Endodontik Tedavide Hidrolik Materyaller
Özet
Bu bölüm, endodontik tedavilerde giderek daha fazla kullanılan hidrolik kalsiyum silikat bazlı materyallerin (HCSCs) temel özelliklerini ve klinik önemini ele almaktadır. Biyoaktif karakterleri sayesinde bu materyaller yalnızca fiziksel bir bariyer oluşturmakla kalmayıp aynı zamanda sert doku oluşumunu teşvik ederek biyolojik iyileşme süreçlerine katkıda bulunmaktadır. Bölümde öncelikle HCSCs’nin kimyasal bileşimi ve hidrasyon reaksiyonuna dayanan sertleşme mekanizması açıklanmakta, ardından güncel literatürde kabul gören sınıflandırma sistemleri sunulmaktadır. Mineral trioksit agregat (MTA) ve modifikasyonları, sentetik trikalsiyum silikat esaslı materyaller, premixed biyoseramik sistemler ve rezin modifiye hibrit materyaller klinik özellikleri ve kullanım alanları açısından karşılaştırmalı olarak değerlendirilmektedir. Ayrıca priz süresi, mekanik dayanım, çözünürlük, radyopasite ve dentine bağlanma gibi fiziksel özellikler ile biyouyumluluk, biyoaktivite ve sert doku indüksiyonu gibi biyolojik etkiler incelenmektedir. Bölüm, farklı materyal sistemlerinin avantaj ve sınırlılıklarını ortaya koyarak klinik endikasyona uygun materyal seçiminin önemini vurgulamaktadır.
This chapter reviews the fundamental characteristics and clinical relevance of hydraulic calcium silicate–based materials (HCSCs) in endodontic therapy. Owing to their bioactive nature, these materials not only function as sealing agents but also promote biological healing by stimulating hard tissue formation. The chapter first describes the chemical composition of HCSCs and their hydration-based setting mechanism, followed by an overview of contemporary classification systems reported in the literature. Major material groups—including mineral trioxide aggregate (MTA) and its modifications, synthetic tricalcium silicate–based materials, premixed bioceramic systems, and resin-modified hybrid materials—are comparatively evaluated in terms of their composition and clinical indications. In addition, key physical properties such as setting time, mechanical strength, solubility, radiopacity, and dentin bonding are discussed alongside biological aspects including biocompatibility, bioactivity, and hard tissue induction. By highlighting the advantages and limitations of different material systems, the chapter emphasizes the importance of evidence-based material selection according to specific clinical indications in endodontic practice.
Referanslar
Sanz JL, Rodríguez-Lozano FJ, Lopez-Gines C, et al. Dental stem cell signaling pathway activation in response to hydraulic calcium silicate-based endodontic cements: A systematic review of in vitro studies. Dental Materials. 2021;37(4): e256-e268. doi:10.1016/j.dental.2021.01.025
Prati C, Gandolfi MG. Calcium silicate bioactive cements: Biological perspectives and clinical applications. Dental Materials. 2015;31(4): 351-370. doi:10.1016/j.dental.2015.01.004
Camilleri J, Atmeh A, Li X, et al. Present status and future directions: Hydraulic materials for endodontic use. International Endodontic Journal. 2022;55 Suppl 3(Suppl 3): 710-777. doi:10.1111/iej.13709
Cardinali F, Camilleri J. A critical review of the material properties guiding the clinician's choice of root canal sealers. Clinical Oral Investigations. 2023;27(8): 4147-4155. doi:10.1007/s00784-023-05140-w
Witte D. The filling of a root canal with Portland cement. J Cent Assoc Ger Dent. 1878;18(153-154.
Viola NV, Tanomaru Filho M, Cerri PS. MTA versus Portland cement: review of literature. Revista Sul-Brasileira de Odontologia. 2011;8(4): 446-452.
Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. Journal of Endodontics. 1993;19(12): 591-595. doi:10.1016/s0099-2399(06)80271-2
Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. Journal of Endodontics. 1993;19(11): 541-544. doi:10.1016/s0099-2399(06)81282-3
Niu LN, Jiao K, Wang TD, et al. A review of the bioactivity of hydraulic calcium silicate cements. Journal of Dentistry. 2014;42(5): 517-533. doi:10.1016/j.jdent.2013.12.015
Camilleri J. Classification of hydraulic cements used in dentistry. Frontiers in Dental Medicine. 2020;1(9.
Eskandari F, Razavian A, Hamidi R, et al. An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy. International Dental Journal. 2022;2022(6858088. doi:10.1155/2022/6858088
Dutta A, Saunders WP. Calcium silicate materials in endodontics. Dental Update. 2014;41(8): 708-722.
Islam I, Chng HK, Yap AU. Comparison of the physical and mechanical properties of MTA and portland cement. Journal of Endodontics. 2006;32(3): 193-197. doi:10.1016/j.joen.2005.10.043
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. Journal of Endodontics. 2010;36(1): 16-27. doi:10.1016/j.joen.2009.09.006
Parirokh M, Torabinejad M. Calcium silicate–based cements. In: (ed.) Mineral trioxide aggregate: Properties and clinical applications. 2014. p. 281-332.
Camilleri J. The chemical composition of mineral trioxide aggregate. Journal of Conservative Dentistry and Endodontics. 2008;11(4): 141-143.
Asgary S, Parirokh M, Eghbal MJ, et al. Chemical differences between white and gray mineral trioxide aggregate. Journal of Endodontics. 2005;31(2): 101-103. doi:10.1097/01.don.0000133156.85164.b2
Camilleri J, Montesin FE, Brady K, et al. The constitution of mineral trioxide aggregate. Dental Materials. 2005;21(4): 297-303. doi:10.1016/j.dental.2004.05.010
Kogan P, He J, Glickman GN, et al. The effects of various additives on setting properties of MTA. Journal of Endodontics. 2006;32(6): 569-572.
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. Journal of Endodontics. 2010;36(3): 400-413. doi:10.1016/j.joen.2009.09.009
Oliveira MG, Xavier CB, Demarco FF, et al. Comparative chemical study of MTA and Portland cements. Brazilian Dental Journal. 2007;18(1): 3-7. doi:10.1590/s0103-64402007000100002
Madfa AA, Al-Sanabani FA, Al-Kudami NH. Endodontic repair filling materials: A review article. British Journal of Medicine and Medical Research. 2014;4(16): 3059-3079.
Grech L, Mallia B, Camilleri J. Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials. Dental Materials. 2013;29(2): e20-28. doi:10.1016/j.dental.2012.11.007
Grech L, Mallia B, Camilleri J. Characterization of set Intermediate Restorative Material, Biodentine, Bioaggregate and a prototype calcium silicate cement for use as root-end filling materials. International Endodontic Journal. 2013;46(7): 632-641. doi:10.1111/iej.12039
Shokouhinejad N, Nekoofar MH, Razmi H, et al. Bioactivity of EndoSequence root repair material and bioaggregate. International Endodontic Journal. 2012;45(12): 1127-1134. doi:10.1111/j.1365-2591.2012.02083.x
Arandi NZ, Thabet M. Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material. BioMed Research International. 2021;2021(5569313. doi:10.1155/2021/5569313
Koutroulis A, Kapralos V, Ørstavik D, et al. Root-filling materials for endodontic surgery: biological and clinical aspects. Biomaterial Investigations in Dentistry. 2024;11(42172. doi:10.2340/biid.v11.42172
Yune JY, Lee D, Kim SY. The Combined Effects of Hydraulic Calcium Silicate Cement and Enamel Matrix Derivative Regarding Osteogenic and Dentinogenic Differentiation on Human Dental Pulp Stem Cells. Materials (Basel). 2023;16(11): doi:10.3390/ma16114003
Schuster L, Sielker S, Kleinheinz J, et al. Effect of light-cured pulp capping materials on human dental pulp cells in vitro. International Endodontic Journal. 2025;58(7): 1060-1072. doi:10.1111/iej.14242
