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      Present status and future directions: Hydraulic materials for endodontic use

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          Abstract

          Background

          Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non‐aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic.

          Objectives

          Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra‐coronal, intra‐radicular and extra‐radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified.

          Methods

          The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated.

          Results

          A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated.

          Conclusions

          The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.

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          Most cited references367

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          On the mechanisms of biocompatibility.

          The manner in which a mutually acceptable co-existence of biomaterials and tissues is developed and sustained has been the focus of attention in biomaterials science for many years, and forms the foundation of the subject of biocompatibility. There are many ways in which materials and tissues can be brought into contact such that this co-existence may be compromised, and the search for biomaterials that are able to provide for the best performance in devices has been based upon the understanding of all the interactions within biocompatibility phenomena. Our understanding of the mechanisms of biocompatibility has been restricted whilst the focus of attention has been long-term implantable devices. In this paper, over 50 years of experience with such devices is analysed and it is shown that, in the vast majority of circumstances, the sole requirement for biocompatibility in a medical device intended for long-term contact with the tissues of the human body is that the material shall do no harm to those tissues, achieved through chemical and biological inertness. Rarely has an attempt to introduce biological activity into a biomaterial been clinically successful in these applications. This essay then turns its attention to the use of biomaterials in tissue engineering, sophisticated cell, drug and gene delivery systems and applications in biotechnology, and shows that here the need for specific and direct interactions between biomaterials and tissue components has become necessary, and with this a new paradigm for biocompatibility has emerged. It is believed that once the need for this change is recognised, so our understanding of the mechanisms of biocompatibility will markedly improve.
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            Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action.

            Mineral trioxide aggregate (MTA) has been recommended for various uses in endodontics. Two previous publications provided a comprehensive list of articles from November 1993-September 2009 regarding the chemical and physical properties, sealing ability, antibacterial activity, leakage, and biocompatibility of MTA. The purpose of Part III of this literature review is to present a comprehensive list of articles regarding animal studies, clinical applications, drawbacks, and mechanism of action of MTA. A review of the literature was performed by using electronic and hand-searching methods for the clinical applications of MTA in experimental animals and humans as well as its drawbacks and mechanism of action from November 1993-September 2009. MTA is a promising material for root-end filling, perforation repair, vital pulp therapy, and apical barrier formation for teeth with necrotic pulps and open apexes. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies regarding clinical applications of this material. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. Hydroxyapatite crystals form over MTA when it comes in contact with tissue synthetic fluid. This can act as a nidus for the formation of calcified structures after the use of this material in endodontic treatments. On the basis of available information, it appears that MTA is the material of choice for some clinical applications. More clinical studies are needed to confirm its efficacy compared with other materials. Copyright (c) 2010. Published by Elsevier Inc.
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              Cement chemistry

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                Author and article information

                Contributors
                J.Camilleri@bham.ac.uk
                Journal
                Int Endod J
                Int Endod J
                10.1111/(ISSN)1365-2591
                IEJ
                International Endodontic Journal
                John Wiley and Sons Inc. (Hoboken )
                0143-2885
                1365-2591
                17 March 2022
                May 2022
                : 55
                : Suppl 3 , Present status and future directions in clinical Endodontics, Part 1 ( doiID: 10.1111/iej.v55.s3 )
                : 710-777
                Affiliations
                [ 1 ] School of Dentistry College of Medical and Dental Sciences University of Birmingham Birmingham UK
                [ 2 ] Hamdan Bin Mohammed College of Dental Medicine (HBMCDM) Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) Dubai United Arab Emirates
                [ 3 ] Department of Oral Health Sciences BIOMAT – Biomaterials Research Group KU Leuven and Dentistry University Hospitals Leuven Leuven Belgium
                Author notes
                [*] [* ] Correspondence

                Josette Camilleri, School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

                Email: J.Camilleri@ 123456bham.ac.uk

                Author information
                https://orcid.org/0000-0003-3556-6365
                https://orcid.org/0000-0002-1019-3171
                https://orcid.org/0000-0002-6979-1037
                https://orcid.org/0000-0003-3537-8831
                Article
                IEJ13709
                10.1111/iej.13709
                9314068
                35167119
                a11c8480-1e4a-4af7-8249-16c9c604686d
                © 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 11 February 2022
                : 13 December 2021
                : 13 February 2022
                Page count
                Figures: 1, Tables: 5, Pages: 68, Words: 33079
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                May 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:25.07.2022

                Dentistry
                antimicrobial properties,biological properties,clinical studies,extra‐radicular,hydraulic calcium silicates,hydraulic cements,intra‐coronal,intra‐radicular,material characterization,physical characteristics

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