Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review

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Abstract

Introduction:

iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent.

Materials and Methods:

A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected.

Results:

A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate.

Conclusion:

iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation.

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Most cited references 37

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Stem cell properties of human dental pulp stem cells.

J Brahim, Paul L. Fisher, S Gronthos … (2002)

In this study, we characterized the self-renewal capability, multi-lineage differentiation capacity, and clonogenic efficiency of human dental pulp stem cells (DPSCs). DPSCs were capable of forming ectopic dentin and associated pulp tissue in vivo. Stromal-like cells were reestablished in culture from primary DPSC transplants and re-transplanted into immunocompromised mice to generate a dentin-pulp-like tissue, demonstrating their self-renewal capability. DPSCs were also found to be capable of differentiating into adipocytes and neural-like cells. The odontogenic potential of 12 individual single-colony-derived DPSC strains was determined. Two-thirds of the single-colony-derived DPSC strains generated abundant ectopic dentin in vivo, while only a limited amount of dentin was detected in the remaining one-third. These results indicate that single-colony-derived DPSC strains differ from each other with respect to their rate of odontogenesis. Taken together, these results demonstrate that DPSCs possess stem-cell-like qualities, including self-renewal capability and multi-lineage differentiation.

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Biocompatibility of two novel root repair materials.

Markus Haapasalo, Ya Shen, J.-J. Ma … (2011)

The purpose of the present study was to evaluate the biocompatibility of 2 root-end filling materials, Endosequence Root Repair Material Putty (ERRM Putty) and Paste (ERRM Paste) and compare them with gray mineral trioxide aggregate (MTA). ERRM Putty, ERRM Paste, MTA, intermediate restorative material (IRM), and Cavit G were tested. For cytotoxicity assay, human gingival fibroblasts were incubated for 1, 3, and 7 days with extracts of varying concentrations from materials set for 2 days or 7 days. Cell viability was evaluated by methyl-thiazol-tetrazolium (MTT) assay. For cell adhesion assay, materials set for 7 days were examined under scanning electron microscope directly after setting, after incubation in cell culture medium for 7 days, and after incubation in gingival fibroblast suspension at a density of 5 × 10(4) cells/well for 2 and 7 days. The constituents of crystals formed on surface of materials were determined by energy dispersive analysis by x-ray. Cell viability was significantly correlated with the type of material, setting time, and incubation time (P < .001 for all parameters). ERRM Putty and ERRM Paste displayed similar cell viabilities to MTA at all experimental conditions, except that fresh samples of ERRM Paste showed slightly lower cell viabilities than MTA. Cell viabilities with IRM and Cavit G were significantly lower than with the other 3 materials (P < .001). Similar surface crystallographic features and cell adhesion were observed on ERRM Paste, ERRM Putty, and MTA. ERRM Putty and ERRM Paste displayed similar in vitro biocompatibility to MTA. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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Inflammatory and immunological aspects of dental pulp repair.

Pamela DenBesten, Arthur Veis, N Six … (2008)

The repair of dental pulp by direct capping with calcium hydroxide or by implantation of bioactive extracellular matrix (ECM) molecules implies a cascade of four steps: a moderate inflammation, the commitment of adult reserve stem cells, their proliferation and terminal differentiation. The link between the initial inflammation and cell commitment is not yet well established but appears as a potential key factor in the reparative process. Either the release of cytokines due to inflammatory events activates resident stem (progenitor) cells, or inflammatory cells or pulp fibroblasts undergo a phenotypic conversion into osteoblast/odontoblast-like progenitors implicated in reparative dentin formation. Activation of antigen-presenting dendritic cells by mild inflammatory processes may also promote osteoblast/odontoblast-like differentiation and expression of ECM molecules implicated in mineralization. Recognition of bacteria by specific odontoblast and fibroblast membrane receptors triggers an inflammatory and immune response within the pulp tissue that would also modulate the repair process.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Soc Prev Community Dent

Journal ID (iso-abbrev): J Int Soc Prev Community Dent

Journal ID (publisher-id): JISPCD

Title: Journal of International Society of Preventive & Community Dentistry

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2231-0762

ISSN (Electronic): 2250-1002

Publication date Collection: Nov-Dec 2019

Publication date (Electronic): 13 November 2019

Volume: 9

Issue: 6

Pages: 542-552

Affiliations

[1 ]Department of General Dentistry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

[2 ]Orthodontic Department Hospital of Stomatology Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China

[3 ]Department of Orthodontics, College of Dentistry, Thamar University, Thamar, Yemen, China

[4 ]Department of Preventive Dental Sciences, Najran University, Najran, Kingdom of Saudi Arabia

[5 ]Private Practice, Yemen Medical Tower, Sana’a, Yemen, China

Author notes

Address for correspondence: Prof. Tao Hong, Department of General Dentistry, The First Affiliated Hospital of Xi’an Jiaotong University, 227 Yantaxi Road, Yanta District, Xi’an, Shaanxi, 710061 P.R. China. E-mail: Taohong9595@ 123456126.com

Article

Publisher ID: JISPCD-9-542

DOI: 10.4103/jispcd.JISPCD_249_19

PMC ID: 6905310

PubMed ID: 32039073

SO-VID: 500f3710-a1fd-4baa-b230-3d2329fb8b1f

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review

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Abstract

Introduction:

Materials and Methods:

Results:

Conclusion:

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Most cited references 37

Stem cell properties of human dental pulp stem cells.

Biocompatibility of two novel root repair materials.

Inflammatory and immunological aspects of dental pulp repair.

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