Skip to main content
SpringerLink
Log in

Development of novel tricalcium silicate-based endodontic cements with sintered radiopacifier phase

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

All implants, bone and endodontic cements need to be sufficiently radiopaque to be able to be distinguished from neighbouring anatomical structures post-operatively. For this purpose, radiopacifying materials are added to the cements to render them sufficiently radiopaque. Bismuth oxide has been quite a popular choice of radiopacifier in endodontic materials. It has been shown to cause dental discoloration. The aim of this study was to develop, characterize and assess the properties of tricalcium silicate cement with alternative radiopacifiers, which are either inter-ground or sintered to the tricalcium silicate cement.

Methods

Custom-made endodontic cements based on tricalcium silicate and 20 % barium, calcium or strontium zirconate, which were either inter-ground or sintered at high temperatures, were produced. The set materials stored for 28 days in Hank’s balanced salt solution were characterized by scanning electron microscopy and X-ray diffraction analysis. Assessment of pH, leaching, interaction with physiological solution, radiopacity, setting time, compressive strength and material porosity were investigated. Mineral trioxide aggregate (MTA) Angelus was used as control.

Results

Addition of radiopacifying materials improved the radiopacity of the material. The sintered cements exhibited the formation of calcium zirconate together with the respective radiopacifier phase. All materials produced calcium hydroxide on hydration, which interacted with tissue fluids forming hydroxyapatite on the material surface. The physical properties of the tricalcium silicate-based cements were comparable to MTA Angelus.

Conclusions

A novel method of producing radiopaque tricalcium silicate-based cements was demonstrated. The novel materials exhibited properties, which were either comparable or else improved over the control.

Clinical relevance

The novel materials can be used to replace MTA for root-end filling, perforation repair and other clinical applications where MTA is indicated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

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

Similar content being viewed by others

References

  1. Torabinejad M, White DJ Tooth Filling Material and Use (1995) US Patent Number 5,769,638.

  2. Laghios CD, Benson BW, Gutmann JL, Cutler CW (2000) Comparative radiopacity of tetracalcium phosphate and other root-end filling materials. Int Endod J 33:311–315

    Article  PubMed  Google Scholar 

  3. Islam I, Chng HK, Yap AU (2006) Comparison of the physical and mechanical properties of MTA and Portland cement. J Endod 32:193–197

    Article  PubMed  Google Scholar 

  4. Camilleri J, Gandolfi MG (2010) Evaluation of the radiopacity of calcium silicate cements containing different radiopacifiers. Int Endod J 43:21–30

    Article  PubMed  Google Scholar 

  5. Camilleri J (2010) Evaluation of the physical properties of an endodontic Portland cement incorporating alternative radiopacifiers used as root-end filling material. Int Endod J 43:231–240

    Article  PubMed  Google Scholar 

  6. Camilleri J (2008) Characterization of hydration products of mineral trioxide aggregate. Int Endod J 41:408–417

    Article  PubMed  Google Scholar 

  7. Belío-Reyes IA, Bucio L, Cruz-Chavez E (2009) Phase composition of ProRoot mineral trioxide aggregate by X-ray powder diffraction. J Endod 35:875–878

    Article  PubMed  Google Scholar 

  8. Camilleri J, Sorrentino F, Damidot D (2013) Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, Biodentine and MTA Angelus. Dent Mater 29:580–593

    Article  PubMed  Google Scholar 

  9. Cavenago BC, Pereira TC, Duarte MA, Ordinola-Zapata R, Marciano MA, Bramante CM, Bernardineli N (2014) Influence of powder-to-water ratio on radiopacity, setting time, pH, calcium ion release and a micro-CT volumetric solubility of white mineral trioxide aggregate. Int Endod J 47:120–126

    Article  PubMed  Google Scholar 

  10. Vivan RR, Ordinola-Zapata R, Bramante CM, Bernardineli N, Garcia RB, Hungaro Duarte MA, de Moraes IG (2009) Evaluation of the radiopacity of some commercial and experimental root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e35–e38

    Article  PubMed  Google Scholar 

  11. Camilleri J (2014) The color stability of white mineral trioxide aggregate in contact with sodium hypochlorite solution. J Endod 40:436–40.

