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Dental Biomaterials 2017

A special issue of Materials (ISSN 1996-1944).

Deadline for manuscript submissions: closed (30 November 2017) | Viewed by 104711

Special Issue Editor

School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
Interests: dental prescribing; oral microbiology; biofilms; novel antimicrobials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is growing interest in the use of alkaline dental materials, which are able to improve clinical outcomes in dentistry and which go beyond the concept of a simple dental material, which fills a space in a tooth or lines a cavity. These biologically-active materials are in the form of alkaline fluids, pastes and dental cements. This Special Issue on biomaterials used in dentistry focuses on alkaline materials used in endodontics and restorative dentistry, which can induce hard tissue formation and exert antimicrobial actions.

Prof. Dr. Laurence J Walsh
Guest Editor

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Keywords

  • bioceramics

  • mineral trioxide aggregate

  • calcium silicates

Published Papers (19 papers)

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Research

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9 pages, 5307 KiB  
Article
Comparison of Commercial Calcium Hydroxide Pastes for Prolonged Antibacterial Effect using a Colourimetric Assessment
by Yu-Yao Teoh, Basil Athanassiadis and Laurence J. Walsh
Materials 2018, 11(3), 348; https://doi.org/10.3390/ma11030348 - 27 Feb 2018
Cited by 11 | Viewed by 3405
Abstract
The anti-microbial activity of calcium hydroxide pastes used in endodontics is dependent on establishing high levels of hydroxyl ions in dentine. This study investigated hydroxyl ion diffusion from different commercial calcium hydroxide pastes using a novel colourimetric method. In this method, human tooth [...] Read more.
The anti-microbial activity of calcium hydroxide pastes used in endodontics is dependent on establishing high levels of hydroxyl ions in dentine. This study investigated hydroxyl ion diffusion from different commercial calcium hydroxide pastes using a novel colourimetric method. In this method, human tooth roots were stained with anthocyanin dye, which changed their colour according to the local pH conditions. Prepared root canals were filled with pastes formulated with the vehicle of water (Pulpdent™, Calasept Plus™), polyethylene glycol (PEG) (Calmix™) or a mixture of water, PEG and ibuprofen (Odontocide™). The changes in dye colour at fixed distances from the canal wall were monitored using standardised digital photography over a period of 3 weeks. A repeated measures analysis tracked changes in each root from baseline. Release of hydroxyl ions varied between the different commercial compositions containing water or PEG as solvents. The colour changes in the dentine, due to released hydroxyl ions, were greatest and more prolonged for completely non-aqueous compositions, when using PEG 400 as the vehicle. When water was present in the product, the duration of the pH changes was shorter. This was attributed to the presence of hydroxyl ions in the water (the common-ion effect) and a more vigorous buffering of hydroxyl ions by dentine proteins. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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8 pages, 729 KiB  
Article
Hydroxyl Ion Diffusion through Radicular Dentine When Calcium Hydroxide Is Used under Different Conditions
by Michael Cai, Paul Abbott and Jacqueline Castro Salgado
Materials 2018, 11(1), 152; https://doi.org/10.3390/ma11010152 - 17 Jan 2018
Cited by 10 | Viewed by 4689
Abstract
Calcium hydroxide’s anti-bacterial action relies on high pH. The aim here was to investigate hydroxyl ion diffusion through dentine under different conditions. Teeth were divided into control (n = 4) and four experimental groups (n = 10): Group 1—no medicament; Group [...] Read more.
Calcium hydroxide’s anti-bacterial action relies on high pH. The aim here was to investigate hydroxyl ion diffusion through dentine under different conditions. Teeth were divided into control (n = 4) and four experimental groups (n = 10): Group 1—no medicament; Group 2—Calmix; Group 3—Calmix/Ledermix; Group 4—Calasept Plus/Ledermix; Group 5—Pulpdent/smear layer. Deep (inner dentine) and shallow (outer dentine) cavities were cut into each root. pH was measured in these cavities for 12 weeks. The inner and outer dentine pH in Group 2 was significantly higher than all groups. Inner dentine pH in Group 3 was slightly higher than that in Group 4 initially but subsequently comparable. After Day 2, Group 5 had significantly lower pH than Groups 3 and 4. The outer dentine pH in Group 3 started higher than that in Groups 4 and 5, but by Day 28 the difference was insignificant. The time for the inner dentine to reach maximum pH was one week for Group 2 and four weeks for Groups 3 and 4. The time for the outer dentine to reach maximum pH was eight weeks for all experimental groups. Mixing different Ca(OH)2 formulations with Ledermix gave similar hydroxyl ion release but pH and total diffusion was lower than Ca(OH)2 alone. The smear layer inhibited diffusion. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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14 pages, 2235 KiB  
