MTA Modifikasyonunda Kullanılan Nanopartiküller
Özet
Mineral trioksit agregat (MTA), biyouyumluluğu, sızdırmazlık özelliği ve sert doku oluşumunu destekleyen biyolojik özellikleri ile endodontide yaygın olarak kullanılan kalsiyum silikat esaslı bir biyoseramik materyaldir. Bununla birlikte uzun sertleşme süresi, sınırlı mekanik dayanım ve bazı fiziksel özelliklere bağlı klinik kısıtlılıklar nedeniyle MTA’nın geliştirilmesine yönelik çeşitli yaklaşımlar araştırılmaktadır. Son yıllarda nanoteknolojideki gelişmeler, dental biyomateryallerin modifikasyonu ve performansının artırılması için önemli fırsatlar sunmaktadır. Bu bölümde MTA’nın farklı nanopartiküller ile güçlendirilmesine yönelik güncel yaklaşımlar ele alınmaktadır. Gümüş, selenyum, hidroksiapatit, çinko oksit, kalsiyum karbonat, titanyum dioksit, silikon dioksit, biyocam ve hekzagonal bor nitrür gibi nanopartiküllerin MTA’nın fiziksel, mekanik ve biyolojik özellikleri üzerindeki etkileri literatür ışığında değerlendirilmiştir. Nanopartiküllerin yüksek yüzey alanı ve reaktivitesi sayesinde antibakteriyel etkinliğin artırılması, sertleşme süresinin azaltılması, mekanik dayanımın geliştirilmesi ve biyolojik yanıtın iyileştirilmesi gibi potansiyel avantajlar sağladığı bildirilmektedir. Bununla birlikte nanopartikül konsantrasyonu, partikül boyutu ve materyal formülasyonu gibi faktörlerin materyal performansını önemli ölçüde etkileyebildiği görülmektedir. Bu nedenle nanopartikül modifikasyonunun klinik uygulamalara aktarılabilmesi için daha kapsamlı deneysel ve klinik araştırmalara ihtiyaç bulunmaktadır.
Mineral trioxide aggregate (MTA) is a calcium silicate–based bioceramic material widely used in endodontics due to its excellent biocompatibility, sealing ability, and capacity to promote hard tissue formation. However, certain limitations such as prolonged setting time, relatively low mechanical strength, and handling difficulties have prompted researchers to explore strategies to enhance its physicochemical and biological properties. Recent advances in nanotechnology have provided promising opportunities for modifying dental biomaterials and improving their clinical performance. This chapter focuses on the reinforcement of MTA using various nanoparticles and reviews current developments in this field. Nanoparticles including silver, selenium, hydroxyapatite, zinc oxide, calcium carbonate, titanium dioxide, silicon dioxide, bioactive glass, and hexagonal boron nitride are discussed in terms of their influence on the physical, mechanical, and biological properties of MTA. Due to their high surface area and increased reactivity, nanoparticles may improve antimicrobial activity, reduce setting time, enhance mechanical strength, and promote favorable biological responses. Nevertheless, the effects of nanoparticle incorporation largely depend on factors such as particle size, concentration, and material formulation. Therefore, further in vitro, in vivo, and clinical studies are required to determine optimal formulations and to fully clarify the long-term safety and effectiveness of nanoparticle-modified MTA materials in endodontic practice.
Referanslar
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.
Dong X, Xu X. Bioceramics in endodontics: updates and future perspectives. Bioengineering. 2023;10(3):354.
Mohammadi Z, Shalavi S, Soltani MK. Mineral trioxide aggregate (MTA)-like materials: an update review. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995). 2014;35(8):557-61: quiz 62.
Estrela C, Cintra LTA, Duarte MAH, et al. Mechanism of action of bioactive endodontic materials. Brazilian Dental Journal. 2023;34(1):1-11.
Huang T-H, Shie M-Y, Kao C-T, et al. The effect of setting accelerator on properties of mineral trioxide aggregate. Journal of endodontics. 2008;34(5):590-3.
