Portland Cement: An Overview as a Root Repair Material: Applications and Various Modifications

Abstract

Background: Portland cement has promisingly been utilized for the reconstruction of root perforation and bone defects, although its key drawbacks, including low mechanical properties and radiopacity as well as long setting time, necessitate pragmatic modifications. Objective: The main objective of this review was an overview of portland cement as a root repair material, its applications and various modifications. Methods: The electronic search of the literature was done on the Pubmed and Google Scholar databases with the keywords of Portland cement, carbon nanotube, graphene oxide, MTA, pulp capping, and root repair material. Results: The first part of this paper presents the data published in the literature on applications of Portland cement in endodontic situations, including vital pulp therapy, root perforation repair, root canal filling and root-end filling following apical endodontic surgery. This bioactive endodontic cement has shown promising success rates compared to mineral trioxide aggregate (MTA), however, considerable modifications are required in order to improve its clinical performance and expand its application scope as a root repair material. Hence, nano-reinforcements (graphene oxide, carbon nanotube, silica and hydroxyapatite) and extensive chemical modifications incorporated into Portland cement composition to produce innovative bio-dental materials with superior rheological properties have been discussed. Moreover, the current knowledge of the microstructure, mechanical properties and durability of nanomaterial-incorporated cement has been summarized. Ultimately, this article outlines the main points of animal and clinical studies on resin-modified Portland cement (TheraCal) as a pulp capping material and suggests further investigations prior to marketing authorization. Conclusion: It can be concluded that Portland cement has the potential to be used as an acceptable pulp capping material with the least complaints in the long term.