Basic Research| Volume 37, ISSUE 1, P67-71, January 2011

Radiopacity Evaluation of Calcium Aluminate Cement Containing Different Radiopacifying Agents



      The aim of this study was to evaluate the radiopacity of calcium aluminate cement (EndoBinder) with 3 different radiopacifiers (bismuth oxide, zinc oxide, or zirconium oxide) in comparison with gray mineral trioxide aggregate (GMTA), white MTA, and dental structures (enamel and dentin).


      Eighteen test specimens of each cement with thicknesses of 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm (n = 3) were made by using a stainless steel matrix and were adapted to a standardizing device (8 × 7 cm) with a graduated aluminum stepwedge varying from 2.0–16.0 mm in thickness. To compare the radiopacity of the cements with that of dental structures, slices of first molars with a thickness increasing from 0.5–3.0 mm were obtained and placed on the standardizing device. One occlusal radiograph for each tested cement was taken, with exposure time of 0.1 seconds and focus-film distance of 20 cm. Films were processed in an automatic device, and the mean radiopacity values were obtained by using a photodensitometer.


      Mean values showed that the thicker the specimen was, the greater was its radiopacity. Only EndoBinder + bismuth oxide (EBBO) and GMTA demonstrated radiopacity values greater than 3.0 mm of the aluminum scale for all thicknesses. When zinc oxide was used as radiopacifier agent, EndoBinder only reached the desired radiopacity with a thickness of 2.0 mm, and with zirconium oxide it was 2.5 mm.


      Bismuth oxide was the most efficient radiopacifier for EndoBinder, providing adequate radiopacity in all studied thicknesses, as recommended by ISO 6876, being similar to GMTA.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ørstavik D.
        • Nordahl I.
        • Tibballs J.E.
        Dimensional change following setting of root canal sealer materials.
        Dent Mater. 2001; 17: 512-519
        • Ribeiro D.A.
        Do endodontic compounds induce genetic damage? a comprehensive review.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 251-256
        • Tanomaru-Filho M.
        • da Silva G.F.
        • Duarte M.A.
        • Gonçalves M.
        • Tanomaru J.M.
        Radiopacity evaluation of root-end filling materials by digitization of images.
        J Appl Oral Sci. 2008; 16: 376-379
        • Al-Kahtani A.
        • Shostad S.
        • Schifferle R.
        • Bhambhani S.
        In vitro evaluation of microleakage of an orthograde apical plug of mineral trioxide aggregate in permanent teeth with simulated immature apices.
        J Endod. 2005; 31: 117-119
        • Accorinte Mde L.
        • Holland R.
        • Reis A.
        • et al.
        Evaluation of mineral trioxide aggregate and calcium hydroxide cement as pulp-capping agents in human teeth.
        J Endod. 2008; 34: 1-6
        • Menezes R.
        • Bramante C.M.
        • Letra A.
        • Carvalho V.G.
        • Garcia R.B.
        Histologic evaluation of pulpotomies in dog using two types of mineral trioxide aggregate and regular and white Portland cements as wound dressings.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 376-379
        • Main C.
        • Mirzayan N.
        • Shabahang S.
        • Torabinejad M.
        Repair of root perforations using mineral trioxide aggregate: a long-term study.
        J Endod. 2004; 30: 80-83
        • Simon S.
        • Rilliard F.
        • Berdal A.
        • Machtou P.
        The use of mineral trioxide aggregate in one-visit apexification treatment: a prospective study.
        Int Endod J. 2007; 40: 186-197
        • Jacobovitz M.
        • de Lima R.K.
        Treatment of inflammatory internal root resorption with mineral trioxide aggregate: a case report.
        Int Endod J. 2008; 41: 905-912
        • Saunders W.P.
        Prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling.
        J Endod. 2008; 34: 660-665
        • Parirokh M.
        • Torabinejad M.
        Mineral trioxide aggregate: a comprehensive literature review—part I: chemical, physical, and antibacterial properties.
        J Endod. 2010; 36: 16-27
        • Asgary S.
        • Parirokh M.
        • Eghbal M.F.
        • Brink F.
        Chemical differences between white and gray mineral trioxide aggregate.
        J Endod. 2005; 31: 101-103
        • Torabinejad M.
        • Hong C.U.
        • McDonald F.
        • Pitt Ford T.R.
        Physical and chemical properties of a new root-end filling material.
        J Endod. 1995; 21: 349-353
        • Ber B.S.
        • Hatton J.F.
        • Stewart G.P.
        Chemical modification of proroot mta to improve handling characteristics and decrease setting time.
        J Endod. 2007; 33: 1231-1234
        • Bortoluzzi E.A.
        • Broon N.J.
        • Bramante C.M.
        • Garcia R.B.
        • de Moraes I.G.
        • Bernardineli N.
        Sealing ability of MTA and radiopaque Portland cement with or without calcium chloride for root-end filling.
        J Endod. 2006; 32: 897-900
        • Camilleri J.
        Evaluation of the physical properties of an endodontic Portland cement incorporating alternative radiopacifiers used as root-end filling material.
        Int Endod J. 2010; 43: 231-240
        • Jacobovitz M.
        • de Pontes Lima R.K.
        The use of calcium hydroxide and mineral trioxide aggregate on apexification of a replanted tooth: a case report.
        Dent Traumatol. 2009; 25: e32-e36
        • Fridland M.
        • Rosado R.
        Mineral trioxide aggregate (MTA) solubility and porosity with different water-to-powder ratios.
        J Endod. 2003; 29: 814-817
        • Porter M.L.
        • Bertó A.
        • Primus C.M.
        • Watanabe I.
        Physical and chemical properties of new-generation endodontic materials.
        J Endod. 2010; 36: 524-528
        • Duarte M.A.
        • De Oliveira Demarchi A.C.
        • Yamashita J.C.
        • Kuga M.C.
        • De Campos Fraga S.
        Arsenic release provided by MTA and Portland cement.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 648-650
        • Monteiro Bramante C.
        • Demarchi A.C.
        • de Moraes I.G.
        • et al.
        Presence of arsenic in different types of MTA and white and gray Portland cement.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: 909-913
      1. Pandolfelli VC, Oliveira IR, Rosseto HL, Jacobovitz M. A composition based on aluminate cement for application in endodontics and the obtained cement product. Patent registration INPI 0704502-6, Portuguese, 2007.

