Riccardo Beltrami

Cytocompatibility and Antibacterial Properties of Capping Materials

The aim of this study was to evaluate and compare the antimicrobial activity and cytocompatibility of six different pulp-capping materials: Dycal (Dentsply), Calcicur (Voco), Calcimol LC (Voco), TheraCal LC (Bisco), MTA Angelus (Angelus), and Biodentine (Septodont). To evaluate antimicrobial activity, materials were challenged in vitro with Streptococcus mutans, Streptococcus salivarius, and Streptococcus sanguis in the agar disc diffusion test. Cytocompatibility of the assayed materials towards rat MDPC-23 cells was evaluated at different times by both MTT and apoptosis assays. Results significantly differed among the different materials tested. Both bacterial growth inhibition halos and cytocompatibility performances were significantly different among materials with different composition. MTA-based products showed lower cytotoxicity and valuable antibacterial activity, different from calcium hydroxide-based materials, which exhibited not only higher antibacterial activity but also higher cytotoxicity.

In vitro cytotoxicity evaluation of different pulp capping materials: a comparative study.

Abstract Direct pulp capping covers the exposed surface of the pulp to maintain its vitality and preserve its functional and biologic activity. The aim of the present study was to compare the biocompatibility effects of seven different pulp-capping materials in vitro: Dycal®, Calcicur®, Calcimol LC®, TheraCal LC®, ProRoot MTA®, MTA-Angelus®, and Biodentine®. Using the Transwell insert methodology by Alamar blue test, we evaluated the cytocompatibility of the above mentioned materials towards murine odontoblasts cells (MDPC-23) at three different times (24, 48, and 72 h). For additional control, the cell viability at 72 hours was also assessed by MTT assay. Morphological analysis of murine odontoblasts was assessed by Confocal Laser Scanning Microscope. The results indicate significantly different biocompatibility among materials with different composition. Biodentine® and mineral trioxide aggregate (MTA)-based products showed lower cytotoxicity, varying from calcium hydroxide-based materials, which exhibited higher cytotoxicity. Although our findings are limited to in vitro conditions, the observation that Biodentine® caused a cytotoxic effect similar to MTA suggests that it may be considered an alternative in pulp-capping treatment, as calcium hydroxide-based materials present higher cytotoxic effects.

Biological and chemical-physical properties of root-end filling materials: A comparative study

Aim: The purpose of the study is to evaluate and compare the biological and chemical-physical properties of four different root-end filling materials. Materials and Methods: Cytotoxicity towards murine odontoblasts cells (MDPC-23) was evaluated using the Transwell insert methodology by Alamar blue test. Streptococcus salivarius, S. sanguis, and S. mutans strains were selected to evaluate the antimicrobial activity by agar disc diffusion test. Solubility was determined after 24 h and 2 months. pH values were measured after 3 and 24 h. To evaluate radiopacity, all materials were scanned on a GE Healthcare Lunar Prodigy. Results: Excellent percentage of vitality were obtained by mineral trioxide aggregate (MTA)-based materials and Biodentine. MTA-Angelus, ProRoot MTA, and Intermediate Restorative Material (IRM) showed the highest values for the inhibition zones when tested for S. mutans, while Biodentine showed the largest inhibition zone when tested for S. sanguis. All the materials fulfilled the requirements of the International Standard 6876, demonstrating low solubility with a weight loss of less than 3%. No significant reduction in pH value was demonstrated after 24 h. ProRoot MTA and MTA-Angelus showed the highest values of radiographic density. Conclusions: The differences showed by the root-end filling materials tested do not cover completely the ideal clinical requests.

Cyclic fatigue resistance of OneShape, Reciproc, and WaveOne: An in vitro comparative study

Aims: The aim of this in vitro study was to evaluate the cyclic fatigue resistance of three single-use nickel–titanium (NiTi) instruments. Materials and Methods: Forty files each of OneShape (OS), Reciproc R25 (R25), WaveOne Primary (WO) file, and ProTaper (PT) F2 (as control) were tested in four curved artificial canals with different angles and radii of curvature. The number of cycles to fracture (NCF) was determined and the data were compared for differences by using two-way analysis of variance (P < 0.05). Results: In general, all single-use instruments were more resistant than traditional rotary instrument used as control. R25 showed the highest cyclic fatigue resistance. One Shape and WO files showed similar cyclic fatigue resistance values, higher than PT F2. Conclusions: Within the limitations of this study, it can be concluded that R25 was the most fatigue resistant. OS rotary instruments seem to have good mechanical resistance, similar to NiTi files developed for reciprocating motion.

