Impact of Bioactive Cements on Mineral Density of Artificially Demineralized Dentin

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346

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352

D.O.I.

10.1922/EJPRD_2946Nekoofar07

Action

• Paul Michael Howell Dummer
• Mohammad Hossein Nekoofar
• Sedighe Sadat Hashemi Kamangar
• Sara Valizadeh
• Zahra Shahidi

Abstract

European Journal of Prosthodontics and Restorative Dentistry (2025) 33, 346–352

Keywords
Dentin
Conservative Treatment
Tooth Remineralization
Biodentine

Authors
Mohammad Hossein Nekoofar * § †
(DDs, MScD, DoIBoE, PhD)

Sedighe Sadat Hashemi Kamangar Δ
(DDs, MScD, DoIBoRD)

Sara Valizadeh ‡

(DDs, MScD, DoIBoRD)

Zahra Shahidi ¤ «

(DDs, MScD, DoIBoRD)

Paul Michael Howell Dummer ^
(BDS, MScD, PhD, DDSc)

Address for Correspondence
Zahra Shahidi *
Email: zr.sh.den1566@gmail.com
* Department of Endodontics, School of Dentistry,
Tehran University of Medical Sciences, Tehran,
Iran
§

Department of Endodontic, Bahçeşehir
University School of Dentistry, Istanbul, Turkey

†

Department of Tissue Engineering and Applied
Cell Sciences, School of Advanced Technologies
in Medicine, Tehran University of Medical
Sciences, Tehran, Iran

Δ

‡

Department of Operative Dentistry, International
Campus, School of Dentistry, Tehran University
of Medical Sciences, Tehran, Iran
Restorative Dentistry Specialist, Tehran, Iran

¤ Dental Research Center, Dentistry Research
Institute, School of Dentistry, Tehran University
of Medical Sciences, Tehran, Iran
« Restorative Dentistry Department, School of
Dentistry, Tehran University of Medical Sciences,
Tehran, Iran
^ School of Dentistry, College of Biomedical and
Life Sciences, Cardiff University, Cardiff, UK

Impact of Bioactive
Cements on Mineral Density
of Artificially Demineralized
Dentin
ABSTRACT
Objectives: Bioactive dental materials have the potential to remineralize carious dentin.
This study compared the ability of four bioactive cements to increase the mineral content
of demineralized dentin. Methods: Four cavities (2×0.5 mm) were prepared within the
dentin of the occlusal surface of 15 teeth. The samples underwent pH-cycling for 14 days
to induce demineralization. Three teeth were randomly assigned to each group (Biodentine, ACTIVA BioACTIVE, Oxford ActiveCal, Dycal, control). After placing the materials in
the cavities, the entire occlusal surfaces were covered with composite resin, the samples
were stored in a remineralizing solution for 30 days. The mineral density of the pulpal
floors was determined using micro-CT. The data was analyzed with one-way ANOVA and
Tukey tests. After horizontal sectioning, SEM-EDS mapping was done at the cementdentin interface of the cavity floor of one sample in each group. Results: There were
significant differences between the test groups compared to the control group in terms
of the mineral density of the cavity pulpal floors. The highest calcium and phosphorus
weight percentages were observed in the Biodentine and ActiveCal groups, respectively.
Conclusions: All the bioactive cements increased the mineral content of artificially demineralized dentin at the pulpal floor of the cavities.

INTRODUCTION
Vital pulp therapy (VPT) preserves pulpal tissue that is at risk from caries,
trauma, restorative procedures, or iatrogenic reasons and increases tooth
survival because it conserves the integrity of the hard dental tissues.1
Various medicaments and restorative materials have been used during
vital pulp treatments. Calcium hydroxide was one of the first materials to
be used because of its antibacterial properties and its ability to prevent
future bacterial penetration and injury to the pulp.2 However, the material
has several disadvantages such as inflammation and surface necrosis of
the pulp, tunnel defects in the tertiary dentin that lead to an incomplete
barrier against recurrent infection, high solubility in oral fluids, and a lack
of adhesion to dentin.3
More recently, bioactive materials have been used to induce remineralization of carious dentin.4 The term ‘bioactive’ in restorative dentistry refers
to materials that form a surface layer similar to apatite in the presence
of a mineral phosphate solution.5 The bioactive materials used in restoring demineralized dentin should provide mineral ions, bind to collagen (to
function as a pattern for calcium and phosphorous and induce the apatite

Received: 11.05.2025
Accepted: 27.08.2025
doi: 10.1922/EJPRD_2946Nekoofar07

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