• The Journal of the Korean dental association
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• v.57 no.1
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• pp.18-25
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• 2018

Objectives: This study aimed to compare the postoperative pain and clinical performance after partial pulpotomy by using ProRoot MTA and Endocem MTA. Materials and Methods: Twenty-eight teeth requiring partial pulpotomy due to deep dental caries or traumatic injury were included in this study. After 2mm removal of exposed pulp and bleeding control, the ProRoot MTA or Endocem MTA was randomly adjusted to the exposed site. 1, 2, 4, and 12 weeks after the final restoration, the patients were recalled to check the postoperative pain or another unfavorable signs. Pearson's chi-square test was used for statistical analysis to evaluate any differences among tested materials. Results: 3 of 28 teeth showed postoperative pain and cold positive during follow-up period (10.7%). There were no statistically differences in pain occurrence between two tested materials (P > 0.05). Conclusions: In the limitations of this study, partial pulpotomy by using Endocem MTA showed the advantages of short setting time and lower postoperative pain incidence, allowing one visit treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.291-301
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• 2015

This study compared the in vitro cell viability and differentiation potentials of human deciduous dental pulp cells (DPCs) on mineral trioxide aggregate (MTA)-like products (ProRoot MTA, RetroMTA and Endocem Zr). The experimental materials were prepared as circular discs, which were used to test the effects of the materials on the viability of human DPCs when placed in direct and indirect contact. Furthermore, the pH of the extracted materials was recorded, and their effect on cell differentiation potential was evaluated by evaluating the alkaline phosphatase (ALP) activity and Alizarin Red S staining of DPCs incubated with the test materials. In direct contact, the cell viability of human DPCs was higher with ProRoot MTA and RetroMTA than with Endocem Zr. However, when in indirect contact, the cell viability of human DPCs was generally higher in Endocem Zr than in ProRoot MTA and Retro MTA. With respect to pH, the alkalinity was lower for Endocem Zr than for the other test materials. The ALP activities of the cells were not enhanced by any of the experimental materials. Alizarin Red S staining of the tested human DPCs revealed that their differentiation potential was lower than for cells incubated with osteogenic induction medium. While there were differences in the responses of the human DPCs to the test materials, all displayed degrees of cytotoxicity and were unable to enhance either the viability or differentiation of human DPCs. However, Endocem Zr exhibited better cell viability and was less alkaline than the other test materials.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.39-44
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• 2014

Objectives: The purpose of this study was to evaluate in vitro cytotoxicity of the pozzolan cement and other root-end filling materials using human periodontal ligament cell. Materials and Methods: Endocem (Maruchi), white ProRoot MTA (Dentsply), white Angelus MTA (Angelus), and Super EBA (Bosworth Co.) were tested after set completely in an incubator at $37^{\circ}C$ for 7 days, Endocem was tested in two ways: 1) immediately after mixing (fresh specimens) and 2) after setting completely like other experimental materials. The methods for assessment included light microscopic examination, cell counting and WST-1 assay on human periodontal ligament cell. Results: In the results of microscopic examination and cell counting, Super EBA showed significantly lower viable cell than any other groups (p < 0.05). As the results of WST-1 assay, compared with untreated control group, there was no significant cell viability of the Endocem group. However, the fresh mixed Endocem group had significantly less cell viability. The cells exposed to ProRoot MTA and Angelus MTA showed the highest viability, whereas the cells exposed to Super EBA displayed the lowest viability (p < 0.05). Conclusions: The cytotoxicity of the pozzolan cement (Endocem) was comparable with ProRoot MTA and Angelus MTA. Considering the difficult manipulation and long setting time of ProRoot MTA and Angelus MTA, Endocem can be used as the alternative of retrofilling material.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.28-37
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• 2017

Mineral trioxide aggregate have been used for many years as a pulp therapy material. The most widely used product, Proroot white $MTA^{(R)}$ has a major drawback that it causes tooth discoloration. This study assessed discoloration of crown when various MTA-based materials were placed in the coronal aspect of the root canal. Seventy-five single-rooted, unrestored premolar teeth were selected. The teeth were randomly assigned to four experimental groups, each of $Biodentine^{(R)}$, Proroot $wMTA^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$ and one negative control groups. Color measurements were utilized by the Commission International de I'Eclairage's L*a*b* system with spectrophotometer. The color was assessed eight times : initial, 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the placement. Statistical analysis was performed using the 2-way repeated analysis of variance and Bonferroni's method with p < 0.05. Proroot $wMTA^{(R)}$ induced significant decreases in $L^*$ values during experiment period. Tooth samples from the $Endocem^{(R)}$ group presented indistinct grayish color changes. The $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ showed color stability. Consequently, while Proroot $wMTA^{(R)}$ and $Endocem^{(R)}$ that contain bismuth oxide as a radiopacifier showed tooth discoloration, displayed no sign of discoloration $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ that contain zirconium oxide as a radiopacifier.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.8.1-8.8
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• 2023

