and others. Dental personal care products are an important part of oral medicine where nanomaterials are increasingly used, e.g., toothpaste for hypersensitivity. Nowadays, nanoparticles such as macrocycles are used in different formulations for early cancer diagnosis in the oral area. Cancer of the oral cavity-human squamous carcinoma-is the sixth leading cause of death. Detection in the early stage offers the best chance at total cure. Along with diagnosis, macrocycles are used for photodynamic mechanism-based treatments, which possess many advantages, such as protecting healthy tissues and producing good cosmetic results. Application of nanostructures in medicine carries potential risks, like long-term influence of toxicity on body, which need to be studied further. The introduction and development of nanotechnologies and nanomaterials are no longer part of a hypothetical future, but an increasingly important element of today's medicine.

Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials

BACKGROUND

The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions.

METHODS

A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test.

RESULTS

The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05).

CONCLUSION

Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.

Comparative Evaluation of Physicomechanical Properties and Antimicrobial Activity of White Portland Micro- and Nanoparticulate Peruvian Cement, Mineral Trioxide Aggregate, and Neomineral Trioxide Aggregate

AIM

To compare the surface microhardness, compressive strength, and antimicrobial activity of white Portland nanoparticle and microparticle Peruvian cement, mineral trioxide aggregate (MTA), and neomineral trioxide aggregate (NeoMTA) at 24 hours and 28 days.

MATERIALS AND METHODS

Twenty specimens were prepared for each group of cement microparticulated powder (PCm), nanoparticulated cement (PCn), MTA, and NeoMTA to be evaluated at two different times, 24 hours and 28 days for the surface microhardness test and compressive strength. For the antimicrobial activity tests, another 20 specimens were prepared for each group of cement where they were subdivided into two subgroups according to the different periods at 24 hours and 48 hours. For the surface microhardness and compressive strength, the specimens, and the cement groups were mixed according to the manufacturer's instructions and transferred to a cylindrical polyethylene mold of 6-mm diameter and 4-mm height. The compressive strength test was conducted using a universal testing machine. Moreover, the agar diffusion technique was to evaluate the antibacterial and antifungal activity of the American Type Culture Collection (ATCC) Enterococcus faecalis and Candida albicans. Finally, the data were statistically analyzed.

RESULTS

The highest microhardness values for the 24-hour subgroup were recorded for NeoMTA cement (16.99 ± 2.02), followed by MTA, PCn, and PCm, respectively. As for the 28-day subgroup, PCn cement (41.64 ± 3.20) presented the highest microhardness, followed by NeoMTA, PCm, and MTA, respectively, with statistically significant differences among them. The compressive strength of both subgroups 24 hours and 28 days exhibited the highest mean for PCn (41.3 ± 4.29, 65.74 ± 3.06), followed by PCm, NeoMTA, and the lowest value for MTA cement. Finally, for the antimicrobial activity, the highest mean for the 24-hours and 48-hours subgroup was recorded for NeoMTA cement (17.6 ± 1.26, 17.8 ± 1.44), followed by PCn, PCm, and the lowest value for MTA, with significant differences between them.

CLINICAL SIGNIFICANCE

It is highly recommended, Portland cement (PC) as a viable substitute since it has very similar components and properties, but at a lower cost.

CONCLUSION

Regardless of the evaluation time, PCn produced higher surface microhardness and compressive strength; however, NeoMTA showed higher antimicrobial activity.

Recent Progress on the Applications of Nanomaterials and Nano-Characterization Techniques in Endodontics: A Review

The impact of nano-based technologies in endodontics for the identification and treatment of various dental infections is showing fast progress. Studies show that nanoparticles could serve as useful agents with many beneficial results and continue to be promising in the field of endodontics. To ensure progress and improvements on novel nanomaterials in relation to their physicochemical and biological properties, nano-identification methods for the detection and evaluation of diseases need to be further highlighted. This study aims to review the current technological progress and recent research outcomes as well as possible prospective applications of nano-based technologies in endodontics. A comprehensive literature survey has been carried out on the utilizations of nanomaterials and nano-characterization techniques in endodontics. The current status and recent applications in endodontics are discussed with illustrative examples. The results have shown that the progress and improved accuracy of nano-identification techniques enabled a better characterization, evaluation and selection of appropriate treatment plans for endodontics-related diseases. The results have been inspiring for further clinical investigations. Nano-endodontics is still a developing field with a strong potential for revolutions of novel materials and techniques in the diagnosis and treatment of dental diseases. Further improvements in nanoparticles properties will pave the way for the development of many beneficial endodontic therapeutic agents. The future looks encouraging for sustainable products and testing methods for clinical endodontic applications.

