Explore the vast range of titles available.

Background To investigate the effects of adding ZrO₂, TiO₂, and two sizes of hydroxyapatite (HAP) nanoparticles on the physicochemical and bioactivity properties of calcium silicate-based cement (CSC). Methods MTA, PC, and nanoparticle-modified groups (5% and 10% n-ZrO₂, n-TiO₂, n-HAP1, n-HAP2) were evaluated for setting time, compressive strength (1, 7, 14 days), solubility (14 days), and bioactivity. Setting time and compressive strength followed ISO 9917–1:2007, solubility followed a modified ISO 6876:2012, and bioactivity was analyzed using SEM–EDS. Results All groups showed significantly reduced setting times (p < 0.001) compared to MTA and PC, with 10% n-HAP1 showing the greatest reduction. Compressive strength increased over time in all groups except 5% and 10% n-ZrO₂, which remained stable (p > 0.05). MTA had the highest strength at 14 days. MTA’s solubility was higher than PC’s (p < 0.001). All groups, except 10% n-TiO₂, 5% and 10% n-HAP1, showed increased solubility vs. MTA (p < 0.003); all exceeded PC (p < 0.001). SEM after 1 day showed spherical apatite structures, which thickened by days 7 and 14. EDS confirmed Ca/P ratios similar to controls. Conclusions All nanoparticles accelerated the setting time, and only ZrO₂ nanoparticles enhanced early strength. Despite increased solubility, all values remained within acceptable limits. All groups demonstrated bioactivity potential.

Objectives The push‐out bond strength (POBS) of calcium silicate‐based cements (CSCs) to the dentinal wall is considered one of the essential physical properties for clinical success. The presence of blood in the treatment area affects the POBS of these types of cement. This study aimed to evaluate the impact of blood contamination on the bond strength of CSCs and dentinal walls. Material and Methods This systematic review was performed by searching electronic databases (MEDLINE‐PubMed, Scopus, and EMBASE) to include relevant in vitro studies published between 1992 and April 2020. Two reviewers independently evaluated the selected studies and extracted data on the type of studied CSCs, evaluated area of the teeth, sample size, the dimension of a prepared area, slice thickness, storage duration, the setting of the universal testing machine (UTM), effects of blood contamination on POBS of CSCs and their failure modes. The bond strength of evaluated CSCs in studies was used for network meta‐analysis. Results Initial searches identified 292 articles, while only 13 articles met the inclusion criteria. Full texts of these articles were evaluated, and data extraction was performed. The effect of blood contamination on bond strength to the dentinal wall was assessed in various CSCs such as PMTA, Biodentine, and AMTA. The network meta‐analysis results showed that the bond strength of Biodentine was significantly higher than other types of cement in blood presence (p < .05). Conclusions Based on the current systematic review, despite controversies among the result of the different articles and the lack of data for some CSCs like bioaggregate, it could be concluded that the bond strength of Biodentine to the dentinal wall is better than other evaluated CSCs in the presence of blood.

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.

Objectives The aim of this study was to evaluate the shear bond strength inherent to immediate and delayed definitive composite resin restorations, over three different biomaterials. Methods Fifty-four aluminum blocks were randomly assigned to six experimental groups ( n = 9) according to the biomaterial (Biodentine, TotalFill BC Putty, or PCM) and restoration timing (immediate or 7 days delayed). Regarding the restorative procedures, a two-step self-etch bonding system (Clearfil SE Bond) was applied and subsequently restored using a flowable composite resin (SDR). After shear bond strength testing, fracture pattern analysis was performed. The significance level was set at α = 0.05. Results Within the immediate groups, Biodentine showed the highest mean shear bond strength value, with no statistically significant differences ( P > 0.05) being detected when compared with both TotalFill ( P = 0.072) and PCM ( P = 0.232) groups. Regarding the delayed restoration groups, Biodentine and TotalFill presented the highest mean shear bond strength value, with statistical differences when compared with PCM ( P = 0.002 and P = 0.043, respectively). No statistically significant differences ( P > 0.05) were verified between both immediate and delayed groups for each tested biomaterial. Also, a statistically significant association was found between the fracture type and the biomaterial ( P < 0.001). Conclusions and clinical relevance Our findings suggest that all tested biomaterials present suitable alternatives which allow to perform restorative procedures immediately after pulp capping biomaterial placement (3 or 12 min, depending on the bioactive cement), therefore requiring one single appointment to complete the procedure. Biodentine and TotalFill BC Putty have shown superior shear bond strength results when compared with PCM, within a delayed timeframe (7 days).

