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      The use of bioceramics in endodontics - literature review

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          Abstract

          Background and aim

          Bioceramics are ceramic compounds obtained both in situ and in vivo, by various chemical processes. Bioceramics exhibit excellent biocompatibility due to their similarity with biological materials, like hydroxyapatite. Bioceramics and multi-substituted hydroxyapatite or similar compounds have the ability to induce a regenerative response in the organism.

          The aim of this paper is to make a literature review on the main bioceramic materials currently used in endodontics and on their specific characteristics.

          Methods

          We conducted a search in the international databases (PubMed), to identify publications in the last 10 years, using the following key words: “bioceramics endodontics”, “bioceramic endodontic cement”, “bioceramic sealer” and “direct pulp capping bioceramic”.

          Results

          Commonly used endodontic sealers (e.g., containing zinc oxide, calcium hydroxide and a resin) have a long tradition in scientific research and clinical use in endodontics. For specific cases, like root resorptions, perforations, apexification, and retrograde fillings, new biocompatible materials were developed in order to improve the clinical outcome: ProRooT MTA (Dentsply Company, Germany); Biodentine (Septodont, France); Endosequence BC sealer (Brassler, SUA); Bioaggregate (IBC, Canada); Generex A (Dentsply Tulsa Dental Specialties, USA).

          Conclusion

          The studies are generally in favor of bioceramic materials even if there are not many products available on the market for endodontic use. As more products are launched and more research is performed regarding these materials, we will provide more reliable data on clinical outcome.

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          Most cited references28

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          Mineral trioxide aggregate: a review of the constituents and biological properties of the material.

          This paper reviews the literature on the constituents and biocompatibility of mineral trioxide aggregate (MTA). A Medline search was conducted. The first publication on the material was in November 1993. The Medline search identified 206 papers published from November 1993 to August 2005. Specific searches on constituents and biocompatibility of mineral trioxide aggregate, however, yielded few publications. Initially all abstracts were read to identify which fitted one of the two categories required for this review, constituents or biocompatibility. Based on this assessment and a review of the papers, 13 were included in the constituent category and 53 in the biocompatibility category. Relatively few articles addressed the constituents of MTA, whilst cytological evaluation was the most widely used biocompatibility test.
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            Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, Sealapex and Dycal.

            The objective of this study was to investigate the antimicrobial action of mineral trioxide aggregate (MTA), Portland cement, calcium hydroxide paste (CHP), Sealapex and Dycal. The chemical elements of MTA and two Portland cements were also analyzed. Four standard bacterial strains: Staphylococcus aureus (ATCC 6538), Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853), Bacillus subtilis (ATCC 6633), one wild fungus, Candida albicans (ICB/USP-562), and one mixture of these were used. Thirty Petri plates with 20 ml of BHI agar were inoculated with 0.1 ml of the experimental suspensions. Three cavities, each one measuring 4 mm in depth and 4 mm in diameter, were made in each agar plate using a copper coil and then completely filled with the product to be tested. The plates were pre-incubated for 1 h at environmental temperature followed by incubation at 37 degrees C for 48 h. The diameters of the zones of microbial inhibition were then measured. Samples from diffusion and inhibition halos were extracted from each plate and immersed in 7 ml BHI broth and incubated at 37 degrees C for 48 h. Analyses of chemical elements present in MTA and in two samples of Portland cement were performed with a fluorescence spectrometer Rx. The results showed that the antimicrobial activity of CHP was superior to those of MTA, Portland cement, Sealapex and Dycal, for all microorganisms tested, presenting inhibition zones of 6-9.5 mm and diffusion zones of 10-18 mm. MTA, Portland cement, and Sealapex presented only diffusion zones and among these, Sealapex produced the largest zone. Dycal did not show inhibition or diffusion zones. Portland cements contain the same chemical elements as MTA except that MTA also contains bismuth.
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              Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study.

              One hundred twenty-three pulp cappings had been performed by students in 1984 to 1987 (= 10-yr group) or in 1990 to 1992 (= 5-yr group) and were followed up in 1997. Teeth were checked for sensitivity (CO2/electrical pulp testing), percussion, and palpation; radiographs were taken to assess periapical status. In addition several other factors were determined that might have an influence on the success or failure rates, such as base material, type of restoration, site of exposure, etc. Results showed 44.5% failures (18.5% questionable and 37% successful cases) in the 5-yr group and 79.7% failing, 7.3% questionable, and 13% successful cases in the 10-yr group. As a factor of influence, the placement of a definitive restoration within the first 2 days after pulp exposure was found to contribute significantly to the survival rate of these teeth.
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                Author and article information

                Journal
                Clujul Med
                Clujul Med
                CM
                Clujul Medical
                Iuliu Hatieganu University of Medicine and Pharmacy
                1222-2119
                2066-8872
                2016
                20 October 2016
                : 89
                : 4
                : 470-473
                Affiliations
                [1 ]Department of Chemistry, Babes-Bolyai University, Cluj-Napoca, Romania
                [2 ]Department of Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
                Author notes
                Address for correspondence: mariusbud@ 123456mbdental.ro
                Article
                cm-89-470
                10.15386/cjmed-612
                5111485
                27857514
                d4d47b5f-2244-416b-8dde-eec98234826c
                Copyright @ 2016

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

                History
                : 17 November 2015
                : 21 December 2015
                : 15 January 2016
                Categories
                Review
                Dental Medicine

                bioceramics,biodentine,endodontics
                bioceramics, biodentine, endodontics

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