Selected Calcium Silicate-Based Endodontic Cements: From Physicochemical Properties and Molecular Bioactivity to Indication-Specific Clinical Performance
6 affiliations
- 1Student Scientific Club of the Department of Orthodontics, Medical University of Lodz, 92-213 Lodz, Poland
- 2Central Teaching Hospital, Medical University of Lodz, 92-213 Lodz, Poland
- 3College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China
- 4Key Laboratory of Molecular Biophysics of the Ministry of Education, Wuhan 430074, China
- 5Department of Orthodontics, Medical University of Lodz, 92-213 Lodz, Poland
- 6Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland
Abstract
Calcium silicate-based cements are increasingly used in vital pulp therapy, endodontic repair, and regenerative procedures, but their selection remains complicated by differences in formulation, hydration behavior, mechanical maturation, biological activity, and clinical evidence. This review integrates physicochemical, mechanical, biological, and clinical data on mineral trioxide aggregate (MTA), Biodentine, EndoSequence Root Repair Material (ERRM), and calcium-enriched mixture (CEM) cement within a mechanistic-to-clinical framework linking material composition and hydration with ion release, alkalization, interfacial mineralization, cellular responses, and indication-specific performance. MTA remains the reference material with the most mature clinical evidence, although conventional formulations remain limited by prolonged setting, handling difficulties, and discoloration risk. Biodentine combines relatively rapid setting, favorable handling and esthetic characteristics, and pronounced early bioactivity. ERRM provides a convenient premixed formulation and promising mechanical, sealing, and biological performance, whereas CEM cement combines calcium- and phosphate-related bioactivity, antimicrobial activity, and encouraging clinical outcomes, particularly in vital pulp therapy. Across all materials, improvements in individual properties are accompanied by formulation-dependent trade-offs involving solubility, porosity, radiopacity, maturation kinetics, and biological response. Substantial methodological heterogeneity limits direct numerical ranking. Material selection should therefore be indication-specific and integrate material behavior with the maturity of supporting clinical evidence.
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BibTeX
@article{sedek2026selected,
title = {{Selected Calcium Silicate-Based Endodontic Cements: From Physicochemical Properties and Molecular Bioactivity to Indication-Specific Clinical Performance}},
author = {Natalia Sędek and Maria Adamska and Kamil Saramowicz and Pengyu Zhao and Konrad Małkiewicz and Wioletta Rozpędek-Kamińska},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = nov,
doi = {10.3390/ijms272110042},
url = {https://www.mdpi.com/1422-0067/27/21/10042},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Selected Calcium Silicate-Based Endodontic Cements: From Physicochemical Properties and Molecular Bioactivity to Indication-Specific Clinical Performance
AU - Natalia Sędek
AU - Maria Adamska
AU - Kamil Saramowicz
AU - Pengyu Zhao
AU - Konrad Małkiewicz
AU - Wioletta Rozpędek-Kamińska
PY - 2026
DA - 2026/11/09
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms272110042
UR - https://www.mdpi.com/1422-0067/27/21/10042
AB - Calcium silicate-based cements are increasingly used in vital pulp therapy, endodontic repair, and regenerative procedures, but their selection remains complicated by differences in formulation, hydration behavior, mechanical maturation, biological activity, and clinical evidence. This review integrates physicochemical, mechanical, biological, and clinical data on mineral trioxide aggregate (MTA), Biodentine, EndoSequence Root Repair Material (ERRM), and calcium-enriched mixture (CEM) cement within a mechanistic-to-clinical framework linking material composition and hydration with ion release, alkalization, interfacial mineralization, cellular responses, and indication-specific performance. MTA remains the reference material with the most mature clinical evidence, although conventional formulations remain limited by prolonged setting, handling difficulties, and discoloration risk. Biodentine combines relatively rapid setting, favorable handling and esthetic characteristics, and pronounced early bioactivity. ERRM provides a convenient premixed formulation and promising mechanical, sealing, and biological performance, whereas CEM cement combines calcium- and phosphate-related bioactivity, antimicrobial activity, and encouraging clinical outcomes, particularly in vital pulp therapy. Across all materials, improvements in individual properties are accompanied by formulation-dependent trade-offs involving solubility, porosity, radiopacity, maturation kinetics, and biological response. Substantial methodological heterogeneity limits direct numerical ranking. Material selection should therefore be indication-specific and integrate material behavior with the maturity of supporting clinical evidence.
SN - 1422-0067
ER -