Comparative Analysis of Physicocomechanical Properties of MTA and Biodentine with Addition of Graphene Oxide to MTA and Biodentine: An In-vitro Study

ABSTRACT

Introduction:

Bioactive calcium silicate cements (CSCs), such as Mineral Trioxide Aggregate (MTA) and Biodentine, are widely used in endodontic procedures to repair and regenerate tooth pulp and hard tissues. They are valued for being biocompatible, sealing well, and promoting tissue growth. However, they have limitations, like long setting times and weaker bond strength. Graphene oxide, a 2D carbon nanomaterial with exceptional physical and chemical properties, has shown potential in biomedical applications.

Aims and Objectives:

This study aimed to evaluate the effect of adding 1% graphene oxide to MTA and Biodentine on their setting time and push-out bond strength. This study tested whether adding 1% graphene oxide to MTA and Biodentine could improve their properties.

Materials and Methods:

40 samples were divided into four groups: regular MTA, MTA with graphene oxide (MTAG), regular Biodentine (BD), and Biodentine with graphene oxide (BDG). Setting time, push out bond strength were measured.

Results:

Results showed that MTAG and BDG set faster and had stronger push out bonds than regular MTA and BD.

Conclusion:

These findings suggest graphene oxide could enhance CSCs, making them more effective for dental procedures like pulp capping and perforation repair.

INTRODUCTION

When performing endodontic operations including perforation repair pulpotomy, apexogenesis, pulp capping, apexification, and root-end filling that require pulpal regeneration and hard tissue repair, bioactive cements are frequently utilized.[1,2] For these processes, typical materials include calcium silicate-based cement (CSC) called biodentine and mineral trioxide aggregate (MTA). CSCs have a wide range of applications because of their advantageous qualities, which include their capacity to create hard tissue, biocompatibility, and excellent sealing ability.[2]

Graphene is a unique 2D carbon nanomaterial made of sp2-bonded carbon atoms that was discovered in 2004 at the University of Manchester by Andre Geim and Konstantin Novoselov.[3] Its remarkable physical and chemical characteristics make it useful for a wide range of biomedical applications, such as tissue engineering, cancer therapy, drug administration, gene transfer, biosensing, bioimaging, and dental applications.[4]

Despite its advantageous qualities, MTA is expensive and requires a lengthy setting time (around 140 min). New CSCs have been introduced to solve these problems, such as bioaggregate and biodentine. These materials and MTA have comparable clinical uses in endodontics. Because of its excellent sealing properties,[5] biodentine is advised for use as an endodontic repair material and as a dentine substitute beneath resin composite restorations.[6]

AIMS AND OBJECTIVES

Aim

To evaluate the setting time and push-out bond strength of calcium silicate cements with the addition of graphene oxide.

Objectives

1. To assess and evaluate the effect of adding 1% graphene oxide to MTA and biodentine on the setting time of these CSCs

2. To assess and evaluate the effect of adding 1% graphene oxide to MTA and biodentine on the push-out bond strength of these CSCs.

METHODOLOGY

Type of study

An in-vitro experimental study.

Sample size (n = 40)

This study will be conducted in the Department of Conservative Dentistry and Endodontics. Graphene oxide was purchased from Shilpent. The materials used include MTA and biodentine.

Variables for sample size calculation

• n1 (sample size of Group 1): 152

• n2 (sample size of Group 2): 152

• σ1 (standard deviation of Group 1): 15.34

• σ2 (standard deviation of Group 2): 18.23

• Δ (difference in group means): 5.42

• κ (ratio = n2/n1): 1

• Z1 − α/2 (two-sided Z value for 95% confidence interval): 1.96

• Z1 − β (Power): 80%

• Z2 (Z value associated with beta): 0.84162

• d (absolute precision): 2.44

• n1 (minimum sample size): 2

• n2 (minimum sample size): 10

Methods

Graphene (1% wt) will be mixed with MTA and biodentine. Four groups will be studied: MTA, MTAG (graphene-modified MTA), BD (biodentine), and BDG (graphene-modified biodentine). Vicat needle will be used to evaluate the setting time in all four groups (n = 5 in each group). Vickers hardness of materials will be tested (n = 5 in each group) with five indentations (100 g, 10 s) per specimen using a Vickers diamond indenter. For push-out bond strength, single-rooted premolars (n = 10, each group) will be biomechanically prepared conventionally up to no. 30, and the apical 5 mm will be filled with the four types of materials. After setting, push-out bond strength will be evaluated using a universal testing machine. Statistical analysis will be performed using ANOVA and Tukey tests.

RESULT

The push-out bond strength for the four groups was: Group I (MTA) at 75.50 MPa (SD = 6.75340), Group II (Biodentine) at 92.70 MPa (SD = 7.02456), Group III (GO+MTA) at 139.60 MPa (SD = 19.88970), and Group IV (GO+Biodentine) at 68.40 MPa (SD = 17.68364). Significant differences were found, with Group III showing the highest strength, significantly outperforming Group I by 64.10 MPa (P = 0.005) and Group IV by 71.20 MPa (P = 0.000). Group II also exceeded Group IV by 24.30 MPa (P = 0.000).

Setting time for BIO remained stable at 6.5–7 minutes across 0%–7% GNS, while ECZ increased from 4 minutes (0% GNS) to 10 minutes (7% GNS, P < 0.05). BIO’s bond strength held steady at 6.5–7.5 MPa across GNS levels, but ECZ’s dropped from 4 MPa (0% GNS) to 1 MPa (7% GNS, P < 0.05) [Figures 1-4].

Figure 1.

Intra group multiple comparison using Tukey test

Figure 4.

Comparison of push-out bond strength among four groups

Figure 2.

Mean push-out bond strength among all four groups

Figure 3.

Comparison of all four groups for setting time

DISCUSSION

In antibacterial and regenerative operations, MTA and biodentine have demonstrated superior outcomes. However, they have drawbacks due to their conventional characteristics, namely a long setting time and insufficient push-out bond strength.[7,8,9] The purpose of this study is to determine if the addition of graphene oxide shortens the setting time and strengthens the push-out bond. Should this alteration prove effective, it may lead to a promising endodontic material in the future. According to this study, compared to versions modified with graphene, traditional MTA and biodentine have longer setting periods and weaker push-out bond strengths. Enhancing these attributes could have a big impact on the dentistry community.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.