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.
Pushpalatha C, Dhareshwar V, Sowmya S, et al. Modified mineral trioxide aggregate—A versatile dental material: An insight on applications and newer advancements. Frontiers in bioengineering and biotechnology. 2022;10:941826.
Morita M, Kitagawa H, Nakayama K, et al. Antibacterial activities and mineral induction abilities of proprietary MTA cements. Dental Materials Journal. 2021;40(2):297-303.
Bolhari B, Sooratgar A, Pourhajibagher M, et al. Evaluation of the antimicrobial effect of mineral trioxide aggregate mixed with fluorohydroxyapatite against E. faecalis in vitro. The Scientific World Journal. 2021;2021(1):6318690.
Saghiri M, Asgar K, Lotfi M, et al. Nanomodification of mineral trioxide aggregate for enhanced physiochemical properties. International endodontic journal. 2012;45(11):979-88.
Saghiri MA, Asatourian A, Orangi J, et al. Effect of particle size on calcium release and elevation of pH of endodontic cements. Dental Traumatology. 2015;31(3):196-201.
Kıvanç M, Barutca B, Koparal AT, et al. Effects of hexagonal boron nitride nanoparticles on antimicrobial and antibiofilm activities, cell viability. Materials Science and Engineering: C. 2018;91:115-24.
Vandekar M, Pendse G, Toprani N, et al. Evaluation of antimicrobial efficacy of mineral trioxide aggregate with and without silver nanoparticles: A systematic review and meta-analysis. Journal of Conservative Dentistry and Endodontics. 2025;28(9):859-66.
Samiei M, Aghazadeh M, Lotfi M, et al. Antimicrobial efficacy of mineral trioxide aggregate with and without silver nanoparticles. Iranian endodontic journal. 2013;8(4):166.
Jonaidi-Jafari N, Izadi M, Javidi P. The effects of silver nanoparticles on antimicrobial activity of ProRoot mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM). Journal of Clinical and Experimental Dentistry. 2016;8(1):e22.
Mousavi SM, Hashemi SA, Ghasemi Y, et al. Green synthesis of silver nanoparticles toward bio and medical applications: review study. Artificial cells, nanomedicine, and biotechnology. 2018;46(sup3):855-72.
Hong X, Wen J, Xiong X, et al. Shape effect on the antibacterial activity of silver nanoparticles synthesized via a microwave-assisted method. Environmental science and pollution research. 2016;23(5):4489-97.
Bélteky P, Rónavári A, Zakupszky D, et al. Are smaller nanoparticles always better? Understanding the biological effect of size-dependent silver nanoparticle aggregation under biorelevant conditions. International journal of nanomedicine. 2021:3021-40.
Zand V, Lotfi M, Aghbali A, et al. Tissue reaction and biocompatibility of implanted mineral trioxide aggregate with silver nanoparticles in a rat model. Iranian endodontic journal. 2015;11(1):13.
Samiei M, Adibkia K, Ghasemi N, et al. Effect of Silver Nanoparticles of Herbal Origin on the Compressive and Push-out Bond Strengths of Mineral Trioxide Aggregate. Iranian endodontic journal. 2023;18(3):159.
Oncu A, Huang Y, Amasya G, et al. Silver nanoparticles in endodontics: recent developments and applications. Restorative Dentistry & Endodontics. 2021;46(3).
Gladyshev VN, Arnér ES, Berry MJ, et al. Selenoprotein gene nomenclature. Journal of Biological Chemistry. 2016;291(46):24036-40.
Hosnedlova B, Kepinska M, Skalickova S, et al. Nano-selenium and its nanomedicine applications: a critical review. International journal of nanomedicine. 2018:2107-28.
Bisht N, Phalswal P, Khanna PK. Selenium nanoparticles: A review on synthesis and biomedical applications. Materials Advances. 2022;3(3):1415-31.