Article
Effect of Exposed Surface Area, Volume and Environmental pH on the Calcium Ion Release of Three Commercially Available Tricalcium Silicate Based Dental Cements
by Sivaprakash Rajasekharan, Chris Vercruysse, Luc Martens and Ronald Verbeeck
Materials 2018, 11(1), 123; https://doi.org/10.3390/ma11010123 - 13 Jan 2018
Cited by 20 | Viewed by 4422 | Correction
Abstract
Tricalcium silicate cements (TSC) are used in dental traumatology and endodontics for their bioactivity which is mostly attributed to formation of calcium hydroxide during TSC hydration and its subsequent release of calcium and hydroxide ions. The aim of this study was to determine [...] Read more.
Tricalcium silicate cements (TSC) are used in dental traumatology and endodontics for their bioactivity which is mostly attributed to formation of calcium hydroxide during TSC hydration and its subsequent release of calcium and hydroxide ions. The aim of this study was to determine the effect of volume (Vol), exposed surface area (ESA) and pH of surrounding medium on calcium ion release. Three commercially available hydraulic alkaline dental cements were mixed and condensed into cylindrical tubes of varying length and diameter (n = 6/group). For the effect of ESA and Vol, tubes were immersed in 10 mL of deionized water. To analyze the effect of environmental pH, the tubes were randomly immersed in 10 mL of buffer solutions with varying pH (10.4, 7.4 or 4.4). The solutions were collected and renewed at various time intervals. pH and/or calcium ion release was measured using a pH glass electrode and atomic absorption spectrophotometer respectively. The change of pH, short-term calcium ion release and rate at which calcium ion release reaches maximum were dependent on ESA (p < 0.05) while maximum calcium ion release was dependent on Vol of TSC (p < 0.05). Maximum calcium ion release was significantly higher in acidic solution followed by neutral and alkaline solution (p < 0.05). Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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13 pages, 7170 KiB  
Article
Effect of Lithium Disilicate Reinforced Liner Treatment on Bond and Fracture Strengths of Bilayered Zirconia All-Ceramic Crown
by Yong-Seok Jang, Hyeong-Rok Noh, Min-Ho Lee, Myung-Jin Lim and Tae-Sung Bae
Materials 2018, 11(1), 77; https://doi.org/10.3390/ma11010077 - 05 Jan 2018
Cited by 6 | Viewed by 6799
Abstract
This study was performed to evaluate the effect of a lithium-disilicate spray-liner application on both the bond strength between zirconia cores and heat-pressed lithium-disilicate glass-ceramic veneers, and the fracture strength of all-ceramic zirconia crowns. A lithium-disilicate reinforced liner was applied on the surface [...] Read more.
This study was performed to evaluate the effect of a lithium-disilicate spray-liner application on both the bond strength between zirconia cores and heat-pressed lithium-disilicate glass-ceramic veneers, and the fracture strength of all-ceramic zirconia crowns. A lithium-disilicate reinforced liner was applied on the surface of a zirconia core and lithium-disilicate glass-ceramic was veneered on zirconia through heat press forming. Microtensile and crown fracture tests were conducted in order to evaluate, respectively, the bonding strength between the zirconia cores and heat pressed lithium-disilicate glass-ceramic veneers, and the fracture strength of bilayered zirconia all-ceramic crowns. The role of lithium-disilicate spray-liner at the interface between zirconia and lithium-disilicate glass-ceramic veneers was investigated through surface and cross-sectional analyses. We confirmed that both the mean bonding strength between the zirconia ceramics and lithium-disilicate glass-ceramic veneers and the fracture strength of the liner-treated groups were significantly higher than those of the untreated groups, which resulted, on the one hand, from the chemical bonding at the interface of the zirconia and lithium-disilicate liner, and, on the other, from the existence of a microgap in the group not treated with liner. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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14 pages, 6374 KiB  
Article
Enhancing of Osseointegration with Propolis-Loaded TiO2 Nanotubes in Rat Mandible for Dental Implants
