Endodontide Kullanılan Kalsiyum Silikat Esaslı Biyomateryallerin Klinik Gerçekliği
Özet
Dünya Sağlık Örgütü düzenli ağız bakımını önermesine rağmen, tedavi edilmemiş diş çürükleri küresel düzeyde önemli bir halk sağlığı sorunu olmaya devam etmektedir. Tedavi edilmeyen çürükler pulpitise ve ilerleyen süreçte periapikal periodontitise yol açmaktadır. Periapikal iyileşmenin sağlanmasında endodontik tedavi temel yaklaşım olup, başarısı büyük ölçüde kullanılan materyallere bağlıdır. 1990’lı yıllarda endodontiye kazandırılan biyoseramikler; biyoinert, biyoaktif ve biyolojik olarak parçalanabilir olarak sınıflandırılmakta, klinik uygulamalarda ise çoğunlukla biyoaktif özellik gösteren kalsiyum silikat esaslı biyomateryaller tercih edilmektedir. Bu materyaller biyouyumluluk, antimikrobiyal etki ve üstün sızdırmazlık özellikleri göstermekte; biyolojik sıvılarla temas ettiklerinde apatit oluşumunu teşvik ederek dentinle kimyasal etkileşim sağlamakta, remineralizasyonu desteklemekte ve mikro sızıntıyı azaltmaktadır. Mineral trioksit agregat (MTA), Biodentine, Bioaggregate, EndoSequence ve kalsiyum ile zenginleştirilmiş karışım materyalleri güncel endodontik uygulamalarda yaygın olarak kullanılmaktadır.
Despite the World Health Organization recommending regular oral care, untreated dental caries remain a significant global public health issue. Untreated caries can lead to pulpitis and, in the advanced stages, to periapical periodontitis. Endodontic treatment is the primary approach for achieving periapical healing, and its success largely depends on the materials used. In the 1990s, the introduction of bioceramics into endodontics marked a significant advancement. These materials are classified as bioinert, bioactive, or biodegradable, with calcium silicate–based biomaterials—mostly exhibiting bioactive properties—being the preferred choice in clinical applications. These materials demonstrate biocompatibility, antimicrobial effects, and superior sealing properties. When in contact with biological fluids, they promote the formation of apatite, enabling chemical interaction with dentin, supporting remineralization, and reducing microleakage. Mineral trioxide aggregate (MTA), Biodentine, Bioaggregate, EndoSequence, and calcium-enriched mixture materials are widely used in current endodontic practice.
Referanslar
Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of untreated caries: a systematic review and metaregression. Journal of Dental Research. 2015;94(5):650-658.
doi:10.1177/0022034515573272
Wang X, Xiao Y, Song W, et al. Clinical application of calcium silicate-based bioceramics in endodontics. Journal of Translational Medicine. 2023;21(1):853.
doi:10.1186/s12967-023-04550-4
Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering. 2023;10(3):354. doi:10.3390/bioengineering10030354
Gangishetti S, Kolluri A, Raj KA, et al. Bioactivity of Calcium Silicate-Based Endodontic Materials: A Comparative in vitro Evaluation. Journal of Pharmacy and Bioallied Sciences. 2024;16(Suppl 2):S1716-S1720. doi: 10.4103/jpbs.jpbs_959_23
Hotta M, Li Y, Sekine I. Mineralization in bovine dentin adjacent to glass-ionomer restorations. Journal of Dentistry. 2001;29:211-5.
Ürkmez EŞ, Pınar AE. Bioactivity evaluation of calcium silicate-based endodontic materials used for apexification. Australian Endodontic Journal. 2020;46(1):60-67.
doi: 10.1111/aej.12367
Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. International Endodontic Journal. 2018;51(2):177-205.
Küçükkaya S, Görduysus MÖ, Zeybek ND, et al. In Vitro Cytotoxicity of Calcium Silicate-Based Endodontic Cement as Root-End Filling Materials. Scientifica. 2016;2016:9203932. doi: 10.1155/2016/9203932
Şimşek E, Akbulut MB. Physicochemical and Biological Properties of Current Calcium Silicate Based Root Repair Materials. Türkiye Klinikleri Dişhekimliği Bilimleri Dergisi. 2021;27(1): 117-128.
Raghavendra SS, Jadhav GR, Gathani KM, et al. Bioceramics in endodontics - a review. Journal of Istanbul University Faculty of Dentistry. 2017;51(3 Suppl 1):S128-S137.
doi: 10.17096/jiufd.63659
Song JS, Mante FK, Romanow WJ, et al. Chemical analysis of powder and set forms of Portland cement, gray ProRoot MTA, white ProRoot MTA, and gray MTA-Angelus. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2006;102(6):809-15.
Malhotra N, Agarwal A, Mala K. Mineral trioxide aggregate: a review of physical properties. Compendium of Continuing Education in Dentistry. 2013;34(2):e25–32.
Song W, Sun W, Chen L, et al. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Frontiers in Bioengineering and Biotechnology. 2020;8:580954. doi: 10.3389/fbioe.2020.580954
Haglund R, He J, Jarvis J, et al. Effects of root-end filling materials on fibroblasts and macrophages in vitro. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2003;95(6):739-45.
