Intratubular crystal formation in the exposed dentin from nano-sized calcium silicate for dentin hypersensitivity treatment

doi:10.21203/rs.3.rs-2093584/v1

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Intratubular crystal formation in the exposed dentin from nano-sized calcium silicate for dentin hypersensitivity treatment

https://doi.org/10.21203/rs.3.rs-2093584/v1

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Objectives

This study aimed to evaluate intratubular crystal formation from the experimental material consisting of dicalcium silicate and tricalcium silicate (C₂S/C₃S).

Materials and Methods

A total of twenty-four specimens were made by isolating 8 mm of the cervical part centered at the cementoenamel junction of extracted premolars. Twelve samples of the exposed upper dentin surface were treated with ethylenediaminetetraacetic acid followed by sodium hypochlorite to simulate sensitive dentin. The other twelve specimens were not treated and considered as controls. The experimental material consisting of C₂S/C₃S with a nano-scaled particle size was applied to the other twelve specimens by brushing for 10,000 strokes. Each group was randomly divided into four subgroups according to the period of immersion in phosphate-buffered saline (PBS) for 1, 30, 60, and 90 days. The specimens were sectioned longitudinally and examined via scanning electron microscopy and energy dispersion X-ray spectroscopy.

Results

The intratubular crystal was formed in PBS and densely filled the dentinal tubules over time. Crystal formation occurred at a depth of more than 50 µm from the dentin surface. The Ca/P ratio of formed intratubular crystals was 1.68 after three months.

Conclusion

Intratubular crystals were formed and grown in the dentin from nano-sized C₂S/C₃S particles under PBS, and the Ca/P ratio of the crystals was similar to that of hydroxyapatite.

Clinical Relevance

C₂S/C₃S with a nanoscale particle size can form intratubular crystals in PBS, and there is a possibility of reducing dentin hypersensitivity by blocking the dentinal fluid flow.

Intratubular crystal

Dicalcium silicate

Tricalcium silicate

Hydroxyapatite

Dentin hypersensitivity

Dentin hypersensitivity (DH) is defined as “pain arising from exposed dentin in response to stimuli, typically thermal, evaporative, tactile, osmotic, or chemical, which cannot be ascribed to any other form of dental defect or pathology” [1]. According to the hydrodynamic theory, teeth with DH have open dentinal tubules with pulpal patency [2], a channel for stimulus transmission by moving fluids within the tubules [3].

There are several approaches to reduce discomfort from DH. Potassium nitrate could decrease the excitability of the intradental nerve fibers and achieve pain relief [4]. Although the effect of the relief DH appears immediately, it does not last long [5], and there is no substantial evidence supporting its efficacy [6]. Another approach is occluding the tubules by hindering the tubular fluid movement. The concept of tubule occlusion is a logical extension of the hydrodynamic theory [7]. Products, including strontium, bioactive glass particles, amorphous calcium phosphate, arginine, oxalate, and fluoride, can be found on the market using ions and salt. The limitations of these desensitizers are related to the lack of intratubular occlusion due to large particle size and high solubility of the occluding materials, and the short duration of effective time due to poor resistance to acid attacks [8–10]. Moreover, the desensitizing effects depend significantly on the individual’s sensory threshold [11].

Effective occlusion of dentinal tubules is difficult due to the small dimensions of dentinal tubules (0.5–4 µm in diameter) [2], the complex structure of a pulp-dentin system, and the outward hydraulic pressure of dental pulp (0.15 kg/cm²) [12]. For effective management of dentine hypersensitivity, new materials are required to penetrate deep enough into dentinal tubules, last a long time, and not easily wash out with the oral environment [13]. Various types of materials, such as bioceramics, synthetic polymers, and peptides, were attempted as alternative desensitizers. However, these alternative materials did not completely overcome the disadvantages of the existing desensitizers mentioned above [14, 15].

Calcium silicate can form calcium phosphate precipitate when in contact with physiological fluid containing phosphate ions [16, 17]. A tag-like structure in the dentinal tubule was observed after calcium silicate-based sealer application during the root canal filling procedure [18]. However, no studies have used calcium silicate as a desensitizer and applied it to the outer dentin surface over a given period.

This study aimed to investigate whether intratubular crystals were formed in dentinal tubules when the experimental material containing dicalcium silicate (2CaO.SiO₂, C₂S)∙tricalcium silicate (3CaO.SiO₂, C₃S) was applied to the exposed outer dentin surface under PBS for three months.