Pedano MS, Li X, Li S, et al. Freshly-mixed and setting calcium-silicate cements stimulate human dental pulp cells. Dental Materials. 2018;34(5): 797-808. doi:10.1016/j.dental.2018.02.005
Setzer FC, Kratchman SI. Present status and future directions: Surgical endodontics. International Endodontic Journal. 2022;55 Suppl 4(1020-1058. doi:10.1111/iej.13783
Rajasekharan S, Martens LC, Cauwels R, et al. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. European Archives of Paediatric Dentistry. 2018;19(1): 1-22. doi:10.1007/s40368-018-0328-x
Kebudi Benezra M, Schembri Wismayer P, Camilleri J. Interfacial Characteristics and Cytocompatibility of Hydraulic Sealer Cements. Journal of Endodontics. 2018;44(6): 1007-1017. doi:10.1016/j.joen.2017.11.011
Hansen SW, Marshall JG, Sedgley CM. Comparison of intracanal EndoSequence Root Repair Material and ProRoot MTA to induce pH changes in simulated root resorption defects over 4 weeks in matched pairs of human teeth. Journal of Endodontics. 2011;37(4): 502-506. doi:10.1016/j.joen.2011.01.010
Zhou HM, Shen Y, Zheng W, et al. Physical properties of 5 root canal sealers. Journal of Endodontics. 2013;39(10): 1281-1286. doi:10.1016/j.joen.2013.06.012
Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering (Basel). 2023;10(3): doi:10.3390/bioengineering10030354
Ree M, Schwartz R. Clinical applications of bioceramics materials in endodontics. Endodontic Practice. 2014;7(32-40.
Jiang Y, Zheng Q, Zhou X, et al. A comparative study on root canal repair materials: a cytocompatibility assessment in L929 and MG63 cells. Scientific World Journal. 2014;2014(463826. doi:10.1155/2014/463826
Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. International Endodontic Journal. 2012;45(6): 571-579. doi:10.1111/j.1365-2591.2012.02013.x
Qureshi A, E S, Nandakumar, et al. Recent advances in pulp capping materials: an overview. Journal of Clinical and Diagnostic Research. 2014;8(1): 316-321. doi:10.7860/jcdr/2014/7719.3980
Jeanneau C, Laurent P, Rombouts C, et al. Light-cured Tricalcium Silicate Toxicity to the Dental Pulp. Journal of Endodontics. 2017;43(12): 2074-2080. doi:10.1016/j.joen.2017.07.010
Assmann E, Scarparo RK, Böttcher DE, et al. Dentin bond strength of two mineral trioxide aggregate-based and one epoxy resin-based sealers. Journal of Endodontics. 2012;38(2): 219-221. doi:10.1016/j.joen.2011.10.018
Gandolfi MG, Taddei P, Siboni F, et al. Development of the foremost light-curable calcium-silicate MTA cement as root-end in oral surgery. Chemical-physical properties, bioactivity and biological behavior. Dental Materials. 2011;27(7): e134-157. doi:10.1016/j.dental.2011.03.011
Gancedo-Caravia L, Garcia-Barbero E. Influence of humidity and setting time on the push-out strength of mineral trioxide aggregate obturations. Journal of Endodontics. 2006;32(9): 894-896. doi:10.1016/j.joen.2006.03.004
Walsh RM, Woodmansey KF, Glickman GN, et al. Evaluation of compressive strength of hydraulic silicate-based root-end filling materials. Journal of Endodontics. 2014;40(7): 969-972. doi:10.1016/j.joen.2013.11.018
Camilleri J, Sorrentino F, Damidot D. Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, Biodentine and MTA Angelus. Dental Materials. 2013;29(5): 580-593. doi:10.1016/j.dental.2013.03.007
Nekoofar MH, Stone DF, Dummer PM. The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate. International Endodontic Journal. 2010;43(9): 782-791. doi:10.1111/j.1365-2591.2010.01745.x
Torabinejad M, Higa RK, McKendry DJ, et al. Dye leakage of four root end filling materials: effects of blood contamination. Journal of Endodontics. 1994;20(4): 159-163. doi:10.1016/s0099-2399(06)80326-2
Iacono F, Gandolfi MG, Huffman B, et al. Push-out strength of modified Portland cements and resins. American Journal of Dentistry. 2010;23(1): 43-46.