by Nithideth Somsanith, Yu-Kyoung Kim, Young-Seok Jang, Young-Hee Lee, Ho-Keun Yi, Jong-Hwa Jang, Kyoung-A Kim, Tae-Sung Bae and Min-Ho Lee
Materials 2018, 11(1), 61; https://doi.org/10.3390/ma11010061 - 01 Jan 2018
Cited by 24 | Viewed by 5347
Abstract
TiO2 nanotubes (TNT) formation is beneficial for improving bone cell–material interaction and drug delivery for Ti dental implants. Among the natural drugs to be installed in TNT, selected propolis has antibacterial and anti-inflammatory properties. It is a resinous natural product which is [...] Read more.
TiO2 nanotubes (TNT) formation is beneficial for improving bone cell–material interaction and drug delivery for Ti dental implants. Among the natural drugs to be installed in TNT, selected propolis has antibacterial and anti-inflammatory properties. It is a resinous natural product which is collected by the honeybees from the various types of plants with their salivary enzymes. This study concludes that TNT loaded with a propolis (PL-TNT-Ti) dental implant has the ability to improve osseointegration. The propolis particles were embedded within the TNT or adhered to the top. In a cytotoxicity test using osteoblast, PL-TNT-Ti group exhibited an increased cell proliferation and differentiation. A Sprague Dawley rat mandibular model was used to evaluate the osseointegration and bone bonding of TNT or PL-TNT-Ti. From the µ-CT and hematoxylin and eosin (HE) histological results after implantation at 1 and 4 weeks to rat mandibular, an increase in the extent of new bone formation and mineral density around the PL-TNT-Ti implant was confirmed. The Masson’s trichrome staining showed the expression of well-formed collagenous for bone formation on the PL-TNT-Ti. Immunohistochemistry staining indicate that bone morphogenetic proteins (BMP-2 and BMP-7) around the PL-TNT-Ti increased the expression of collagen fibers and of osteogenic differentiation whereas the expression of inflammatory cytokine such as interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) is decreased. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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1212 KiB  
Article
Rheological Characterization as an Alternative Method to Indentation for Determining the Setting Time of Restorative and Endodontic Cements
by William N. Ha, Timothy M. Nicholson, Bill Kahler and Laurence J. Walsh
Materials 2017, 10(12), 1451; https://doi.org/10.3390/ma10121451 - 20 Dec 2017
Cited by 7 | Viewed by 3681
Abstract
This study explored an alternative approach using rheology to assess setting time. The following cements were tested: ProRoot® MTA (Dentsply, Tulsa, OK, USA), Biodentine® (Septodont, Saint Maur des Fosses, France), Fuji VII®, FujiVII® EP, and Fuji IX® [...] Read more.
This study explored an alternative approach using rheology to assess setting time. The following cements were tested: ProRoot® MTA (Dentsply, Tulsa, OK, USA), Biodentine® (Septodont, Saint Maur des Fosses, France), Fuji VII®, FujiVII® EP, and Fuji IX® (from GC Corporation, Tokyo, Japan), RealSeal SE™ Sealer (SybronEndo, Amersfoort, The Netherlands), AH 26® and AH Plus (both from Dentsply DeTrey, Konstanz, Germany). Freshly mixed cements were placed into a strain-controlled rheometer (1 rad·s−1 with an applied strain of 0.01%). From measurements of elastic modulus over time, the time taken to reach 90% of the plateau elastic modulus (designated as the setting time) was determined for each cement. In increasing order, the setting times were as follows: Fuji VII EP 3.3 min, Fuji VII 3.6 min, Fuji IX 3.7 min, ProRoot MTA 5.1 min, Biodentine 15.9 min, RealSeal 22.2 min, AH Plus 5933 min, and AH 26 5067 min. However, ProRoot MTA did not yield reliable results. The time to reach the 90% plateau elastic modulus correlates well with the setting time of glass ionomer cements and Biodentine. Using this approach gives much longer setting times for endodontic sealers than previously recognized. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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9306 KiB  
Article
Residual Endodontic Filling Material after Post Space Preparation: A Confocal Microscopic Study
by Yu-Yao Teoh and Laurence J. Walsh
Materials 2017, 10(11), 1333; https://doi.org/10.3390/ma10111333 - 21 Nov 2017
Cited by 8 | Viewed by 4603
Abstract
This laboratory study assessed removability of endodontic alkaline cements and resin sealers using coronal cross-sectional slices of roots with single canals. Materials were labelled with 0.1% (w/w) sodium fluorescein prior to mixing so that confocal microscopy could be used [...] Read more.