Objectives: This study was designed to evaluate the parameters of bonding performance to root dentin, including push-out bond strength and dentinal tubular biomineralization, of a hydraulic bioceramic root-end filling material premixed with dimethyl sulfoxide (Endocem MTA Premixed) in comparison to a conventional powder-liquid-type cement (ProRoot MTA). Materials and Methods: The root canal of a single-rooted premolar was filled with either ProRoot MTA or Endocem MTA Premixed (n = 15). A slice of dentin was obtained from each root. Using the sliced specimen, the push-out bond strength was measured, and the failure pattern was observed under a stereomicroscope. The apical segment was divided into halves; the split surface was observed under a scanning electron microscope, and intratubular biomineralization was examined by observing the precipitates formed in the dentinal tubule. Then, the chemical characteristics of the precipitates were evaluated with energy-dispersive X-ray spectroscopic (EDS) analysis. The data were analyzed using the Student's t-test followed by the Mann-Whitney U test (p < 0.05). Results: No significant difference was found between the 2 tested groups in push-out bond strength, and cohesive failure was the predominant failure type. In both groups, flake-shaped precipitates were observed along dentinal tubules. The EDS analysis indicated that the mass percentage of calcium and phosphorus in the precipitate was similar to that found in hydroxyapatite. Conclusions: Regarding bonding to root dentin, Endocem MTA Premixed may have potential for use as an acceptable root-end filling material.

• Journal of dental hygiene science
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• v.22 no.3
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• pp.191-198
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• 2022

Background: The purpose of this study was to evaluate the composition of the crystal phases of various calcium silicate-based materials (CSMs): ProRoot white MTA^Ⓡ (mineral trioxide aggregate) (WMTA), Ortho MTA^Ⓡ (OM), Endocem MTA^Ⓡ (EM), Retro MTA^Ⓡ (RM), Endocem Zr^Ⓡ (EN-Z), Biodentine^TM (BD), EZ-seal^TM (EZ), and OrthoMTA III (OM3). Methods: In a sample holder, 5 g of the powder sample was placed and the top surface of the material was packed flat using a sterilized glass slide. The prepared slides were mounted on an X-ray diffraction (XRD) instrument (D8 Advance; Bruker AXS GmbH, Germany). The X-ray beam 2θ angle range was set at 10~90° and scanned at 1.2° per minute. The Cu X-ray source set to operate at 40 kV and 40 mA in the continuous mode. The peaks in the diffraction pattern of each sample were analyzed using the software Diffrac (version 2.1). Then, the peaks were compared and matched with those of standard materials in the corresponding Powder Diffraction File (PDF-2, JCPDS International Center for Diffraction Data). A powder samples of the materials were analyzed using XRD and the peaks in diffraction pattern were compared to the Powder Diffraction File data. Results: Eight CSMs showed a similar diffraction pattern because their main component was calcium silicate. Eight CSMs showed similar diffraction peaks because calcium silicate was their main component. Two components were observed to have been added as radiopacifiers: bismuth oxide was detected in WMTA, OM, and EM while zirconium oxide was detected in RM, EN-Z, BD, EZ, and OM3. Unusual patterns were detected for the new material, OM3, which had strong peaks at low angles. Conclusion: It was caused by the presence of Brushite, which is believed to have resulted in crystal growth in a particular direction for a specific purpose.

• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.2
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• pp.165-175
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• 2024

This study aimed to investigate the effects of blood contamination on the Vickers hardness and the surface morphology of premixed MTA and compare them with the effects on conventional MTA. The Vickers microhardness of Endocem MTA Premixed Regular (EP) and ProRoot MTA (PM) was assessed after immersion in fetal bovine serum (FBS) and saline. Stem cells from human exfoliated deciduous teeth (SHED) were seeded on MTA after immersion in FBS, saline, and deionized water (DW). Cell adhesion patterns and surface morphology were visualized via scanning electron microscopy (SEM). The surface microhardness of EP and PM in FBS was lower than in saline. However, short-term exposure of PM to FBS did not reduce the microhardness compared to saline. Angular crystals formed in water, while rounded crystals with more air voids appeared in FBS. Favorable SHED attachment occurred in all groups. Overall, the surface hardness of EP and PM decreased after FBS exposure, although PM was less influenced. We suggest minimizing the amount of bleeding when using MTA clinically; nevertheless, PM remains an option with more expected blood contamination than EP. In summary, exposure to FBS decreased mechanical performance but allowed cell adhesion for both MTAs, with PM being more resistant to these changes.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.2
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• pp.217-228
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• 2023