In vitro antibacterial activity of different pulp capping materials

Background Direct pulp capping involves the application of a dental material to seal communications between the exposed pulp and the oral cavity (mechanical and carious pulp exposures) in an attempt to act as a barrier, protect the dental pulp complex and preserve its vitality. The aim of this study was to evaluate and compare, by the agar disc diffusion test, the antimicrobial activity of six different pulp-capping materials: Dycal (Dentsply), Calcicur (Voco), Calcimol LC (Voco), TheraCal LC (Bisco), MTA Angelus (Angelus), Biodentine (Septodont). Material and Methods Streptococcus salivarius, Streptococcus sanguis and Streptococcus mutans strains were selected to evaluate the antimicrobial activity by the agar disc diffusion test of different pulp capping materials. Paper disks were impregnated whit each pulp capping materials and placed onto culture agar-plates pre-adsorbed with bacterial cells and further incubated for 24 h at 37°C. The growth inhibition zones around each pulp capping materials were recorded and compared for each bacterial strain. Results For the investigation of the antibacterial properties the ANOVA showed the presence of significant differences among the various materials. Tukey test showed that MTA-based materials induced lower growth inhibition zones. Conclusions MTA-based products show a discrete antibacterial activity varying from calcium hydroxide-based materials which present an higher antibacterial activity. Key words:Agar disc diffusion test, antimicrobial activity, calcium hydroxide, MTA, pulp capping materials.

F360 and F6 Skytaper: SEM evaluation of cleaning efficiency.

AIM Root canal preparation may produce a large quantity of smear layer that covers canal walls. Single-file systems have recently appeared, with the aim of reducing the number of steps and files to reach a correct endodontic treatment. The purpose of this study was to evaluate by SEM the root canal walls after instrumentation with F360 (Komet, Brasseler GmbH & Co., Lemgo, Germany) and F6 Skytaper (Komet, Brasseler GmbH & Co., Lemgo, Germany), in order to evaluate the presence/absence of smear layer and the presence/absence of open tubules on the root canal walls at coronal, middle, and apical third of each sample. METHODS Twenty single-rooted freshly extracted teeth were selected and divided into 2 groups. For each group root canals were shaped with F360 (Komet, Brasseler GmbH & Co., Lemgo, Germany) and F6 Skytaper (Komet, Brasseler GmbH & Co., Lemgo, Germany) instruments under irrigation with 5,25% NaOCl and 17% EDTA. Specimens were fractured longitudinally and analyzed by SEM at standard magnification of 5000x. The presence/absence of smear layer and the presence/absence of open tubules at the coronal, middle, and apical third of each canal were evaluated using a 5-step scale for scores. Numeric data were analyzed using Kruskall-Wallis and Mann-Whitney U statistical tests and significance was predetermined at P <0.05. RESULTS This study did not reveal differences among two groups at the coronal and apical third. The apical third showed the highest values of scores for all Ni-Ti systems used. Significant differences in smear layer scores were recorded among the Ni-Ti systems at middle canal level (P < 0.05), where F6 Skytaper showed significantly lower scores than F360. CONCLUSIONS Within the limitation of this study, F360 and F6 Skytaper rotary instruments seem to be effective in shaping root canals with good debridement from canal walls, without significant differences between the two systems as it regards the coronal third and the apical third, the area where more debris is still visible. Instead, in the middle third F6 Skytaper seems to be more effective than F360, with statistically significative differences between the two systems.

Solubility and pH of direct pulp capping materials: a comparative study

Background The objective of the present study was to compare solubility and pH of 6 direct pulp capping materials. Methods Specimens of each material – i.e., Dycal, Calcicur, Calcimol LC, TheraCal LC, MTA Angelus and ProRoot MTA – were prepared and immersed in water. Solubility was determined after 24 hours and 2 months and analyzed statistically using a 1-way ANOVA and post hoc Tukey test. pH values were measured 3 and 24 hours after manipulation. Results All direct pulp capping materials showed low solubility; the pH of tested materials ranged from 10 to 12 and showed a nonsignificant increase/reduction after 24 hours. Conclusions Within the limitations of this in vitro study, the direct pulp capping materials studied showed different solubility even if no changes were recorded over time. All of the materials showed a very alkaline pH.

Surface discoloration of composite resins: Effects of staining and bleaching.

