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Abstract Calcium silicate-based root canal sealers have been developed in powder/liquid or premixed ready-to-use forms. The evaluation of the physico-chemical properties of a prototype powder/liquid MTApex Sealer (Ultradent) in comparison to a ready-to-use material EndoSequence BC Sealer (Brasseler) was performed. The paste/paste epoxy resin-based AH Plus (Dentsply) served as control for comparisons. The sealers were evaluated (n = 6) regarding setting time (in dry and moist environments), flow and radiopacity, following the ISO-6876/2012 standard. Also, the pH was assessed. Material's surface and chemical characterization was evaluated using scanning-electron-microscopy (SEM) and energy-dispersive-spectrometry (EDS). Mixed ANOVA, Shapiro-Wilk, Levene, and post-hoc analysis with Bonferroni correction were performed at a significance level of 5%. MTApex Sealer exhibited the highest flow and EndoSequence BC Sealer had a significantly longer setting time in dry compared to the moist environment; however, for MTApex Sealer and AH Plus no significant changes occurred when additional moisture was provided. All materials exceeded 7 mm Al of radiopacity and showed a decreasing alkalinity over the 21 day-analysis. SEM/EDS evaluation resulted in peaks of calcium, silicon, and the respective radiopacifier. The prototype powder/liquid MTApex Sealer had the highest flow and similar setting time in both dry and moist environments; opposingly, EndoSequence BC Sealer was crucially influenced by external moisture. This suggests that the powder/liquid materials' setting seems to be more predictable.

Resumo Os cimentos endodônticos obturadores à base de silicato de cálcio foram desenvolvidos em formas pó/líquido ou pré-misturadas prontas para o uso. Foi realizada a avaliação das propriedades físico-químicas de um protótipo pó/líquido MTApex Sealer (Ultradent) em comparação com um material pronto para uso EndoSequence BC Sealer (Brasseler). O cimento obturador pasta/pasta à base de resina epóxi AH Plus (Dentsply) serviu de controle para as comparações. Os cimentos foram avaliados (n = 6) quanto a: tempo de presa (em ambientes secos e úmidos), escoamento e radiopacidade, seguindo a norma ISO-6876/2012; como também o pH. A superfície do material e a caracterização química foram realizadas utilizando a microscopia eletrônica de varredura (MEV) e espectrometria dispersiva de energia (EDS). ANOVA, Shapiro-Wilk, Levene e análise post-hoc com correção de Bonferroni foram realizadas com nível de significância de 5%. O MTApex Sealer exibiu um escoamento mais alto e o EndoSequence BC Sealer teve um tempo de presa significativamente mais longo em ambiente seco em comparação com o ambiente úmido; entretanto, para MTApex Sealer e AH Plus, nenhuma mudança significativa ocorreu quando umidade adicional foi fornecida. Todos os materiais excederam 7 mm de Al de radiopacidade e mostraram uma alcalinidade decrescente ao longo dos 21 dias de análise. A avaliação MEV/EDS resultou em picos de cálcio, silício e respectivo radiopacificador. O protótipo de pó/líquido MTApex Sealer teve o maior escoamento e tempo de presa semelhante em ambientes secos e úmidos; ao contrário, o EndoSequence BC Sealer foi influenciado de maneira crucial pela umidade externa. Isso sugere que a configuração dos materiais em pó/líquido parece ser mais previsível.

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OBJECTIVES: This study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison. MATERIALS AND METHODS: A total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics. RESULTS: The comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05). CONCLUSIONS: The bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.

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OBJECTIVE: This study aims to perform a systematic review and meta-analysis of clinical trials in order to evaluate the clinical and radiographic success rates of primary teeth pulpotomy performed with biodentine, when compared to MTA. METHODS: Search strategies were conducted in nine databases on August 5th, 2017, update on February 14th, 2018. Clinical articles were selected, which were in accordance with the inclusion and exclusion criteria and the research objective. They were analyzed by meta-analysis at three time points (6, 12, and 18 months). RESULTS: Out of the 233 publications initially identified, only 9 studies that fulfilled the inclusion criteria were included in the review. The 6-month overall clinical (RR = 0.99; 95% CI = 0.96-1.02, p = 0.92) and radiographic success rates (RR = 0.96; 95% CI = 0.92-1.00, p = 0.28) showed that biodentine vs. MTA did not differ statistically. The 12 and 18-month overall clinical success rates, respectively (RR = 1.01; 95% CI = 0.97-1.04, p = 0.77; RR = 0.98; 95% CI = 0.92-1.05, p = 0.74) and radiographic success rates, respectively (RR = 0.97; 95% CI = 0.92-1.02, p = 0.11; RR = 1.00; 95% CI = 0.91-1.10, p = 0.56) also showed that biodentine vs. MTA did not differ statistically. CONCLUSION: There is no superiority of one material over the other, MTA versus biodentine. CLINICAL RELEVANCE: This systematic review comparing the performance of biodentine in relation to the MTA when used in the pulpotomy technique in primary teeth. Although MTA is considered the gold standard material for pulpotomy procedures, it has some drawbacks (poor handling, staining potential, long setting time); thus, it is important to evaluate the clinical performance of other calcium silicate-based cements like biodentine that overcome this drawbacks.

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INTRODUCTION: The aim of this study was to evaluate the cell viability and tissue reaction of NeoMTA Plus (NMP; Avalon Biomed Inc, Houston, TX) compared with mineral trioxide aggregate (MTA; Angelus, Londrina, PR, Brazil) and Biodentine (BD; Septodont, Saint-Maur-de-Fossés, France). METHODS: Fibroblasts (3T3) were plated and exposed to 1% extract from the test material before and after setting. Cytotoxicity assessment was performed using the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide and sulforhodamine B assays. In vivo evaluation consisted of polyethylene tube implantation of the materials in rat subcutaneous tissue. Histologic analysis occurred at 7, 30, and 90 days, scoring inflammatory events and collagen fiber formation. Analysis of variance and the Tukey and t tests were used for cytocompatibility assays, and the Kruskal-Wallis test followed by the Dunn test were used for biocompatibility assays (P ≤ .05). RESULTS: The materials in the cytotoxicity assays presented greater viability after setting (P ≤ .05). NMP and MTA presented higher viability than the control (Dulbecco modified Eagle medium) on the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide assay before and after setting (P ≤ .05). The sulforhodamine B assay showed that MTA and BD presented less viability than NMP and the control, and NMP was similar to the control before setting. After setting, MTA and BD presented higher viability when compared with the control group (P ≤ .05), and NMP was similar to control. Inflammatory infiltrate reduction occurred throughout the test periods for all materials. At 7 days, neutrophils were present in BD (P ≤ .05), and granuloma and giant cells were present in BD and MTA. At 30 days, BD showed intense inflammatory infiltrates and a large number of macrophages when compared with NMP, MTA, and the control (P ≤ .05). At 90 days, BD presented a thick fiber layer compared with NMP (P ≤ .05). CONCLUSIONS: NMP showed similar biocompatible behavior to MTA and BD.

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