• Restorative Dentistry and Endodontics
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• 제44권2호
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• pp.17.1-17.10
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• 2019

Objectives: Root resorption is an unexpected complication after replantation procedures. Combining anti-osteoclastic medicaments with retrograde root filling materials may avert this resorptive activity. The purpose of this study was to assess effects of a cathepsin K inhibitor with calcium silicate-based cements on osteoclastic activity. Methods: MC3T3-E1 cells were cultured for biocompatibility analyses. RAW 264.7 cells were cultured in the presence of the receptor activator of nuclear factor-kappa B and lipopolysaccharide, followed by treatment with Biodentine (BIOD) or ProRoot MTA with or without medicaments (Odanacatib [ODN], a cathepsin inhibitor and alendronate, a bisphosphonate). After drug treatment, the cell counting kit-8 assay and Alizarin red staining were performed to evaluate biocompatibility in MC3T3-E1 cells. Reverse-transcription polymerase chain reaction, tartrate-resistant acid phosphatase (TRAP) staining and enzyme-linked immunosorbent assays were performed in RAW 264.7 cells to determine the expression levels of inflammatory cytokines, interleukin $(IL)-1{\beta}$, IL-6, tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) and prostaglandin E2 (PGE2). Data were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05). Results: Biocompatibility results showed that there were no significant differences among any of the groups. RAW 264.7 cells treated with BIOD and ODN showed the lowest levels of $TNF-{\alpha}$ and PGE2. Treatments with BIOD + ODN were more potent suppressors of inflammatory cytokine expression (p < 0.05). Conclusion: The cathepsin K inhibitor with calcium silicate-based cement inhibits osteoclastic activity. This may have clinical application in preventing inflammatory root resorption in replanted teeth.

• Restorative Dentistry and Endodontics
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• 제48권2호
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• pp.21.1-21.15
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• 2023

Objectives: This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods: Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Results: No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions: The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

• Restorative Dentistry and Endodontics
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• 제46권1호
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• pp.2.1-2.8
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• 2021

Objectives: New premixed bioceramic root repair materials require moisture for setting. Using micro-computed tomography (micro-CT), this study evaluated the filling ability and volumetric changes of calcium silicate-based repair materials (mineral trioxide aggregate repair high-plasticity [MTA HP] and Bio-C Repair, Angelus), in comparison with a zinc oxide and eugenol-based material (intermediate restorative material [IRM]; Dentsply DeTrey). Materials and Methods: Gypsum models with cavities 3 mm deep and 1 mm in diameter were manufactured and scanned using micro-CT (SkyScan 1272. Bruker). The cavities were filled with the cements and scanned again to evaluate their filling capacity. Another scan was performed after immersing the samples in distilled water for 7 days to assess the volumetric changes of the cements. The statistical significance of differences in the data was evaluated using analysis of variance and the Tukey test with a 5% significance level. Results: Bio-C Repair had a greater filling ability than MTA HP (p < 0.05). IRM was similar to Bio-C and MTA HP (p > 0.05). MTA HP presented the largest volumetric change (p < 0.05), showing more volume loss than Bio-C and IRM, which were similar (p > 0.05). Conclusions: Bio-C Repair is a new endodontic material with excellent filling capacity and low volumetric change. The gypsum model proposed for evaluating filling ability and volumetric changes by micro-CT had appropriate and reproducible results. This model may enhance the physicochemical evaluation of premixed bioceramic materials, which need moisture for setting.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.10.1-10.11
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• 2022