This laboratory study assessed removability of endodontic alkaline cements and resin sealers using coronal cross-sectional slices of roots with single canals. Materials were labelled with 0.1% (w/w) sodium fluorescein prior to mixing so that confocal microscopy could be used to quantify material remaining on the walls of post spaces, to assess cleanliness. Roots of extracted teeth were prepared using rotary NiTi instruments then obturated using lateral condensation with gutta percha and epoxy resin sealers (AH-Plus™ or Zirmix™), or were filled by injecting mineral trioxide aggregate (MTA) cement (GC Nex™ MTA or MTAmix™) or a hard-setting calcium hydroxide cement (Supercal™). Brown (#3) ParaPost™ drills were used at 600 rpm with a torque setting of 3 N cm−1 for 2 min to remove 5 mm of the root filling. Roots were embedded and coronal slices examined by confocal microscopy, with the perimeter of the drill channel divided into clean, unclean and non-accessible regions. The choice of material affects cleanliness, with MTA being the most difficult and calcium hydroxide cement the easiest to remove. With epoxy resin-based sealers, almost half of the accessible canal walls remained coated with remnants of sealer after post space preparation. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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3493 KiB  
Article
Calcium Phosphate Cement with Antimicrobial Properties and Radiopacity as an Endodontic Material
by Tzong-Ming Shieh, Shih-Ming Hsu, Kai-Chi Chang, Wen-Cheng Chen and Dan-Jae Lin
Materials 2017, 10(11), 1256; https://doi.org/10.3390/ma10111256 - 31 Oct 2017
Cited by 14 | Viewed by 4956
Abstract
Calcium phosphate cements (CPCs) have several advantages for use as endodontic materials, and such advantages include ease of use, biocompatibility, potential hydroxyapatite-forming ability, and bond creation between the dentin and appropriate filling materials. However, unlike tricalcium silicate (CS)-based materials, CPCs do not have [...] Read more.
Calcium phosphate cements (CPCs) have several advantages for use as endodontic materials, and such advantages include ease of use, biocompatibility, potential hydroxyapatite-forming ability, and bond creation between the dentin and appropriate filling materials. However, unlike tricalcium silicate (CS)-based materials, CPCs do not have antibacterial properties. The present study doped a nonwashable CPC with 0.25–1.0 wt % hinokitiol and added 0, 5, and 10 wt % CS. The CPCs with 0.25–0.5 wt % hinokitiol showed appreciable antimicrobial properties without alterations in their working or setting times, mechanical properties, or cytocompatibility. Addition of CS slightly retarded the apatite formation of CPC and the working and setting time was obviously reduced. Moreover, addition of CS dramatically increased the compressive strength of CPC. Doping CS with 5 wt % ZnO provided additional antibacterial effects to the present CPC system. CS and hinokitiol exerted a synergic antibacterial effect, and the CPC with 0.25 wt % hinokitiol and 10 wt % CS (doped with 5 wt % ZnO) had higher antibacterial properties than that of pure CS. The addition of 10 wt % bismuth subgallate doubled the CPC radiopacity. The results demonstrate that hinokitiol and CS can improve the antibacterial properties of CPCs, and they can thus be considered for endodontic applications. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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853 KiB  
Article
Sealing Ability of Alkaline Endodontic Cements versus Resin Cements
by Yu-Yao Teoh, Basil Athanassiadis and Laurence J. Walsh
Materials 2017, 10(11), 1228; https://doi.org/10.3390/ma10111228 - 25 Oct 2017
Cited by 7 | Viewed by 3503
Abstract
Penetration of oral bacteria through root fillings leads to their long term failure. Dimensionally stable alkaline cements have been developed. A saliva challenge model was used to compare resistance to bacterial penetration of these alkaline cements to conventional root fillings that combine gutta [...] Read more.
Penetration of oral bacteria through root fillings leads to their long term failure. Dimensionally stable alkaline cements have been developed. A saliva challenge model was used to compare resistance to bacterial penetration of these alkaline cements to conventional root fillings that combine gutta percha (GP) with epoxy resin sealers. A sample of 140 human roots with single straight canals prepared to standard length and canal size were obturated with mineral trioxide aggregate (MTA) (Nex MTA or MTAmix), with an alkaline calcium hydroxide hard setting cement (Supercal), or with GP and a resin cement (either AH-Plus or Zirmix). Negative control roots were sealed with wax, while positive controls were left open. The test assemblies were gamma sterilised, then the coronal root face was exposed daily to fresh stimulated human saliva diluted in broth. Bacterial penetration was determined by