Evaluation of the Physical Properties of Cockle Shell-derived Bioceramic Pulp Capping Material: A Pilot Study
Objectives: To investigate the physical properties of cockle shell derived tricalcium silicate pulp capping material (C-Cap).
Methods: C-Cap was manufactured by processing cockle shell and rice husk ash under specific conditions, and various additives were added to gain the desirable physical properties. C-Cap consisted of two parts: a powder (mixture of cockle shell-derived tricalcium silicate, zirconium silicate and silicon dioxide) and a liquid (methyl salicylate and N-Butyl benzene sulfonamide). The mixing of the materials was performed via loading powder and liquid into a plastic capsule and put into an amalgamator for 8 seconds at a speed of 4,000 vibrations/minute. Life and Dycal® were tested for their physical properties and compared with C-Cap. The setting time, flowability and solubility tests were conducted in accordance with the modified ISO 6876:2012. pH was assessed at 3 hours, 1, 3, 7, 14 and 28 days. Statistical analysis was performed using Two-way repeated measures ANOVA analysis, Oneway ANOVA with Tukey’s test and repeated measures ANOVA analysis with Bonferroni test (p<0.05).
Results: C-Cap, Dycal®, and Life had setting times in the range of 1-2 minutes. C-Cap provided the highest flowability. The solubility test showed no significant difference among groups (10.6-12.4 % by weight). In comparison to Dycal® and Life, C-Cap showed the highest alkaline properties (with the pH of 9.9-10.5 over the period of 28 days).
Conclusions: C-Cap exhibited suitable physical properties for use as pulp capping material.
1. Schröder U. Effects of Calcium Hydroxide-containing Pulp-capping Agents on Pulp Cell Migration, Proliferation, and Differentiation. J Dent Res. 1985;64(4):541-8.
2. Sangwan P, Sangwan A, Duhan J, Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J. 2013;46(1):3-19.
3. Cox CF, Suzuki S. Re-evaluating pulp protection: calcium hydroxide liners vs. cohesive hybridization. J Am Dent Assoc. 1994;125(7):823-31.
4. Nowicka A, Wilk G, Lipski M, Kołecki J, Buczkowska-Radlińska J. Tomographic evaluation of reparative dentin formation after direct pulp capping with Ca(OH)2, MTA, Biodentine, and dentin bonding system in human teeth. J Endod. 2015;41(8):1234-40.
5. Takita T, Hayashi M, Takeichi O, Ogiso B, Suzuki N, Otsuka K, Ito K. Effect of mineral trioxide aggregate on proliferation of cultured human dental pulp cells. Int Endod J. 2006;39(5):415–22.
6. Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: a review of the literature. Dent Mater. 2008;24(2):149-64.
7. Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review-part I: chemical, physical, and antibacterial properties. J Endod. 2010;36(1):16–27.
8. Darvell BW, Wu RCT. "MTA"—An hydraulic silicate cement: Review update and setting reaction. Dent Mater. 2011;27(5):407–22.
9. Li Z, Cao L, Fan M, Xu Q. Direct Pulp Capping with Calcium Hydroxide or Mineral Trioxide Aggregate: A Meta-analysis. J Endod. 2015;41(9):1412–17.
10. Didilescu AC, Cristache CM, Andrei M, Voicu G, Perlea P. The effect of dental pulp-capping materials on hard-tissue barrier formation: A systematic review and meta-analysis. J Am Dent Assoc. 2018;149(10):903-17.
11. Suhag K, Duhan J, Tewari S, Sangwan P. Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up. J Endod. 2019;45(7):840-7.
12. Berzins DW. Chemical properties of MTA. In: Torabinejad M, editor. Mineral trioxide aggregate: properties and clinical application. Wiley: Oxford; 2014. p. 17–35
13.Mailafiya MM, Abubakar K, Danmaigoro A, Chiroma SM, Abdul Rahim EB, Mohd Moklas MA, et al. Cockle shell derived calcium carbonate (aragonite) nanoparticles: a dynamite to nanomedicine. Appl Sci. 2019;9(14):2897.
14.Korotkova TG, Ksandopulo SJ, Donenko AP, Bushumov SA, Danilchenko AS. Physical properties and chemical composition of the rice husk and dust. Orient J Chem. 2016;32(6):3213-9.
15. Tram NXT. Synthesis and characterization of calcite nano-particle derived from cockle shell for clinical application. ASEAN Eng J. 2020;10(1):49–54.
