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Bacteria and pulpal reactions under silicate cement restorations.

Silicate cement was inserted in deep unlined cavities in 70 human teeth; 35 cavities were cleaned with an antibacterial cleanser, and the other 35 cavities in the contralateral teeth were treated with water spray only. In all teeth, invasion of bacteria from the tooth surface was prevented with a surface seal. Histologic examinations after 4 weeks revealed bacterial growth on dentinal walls in 9 of the uncleaned and in 2 cleaned cavities. Only in these 11 teeth was an inflammatory reaction seen in the pulp. Under eight cavities without bacterial growth and with silicate cement placed directly on an exposed pulp, no serious injury and no inflammatory reactions were observed. It was concluded that silicate cement per se does not seriously irritate the pulp. Infection of cavity walls should be avoided, not only by removing grinding debris and antibacterial cleansing, but also by use of a liner to prevent invasion of bacteria from the surface of the tooth.

Anti-Bacterial Agents

Toxic elements in silicate cements.

Six brands of silicate cements have been characterized by means of optical emission spectrography with respect to the contents of elements in minor or trace quantities in a search for presence of possible toxic elements. Beryllium was observed in two powders at levels of 1.3 and 1.6% Cadmium was found in two powders at levels of 0.02 and 0.03%. Lead was measured in three powders at levels of 0.001-0.003%. Bismuth, boron, copper, gallium, iron, manganese, titanium, tin and zirconium were found in various brands in either powder or liquid at levels of 0.001-0.1%. Upper limits of the amounts of the various elements that might be transferred to the gastrointestinal tract after dissolution of the cement matrix in the oral cavity have been calculated.

Beryllium

Evaluation of methacrylic resin-modified calcium silicate cements for pulpal healing using an experimental pulpitis model.

Recently, vital pulp treatment (VPT), including direct pulp capping, which preserves pulp vitality and extends the functional lifespan of teeth, has garnered significant attention. The purpose of this study was to evaluate the performance of calcium silicate cement, the gold standard for VPT, alongside hydraulic calcium silicate cement (Pro-MTA), a material with extensive evidence of effectiveness, Bis-GMA resin-modified calcium silicate cement (TH), and a newly developed material, methacrylate resin-modified calcium silicate cement (RM-MTA), in a model of pulpitis induced by caries progression. Additionally, the calcium ion (Ca2+) release capacity of these materials and their comprehensive effects on pulpal wound healing were assessed using RNA sequencing (RNA-seq). In both sound pulp models and caries-induced pulpitis models, RM-MTA and Pro-MTA exhibited similar performances. Unlike TH, they induced significant tertiary dentin formation within the dental pulp beneath the material, without any residual inflammatory cells. Inflammation was specifically assessed with a focus on M1/M2 macrophages. While the timing of Ca2+ ion release differed among the materials, the total amount released was comparable, although the release of calcium ions (Ca2+) from TH was significantly lower compared to that observed for the above materials. Moreover, comprehensive genetic analysis revealed that the expression of cell proliferation-related genes was selectively reduced in TH, suggesting that differences in resin composition may account for these variations in behavior. These findings suggest that RM-MTA induces tertiary dentin and demonstrates biocompatibility comparable to that of Pro-MTA. This makes it suitable for the treatment of both sound and mildly inflamed pulp tissues. Additionally, its resin properties are expected to enhance both mechanical performance and clinical handling.

Journal Article

Penetration of ions from silicate cement restorations into Copalite--covered cavity walls.

This study aimed to asses the effect of silicate cement on Copalite -covered cavity walls in extracted human teeth. Class V cavities were prepared in 24 premolars and filled with silicate cement (Bio-Trey). Four cavities were unlined, the rest of the cavities were lined with 1 or 2 layers of Copalite before insertion of the restorations. After 6 months, 70-100 microns thick longitudinal sections of the teeth were studied by polarized light microscopy, microradiography and electron probe microanalysis. When imbibed in water or quinoline, a subsurface zone of altered birefringence was noticed in nearly all cavity walls. Nearly half of the cavity walls in the experimental groups showed a surface zone of increased radiopacity. In a few instances a subsurface radiolucent zone was present. By electron probe microanalysis F (0,4-3% by weight), Zn (1-4%) and Al (0,2-6%) were measured in the outer 10-60 microns of the cavity walls. The study shows that even with a double layer of Copalite, known to prevent microleakage, a desirable uptake of F and Al from silicate restorations into cavity walls can take place. Copalite does not prevent a phosphoric acid effect on the cavity walls.

Aluminum

Pulpal reactions to surface-sealed silicate cement and composite resin restorations.

The effect of surface sealing and presence of bacteria in connection with pulpal response to silicate cement and composite resin restorations was tested in monkey teeth. Surface-sealing of silicates reduced the pulpal reactions to this material, whereas no such effect was observed when composites were sealed. Bacteria regularly occurred on the cavity walls except underneath zinc oxide/eugenol (ZOE) fillings and when silicates were sealed with ZOE. The frequency of bacteria was higher in teeth with unacceptable pulpal responses (44 of 49) than in teeth with acceptable reactions (48 of 79).

Animals

The effect of silicate cement on the mitochondria and lysosomes of cultured cells assessed by quantitative enzyme histochemistry.

The cytotoxic effect of the silicate cement "Silicap" was evaluated in an in vitro system which simulates the clinical usage of the material. BHK-21 (C-13) cells on cover slips were exposed to the freshly mixed material for 1h, and stained for the demonstration of succinic dehydrogenase and acid phosphatase. The mean stain density for succinic dehydrogenase and acid phosphatase in the experimental cells was 77% and 153% of the control values respectively. The mechanism of cytotoxicity of "Silicap" is discussed.

Acid Phosphatase

Pulp reactions to silicate cement in teeth with healing pulpitis.

Unlined silicate restorations were placed in intact and experimentally altered monkey, teeth. Pulpitis had been induced experimentally by sealing soft carious human dentin in Class V cavities with amalgam for 7 d. These fillings were then removed and healing allowed by inserting zinc oxide/eugenol cement. A protective effect of the secondary dentin in teeth with healing pulpitis could be demonstrated in short-term experiments. After a 1-month observation period no difference in response to silicate cement could be found between intact and experimentally altered pulps, both groups exhibiting no or slight pulp reactions and secondary dentin formations.

Animals