assessing growth in sterile brain-heart infusion (BHI) medium in contact with the root apex. Using Kaplan–Meier survival analysis, in order of performance from highest to lowest: Negative control, Supercal, Nex MTA, Zirmix, MTAmix, GP + AH-Plus, and the positive control. In addition, statistically significant differences were noted between Supercal and AH-Plus, and between the two MTA cements. It can be concluded that alkaline cements, particularly Supercal, can show considerable resistance to bacterial penetration from constant saliva challenge, and provide superior sealing ability in comparison to resin cements. While this property is due mostly to dimensional stability, the release of hydroxide ions could be a contributing factor to impaired bacterial survival, and this aspect should be explored further. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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1670 KiB  
Article
Comparison of the Percentage of Voids in the Canal Filling of a Calcium Silicate-Based Sealer and Gutta Percha Cones Using Two Obturation Techniques
by Sohee Kim, Sunil Kim, Jeong-Won Park, Il-Young Jung and Su-Jung Shin
Materials 2017, 10(10), 1170; https://doi.org/10.3390/ma10101170 - 12 Oct 2017
Cited by 33 | Viewed by 5424
Abstract
This study evaluated the root-filling quality of a calcium silicate-based sealer and gutta percha (GP) cones by measuring the percentage of voids. Twenty artificial molar teeth were divided into two groups: one obturated using the single-cone (SC) technique, and the other using the [...] Read more.
This study evaluated the root-filling quality of a calcium silicate-based sealer and gutta percha (GP) cones by measuring the percentage of voids. Twenty artificial molar teeth were divided into two groups: one obturated using the single-cone (SC) technique, and the other using the continuous wave (CW) technique. Obturation was performed with GP cones and Endoseal MTA (mineral trioxide aggregate, Maruchi, Wonju, Korea). Obturated teeth were scanned using microcomputed tomography, and the percentage of void volume was calculated in the apical and coronal areas. A linear mixed model was used to determine the differences between the two techniques (p < 0.05). The percentage of voids between the filling materials and root canal walls was not significantly different between the two obturation methods (p > 0.05), except for the CW group, which demonstrated a significantly higher void volume in the coronal area of the distal canal (p < 0.05). The percentage of voids inside the filling material was significantly higher in the CW groups for all of the comparisons (p < 0.05), except in the apical area of the distal canal (p > 0.05). The voids between the filling material and canal wall in the apical area were not significantly different between the two techniques. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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23925 KiB  
Article
The Efficacy of Electron Beam Irradiated Bacterial Cellulose Membranes as Compared with Collagen Membranes on Guided Bone Regeneration in Peri-Implant Bone Defects
by So-Hyoun Lee, Sung-Jun An, Youn-Mook Lim and Jung-Bo Huh
Materials 2017, 10(9), 1018; https://doi.org/10.3390/ma10091018 - 01 Sep 2017
Cited by 23 | Viewed by 7377
Abstract
Bacterial cellulose (BC) is a natural polysaccharide produced by some bacteria, and consists of a linear polymer linked by β-(1,4) glycosidic bonds. BC has been developed as a material for tissue regeneration purposes. This study was conducted to evaluate the efficacy of resorbable [...] Read more.
Bacterial cellulose (BC) is a natural polysaccharide produced by some bacteria, and consists of a linear polymer linked by β-(1,4) glycosidic bonds. BC has been developed as a material for tissue regeneration purposes. This study was conducted to evaluate the efficacy of resorbable electron beam irradiated BC membranes (EI-BCMs) for guided bone regeneration (GBR). The electron beam irradiation (EI) was introduced to control the biodegradability of BC for dental applications. EI-BCMs had higher porosity than collagen membranes (CMs), and had similar wet tensile strengths to CMs. NIH3T3 cell adhesion and proliferation on EI-BCMs were not significantly different from those on CMs (p > 0.05). Micro-computed tomography (μCT) and histometric analysis in peri-implant dehiscence defects of beagle dogs showed that EI-BCMs were non-significantly different from CMs in terms of new bone area (NBA; %), remaining bone substitute volume (RBA; %) and bone-to-implant contact (BIC; %) (p > 0.05). These results suggest resorbable EI-BCMs can be used as an alternative biomaterial for bone tissue regeneration. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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Review