16. Nugroho JJ, Natsir N, Trilaksana AC, Rovani CA, Atlanta MM. The increase of tooth enamel surface hardness after application blood cockle shells (Anadara granosa) paste as remineralization agent. Int J Appl Pharm. 2019;11(4):26–9.
17. Perimal EK, Bharatham H. A short review on cockle shells as biomaterials in the context of bone scaffold fabrication. Sains Malays. 2019;48(7):1539–45.
18. Miles S. Methyl salicylate. In: Enna SJ, Bylund DB, editors. xPharm: The Comprehensive Pharmacology Reference. Boston: Elsevier; 2007. p. 1–6.
19. Portella FF, Collares FcM, Santos PD, Sartori Cu, Wegner E, Leitune VCB, et al. Glycerol Salicylate-based Pulp-Capping Material Containing Portland Cement. Braz Dent J. 2015;26(4):357-62.
20. Rani P, Pal D, Hoda MN, Ara TJ, Beg S, Hasnain MS, et al. Dental pulp capping nanocomposites. In: Asiri AM, Mohammad A, editors. Applications of Nanocomposite Materials in Dentistry. Cambridge: Woodhead Publishing; 2019. p. 65-91.
21. Camilleri J, Sorrentino F, Damidot D. Characterization of un-hydrated and hydrated BioAggregate and MTA Angelus. Clin Oral Investig. 2015;19(3):689-98.
22. Lestari ND, Nurlaila R, Muwwaqor NF, Pratapa S. Synthesis of high-purity zircon, zirconia, and silica nanopowders from local zircon sand. Ceram Int. 2019;45(6):6639-47.
23. Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. Int Endod J. 2012;45(6):571-9.
24. Gandolfi MG, Siboni F, Botero T, Bossù M, Riccitiello F, Prati C. Calcium silicate and calcium hydroxide materials for pulp capping: biointeractivity, porosity, solubility and bioactivity of current formulations. J Appl Biomater Funct. 2015;13(1):43-60.
25. Harms CS, Schäfer E, Dammaschke T. Clinical evaluation of direct pulp capping using a calcium silicate cement-treatment outcomes over an average period of 2.3 years. Clin Oral Investig. 2019;23(9):3491–9.
26. Peskersoy C, Lukarcanin J, Turkun M. Efficacy of different calcium silicate materials as pulp-capping agents: Randomized clinical trial. J Dent Sci. 2021;16(2):723-31.
27. Leye Benoist F, Gaye Ndiaye F, Kane AW, Benoist HM, Farge P. Evaluation of mineral trioxide aggregate (MTA) versus calcium hydroxide cement (Dycal®) in the formation of a dentine bridge: a randomised controlled trial. Int Dent J. 2012;62(1):33-9.
28. Neelakantan P, Rao CVS, Indramohan J. Bacteriology of deep carious lesions underneath amalgam restorations with different pulp-capping materials-an in vivo analysis. J Appl Oral Sci. 2012;20(2):139-45.
29. Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R, et al. European Society of Endodontology position statement: Management of deep caries and the exposed pulp. Int Endod J. 2019;52(7):923-34.
30. Zhu C, Ju B, Ni R. Clinical outcome of direct pulp capping with MTA or calcium hydroxide: a systematic review and meta-analysis. Int J Clin Exp Med. 2015;8(10):17055-60.
31. Schwendicke F, Brouwer F, Schwendicke A, Paris S. Different materials for direct pulp capping: systematic review and meta-analysis and trial sequential analysis. Clin Oral Investig. 2016;20(6):1121-32.
32. da Rosa WLO, Cocco AR, Silva TM, Mesquita LC, Galarca AD, Silva AF, Piva E. Current trends and future perspectives of dental pulp capping materials: A systematic review. J Biomed Mater Res Part B Appl Biomater. 2018;106(3):1358-68.
33. Garrocho-Rangel A, Esparza-Villalpando V, Pozos-Guillen A. Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: A systematic review. Int J Paediatr Dent. 2020;30(5):536-46.
34. Cushley S, Duncan H, Lappin M, Chua P, Elamin A, Clarke M, et al. Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta‐analysis. Int Endod J. 2021;54(4):556-71.
35. Accorinte ML, Loguercio AD, Reis A, Carneiro E, Grande RH, Murata SS, Holland R. Response of human dental pulp capped with MTA and calcium hydroxide powder. Oper Dent. 2008;33(5):488-95.