Dawood AE, Manton DJ, Parashos P, et al. The physical properties and ion release of CPP-ACP-modified calcium silicate-based cements. Australian Dental Journal. 2015;60(4): 434-444. doi:10.1111/adj.12255
Gandolfi MG, Siboni F, Botero T, et al. Calcium silicate and calcium hydroxide materials for pulp capping: biointeractivity, porosity, solubility and bioactivity of current formulations. Journal of Applied Biomaterials and Functional Materials. 2015;13(1): 43-60. doi:10.5301/jabfm.5000201
Marciano MA, Costa RM, Camilleri J, et al. Assessment of color stability of white mineral trioxide aggregate angelus and bismuth oxide in contact with tooth structure. Journal of Endodontics. 2014;40(8): 1235-1240. doi:10.1016/j.joen.2014.01.044
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Staffoli S, Plotino G, Nunez Torrijos BG, et al. Regenerative Endodontic Procedures Using Contemporary Endodontic Materials. Materials (Basel). 2019;12(6): doi:10.3390/ma12060908
Herbst SR, Pitchika V, Herbst CS, et al. Effectiveness of calcium hydroxide compared to hydraulic calcium silicate cements for direct pulp capping in managing deep caries in vital permanent teeth: A systematic review and meta-analysis. International Endodontic Journal. 2025;58(8): 1110-1125. doi:10.1111/iej.14256
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Referanslar
Sanz JL, Rodríguez-Lozano FJ, Lopez-Gines C, et al. Dental stem cell signaling pathway activation in response to hydraulic calcium silicate-based endodontic cements: A systematic review of in vitro studies. Dental Materials. 2021;37(4): e256-e268. doi:10.1016/j.dental.2021.01.025
Prati C, Gandolfi MG. Calcium silicate bioactive cements: Biological perspectives and clinical applications. Dental Materials. 2015;31(4): 351-370. doi:10.1016/j.dental.2015.01.004
Camilleri J, Atmeh A, Li X, et al. Present status and future directions: Hydraulic materials for endodontic use. International Endodontic Journal. 2022;55 Suppl 3(Suppl 3): 710-777. doi:10.1111/iej.13709
Cardinali F, Camilleri J. A critical review of the material properties guiding the clinician's choice of root canal sealers. Clinical Oral Investigations. 2023;27(8): 4147-4155. doi:10.1007/s00784-023-05140-w
Witte D. The filling of a root canal with Portland cement. J Cent Assoc Ger Dent. 1878;18(153-154.
Viola NV, Tanomaru Filho M, Cerri PS. MTA versus Portland cement: review of literature. Revista Sul-Brasileira de Odontologia. 2011;8(4): 446-452.
Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. Journal of Endodontics. 1993;19(12): 591-595. doi:10.1016/s0099-2399(06)80271-2
Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. Journal of Endodontics. 1993;19(11): 541-544. doi:10.1016/s0099-2399(06)81282-3
Niu LN, Jiao K, Wang TD, et al. A review of the bioactivity of hydraulic calcium silicate cements. Journal of Dentistry. 2014;42(5): 517-533. doi:10.1016/j.jdent.2013.12.015
Camilleri J. Classification of hydraulic cements used in dentistry. Frontiers in Dental Medicine. 2020;1(9.