Specimen preparation

This study was approved by the Ethics Committee of Seoul National University, Graduate School of Dentistry (IRB number: S-D20190010). Twenty-four recently extracted human premolars for orthodontic treatment with intact coronal and root surfaces were prepared. They were stored in 0.1% thymol solution to inhibit microbial growth for no longer than three months prior to use. The debris on the surface of all teeth was removed using a perio-curette and examined whether there were crack lines under a microscope (200×) (Carl Zeiss Surgical GmbH, Oberkochen, Germany).

A specimen with a total length of 8 mm was made by cutting the 4 mm above and below the cemento-enamel junction with a low-speed diamond saw (Isomet™, Buehler, Lake Bluff, IL, USA) under constant water cooling. Flat and fresh dentin was exposed on the occlusal side surface without perforation at the pulp horn area. The residual pulp tissue was removed carefully using small forceps without touching the inner part of the pulpal space. Then, the sectioned tooth was mounted in the ring-shaped acrylic mold with self-cured acrylic resin (Bosworth Fastray, Keystone Industries GmbH, Singen, Germany) (Fig. 1).

The exposed upper dentin surface of each specimen was treated with 17% ethylenediaminetetraacetic acid (EDTA) for one minute, followed by 2.5 mL of 5.25% sodium hypochlorite to open dentinal tubules and remove the smear layer on the exposed dentin surface and rinsed with 10 mL of distilled water twice.

Table 1

Experimental materials of the study
Groups (n = 12)	Component	Content (wt%)
C₂S/C₃S	Dicalcium silicate (2CaO.SiO₂, C₂S)	10–15
	Tricalcium silicate (3CaO.SiO₂, C₃S)	70–80
	Others	5

C₂S/C₃S preparation and application

The experimental material consisting of dicalcium silicate and tricalcium silicate (C₂S/C₃S) was prepared via a sol-gel method described by Zhao W and Chang J [19] using CaCO₃, SiO₂, and Al₂O₃ as raw materials, and the obtained material calcined at 1,450 ℃ for 6 hours. The resultant powders were ground at 300 rpm using a Disk Mill (Disk Mill, KM tech, Icheon, Republic of Korea) and then at 200 rpm using a Ball Mill (BML-2, DAITHAN SCIENTIFIC GROUP, Wonju-si, Republic of Korea) for 48 hours. Table 1 shows the main component and content of the experimental material. The particle size of the experimental material ranged from 0.052 µm (D0.1) to 1.267 µm (D0.9), and the median value (D0.5) was 0.184 µm (Fig. 2).

After preparing the specimens, 0.5 g of C₂S/C₃S was mixed with 5 ml of distilled water and applied to the exposed dentin surface of the specimen via tooth brushing motion. Per the ISO 11609 standards for the dentin wear test, the abrasive in the dentifrice is approximately 10% of the dentifrice and water mixture. The concentration of the tricalcium silicate applied followed this standard. A total of 10,000 repeated strokes (1 stroke/second) were applied using the toothbrush onto each specimen under a 150-g load continuously being touched among test material mixtures and the exposed dentin surface.

The specimens were randomly divided into four subgroups according to the period of immersion in PBS (D8662, Sigma-Aldrich, St. Louis, MO, U.S.A.) media for 1, 30, 60, and 90 days at 37 ℃ (n = 3). The PBS solution was replaced every seven days. The composition (in g/L) of used PBS was CaCl₂•2H₂O 0.133, MgCl₂•6H₂O 0.1, KCI 0.2, KH₂PO₄ 0.2, NaCl 8.0, Na₂HPO₄ (anhydrous) 1.15, and the pH was 7.4.

Scanning electron microscope analysis and EDS analysis

The specimens were longitudinally sectioned, and six sectioned surfaces in each group were examined to assess crystal formation in dentinal tubules after C₂S/C₃S application on exposed upper dentin surfaces. All specimens were mounted on aluminum stubs and sputter-coated with a 30-nm layer of gold and examined using field emission scanning electron microscopy (FE-SEM, Apreo S; Thermo Fisher SCIENTIFIC, Waltham, MA, U.S.A.). The intratubular crystals were examined using energy-dispersive spectroscopy (EDS, XFlash 6160, Bruker, Germany) to analyze the components.