Atabek D, Sillelioğlu H, Olmez A. Bond strength of adhesive systems to mineral trioxide aggregate with different time intervals. Journal of Endodontics. 2012;38(9):1288-92.
Yesilyurt C, Yildirim T, Taşdemir T, et al. Shear bond strength of conventional glass ionomer cements bound to mineral trioxide aggregate. Journal of Endodontics. 2009;35(10):1381-3.
Guven Y, Tuna EB, Dincol ME, et al. Long-Term Fracture Resistance of Simulated Immature Teeth Filled with Various Calcium Silicate-Based Materials. BioMed Research International. 2016;2016:2863817. doi: 10.1155/2016/2863817
El Sayed M, Saeed M. In vitro comparative study of sealing ability of Diadent BioAggregate and other root-end filling materials. Journal of Conservative Dentistry. 2012;15(3):249-52.
Song W, Li S, Tang Q, et al. In vitro biocompatibility and bioactivity of calcium silicate-based bioceramics in endodontics (Review). International Journal of Molecular Medicine. 2021;48(1):128. doi: 10.3892/ijmm.2021.4961
Ma J, Shen Y, Stojicic S, et al. Biocompatibility of two novel root repair materials. Journal of Endodontics. 2011;37(6):793-8. doi: 10.1016/j.joen.2011.02.029
Shi S, Bao ZF, Liu Y, et al. Comparison of in vivo dental pulp responses to capping with iRoot BP Plus and mineral trioxide aggregate. International Endodontic Journal. 2016;49(2):154-60. doi: 10.1111/iej.12439
Dawood AE, Parashos P, Wong RHK, et al. Calcium silicate-based cements: composition, properties, and clinical applications. Journal of Investigative and Clinical Dentistry. 2017;8(2). doi: 10.1111/jicd.12195
Ayatollahi F, Tabrizizadeh M, Zare BF, et al. Comparison of Marginal Adaptation of MTA and CEM Cement Apical Plugs in Three Different Media. Iranian Endodontic Journal. 2016;11(4):332-335. doi: 10.22037/iej.2016.15
Asgary S, Akbari KF, Taheri S. Evaluation of antimicrobial effect of MTA, calcium hydroxide, and CEM cement. Iranian Endodontic Journal. 2007;2(3):105-9.
Asgary S, Parirokh M, Eghbal MJ, et al. SEM evaluation of pulp reaction to different pulp capping materials in dog's teeth. Iranian Endodontic Journal. 2006;1(4):117-23.
Qureshi A, Soujanya E, Nandakumar, et al. Recent advances in pulp capping materials: an overview. Journal of Clinical and Diagnostic Research. 2014;8(1):316-21. doi: 10.7860/JCDR/2014/7719.3980
Poggio C, Lombardini M, Colombo M, et al. Solubility and pH of direct pulp capping materials: a comparative study. Journal of Applied Biomaterials and Functional Materials. 2015;13(2):e181-5. doi: 10.5301/jabfm.5000230
Meraji N, Camilleri J. Bonding over Dentin Replacement Materials. Journal of Endodontics. 2017;43(8):1343-1349. doi: 10.1016/j.joen.2017.03.025
Poggio C, Arciola CR, Beltrami R, et al. Cytocompatibility and antibacterial properties of capping materials. The Scientific World Journal. 2014;2014:181945. doi: 10.1155/2014/181945
Rodríguez-Lozano FJ, López-García S, García-Bernal D, et al. Cytocompatibility and bioactive properties of the new dual-curing resin-modified calcium silicate-based material for vital pulp therapy. Clinical Oral Investigations. 2021;25(8):5009-5024. doi: 10.1007/s00784-021-03811-0
Murata K, Washio A, Morotomi T, et al. Physicochemical Properties, Cytocompatibility, and Biocompatibility of a Bioactive Glass Based Retrograde Filling Material. Nanomaterials (Basel). 2021;11(7):1828.
doi: 10.3390/nano11071828
Ree MH, Schwartz RS. Long-term Success of Nonvital, Immature Permanent Incisors Treated With a Mineral Trioxide Aggregate Plug and Adhesive Restorations: A Case Series from a Private Endodontic Practice. Journal of Endodontics. 2017;43(8):1370-1377. doi: 10.1016/j.joen.2017.02.017
von Arx T, Jensen SS, Janner SFM, et sl. A 10-year Follow-up Study of 119 Teeth Treated with Apical Surgery and Root-end Filling with Mineral Trioxide Aggregate. Journal of Endodontics. 2019;45(4):394-401.
doi: 10.1016/j.joen.2018.12.015
Uğur AZ, Toptaş O, Göller BD, et al. Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clinical Oral Investigations. 2019;23(9):3645-3651.
doi: 10.1007/s00784-019-02967-0
Paños-Crespo A, Sánchez-Torres A, Gay-Escoda C. Retrograde filling material in periapical surgery: a systematic review. Medicina Oral Patología Oral y Cirugía Bucal. 2021;26(4):e422-e429. doi: 10.4317/medoral.24262
Abusrewil SM, McLean W, Scott JA. The use of Bioceramics as root-end filling materials in periradicular surgery: A literature review. Saudi Dental Journal. 2018;30(4):273-282. doi: 10.1016/j.sdentj.2018.07.004
Shinbori N, Grama AM, Patel Y, et al. Clinical outcome of endodontic microsurgery that uses EndoSequence BC root repair material as the root-end filling material. Journal of Endodontics. 2015;41(5):607-12.