Kumar H, Bhardwaj K, Nepovimova E, et al. Antioxidant functionalized nanoparticles: A combat against oxidative stress. Nanomaterials. 2020;10(7):1334.
Wang H, Zhang J, Yu H. Elemental selenium at nano size possesses lower toxicity without compromising the fundamental effect on selenoenzymes: comparison with selenomethionine in mice. Free Radical Biology and Medicine. 2007;42(10):1524-33.
Shehab NF, Hasan NH, Ismail HK. Investigating the effect of selenium nanoparticles on mineral trioxide aggregates as a promising novel dental material. Journal of International Society of Preventive and Community Dentistry. 2024;14(1):16-27.
Doğan MS. Relation of trace elements on dental health. Trace Elements-Human Health and Environment. 2018:5.
Shehab NF, Hasan NH, Ismail HK. Investigating the Alkaline Potential of Mineral Trioxide Aggregate Repair Using Selenium Nanoparticles. Brazilian Dental Journal. 2024;35:e24-5760.
Vu TT, Nguyen PTM, Pham NH, et al. Green synthesis of selenium nanoparticles using Cleistocalyx operculatus leaf extract and their acute oral toxicity study. Journal of composites Science. 2022;6(10):307.
Joudeh N, Linke D. Nanoparticle classification, physicochemical properties, characterization, and applications: a comprehensive review for biologists. Journal of nanobiotechnology. 2022;20(1):262.
Rayman MP. Selenium and human health. The Lancet. 2012;379(9822):1256-68.
Menon S, Ks SD, Kumar V. Selenium nanoparticles: A potent chemotherapeutic agent and an elucidation of its mechanism. Colloids and Surfaces B: Biointerfaces. 2018;170:280-92.
Khurana A, Tekula S, Saifi MA, et al. Therapeutic applications of selenium nanoparticles. Biomedicine & Pharmacotherapy. 2019;111:802-12.
Mondal S, Park S, Choi J, et al. Hydroxyapatite: A journey from biomaterials to advanced functional materials. Advances in colloid and interface science. 2023;321:103013.
Sipert CR, Hussne RP, Nishiyama CK, et al. In vitro antimicrobial activity of fill canal, sealapex, mineral trioxide aggregate, Portland cement and endorez. International endodontic journal. 2005;38(8):539-43.
Akbarpour MR, Farajnezhad F, Poureshagh AH, et al. Effects of Copper Doping on Fluorohydroxyapatite Coating: Analysis of Microstructure, Biocompatibility, Corrosion Resistance, and Cell Adhesion Characteristics. Inorganic Chemistry. 2024;63(43):20314-24.
Bolhari B, Chitsaz N, Nazari S, et al. Effect of fluorohydroxyapatite on biological and physical properties of MTA angelus. The Scientific World Journal. 2023;2023(1):7532898.
Eskandarinezhad M, Ghodrati M, Azar FP, et al. Effect of incorporating hydroxyapatite and zinc oxide nanoparticles on the compressive strength of white mineral trioxide aggregate. Journal of dentistry. 2020;21(4):300.
Pushpalatha C, Suresh J, Gayathri V, et al. Zinc oxide nanoparticles: a review on its applications in dentistry. Frontiers in bioengineering and biotechnology. 2022;10:917990.
Baek M, Chung H-E, Yu J, et al. Pharmacokinetics, tissue distribution, and excretion of zinc oxide nanoparticles. International journal of nanomedicine. 2012:3081-97.
Guerreiro-Tanomaru JM, Figueiredo Pereira K, Almeida Nascimento C, et al. Use of nanoparticulate zinc oxide as intracanal medication in endodontics: pH and antimicrobial activity. Acta Odontológica Latinoamericana. 2013;26(3):167-72.
Prada I, Micó-Muñoz P, Giner-Lluesma T, et al. Influence of microbiology on endodontic failure. Literature review. Medicina oral, patologia oral y cirugia bucal. 2019;24(3):e364.