Figure 3 represents SEM images of a longitudinally sectioned specimen immersed for two months in PBS after applying the experimental material consisting of dicalcium silicate and tricalcium silicate (C₂S/C₃S). There were plug-shaped precipitates below the dentinal tubule orifice. The lower surface of the occluding plug became rough, and plate-shaped intratubular crystals were formed below the occluding plug. The intratubular crystals were formed at a depth of more than 50 µm from the surface of the exposed dentin (Fig. 3, white arrows).

Figure 4 shows the SEM images of longitudinally sectioned specimens. There was no intratubular crystal formation in all specimens for the entire observation period in the control group (white arrows in a). In the experimental group, the roughening of the inner surface of the dentinal tubules was observed after one day, and plate-shaped crystals were formed in the dentinal tubules after two months. As the period of storage in the media gets longer, the plate-shaped crystals are linked together to form a denser collection (white arrows in b).

Table 2

Ca/P ratio of the intratubular crystals
Time	1d	30d	60d	90d
Ca/P	1.57	1.59	1.64	1.68
^* Hydroxyapatite (HAp), Ca₁₀(PO₄)₆(OH)₂, Ca/P = 1.67

The composition of the intratubular crystals in PBS was evaluated using EDS. After immersion in PBS for one day, the Ca/P ratio of the crystal was 1.57. Then, the Ca/P ratio increased to 1.68 after 90 days, which meant the crystals from C₂S/C₃S in PBS were supposed to be hydroxyapatite-like crystals, of which the Ca/P ratio was 1.67.

Per the hydrodynamic theory, blocking the opened dentinal tubules could reduce discomfort from DH by reducing fluid movement through dentinal tubules [3]. In this study, intratubular crystals were formed in PBS after the experimental material was applied to the exposed dentin surface and filled the dentinal tubules more densely as the period of storage in PBS increased.

In the case of intratubular crystal formation in a previous study [18], when using a calcium silicate-based sealer for root canal treatment, calcium silicate was continuously present inside the root canal and in contact with the dentinal tubules. For DH treatment, a desensitizer should be applied to the dentin surface exposed to the outside, which is not in contact with the surface of dentin continuously exposed due to physical and chemical factors in the oral cavity. Therefore, to improve intratubular occlusion, desensitizers must efficiently penetrate the dentinal tubules.

In this study, efforts were made to achieve efficient penetration of experimental particles as greater penetration of particles into the dentinal tubules would have occurred. First, the experimental material used in this study consisted of particles with a smaller diameter than in other studies using calcium silicate (lower than 85 µm or 0.5 mm) [20, 21] or calcium silicate in commercially available mineral trioxide aggregate products [22]. The diameter of dentinal tubules of sensitive dentin is larger than that of non-sensitive dentin; however, it is only 0.83 µm on average [2]. The small dimension of dentinal tubules makes it difficult for desensitizers to efficiently penetrate [12]. According to a study by Kim et al. [23], comparing the degree of absorption according to the particle size of the desensitizer, desensitizers with small-sized particles were more likely to penetrate the dental tubules. Therefore, the experimental materials consisting of specially designed nanoscale particles used in this study would effectively penetrate the dentinal tubules and form occluding plugs, as in other studies [24]. Second, C₂S/C₃S was applied via a brushing motion to the dentin surface. This indicated that calcium silicate was contained in toothpaste and applied to the surface of the dentin when brushing. A total of 10,000 repeated strokes (1 stroke/second) of brushing simulated for about 18.5 days assuming brushing three minutes/time and three times a day [25]. It can more likely push desensitizing materials into dentinal tubules compared with just dropping or rubbing with a micro-brush on the specimen surface. As a result, the occluding plug was formed below the dentinal tubule orifice in applying the experimental material to the brushing motion (Fig. 3).

The occluding plugs can act as a reservoir of calcium ions, continuously dissolving calcium ions and forcing the inside of the dentinal tubules into a supersaturation state [26]. The supersaturation condition was expected to cause the local aggregation of calcium ions and phosphate ions due to their interaction with ions present on the inner surface of the dentinal tubules, which caused the growth of the intratubular crystals [24]. From this reaction, it can be inferred that the lower part of the occluding plug was rough, and plate-shaped crystals were formed below (Fig. 3b, white arrowheads).