doi: 10.1016/j.joen.2014.12.028
von Arx T, Janner SFM, Haenni S, et al. Bioceramic root repair material (BCRRM) for root-end obturation in apical surgery. An analysis of 174 teeth after 1 year. Swiss Dental Journal. 2020;130(5):390-396. doi: 10.61872/sdj-2020-05-644
Becker BD. Intentional Replantation Techniques: A Critical Review. Journal of Endodontics. 2018;44(1):14-21.
doi: 10.1016/j.joen.2017.08.002
Jang Y, Lee SJ, Yoon TC, et al. Survival Rate of Teeth with a C-shaped Canal after Intentional Replantation: A Study of 41 Cases for up to 11 Years. Journal of Endodontics. 2016;42(9):1320-5. doi: 10.1016/j.joen.2016.05.010
Asgary S, Talebzadeh B. Intentional replantation of a molar with several endodontic complications. Journal of Stomatology Oral and Maxillofacial Surgery. 2019;120(5):489-492.
doi: 10.1016/j.jormas.2018.11.019
Liu M, He L, Wang H, et al. Comparison of in vitro biocompatibility and antibacterial activity of two calcium silicate-based materials Journal of Materials Science: Materials in Medicine. 2021;32(5):52. doi: 10.1007/s10856-021-06523-9
Girish K, Mandava J, Chandra RR, et al. Effect of obturating materials on fracture resistance of simulated immature teeth. Journal of Conservative Dentistry. 2017;20(2):115-119.
doi: 10.4103/0972-0707.212238
Luczaj-Cepowicz E, Marczuk-Kolada G, Pawinska M, et al. Direct Pulp Capping in Primary Molars using Mineral Trioxide Aggregate: An in Vivo Study. Journal of Clinical Pediatric Dentistry. 2017;41(6):446-449. doi: 10.17796/1053-4628-41.6.5
Katge FA, Patil DP. Comparative Analysis of 2 Calcium Silicate-based Cements (Biodentine and Mineral Trioxide Aggregate) as Direct Pulp-capping Agent in Young Permanent Molars: A Split Mouth Study. Journal of Endodontics. 2017;43(4):507-513. doi: 10.1016/j.joen.2016.11.026
Hoseinifar R, Eskandarizadeh A, Parirokh M, et al. Histological evaluation of human pulp response to direct pulp capping with MTA, CEM cement, and biodentine. Journal of Dentistry. 2020;21(3):177.
Abdul MSM, Murali N, Rai P, et al. Clinico-Histological Evaluation of Dentino-Pulpal Complex of Direct Pulp Capping Agents: A Clinical Study. ournal of Pharmacy and Bioallied Sciences. 2021;13(1):S194-S198.
doi: 10.4103/jpbs.JPBS_665_20
Liu SY, Gong WY, Liu MQ, et al. Clinical efficacy observation of direct pulp capping using iRoot BP Plus therapy in mature permanent teeth with carious pulp exposure. Zhonghua Kou Qiang Yi Xue Za Zhi. 2020;55(12):945–951.
doi: 10.3760/cma.j.cn112144-20200327-00173
Bakhurji E. Mineral Trioxide Aggregate Could Have a Better Success Rate Than Calcium Hydroxide for Partial Pulpotomy of Symptomatic Mature Permanent Molars. ournal of Evidence-Based Dental Practice. 2020;20(1):101341.
doi: 10.1016/j.jebdp.2019.101341
Tran XV, Ngo LTQ, Boukpessi T. BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis. Healthcare (Basel). 2021;9(6):720. doi: 10.3390/healthcare9060720
Çelik BN, Mutluay MS, Arıkan V, et al. The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth. Clinical Oral Investigations. 2019;23(2):661-666. doi: 10.1007/s00784-018-2472-4
Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis International Endodontic Journal. 2018 Aug;51(8):819-828. doi: 10.1111/iej.12903
Guan X, Zhou Y, Yang Q, et al. Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study. Journal of Personalized Medicine. 2021;11(11):1125. doi: 10.3390/jpm11111125
Xie Y, Lu F, Hong Y, et al. Revascularisation versus apexification for treatment of immature teeth based on periapical healing and root development: A systematic review and meta-analysis. European Journal of Paediatric Dentistry. 2021;22(3):207-214. doi: 10.23804/ejpd.2021.22.03.6
Chung H, Kim M, Yang W, et al. An interesting healing outcome of a replanted immature permanent tooth: a case report. Dental Traumatology. 2011;27(1):77-80.
