Moon Ho-Jin, Lee Jung-Hwan, Kim Joong-Hyun, Knowles Jonathan C, Cho Yong-Bum, Shin Dong-Hoon, Lee Hae-Hyoung, Kim Hae-Won
Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Republic of Korea.
Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea.
J Tissue Eng. 2018 Oct 30;9:2041731418807396. doi: 10.1177/2041731418807396. eCollection 2018 Jan-Dec.
Mineral trioxide aggregate, which comprises three major inorganic components, namely, tricalcium silicate (C3S), dicalcium silicate (C2S), and tricalcium aluminate (C3A), is promising regenerative cement for dentistry. While mineral trioxide aggregate has been successfully applied in retrograde filling, the exact role of each component in the mineral trioxide aggregate system is largely unexplored. In this study, we individually synthesized the three components, namely, C3S, C2A, and C3A, and then mixed them to achieve various compositions (a total of 14 compositions including those similar to mineral trioxide aggregate). All powders were fabricated to obtain high purity. The setting reaction of all cement compositions was within 40 min, which is shorter than for commercial mineral trioxide aggregate (~150 min). Over time, the pH of the composed cements initially showed an abrupt increase and then plateaued (pH 10-12), which is a typical behavior of mineral trioxide aggregate. The compression and tensile strength of the composed cements increased (2-4 times the initial values) with time for up to 21 days in an aqueous medium, the degree to which largely depended on the composition. The cell viability test with rat mesenchymal stem cells revealed no toxicity for any composition except C3A, which contained aluminum. To confirm the in vivo biological response, cement was retro-filled into an extracted rat tooth and the complex was re-implanted. Four weeks post-operation, histological assessments revealed that C3A caused significant tissue toxicity, while good tissue compatibility was observed with the other compositions. Taken together, these results reveal that of the three major constituents of mineral trioxide aggregate, C3A generated significant toxicity in vitro and in vivo, although it accelerated setting time. This study highlights the need for careful consideration with regard to the composition of mineral trioxide aggregate, and if possible (when other properties are satisfactory), the C3A component should be avoided, which can be achieved by the mixture of individual components.
矿物三氧化物凝聚体由三种主要无机成分组成,即硅酸三钙(C3S)、硅酸二钙(C2S)和铝酸三钙(C3A),是一种很有前景的牙科再生水泥。虽然矿物三氧化物凝聚体已成功应用于根管倒充填,但各成分在矿物三氧化物凝聚体系统中的确切作用在很大程度上仍未得到探索。在本研究中,我们分别合成了这三种成分,即C3S、C2S和C3A,然后将它们混合以获得各种组成(总共14种组成,包括那些与矿物三氧化物凝聚体相似的组成)。所有粉末均制备成高纯度。所有水泥组合物的凝结反应在40分钟内完成,这比市售矿物三氧化物凝聚体(约150分钟)要短。随着时间的推移,所组成水泥的pH值最初急剧上升,然后趋于平稳(pH值为10 - 12),这是矿物三氧化物凝聚体的典型行为。在所组成的水泥中,抗压强度和抗拉强度在水介质中随时间增加(初始值的2 - 4倍),持续长达21天,其增加程度在很大程度上取决于组成。对大鼠间充质干细胞进行的细胞活力测试表明,除含铝的C3A外,任何组成均无毒性。为了确认体内生物学反应,将水泥逆行充填到拔除的大鼠牙齿中,并将复合体重新植入。术后四周,组织学评估显示C3A引起显著的组织毒性,而其他组成则表现出良好的组织相容性。综上所述,这些结果表明,在矿物三氧化物凝聚体的三种主要成分中,C3A虽然加速了凝结时间,但在体外和体内均产生了显著的毒性。本研究强调了在考虑矿物三氧化物凝聚体的组成时需要谨慎,如果可能的话(当其他性能令人满意时),应避免使用C3A成分,这可以通过混合各成分来实现。