The intratubular crystal formation reaction by diffusion per the concentration gradient of ions can occur at a deep point in the dentinal tubules. In this study, the intratubular crystals were formed at a depth of more than 50 µm from the exposed dentin surface (Fig. 3a, white arrows). In a clinical situation, the superficial occlusion of dentinal tubules has a short-term effect as the precipitates can be easily removed due to daily tooth brushing, dissolution by saliva, and the consumption of acidic beverages [27]. For the long-term effect of desensitizers, the material blocking the dentinal tubules should be deep enough [28].

Crystal formation reactions continuously occur in dentinal tubules forming denser crystal complexes as the duration of storage in PBS increases (Fig. 4). The crystal complex is expected to contribute to preventing the movement of the pulpal fluid through the dentinal tubules and reduce discomfort from DH more effectively [7, 29]. Further research will be needed on the clinical effectiveness of the experimental material.

When C₂S and C₃S are in contact with water, they are hydroxylated, and the surface dissolves according to the equation below [30]:

$$2(2CaO\bullet Si{O}_{2})+4{H}_{2}O\to 3CaO\bullet 2Si{O}_{2}\bullet 3{H}_{2}O+Ca{\left(OH\right)}_{2}$$

$$2(3CaO\bullet Si{O}_{2})+6{H}_{2}O\to 3CaO\bullet 2Si{O}_{2}\bullet 3{H}_{2}O+3Ca{\left(OH\right)}_{2}$$

As a result of these reactions, calcium and hydroxyl ions are released, resulting in a highly alkaline environment [31]. After the hydration reaction of calcium silicate, the hydroxyapatite-like crystals are formed during contact with PBS [32, 33]. A previous study showed calcium-deficient and B-type carbonated apatite with a 1.4–1.5 Ca/P ratio formed from Portland cement in PBS [33]. Other studies demonstrated that calcium silicate in PBS could make hydroxyapatite after hydration [34–36]. In this study, the Ca/P ratio of formed intratubular crystals was 1.68 after three months. Considering that the Ca/P ratio of hydroxyapatite is 1.67 [37], it can be expected that the intratubular crystals made in this experiment would be hydroxyapatite-like crystals.

However, this experimental design could not simulate a real oral environment, such as an acid challenge from the diet. Therefore, further studies need to be performed to evaluate the effect of the acid-neutral cycle on intratubular crystal formation.

This study demonstrated that the experimental material could form intratubular crystals in PBS after being applied to the exposed dentin surface. The crystal formation occurred at a distance of more than 50 µm from the dentin surface, and the crystals more densely filled the dentinal tubules over time. The experimental material consisting of C₂S/C₃S with a nano-scaled particle size used in this study allowed for effective penetration to dentinal tubules and the formation of intratubular crystals, which makes the material a promising alternative for clinical use to reduce discomfort from DH.

Ethical Approval Approval was obtained from the ethics committee of Seoul National University (IRB number: S-D20190010). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participate Informed consent was obtained from all individual participants included in the study.

Funding This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2020R1F1A1076307).

Conflict of interest The authors declare that they have no conflict of interest.

Authors' contributions Mi-Jeong Jeon designed the analysis, collected the data, performed the analysis, and wrote the main manuscript text. Jeong-Won Park designed and performed the analysis. Deog-Gyu Seo designed experiment, performed the analysis, contributed analysis method and tool. All authors reviewed and edited the manuscript.

Acknowledgments

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2020R1F1A1076307).