Objectives: This study aimed to investigate the color stability, solubility, and surface characteristics of 3 calcium silicate-based cements (CSCs) after immersion in different solutions. Materials and Methods: ProRoot white mineral trioxide aggregate (MTA), Biodentine, and Endosequence Root Repair Material (ERRM) were placed in cylindrical molds and stored at 37℃ for 24 hours. Each specimen was immersed in distilled water, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine, or 0.1% octenidine hydrochloride (OCT) for 24 hours. Color changes were measured with a spectrophotometer. Solubility was determined using an analytical balance with 10^-5 g accuracy. The surface characteristics were analyzed using scanning electron microscopy and energy-dispersive spectroscopy. Data were analyzed using 2-way analysis of variance, the Tukey test, and the paired t-test. Results: MTA exhibited significant discoloration in contact with NaOCl (p < 0.05). White precipitation occurred on the surfaces of Biodentine and ERRM after contact with the solutions, and none of the materials presented dark brown discoloration. All materials showed significant solubility after immersion in the solutions (p < 0.05), irrespective of the solution type (p > 0.05). The surface topography and elemental composition of the samples showed different patterns of crystal formation and precipitation depending on the solution type. Conclusions: All materials presented some amount of solubility and showed crystal precipitation after contact with the solutions. Biodentine and ERRM are suitable alternatives to ProRoot MTA as they do not exhibit discoloration. The use of OCT can be considered safe for CSCs.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.2.1-2.11
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• 2022

Objectives: This study investigated the impact of micro-computed tomography (micro-CT)-based voxel size on the analysis of material/dentin interface voids and thickness of different endodontic cements. Materials and Methods: Following root-end resection and apical preparation, maxillary premolars were filled with mineral trioxide aggregate (MTA), Biodentine, and intermediate restorative material (IRM) (n = 24). The samples were scanned using micro-CT (SkyScan 1272; Bruker) and the cement/dentin interface and thickness of materials were evaluated at voxel sizes of 5, 10, and 20 ㎛. Analysis of variance and the Tukey test were conducted, and the degree of agreement between different voxel sizes was evaluated using the Bland and Altman method (p < 0.05). Results: All materials showed an increase in thickness from 5 to 10 and 20 ㎛ (p < 0.05). When evaluating the interface voids, materials were similar at 5 ㎛ (p > 0.05), while at 10 and 20 ㎛ Biodentine showed the lowest percentage of voids (p < 0.05). A decrease in the interface voids was observed for MTA and IRM at 20 ㎛, while Biodentine showed differences among all voxel sizes (p < 0.05). The Bland-Altman plots for comparisons among voxel sizes showed the largest deviations when comparing images between 5 and 20 ㎛. Conclusions: Voxel size had an impact on the micro-CT evaluation of thickness and interface voids of endodontic materials. All cements exhibited an increase in thickness and a decrease in the void percentage as the voxel size increased, especially when evaluating images at 20 ㎛.

• Restorative Dentistry and Endodontics
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• 제46권2호
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• pp.17.1-17.9
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• 2021

Objectives: In recent in vitro study, it was reported that osteostatin (OST) has an odontogenic effect and synergistic effect with mineral trioxide aggregate (MTA) in human dental pulp cells. Therefore, the aim of this study was to evaluate whether OST has a synergistic effect with MTA on hard tissue formation in vivo. Materials and Methods: Thirty-two maxillary molars of Spraque-Dawley rats were used in this study. An occlusal cavity was prepared and the exposed pulps were randomly divided into 3 groups: group 1 (control; ProRoot MTA), group 2 (OST 100 μM + ProRoot MTA), group 3 (OST 10 mM + ProRoot MTA). Exposed pulps were capped with each material and cavities were restored with resin modified glass ionomer. The animals were sacrificed after 4 weeks. All harvested teeth were scanned with micro-computed tomography (CT). The samples were prepared and hard tissue formation was evaluated histologically. For immunohistochemical analysis, the specimens were sectioned and incubated with primary antibodies against dentin sialoprotein (DSP). Results: In the micro-CT analysis, it is revealed that OST with ProRoot MTA groups showed more mineralized bridge than the control (p < 0.05). In the H&E staining, it is showed that more quantity of the mineralized dentin bridge was formed in the OST with ProRoot MTA group compared to the control (p < 0.05). In all groups, DSP was expressed in newly formed reparative dentin area. Conclusions: OST can be a supplementary pulp capping material when used with MTA to make synergistic effect in hard tissue formation.

