bio mimetic materials
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BIOMIMETIC
MATERIALS
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DEFINITION OFBIOMIMETIC MATERIALS
Biomimetic materials are materials that have
been designed such that they elicit specifiedcellular responses mediated by interactions withscaffold-tethered peptides from extracellular
matrix (ECM) proteins; essentially, the
incorporation of cell-binding peptides intobiomaterials via chemical or physicalmodification.
http://en.wikipedia.org/wiki/Biomimetic_materials. Accessed on 15/02/09
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: Collagen MembranesEnamel Matrix Proteins
Graft materials
Platelet Rich Plasma
Implants
: Mineral Trioxide Aggregate
Calcium Hydroxide
Bioactive glass
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CALCIUM HYDROXIDE:
THE PRODIGAL CHILD OF HERMANN
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CALCIUM HYDROXIDE
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CALCIUM HYDROXIDE
EFFECT ON HEALTHY PULP TISSUE
Superficial zone : application of pressure
Latter zone: chemical injury; edema and liquefactivenecrosis
Apical most region: Coagulation necrosis
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation.J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation.
J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
MATRIX FORMATION
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation.J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
MINERALIZATION OF THE BARRIER ANDCELLULAR DIFFERENTIATION
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation.J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation.J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
THE ROLE OF CALCIUM
Holland et. al. (1982) demonstrated that the calcium of the calcifiedtissues is derived from the calcium hydroxide
Used calcium, Barium and Strontium hydroxides in histochemicalstudies of dog pulp following pulpotomy and found the two zones
seen with calcium hydroxide pulp capping agents
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulpcell migration, proliferation and differentiation.
J Dent Res 1985; 64 (Spec Iss): 541- 548
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CALCIUM HYDROXIDE
CONTRADICTORY FINDING
Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23: 383- 297
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CALCIUM HYDROXIDECa(OH)2
Ca2+ OH-
Neutralizes acids producedby osteoclasts
Reduced serum flow Optimum pH forpyrophosphatse activity
Reduced levels ofinhibitory pyrophosphatase Increased levels of Ca2+
dependant pyrophosphatase
Uncontrolled mineralization
Reduced capillarypermeability
Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23: 383- 297
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CALCIUM HYDROXIDE
Cvek M. A clinical report on partial pulpotomy and capping with
calcium hydroxide in permanent incisors with complicated crown
fracture. J Endod 1978; 4(8):232- 237
O
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CALCIUM HYDROXIDE
Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg
1974; 38(6): 945- 953
CALCIUM HYDROXIDE
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CALCIUM HYDROXIDE
In 1985, Stanley HR reported the advantages of a light- cured
calcium hydroxide.
Prisma VLC Dycal
Dentinal bridge formation
Chemical cautery effect
Resistance to dissolution in acid and water
Improved strength
Stanley HR, Pameijer CH. Pulp Capping with a new visible- light- curing calcium hydroxidecomposition (Prisma VLC Dycal). Oper Dent 1985; 10: 152- 163
CALCIUM HYDROXIDE
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CALCIUM HYDROXIDE
COMPOSITIONBase paste: Titanium dioxide- 56.7%
Glycol salicylate
Catalyst paste: Calcium hydroxide- 53.5%
Zinc oxide- 9.7%Ethyltoluene sulfonamide
Drawbacks
Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg 1974; 38(6): 945- 953
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The initial patented form of MTA :50- 75wt% CaO and 15-
25wt% SiO2. (Torabinejad and White, 1995)
Tricalcium silicate, dicalcium silicate, tricalcium aluminateand tetracalcium aluminoferrite
Hydrates to form silicate hydrate gel
Camilleri J and Pitt ford TR. Mineral Trioxide Aggregate: a review of the constituents andbiological properties of the material. Int Endod J 2006; 39: 747- 754
Water
CONSTITUENTS
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According to the patent:MTA is a type I ordinary Portland cement
(American society for Testing Materials) witha fineness in the range of 4500- 4600cm/g.Radiopacifier, bismuth oxide is added to the
cement for dental radiological diagnosis
Camilleri J and Pitt ford TR. Mineral Trioxide Aggregate: a review of the constituents andbiological properties of the material. Int endod J 2006; 39: 747- 754
CONSTITUENTS
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Traces of SiO2, CaO, MgO, gypsum,K2SO4, andNa2SO4
MTA
Refined Portland cement
Bismuth Oxide
Dicalcium SilicateTricalcium SilicateTricalcium AluminateTetracalcium Aluminoferrite
Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral Trioxide Aggregate material use inendodontic treatment: A review of the literature. Dental Materials 2008; 24: 149- 164
CONSTITUENTS
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CHEMICAL GMTA WMTA
CaO 44.23 40.45
SiO2 21.20 17.00
Bi2O3 16.13 15.90
Al2O3 1.92 4.26
MgO 1.35 3.10
SO3 0.53 0.51
Cl 0.43 0.43
FeO 0.40 4.39P2O5 0.21 0.18
TiO2 0.11 0.06
H2O + CO2 14.49 13.72
CHEMICAL COMPOSITION OF GMTA AND WMTA (wt%)
Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate material use in endodontictreatment: A review of the literature. Dental Materials 2008; 24: 149- 164
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Similar to other mineral cementsOriginal material: anhydrous
Hydrated calcium silicate gel
Crystallization of the hydrated mass
SETTING MECHANICS AND SET CEMENT
FLUIDS
Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate material use inendodontic treatment: A review of the literature. Dental Materials 2008; 24: 149- 164
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Sarkar NK, Caicedo R, Ritwik P, Mioseyeva R and Kawashima L. Physiochemical basis of thebiologic properties of Mineral Trioxide Aggregate. J Endod 2005; 31(2): 97- 100
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Zhu Q, Haglund R, Safavi KE. Adhesion of human osteoblasts on root- end fillingmaterials.
