Shokouhinejad Noushin, Tahun Ibrahim Abu, Tahan Shima Saber, Mohandes Fatemeh, Nekoofar Mohammad H, Dummer Paul M H
Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Department of Conservative Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan.
Clin Oral Investig. 2023 Mar;27(3):1193-1206. doi: 10.1007/s00784-022-04733-1. Epub 2022 Dec 31.
To investigate the effects of blood and platelet-rich fibrin (PRF), commonly used scaffolds in regenerative endodontic treatment (RET), on the hydration, microstructure, and color stability of three hydraulic calcium silicate cements (HCSCs), OrthoMTA, RetroMTA, and TotalFill-BC-RRM.
The HCSCs were prepared and placed into polyethylene molds and transferred to Eppendorf tubes containing PRF, blood, or PBS and then incubated for 1 week or 1 month. The microstructure and hydration of the cements were studied by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The chromatic alteration of materials was also measured using a spectrophotometer. The data for color stability were analyzed using 2-way analysis of variance and Tukey post hoc tests.
There was no significant difference between the color stability of cements exposed to PBS (p > 0.05). The chromatic alteration of cements exposed to blood was significantly greater than those exposed to PRF and PBS (p < 0.001). In the presence of blood and PRF, the color change of OrthoMTA was significantly greater than that of RetroMTA and TotalFill (p < 0.05), with no significant difference between RetroMTA and TotalFill (p > 0.05). XRD analysis of all cements revealed a calcium hydroxide peak after 1-week and 1-month exposure to the media; however, OrthoMTA and TotalFill exposed to blood and PRF for 1 month showed weaker calcium hydroxide peaks. SEM images revealed cements exposed to PBS had a different surface microstructure compared to those exposed to blood and PRF. Furthermore, the surface microstructure of HCSCs was influenced by the type of cement radiopacifier (bismuth oxide or zirconium oxide). EDS analysis of the elemental composition in all groups displayed peaks of Ca, O, C, Si, P, and Al.
Color stability, hydration behavior, and microstructure of HCSCs were affected by exposure to PRF and blood and the type of cement radiopacifier.
As some important physicochemical properties of HCSCs could be influenced by the environmental conditions and the type of radiopacifier, alternatives to blood clot and HCSCs containing substitutes for bismuth oxide might be more suitable in RETs.
研究再生性牙髓治疗（RET）中常用的支架材料血液和富血小板纤维蛋白（PRF）对三种水硬性硅酸钙水泥（HCSCs）、正颌MTA、倒充MTA和TotalFill-BC-RRM的水化、微观结构和颜色稳定性的影响。
制备HCSCs并放入聚乙烯模具中，转移至含有PRF、血液或磷酸盐缓冲液（PBS）的Eppendorf管中，然后孵育1周或1个月。通过扫描电子显微镜（SEM）、能量色散X射线光谱仪（EDS）和X射线衍射（XRD）研究水泥的微观结构和水化情况。还使用分光光度计测量材料的颜色变化。使用双向方差分析和Tukey事后检验分析颜色稳定性数据。
暴露于PBS的水泥的颜色稳定性之间无显著差异（p>0.05）。暴露于血液的水泥的颜色变化显著大于暴露于PRF和PBS的水泥（p<0.001）。在有血液和PRF的情况下，正颌MTA的颜色变化显著大于倒充MTA和TotalFill（p<0.05），倒充MTA和TotalFill之间无显著差异（p>0.05）。所有水泥的XRD分析显示，在暴露于培养基1周和1个月后出现氢氧化钙峰；然而，暴露于血液和PRF 1个月的正颌MTA和TotalFill显示出较弱的氢氧化钙峰。SEM图像显示，暴露于PBS的水泥与暴露于血液和PRF的水泥具有不同的表面微观结构。此外，HCSCs的表面微观结构受水泥射线阻射剂类型（氧化铋或氧化锆）的影响。所有组元素组成的EDS分析显示有钙、氧、碳、硅、磷和铝的峰。
HCSCs的颜色稳定性、水化行为和微观结构受暴露于PRF和血液以及水泥射线阻射剂类型的影响。
由于HCSCs的一些重要物理化学性质可能受环境条件和射线阻射剂类型的影响，血凝块的替代品和含有氧化铋替代品的HCSCs可能在RET中更合适。
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