Novel pulp capping material based on sodium trimetaphosphate: synthesis, characterization, and antimicrobial properties

OBJECTIVES

To evaluate the mechanical, physicochemical, and antimicrobial properties of four different formulations containing micro- or nanoparticles of sodium trimetaphosphate (mTMP and nTMP, respectively).

METHODOLOGY

Four experimental groups were used in this investigation: two mTMP groups and two nTMP groups, each containing zirconium oxide (ZrO2), and solution containing either chitosan or titanium oxide (TiO2) nanoparticles (NPs). Setting time, compression resistance, and radiopacity were estimated. The agar diffusion test was used to assess the antimicrobial activity of the formulations against five different microbial strains: Streptococcus mutans, Lactobacillus casei, Actinomyces israelii, Candida albicans, and Enterococcus faecalis. Parametric and nonparametric tests were performed after evaluating homoscedasticity data (p<0.05).

RESULTS

From the properties evaluated, nTMP cements required less setting time and showed greater resistance to compression. Cements containing TiO2 showed greater radiopacity for both nTMP and mTMP. All four cement formulations showed antimicrobial activity against S. mutans and L. casei.

CONCLUSION

Formulations containing nTMP have shorter setting times and higher compressive strength, and those with TiO2 nanoparticles showed antimicrobial activities. Clinical relevance: The cement containing nTMP, ZrO2, and TiO2 could be an alternative material for protecting the pulp complex.

Evaluation of Mechanical Activation and Chemical Synthesis for Particle Size Modification of White Mineral Trioxide Aggregate

Objective

Initial setting time is one of the most important properties of calcium silicate cements (CSCs) such as white mineral trioxide aggregate (WMTA). This study aimed to evaluate the effect of two methods used to reduce the particle size of WMTA, mechanical activation and chemical synthesis.

Methods

WMTA without bismuth oxide (WMTA-B) was provided and divided into four groups (n=5) including: WMTA-B, WMTA-B+10 min milling, WMTA-B+30 min milling, and sol-gel. In groups 2 and 3, the milling was performed by using tungsten carbide balls in a ratio 1:15 (w/w) and a vibration frequency of 30 Hz together with absolute ethanol. For the fourth group, polyethylene glycol (PEG), calcium acetate (Ca(C₂H₃O₂)₂), SiO₂, and aluminum oxide (Al₂O₃) were used for the sol-gel process. After preparation, sample powders were mixed with distilled water and placed in cylindrical molds, covered with water-moistened gauze, and incubated at 37°C for 24 hours. The Vicat needle test analyzed the initial setting time. Data were analyzed by ANOVA and Tukey tests at a significance level of P<0.05. The correlation between particle size and setting time was determined.

Results

Initial setting time of the sol-gel and WMTA-B+30 min milling was significantly lower than in the other two groups (P<0.05). A significant correlation was noticed between particle size and initial setting time (P<0.05).

Conclusion

Sol-gel process introduces a promising alternative strategy for the reduction of initial setting time of CSC materials. While both methods increased surface area, mechanical activation was not as successful in reducing surface area and initial setting time as effectively as the sol-gel process.

Design Variability of the Push-out Bond Test in Endodontic Research: A Systematic Review

INTRODUCTION

There is limited literature on the impact of testing variables on the push-out bond test (POBT). This review identified designs of the POBT used in the endodontic literature and aimed to determine which experimental variables may influence the push-out bond strength (POBS).

METHODS

A systematic review based on PRISMA guidelines was performed by searching the PubMed, SCOPUS, and Cochrane library databases using terms including push-out and dislocation resistance and descriptions of endodontic materials. Test variables assessed included method of root preparation, timing of sectioning compared with filling, thickness, diameter and taper of sections, and plunger size and velocity. The POBS of 3 common materials (gutta-percha and AH Plus, mineral trioxide aggregate, and Biodentine) were collected from investigations, and a comparison was attempted.

RESULTS

One hundred thirty-three studies assessed the POBS of root-filling materials, 68 assessed root repair cements/root-end filling materials, and 16 assessed orifice barrier materials other than mineral trioxide aggregate. There was significant variation in all of the assessed variables, resulting in a large range of reported values for the POBS of the various materials. Because of this heterogeneity in study design, no further statistical analysis of the impact of the test variables on POBS was possible.

CONCLUSIONS

There was considerable variation in the POBT design used in endodontic research. Greater standardization is required for future research as well as accurate reporting for all test variables to assess the impact of specific design variables on POBS.