• Restorative Dentistry and Endodontics
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• 제46권1호
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• pp.1.1-1.13
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• 2021

Objectives: The aim of this study was to evaluate the dystrophic mineralization deposits from 3 calcium silicate-based cements (Micro-Mega mineral trioxide aggregate [MM-MTA], Biodentine [BD], and EndoSequence Root Repair Material [ESRRM] putty) over time after subcutaneous implantation into rats. Materials and Methods: Forty-five silicon tubes containing the tested materials and 15 empty tubes (serving as a control group) were subcutaneously implanted into the backs of 15 Wistar rats. At 1, 4, and 8 weeks after implantation, the animals were euthanized (n = 5 animals/group), and the silicon tubes were removed with the surrounding tissues. Histopathological tissue sections were stained with von Kossa stain to assess mineralization. Scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDX) were also used to assess the chemical components of the surface precipitates deposited on the implant and the pattern of calcium and phosphorus distribution at the material-tissue interface. The calcium-to-phosphorus ratios were compared using the non-parametric Kruskal-Wallis test at a significance level of 5%. Results: The von Kossa staining showed that both BD and ESRRM putty induced mineralization starting at week 1; this mineralization increased further until the end of the study. In contrast, MM-MTA induced dystrophic calcification later, from 4 weeks onward. SEM/EDX showed no statistically significant differences in the calcium- and phosphorus-rich areas among the 3 materials at any time point (p > 0.05). Conclusions: After subcutaneous implantation, biomineralization of the 3-calcium silicate-based cements started early and increased over time, and all 3 tested cements generated calcium- and phosphorus-containing surface precipitates.

• Restorative Dentistry and Endodontics
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• 제35권1호
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• pp.5-12
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• 2010

본 연구에서는 인위적으로 노출시킨 비글견의 치수조직을 기존의 수산화칼슘제재와 MTA, 접착성 레진, 광중합형 수산화칼슘제재를 사용하여 직접치수복조한 후 각 재료에 따른 치수의 반응을 광학현미경 하에서 조직학적으로 관찰하여 비교분석하였다. 2마리 비글견의 36개 치아를 이용하여, 실험적으로 치수를 노출시키고 노출된 치수에 치수복조재를 적용한 후 와동은 복합레진으로 충전하여 직접치수복조술을 시행하였다: (1) Mineral Trioxide Aggregate (MTA: $ProRoot^{(R)}$ MTA, Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photopolymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA). 희생전 90일, 30일, 7일 전에 각 복조재별로 3개씩의 와동을 충전하였고 비글견을 희생시키고 조직시편을 제작하였다. 시편을 H&E 염색 후 광학 현미경으로 치수염증반응과 경조직 형성 정도를 관찰하였다. MTA 군은 초기에는 경조직 형성이 관찰되지 않고 치수조직의 위축과 부분괴사가 관찰되었으나 시간이 지나면서 경조직 형성이 관찰되었다. Clearfil SE Bond군은 초기에 염증세포의 침윤과 치수세포의 괴사를 관찰할 수 있었고 시간이 지날수록 치수 세포의 괴사가 더욱 진행한 양상을 보였다. Ultra-blend 군과 Dycal 군은 MTA 군과 비슷하게 초기에는 경조직 형성을 보이지 않고 중등도의 염증반응이 관찰되었으며 시간이 지나면서 경조직 형성이 관찰되었다. MTA, 수산화칼슘제재와 광중합 수산화칼슘제재는 초기의 치수염증반응 이후 조상아세포층, 상아질교 형성을 보여 직접치수복조재로 적당하였으며, 접착성 레진은 심한 염증반응과 치수 조직의 괴사 양상을 보여 직접치수복조재로 부적당하다는 결론을 얻을 수 있었다.