Bianchini Fulindi R, Domingues Rodrigues J, Lemos Barbosa TW, et al. Zinc-based nanoparticles reduce bacterial biofilm formation. Microbiology Spectrum. 2023;11(2):e04831-22.
Nair N, James B, Devadathan A, et al. Comparative Evaluation of Antibiofilm Efficacy of Chitosan Nanoparticle-and Zinc Oxide Nanoparticle-Incorporated Calcium Hydroxide-Based Sealer: An: In vitro: Study. Contemporary clinical dentistry. 2018;9(3):434-9.
Rengaraj K, Paramasivan M, Perumal G, et al. Nanotechnology-based electrochemical approach for effective root canal irrigation. Journal of Microbiological Methods. 2025:107189.
Vaidya S, Joshi M, Ghosh S, et al. Bioactive ZnO Decorated PVDF‐Based Piezoelectric, Osteoconductive Nanofibrous Coatings for Orthopedic Implants. Journal of Biomedical Materials Research Part A. 2025;113(8):e37971.
Azimi R, Shahgholi M, Khandan A. Fabrication and characterization of reinforced glass ionomer cement by zinc oxide and hydroxyapatite nanoparticles. Heliyon. 2024;10(20).
Sirelkhatim A, Mahmud S, Seeni A, et al. Review on zinc oxide nanoparticles: antibacterial activity and toxicity mechanism. Nano-micro letters. 2015;7(3):219-42.
Camilleri J. Hydration mechanisms of mineral trioxide aggregate. International endodontic journal. 2007;40(6):462-70.
Kakali G, Tsivilis S, Aggeli E, et al. Hydration products of C3A, C3S and Portland cement in the presence of CaCO3. Cement and concrete Research. 2000;30(7):1073-7.
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Referanslar
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.
Dong X, Xu X. Bioceramics in endodontics: updates and future perspectives. Bioengineering. 2023;10(3):354.
Mohammadi Z, Shalavi S, Soltani MK. Mineral trioxide aggregate (MTA)-like materials: an update review. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995). 2014;35(8):557-61: quiz 62.
Estrela C, Cintra LTA, Duarte MAH, et al. Mechanism of action of bioactive endodontic materials. Brazilian Dental Journal. 2023;34(1):1-11.
Huang T-H, Shie M-Y, Kao C-T, et al. The effect of setting accelerator on properties of mineral trioxide aggregate. Journal of endodontics. 2008;34(5):590-3.
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.
Pushpalatha C, Dhareshwar V, Sowmya S, et al. Modified mineral trioxide aggregate—A versatile dental material: An insight on applications and newer advancements. Frontiers in bioengineering and biotechnology. 2022;10:941826.
Morita M, Kitagawa H, Nakayama K, et al. Antibacterial activities and mineral induction abilities of proprietary MTA cements. Dental Materials Journal. 2021;40(2):297-303.
Bolhari B, Sooratgar A, Pourhajibagher M, et al. Evaluation of the antimicrobial effect of mineral trioxide aggregate mixed with fluorohydroxyapatite against E. faecalis in vitro. The Scientific World Journal. 2021;2021(1):6318690.
Saghiri M, Asgar K, Lotfi M, et al. Nanomodification of mineral trioxide aggregate for enhanced physiochemical properties. International endodontic journal. 2012;45(11):979-88.
Saghiri MA, Asatourian A, Orangi J, et al. Effect of particle size on calcium release and elevation of pH of endodontic cements. Dental Traumatology. 2015;31(3):196-201.
Kıvanç M, Barutca B, Koparal AT, et al. Effects of hexagonal boron nitride nanoparticles on antimicrobial and antibiofilm activities, cell viability. Materials Science and Engineering: C. 2018;91:115-24.
Vandekar M, Pendse G, Toprani N, et al. Evaluation of antimicrobial efficacy of mineral trioxide aggregate with and without silver nanoparticles: A systematic review and meta-analysis. Journal of Conservative Dentistry and Endodontics. 2025;28(9):859-66.