Hypersensitivity CABoD (2003) Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc 69:221–226.
Absi EG, Addy M, Adams D (1987) Dentine hypersensitivity: a study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. J Clin Periodontol 14:280–284. https://doi.org/10.1111/j.1600-051X.1987.tb01533.x
Brannstrom M (1963) A hydrodynamic mechanism in the transmission of pain-producing stimuli through the dentine. Sensory mechanisms in dentine:73–79.
Schmidlin PR, Sahrmann P (2013) Current management of dentin hypersensitivity. Clin Oral Investig 17 Suppl 1:S55-59. https://doi.org/10.1007/s00784-012-0912-0
Solati M, Fekrazad R, Vahdatinia F, Farmany A, Farhadian M, Hakimiha N (2022) Dentinal tubule blockage using nanobioglass in the presence of diode (980 nm) and Nd: YAG lasers: an in vitro study. Clin Oral Investig 26:2975–2981. https://doi.org/10.1007/s00784-021-04279-8
Poulsen S, Errboe M, Lescay Mevil Y, Glenny AM (2006) Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database Syst Rev 2006:Cd001476. https://doi.org/10.1002/14651858.CD001476.pub2
Pashley DH (1986) Dentin permeability, dentin sensitivity, and treatment through tubule occlusion. J Endod 12:465–474. https://doi.org/10.1016/S0099-2399(86)80201-1
Suge T, Ishikawa K, Kawasaki A, Yoshiyama M, Asaoka K, Ebisu S (1995) Duration of dentinal tubule occlusion formed by calcium phosphate precipitation method: in vitro evaluation using synthetic saliva. J Dent Res 74:1709–1714. https://doi.org/10.1177/00220345950740101301
Orchardson R, Gillam DG (2006) Managing dentin hypersensitivity. J Am Dent Assoc 137:990–998; quiz 1028–1029. https://doi.org/10.14219/jada.archive.2006.0321
Al-Sabbagh M, Brown A, Thomas MV (2009) In-office treatment of dentinal hypersensitivity. Dent Clin North Am 53:47–60, viii. https://doi.org/10.1016/j.cden.2008.11.003
Bartold PM (2006) Dentinal hypersensitivity: a review. Aust Dent J 51:212–218. https://doi.org/10.1111/j.1834-7819.2006.tb00431.x
Chiang Y-C, Lin H-P, Chang H-H, Cheng Y-W, Tang H-Y, Yen W-C, Lin P-Y, Chang K-W, Lin C-P (2014) A mesoporous silica biomaterial for dental biomimetic crystallization. ACS nano 8:12502–12513. https://doi.org/10.1021/nn5053487
Addy M, Embery G, Edgar WM, Orchardson R (2000) Tooth wear and sensitivity. London Martin Dunitz:339–362.
Mrinalini UB, Hegde MN, Bhat GS (2021) An update on dentinal hypersensitivity-aetiology to management–a review. J Evolution Med Dent Sci 10:3289–3293. https://doi.org/10.14260/jemds/2021/667
Miglani S, Aggarwal V, Ahuja B (2010) Dentin hypersensitivity: Recent trends in management. J Conserv Dent 13:218–224. https://doi.org/10.4103/0972-0707.73385
Gou Z, Chang J, Zhai W, Wang J (2005) Study on the self-setting property and the in vitro bioactivity of beta-Ca2SiO4. J Biomed Mater Res B Appl Biomater 73:244–251. https://doi.org/10.1002/jbm.b.30203
Zhao W, Wang J, Zhai W, Wang Z, Chang J (2005) The self-setting properties and in vitro bioactivity of tricalcium silicate. Biomaterials 26:6113–6121. https://doi.org/10.1016/j.biomaterials.2005.04.025
Yoo YJ, Baek SH, Kum KY, Shon WJ, Woo KM, Lee W (2016) Dynamic intratubular biomineralization following root canal obturation with pozzolan-based mineral trioxide aggregate sealer cement. Scanning 38:50–56. https://doi.org/10.1002/sca.21240
Zhao W, Chang J (2004) Sol–gel synthesis and in vitro bioactivity of tricalcium silicate powders. Materials Letters 58:2350–2353. https://doi.org/10.1016/j.matlet.2004.02.045
Dong Z, Chang J, Deng Y, Joiner A (2011) Tricalcium silicate induced mineralization for occlusion of dentinal tubules. Aust Dent J 56:175–780. https://doi.org/10.1111/j.1834-7819.2011.01321.x
Gandolfi MG, Silvia F, Gasparotto G, Carlo P (2008) Calcium silicate coating derived from Portland cement as treatment for hypersensitive dentine. J Dent 36:565–578. https://doi.org/10.1016/j.jdent.2008.03.012
Komabayashi T, Spångberg LS (2008) Comparative analysis of the particle size and shape of commercially available mineral trioxide aggregates and Portland cement: a study with a flow particle image analyzer. J Endod 34:94–98. https://doi.org/10.1016/j.joen.2007.10.013
Yuan P, Liu S, Lv Y, Liu W, Ma W, Xu P (2019) Effect of a dentifrice containing different particle sizes of hydroxyapatite on dentin tubule occlusion and aqueous Cr (VI) sorption. Int J Nanomedicine 14:5243–5256. https://doi.org/10.2147/ijn.S205804