  12. Vallés M, Mercadé M, Duran-Sindreu F, Bourdelande JL, Roig M (2013) Influence of light and oxygen on the color stability of five calcium silicate-based materials. J Endod 39:525–528

    Article  PubMed  Google Scholar 

  13. Vallés M, Mercadé M, Duran-Sindreu F, Bourdelande JL, Roig M (2013) Color stability of white mineral trioxide aggregate. Clin Oral Investig 17:1155–1159

    Article  PubMed  Google Scholar 

  14. Min KS, Chang HS, Bae JM, Park SH, Hong CU, Kim EC (2007) The induction of heme oxygenase-1 modulates bismuth oxide-induced cytotoxicity in human dental pulp cells. J Endod 33:1342–1346

    Article  PubMed  Google Scholar 

  15. Camilleri J, Montesin FE, Papaioannou S, McDonald F, Pitt Ford TR (2004) Biocompatibility of two commercial forms of mineral trioxide aggregate. Int Endod J 37:699–704

    Article  PubMed  Google Scholar 

  16. Koulaouzidou EA, Economides N, Beltes P, Geromichalos G, Papazisis K (2008) In vitro evaluation of the cytotoxicity of ProRoot MTA and MTA Angelus. J Oral Sci 50:397–402

    Article  PubMed  Google Scholar 

  17. Coomaraswamy KS, Lumley PJ, Hofmann MP (2007) Effect of bismuth oxide radioopacifier content on the material properties of an endodontic Portland cement-based (MTA-like) system. J Endod 33:295–298

    Article  PubMed  Google Scholar 

  18. Saliba E, Abassi Ghadi S, Vowles R, Camilleri J, Hooper S, Camilleri J (2009) Evaluation of the strength and radiopacity of Portland cement with varying additions of bismuth oxide. Int Endod J 42:322–328

    Article  PubMed  Google Scholar 

  19. Camilleri J (2010) Hydration characteristics of calcium silicate cements with alternative radiopacifiers used as root-end filling materials. J Endod 36:502–508

    Article  PubMed  Google Scholar 

  20. Cutajar A, Mallia B, Abela S, Camilleri (2011) Replacement of radiopacifier in mineral trioxide aggregate; characterization and determination of physical properties. Dent Mater 27:879–891.

  21. Camilleri J, Cutajar A, Mallia B (2011) Hydration characteristics of zirconium oxide replaced Portland cement for use as a root-end filling material. Dent Mater 27:845–854

    Article  PubMed  Google Scholar 

  22. Húngaro Duarte MA, de Oliveira El Kadre GD, Vivan RR, Guerreiro Tanomaru JM, Tanomaru Filho M, de Moraes IG (2009) Radiopacity of Portland cement associated with different radiopacifying agents. J Endod 35:737–740

    Article  PubMed  Google Scholar 

  23. Sorrentino F (2008) Upscaling the synthesis of tricalcium silicate and alite. Cem Wapno beton. XIII/LXXV:177–183.

  24. Sorrentino F (2008) Manufacture of tricalcium silicate and alite by a modified Pechini process. Cemento Hormigon 917

  25. Pancrazi F, Phalipou J, Sorrentino F, Zarzycki J (1984) Preparation of gels in the CaO-Al2O3-SiO2 system. J Non-Cryst solids 63:81–93

    Article  Google Scholar 

  26. Hauyashi T, Saito H (1980) Preparation of CaO-SiO2 glasses by the gel method. Journal of Material Science 15:1971–1977

    Article  Google Scholar 

  27. Wei-ping G, Teng-Fei C, Zhan-Peng J (2007) Thermodynamic investigation of ZrO2-BaO system. Trans. Nonferrous Met. Soc. China 17:236

    Google Scholar 

  28. Ball RGJ, Mignanelli MA, Barry TI, Gisbi JA (1993) The calculation of phase equilibria of oxide core-concrete systems. J Nucl Mater 201:241

    Google Scholar 

  29. Tilloca G, Perez y Jorba M (1964) System SrO ZrO2. Rev Hautes Temperatures Refractaires 337.

  30. International Standards Organization ISO 6876 (2002) Dentistry—root canal sealing materials.

  31. International Standards Organization ISO 9917-1. (2007) Dentistry—water-based cements Part 1.

  32. Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller RN (2007) Calcium phosphate phase transformation produced by the interaction of the Portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid. J Endod 33:1347–1351

