Characterization of a novel calcium phosphate cement–calcium sulfate hemihydrate–acemannan for vital pulp therapy
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Background: Dental caries remains as one of the most prevalent oral diseases worldwide, especially in developing nations like Indonesia. Untreated caries may lead to pulp involvement, prompting vital pulp therapy (VPT) to protect pulp vitality. The success of VPT is dependent on the biological and physical properties of the capping materials. Traditional pulp capping materials, such calcium hydroxide Ca(OH)₂ and mineral trioxide aggregate (MTA), show bio-activity but are limited by issues of solubility, manipulation, and bio-compatibility. Consequently, calcium phosphate cement (CPC) and calcium sulfate hemihydrate (CSH) with acemannan (Ace) have been explored as potential alternatives. Purpose: This research aimed to evaluate the potential of a mixture containing CPC-CSH-Ace as a bio-active material for vital pulp therapy. Methods: CPC–CSH–Ace was formulated by combining 70 wt% CPC and 30 wt% CSH with acemannan concentrations of 3 wt%, 5 wt%, and 10 wt%. Calcium hydroxide (Dycal, Dentsply) and MTA (Bio MTA+, Cerkamed) were used as controls. Particle size was measured using a Particle Size Analyzer (Horiba SZ-100), surface morphology and calcium ratio were tested with SEM–EDS, and crystal structure was determined using XRD (Rigaku Miniflex). Data were examined utilizing one-way ANOVA and subsequent post-hoc testing (p < 0.05). Results: CPC–CSH–Ace exhibited smaller particle sizes, smoother surfaces, higher Ca/P ratios, and more defined hydroxyapatite peaks than Ca(OH)₂ and MTA. Conclusion The combination of CPC–CSH-Ace showed significant chemical and physical characteristics and has promise as a new bio-active material for vital pulp therapy.
Garg N, Garg A. Textbook of endodontics. Fourth edition. New Delhi: Jaypee Brothers Medical Publishers, 2019.p. 22-61.
Fejerskov O, Nyvad B, Kidd EAM. Dental caries: the disease and its clinical management. Third edition. Chichester, West Sussex, UK ; Ames, Iowa: John Wiley & Sons Inc, 2015.p. 66-85.
World Health Organization. Oral health, https://www.who.int/health-topics/oral-health (2023).
Grossman LI. Grossman’s endodontic practice. 14th edition. Gurgaon: Wolters Kluwer Health (India), 2021.p. 189-213.
Ibrahim S. Vital Pulp Therapy An insight over the available literature and future expectations. Eur Endod J 2019; 1: 46–53.
Basir L, Nadaf H, Karimi B, Noghani MT. Comparison of Pulpal Response Following Direct Pulp Capping Using MTA and Zinc-doped Bioglass. J Babol Univ Med Sci 2023; 25: 59–69.
Nammour S, El Mobadder M, Namour M, Haueis S, Heysselaer Daniel, Nahas P, Todea CD, Matys J, Lesniak KG, Olszewska A, El Mobadder W, Giovannacci I, Laky M, Namour A, Greets S. Success Rate of Direct Pulp Capping with Conventional Procedures Using Ca (OH)2 and Bioactive Tricalcium Silicate Paste vs. Laser-Assisted Procedures (Diode 980 nm, CO2, and Er: YAG). Photonics 2023; 10: 834.
Karina TA, Fatriadi F. Indirect Pulp Capping Treatment Using Calcium Hydroxide with Follow-Up Class 1 Composite Restoration on Tooth 36. JKG jurnal kesehatan gigi 2023; 10: 178–185.
Irmawati A, Pratiwi AI, Azizi MRA, Apriliyanti NA, Annafi A, Azzaim YA, Alqhtani AS. Potential Combination of Acemannan Sponge and Calcium Phosphate Cement-Calcium Sulfate Hemihydrate (CPC-CSH) as Direct Pulp Capping Alternative Materials for Reparative Dentin Formation. Journal of Health and Allied Sciences NU 2024; 14: 047–053.
Chang H-H, Chang Y-J, Yeh C-L, Lin T-A, Lin C-P. Development of calcium phosphate/calcium sulfate biphasic biomedical material with hyaluronic acid containing collagenase and simvastatin for vital pulp therapy. Dental Materials 2020; 36: 755–764.
Songsiripradubboon S, Kladkaew S, Trairatvorakul C, Sangvanich P, Soontornvipart K, Banlunara W, Thunyakitpisal P. Stimulation of Dentin Regeneration by Using Acemannan in Teeth with Lipopolysaccharide-induced Pulp Inflammation. Journal of Endodontics 2017; 43: 1097–1103.
Vu TT, Nguyen MT, Sangvanich P, Nguyen QN, Thunyakitpisal P. Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation. Pharmaceutics 2020; 12: 644.
Negi D, Bhavya K, Pal D, Singh Y. Acemannan coated, cobalt-doped biphasic calcium phosphate nanoparticles for immunomodulation regulated bone regeneration. Biomater Sci 2024; 12: 3672–3685.
Wijaya YH, Pangabdian F, Puspita S, Aprilia, Sari RP. Particle Size Analyses and Cytotoxicity of Nanoencapsulation of β-Tricalcium Phosphate from Synthesis of Anadara granosa Shell as Pulp Capping Material. Mal J Med Health Sci 2024; 20: 174–180.
Ali A, Zhang N, Santos RM. Mineral Characterization Using Scanning Electron Microscopy (SEM): A Review of the Fundamentals, Advancements, and Research Directions. Applied Sciences 2023; 13: 12600.
Jervøe P. X-Ray Diffraction Investigation on the Effect of Experimental and in Situ Radiation on Mature Human Teeth a Preliminary Report. Acta Odontologica Scandinavica 2017; 28: 623–631.
Islam R, Islam MdRR, Tsuchiya K, Toida Y, Sano H, Yamauti M, Ahmed HMA, Tomokiyo A. Bioactivity and biocompatibility of bioceramic-based pulp capping materials in laboratory and animal models. J Mater Sci: Mater Med 2025; 36: 83.
Ashtijoo Z, Pishevar L, MalekipourMalekipour M, Khdodaei M, Sabouri Z. Comparative evaluation of incorporation calcium silicate and calcium phosphate nanoparticles on biomimetic dentin remineralization and bioactivity in an etch-and-rinse adhesive system. J Clin Exp Dent 2022; 14: 903–910.
Yong D, Choi JJE, Cathro P, Cooper PR, Dias G, Huang J, Ratnayake J. Development and Analysis of a Hydroxyapatite Supplemented Calcium Silicate Cement for Endodontic Treatment. Materials 2022; 15: 1176.
Prasertsuksom N, Ositi S, Jaruchotiratanasakul N, Ongchavalit L. Treatment Outcomes and Prognostic Factors of Direct Pulp Capping in Permanent Teeth: A Systematic Review and Meta-analysis. Eur Endod J 2024; 9: 295–307.
Grawish ME, Grawish LM, Grawish HM, Grasidh MM, Holiel AA, El-Negoly SA. Demineralized Dentin Matrix for Dental and Alveolar Bone Tissues Regeneration: An Innovative Scope Review. Tissue Eng Regen Med 2022; 19: 687–701.
An S-Y, Lee M-J, Shim Y-S. X-Ray Diffraction Analysis of Various Calcium Silicate-Based Materials. J Dent Hyg Sci 2022; 22: 191–198.
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