Development of novel tricalcium silicate-based endodontic cements with sintered radiopacifier phase

Clinical Oral Investigations
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All implants, bone and endodontic cements need to be sufficiently radiopaque to be able to be distinguished from neighbouring anatomical structures post-operatively. For this purpose, radiopacifying materials are added to the cements to render them sufficiently radiopaque. Bismuth oxide has been quite a popular choice of radiopacifier in endodontic materials. It has been shown to cause dental discoloration. The aim of this study was to develop, characterize and assess the properties of tricalcium silicate cement with alternative radiopacifiers, which are either inter-ground or sintered to the tricalcium silicate cement.


Custom-made endodontic cements based on tricalcium silicate and 20 % barium, calcium or strontium zirconate, which were either inter-ground or sintered at high temperatures, were produced. The set materials stored for 28 days in Hank’s balanced salt solution were characterized by scanning electron microscopy and X-ray diffraction analysis. Assessment of pH, leaching, interaction with physiological solution, radiopacity, setting time, compressive strength and material porosity were investigated. Mineral trioxide aggregate (MTA) Angelus was used as control.


Addition of radiopacifying materials improved the radiopacity of the material. The sintered cements exhibited the formation of calcium zirconate together with the respective radiopacifier phase. All materials produced calcium hydroxide on hydration, which interacted with tissue fluids forming hydroxyapatite on the material surface. The physical properties of the tricalcium silicate-based cements were comparable to MTA Angelus.


A novel method of producing radiopaque tricalcium silicate-based cements was demonstrated. The novel materials exhibited properties, which were either comparable or else improved over the control.

Clinical relevance

The novel materials can be used to replace MTA for root-end filling, perforation repair and other clinical applications where MTA is indicated.


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