doi: 10.1111/j.1600-9657.2010.00940.x
Yadav P, Pruthi PJ, Naval RR, et al. Novel use of platelet-rich fibrin matrix and MTA as an apical barrier in the management of a failed revascularization case. Dental Traumatology. 2015;31(4):328-31. doi: 10.1111/edt.12168
Demiriz L, Hazar BE. Retrospective evaluation of healing of periapical lesions after unintentional extrusion of mineral trioxide aggregate. Journal of Applied Biomaterials & Functional Materials. 2017;15(4):e382-e386. doi: 10.5301/jabfm.5000359
Santos JM, Diogo P, Dias S, et al. Long-Term Outcome of Nonvital Immature Permanent Teeth Treated With Apexification and Corono-Radicular Adhesive Restoration: A Case Series. Journal of Endodontics. 2022;48(9):1191-1199.
doi: 10.1016/j.joen.2022.06.007
Sharma S, Sharma V, Passi D, et al. Large Periapical or Cystic Lesions in Association with Roots Having Open Apices Managed Nonsurgically Using 1-step Apexification Based on Platelet-rich Fibrin Matrix and Biodentine Apical Barrier: A Case Series. Journal of Endodontics. 2018;44(1):179-185.
doi: 10.1016/j.joen.2017.08.036
El Ashiry EA, Farsi NM, Abuzeid ST, et al. Dental Pulp Revascularization of Necrotic Permanent Teeth with Immature Apices. Journal of Clinical Pediatric Dentistry. 2016;40(5):361-6. doi: 10.17796/1053-4628-40.5.361
John A, Hegde AM, Shetty P, et al. Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report. International Journal of Clinical Pediatric Dentistry. 2019;12(1):59-63.
doi: 10.5005/jp-journals-10005-1574
Chung SY, Kim YH, Chae YK, et al. Void characteristics and tortuosity of calcium silicate-based cements for regenerative endodontics: a micro-computed tomography analysis. BMC Oral Health. 2021;21(1):565.
doi: 10.1186/s12903-021-01940-2
Wattanapakkavong K, Srisuwan T. Release of Transforming Growth Factor Beta 1 from Human Tooth Dentin after Application of Either ProRoot MTA or Biodentine as a Coronal Barrier. Journal of Endodontics. 2019;45(6):701-705. doi: 10.1016/j.joen.2019.03.011
Bukhari S, Kohli MR, Setzer F, et al. Outcome of Revascularization Procedure: A Retrospective Case Series. Journal of Endodontics. 2016;42(12):1752-1759.
doi: 10.1016/j.joen.2016.06.021
Saed SM, Ashley MP, Darcey J. Root perforations: aetiology, management strategies and outcomes. The hole truth. British Dental Journal. 2016;220(4):171-80.
doi: 10.1038/sj.bdj.2016.132
Gorni FG, Andreano A, Ambrogi F, et al. Patient and Clinical Characteristics Associated with Primary Healing of Iatrogenic Perforations after Root Canal Treatment: Results of a Long-term Italian Study. Journal of Endodontics. 2016;42(2):211-5. doi: 10.1016/j.joen.2015.11.006
Borkar S, de Noronha de Ataide I. Management of a massive resorptive lesion with multiple perforations in a molar: case report. Journal of Endodontics. 2015;41(5):753-8.
doi: 10.1016/j.joen.2014.12.022.
Mohan D, Singh AK, Kuriakose F, et al. Evaluation of Sealing Potential of Different Repair Materials in Furcation Perforations Using Dye Penetration: An In Vitro Study. Journal of Contemporary Dental Practice. 2021;22(1):80-83.
Aslan T, Esim E, Üstün Y, et al. Evaluation of Stress Distributions in Mandibular Molar Teeth with Different Iatrogenic Root Perforations Repaired with Biodentine or Mineral Trioxide Aggregate: A Finite Element Analysis Study. Journal of Endodontics. 2021;47(4):631-640.
doi: 10.1016/j.joen.2020.11.018.
Wang M, Yin S, Wang Q, et al. Study of molar furcal perforation repaired with iRoot BP. Hua Xi Kou Qiang Yi Xue Za Zhi. 2013;31(3):257–259.
Aminov L, Moscalu M, Melian A, et al. Clinical-radiological study on the role of biostimulating materials in iatrogenic furcation lesions. Revista Medico-Chirurgicala a Societatii de Medici si Naturalisti din Iasi. 2012;116(3):907-13.
Miao H, Chen M, Otgonbayar T, et al. Papillary reconstruction and guided tissue regeneration for combined periodontal-endodontic lesions caused by palatogingival groove and additional root: a case report. Clinical Case Reports. 2015;3(12):1042-9. doi: 10.1002/ccr3.441
Arnold M. Reparative Endodontic Treatment of a Perforating Internal Inflammatory Root Resorption: A Case Report. Journal of Endodontics. 2021;47(1):146-155.
doi: 10.1016/j.joen.2020.09.022
Khalil WA, Alghamdi F, Aljahdali E. Strengthening effect of bioceramic cement when used to repair simulated internal resorption cavities in endodontically treated teeth. Dental and Medical Problems. 2020;57(2):165-169.
doi: 10.17219/dmp/116743
Karypidou A, Chatzinikolaou ID, Kouros P, et al. Management of bilateral invasive cervical resorption lesions in maxillary incisors using a novel calcium silicate-based cement: A case report. Quintessence International. 2016;47(8):637-42.