Hydrogel Arrays and Choroidal Neovascularization Models for Evaluation of Angiogenic Activity of Vital Pulp Therapy Biomaterials

INTRODUCTION

This study intended to evaluate the angiogenic properties of vital pulp therapy materials including white mineral trioxide aggregate (WMTA), calcium hydroxide (Ca[OH]2), Geristore (Den-Mat, Santa Maria, CA), and nano WMTA biomaterials.

METHODS

WMTA, Ca(OH)2, Geristore, and nano WMTA disks were prepared, dispersed into 2 mL Milli-Q (Millipore, ThermoFisher, Hanover Park, IL) distilled water, and centrifuged to obtain 2 mL supernatant elution. Thirty-five wells of polyethylene glycol hydrogel arrays were prepared and divided into 5 groups of 7 (n = 7). Mice molar endothelial cells (ECs) were placed on hydrogel arrays. The elution prepared from each sample was diluted in growth medium (1:3) and added to the hydrogel arrays. The EC medium alone was used for the control. For the choroidal neovascularization (CNV) model, thirty-five 6-week-old female mice were lasered and divided into 5 groups, and elution from each sample (2 μL) or saline (control) was delivered by intravitreal injection on the day of the laser treatment and 1 week later. The mean number of nodes, the total length of the branches in the hydrogel arrays, and the mean area of CNV were calculated using ImageJ software (National Institutes of Health, Bethesda, MD) and analyzed by 1-way analysis of variance and post hoc Tukey honest significant difference tests.

RESULTS

The comparison of results regarding the number of nodes showed the values of control > Geristore > nano WMTA > WMTA > Ca(OH)2. Regarding the total branch length and the CNV area, the comparison of results showed values of Geristore > control > nano WMTA > WMTA > Ca(OH)2.

CONCLUSIONS

All tested materials showed minimal antiangiogenic activity, whereas Geristore and nano WMTA showed a higher proangiogenic activity than WMTA and Ca(OH)2.

Storage Medium Affects the Surface Porosity of Dental Cements

INTRODUCTION

Calcium silicate-based cements physical properties is influenced by environmental changes.

AIM

Here, we intended to evaluate the effect of storage medium on surface porosity of root Mineral Trioxide Aggregate (MTA) and Biodentine cement.

MATERIALS AND METHODS

A total of 40 polyethylene tubes were selected and divided into two groups: Group A (MTA) and Group B (Biodentine). Each group was subdivided into two subgroups (n=10). In subgroups A1 and B1, tubes were transferred to Distilled Water (DW), while samples of subgroup A2 and B2 were transferred to Synthetic Tissue Fluid (STF) as storage medium and samples were stored for three days. All specimens were then placed in a desiccator for 24 hours and then subject to surface porosity evaluation by Scanning Electron Microscopy (SEM) at ×500, ×1000, ×2000 and ×5000 magnifications. The number and the surface porosities were determined by Image J analysis. Data were analyzed by ANOVA at level of significance of p<0.05.

RESULTS

The lowest surface porosity was observed in MTA samples stored in STF and the highest was in Biodentine samples stored in DW. Significant differences were noted between groups and subgroups of each group (p< 0.05). MTA samples stored in DW and STF showed significantly lower surface porosities compared to Biodentine samples (p < 0.05).

CONCLUSION

Storage medium can drastically affect the surface porosity of tested calcium silicate-based cements. However, MTA showed lower surface porosity compared to Biodentine cement, which can result in lower microleakage in applied area.

Bcl-2 expression is essential for development and normal physiological properties of tooth hard tissue and saliva production

BACKGROUND

Apoptosis plays a fundamental role in appropriate tissue development and function. Although expression of Bcl-2 has been reported during tooth and submandibular gland (SMG) development, the physiological role Bcl-2 plays during these processes has not been addressed. This study was performed to evaluate the impact of Bcl-2 expression on the formation and properties of tooth hard tissue, and saliva production.

METHODS

Twenty-four mice (12 males and 12 females) were divided into three groups of eight (n=8): group A (Bcl-2 +/+), group B (Bcl-2 +/-), and group C (Bcl-2 -/-) and subjected to micro-CT analyses. The mineral content of first molars was analyzed by X-Ray diffraction (XRD) and scanning electron microscopy (SEM) color dot map. The surface microhardness was determined by Vickers test on labial surfaces of incisors. Saliva was collected from different groups of mice after subcutaneous injection of pilocarpine.

RESULTS

Samples from Bcl-2 -/- mice showed significantly smaller micro-CT values, lower and poor crystallinity of hydroxyapatite (HA), and lowest surface micro hardness. SMG from Bcl-2 -/- mice showed remarkable reduction in size, consistent with reduced saliva accumulation.