Jump to: Research, Other

1063 KiB  
Review
Alkaline Material Effects on Roots of Teeth
by Sowmya Shetty, Sam L. Kahler and Bill Kahler
Materials 2017, 10(12), 1412; https://doi.org/10.3390/ma10121412 - 10 Dec 2017
Cited by 7 | Viewed by 4541
Abstract
The aim of this review was to identify and analyse all studies related to the effects of alkaline materials used in dentistry on roots of teeth. The first part of the review focused on mechanical property alterations of root dentine due to sodium [...] Read more.
The aim of this review was to identify and analyse all studies related to the effects of alkaline materials used in dentistry on roots of teeth. The first part of the review focused on mechanical property alterations of root dentine due to sodium hypochlorite (SH) used as an irrigant solution based on MeSH (Medical Subject Heading) terms from a previous study by Pascon et al in 2009. The second part reviewed literature on calcium hydroxide (CH), mineral trioxide aggregate (MTA) and other alkaline materials used as root canal dressings or filling materials. Additional MeSH terms used included “compressive strength”, “elastic modulus” “flexural strength”, “fracture strength” and “fracture resistance”. The language filter was English. Of the initial 205 articles identified, 49 were included in this review, of which 29 were on SH, 21 on CH/MTA, and 1 relating to both. Many in vitro studies indicated a strong link between reduced mechanical properties of roots of teeth or radicular dentine treated with SH, and when sealers or root fillings with CH- or MTA-based materials were placed in contact with roots or radicular dentine. Recent literature indicates that the association between reduced mechanical properties and alkaline sealers and/or root-filling materials is not as straightforward as previously assumed, and requires further investigation using more valid experimental models. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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519 KiB  
Review
Alkaline Materials and Regenerative Endodontics: A Review
by Bill Kahler, Nadia Chugal and Louis M. Lin
Materials 2017, 10(12), 1389; https://doi.org/10.3390/ma10121389 - 05 Dec 2017
Cited by 21 | Viewed by 7562
Abstract
Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the [...] Read more.
Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs) have been described as a “paradigm shift” in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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274 KiB  
Review
Mineral Trioxide Aggregate—A Review of Properties and Testing Methodologies
by William N. Ha, Timothy Nicholson, Bill Kahler and Laurence J. Walsh
Materials 2017, 10(11), 1261; https://doi.org/10.3390/ma10111261 - 02 Nov 2017
Cited by 39 | Viewed by 6466
Abstract
Mineral trioxide aggregate (MTA) restoratives and MTA sealers are commonly used in endodontics. Commonly referenced standards for testing of MTA are ISO 6876, 9917-1 and 10993. A PubMed search was performed relating to the relevant tests within each ISO and “mineral trioxide aggregate”. [...] Read more.
Mineral trioxide aggregate (MTA) restoratives and MTA sealers are commonly used in endodontics. Commonly referenced standards for testing of MTA are ISO 6876, 9917-1 and 10993. A PubMed search was performed relating to the relevant tests within each ISO and “mineral trioxide aggregate”. MTA restoratives are typically tested with a mixture of tests from multiple standards. As the setting of MTA is dependent upon hydration, the results of various MTA restoratives and sealers are dependent upon the curing methodology. This includes physical properties after mixing, physical properties after setting and biocompatibility. The tests of flow, film thickness, working time and setting time can be superseded by rheology as it details how MTA hydrates. Physical property tests should replicate physiological conditions, i.e. 37 °C and submerged in physiological solution. Biocompatibility tests should involve immediate placement of samples immediately after mixing rather than being cured prior to placement as this does not replicate clinical usage. Biocompatibility tests should seek to replicate physiological conditions with MTA tested immediately after mixing. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