Samiei M, Aghazadeh M, Lotfi M, et al. Antimicrobial efficacy of mineral trioxide aggregate with and without silver nanoparticles. Iranian endodontic journal. 2013;8(4):166.
Jonaidi-Jafari N, Izadi M, Javidi P. The effects of silver nanoparticles on antimicrobial activity of ProRoot mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM). Journal of Clinical and Experimental Dentistry. 2016;8(1):e22.
Mousavi SM, Hashemi SA, Ghasemi Y, et al. Green synthesis of silver nanoparticles toward bio and medical applications: review study. Artificial cells, nanomedicine, and biotechnology. 2018;46(sup3):855-72.
Hong X, Wen J, Xiong X, et al. Shape effect on the antibacterial activity of silver nanoparticles synthesized via a microwave-assisted method. Environmental science and pollution research. 2016;23(5):4489-97.
Bélteky P, Rónavári A, Zakupszky D, et al. Are smaller nanoparticles always better? Understanding the biological effect of size-dependent silver nanoparticle aggregation under biorelevant conditions. International journal of nanomedicine. 2021:3021-40.
Zand V, Lotfi M, Aghbali A, et al. Tissue reaction and biocompatibility of implanted mineral trioxide aggregate with silver nanoparticles in a rat model. Iranian endodontic journal. 2015;11(1):13.
Samiei M, Adibkia K, Ghasemi N, et al. Effect of Silver Nanoparticles of Herbal Origin on the Compressive and Push-out Bond Strengths of Mineral Trioxide Aggregate. Iranian endodontic journal. 2023;18(3):159.
Oncu A, Huang Y, Amasya G, et al. Silver nanoparticles in endodontics: recent developments and applications. Restorative Dentistry & Endodontics. 2021;46(3).
Gladyshev VN, Arnér ES, Berry MJ, et al. Selenoprotein gene nomenclature. Journal of Biological Chemistry. 2016;291(46):24036-40.
Hosnedlova B, Kepinska M, Skalickova S, et al. Nano-selenium and its nanomedicine applications: a critical review. International journal of nanomedicine. 2018:2107-28.
Bisht N, Phalswal P, Khanna PK. Selenium nanoparticles: A review on synthesis and biomedical applications. Materials Advances. 2022;3(3):1415-31.
Kumar H, Bhardwaj K, Nepovimova E, et al. Antioxidant functionalized nanoparticles: A combat against oxidative stress. Nanomaterials. 2020;10(7):1334.
Wang H, Zhang J, Yu H. Elemental selenium at nano size possesses lower toxicity without compromising the fundamental effect on selenoenzymes: comparison with selenomethionine in mice. Free Radical Biology and Medicine. 2007;42(10):1524-33.
Shehab NF, Hasan NH, Ismail HK. Investigating the effect of selenium nanoparticles on mineral trioxide aggregates as a promising novel dental material. Journal of International Society of Preventive and Community Dentistry. 2024;14(1):16-27.
Doğan MS. Relation of trace elements on dental health. Trace Elements-Human Health and Environment. 2018:5.
Shehab NF, Hasan NH, Ismail HK. Investigating the Alkaline Potential of Mineral Trioxide Aggregate Repair Using Selenium Nanoparticles. Brazilian Dental Journal. 2024;35:e24-5760.
Vu TT, Nguyen PTM, Pham NH, et al. Green synthesis of selenium nanoparticles using Cleistocalyx operculatus leaf extract and their acute oral toxicity study. Journal of composites Science. 2022;6(10):307.
Joudeh N, Linke D. Nanoparticle classification, physicochemical properties, characterization, and applications: a comprehensive review for biologists. Journal of nanobiotechnology. 2022;20(1):262.
Rayman MP. Selenium and human health. The Lancet. 2012;379(9822):1256-68.