Eskandari F, Razavian A, Hamidi R, et al. An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy. International Dental Journal. 2022;2022(6858088. doi:10.1155/2022/6858088
Dutta A, Saunders WP. Calcium silicate materials in endodontics. Dental Update. 2014;41(8): 708-722.
Islam I, Chng HK, Yap AU. Comparison of the physical and mechanical properties of MTA and portland cement. Journal of Endodontics. 2006;32(3): 193-197. doi:10.1016/j.joen.2005.10.043
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. Journal of Endodontics. 2010;36(1): 16-27. doi:10.1016/j.joen.2009.09.006
Parirokh M, Torabinejad M. Calcium silicate–based cements. In: (ed.) Mineral trioxide aggregate: Properties and clinical applications. 2014. p. 281-332.
Camilleri J. The chemical composition of mineral trioxide aggregate. Journal of Conservative Dentistry and Endodontics. 2008;11(4): 141-143.
Asgary S, Parirokh M, Eghbal MJ, et al. Chemical differences between white and gray mineral trioxide aggregate. Journal of Endodontics. 2005;31(2): 101-103. doi:10.1097/01.don.0000133156.85164.b2
Camilleri J, Montesin FE, Brady K, et al. The constitution of mineral trioxide aggregate. Dental Materials. 2005;21(4): 297-303. doi:10.1016/j.dental.2004.05.010
Kogan P, He J, Glickman GN, et al. The effects of various additives on setting properties of MTA. Journal of Endodontics. 2006;32(6): 569-572.
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. Journal of Endodontics. 2010;36(3): 400-413. doi:10.1016/j.joen.2009.09.009
Oliveira MG, Xavier CB, Demarco FF, et al. Comparative chemical study of MTA and Portland cements. Brazilian Dental Journal. 2007;18(1): 3-7. doi:10.1590/s0103-64402007000100002
Madfa AA, Al-Sanabani FA, Al-Kudami NH. Endodontic repair filling materials: A review article. British Journal of Medicine and Medical Research. 2014;4(16): 3059-3079.
Grech L, Mallia B, Camilleri J. Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials. Dental Materials. 2013;29(2): e20-28. doi:10.1016/j.dental.2012.11.007
Grech L, Mallia B, Camilleri J. Characterization of set Intermediate Restorative Material, Biodentine, Bioaggregate and a prototype calcium silicate cement for use as root-end filling materials. International Endodontic Journal. 2013;46(7): 632-641. doi:10.1111/iej.12039
Shokouhinejad N, Nekoofar MH, Razmi H, et al. Bioactivity of EndoSequence root repair material and bioaggregate. International Endodontic Journal. 2012;45(12): 1127-1134. doi:10.1111/j.1365-2591.2012.02083.x
Arandi NZ, Thabet M. Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material. BioMed Research International. 2021;2021(5569313. doi:10.1155/2021/5569313
Koutroulis A, Kapralos V, Ørstavik D, et al. Root-filling materials for endodontic surgery: biological and clinical aspects. Biomaterial Investigations in Dentistry. 2024;11(42172. doi:10.2340/biid.v11.42172
Yune JY, Lee D, Kim SY. The Combined Effects of Hydraulic Calcium Silicate Cement and Enamel Matrix Derivative Regarding Osteogenic and Dentinogenic Differentiation on Human Dental Pulp Stem Cells. Materials (Basel). 2023;16(11): doi:10.3390/ma16114003
Schuster L, Sielker S, Kleinheinz J, et al. Effect of light-cured pulp capping materials on human dental pulp cells in vitro. International Endodontic Journal. 2025;58(7): 1060-1072. doi:10.1111/iej.14242
Pedano MS, Li X, Li S, et al. Freshly-mixed and setting calcium-silicate cements stimulate human dental pulp cells. Dental Materials. 2018;34(5): 797-808. doi:10.1016/j.dental.2018.02.005
