Restor Dent Endod.  2023 Feb;48(1):e8. 10.5395/rde.2023.48.e8.

Push-out bond strength and intratubular biomineralization of a hydraulic root-end filling material premixed with dimethyl sulfoxide as a vehicle

• Park JH
• Kim HJ
• Lee KW
• Yu MK
• Min KS

• KMID: 2548176
• DOI: http://doi.org/10.5395/rde.2023.48.e8

Abstract

Objectives
This study was designed to evaluate the parameters of bonding performance to root dentin, including push-out bond strength and dentinal tubular biomineralization, of a hydraulic bioceramic root-end filling material premixed with dimethyl sulfoxide (Endocem MTA Premixed) in comparison to a conventional powder-liquid–type cement (ProRoot MTA).
Materials and Methods
The root canal of a single-rooted premolar was filled with either ProRoot MTA or Endocem MTA Premixed (n = 15). A slice of dentin was obtained from each root. Using the sliced specimen, the push-out bond strength was measured, and the failure pattern was observed under a stereomicroscope. The apical segment was divided into halves; the split surface was observed under a scanning electron microscope, and intratubular biomineralization was examined by observing the precipitates formed in the dentinal tubule. Then, the chemical characteristics of the precipitates were evaluated with energy-dispersive X-ray spectroscopic (EDS) analysis. The data were analyzed using the Student’s t-test followed by the Mann-Whitney U test (p < 0.05).
Results
No significant difference was found between the 2 tested groups in push-out bond strength, and cohesive failure was the predominant failure type. In both groups, flake-shaped precipitates were observed along dentinal tubules. The EDS analysis indicated that the mass percentage of calcium and phosphorus in the precipitate was similar to that found in hydroxyapatite.
Conclusions
Regarding bonding to root dentin, Endocem MTA Premixed may have potential for use as an acceptable root-end filling material.

Keyword

Bioceramic; Push-out; Biomineralization; Vehicle; Premixed

Figure

• 

  Figure 1 Illustration of the experimental procedure. (A) The tooth filled with the tested materials was sectioned horizontally to obtain a sliced specimen and an apical segment. (B) Push-out bond strength was measured with the sliced specimen using a universal testing machine. (C) The apical segment was sectioned longitudinally, and the intratubular biomineralization was observed under scanning electron microscopy.SEM, scanning electron microscope.

• 

  Figure 2 Push-out bond strength and the failure patterns of the tested materials. (A) Bar chart showing the mean bond strength of the 2 tested material groups. (B) Failure mode distribution according to filling material.PR, ProRoot MTA; EP, Endocem MTA Premixed.

• 

  Figure 3 Failure mode analysis using a stereomicroscope at ×30 magnification. (A-C) Representative images of the ProRoot MTA group. (D-F) Representative images of the Endocem MTA Premixed group.

• 

  Figure 4 Representative scanning electron microscopy images of intratubular biomineralization. (A) ProRoot MTA-filled root canal. (B) Endocem MTA Premixed-filled root canal. Arrows indicate the flake-shaped intratubular precipitates.

• 

  Figure 5 EDS analysis of the chemical characteristics of intratubular precipitate. (A) A scanning electron microscope image showing the precipitate (white cross). (B) Representative graph of EDS analysis of the precipitate. (C) Semiquantitative chemical composition showing the calcium/phosphorus ratio of the crystalline area denoted with a white cross.EDS, energy-dispersive X-ray spectroscopic.

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