This ex-vivo study compares the adaptation, porosity, and sealing performance of ProRoot MTA, NeoPutty, and Biodentine in standardized, simulated furcation perforations created in extracted mandibular molars using clinical evaluation and high-resolution micro-computed tomography (micro-CT). Thirty-six mandibular molars with furcation perforations were randomly assigned to three groups ( n  = 12). Clinical evaluation assessed adaptation, porosity, and overfilling, while micro-computed tomography (micro-CT) provided quantitative data on voids and gaps. Statistical analysis used chi-square, Kruskal–Wallis, and Mann–Whitney U tests. NeoPutty and ProRoot MTA showed superior adaptation compared to Biodentine ( p  < 0.05). Biodentine showed higher porosity (28.44%) than ProRoot MTA (0%) and NeoPutty (8.3%) ( p  < 0.001). Biodentine also had the highest void volume (1.05 mm 3 ) and gap volume (1.37 mm 3 ), while ProRoot MTA recorded the lowest void volume (0.59 mm 3 ), and NeoPutty had the smallest gap volume (0.85 mm 3 ). No significant differences were observed in overfilling rates. Overall, ProRoot MTA exhibited the most consistent sealing ability, whereas NeoPutty emerged as a viable alternative due to its favorable handling and reliable adaptation. Biodentine, by contrast, showed the poorest performance in terms of structural integrity and sealing capacity. Within the limitations of this study, these findings support the use of ProRoot MTA or NeoPutty for furcation perforation repair, while suggesting more cautious use of Biodentine in such applications.

We compared calcium silicate-based pulp capping materials to conventional calcium hydroxide in terms of their biological properties and potential effects on odontogenic differentiation in human dental pulp stem cells (hDPSCs). We cultured hDPSCs on disks (7-mm diameter, 4-mm high) of ProRoot MTA (Dentsply Tulsa Dental Specialties), Biodentine (Septodont), TheraCal LC (Bisco), or Dycal (Dentsply Tulsa Dental Specialties). Cell viability was assessed with cell counting (CCK) and scanning electron microscopy (SEM). Odontogenic activity was assessed by measuring alkaline phosphatase (ALP) activity and gene expression (quantitative real-time PCR). CCK assays showed that Dycal reduced cell viability compared to the other materials (p < 0.05). SEM showed low and absent cell attachment on TheraCal LC and Dycal disks, respectively. hDPSCs exposed to TheraCal LC and Dycal showed higher ALP activity on day 6 than the control group (p < 0.05). The day-9 Runx2 expression was higher in the ProRoot MTA and TheraCal LC groups than in the control group (p < 0.05). On day 14, the ProRoot MTA group showed the highest dentin sialophosphoprotein levels (not significant; p > 0.05). In conclusion, various pulp capping materials, except Dycal, exhibited biological properties favorable to hDPSC viability. ProRoot MTA and TheraCal LC promoted higher Runx2 expression than Biodentine. Future studies should explore the odontogenic potential of pulp capping materials.

Premixed calcium silicate-based cements (CSCs) and fast-set CSCs were developed for the convenience of retrograde filling during endodontic microsurgery. The aim of this study was to analyze the biocompatible properties and mineralization potential of premixed CSCs, such as Endocem MTA Premixed (EM Premixed) and EndoSequence BC RRM putty (EndoSequence), and fast-set RetroMTA on human bone marrow-derived mesenchymal stem cells (BMSCs) compared to ProRoot MTA. Using CCK-8, a significantly higher proliferation of BMSCs occurred only in the EM Premixed group on days 2 and 4 (p < 0.05). On day 6, the ProRoot MTA group had significantly higher cell proliferation than the control group (p < 0.05). Regardless of the experimental materials, all groups had complete cell migration by day 4. Alizarin Red-S staining and alkaline phosphatase assay demonstrated higher mineralization potential of all CSCs similar to ProRoot MTA (p < 0.05). The EndoSequence group showed more upregulation of SMAD1 and OSX gene expression than the other experimental groups (p < 0.05), and all experimental cements upregulated osteogenic gene expression more than the control group (p < 0.05). Therefore, using premixed CSCs and fast-set CSCs as retrograde filling cements may facilitate satisfactory biological responses and comparable osteogenic potential to ProRoot MTA.