421 KiB  
Review
Aspects of Solvent Chemistry for Calcium Hydroxide Medicaments
by Basil Athanassiadis and Laurence J. Walsh
Materials 2017, 10(10), 1219; https://doi.org/10.3390/ma10101219 - 23 Oct 2017
Cited by 30 | Viewed by 5198
Abstract
Calcium hydroxide pastes have been used in endodontics since 1947. Most current calcium hydroxide endodontic pastes use water as the vehicle, which limits the dissolution of calcium hydroxide that can be achieved and, thereby, the maximum pH that can be achieved within the [...] Read more.
Calcium hydroxide pastes have been used in endodontics since 1947. Most current calcium hydroxide endodontic pastes use water as the vehicle, which limits the dissolution of calcium hydroxide that can be achieved and, thereby, the maximum pH that can be achieved within the root canal system. Using polyethylene glycol as a solvent, rather than water, can achieve an increase in hydroxyl ions release compared to water or saline. By adopting non-aqueous solvents such as the polyethylene glycols (PEG), greater dissolution and faster hydroxyl ion release can be achieved, leading to enhanced antimicrobial actions, and other improvements in performance and biocompatibility. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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241 KiB  
Review
Activation of Alkaline Irrigation Fluids in Endodontics
by Laurence J. Walsh and Roy George
Materials 2017, 10(10), 1214; https://doi.org/10.3390/ma10101214 - 23 Oct 2017
Cited by 24 | Viewed by 5847
Abstract
In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use [...] Read more.
In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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221 KiB  
Review
Alkaline Sodium Hypochlorite Irrigant and Its Chemical Interactions
by Patricia P. Wright, Bill Kahler and Laurence J. Walsh
Materials 2017, 10(10), 1147; https://doi.org/10.3390/ma10101147 - 29 Sep 2017
Cited by 35 | Viewed by 7758
Abstract
Endodontic irrigating solutions may interact chemically with one another. This is important, because even when solutions are not admixed, they will come into contact with one another during an alternating irrigation technique, forming unwanted by-products, which may be toxic or irritant. Mixing or [...] Read more.
Endodontic irrigating solutions may interact chemically with one another. This is important, because even when solutions are not admixed, they will come into contact with one another during an alternating irrigation technique, forming unwanted by-products, which may be toxic or irritant. Mixing or alternating irrigants can also reduce their ability to clean and disinfect the root canal system of teeth by changing their chemical structure with subsequent loss of the active agent, or by inducing precipitate formation in the root canal system. Precipitates occlude dental tubules, resulting in less penetration of antimicrobials and a loss of disinfection efficacy. Sodium hypochlorite is not only a very reactive oxidizing agent, but is also the most commonly used endodontic irrigant. As such, many interactions occurring between it and other irrigants, chelators and other antimicrobials, may occur. Of particular interest is the interaction between sodium hypochlorite and the chelators EDTA, citric acid and etidronate and between sodium hypochlorite and the antimicrobials chlorhexidine, alexidine, MTAD and octenisept. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)

