• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.335-343
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• 2014

Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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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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• v.40 no.1
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• pp.1-13
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• 2015

Advancements in bio-ceramic technology has revolutionised endodontic material science by enhancing the treatment outcome for patients. This class of dental materials conciliates excellent biocompatibility with high osseoconductivity that render them ideal for endodontic care. Few recently introduced bio-ceramic materials have shown considerable clinical success over their early generations in terms of good handling characteristics. Calcium enriched mixture (CEM) cement, Endosequence sealer, and root repair materials, Biodentine and BioAggregate are the new classes of bio-ceramic materials. The aim of this literature review is to present investigations regarding properties and applications of CEM cement in endodontics. A review of the existing literature was performed by using electronic and hand searching methods for CEM cement from January 2006 to December 2013. CEM cement has a different chemical composition from that of mineral trioxide aggregate (MTA) but has similar clinical applications. It combines the biocompatibility of MTA with more efficient characteristics, such as significantly shorter setting time, good handling characteristics, no staining of tooth and effective seal against bacterial leakage.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.108-115
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• 2017

Numerous therapeutic approaches are available for impacted teeth, including orthodontic retraction, implantation, and autogenous tooth transplantation. Autotransplantation is a promising method, especially for juvenile patients, as it enables preservation of the function of the periodontal tissues, as well as continued alveolar bone growth. This report describes autotransplantation in two cases in which the tooth was fully-ectopically impacted. With case 1, an ectopically impacted premolar was extracted and transplanted in an upright position, and regenerative endodontic treatment was performed using a platelet-rich fibrin clot and mineral trioxide aggregate (MTA). With case 2, a calcifying odontogenic cyst with an impacted left mandibular second molar was treated by enucleation. The tooth was transplanted into the proper position 3 months after enucleation, and endodontic treatment was performed using MTA. In both cases, autotransplantation appeared to provide a simple and rapid treatment option for patients with ectopically impacted teeth. These cases demonstrate that autotransplantation of ectopically impacted teeth is a viable treatment option rather than implant placement or prosthesis, especially in juvenile patients.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.17-32
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• 1995

The purpose of this study was to examine the response of periradicular tissues to amalgam, IRM, Ketac-silver and MTA(Mineral trioxide aggregate) used as a root end fillings. The lower third and fourth premolars of 5 mongrel dogs were used. Each root was resected, followed by root end fillings with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows : 1. Severe inflammation around apex and disruption of cortical were noted in relation to the amalgam. 2. With IRM, there was severe infiltration of inflammatory cells around filling material, but healing of cortical bone was noted. 3. With Ketac-silver, mild inflammation and thick band of fibrous connetive tissue around filling material were seen, with a cortical bone healing. 4. In case of MTA, complete regeneration of cortical bone was seen, and free MTA was surrounded with newly formed bone tissue.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.10.1-10.8
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• 2020

Objectives: This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal. Materials and Methods: Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance. Results: A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal. Conclusions: Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

• Restorative Dentistry and Endodontics
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• v.35 no.3
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• pp.222-228
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• 2010

The purpose of this study was to compare mineral trioxide aggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK, USA), which is widely used as root-end filling material, with DiaRoot BioAggregate (DB; Innovative BioCaramix Inc, Vancouver, BC, Canada), newly developed product, by using MG63 osteoblast-like cells. MTA, DB, and Intermediate Restorative Material (IRM; Dentsply Caulk, Milford, DE, USA) were used for root-end filling material while tissue culture plastic was used for control group. Each material was mixed and, the mixtures were left to set for 24 hours. MG63 cells were seeded to each group and then they were cultured for attachment for 4 hours. Following the attachment of cells to the root-end filling material, early cellular response was observed. After another 12 hours'culture, the level of attachment between cells and material was observed and in order to identify the effect of each material to bone formation, transforming growth factor beta1 ($TGF{\beta}1$) and osteocalin (OC) were estimated by using enzyme-linked immunosorbent assay (ELISA), and the amount of alkaline phosphatase (ALP) was also measured. The data were analyzed using one-way ANOVA. As a result, only at OC and the number of cells which were attached to materials, there was no statistical difference between MTA and DB. At other items, there was statistically significant difference in all groups. Although DB has not shown exactly the same cellular response like that of MTA, the number of attached cells shows that biocompatibility of the material and OC indicates bone formation rate. Therefore, if DB is used for root end filling material, it is expected to lead to similar results to MTA.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.305-324
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• 1997

Numerous materials such as amalgam, IRM, SuperEBA, dessicated ZOE, and Ketac-Silver have been used as a root-end filling material or to repair furcation perforations. But so far no material has been found to satisfy all of the requirements of an ideal restorative material. Recently, mineral trioxide aggregate (MTA) has been suggested for use as a root end filling material and for the repair of furcation perforations. The purpose of this study was to compare the effect of MTA on the proliferation of MC3T3/E1 osteoblastic cell, formation of bone nodule, alkaline phosphatase activity, and finally the tissue reaction of bone with those of amalgam, IRM, SuperEBA, dessicated ZOE, and Ketac-Silver. The following conclusions were drawn within the limits of the experimental results : 1. MTA showed a excellent proliferation of osteoblastic cell and Ketac-Silver showed moderate proliferation of osteoblastic cell. The rest of test materials showed no proliferation of osteoblastic cell. 2. Many of definite bone nodules were found in the MTA group. In contrast, Ketac-Silver group showed no definite bone formation but only showed mild sign of bone formation. 3. Alkaline phosphatase activity of Ketac-Silver and MTA showed similar results. But both of them showed higher activity than that of other materials (p<0.005). 4. The tissue reaction to implanted MTA in the calbarium of mouse was milder than that observed with other materials. The tissue reaction of dessicated ZOE showed the worst results among the test materials.

• Restorative Dentistry and Endodontics
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• v.48 no.2
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.129-136
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• 2016

The purpose of this study is to examine the sealing effect and efficiency of root canal filling MTA (Endoseal, Endoseal MTA). A total of 106 extracted single rooted teeth were used and classified with group AH (AH-26), group PR (ProRoot MTA), group ES (Endoseal) and group EM (Endoseal MTA) depending on filled sealers. Time was measured in each group when sealers were filled. The groups were divided into subgroup A and subgroup B. The sealing of root canal walls and penetration of sealer in the dentinal tubule were evaluated, respectively. According to the results, the sealing of root canal walls and dentinal tubule penetration of root canal filling MTA were inferior to AH-26 (p < 0.05). When compared with ProRoot MTA, however, there was no significant difference in sealing of root canal walls (p > 0.05), but dentinal tubule penetration was high (p < 0.05). Working time was shorter in root canal filling MTA than ProRoot MTA and AH-26 (p < 0.05). In conclusion, root canal filling MTA has lower root canal sealing effect than resin-based sealer, however, when in MTA needed root canal filling, it could be an effective alternative.