CONCLUSIONS

The absence of Bcl-2 expression in SMG did not affect the expression of other Bcl-2 family members. Thus, Bcl-2 expression influence on the formation and properties of tooth hard tissue, and saliva accumulation.

SIGNIFICANCE

Bcl-2 expression has a significant impact on the mineralogical content of enamel crystals of tooth structure. Lack of Bcl-2 expression led to impaired production of enamel ACP crystals.

Effect of MTA particle size on periapical healing

AIM

To examine the effect of reduction in MTA particle size on dento-alveolar and osseous healing in dogs.

METHODOLOGY

Root canals of 24 mandibular premolars in four 2-year-old beagles were prepared and filled with gutta-percha and sealer. Two to four weeks later, during periapical surgery, the root-end cavity preparations in these teeth were filled with either grey ProRoot MTA or modified (reduced particle sizes with faster setting time) MTA. The animals were sacrificed 4 months later. Degrees of inflammation, type of inflammatory cells, fibrous connective tissue adjacent to the root-end filling materials, cementum formation over the resected roots and root-end filling materials and bone healing were examined. Data were analysed using the McNemar test.

RESULTS

No significant differences in healing of periapical tissues were found when comparing ProRoot MTA to a modified MTA containing reduced particle sizes.

CONCLUSION

Reducing the particle sizes of MTA did not impact its biological properties.

Calcium silicate-based cements and functional impacts of various constituents

Calcium silicate-based cements have superior sealing ability, bioactivity, and marginal adaptation, which make them suitable for different dental treatment applications. However, they exhibit some drawbacks such as long setting time and poor handling characteristics. To overcome these limitations calcium silicates are engineered with various constituents to improve specific characteristics of the base material, and are the focus of this review. An electronic search of the PubMed, MEDLINE, and EMBASE via OVID databases using appropriate terms and keywords related to the use, application, and properties of calcium silicate-based cements was conducted. Two independent reviewers obtained and analyzed the full texts of the selected articles. Although the effects of various constituents and additives to the base Portland cement-like materials have been investigated, there is no one particular ingredient that stands out as being most important. Applying nanotechnology and new synthesis methods for powders most positively affected the cement properties.

Effect of biomaterials on angiogenesis during vital pulp therapy

This review intended to provide an overview of the effects of dental materials, used in dentin-pulp complex and dental pulp regeneration, on angiogenesis processes during regenerative endodontic procedures. An electronic search was performed in PubMed and MEDLINE databases via OVID using the keywords mentioned in the PubMed and MeSH headings for English language published articles from January 2005-April 2014 that evaluated the angiogenic properties of different dental materials used in regenerative endodontic procedures. Of the articles identified in an initial search, only 40 articles met the inclusion criteria set for this review. Vital pulp therapy materials might have positive effects on angiogenesis events, while most of the canal irrigating solutions and antibiotic pastes have anti-angiogenic activity except for EDTA. Future clinical studies will be helpful in defining the mechanisms of action for dental materials that promote or inhibit angiogenesis events at applied areas.

The role of angiogenesis in implant dentistry part I: Review of titanium alloys, surface characteristics and treatments

Background

Angiogenesis plays an important role in osseointegration process by contributing to inflammatory and regenerative phases of surrounding alveolar bone. The present review evaluated the effect of titanium alloys and their surface characteristics including: surface topography (macro, micro, and nano), surface wettability/energy, surface hydrophilicity or hydrophobicity, surface charge, and surface treatments of dental implants on angiogenesis events, which occur during osseointegration period.

Material and Methods

An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014.

Results

Of the 2,691 articles identified in our initial search results, only 30 met the inclusion criteria set for this review. The hydrophilicity and topography of dental implants are the most important and effective surface characteristics in angiogenesis and osteogenesis processes. The surface treatments or modifications of dental implants are mainly directed through the enhancement of biological activity and functionalization in order to promote osteogenesis and angiogenesis, and accelerate the osseointegration procedure.

Conclusions

Angiogenesis is of great importance in implant dentistry in a manner that most of the surface characteristics and treatments of dental implants are directed toward creating a more pro-angiogenic surface on dental implants. A number of studies discussed the effect of titanium alloys, dental implant surface characteristic and treatments on agiogenesis process. However, clinical trials and in-vivo studies delineating the mechanisms of dental implants, and their surface characteristics or treatments, action in angiogenesis processes are lagging.

Key words:Angiogenesis, dental implant, osseointergration.