J Endod 2000; 26(7): 404- 406
Cell morphology of osteoblasts on MTA
SEM image of osteoblasts cultured
on MTA after 24hrs
The study used SEM to evaluate the cellular response of humanosteoblasts to commonly used root- end filling materials in vitro.
Composite resin, amalgam , IRM and Mineral Trioxide Aggregate.Adhesion and spreading of cells on a material surface are the initialphases of cellular function.The persistence of rounded cells with little or no spreading suggeststhat the surface material could toxic.
Favorable response was seen with MTA and composite resin.
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The study characterized the interactions of MTA withsynthetic tissue fluid composed of a neutral phosphatebuffer saline solution and root canal dentin in extractedhuman teeth.
Atomic Emission SpectroscopyScanning Electron MicroscopyEnergy Dispersive X- Ray analysisX- Ray diffraction
10Ca2+ + 6(PO4)3- + 2(OH)- Ca10 (PO4)6 (OH)2
Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic properties ofMineral Trioxide Aggregate . J endod 2005; 31(2): 97- 100
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The pH at which the reaction occurs
Porous nature of MTA
Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic properties of MineralTrioxide Aggregate . J Endod 2005; 31(2): 97- 100
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Experiments measuring the cytokineexpression:
Huang TH, Yang CC, Ding SJ. Inflammatory cytokines reaction elicited by root- end fillingmaterials. J Biomed Mater Res, Part B Applied biomaterials2005; 73: 123- 128
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Saidon J, He J, Zhu Q, Safavi K, Spngberg SW. Cell and tissue reactions tomineral trioxide aggregate and Portland cement.Oral surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 483- 489
The study compared the cytotoxic effect in vitro and the tissuereaction of MTA and Portland Cement in bone implantation in themandibles of guinea pigs.
Two types of reactions :Type I: new bone apposition in direct contact with the materialType II: Newly formed bone separated from the material by a thinlayer of fibrous connective tissue.
Area under a freshly prepared materialProRoot implant at 2weeks observation perioProRoot impant at 12 weeks observation
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This study investigated cell growth and morphology ofcementoblast like cells on MTA by Scanning electronMicroscopy and to determine if MTAallows the prodiction of
gene and protein markers consistent with the expression ofmineralized cell phenotype in tissue cultures.
Materials used: Amalgam, IRM and MTA
Cellular morphology: Scanning Electron MicroscopyGene expression: Reverse Polymerase Chain ReactionIn vivo matrix protein evaluation: Confocal Microscopy
Thomson TS, Berry JE, somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate.J Endod 2003; 29(6): 407- 412
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Cells adhering to IRM and amalgam: few, showed cytoplasmic
shrinking, rounded CYTOTOXICITY
Cells adhering to MTA: abundant, normal cellular morphology
Thomson TS, Berry JE, Somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate.J Endod 2003; 29(6): 407- 412
Cementoblasts on MTA Cementoblasts on amalgamCementoblasts on IRM
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Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregateand calcium hydroxide as pulp- capping agents in human teeth: a perliminaryreport. Int Endod J 2002; 36: 225- 231
2 months sample covered with MTA 3 months sample capped withcalcium hydroxide
The study aimed to compare MTA and calcium hydroxide whenused as pulp- capping agents in human teeth.
