title: Bioactivity Potential of EndoSequence BC RRM Putty.
abstract: BACKGROUND
  The aim of this study was to characterize and assess the interaction of EndoSequence BC RRM putty (Brasseler USA, Savannah, GA) in contact with blood and simulated body fluid. Tricalcium silicate-based materials are in contact with blood and tissue fluids during and after their setting. These materials are hydraulic; thus, their properties improve in moist conditions. However, specific environmental conditions may modify the material setting.
  
  
  METHODS
  EndoSequence BC RRM putty was characterized by scanning electron microscopy, energy dispersive spectroscopy, and X-ray diffraction analysis. This was done before setting and after contact with water, Hank's balanced salt solution, and heparinized whole blood. Furthermore, characterization of an explanted material from a failed root-end surgery was performed.
  
  
  RESULTS
  The EndoSequence BC RRM putty was composed of tricalcium silicate, tantalum oxide, and zirconium oxide. The tricalcium silicate reaction led to the formation of calcium hydroxide, and this was evident over the putty in contact with water and Hank's balanced salt solution. In the latter case, there was also the formation of globular crystals synonymous with hydroxyapatite formation. The material in contact with blood exhibited a poorly crystalline surface with additional peaks for calcium, phosphorus, and chlorine, whereas the material retrieved from the failed root-end surgery had deposition of calcium carbonate on its surface.
  
  
  CONCLUSIONS
  The environmental conditions affect the hydration of the EndoSequence RMM putty and consequentially the material interaction with the environment. However, in vitro material assessment may not be representative of the clinical situation because carbon dioxide present in vivo leads to the formation of calcium carbonate rather than the hydroxyapatite reported in in vitro studies.
authors.affiliation: Department of Endodontology, Academic Center for Dentistry Amsterdam, VU University, Amsterdam, The Netherlands; University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Amir T
authors.initials: AT
authors.lastname: Moinzadeh
authors.affiliation: Private Practice Limited to Endodontics, Santpoort-Zuid, The Netherlands.
authors.forename: Carlos
authors.initials: C
authors.lastname: Aznar Portoles
authors.affiliation: Department of Anatomy, Faculty of Medicine and Surgery, Malta.
authors.forename: Pierre
authors.initials: P
authors.lastname: Schembri Wismayer
authors.affiliation: Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, Malta. Electronic address: josette.camilleri@um.edu.mt.
authors.forename: Josette
authors.initials: J
authors.lastname: Camilleri
mesh_terms: D000328:Adult; D002119:Calcium Carbonate / Q000737:chemistry; D017610:Calcium Compounds / Q000097:blood / Q000737:chemistry*; D002126:Calcium Hydroxide / Q000737:chemistry; D017886:Durapatite / Q000737:chemistry; D005260:Female; D006801:Humans; D008422:Materials Testing; D010087:Oxides / Q000737:chemistry; D012387:Root Canal Filling Materials / Q000737:chemistry*; D017640:Silicates / Q000097:blood / Q000737:chemistry*; D013052:Spectrometry, X-Ray Emission / Q000379:methods; D013499:Surface Properties; D013635:Tantalum / Q000737:chemistry; D014867:Water / Q000737:chemistry; D014961:X-Ray Diffraction / Q000379:methods; D015040:Zirconium
chemical_list: D017610:Calcium Compounds; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; D014867:Water; D013635:Tantalum; D017886:Durapatite; D015040:Zirconium; D002119:Calcium Carbonate; C078151:tantalum oxide; D002126:Calcium Hydroxide; C028541:zirconium oxide
keywords: Bioactivity; characterization; root repair material; tissue interaction