The effect of human blood on the setting and surface micro-hardness of calcium silicate cements

Abstract

Objectives

The purpose of the present study was to evaluate the effects of human blood on the setting and microhardness of calcium silicate cements.

Materials and methods

Three types of silicate-based cements were used: ProRoot MTA (PMTA), OrthoMTA (OMTA), and RetroMTA (RMTA). Mixed cement was placed into polyethylene molds with lengths of 2 and 4 mm. After storage for 4 days under three different storage conditions, i.e., saline, saline after 5 min of human blood, and human blood, the polyethylene molds were removed. With the specimens set, the surface microhardness was measured using a Vickers microhardness tester, crystalline structure was analyzed with X-ray diffraction (XRD), and the surface characteristics were examined with scanning electron microscopy (SEM).

Results

All specimens of 4 mm in length were set with all materials, and the blood groups exhibited lower microhardnesses than did the saline groups (p < 0.05). Among the 2-mm specimens that were stored in blood, the numbers of specimens that set were significantly different across the materials (p < 0.001). Regarding the microhardnesses of the RMTA and OMTA groups, there were no significant differences between storage conditions. For the PMTA group, only one specimen that was set in the blood group exhibited reduced microhardness. XRD showed changes of crystalline structure in the PMTA and OMTA blood group, whereas RMTA did not. SEM analysis revealed more rounded and homogeneous structures and demonstrated a clear lack of acicular or needle-like crystals in the PMTA and OMTA blood groups, while RMTA did not reveal substantial differences between the saline- and blood-stored groups.

Conclusion

Blood contamination detrimentally affected the surface microhardnesses of all materials; furthermore, among the 2-mm specimens, blood contamination interfered with normal setting. Therefore, RMTA might be a more suitable choice when blood contamination is unavoidable due to limited depth.

Clinical relevance

RetroMTA might be a more suitable choice in situations in which blood contamination is unavoidable.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. 1.

    Lee Y-L, Lee B-S, Lin F-H, Yun Lin A, Lan W-H, Lin C-P (2004) Effects of physiological environments on the hydration behavior of mineral trioxide aggregate. Biomaterials 25(5):787–793

    Article  PubMed  Google Scholar 

  2. 2.

    Camilleri J, Montesin FE, Brady K, Sweeney R, Curtis RV, Ford TRP (2005) The constitution of mineral trioxide aggregate. Dent Mater 21(4):297–303

    Article  PubMed  Google Scholar 

  3. 3.

    Torabinejad M, Parirokh M (2010) Mineral trioxide aggregate: a comprehensive literature review—part II: leakage and biocompatibility investigations. J Endod 36(2):190–202

    Article  PubMed  Google Scholar 

  4. 4.

    Torabinejad M, Ford TRP, McKendry DJ, Abedi HR, Miller DA, Kariyawasam SP (1997) Histologic assessment of mineral trioxide aggregate as a root-end filling in monkeys. J Endod 23(4):225–228

    Article  PubMed  Google Scholar 

  5. 5.

    Parirokh M, Torabinejad M (2010) Mineral trioxide aggregate: a comprehensive literature review—part I: chemical, physical, and antibacterial properties. J Endod 36(1):16–27

    Article  PubMed  Google Scholar 

  6. 6.

    Zhu Q, Haglund R, Safavi KE, Spangberg LS (2000) Adhesion of human osteoblasts on root-end filling materials. J Endod 26(7):404–406

    Article  PubMed  Google Scholar 

  7. 7.

    Parirokh M, Torabinejad M (2010) Mineral trioxide aggregate: a comprehensive literature review—part III: clinical applications, drawbacks, and mechanism of action. J Endod 36(3):400–413

    Article  PubMed  Google Scholar 

  8. 8.

    Torabinejad M, Chivian N (1999) Clinical applications of mineral trioxide aggregate. J Endod 25(3):197–205

    Article  PubMed  Google Scholar 

  9. 9.

    Torabinejad M, Higa RK, McKendry DJ, Pitt Ford TR (1994) Dye leakage of four root end filling materials: effects of blood contamination. J Endod 20(4):159–163

    Article  PubMed  Google Scholar 

  10. 10.

    Montellano AM, Schwartz SA, Beeson TJ (2006) Contamination of tooth-colored mineral trioxide aggregate used as a root-end filling material: a bacterial leakage study. J Endod 32(5):452–455

    Article  PubMed  Google Scholar 

  11. 11.

    Tingey MC, Bush P, Levine MS (2008) Analysis of mineral trioxide aggregate surface when set in the presence of fetal bovine serum. J Endod 34(1):45–49

    Article  PubMed  Google Scholar 

  12. 12.

    VanderWeele RA, Schwartz SA, Beeson TJ (2006) Effect of blood contamination on retention characteristics of MTA when mixed with different liquids. J Endod 32(5):421–424

    Article  PubMed  Google Scholar 

  13. 13.

    Nekoofar MH, Oloomi K, Sheykhrezae MS, Tabor R, Stone DF, Dummer PM (2010) An evaluation of the effect of blood and human serum on the surface microhardness and surface microstructure of mineral trioxide aggregate. Int Endod J 43(10):849–858

    Article  PubMed  Google Scholar 

  14. 14.