Histological evaluation
At 1wk, 2, 3, 4 and 6mths after treatment
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Calcium hydroxide specimens:At 6mths: thickness of dentinal bridge: 0.15mm
MTA specimens:At 2mths: thickness of dentinal bridge: 0.28mmAt 6mths: 0.43mm
Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregate andcalcium hydroxide as pulp- capping agents in human teeth: a perliminary report. Int EndodJ 2002; 36: 225- 231
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Compared WMTA and calcium hydroxide for direct pulp cappingin 3rd molars
Single blinded, randomized, controlled clinical study
At 20day post treatment:WMTA group: 20 teeth- clinically normal pulps
3 teeth: reversible pulpitis
Calcium hydroxide group: 17 teeth- clinically normal pulps6 teeth- reversible pulpitis1 tooth- irreversible pulpitis
Iwamoto CE, Adachi E, Pameijer CH, et. al. Clinical and histological evaluation ofwhite ProRoot MTA in direct pulp capping. Am J Dent 2006; 19: 85- 90
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At 136 day recall:WMTA group: 23 teeth- clinically successful
Calcium hydroxide group: 22 teeth- clinically successful
NO SIGNIFICANT DIFFERENCES AT BOTH PERIODS
Iwamoto CE, Adachi E, Pameijer CH, et. al. Clinical and histological evaluation of whiteProRoot MTA in direct pulp capping. Am J Dent 2006; 19: 85- 90
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Abedi et. al. : greater tendency of dentin bridge formationwith MTAAbedi HR,Torabinejad M, Pitt Ford TR, Bakland LK. The use of Mineral Trioxide
Aggrgate cement as a direct pulp capping agent. J Endod 1996; 22: 199
Samples capped with Calcium Hydroxide vs. those cappedwith MTA
Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK. Using Mineral Aggregate as a
pulp capping material. J Am Dent Assoc 1996; 127: 1491- 1494
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CERAMICS AND GLASSES
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
Virtually inert ceramics :alumina (Al2O3) andzirconia (ZrO2)
Porous ceramics:such as synthetic hydroxyapatite
calcium silicate-based glasses,
ceramics and glass-ceramic composites
calcium phosphate cements
www.rsc.org/Education/Issues/2006Nov/GlassBones . Accessed on 20/02/09
CERAMICS AND GLASSES
http://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBones -
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CERAMICS AND GLASSES
BIOACTIVE GLASSES
Synthetic, alloplastic, non ceramic material
Bioactive: osteoconductive and osteoinductive
Regeneration of bone
Glass and Bioabsorbable Membrane in the treatment of maxillary Class II
furcation defects: Case report with 6 month re- entry.
Compennd Cont Educ Dent 2005; 26(1): 41- 50
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
The Bioactive Glass formula 45S5 is a very active
bone inducer, many times more active thanhydroxyapatite.
Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modified
Bioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
SiO2- 46mol%
CaO- 26.9mol%Na2O- 24.4mol%
P2O5- 2.6mol%
Bioactive Glass and Bioabsorbable Membrane in the treatment of maxillary Class II
furcation defects: Case report with 6 month re- entry. Compennd Cont Educ Dent
2005; 26(1): 41- 50
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
.
THE MELT GLASS TECHNIQUE
www.rsc.org/Education/Issues/2006Nov/GlassBones . Accessed on 20/02/09
CERAMICS AND GLASSES
http://www.rsc.org/Education/Issues/2006Nov/GlassBoneshttp://www.rsc.org/Education/Issues/2006Nov/GlassBones -
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Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modifiedBioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232
CERAMICS AND GLASSES
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Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modified
Bioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
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The gel can be obtained by the dispersion ofcolloidal powders or by the controlled
hydrolysis and condensation of liquid metal
alkoxide precursors under acidic or basicconditions.
THE SOL- GEL TECHNIQUE
CERAMICS AND GLASSES
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X-ray microcomputed tomography (CT) image of a typical
Bioactive Glass scaffold produced by the sol-gel foaming
process, with streak lines showing calculated paths of fluid
flow
elements.geoscienceworld.org/.../coverfig.gif. Accessed on 20/02/09
CERAMICS AND GLASSES
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Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp
capping with a modified Bioglass formula (#A68-
Modified). Am J Dent 2001; 14: 227- 232
Oguntebi et. al
The Bioactive Glass formulae given by Clark et. al. in 1996 were:
A58: 58% SiO2
38% CaO
4% P2O5
A68: 68% SiO2
28% CaO
4% P2O5
Particle size : 90m to 350m
CERAMICS AND GLASSES
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Advantages of the modified BAG preparation
The particle size of these particles ranges from 90m to
350m.
CERAMICS AND GLASSES
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BAGA58 at 25 days
Stanley HR, Clark AE, Pameijer CH and Louw NP. Pulp capping with a modified
Bioglass formula (#A68- Modified). Am J Dent 2001; 14: 227- 232
A better attempt of dentin bridging at 70 daysA solid dentin bridge with modified BioGlass formula
CERAMICS AND GLASSES
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.