Menon S, Ks SD, Kumar V. Selenium nanoparticles: A potent chemotherapeutic agent and an elucidation of its mechanism. Colloids and Surfaces B: Biointerfaces. 2018;170:280-92.
Khurana A, Tekula S, Saifi MA, et al. Therapeutic applications of selenium nanoparticles. Biomedicine & Pharmacotherapy. 2019;111:802-12.
Mondal S, Park S, Choi J, et al. Hydroxyapatite: A journey from biomaterials to advanced functional materials. Advances in colloid and interface science. 2023;321:103013.
Sipert CR, Hussne RP, Nishiyama CK, et al. In vitro antimicrobial activity of fill canal, sealapex, mineral trioxide aggregate, Portland cement and endorez. International endodontic journal. 2005;38(8):539-43.
Akbarpour MR, Farajnezhad F, Poureshagh AH, et al. Effects of Copper Doping on Fluorohydroxyapatite Coating: Analysis of Microstructure, Biocompatibility, Corrosion Resistance, and Cell Adhesion Characteristics. Inorganic Chemistry. 2024;63(43):20314-24.
Bolhari B, Chitsaz N, Nazari S, et al. Effect of fluorohydroxyapatite on biological and physical properties of MTA angelus. The Scientific World Journal. 2023;2023(1):7532898.
Eskandarinezhad M, Ghodrati M, Azar FP, et al. Effect of incorporating hydroxyapatite and zinc oxide nanoparticles on the compressive strength of white mineral trioxide aggregate. Journal of dentistry. 2020;21(4):300.
Pushpalatha C, Suresh J, Gayathri V, et al. Zinc oxide nanoparticles: a review on its applications in dentistry. Frontiers in bioengineering and biotechnology. 2022;10:917990.
Baek M, Chung H-E, Yu J, et al. Pharmacokinetics, tissue distribution, and excretion of zinc oxide nanoparticles. International journal of nanomedicine. 2012:3081-97.
Guerreiro-Tanomaru JM, Figueiredo Pereira K, Almeida Nascimento C, et al. Use of nanoparticulate zinc oxide as intracanal medication in endodontics: pH and antimicrobial activity. Acta Odontológica Latinoamericana. 2013;26(3):167-72.
Prada I, Micó-Muñoz P, Giner-Lluesma T, et al. Influence of microbiology on endodontic failure. Literature review. Medicina oral, patologia oral y cirugia bucal. 2019;24(3):e364.
Bianchini Fulindi R, Domingues Rodrigues J, Lemos Barbosa TW, et al. Zinc-based nanoparticles reduce bacterial biofilm formation. Microbiology Spectrum. 2023;11(2):e04831-22.
Nair N, James B, Devadathan A, et al. Comparative Evaluation of Antibiofilm Efficacy of Chitosan Nanoparticle-and Zinc Oxide Nanoparticle-Incorporated Calcium Hydroxide-Based Sealer: An: In vitro: Study. Contemporary clinical dentistry. 2018;9(3):434-9.
Rengaraj K, Paramasivan M, Perumal G, et al. Nanotechnology-based electrochemical approach for effective root canal irrigation. Journal of Microbiological Methods. 2025:107189.
Vaidya S, Joshi M, Ghosh S, et al. Bioactive ZnO Decorated PVDF‐Based Piezoelectric, Osteoconductive Nanofibrous Coatings for Orthopedic Implants. Journal of Biomedical Materials Research Part A. 2025;113(8):e37971.
Azimi R, Shahgholi M, Khandan A. Fabrication and characterization of reinforced glass ionomer cement by zinc oxide and hydroxyapatite nanoparticles. Heliyon. 2024;10(20).
Sirelkhatim A, Mahmud S, Seeni A, et al. Review on zinc oxide nanoparticles: antibacterial activity and toxicity mechanism. Nano-micro letters. 2015;7(3):219-42.
Camilleri J. Hydration mechanisms of mineral trioxide aggregate. International endodontic journal. 2007;40(6):462-70.
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