Repair of bone defect by nano-modified white mineral trioxide aggregates in rabbit: A histopathological study

Background

Many researchers have tried to enhance materials functions in different aspects of science using nano-modification method, and in many cases the results have been encouraging. To evaluate the histopathological responses of the micro-/nano-size cement-type biomaterials derived from calcium silicate-based composition with addition of nano tricalcium aluminate (3CaO.Al2O3) on bone healing response.

Material and Methods

Ninety mature male rabbits were anesthetized and a bone defect was created in the right mandible. The rabbits were divided into three groups, which were in turn subdivided into five subgroups with six animals each based on the defect filled by: white mineral trioxide aggregate (WMTA), Nano-WMTA, WMTA without 3CaO.Al2O3, Nano-WMTA with 2% Nano-3CaO.Al2O3, and empty as control. Twenty, forty and sixty days postoperatively the animals were sacrificed and the right mandibles were removed for histopathological evaluations. Kruskal-Wallis test with post-hoc comparisons based on the LSMeans procedure was used for data analysis.

Results

All the experimental materials provoked a moderate to severe inflammatory reaction, which significantly differed from the control group (p< 0.05). Statistical analysis of bone formation and bone regeneration data showed significant differences between groups at 40- and 60- day intervals in all groups. Absence of 3CaO.Al2O3 leads to more inflammation and foreign body reaction than other groups in all time intervals.

Conclusions

Both powder nano-modification and addition of 2% Nano-3CaO.Al2O3 to calcium silicate-based cement enhanced the favorable tissue response and osteogenesis properties of WMTA based materials.

Key words:Bone regeneration, cement, endodontics, histopathology, nano-wmta, tricalcium aluminate.

Effect of particle size on calcium release and elevation of pH of endodontic cements

BACKGROUND/AIM

Elevation of pH and calcium ion release are of great importance in antibacterial activity and the promotion of dental soft and hard tissue healing process. In this study, we evaluated the effect of particle size on the elevation of pH and the calcium ion release from calcium silicate-based dental cements.

MATERIAL AND METHODS

Twelve plastic tubes were divided into three groups, filled with white mineral trioxide aggregate (WMTA), WMTA plus 1% methylcellulose, and nano-modified WMTA (nano-WMTA), and placed inside flasks containing 10 ml of distilled water. The pH values were measured using a pH sensor 3, 24, 72, and 168 h after setting of the cements. The calcium ion release was measured using an atomic absorption spectrophotometer with same sample preparation method. Data were subjected to two-way analysis of variance (anova) followed by post hoc Tukey tests with significance level of P < 0.05.

RESULTS

Nano-WMTA showed significant pH elevation only after 24 h (P < 0.05) compared with WMTA, and after 3, 24, and 72 h compared with WMTA plus 1% methylcellulose (P < 0.05). Nano-WMTA showed significantly higher calcium ion release values compared to the other two groups (P < 0.05).

CONCLUSIONS

Nano-modification of WMTA remarkably increased the calcium ion release at all time intervals postsetting, which can significantly influence the osteogenic properties of human dental pulp cells and as a consequence enhance mineralized matrix nodule formation to achieve desirable clinical outcomes. However, the increase in pH values mainly occurred during the short time postsetting. Addition of 1% methylcellulose imposed a delay in elevation of pH and calcium ion release by WMTA.

Radiopacifier particle size impacts the physical properties of tricalcium silicate-based cements

INTRODUCTION

The aim of this study was to evaluate the impact of radiopaque additive, bismuth oxide, particle size on the physical properties, and radiopacity of tricalcium silicate-based cements.

METHODS

Six types of tricalcium silicate cement (CSC) including CSC without bismuth oxide, CSC + 10% (wt%) regular bismuth oxide (particle size 10 μm), CSC + 20% regular bismuth oxide (simulating white mineral trioxide aggregate [WMTA]) as a control, CSC + 10% nano bismuth oxide (particle size 50-80 nm), CSC + 20% nano-size bismuth oxide, and nano WMTA (a nano modification of WMTA comprising nanoparticles in the range of 40-100 nm) were prepared. Twenty-four samples from each group were divided into 4 groups and subjected to push-out, surface microhardness, radiopacity, and compressive strength tests. Data were analyzed by 1-way analysis of variance with the post hoc Tukey test.

RESULTS

The push-out and compressive strength of CSC without bismuth oxide and CSC with 10% and 20% nano bismuth oxide were significantly higher than CSC with 10% or 20% regular bismuth oxide (P < .05). The surface microhardness of CSC without bismuth oxide and CSC with 10% regular bismuth oxide had the lowest values (P < .05). The lowest radiopacity values were seen in CSC without bismuth oxide and CSC with 10% nano bismuth oxide (P < .05). Nano WMTA samples showed the highest values for all tested properties (P < .05) except for radiopacity.

