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References

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Calcium silicate materials in endodontics

From Volume 41, Issue 8, October 2014 | Pages 708-722

Authors

Arindam Dutta

BDS, MDS, MFDS RCPS(Glasg)

Edinburgh Dental Institute

Articles by Arindam Dutta

William P Saunders

BDS DSc (hc) PhD FRCSEd (hon) FDS RCS Edin FDS RCPS Glas FDS RCS Eng MRD FHEA FDTFEd FCDSHK

Professor of Endodontology/Hon Consultant in Restorative Dentistry, Unit of Restorative Dentistry, Dundee Dental Hospital and School, Dundee, UK

Articles by William P Saunders

Abstract

Calcium silicate materials have been recently introduced to dentistry and have found wide applications in endodontics because of their favourable biological properties. This review discusses materials that have become available commercially as well as those that are currently experimental. The compositional aspects of Mineral Trioxide Aggregate (MTA) are discussed with modifications and the development of newer materials. Based upon this information, a definition and classification for calcium silicate materials has been proposed. Calcium silicate materials have properties that make them suitable for use in endodontics. Research with hybrid materials may lead to the development of a cement with more desirable characteristics.

Clinical Relevance: Dentists should be aware of the chemistry of the calcium silicate group of materials that includes Mineral Trioxide Aggregate and several newer materials.

Article

The past two decades have witnessed developments in endodontic treatment with strategies that have served to preserve pulpal vitality coupled with the introduction of advanced materials for both surgical and non-surgical root canal treatment. The major emphasis has been on the use of biocompatible and bioactive materials that can lead to the regeneration of both peri-radicular and pulpal tissue, rather than promoting repair. The properties for a material to be used for various endodontic applications (such as a root-end filling, perforation repair, root canal sealer and for pulp capping or pulpotomy) share certain common desirable characteristics. These characteristics are listed in Table 1.

The introduction of Mineral Trioxide Aggregate in 1993 brought about a paradigm shift in the use of dental materials. Subsequent laboratory, animal and clinical studies have established its pre-eminent position for several applications along the dentine-pulp and the pulp space-periradicular tissue continua. Initial animal studies had indicated MTA was associated with minimal inflammation in the periodontal tissues at the site of furcal perforation repair and in the peri-radicular tissues when used as a root-end filling material.1,2 In both instances, there was also evidence of cementum covering the restoration site. Since these initial studies, there are records of good clinical success when it has been used as a root-end filling material3,4 (Figures 1 and 2) for root perforation repair,5 direct pulp capping,6 apexification7 and pulpotomy.8 It has also been used for placement as an apical plug during orthograde endodontic treatment (Figures 3 and 4). The principal constituent of MTA is calcium silicate. Several important properties that develop when the material sets are influenced by the formation of the hydrated calcium silicate phases and its interaction with biological tissue fluid. Innovations in recent years have attempted to overcome the shortcomings of MTA, including relatively long setting time and difficult handling properties, by modifying the composition of this material. Such research has led to the development of a new family of bioactive and biocompatible dental materials for endodontic use that are based on calcium silicate chemistry. This review describes the calcium silicate materials that have been investigated for their application to endodontics with respect to their chemistry and physical properties.

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