ArticleBMC oral health2026
Assessment of the surface characterization, physicochemical and biological properties of mineral trioxide aggregate mixed with different ionic vehicles on diabetic root dentine: a laboratory investigation.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo comparatively evaluate the effects of mineral trioxide aggregate (MTA) mixed with distilled water (DW), phosphate-buffered saline (PBS), and disodium hydrogen phosphate (DSHP) on the root dentine of teeth affected by diabetes mellitus (DM). MATERIALS AND
methodsFive samples of MTA were mixed with either distilled water (DW), phosphate-buffered saline (PBS), or disodium hydrogen phosphate (DSHP). Then, they were assessed for surface characteristics using high-resolution scanning electron microscopy-energy-dispersive X-ray spectroscopy (HRSEM-EDX), surface microhardness via Vickers indentation, and in vitro bioactivity after 21 days of immersion in simulated body fluid. For the other in vitro tests, 82 single-root human permanent premolars (nondiabetic = 41; diabetic = 41) were decoronated to a standardized length of 12 ± 1 mm. Following tubular density evaluation (n = 5) using HRSEM, push-out bond strength (n = 18) and fracture resistance (n = 9) were assessed using a universal testing machine, whereas the cement-dentine interface (n = 9) was analyzed using HRSEM-EDX. The root specimens were then randomly subdivided into subgroups based on the different ionic MTA formulations as follows: subgroup I: MTA + DW, subgroup II: MTA + PBS, and subgroup III: MTA + DSHP. Statistical analysis was conducted using GraphPad Prism 10.4.1, using independent t-tests and two-way analysis of variance with Bonferroni correction for comparisons (P < 0.05).
resultsMTA + PBS exhibited a uniform matrix with distinct crystalline structures and the highest microhardness (69.2 ± 3.97 VHN), followed by MTA + DSHP and MTA + DW test materials. All formulations promoted apatite formation, with MTA + PBS showing dense, homogenous platelet-like crystals. Tubular density was reported to be higher in diabetic dentine (P < 0.05). MTA + PBS demonstrated superior cement-dentine interface, push-out bond strength, and fracture resistance, followed by MTA + DSHP and MTA + DW in both DM and non-DM root dentine specimens (P < 0.05).
conclusionDM significantly affects the physicochemical and biological properties of root dentine. Among the various test ionic formulations, MTA + PBS exhibited superior surface characteristics, physicochemical, and biological characteristics compared to MTA + DSHP and MTA + DW. Hence, MTA mixed with phosphate ionic vehicles, is clinically recommended for effective endodontic management of diabetic dentine. CLINICAL TRIAL NUMBER: Not applicable.
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