CONCLUSIONS

The addition of 20% nano bismuth oxide enhanced the physical properties of CSC without any significant changes in radiopacity. Regular particle-size bismuth oxide reduced the physical properties of CSC material for tested parameters.

Comparison of particle morphology between commercial- and research-grade calcium hydroxide in endodontics

Ca(OH)2 aqueous slurry is widely used as an inter-appointment antimicrobial dressing in root canal treatment. The aim of this study was to quantify the particle size and shape of commercial-grade UltraCal XS (UC) and to compare it with that of research-grade Ca(OH)2 (RG) using a flow particle image analyzer (FPIA). The morphology and penetration inside the dentin tubules of the UC and RG particles were examined using a scanning electron microscope (SEM). UC and RG (10 mg) were mixed with 15 mL of alcohol, and were sonicated. Five milliliters of the dispersion was subjected to FPIA, and particle length, width, perimeter and aspect ratio were analyzed. In addition, UC paste and RG aqueous slurry were agitated on dentin discs and were prepared for SEM examination. There were significant differences between UC and RG with regard to the frequency of different length groups (P < 0.0001). UC contained smaller particles than RG (P < 0.0001). Under SEM, the agitated UC and RG particles occluded the opening of dentin tubules and penetrated inside the dentin tubules. The size of UC particles is smaller than those of RG. Both UC and RG particles were able to penetrate into open dentin tubules.

The effect of pH on solubility of nano-modified endodontic cements

AIMS

To evaluate the effect of storage pH on solubility of white mineral trioxide aggregate (WMTA), bioaggregate (BA), and nano WMTA cements.

MATERIALS AND METHODS

Forty-eight moulds randomly allocated into three groups of pH 4.4 (group A), 7.4 (group B), and 10.4 (group C); and one empty as control in each group. Each group was further divided into three subgroups according to the material studied; WMTA, BA, and nano WMTA. The specimens in subgroup A were soaked in butyric acid buffered with synthetic tissue fluid (STF) (pH 4.4), while the samples in subgroups B (pH 7.4) and C (pH 10.4) buffered in potassium hydroxide for 24 h and then the loss of cement was determined. A two-way analysis of variance (ANOVA) and Tukey post-hoc statistical tests were used to detect any statistically significant differences among the groups/subgroups.

RESULTS

Statistical analysis has showed the highest solubility in acidic pH for all tested materials. Nano WMTA samples in pH = 10.4 had the lowest and BA samples in pH = 4.4 showed the highest cement loss.

CONCLUSION

The solubility of all tested cements can be jeopardized in acidic environment which might affect on their sealing characteristic in clinical scenario. However, nano WMTA cement due to its small size particles and different additives was capable of producing lower porosity in set material, which resulted in showing more resistance in acidic environment.

Microparticulated and nanoparticulated zirconium oxide added to calcium silicate cement: Evaluation of physicochemical and biological properties

The physicochemical and biological properties of calcium silicate-based cement (CS) associated to microparticulated (micro) or nanoparticulated (nano) zirconium oxide (ZrO2 ) were compared with CS and bismuth oxide (BO) with CS. The pH, release of calcium ions, radiopacity, setting time, and compression strength of the materials were evaluated. The tissue reaction promoted by these materials in the subcutaneous was also investigated by morphological, immunohistochemical, and quantitative analyses. For this purpose, polyethylene tubes filled with materials were implanted into rat subcutaneous. After 7, 15, 30, and 60 days, the tubes surrounded by capsules were fixed and embedded in paraffin. In the H&E-stained sections, the number of inflammatory cells (ICs) in the capsule was obtained. Moreover, detection of interleukin-6 (IL-6) by immunohistochemistry and number of IL-6 immunolabeled cells were carried out. von Kossa method was also performed. The differences among the groups were subjected to Tukey test (p ≤ 0.05). The solutions containing the materials presented an alkaline pH and released calcium ions. The addition of radiopacifiers increased setting time and radiopacity of CS. A higher compressive strength in the CS + ZrO2 (micro and nano) was found compared with CS + BO. The number of IC and IL-6 positive cells in the materials with ZrO2 was significantly reduced in comparison with CS + BO. von Kossa-positive structures were observed adjacent to implanted materials. The ZrO2 associated to the CS provides satisfactory physicochemical properties and better biological response than BO. Thus, ZrO2 may be a good alternative for use as radiopacifying agent in substitution to BO.