    Nekoofar MH, Davies TE, Stone D, Basturk FB, Dummer PM (2011) Microstructure and chemical analysis of blood-contaminated mineral trioxide aggregate. Int Endod J 44(11):1011–1018

    Article  PubMed  Google Scholar 

  15. 15.

    Salem Milani A, Rahimi S, Froughreyhani M, Vahid Pakdel M (2013) Effect of blood contamination on marginal adaptation and surface microstructure of mineral trioxide aggregate: a SEM study. J Dent Res Dent Clin Dent Prospects 7(3):157–163

    PubMed  PubMed Central  Google Scholar 

  16. 16.

    Kim Y, Kim S, Shin YS, Jung IY, Lee SJ (2012) Failure of setting of mineral trioxide aggregate in the presence of fetal bovine serum and its prevention. J Endod 38(4):536–540

    Article  PubMed  Google Scholar 

  17. 17.

    Dentsply (2010) ProRoot® MTA Directions for Use.

  18. 18.

    Kim Y, Lee C-Y, Kim E, Jung I-Y (2011) Failure of orthograde MTA filling: MTA wash-out? J Korean Acad Conserv Dent 36(6):510–514

    Article  Google Scholar 

  19. 19.

    Kim H-Y (2014) Statistical notes for clinical researchers: two-way analysis of variance (ANOVA)-exploring possible interaction between factors. Restor Dent Endod 39(2):143–147

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Hachmeister DR, Schindler WG, Walker 3rd WA, Thomas DD (2002) The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification. J Endod 28(5):386–390

    Article  PubMed  Google Scholar 

  21. 21.

    Valois CRA, Costa Jr ED (2004) Influence of the thickness of mineral trioxide aggregate on sealing ability of root-end fillings in vitro. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 97(1):108–111

    Article  PubMed  Google Scholar 

  22. 22.

    Gilman JJ (1997) Chemical and physical "hardness". Mater Res Innov 1(2):71–76

    Article  Google Scholar 

  23. 23.

    Coleman NJ, Nicholson JW, Awosanya K (2007) A preliminary investigation of the in vitro bioactivity of white Portland cement. Cem Concr Res 37(11):1518–1523

    Article  Google Scholar 

  24. 24.

    Lee YL, Lee BS, Lin FH, Lin AY, Lan WH, Lin CP (2004) Effects of physiological environments on the hydration behavior of mineral trioxide aggregate. Biomaterials 25(5):787–793

    Article  PubMed  Google Scholar 

  25. 25.

    Chang SW, Baek SH, Yang HC, Seo DG, Hong ST, Han SH, et al. (2011) Heavy metal analysis of ortho MTA and ProRoot MTA. J Endod 37(12):1673–1676

    Article  PubMed  Google Scholar 

  26. 26.

    Kim E, Song JS, Jung IY, Lee SJ, Kim S (2008) Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod 34(5):546–551

    Article  PubMed  Google Scholar 

  27. 27.

    Walsh RM, Woodmansey KF, Glickman GN, He J (2014) Evaluation of compressive strength of hydraulic silicate-based root-end filling materials. J Endod 40(7):969–972

    Article  PubMed  Google Scholar 

  28. 28.

    Wang W-H, Wang C-Y, Shyu Y-C, Liu C-M, Lin F-H, Lin C-P (2010) Compositional characteristics and hydration behavior of mineral trioxide aggregates. Journal of Dental Sciences 5(2):53–59

    Article  Google Scholar 

  29. 29.

    Nekoofar MH, Stone DF, Dummer PM (2010) The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate. Int Endod J 43(9):782–791

    Article  PubMed  Google Scholar 

  30. 30.

    Namazikhah MS, Nekoofar MH, Sheykhrezae MS, Salariyeh S, Hayes SJ, Bryant ST, et al. (2008) The effect of pH on surface hardness and microstructure of mineral trioxide aggregate. Int Endod J 41(2):108–116

    PubMed  Google Scholar 

  31. 31.

    Camilleri J (2007) Hydration mechanisms of mineral trioxide aggregate. Int Endod J 40(6):462–470

    Article  PubMed  Google Scholar 

  32. 32.

    Kellum JA (2000) Determinants of blood pH in health and disease. Crit Care 4(1):6–14

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Gandolfi MG, Iacono F, Agee K, Siboni F, Tay F, Pashley DH, et al. (2009) Setting time and expansion in different soaking media of experimental accelerated calcium-silicate cements and ProRoot MTA. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108(6):e39–e45

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Euiseong Kim.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2015R1D1A1A09057552).

Ethical approval

This article contains study with human participants. Approval for this project was obtained from the Yonsei University Committee for Research on Human Subjects (2014–0024).

Informed consent

For this study, informed consents for human blood collection were acquired.

Additional information

Dr. Minju Song and Wonyoung Yue contributed equally to this work as first authors.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Song, M., Yue, W., Kim, S. et al. The effect of human blood on the setting and surface micro-hardness of calcium silicate cements. Clin Oral Invest 20, 1997–2005 (2016). https://doi.org/10.1007/s00784-015-1693-z

Download citation

Keywords

  • Human blood
  • Calcium silicate cements
  • Micro-hardness
  • Mineral trioxide aggregate
  • RetroMTA