doi: 10.3290/j.qi.a36385
Nosrat A, Nekoofar MH, Bolhari B, et al. Unintentional extrusion of mineral trioxide aggregate: a report of three cases. International Endodontic Journal. 2012;45(12):1165-76. doi: 10.1111/j.1365-2591.2012.02082.x
Asgary S, Fayazi S. Endodontic Surgery of a Symptomatic Overfilled MTA Apical Plug: A Histological and Clinical Case Report. Iranian Endodontic Journal. 2017;12(3):376-380. doi: 10.22037/iej.v12i3.17689
Tahan E, Celik D, Er K, et al. Effect of unintentionally extruded mineral trioxide aggregate in treatment of tooth with periradicular lesion: a case report. Journal of Endodontics. 2010;36(4):760-3. doi: 10.1016/j.joen.2009.11.026
Nagmode PS, Satpute AB, Patel AV, et al. The Effect of Mineral Trioxide Aggregate on the Periapical Tissues after Unintentional Extrusion beyond the Apical Foramen. Case Reports in Dentistry. 2016;2016:3590680.
doi: 10.1155/2016/3590680
da Silva EJNL, Versiani MA. The paradox of calcium silicate-based sealers: a reflection on bioactivity, solubility and clinical meaning. International Endodontic Journal. 2025.
doi: 10.1111/iej.70083
Referanslar
Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of untreated caries: a systematic review and metaregression. Journal of Dental Research. 2015;94(5):650-658.
doi:10.1177/0022034515573272
Wang X, Xiao Y, Song W, et al. Clinical application of calcium silicate-based bioceramics in endodontics. Journal of Translational Medicine. 2023;21(1):853.
doi:10.1186/s12967-023-04550-4
Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering. 2023;10(3):354. doi:10.3390/bioengineering10030354
Gangishetti S, Kolluri A, Raj KA, et al. Bioactivity of Calcium Silicate-Based Endodontic Materials: A Comparative in vitro Evaluation. Journal of Pharmacy and Bioallied Sciences. 2024;16(Suppl 2):S1716-S1720. doi: 10.4103/jpbs.jpbs_959_23
Hotta M, Li Y, Sekine I. Mineralization in bovine dentin adjacent to glass-ionomer restorations. Journal of Dentistry. 2001;29:211-5.
Ürkmez EŞ, Pınar AE. Bioactivity evaluation of calcium silicate-based endodontic materials used for apexification. Australian Endodontic Journal. 2020;46(1):60-67.
doi: 10.1111/aej.12367
Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. International Endodontic Journal. 2018;51(2):177-205.
Küçükkaya S, Görduysus MÖ, Zeybek ND, et al. In Vitro Cytotoxicity of Calcium Silicate-Based Endodontic Cement as Root-End Filling Materials. Scientifica. 2016;2016:9203932. doi: 10.1155/2016/9203932
Şimşek E, Akbulut MB. Physicochemical and Biological Properties of Current Calcium Silicate Based Root Repair Materials. Türkiye Klinikleri Dişhekimliği Bilimleri Dergisi. 2021;27(1): 117-128.
Raghavendra SS, Jadhav GR, Gathani KM, et al. Bioceramics in endodontics - a review. Journal of Istanbul University Faculty of Dentistry. 2017;51(3 Suppl 1):S128-S137.
doi: 10.17096/jiufd.63659
Song JS, Mante FK, Romanow WJ, et al. Chemical analysis of powder and set forms of Portland cement, gray ProRoot MTA, white ProRoot MTA, and gray MTA-Angelus. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2006;102(6):809-15.
Malhotra N, Agarwal A, Mala K. Mineral trioxide aggregate: a review of physical properties. Compendium of Continuing Education in Dentistry. 2013;34(2):e25–32.
Song W, Sun W, Chen L, et al. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Frontiers in Bioengineering and Biotechnology. 2020;8:580954. doi: 10.3389/fbioe.2020.580954
Haglund R, He J, Jarvis J, et al. Effects of root-end filling materials on fibroblasts and macrophages in vitro. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2003;95(6):739-45.
Atabek D, Sillelioğlu H, Olmez A. Bond strength of adhesive systems to mineral trioxide aggregate with different time intervals. Journal of Endodontics. 2012;38(9):1288-92.
Yesilyurt C, Yildirim T, Taşdemir T, et al. Shear bond strength of conventional glass ionomer cements bound to mineral trioxide aggregate. Journal of Endodontics. 2009;35(10):1381-3.
Guven Y, Tuna EB, Dincol ME, et al. Long-Term Fracture Resistance of Simulated Immature Teeth Filled with Various Calcium Silicate-Based Materials. BioMed Research International. 2016;2016:2863817. doi: 10.1155/2016/2863817
El Sayed M, Saeed M. In vitro comparative study of sealing ability of Diadent BioAggregate and other root-end filling materials. Journal of Conservative Dentistry. 2012;15(3):249-52.