Setzer FC, Kratchman SI. Present status and future directions: Surgical endodontics. International Endodontic Journal. 2022;55 Suppl 4(1020-1058. doi:10.1111/iej.13783
Rajasekharan S, Martens LC, Cauwels R, et al. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. European Archives of Paediatric Dentistry. 2018;19(1): 1-22. doi:10.1007/s40368-018-0328-x
Kebudi Benezra M, Schembri Wismayer P, Camilleri J. Interfacial Characteristics and Cytocompatibility of Hydraulic Sealer Cements. Journal of Endodontics. 2018;44(6): 1007-1017. doi:10.1016/j.joen.2017.11.011
Hansen SW, Marshall JG, Sedgley CM. Comparison of intracanal EndoSequence Root Repair Material and ProRoot MTA to induce pH changes in simulated root resorption defects over 4 weeks in matched pairs of human teeth. Journal of Endodontics. 2011;37(4): 502-506. doi:10.1016/j.joen.2011.01.010
Zhou HM, Shen Y, Zheng W, et al. Physical properties of 5 root canal sealers. Journal of Endodontics. 2013;39(10): 1281-1286. doi:10.1016/j.joen.2013.06.012
Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering (Basel). 2023;10(3): doi:10.3390/bioengineering10030354
Ree M, Schwartz R. Clinical applications of bioceramics materials in endodontics. Endodontic Practice. 2014;7(32-40.
Jiang Y, Zheng Q, Zhou X, et al. A comparative study on root canal repair materials: a cytocompatibility assessment in L929 and MG63 cells. Scientific World Journal. 2014;2014(463826. doi:10.1155/2014/463826
Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. International Endodontic Journal. 2012;45(6): 571-579. doi:10.1111/j.1365-2591.2012.02013.x
Qureshi A, E S, Nandakumar, et al. Recent advances in pulp capping materials: an overview. Journal of Clinical and Diagnostic Research. 2014;8(1): 316-321. doi:10.7860/jcdr/2014/7719.3980
Jeanneau C, Laurent P, Rombouts C, et al. Light-cured Tricalcium Silicate Toxicity to the Dental Pulp. Journal of Endodontics. 2017;43(12): 2074-2080. doi:10.1016/j.joen.2017.07.010
Assmann E, Scarparo RK, Böttcher DE, et al. Dentin bond strength of two mineral trioxide aggregate-based and one epoxy resin-based sealers. Journal of Endodontics. 2012;38(2): 219-221. doi:10.1016/j.joen.2011.10.018
Gandolfi MG, Taddei P, Siboni F, et al. Development of the foremost light-curable calcium-silicate MTA cement as root-end in oral surgery. Chemical-physical properties, bioactivity and biological behavior. Dental Materials. 2011;27(7): e134-157. doi:10.1016/j.dental.2011.03.011
Gancedo-Caravia L, Garcia-Barbero E. Influence of humidity and setting time on the push-out strength of mineral trioxide aggregate obturations. Journal of Endodontics. 2006;32(9): 894-896. doi:10.1016/j.joen.2006.03.004
Walsh RM, Woodmansey KF, Glickman GN, et al. Evaluation of compressive strength of hydraulic silicate-based root-end filling materials. Journal of Endodontics. 2014;40(7): 969-972. doi:10.1016/j.joen.2013.11.018
Camilleri J, Sorrentino F, Damidot D. Investigation of the hydration and bioactivity of radiopacified tricalcium silicate cement, Biodentine and MTA Angelus. Dental Materials. 2013;29(5): 580-593. doi:10.1016/j.dental.2013.03.007
Nekoofar MH, Stone DF, Dummer PM. The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate. International Endodontic Journal. 2010;43(9): 782-791. doi:10.1111/j.1365-2591.2010.01745.x
Torabinejad M, Higa RK, McKendry DJ, et al. Dye leakage of four root end filling materials: effects of blood contamination. Journal of Endodontics. 1994;20(4): 159-163. doi:10.1016/s0099-2399(06)80326-2
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