• Restorative Dentistry and Endodontics
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• 제32권2호
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• pp.95-101
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• 2007

개의 치수에 MTA, calcium hydroxide 및 calcium sulfate로 치수복조 후 치수 반응을 서로 비교하여 MTA와 calcium sulfate가 임상적으로 치수복조제로서 사용 가능할 것인가를 구명하고자 본 연구를 시행하였다. 8개월 된 2마리 개의 24개의 치아가 본 연구에 사용되었다 전신 마취하에 고속 핸드피스를 사용하여 멸균된 #2 round bur로 치경부에 와동을 형성한 후 치수를 노출시켰다. MTA, calcium hydroxide 및 calcium sulfate를 치수노출부에 도포하였다. 와동 부위는 IRM으로 가봉하고 광중합레진으로 수복하였다. 처리 2개월 후, 전신 마취하에 희생시킨 후 조직학적으로 관찰하였다. MTA처리군에서는 치수 노출부위에 경조직의 상아질교가 형성되었으며 새로 형성된 상아질교 하방에 조상아세포가 새로 형성되었다. 치수충혈과 함께 국소적 인 혈관 증식 이 나타났으며 치수에 염증반응은 나타나지 않았다. Calcium hydroxide로 처리한 군은 상아질교 하방에 조상아세포가 관찰되지 않았으며 만성 염증반응이 다양하게 나타났다. Calcium sulfate로 처리한 군은 경조직의 상아질교가 관찰되었으며, 상아질교 하방에 조상아세포 층이 새로 관찰되었다. 몇몇의 중성구 침윤과 함께 미약한 정도의 만성염증반응이 관찰되었다. 이상의 결과에서 MTA가 calcium hydroxide및 calcium sulfate에 비해 치수에 생체친화적임을 시사하며 기계적 치수노출시 치수복조제로 사용할 수 있음을 시사한다.

• Restorative Dentistry and Endodontics
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• 제33권4호
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• pp.369-376
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• 2008

이 연구의 목적은 3 종의 포틀랜드 시멘트 (포틀랜드 시멘트, 백색 포틀랜드 시멘트, 초속경 시멘트)와 white MTA의 성분 및 세포독성을 비교하는 것이다. 성분비교를 위해서 X선 회절기 (XRD), X선 형광분석기 (XRF), 유도결합플라즈마 원자방출분광 분석기 (ICP-AES)를 사용하였으며, 세포독성비교를 위해서는 우무확산법 (agar diffusion test)을 사용하였다. 분석 결과, white MTA와 백색 포틀랜드 시멘트는 포틀랜드 시멘트나 초속경 시멘트에 비해 적은 양의 마그네슘 (mg), 철 (Fe), 아연 (Zn), 그리고 망간 (Mn)을 함유하고 있었다. 또한 초속경 시멘트는 다른 시멘트 및 white MTA에 비해 많은 산화 알루미늄 ($Al_2O_3$)을 함유하고 있었다. MTA와 포틀랜드 시멘트의 주된 성분은 tricalcicium silicate ($3CaO{\cdot}SiO_2$), dicalcium Silicate ($2CaO{\cdot}SiO_2$), tricalcium aluminate ($3CaO{\cdot}Al_2O_3$), 그리고 tetracalcium aluminoferrite (4CaO{\cdot}Al_2O_3{\cdot}Fe_2O_3)등이었다 세포독성 실험결과를 Kruskal-Wallis Exact test와 Bonferroni 사후 검정법을 사용하여 분석 한 결과 white MTA와 3 종의 포틀랜드 시멘트 군 사이에서 통계적으로 유의성 있는 차이를 보이지 않았다 (p > 0.05). White MTA와 3종의 포틀랜드 시멘트의 주성분은 유사하였으나 알루미늄 (Al), 마그네슘 (mg), 철 (Fe), 아연 (Zn), 그리고 망간 (Mn) 등의 함량에서는 차이를 보였으며 이러한 차이들은 물리적 성질에 영향을 미칠 것으로 보인다.