Song W, Li S, Tang Q, et al. In vitro biocompatibility and bioactivity of calcium silicate-based bioceramics in endodontics (Review). International Journal of Molecular Medicine. 2021;48(1):128. doi: 10.3892/ijmm.2021.4961
Ma J, Shen Y, Stojicic S, et al. Biocompatibility of two novel root repair materials. Journal of Endodontics. 2011;37(6):793-8. doi: 10.1016/j.joen.2011.02.029
Shi S, Bao ZF, Liu Y, et al. Comparison of in vivo dental pulp responses to capping with iRoot BP Plus and mineral trioxide aggregate. International Endodontic Journal. 2016;49(2):154-60. doi: 10.1111/iej.12439
Dawood AE, Parashos P, Wong RHK, et al. Calcium silicate-based cements: composition, properties, and clinical applications. Journal of Investigative and Clinical Dentistry. 2017;8(2). doi: 10.1111/jicd.12195
Ayatollahi F, Tabrizizadeh M, Zare BF, et al. Comparison of Marginal Adaptation of MTA and CEM Cement Apical Plugs in Three Different Media. Iranian Endodontic Journal. 2016;11(4):332-335. doi: 10.22037/iej.2016.15
Asgary S, Akbari KF, Taheri S. Evaluation of antimicrobial effect of MTA, calcium hydroxide, and CEM cement. Iranian Endodontic Journal. 2007;2(3):105-9.
Asgary S, Parirokh M, Eghbal MJ, et al. SEM evaluation of pulp reaction to different pulp capping materials in dog's teeth. Iranian Endodontic Journal. 2006;1(4):117-23.
Qureshi A, Soujanya E, Nandakumar, et al. Recent advances in pulp capping materials: an overview. Journal of Clinical and Diagnostic Research. 2014;8(1):316-21. doi: 10.7860/JCDR/2014/7719.3980
Poggio C, Lombardini M, Colombo M, et al. Solubility and pH of direct pulp capping materials: a comparative study. Journal of Applied Biomaterials and Functional Materials. 2015;13(2):e181-5. doi: 10.5301/jabfm.5000230
Meraji N, Camilleri J. Bonding over Dentin Replacement Materials. Journal of Endodontics. 2017;43(8):1343-1349. doi: 10.1016/j.joen.2017.03.025
Poggio C, Arciola CR, Beltrami R, et al. Cytocompatibility and antibacterial properties of capping materials. The Scientific World Journal. 2014;2014:181945. doi: 10.1155/2014/181945
Rodríguez-Lozano FJ, López-García S, García-Bernal D, et al. Cytocompatibility and bioactive properties of the new dual-curing resin-modified calcium silicate-based material for vital pulp therapy. Clinical Oral Investigations. 2021;25(8):5009-5024. doi: 10.1007/s00784-021-03811-0
Murata K, Washio A, Morotomi T, et al. Physicochemical Properties, Cytocompatibility, and Biocompatibility of a Bioactive Glass Based Retrograde Filling Material. Nanomaterials (Basel). 2021;11(7):1828.
doi: 10.3390/nano11071828
Ree MH, Schwartz RS. Long-term Success of Nonvital, Immature Permanent Incisors Treated With a Mineral Trioxide Aggregate Plug and Adhesive Restorations: A Case Series from a Private Endodontic Practice. Journal of Endodontics. 2017;43(8):1370-1377. doi: 10.1016/j.joen.2017.02.017
von Arx T, Jensen SS, Janner SFM, et sl. A 10-year Follow-up Study of 119 Teeth Treated with Apical Surgery and Root-end Filling with Mineral Trioxide Aggregate. Journal of Endodontics. 2019;45(4):394-401.
doi: 10.1016/j.joen.2018.12.015
Uğur AZ, Toptaş O, Göller BD, et al. Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clinical Oral Investigations. 2019;23(9):3645-3651.
doi: 10.1007/s00784-019-02967-0
Paños-Crespo A, Sánchez-Torres A, Gay-Escoda C. Retrograde filling material in periapical surgery: a systematic review. Medicina Oral Patología Oral y Cirugía Bucal. 2021;26(4):e422-e429. doi: 10.4317/medoral.24262
Abusrewil SM, McLean W, Scott JA. The use of Bioceramics as root-end filling materials in periradicular surgery: A literature review. Saudi Dental Journal. 2018;30(4):273-282. doi: 10.1016/j.sdentj.2018.07.004
Shinbori N, Grama AM, Patel Y, et al. Clinical outcome of endodontic microsurgery that uses EndoSequence BC root repair material as the root-end filling material. Journal of Endodontics. 2015;41(5):607-12.
doi: 10.1016/j.joen.2014.12.028
von Arx T, Janner SFM, Haenni S, et al. Bioceramic root repair material (BCRRM) for root-end obturation in apical surgery. An analysis of 174 teeth after 1 year. Swiss Dental Journal. 2020;130(5):390-396. doi: 10.61872/sdj-2020-05-644
Becker BD. Intentional Replantation Techniques: A Critical Review. Journal of Endodontics. 2018;44(1):14-21.
doi: 10.1016/j.joen.2017.08.002
Jang Y, Lee SJ, Yoon TC, et al. Survival Rate of Teeth with a C-shaped Canal after Intentional Replantation: A Study of 41 Cases for up to 11 Years. Journal of Endodontics. 2016;42(9):1320-5. doi: 10.1016/j.joen.2016.05.010
Asgary S, Talebzadeh B. Intentional replantation of a molar with several endodontic complications. Journal of Stomatology Oral and Maxillofacial Surgery. 2019;120(5):489-492.