THE GLASS- BONE BOND
CERAMICS AND GLASSES
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CERAMICS AND GLASSES
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Salako M, Joseph B, Ritwik P, Salonen J, John P andJunaid TA. Comparison of bioactive glass, mineraltrioxide aggregate, ferric sulfate, and formocresol aspulpotomy agents in rat molar. Dent Traumatol 2003;19: 314- 320
CERAMICS AND GLASSES
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FUTURE TRENDS.
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REFERENCES
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Andreason JO, rud J. Mode of healing histologically after endodonticsurgery in 70 cases. Int J Oral Surg 1972; 1: 148- 160
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Barrier membrane techniques in endodontic microsurgery. Dent Clin NAm 1997; 41(3): 585- 602
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Melcher AH. Repair potential of periodontal tissues. J Periodontol 1976;47:256-60.
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Bunyaratavej P and Wang HL. Collagen membranes: A Review. J
Periodontol 2001; 72: 215- 229
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Postlethwaite AE , Seyer JM, and Kang AH Chemotactic attraction of humanfibroblasts to type I, II, and III collagens and collagen-derived peptides Proc. Natl.Acad. Sci. (USA) 1978; 75(2): 871-875
Hirooka H. The biologic concept for the use of enamel matrix protein: trueperiodontal regeneration. Quint Int 1998; 29: 621- 630
Nanci A. Ten Cates Oral Histology. Development, Structure and Function.7th Ed.
2008. Mosby, Elsevier, St. Louis, Missouri
Cochran DL.Biomimetics in Periodontal Regeneration. Rationale and clinical Useof Enamel Matrix Derivative. 2003. quint Pub, Illinois.
Iqbal MK Bamaas NS. Effect of enamel matrix derivative (EMDOGAIN) uponperiodontal healing after replantation of permanent incisors in Beagle dogs. DentTraumatol 2001; 17: 36- 45
Marx R and Garg A.Dental and Craniofacial Application of Platelet rich Plasma
2005. Quint Pub, Illinois
Carranza FA, Mc Clain P and Schallhorn R. Regenerative Osseous surgery inCarranzas Clinical Periodontology. 9th Ed. 2003. Elsevier, Pennsylvania
Foreman PC and Barnes IE. A review of calcium hydroxide. Int Endod J 1990; 23:383- 297
Schrder U. Effects of calcium hydroxide- containing pulp- capping agents on pulp
cell migration, proliferation and differentiation J Dent Res 1985; 64 (Spec Iss):
REFERENCES
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Salako M, Joseph B, Ritwik P, Salonen J, John P and Junaid TA. Comparison ofbioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol aspulpotomy agents in rat molar. Dent Traumatol 2003; 19: 314- 320
Aeinehchi M, Eslami B, Ghanbariha M and Saffar AS. Mineral TrioxideAggregate
and calcium hydroxide as pulp- capping agents in human teeth: a perliminaryreport. Int Endod J 2002; 36: 225- 231
Thomson TS, Berry JE, Somerman MJ and Kirkwood KL. Cementoblasts maintainexpression of osteocalcin in the presence of Mineral Trioxide Aggregate. J Endod2003; 29(6): 407- 412
Saidon J, He J, Zhu Q, Safavi K, Spngberg SW. Cell and tissue reactions tomineral trioxide aggregate and Portland cement. Oral surg Oral Med Oral PatholOral Radiol Endod 2003; 95: 483- 489
Huang TH, Yang CC, Ding SJ. Inflammatory cytokines reaction elicited by root-end filling materials. J Biomed Mater Res, Part B Applied biomaterials2005; 73:123- 128
Sarkar NK, Caicedo R, Ritwik P.Physicochemical basis of the biologic propertiesof Mineral Trioxide Aggregate . J Endod 2005; 31(2): 97- 100
Zhu Q, Haglund R, Safavi KE. Adhesion of human osteoblasts on root- end fillingmaterials. J Endod 2000; 26(7): 404- 406
Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide Aggregate
material use in endodontic treatment: A review of the literature. Dental Materials-
REFERENCES
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REFERENCES Abedi HR,Torabinejad M, Pitt Ford TR, Bakland LK. The use of Mineral
Trioxide Aggrgate cement as a direct pulp capping agent. J Endod 1996;22: 199
Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK. Using MineralAggregate as a pulp capping material. J Am Dent Assoc 1996; 127: 1491-1494
Tronstad L et. al. Reaction of the exposed pulp to Dycal. Oral Surg 1974;38(6): 945- 953
Cvek M. A clinical report on partial pulpotomy and capping with calciumhydroxide in permanent incisors with complicated crown fracture. J Endod1978; 4(8):232- 237
Stanley HR, Pameijer CH. Pulp Capping with a new visible- light- curingcalcium hydroxide composition (Prisma VLC Dycal). Oper Dent 1985; 10:152- 163
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