Aim To investigate the outcome of elective full pulpotomy, using calcium silicate-based cements (CSBC), after 2 years, in symptomatic mature permanent teeth with carious lesions, diagnosed as irreversible pulpitis, and analyse the capacity of Wolters et al. (2017) classification to predict the likelihood of treatment failure. Methods The treatment records of 56 patients with symptomatic mature teeth with carious lesions, diagnosed as irreversible pulpitis and treated by elective full pulpotomy, using CSBCs as pulp capping materials, were reviewed. Thirteen teeth were excluded. The remaining 43 teeth were evaluated retrospectively at 24 months. Fisher`s exact test with the Lancaster’s mid-P adjustment was used to assess different outcomes amongst the diagnostic categories. Results Four of the cases failed before 24 months and required root canal treatment (RCT). Overall success rate at 2 years was 90.7% (39 of 43). An inverse, but non-significant, correlation was observed between the severity of pulpitis according to the Wolters classification and the treatment success rate ( p  > 0.05). The type of CSBC used was associated to the success rate (OR = 10.5; 95% C.I. = 0.5 – 207.4; p  = 0.027), being 82% with Endosequence and 100% with Biodentine. Postoperative pain associated significantly to lower success rate (66.7%) (Odds ratio = 8.0; 95% C.I. = 0.7 – 95.9; p  = 0.047). Conclusions Elective full pulpotomy using a CSBC was a successful choice for the treatment of mature permanent teeth with symptoms indicative of irreversible pulpitis. There were no significant differences between the success rate of mild, moderate and severe pulpitis. Postoperative pain could be considered a risk marker for failure of full pulpotomy. The term “irreversible pulpitis” should be re-signified to indicate the need for access to the pulp chamber, rather than an indication for extraction or RCT.

The goal of this study was to evaluate the pH and the release of calcium from four calcium-silicate-based cements. Methods: Four materials were tested (ProClinic MTA; Angelus MTA; ProRoot MTA; Biodentine). The palatal canal root of acrylic upper molars was filled with each cement. Afterwards, they were set in phosphate-buffered saline. Measurements were taken by atomic adsorption spectroscopy (AAS) at 3, 24, 72, 168, 336, 672, and 1008 h. The pH was measured at the same timepoints. Kruskal–Wallis tests were carried out in each period, as the Kolmogorov–Smirnov and Shapiro–Wilk tests showed no parametric results. Results: Significant differences (p < 0.05) in calcium release were found at the 3-, 24-, and 72-hour evaluations. All of the analyzed groups presented a release of calcium ions up to 168 h, and the general tendency was to increase up to 672 h, with a maximum release of 25.45 mg/g in the ProRoot group. We could only observe significant differences (p < 0.05) in pH value over 168 h between the Biodentine (7.93) and Angelus MTA (7.31) groups. Conclusions: There were significant differences (p < 0.05) in calcium release. Nevertheless, no significant differences (p > 0.05) in the pH values were found at the studied timepoints, except for the values at 168 h.

Vital pulp therapy aims to preserve the vitality of dental pulp exposed due to caries, trauma, or restorative procedures. The aim of the present review was to evaluate the clinical, radiographic, and histological outcomes of different calcium silicate-based cements used in vital pulp therapy for both primary and permanent teeth. The review included 40 randomized controlled trials from a search across PubMed, LILACS, and the Cochrane Collaboration, as well as manual searches and author inquiries according to specific inclusion and exclusion criteria. A critical assessment of studies was conducted, and after data extraction the results were submitted to a quantitative statistical analysis using meta-analysis. The studies, involving 1701 patients and 3168 teeth, compared a total of 18 different calcium silicate-based cements in both dentitions. The qualitative synthesis showed no significant differences in short-term outcomes (up to 6 months) between different calcium silicate-based cements in primary teeth. ProRoot MTA and Biodentine showed similar clinical and radiographic success rates at 6 and 12 months. In permanent teeth, although the global results appeared to be well balanced, ProRoot MTA generally seemed to perform better than other calcium silicate-based cements except for Biodentine, which had comparable or superior results at 6 months. Meta-analyses for selected comparisons showed no significant differences in clinical and radiographic outcomes between ProRoot MTA and Biodentine over follow-up periods. The present review highlights the need for standardized definitions of success and follow-up periods in future studies to better guide clinical decisions. Despite the introduction of new calcium silicate-based cements aiming to address limitations of the original MTA. ProRoot MTA and Biodentine remain the most used and reliable materials for vital pulp therapy, although the results did not deviate that much from the other calcium silicate-based cements. Further long-term studies are required to establish the optimal CSC for each clinical scenario in both dentitions.