Investigation of the effect of addition/replacement of bioactive glass to hydraulic calcium silicate cement

Andreas Koutroulis*, Nandita Menon, Vasileios Kapralos, Dag Ørstavik, Maria Pain, Håkon Valen, Josette Camilleri, Anil Kishen, Pia Titterud Sunde

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objectives: Assess the effect of addition or replacement of bioactive glass (BG) on the physico-chemical, antibacterial and biological properties of radiopacified tricalcium silicate cement (TCS).
Methods: Four materials were tested: An experimental cement with 80 % TCS, 20 % zirconium oxide (TZ-base); two modified versions of TZ-base incorporating 20 % BG 45S5 either as TCS-replacement (TZ-bg-R) or addition (TZ-bg-A); and Biodentine (Septodont). Setting time was assessed using ISO 6876:2012 method. Materials were immersed in water or Dulbecco's modified eagle medium with 10 % fetal bovine serum (DMEM-sup). After seven days, water sorption and solubility were assessed using ISO 4049:2019 methods; water uptake and porosity were also calculated; leachate alkalinity and calcium release were assessed with a pH meter and inductively coupled plasma respectively; specimens were characterized with scanning electron microscopy, energy dispersive X-ray and X-ray diffraction analysis. At one-day, antibacterial properties of material surfaces and leachates were tested against Enterococcus faecalis and Staphylococcus epidermidis biofilms; leachate cytotoxicity and cytokine release were assessed with the 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyl tetrazolium bromide assay and an enzyme-linked immunosorbent assay. Regression models were fitted for all dependent variables.
Results: Compared to TZ-base, the BG-containing materials had overall increased water sorption, water uptake and porosity; decreased solubility in DMEM-sup; lower calcium release; and generally similar pH, antibacterial activity, cytotoxicity and cytokine release. All experimental cements were more cytotoxic than Biodentine, but the latter caused higher cytokine release.
Significance The BG-incorporation whether added or replacing the cement decreased the solubility in clinically relevant media and did not deteriorate the antimicrobial and biological properties of the materials.
Original languageEnglish
Pages (from-to)1067-1079
Number of pages13
JournalDental Materials
Volume41
Issue number9
Early online date25 Jun 2025
DOIs
Publication statusPublished - Sept 2025

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