• 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.

• 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.

• 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.47 no.2
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• pp.18.1-18.9
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• 2022

Objectives: This study evaluated alterations in neuronal conductivity related to calcium silicate cements (CSCs) by investigating compound action potentials (cAPs) in rat sciatic nerves. Materials and Methods: Sciatic nerves were placed in a Tyrode bath and cAPs were recorded before, during, and after the application of test materials for 60-minute control, application, and recovery measurements, respectively. Freshly prepared ProRoot MTA, MTA Angelus, Biodentine, Endosequence RRM-Putty, BioAggregate, and RetroMTA were directly applied onto the nerves. Biopac LabPro version 3.7 was used to record and analyze cAPs. The data were statistically analyzed. Results: None of the CSCs totally blocked cAPs. RetroMTA, Biodentine, and MTA Angelus caused no significant alteration in cAPs (p > 0.05). Significantly lower cAPs were observed in recovery measurements for BioAggregate than in the control condition (p < 0.05). ProRoot MTA significantly but transiently reduced cAPs in the application period compared to the control period (p < 0.05). Endosequence RRM-Putty significantly reduced cAPs. Conclusions: Various CSCs may alter cAPs to some extent, but none of the CSCs irreversibly blocked them. The usage of fast-setting CSCs during apexification or regeneration of immature teeth seems safer than slow-setting CSCs due to their more favorable neuronal effects.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.445-452
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• 2010

Objectives: The aim of this study was to compare apical sealing ability and physical properties of MTA, MTA - AH-plus mixture (AMTA) and experimental Portland cement - Epoxy resin mixture (EPPC) for a development of a novel retro-filling material. Materials and Methods: Forty-nine extracted roots were instrumented and filled with gutta-percha. Apical root was resected at 3 mm and the retro-filling cavity was prepared for 3 mm depth. Roots were randomly divided into 3 groups of 15 roots each. The retro-filling was done using MTA, AMTA, and EPPC as the groups divided. Four roots were used as control groups. After setting in humid condition for 24 hours, the roots were immersed in 1% methylene blue dye solution for 72 hours to test the apical leakage. After immersion, the roots were vertically sectioned and photos were taken to evaluate microleakage. Setting times were measured with Vicat apparatus and digital radiographs were taken to evaluate aluminum equivalent thickness using aluminum step wedge. The results of microleakage and setting time were compared between groups using one-way ANOVA and Scheffe's post-hoc comparison at the significance level of 95%. Results: AMTA and EPPC showed less microleakage than MTA group (p < 0.05). AMTA showed the highest radio-opacity than other groups and the novel EPPC showed 5 mm aluminum thickness radio-opacity. EPPC showed the shortest initial and final setting times than other groups while the MTA showed the longest (p < 0.05). Conclusions: Under the condition of this study, the novel composite using Portland cement-Epoxy resin mixture may useful for retro-filling with the properties of favorable leakage resistance, radio-opacity and short setting time.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.445-454
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• 2018

The aim of this study was to measure the shear bond strength (SBS) of different adhesive systems to calcium silicate-based materials (Biodentine and RetroMTA). Eighty cylindrical acrylic blocks, with a hole (5.0 mm diameter, 2.0 mm height) in each, were prepared. The holes were filled with Biodentine (BD) and RetroMTA (RMTA), and the specimens were divided into 2 groups. Each group was classified into 4 subgroups: Clearfil$^{TM}$ SE (CSE) ; AQ bond (AQ) ; All bond universal Self-etch (ABU-SE) ; and All bond universal Total-etch (ABU-TE). After the application of different adhesive systems, composite resin (Z350) was applied over BD and RMTA. The SBS was measured using a universal testing machine, and the data were compared using the Kruskal-Wallis test and the Mann-Whitney test. The highest and lowest values of SBS were observed for BD-ABU-SE and RMTA-AQ, respectively. No significant differences were found in the SBS between ABU-TE and ABU-SE and between ABU-TE and CSE to BD and RMTA. According to the data, BD showed a higher SBS than did RMTA when BD and RMTA are compared in the same adhesive agents. Further, among all groups, composite resin with ABU-SE showed better bond strength to BD and RMTA.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.2
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• pp.148-156
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• 2020

The purpose of this study was to compare the success rates of two pulp capping materials, Biodentine™ and RetroMTA^®, used for partial pulpotomy in permanent molars after carious exposures and to compare the final restorative outcome of using composite resin to that of using a stainless steel crown. We studied children who were diagnosed with dental caries of permanent molars and underwent partial pulpotomy. The patients were followed up for more than 1 year. Clinical and radiographic evaluation were used to evaluate the success of each treatment. Fisher's exact test was used to compare the outcomes of two groups. For pulp capping agents, the success rate of using RetroMTA^® was lower than that of using Biodentine™(p < 0.05). Final restoration with composite resin was less successful than restoration with an stainless steel crown(p < 0.05). In combination of pulp capping agents and final restoration material, RetroMTA^®-composite resin shows the lowest success rate(p < 0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.236-241
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• 2010

Purpose: The purpose of this retrospective clinical study was to monitor the outcomes of periapical surgery in periapically infected tooth with or without retrograde filling materials (MTA or IRM). Patients and Methods: A total of 85 teeth in 63 patients were included in the study between November 2004 and August 2008. Randomly, MTA or IRM was used as a retrograde filling material or only apical resection without retrograde filling. Teeth with advanced periodontal bone loss or presence of root fracture were excluded from the study. The patients were subjected to a minimum follow-up period of 12 months, with a mean of 17.1 months. Results: Successful healing was observed in 83.3% of the MTA-treated teeth, 80% of the IRM-treated teeth and 75% of the teeth which was not retrograde filling. Doubtful healing was seen 9.3% (MTA), 13.3% (IRM), 12.5% (no retro-filling). The success rate of upper incisors (92%) was higher than lower lincisor and molars (66.7% and 50%, respectively). Conclusion: In this study, periapical surgery including retrograde filling improves the prognosis. And, no statistically significant differences were found between retrograde filling materials (MTA or IRM).

• 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.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.