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      Effect of Fluorohydroxyapatite on Biological and Physical Properties of MTA Angelus

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          Abstract

          Objectives

          This study aimed to assess the effect of addition of fluorohydroxyapatite (FHI) on biological and physical properties of mineral trioxide aggregate (MTA) Angelus.

          Materials and Methods

          In this in vitro, experimental study, nano-FHI powder was first synthesized, and the morphology and chemical structure of particles were evaluated by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). Three groups were evaluated in this study: MTA Angelus, MTA modified with 10% FHA, and MTA modified with 15% FHA. After mixing, the materials were applied to ring molds (10 mm diameter, 1 mm height), and the setting time of the three groups was evaluated according to ISO6876 and ASTMC266-03 with a Gillmore needle. The pH was measured using a pH meter at 24 and 48 hours and 7 days after mixing. The cytotoxicity of the materials was assessed in freshly mixed form and after 1 and 7 days using the methyl thiazolyl tetrazolium (MTT) assay according to ISO10993-5. Data were analyzed by one-way and repeated measures ANOVA and Tukey's test (alpha = 0.05).

          Results

          The addition of FHA to MTA significantly decreased the initial setting time ( P < 0.05) and had no significant effect on cell viability (compared with pure MTA Angelus) at 1 and 7 days. However, modified MTA groups in freshly mixed form showed significantly lower cell viability ( P < 0.05). The pH remained alkaline at all time points.

          Conclusion

          Addition of 15% FHA to MTA Angelus decreased its setting time with no adverse effect on cell viability (except for fresh form) or pH.

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          Most cited references49

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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.
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            Hydration mechanisms of mineral trioxide aggregate.

            To report the hydration mechanism of white mineral trioxide aggregate (White MTA, Dentsply, Tulsa Dental Products, Tulsa, OK, USA). The chemical constitution of white MTA was studied by viewing the powder in polished sections under the scanning electron microscope (SEM). The hydration of both white MTA and white Portland cement (PC) was studied by characterizing cement hydrates viewed under the SEM, plotting atomic ratios, performing quantitative energy dispersive analyses with X-ray (EDAX) and by calculation of the amount of anhydrous clinker minerals using the Bogue calculation. Un-hydrated MTA was composed of impure tri-calcium and di-calcium silicate and bismuth oxide. The aluminate phase was scarce. On hydration the white PC produced a dense structure made up of calcium silicate hydrate, calcium hydroxide, monosulphate and ettringite as the main hydration products. The un-reacted cement grain was coated with a layer of hydrated cement. In contrast MTA produced a porous structure on hydration. Levels of ettringite and monosulphate were low. Bismuth oxide was present as un-reacted powder but also incorporated with the calcium silicate hydrate. White MTA was deficient in alumina suggesting that the material was not prepared in a rotary kiln. On hydration this affected the production of ettringite and monosulphate usually formed on hydration of PC. The bismuth affected the hydration mechanism of MTA; it formed part of the structure of C-S-H and also affected the precipitation of calcium hydroxide in the hydrated paste. The microstructure of hydrated MTA would likely be weaker when compared with that of PC.
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              Apexification: a review.

              This paper reviews the rationale and techniques for treatment of the non-vital immature tooth. The importance of careful case assessment and accurate pulpal diagnosis in the treatment of immature teeth with pulpal injury cannot be overemphasized. The treatment of choice for necrotic teeth is apexification, which is induction of apical closure to produce more favorable conditions for conventional root canal filling. The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has been expressed in the use of mineral trioxide aggregate. Introduction of techniques for one-visit apexification provide an alternative treatment option in these cases. Success rates for calcium hydroxide apexification are high although risks such as reinfection and tooth fracture exist. Prospective clinical trials comparing this and one-visit apexification techniques are required.
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                Author and article information

                Contributors
                Journal
                ScientificWorldJournal
                ScientificWorldJournal
                tswj
                The Scientific World Journal
                Hindawi
                2356-6140
                1537-744X
                2023
                6 November 2023
                : 2023
                : 7532898
                Affiliations
                1Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences (TUMS), Tehran, Iran
                2Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                3Department of Dental Biomaterials, School of Dentistry, Tehran University of Medical Sciences (TUMS), Tehran, Iran
                4Department of Endodontics, Tehran University of Medical Sciences (TUMS), International Campus, Tehran, Iran
                Author notes

                Academic Editor: Nirmal Kumar Sarkar

                Author information
                https://orcid.org/0000-0001-8922-9802
                https://orcid.org/0000-0001-7711-0310
                https://orcid.org/0009-0008-7194-9842
                https://orcid.org/0000-0002-4421-5009
                https://orcid.org/0000-0002-0105-5332
                https://orcid.org/0000-0003-3712-0279
                Article
                10.1155/2023/7532898
                10643032
                5be9713f-8266-4ce1-a108-f7c7feedb744
                Copyright © 2023 Behnam Bolhari et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 September 2022
                : 3 October 2023
                : 18 October 2023
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