doi: 10.1016/j.jormas.2018.11.019
Liu M, He L, Wang H, et al. Comparison of in vitro biocompatibility and antibacterial activity of two calcium silicate-based materials Journal of Materials Science: Materials in Medicine. 2021;32(5):52. doi: 10.1007/s10856-021-06523-9
Girish K, Mandava J, Chandra RR, et al. Effect of obturating materials on fracture resistance of simulated immature teeth. Journal of Conservative Dentistry. 2017;20(2):115-119.
doi: 10.4103/0972-0707.212238
Luczaj-Cepowicz E, Marczuk-Kolada G, Pawinska M, et al. Direct Pulp Capping in Primary Molars using Mineral Trioxide Aggregate: An in Vivo Study. Journal of Clinical Pediatric Dentistry. 2017;41(6):446-449. doi: 10.17796/1053-4628-41.6.5
Katge FA, Patil DP. Comparative Analysis of 2 Calcium Silicate-based Cements (Biodentine and Mineral Trioxide Aggregate) as Direct Pulp-capping Agent in Young Permanent Molars: A Split Mouth Study. Journal of Endodontics. 2017;43(4):507-513. doi: 10.1016/j.joen.2016.11.026
Hoseinifar R, Eskandarizadeh A, Parirokh M, et al. Histological evaluation of human pulp response to direct pulp capping with MTA, CEM cement, and biodentine. Journal of Dentistry. 2020;21(3):177.
Abdul MSM, Murali N, Rai P, et al. Clinico-Histological Evaluation of Dentino-Pulpal Complex of Direct Pulp Capping Agents: A Clinical Study. ournal of Pharmacy and Bioallied Sciences. 2021;13(1):S194-S198.
doi: 10.4103/jpbs.JPBS_665_20
Liu SY, Gong WY, Liu MQ, et al. Clinical efficacy observation of direct pulp capping using iRoot BP Plus therapy in mature permanent teeth with carious pulp exposure. Zhonghua Kou Qiang Yi Xue Za Zhi. 2020;55(12):945–951.
doi: 10.3760/cma.j.cn112144-20200327-00173
Bakhurji E. Mineral Trioxide Aggregate Could Have a Better Success Rate Than Calcium Hydroxide for Partial Pulpotomy of Symptomatic Mature Permanent Molars. ournal of Evidence-Based Dental Practice. 2020;20(1):101341.
doi: 10.1016/j.jebdp.2019.101341
Tran XV, Ngo LTQ, Boukpessi T. BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis. Healthcare (Basel). 2021;9(6):720. doi: 10.3390/healthcare9060720
Çelik BN, Mutluay MS, Arıkan V, et al. The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth. Clinical Oral Investigations. 2019;23(2):661-666. doi: 10.1007/s00784-018-2472-4
Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis International Endodontic Journal. 2018 Aug;51(8):819-828. doi: 10.1111/iej.12903
Guan X, Zhou Y, Yang Q, et al. Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study. Journal of Personalized Medicine. 2021;11(11):1125. doi: 10.3390/jpm11111125
Xie Y, Lu F, Hong Y, et al. Revascularisation versus apexification for treatment of immature teeth based on periapical healing and root development: A systematic review and meta-analysis. European Journal of Paediatric Dentistry. 2021;22(3):207-214. doi: 10.23804/ejpd.2021.22.03.6
Chung H, Kim M, Yang W, et al. An interesting healing outcome of a replanted immature permanent tooth: a case report. Dental Traumatology. 2011;27(1):77-80.
doi: 10.1111/j.1600-9657.2010.00940.x
Yadav P, Pruthi PJ, Naval RR, et al. Novel use of platelet-rich fibrin matrix and MTA as an apical barrier in the management of a failed revascularization case. Dental Traumatology. 2015;31(4):328-31. doi: 10.1111/edt.12168
Demiriz L, Hazar BE. Retrospective evaluation of healing of periapical lesions after unintentional extrusion of mineral trioxide aggregate. Journal of Applied Biomaterials & Functional Materials. 2017;15(4):e382-e386. doi: 10.5301/jabfm.5000359
Santos JM, Diogo P, Dias S, et al. Long-Term Outcome of Nonvital Immature Permanent Teeth Treated With Apexification and Corono-Radicular Adhesive Restoration: A Case Series. Journal of Endodontics. 2022;48(9):1191-1199.
doi: 10.1016/j.joen.2022.06.007
Sharma S, Sharma V, Passi D, et al. Large Periapical or Cystic Lesions in Association with Roots Having Open Apices Managed Nonsurgically Using 1-step Apexification Based on Platelet-rich Fibrin Matrix and Biodentine Apical Barrier: A Case Series. Journal of Endodontics. 2018;44(1):179-185.
doi: 10.1016/j.joen.2017.08.036
El Ashiry EA, Farsi NM, Abuzeid ST, et al. Dental Pulp Revascularization of Necrotic Permanent Teeth with Immature Apices. Journal of Clinical Pediatric Dentistry. 2016;40(5):361-6. doi: 10.17796/1053-4628-40.5.361
John A, Hegde AM, Shetty P, et al. Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report. International Journal of Clinical Pediatric Dentistry. 2019;12(1):59-63.