Background: The purpose of this in vitro study was to evaluate surface discoloration of three microhybrid composite resins (Esthet•X HD, Clearfil AP-X, Gradia Direct) and five nanohybrid composite resins (Ceram•X, GC Kalore, G-aenial, Grandio, GrandioSO), after staining and bleaching procedures. Materials and Methods: The composite resins were polymerized with a curing light (Celalux II, Voco, Cuxhaven, Germany) into 160 silicon molds (6,4 mm in diameter and 2 mm in thickness) to obtain identical specimens. Twenty samples for each composite resin were prepared. The specimens were polished using an automated polishing machine with the sequence of 600-, 800-, 1000-grit abrasive paper under water irrigation. The specimens were immersed in tea and distilled water: the specimens were dipped for 20 min, once a day (every 24 h), for 14 days into the drinks. The specimens were then bleached with carbamide peroxide at 17% (Perfect Bleach-Voco). The color of specimens was measured with a spectrophotometer according to the CIE L*a*b* system after light-polymerization of composite resin specimens, after 7 days, after 14 days, and after bleaching. The color difference h index (DEab*) between each measurement was calculated. Statistical analysis was made using analysis of variance (ANOVA). Results: All specimens showed a significant increase in staining with a similar trend and no significant differences between microhybrid and nanohybrid composite resins. After whitening procedures, materials tested showed both significant and unsignificant differences of the h index. Conclusions: Microhybrid and nanohybrid composite resins had similar in vitro surface discoloration in tea. After bleaching, discoloration was removed from some composite resins tested.

Effect of self-assembling peptide P11 -4 on enamel erosion: AFM and SEM studies.

The aim of the present in vitro study was to evaluate the protective effect of self-assembling peptide P11 -4 (Curodont™ Protect/Credentis) on enamel erosion produced by a soft-drink, by using Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM). Thirty human incisors were equally and randomly assigned to 6 groups. Group 1: intact enamel, group 2: soft drink, group 3: Curodont(™) Protect applied, group 4: Curodont(™) Protect applied + soft drink, group 5: soft drink + Curodont(™) Protect applied, group 6: soft drink + Curodont(™) Protect applied + soft drink. Specimens were observed through atomic force microscopy (AFM). The root mean-square roughness (Rrms) was obtained from the AFM images and the differences in the averaged values among the groups were analyzed by Shapiro-Wilk test in order to assess the normality of the distribution. Parametric ANOVA and post hoc Tuckey test were performed to assess the differences between the different groups. After demineralization process, enamel demonstrated a high degree of surface porosity. This morphological aspect was reflected in the increase of Rrms values. No significant differences (p > 0.05) were reported between intact enamel and enamel only treated with P11 -4 and between eroded enamel and enamel treated with P11 -4 and then demineralized. However significant differences (p < 0.05) were recorded when comparing softened enamel with softened enamel further remineralized with biomimetic self-assembling peptides and enamel treated with the protective paste between two acid attacks. The use of P11 -4 remineralizing may offer a degree of protection from enamel erosion. SCANNING 38:344-351, 2016.

Cleaning Effectiveness of Three NiTi Rotary Instruments: A Focus on Biomaterial Properties

Nickel-titanium (NiTi) instruments are commonly used for shaping the root canal system in endodontic practice. They are more flexible and have better cutting efficiency than conventional stainless steel files. The superelasticity of NiTi rotary files allows the clinicians to produce the desirable tapered root canal form with a reduced tendency to canal transportation and instrument fracture. HyFlex CM instruments are new NiTi rotary instruments with shape memory produced by an innovative methodology (patent pending) that uses a complex heating and cooling treatment that controls the material’s memory. The aim of the present study was to compare the cleaning efficacy of two conventional (Mtwo, Revo-S) Ni-Ti rotary instruments with HyFlex CM. 30 single-rooted freshly extracted teeth were divided into three groups. Root canals were shaped with three NiTi instruments (Mtwo, Revo-S and HyFlex CM) using 5.25% NaOCl and 17% EDTA solutions. Specimens were fractured longitudinally and prepared for SEM analysis at standard magnification of 1000×. The presence/absence of debris smear layer and the presence/absence of smear layer at coronal, middle, and apical third of each canal were evaluated using a 5-step scale for scores. Numeric data were analyzed using Kruskall-Wallis and Mann-Whitney U statistical tests and significance was predetermined at P < 0.05. This study revealed significant differences among the various groups. Despite some minor differences, all instruments removed smear layer and debris produced during instrumentation. HyFlex CM seem to be not so effective in promoting cleanliness of root canal walls and in removing smear layer from dentine if compared to Mtwo and Revo-S.