Effect of endodontic cement on bone mineral density using serial dual-energy x-ray absorptiometry

INTRODUCTION

Materials with new compositions were tested in order to develop dental materials with better properties. Calcium silicate-based cements, including white mineral trioxide aggregate (WMTA), may improve osteopromotion because of their composition. Nano-modified cements may help researchers produce ideal root-end filling materials. Serial dual-energy x-ray absorptiometry measurement was used to evaluate the effects of particle size and the addition of tricalcium aluminate (C3A) to a type of mineral trioxide aggregate-based cement on bone mineral density and the surrounding tissues in the mandible of rabbits.

METHODS

Forty mature male rabbits (N = 40) were anesthetized, and a bone defect measuring 7 × 1 × 1 mm was created on the semimandible. The rabbits were divided into 2 groups, which were subdivided into 5 subgroups with 4 animals each based on the defect filled by the following: Nano-WMTA (patent application #13/211.880), WMTA (as standard), WMTA without C3A, Nano-WMTA + 2% Nano-C3A (Fujindonjnan Industrial Co, Ltd, Fujindonjnan Xiamen, China), and a control group. Twenty and forty days postoperatively, the animals were sacrificed, and the semimandibles were removed for DXA measurement.

RESULTS

The Kruskal-Wallis test followed by the Mann-Whitney U test showed significant differences between the groups at a significance level of P < .05. P values calculated by the Kruskal-Wallis test were .002 for bone mineral density at both intervals and P20 day = .004 and P40 day = .005 for bone mineral content.

CONCLUSIONS

This study showed that bone regeneration was enhanced by reducing the particle size (nano-modified) and C3A mixture. This may relate to the existence of an external supply of minerals and a larger surface area of nano-modified material, which may lead to faster release rate of Ca(2+), inducing bone formation. Adding Nano-C3A to Nano-WMTA may improve bone regeneration properties.

Mechanical response of dental cements as determined by nanoindentation and scanning electron microscopy

This study evaluated the effects of nanoindentation on the surface of white mineral trioxide aggregate (WMTA), Bioaggregate and Nano WMTA cements. Cements were mixed according to the manufacturer directions, condensed inside glass tubes, and randomly divided into three groups (n = 8). Specimens were soaked in synthetic tissue fluid (pH = 7.4) and incubated for 3 days. Cement pellets were subjected to nanoindentation tests and observed by scanning electron microscopy. Then, the images were processed and the number of cracks and total surface area of defects on the surface were calculated and analyzed using ImageJ. Data were submitted to one-way analysis of variance and a post hoc Tukey's test. The lowest number of cracks and total surface of defects were detected in Nano WMTA samples; however, it was not significantly different from WMTA samples (p = 0.588), while the highest values were noticed in Bioaggregate specimens that were significantly different from Nano WMTA and WMTA (p = 0.0001). The surface of WMTA and Nano WMTA showed more resistance after exposure to nano-compressive forces which indicated a better surface tolerance against these forces and crack formation. This suggests these substances are more tolerant cement materials which can predictably withstand loaded situations in a clinical scenario.

Effects of various mixing techniques on physical properties of white mineral trioxide aggregate

INTRODUCTION

The aim of this study was to evaluate the effects of three different mixing techniques on surface microhardness, initial setting time, and phase formation of white mineral trioxide aggregate.

METHODS

Twenty-one cylindrical glass tubes were selected and divided into three groups of seven in each (n = 7). White mineral trioxide aggregate (WMTA) in groups A, B, and C were mixed by conventional, trituration, and ultrasonic techniques, respectively. Cements were mixed and packed into the glass tubes and incubated at 37°C for 3 days. After incubation, samples were subjected to microhardness evaluation, and four specimens from each group were prepared and observed under a scanning electron microscopy and X-ray diffraction. For setting time assessment, WMTA was mixed in three parts again, and Gilmore needle test was performed until the initial setting time of cement. Data were analyzed by one-way anova and post hoc Tukey's test.

RESULTS

Samples mixed by trituration technique significantly showed the highest microhardness (P < 0.001) and the lowest setting time, while the ultrasonically mixed specimens significantly revealed the highest setting time in comparison with other groups (P < 0.001). Samples mixed by trituration technique showed the highest uniformity in the bulk and highest amount of hydrated calcium silicate (CS) phases, while the lowest value was observed in ultrasonically mixed cements, which also showed the highest amount of anhydrated CS phases.

CONCLUSION

Trituration and conventional techniques were more suitable mixing methods for mineral trioxide aggregate in comparison with ultrasonic technique. Trituration resulted in better hydration and crystallization, which prevents clustering of powder and reduces voids and setting time of mixed cement.