Berg C, Unosson E, Engqvist H, Xia W (2020) Amorphous calcium magnesium phosphate particles for treatment of dentin hypersensitivity: a mode of action study. ACS Biomater Sci Eng 6:3599–3607. https://doi.org/10.1021/acsbiomaterials.0c00262
Jang Y, Ihm J-J, Baik S-J, Yoo K-J, Jang D-H, Roh B-D, Seo D-G (2015) Dentin wear after simulated toothbrushing with water, a liquid dentifrice or a standard toothpaste. Am J Dent 28:333–336.
Reynolds EC (1997) Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 76:1587–1595. https://doi.org/10.1177/00220345970760091101
Kuroiwa M, Kodaka T, Kuroiwa M, Abe M (1994) Dentin hypersensitivity. Occlusion of dentinal tubules by brushing with and without an abrasive dentifrice. J Periodontol 65:291–296. https://doi.org/10.1902/jop.1994.65.4.291
Kunam D, Manimaran S, Sampath V, Sekar M (2016) Evaluation of dentinal tubule occlusion and depth of penetration of nano-hydroxyapatite derived from chicken eggshell powder with and without addition of sodium fluoride: an in vitro study. J Conserv Dent 19:239–244. https://doi.org/10.4103/0972-0707.181940
Mehta D, Gowda V, Finger WJ, Sasaki K (2015) Randomized, placebo-controlled study of the efficacy of a calcium phosphate containing paste on dentin hypersensitivity. Dent Mater 31:1298–1303. https://doi.org/10.1016/j.dental.2015.08.162
Camilleri J (2008) Characterization of hydration products of mineral trioxide aggregate. Int Endod J 41:408–417. https://doi.org/10.1111/j.1365-2591.2007.01370.x
Camilleri J (2007) Hydration mechanisms of mineral trioxide aggregate. Int Endod J 40:462–470. https://doi.org/10.1111/j.1365-2591.2007.01248.x
Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I (2005) Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 31:97–100. https://doi.org/10.1097/01.don.0000133155.04468.41
Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller RN (2007) Calcium phosphate phase transformation produced by the interaction of the portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid. J Endod 33:1347–1351. https://doi.org/10.1016/j.joen.2007.07.008
Martin RL, Monticelli F, Brackett WW, Loushine RJ, Rockman RA, Ferrari M, Pashley DH, Tay FR (2007) Sealing properties of mineral trioxide aggregate orthograde apical plugs and root fillings in an in vitro apexification model. J Endod 33:272–275. https://doi.org/10.1016/j.joen.2006.11.002
Reyes-Carmona JF, Felippe MS, Felippe WT (2009) Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid. J Endod 35:731–736. https://doi.org/10.1016/j.joen.2009.02.011
Reyes-Carmona JF, Felippe MS, Felippe WT (2010) The biomineralization ability of mineral trioxide aggregate and Portland cement on dentin enhances the push-out strength. J Endod 36:286–291. https://doi.org/10.1016/j.joen.2009.10.009
Guo H, Wei J, Yuan Y, Liu C (2007) Development of calcium silicate/calcium phosphate cement for bone regeneration. Biomed Mater 2:S153. https://doi.org/10.1088/1748-6041/2/3/S13

No competing interests reported.

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Version 1

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Read the latest preprint version →

Intratubular crystal formation in the exposed dentin from nano-sized calcium silicate for dentin hypersensitivity treatment

Archived Versions:

Version 1

Abstract

Objectives

Materials and Methods

Results

Conclusion

Clinical Relevance

Figures

Introduction

Materials And Methods

Specimen preparation

C₂S/C₃S preparation and application

Scanning electron microscope analysis and EDS analysis

Results

Discussion

Conclusions

Declarations

References

Additional Declarations

Archived Versions:

Version 1

Intratubular crystal formation in the exposed dentin from nano-sized calcium silicate for dentin hypersensitivity treatment

Archived Versions:

Version 1

Abstract

Objectives

Materials and Methods

Results

Conclusion

Clinical Relevance

Figures

Introduction

Materials And Methods

Specimen preparation

C2S/C3S preparation and application

Scanning electron microscope analysis and EDS analysis

Results

Discussion

Conclusions

Declarations

References

Additional Declarations

Archived Versions:

Version 1

C₂S/C₃S preparation and application