Bioactivity evaluation of calcium silicate-based endodontic materials used for apexification

This study aims to compare the bioactivity of Biodentine, ProRoot MTA and NeoMTA Plus with regard to their element uptake (Ca, Si and Ca/P) by root canal dentine in a simulated apex (n = 30 each) and evaluate the correlation between the dentine fracture resistance (n = 30 each) and interfacial layer thickness. Specimens immersed in a corrected simulated body solution (c-SBF) for 1, 30 and 90 days were used. In all test materials, the Ca and Si concentrations in the root dentine were found to be significantly higher, whereas the Ca/P and Si concentrations increased over time (P < 0.05). The dentine fracture resistance showed a difference at only day 30. The dentine fracture resistance of Biodentine and ProRoot MTA was positively correlated with the Si and Ca/P values, and the mean interfacial layer thickness of all specimens. A high biomineralisation capacity of ProRoot MTA and Biodentine, and their positive effects on the dentine fracture resistance during the first 30 days suggest that they may present more advantages than NeoMTA Plus in apexification treatment.