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      Bio-Inductive Materials in Direct and Indirect Pulp Capping—A Review Article


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          The article is aimed at analyzing the available research and comparing the properties of bio-inductive materials in direct and indirect pulp capping procedures. The properties and clinical performances of four calcium-silicate cements (ProRoot MTA, MTA Angelus, RetroMTA, Biodentine), a light-cured calcium silicate-based material (TheraCal LC) and an enhanced resin-modified glass-ionomer (ACTIVA BioACTIVE) are widely discussed. A correlation of in vitro and in vivo data revealed that, currently, the most validated material for pulp capping procedures is still MTA. Despite Biodentine’s superiority in relatively easier manipulation, competitive pricing and predictable clinical outcome, more long-term clinical studies on Biodentine as a pulp capping agent are needed. According to available research, there is also insufficient evidence to support the use of TheraCal LC or ACTIVA BioACTIVE BASE/LINER in vital pulp therapy.

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          Most cited references127

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          Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action.

          Mineral trioxide aggregate (MTA) has been recommended for various uses in endodontics. Two previous publications provided a comprehensive list of articles from November 1993-September 2009 regarding the chemical and physical properties, sealing ability, antibacterial activity, leakage, and biocompatibility of MTA. The purpose of Part III of this literature review is to present a comprehensive list of articles regarding animal studies, clinical applications, drawbacks, and mechanism of action of MTA. A review of the literature was performed by using electronic and hand-searching methods for the clinical applications of MTA in experimental animals and humans as well as its drawbacks and mechanism of action from November 1993-September 2009. MTA is a promising material for root-end filling, perforation repair, vital pulp therapy, and apical barrier formation for teeth with necrotic pulps and open apexes. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies regarding clinical applications of this material. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. Hydroxyapatite crystals form over MTA when it comes in contact with tissue synthetic fluid. This can act as a nidus for the formation of calcified structures after the use of this material in endodontic treatments. On the basis of available information, it appears that MTA is the material of choice for some clinical applications. More clinical studies are needed to confirm its efficacy compared with other materials. Copyright (c) 2010. Published by Elsevier Inc.
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            Sealing ability of a mineral trioxide aggregate when used as a root end filling material.

            This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam, super EBA, and a mineral trioxide aggregate when used as root end filling materials. Thirty single-canal teeth were cleaned, shaped, and obturated with gutta-percha and root canal sealer. After application of nail polish to the external surface, the apical 3 mm of each root was resected and 3-mm deep root end preparations were made. The roots were randomly divided into three groups and the root end preparations filled with the experimental materials. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h, longitudinally sectioned, and the extent of dye penetration measured using a confocal microscope. Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA.
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              Physicochemical basis of the biologic properties of mineral trioxide aggregate.

              This study characterized the interactions of mineral trioxide aggregate with a synthetic tissue fluid composed of a neutral phosphate buffer saline solution and root canal dentin in extracted human teeth using inductively coupled plasma-atomic emission spectroscopy, scanning electron microscopy, energy dispersive X-ray analysis, and X-ray diffraction. Mineral trioxide aggregate exposed to synthetic tissue fluid at 37 degrees C released its metallic constituents and produced precipitates with a composition and structure similar to that of hydroxyapatite [Ca10(PO4)6(OH)2-HA]. Endodontically prepared teeth filled with mineral trioxide aggregate and stored in synthetic tissue fluid at 37 degrees C for 2 months produced at the dentin wall an adherent interfacial layer that resembled hydroxyapatite in composition. The authors conclude that Ca, the dominant ion released from mineral trioxide aggregate, reacts with phosphates in synthetic tissue fluid, yielding hydroxyapatite. The dentin-mineral trioxide aggregate interfacial layer results from a similar reaction. The sealing ability, biocompatibility, and dentinogenic activity of mineral trioxide aggregate is attributed to these physicochemical reactions.

                Author and article information

                Materials (Basel)
                Materials (Basel)
                07 March 2020
                March 2020
                : 13
                : 5
                : 1204
                Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; marta.kunert@ 123456stud.umed.lodz.pl
                Author notes
                [* ]Correspondence: monika.lukomska-szymanska@ 123456umed.lodz.pl ; Tel.: +48-42-675-7461
                Author information
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                : 05 February 2020
                : 04 March 2020

                direct pulp capping,indirect pulp capping,proroot mta,mta angelus,retromta,biodentine,theracal lc,activa bioactive,vital pulp therapy


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