Introduction: The aim of this in vitro study was to assess the apical microleakage of mineral trioxide aggregate (MTA), calcium enriched MIXTURE (CEM) cement, and biodentine. Materials & Methods: The study was performed on 76 single-canal human teeth. Root canals were prepared by ProTaper rotary system, then obturated with gutta-percha. Thereafter, the apical section of the teeth was cut from 3 mm above the apex, and 3 mm of gutta-percha was removed by an ultrasonic device from the apical part of the root canals. Then, 60 teeth were randomly assigned to 3 groups and filled with MTA, CEM cement, and biodentine. Control groups were also prepared. All surfaces of the samples were covered with two layers of nail polish, except for the surfaces near the apical filling. In each group, half of the samples were immersed in indian ink for 3 days and the other half for 7 days. After clearing, the samples were examined using stereo microscope with 20x magnification and dye penetration was evaluated. Data analysis was performed using Repeated measures and One-way ANOVA and p<0. 05 was considered significant. Results: The mean microleakage for MTA, CEM cement and biodentine on the third day were 2576. 80 and 2567. 60, 2370. 20 and the mean on the seventh day were 2431. 50, 1516. 50 and 1560. 70, respectively. The mean leakage was not statistically different in samples on the third and seventh days. The difference of microleakage was statistically significant among these materials. Conclusion: It seems the biodentine compared to MTA and CEM cement have better apical sealing ability.

Background: The bond strength of the materials used as a cervical barrier in the pulp regeneration is essential for the success of treatment. This study aimed to evaluate the effects of triple antibiotic paste (TAP), double antibiotic paste (DAP), and simvastatin as intracanal medicaments on the dislodgement resistance of mineral trioxide aggregate (MTA) and calciumenriched MIXTURE (CEM). Methods: A total of 160 extracted human single-rooted teeth were selected, and root canal preparation was carried out. The teeth in each group were randomly divided into four subgroups: TAP, DAP, simvastatin, and the control group (without intracanal medicament). Four weeks after placing the medicaments, it was removed by sodium hypochlorite, and MTA and CEM were placed in the coronal third of the root canals. After a week, 2-mm-thick dentin disks were prepared from the coronal third of the roots, and the push-out test was performed using a universal testing machine. The data were analyzed using two-way ANOVA and independent t-test at a significance level of 0. 05. Results: Regardless of the intracanal medicament, there was no significant difference between the overall bond strength of MTA (59. 3 ±,10 MPa) and CEM (55. 8 ±,11 MPa) (P = 0. 6). Furthermore, there were no significant differences in bond strength between the two intracanal medicament groups and the control group (P > 0. 05). Conclusion: Under the limitations of the current study, DAP, simvastatin, and TAP, as intracanal medicaments, did not adversely affect the push-out bond strength of CEM and MTA.

Dentists always prioritize the preservation of the dental pulp. Nowadays, minimally invasive endodontic techniques such as Vital Pulp Therapy (VPT) are considered due to their affordability and remarkable success compared to conventional treatments such as Root Canal Treatment (RCT). VPT aims at preserving healthy portions of the exposed pulp while removing the inflamed parts with biocompatible materials to seal the pulp. The present case report aimed to describe a successful VPT of a right mandibular permanent first molar with reversible pulpitis using Calcium Enriched MIXTURE (CEM) cement in an 18-year-old female patient. As pulp exposure happened regarding extensive caries removal, 2 mm of the inflamed pulp was removed and replaced with CEM cement. CEM was covered with Resin-modified glass ionomers (RMGI) and the tooth was restored with amalgam. Regular follow-ups were performed at 3 and 6 months and 1, 2, and 4 years after treatment. Conclusion: The tooth was clinically and radiographically functional without signs and symptoms of infection or inflammation. The result of this case suggests that pinpoint pulp exposure during deep caries excavation can be successfully treated with VPT using CEM cement.

Introduction: Root mineral trioxide aggregate (MTA) is a type of MTA that has been introduced in the Iranian market. There have been few studies on this substance. This study compared the push-out bond strength of Root MTA and CEM cement, which were both Iranian products. Materials & Methods: This in vitro study was performed on 20 extracted maxillary incisors. Samples were divided in two groups. The canals of the first group were filled with Root MTA and the second group by CEM cement. In order to investigate the push-out bond strength, the device applied a force in the direction parallel to the longitudinal axis of the sample so that the desired materials would fail. Each sample was classified into one of three types of failureincluding adhesive (failure in the material and dentin interface), cohesive (failure in the material itself) or a combination of both. Results: There was no significant difference between the mean pressure on teeth for the two groups (P>0. 05). There was no significant difference between the frequencies of different types of failure between the two groups (P>0. 05). Cohesive failure in the CEM group was twice as high as in the MTA group (P>0. 05). Conclusion: There was not any significant difference between the push-out bond strength of CEM cement and Root MTA cement. These findings demonstrated that Root MTA material showed a satisfactory result in the bond strength test compared to CEM material, and could be used as an alternative to CEM cement.

Introduction: Root-end preparation and restoration with an endodontic material are required when nonsurgical endodontic retreatment has failed or is impossible. The present clinical study reports the treatment outcomes of periradicular surgery using calciumenriched MIXTURE (CEM) cement.Materials and Methods: A prospective outcome study of periradicular surgery using CEM was conducted on 14 permanent teeth with persistent apical periodontitis. Using a standardized surgical protocol, 2-3 mm of the root apex was resected; approximately 3 mm deep root-end cavities were ultrasonically prepared and filled with CEM cement. All patients were available for recall.Results: Clinical and radiographic examination revealed complete healing of periradicular lesions, i.e.regeneration of periodontal ligament and lamina dura in 13 teeth (93% success) during a mean time of 18 months; moreover, the teeth were functional and asymptomatic.Conclusion: Favorable treatment outcomes in this prospective clinical study suggested that CEM cement may be a suitable root-end filling biomaterial.

Introduction: Most of the materials used in endodontic procedures may lead to discoloration. This study compared the discolorations induced following treatment by MTA, CEM, and Biodentine using a spectrophotometric analysis. Material & Methods: In this experimental study Forty extracted mandibular anterior teeth were selected and sectioned from 2 mm below Cemento Enamel Junction (CEJ) using a disc. A retrograde method was used for drilling cavities 2 mm away from incisal edge. Then the cavities were washed using 5. 25% NaOCL and normal saline and the samples were divided randomly into 4 groups. The cavities in groups 1, 2, and 3 were filled by MTA Angleus, Cem cement, and Biodentine, respectively as deep as CEJ level and they were sealed by 2mm of A3 composite color. All of cavities of group 4/control, were all filled by composite A3. Then the samples were stored in a glass incubator with 100% humidity and under laboratory light. they were exposed to a spectrophotometric analysis within 6 periods from placement including base line, 1 week, 2 weeks, 1 month, 3 months, 6 months. The data were analyzed by SPSS 17, Tukey HSD and ANOVA statistical test. Results: The results showed no statistically significant difference in discoloration rate during measurement periodsin each group. However, the discoloration rate varied in various materials. The minimum and maximum discolorations occurred in Biodentine and MTA, respectively and their difference was statistically significant. (p=0. 033)Other groups showed no statistically significant difference. Conclusion: The biodentinehad minimum discolorations compared with other two materials; thus, it seems that it can be recommended for cosmetic areas.