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2239 KiB  
Case Report
Intratubular Biomineralization in a Root Canal Filled with Calcium-Enriched Material over 8 Years
by Yeon-Jee Yoo, Yoo Sang Lee, Jun Sang Yoo, Hiran Perinpanayagam, Chang Seon Yoo, Hyen Sug Kang, Soram Oh, Seok Woo Chang and Kee-Yeon Kum
Materials 2017, 10(12), 1388; https://doi.org/10.3390/ma10121388 - 05 Dec 2017
Cited by 2 | Viewed by 3755
Abstract
This case report describes intratubular biomineralization in root canal, filled with calcium-enriched material after 8 years of clinical maintenance. The schematic findings of dentinal tubules were investigated with scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The root canal obturation material was [...] Read more.
This case report describes intratubular biomineralization in root canal, filled with calcium-enriched material after 8 years of clinical maintenance. The schematic findings of dentinal tubules were investigated with scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The root canal obturation material was closely adapted to root dentin surface, suggesting the possibility of chemical bonding between the two interfaces. SEM and EDS observation of dentinal tubules showed intratubular biomineralized crystal structures with Ca/P ratio in a range of 1.30–2.12, suggesting bioactive capacity of calcium-enriched material. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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1276 KiB  
Case Report
Treatment of Severely Resorbed Maxilla Due to Peri-Implantitis by Guided Bone Regeneration Using a Customized Allogenic Bone Block: A Case Report
by Oliver Blume, Lisa Hoffmann, Phil Donkiewicz, Sabine Wenisch, Michael Back, Jörg Franke, Reinhard Schnettler and Mike Barbeck
Materials 2017, 10(10), 1213; https://doi.org/10.3390/ma10101213 - 21 Oct 2017
Cited by 27 | Viewed by 8312
Abstract
The objective of this case report is to introduce a customized CAD/CAM freeze-dried bone allograft (FDBA) block for its use in Guided Bone Regeneration (GBR) procedures for severely deficient maxillary bones. Additionally, a special newly developed remote incision technique is presented to avoid [...] Read more.
The objective of this case report is to introduce a customized CAD/CAM freeze-dried bone allograft (FDBA) block for its use in Guided Bone Regeneration (GBR) procedures for severely deficient maxillary bones. Additionally, a special newly developed remote incision technique is presented to avoid wound dehiscence. The results show optimal integration behavior of the FDBA block after six months and the formation of new vital bone. Thus, the results of the present case report confirm the use of the customized CAD/CAM bone block for augmentation of complex defects in the maxillary aesthetic zone as a successful treatment concept. Full article
(This article belongs to the Special Issue Dental Biomaterials 2017)
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