    Article  PubMed  Google Scholar 

  33. Reyes-Carmona JF, Felippe MS, Felippe WT (2009) Biomineralization ability and interaction of mineral trioxide aggregate and white Portland cement with dentin in a phosphate-containing fluid. J Endod 35:731–736

    Article  PubMed  Google Scholar 

  34. Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I (2005) Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 31:97–100

    Article  PubMed  Google Scholar 

  35. Duarte MA, De Oliveira Demarchi AC, Yamashita JC, Kuga MC, De Campos FS (2005) Arsenic release provided by MTA and Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:648–650

    Article  PubMed  Google Scholar 

  36. Monteiro Bramante C, Demarchi AC, de Moraes IG, Bernadineli N, Garcia RB, Spångberg LS, Duarte MA (2008) Presence of arsenic in different types of MTA and white and gray Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:909–913

    Article  PubMed  Google Scholar 

  37. De-Deus G, de Souza MC, Sergio Fidel RA, Fidel SR, de Campos RC, Luna AS (2009) Negligible expression of arsenic in some commercially available brands of Portland cement and mineral trioxide aggregate. J Endod 35:887–890

    Article  PubMed  Google Scholar 

  38. Schembri M, Peplow G, Camilleri J (2010) Analyses of heavy metals in mineral trioxide aggregate and Portland cement. J Endod 36:1210–1215

    Article  PubMed  Google Scholar 

  39. Matsunaga T, Tsujimoto M, Kawashima T, Tsujimoto Y, Fujiwara M, Ookubo A, Hayashi Y (2010) Analysis of arsenic in gray and white mineral trioxide aggregates by using atomic absorption spectrometry. J Endod 36:1988–1990

    Article  PubMed  Google Scholar 

  40. Chang SW, Baek SH, Yang HC, Seo DG, Hong ST, Han SH, Lee Y, Gu Y, Kwon HB, Lee W, Bae KS, Kum KY (2011) Heavy metal analysis of ortho MTA and ProRoot MTA. J Endod 37:1673–1676

    Article  PubMed  Google Scholar 

  41. Camilleri J, Kralj P, Veber M, Sinagra E (2012) Characterization and analyses of acid-extractable and leached trace elements in dental cements. Int Endod J 45:737–743

    Article  PubMed  Google Scholar 

  42. Forbes WF, Gentleman JF (1998) Risk factors, causality, and policy initiatives: the case of aluminum and mental impairment. Exp Gerontol 33:141–154

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  44. Camilleri J (2014) Tricalcium silicate cements with resins and alternative radiopacifiers. J Endod 40:2030–2035

    Article  PubMed  Google Scholar 

  45. Camilleri J, Formosa L, Damidot D (2013) The setting characteristics of MTA Plus in different environmental conditions. Int Endod J 46:831–840

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Ing. James Camilleri and Dr. Glenn Cassar of the Department of Metallurgy and Materials Engineering, Faculty of Engineering, University of Malta, Malta, and Dr. Vincent Thiery of Ecole de Mines, Douai, France, for their technical expertise; ERDF (Malta) for the financing of the testing equipment through the project: “Developing an Interdisciplinary Material Testing and Rapid Prototyping R&D Facility” (Ref. no. 012); The Directorate for Lifelong Learning Ministry of Education and employment for offering the Strategic Educational Pathways Scholarship Scheme (STEPS) throughout the Master’s Programme; and to the Short Scientific Internship Grants (through the University of Malta, the French Embassy in Malta, CNRS and the Malta Council of Science and Technology).

Compliance with ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Funding

No funding

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Restorative Dentistry, Faculty of Dental Surgery, Mater Dei Hospital, University of Malta Medical School, Msida, MSD 2090, Malta

    M. Xuereb & Josette Camilleri

  2. Mineral Research Processing, Meyzieu, France

    F. Sorrentino

  3. University Lille Nord de France, Lille, France

    D. Damidot

  4. EM Douai, LGCgE-GCE, Douai, France

    D. Damidot

Authors
  1. M. Xuereb
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Sorrentino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Damidot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Josette Camilleri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Josette Camilleri.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xuereb, M., Sorrentino, F., Damidot, D. et al. Development of novel tricalcium silicate-based endodontic cements with sintered radiopacifier phase. Clin Oral Invest 20, 967–982 (2016). https://doi.org/10.1007/s00784-015-1578-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-015-1578-1

Keywords

Search

Navigation