Effect of bismuth oxide on white mineral trioxide aggregate: chemical characterization and physical properties

AIM

To assess the effect of bismuth oxide (Bi2 O3 ) on the chemical characterization and physical properties of White mineral trioxide aggregate (MTA) Angelus.

METHODOLOGY

Commercially available White MTA Angelus and White MTA Angelus without Bi2 O3 provided by the manufacturer especially for this study were subjected to the following tests: Rietveld X-ray diffraction analysis (XRD), energy-dispersive X-ray analysis (EDX), scanning electron microscopy (SEM), compressive strength, Vickers microhardness test and setting time. Chemical analysis data were reported descriptively, and physical properties were expressed as means and standard deviations. Data were analysed using Student's t-test and Mann-Whitney U test (P = 0.05).

RESULTS

Calcium silicate peaks were reduced in the diffractograms of both hydrated materials. Bismuth particles were found on the surface of White MTA Angelus, and a greater amount of particles characterized as calcium hydroxide was observed by visual examination on White MTA without Bi2 O3 . The material without Bi2 O3 had the shortest final setting time (38.33 min, P = 0.002), the highest Vickers microhardness mean value (72.35 MPa, P = 0.000) and similar compressive strength results (P = 0.329) when compared with the commercially available White MTA Angelus containing Bi2 O3 .

CONCLUSION

The lack of Bi2 O3 was associated with an increase in Vickers microhardness, a reduction in final setting time, absence of Bi2 O3 peaks in diffractograms, as well as a large amount of calcium and a morphology characteristic of calcium hydroxide in EDX/SEM analysis.

The impact of thermocycling process on the dislodgement force of different endodontic cements

To evaluate the effects of thermocycling (500 cycles, 5°C/55°C) on the push-out bond strength of calcium silicate based cements including WMTA, Nano-WMTA, and Bioaggregate to root dentin. Forty-eight dentin slices were prepared and divided into 3 groups (n = 16) and filled with Angelus WMTA, Nano-WMTA, or Bioaggregate. After incubation, half of the samples were thermocycled while the other half remained untreated. Push-out bond strength was calculated, and the modes of the bond failures were determined by SEM. The highest bond strength was seen in nonthermocycled Nano-WMTA samples and the lowest in thermocycled Bioaggregate samples. The significant differences between nonthermocycled and thermocycled samples were only noticed in WMTA and Nano-WMTA groups (P < 0.001). The mode of failure for thermocycled samples of all three cements was mostly cohesive. Thermocycling process can drastically affect the push-out bond strength of calcium silicate based cements. The intrastructural damages occurred due to the thermal stresses, causing cohesive failures in set materials. Sealing property of endodontic cements which have experienced the thermal stresses can be jeopardized due to occlusal forces happening in furcation cites.

Effect of pH on compressive strength of some modification of mineral trioxide aggregate

Objectives: Recently, it was shown that NanoMTA improved the setting time and promoted a better hydration process which prevents washout and the dislodgment of this novel biomaterial in comparison with WTMA. This study analyzed the compressive strength of ProRoot WMTA (Dentsply), a NanoWMTA (Kamal Asgar Research Center), and Bioaggregate (Innovative Bioceramix) after its exposure to a range of environmental pH conditions during hydration. Study Design: After mixing the cements under aseptic condition and based on the manufacturers` recommendations, the cements were condensed with moderate force using plugger into 9 × 6 mm split molds. Each type of cement was then randomly divided into three groups (n=10). Specimens were exposed to environments with pH values of 4.4, 7.4, or 10.4 for 3 days. Cement pellets were compressed by using an Instron testing machine. Values were recorded and compared. Data were analyzed by using one-way analysis of variance and a post hoc Tukey’s test. Results: After 3 days, the samples were solid when probed with an explorer before removing them from the molds. The greatest mean compressive strength 133.19±11.14 MPa was observed after exposure to a pH value of 10.4 for NanoWMTA. The values decreased to 111.41±8.26 MPa after exposure to a pH value of 4.4. Increasing of pH had a significant effect on the compressive strength of the groups (p<0.001). The mean compressive strength for the NanoWMTA was statistically higher than for ProRoot WMTA and Bioaggregate (p<0.001). Moreover, increasing of pH values had a significant effect on compressive strength of the experimental groups (p<0.001). Conclusion: The compressive strength of NanoWMTA was significantly higher than WMTA and Bioaggregate; the more acidic the environmental pH, the lower was the compressive strength.

Key words:Compressive strength, mineral trioxide aggregate, Nano.