doi: 10.5005/jp-journals-10005-1574
Chung SY, Kim YH, Chae YK, et al. Void characteristics and tortuosity of calcium silicate-based cements for regenerative endodontics: a micro-computed tomography analysis. BMC Oral Health. 2021;21(1):565.
doi: 10.1186/s12903-021-01940-2
Wattanapakkavong K, Srisuwan T. Release of Transforming Growth Factor Beta 1 from Human Tooth Dentin after Application of Either ProRoot MTA or Biodentine as a Coronal Barrier. Journal of Endodontics. 2019;45(6):701-705. doi: 10.1016/j.joen.2019.03.011
Bukhari S, Kohli MR, Setzer F, et al. Outcome of Revascularization Procedure: A Retrospective Case Series. Journal of Endodontics. 2016;42(12):1752-1759.
doi: 10.1016/j.joen.2016.06.021
Saed SM, Ashley MP, Darcey J. Root perforations: aetiology, management strategies and outcomes. The hole truth. British Dental Journal. 2016;220(4):171-80.
doi: 10.1038/sj.bdj.2016.132
Gorni FG, Andreano A, Ambrogi F, et al. Patient and Clinical Characteristics Associated with Primary Healing of Iatrogenic Perforations after Root Canal Treatment: Results of a Long-term Italian Study. Journal of Endodontics. 2016;42(2):211-5. doi: 10.1016/j.joen.2015.11.006
Borkar S, de Noronha de Ataide I. Management of a massive resorptive lesion with multiple perforations in a molar: case report. Journal of Endodontics. 2015;41(5):753-8.
doi: 10.1016/j.joen.2014.12.022.
Mohan D, Singh AK, Kuriakose F, et al. Evaluation of Sealing Potential of Different Repair Materials in Furcation Perforations Using Dye Penetration: An In Vitro Study. Journal of Contemporary Dental Practice. 2021;22(1):80-83.
Aslan T, Esim E, Üstün Y, et al. Evaluation of Stress Distributions in Mandibular Molar Teeth with Different Iatrogenic Root Perforations Repaired with Biodentine or Mineral Trioxide Aggregate: A Finite Element Analysis Study. Journal of Endodontics. 2021;47(4):631-640.
doi: 10.1016/j.joen.2020.11.018.
Wang M, Yin S, Wang Q, et al. Study of molar furcal perforation repaired with iRoot BP. Hua Xi Kou Qiang Yi Xue Za Zhi. 2013;31(3):257–259.
Aminov L, Moscalu M, Melian A, et al. Clinical-radiological study on the role of biostimulating materials in iatrogenic furcation lesions. Revista Medico-Chirurgicala a Societatii de Medici si Naturalisti din Iasi. 2012;116(3):907-13.
Miao H, Chen M, Otgonbayar T, et al. Papillary reconstruction and guided tissue regeneration for combined periodontal-endodontic lesions caused by palatogingival groove and additional root: a case report. Clinical Case Reports. 2015;3(12):1042-9. doi: 10.1002/ccr3.441
Arnold M. Reparative Endodontic Treatment of a Perforating Internal Inflammatory Root Resorption: A Case Report. Journal of Endodontics. 2021;47(1):146-155.
doi: 10.1016/j.joen.2020.09.022
Khalil WA, Alghamdi F, Aljahdali E. Strengthening effect of bioceramic cement when used to repair simulated internal resorption cavities in endodontically treated teeth. Dental and Medical Problems. 2020;57(2):165-169.
doi: 10.17219/dmp/116743
Karypidou A, Chatzinikolaou ID, Kouros P, et al. Management of bilateral invasive cervical resorption lesions in maxillary incisors using a novel calcium silicate-based cement: A case report. Quintessence International. 2016;47(8):637-42.
doi: 10.3290/j.qi.a36385
Nosrat A, Nekoofar MH, Bolhari B, et al. Unintentional extrusion of mineral trioxide aggregate: a report of three cases. International Endodontic Journal. 2012;45(12):1165-76. doi: 10.1111/j.1365-2591.2012.02082.x
Asgary S, Fayazi S. Endodontic Surgery of a Symptomatic Overfilled MTA Apical Plug: A Histological and Clinical Case Report. Iranian Endodontic Journal. 2017;12(3):376-380. doi: 10.22037/iej.v12i3.17689
Tahan E, Celik D, Er K, et al. Effect of unintentionally extruded mineral trioxide aggregate in treatment of tooth with periradicular lesion: a case report. Journal of Endodontics. 2010;36(4):760-3. doi: 10.1016/j.joen.2009.11.026
Nagmode PS, Satpute AB, Patel AV, et al. The Effect of Mineral Trioxide Aggregate on the Periapical Tissues after Unintentional Extrusion beyond the Apical Foramen. Case Reports in Dentistry. 2016;2016:3590680.
doi: 10.1155/2016/3590680
da Silva EJNL, Versiani MA. The paradox of calcium silicate-based sealers: a reflection on bioactivity, solubility and clinical meaning. International Endodontic Journal. 2025.
doi: 10.1111/iej.70083
