title: Ion release, porosity, solubility, and bioactivity of MTA Plus tricalcium silicate.
abstract: BACKGROUND
  The aim of this study was to evaluate MTA Plus (Prevest Denpro Limited, Jammu, India, for Avalon Biomed Inc) material's properties, namely calcium release, the pH change, solubility, water sorption, porosity, surface morphology, and apatite-forming ability after immersion in simulated body fluid.
  
  
  METHODS
  Two tricalcium silicate powders (MTA Plus and ProRoot MTA; Dentsply Tulsa Specialties, Tulsa, OK) and Dycal (Dentsply Caulk, Milford, DE) were tested. After incubation at 37°C and 99% relative humidity, calcium and hydroxyl ion release were tested up to 28 days in deionized water at 37°C. Water absorption, interconnected pores, apparent porosity, and solubility were measured after 24 hours of immersion in deionized water at 37°C. The morphologic and elemental analysis of the materials' surfaces were examined using an environmental scanning electron microscope/energy dispersive x-ray analysis after storage at 37°C for 1-28 days in simulated body fluid using the ISO 23317 method.
  
  
  RESULTS
  All 3 materials created an alkaline pH within 3 hours, which continued for 28 days. MTA Plus had a higher ion release than ProRoot MTA and Dycal; the use of the MTA Plus gel enhanced the initial calcium release and the increase of the pH. Both MTA materials were more porous, water soluble, and water sorptive than Dycal and more bioactive. After aging in simulated body fluid, MTA Plus material caused precipitation of an apparent calcium phosphate layer.
  
  
  CONCLUSIONS
  MTA Plus showed improved reactivity and prolonged capability to release calcium and increase the local pH to alkaline values in comparison with ProRoot MTA. These pronounced ion-releasing properties are interlinked with its noticeable porosity, water sorption, and solubility and with the formation of calcium phosphorus minerals. The finer calcium silicate powder may explain the higher ion release, water sorption, porosity, and solubility of MTA Plus compared with ProRoot MTA. For clinicians, MTA Plus represents a lower-cost bioactive tricalcium silicate material with interesting chemical-physical properties that could be a convenient alternative to the conventional calcium silicate mineral trioxide aggregate-like cements.
authors.affiliation: Laboratory of Biomaterials and Oral Pathology, Unit of Odontostomatological Sciences, Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy. Electronic address: mgiovanna.gandolfi@unibo.it.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Gandolfi
authors.affiliation: Laboratory of Biomaterials and Oral Pathology, Unit of Odontostomatological Sciences, Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Siboni
authors.affiliation: Primus Consulting, Bradenton, Florida.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Primus
authors.affiliation: Endodontic Clinical Section, Unit of Odontostomatological Sciences, Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Prati
mesh_terms: D065966:Absorption, Physicochemical; D000468:Alkalies / Q000737:chemistry; D017607:Aluminum Compounds / Q000737:chemistry*; D001031:Apatites / Q000737:chemistry; D001672:Biocompatible Materials / Q000737:chemistry; D002118:Calcium / Q000737:chemistry; D017610:Calcium Compounds / Q000737:chemistry*; D002126:Calcium Hydroxide / Q000737:chemistry; D002130:Calcium Phosphates / Q000737:chemistry; D011232:Chemical Precipitation; D004338:Drug Combinations; D004577:Electron Probe Microanalysis; D006801:Humans; D006813:Humidity; D006863:Hydrogen-Ion Concentration; D006878:Hydroxides / Q000737:chemistry; D007552:Isotonic Solutions / Q000737:chemistry; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D008903:Minerals / Q000737:chemistry; D010087:Oxides / Q000737:chemistry*; D016062:Porosity; D012387:Root Canal Filling Materials / Q000737:chemistry*; D017640:Silicates / Q000737:chemistry*; D012995:Solubility; D013499:Surface Properties; D013696:Temperature; D013997:Time Factors; D014867:Water / Q000737:chemistry
chemical_list: D000468:Alkalies; D017607:Aluminum Compounds; D001031:Apatites; D001672:Biocompatible Materials; D017610:Calcium Compounds; D002130:Calcium Phosphates; D004338:Drug Combinations; C072670:Hanks Balanced Salt Solution; D006878:Hydroxides; D007552:Isotonic Solutions; D008903:Minerals; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D014867:Water; C506393:tricalcium silicate; C025702:Dycal; C031356:hydroxide ion; C020243:calcium phosphate; D002126:Calcium Hydroxide; D002118:Calcium
keywords: Calcium phosphate formation; MTA Plus; ProRoot MTA; ion releasing; mineral trioxide aggregate; porosity; root-end filling materials; solubility; tricalcium silicate; water sorption