This study aimed to compare the physical properties of 4 kinds of calcium silicate-based cements (CSCs): 2 kinds of powder-liquid mix type (RetroMTA^® [RTMX] and Endocem^® MTA Zr [EZMX]) and 2 kinds of premixed type (Well-Root^TMPT [WRPR] and Endocem^® MTA premixed [ECPR]) CSCs, respectively. Further, we assessed the setting times, solubility values, and compressive strengths of the cements. The shortest setting time was observed for EZMX (123.33 ± 5.77 seconds), followed by RTMX (146.67 ± 5.77 seconds), ECPR (260.00 ± 17.32 seconds), and WRPR (460.00 ± 17.32 seconds), respectively. The highest solubility was observed for WRPR (9.01 ± 0.55%), followed by RTMX (2.17 ± 0.07%), EZMX (0.55 ± 0.03%), and ECPR (0.17 ± 0.03%). Furthermore, the highest compressive strength was observed for ECPR (76.67 ± 25.67 Mpa), followed by WRPR (38.39 ± 7.25 Mpa), RTMX (35.07 ± 5.34 Mpa), and EZMX (4.07 ± 0.60 Mpa). In conclusion, the premixed type CSCs (WRPR and ECPR) exhibited longer setting times compared to the powder-liquid mix type CSCs (EZMX and RTMX). The solubility test showed that ECPR had the lowest solubility while WRPR had the highest solubility, with a statistically significant difference between them (p < 0.0083). Additionally, the compressive strength test showed that ECPR had the highest compressive strength, while EZMX had the lowest compressive strength, also with a statistically significant difference between them (p < 0.0083). ECPR is a promising material as it is premixed, eliminating the need for mixing time, and it has also demonstrated improved solubility and compressive strength, making it a potentially favorable option for clinical use.

• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.2
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• pp.176-184
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• 2024

This study aimed to compare color matching between single-shade composite resin-restored teeth with various pulp capping materials and the dentin surrounding the restoration through instrumental analysis and visual evaluation of the color difference. Fifty maxillary right central incisor acrylic resin teeth were prepared with standardized Class III cavities on the proximal surfaces. These teeth were divided into five groups: restored with single-shade composite resin only; Ultra-Blend^TM plus followed by single-shade composite resin; TheraCal PT^TM followed by single-shade composite resin; Endocem^® MTA premixed followed by single-shade composite resin; and Well-root PT^TM followed by single-shade composite resin. The color difference (ΔE_ab^*) between the restored area and the center of the resin teeth was measured using a spectrophotometer. No significant color difference was observed in groups restored with only single-shade composite resin, Ultra-Blend^TM plus, and TheraCal PT^TM. The visual evaluation revealed that Ultra-Blend^TM plus exhibited the best color matching score, whereas the Endocem^® MTA premixed and Well-root PT^TM groups showed significantly lower color matching scores than the single-shade composite resin-only group. When opting for single-shade composite resin usage for anterior tooth restorations with the aim of reducing chair time, pulp capping materials Ultra-Blend^TM plus and TheraCal PT^TM provide esthetically pleasing results.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.379-391
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• 2022

The current study aimed to compare the pH, solubility value, and ion release capability of premixed mineral trioxide aggregates (MTAs) versus conventional pulp capping materials before and after setting. The following materials were used: resin-modified calcium silicate cement (TheraCal LC^®, TLC), resin-modified calcium hydroxide cement (Ultra-Blend^TM plus, UBP), and 2 kinds of premixed MTA (Endocem MTA^® premixed regular [EMPR] and Well-Root^TM PT [WRP]). The specimens of each material were prepared before and after setting and were immersed in distilled water. The materials' pH and solubility value were assessed. Next, three kinds of ion (calcium, sulfide, and strontium) released by pulp capping materials were evaluated via inductively coupled plasma atomic emission spectrometry. In the after-setting group, the pH of TLC and UBP decreased. However, the pH of the premixed MTAs increased with time. TLC released a higher concentration of strontium ion compared with the other materials. Meanwhile, EMPR released a significantly high concentration of sulfide ion (p < 0.05). In the after-setting group, the 2 kinds of premixed MTAs released a significantly higher concentration of calcium ion compared with the other materials (p < 0.05). In the after-setting group, EMPR had a significantly low solubility value (p < 0.05). The Kruskal-Wallis test, followed by the Mann-Whitney U test with Bonferroni correction, was used in statistical analysis. In conclusion, resin-modified calcium silicate cement, modified calcium hydroxide cement, and the 2 kinds of premixed MTAs had an alkaline pH and low solubility value and they released various concentrations of ions after setting.