        • Jacobovitz M.
        • Vianna M.E.
        • Pandolfelli V.C.
        • Oliveira I.R.
        • Rossetto H.L.
        • Gomes B.P.
        Root canal filling with cements based on mineral aggregates: an in vitro analysis of bacterial microleakage.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: 140-144
        • International Standards Organization
        Dental root canal sealing materials.
        International Standards Organization, Geneva, Switzerland2001 (BS EN ISO 6876-7.8)
        • ANSI/ADA
        Specification no. 57 endodontic sealing material.
        ANSI/ADA, Chicago, IL2000
        • Kim E.C.
        • Lee B.C.
        • Chang H.S.
        • Lee W.
        • Hong C.U.
        • Min K.S.
        Evaluation of the radiopacity and cytotoxicity of Portland cements containing bismuth oxide.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: e54-e57
        • Camilleri J.
        Characterization of hydration products of mineral trioxide aggregate.
        Int Endod J. 2008; 41: 408-417
        • Ozdemir H.O.
        • Ozçelik B.
        • Karabucak B.
        • Cehreli Z.C.
        Calcium ion diffusion from mineral trioxide aggregate through simulated root resorption defects.
        Dent Traumatol. 2008; 24: 70-73
        • Camilleri J.
        Hydration mechanisms of mineral trioxide aggregate.
        Int Endod J. 2007; 40: 462-470
        • Camilleri J.
        The physical properties of accelerated Portland cement for endodontic use.
        Int Endod J. 2008; 41: 151-157
        • Camilleri J.
        • Gandolfi M.G.
        Evaluation of the radiopacity of calcium silicate cements containing different radiopacifiers.
        Int Endod J. 2010; 43: 21-30
        • Piconi C.
        • Maccauro G.
        Zirconia as a ceramic biomaterial.
        Biomaterials. 1999; 20: 1-25
        • Manson-Hing L.R.
        • Bloxom R.M.
        A stepwedge quality assurance test for machine and processor in dental radiography.
        J Am Dent Assoc. 1985; 110: 910-913
        • Hertz A.
        • Bruce I.J.
        Inorganic materials for bone repair or replacement applications.
        Nanomedicine (Lond). 2007; 2: 899-918
        • Camilleri J.
        The chemical composition of mineral trioxide aggregate.
        J Conserv Dent. 2008; 11: 141-143
        • Islam I.
        • Chng H.K.
        • Yap A.U.
        Comparison of the physical and mechanical properties of MTA and Portland cement.
        J Endod. 2006; 32: 193-197
        • Estrela C.
        • Bammann L.L.
        • Estrela C.R.
        • Silva R.S.
        • Pécora J.D.
        Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, Sealapex and Dycal.
        Braz Dent J. 2000; 11: 3-9
        • Vosoughhosseini S.
        • Lotfi M.
        • Shahi S.
        • et al.
        Influence of white versus gray mineral trioxide aggregate on inflammatory cells.
        J Endod. 2008; 34: 715-717
        • Hammad M.
        • Qualtrough A.
        • Silikas N.
        Extended setting shrinkage behavior of endodontic sealers.
        J Endod. 2008; 34: 90-93
        • Watts D.C.
        • McCabe J.F.
        Aluminium radiopacity standards for dentistry: an international survey.
        J Dent. 1999; 27: 73-78
        • Húngaro Duarte M.A.
        • de Oliveira El Kadre G.D.
        • Vivan R.R.
        • Guerreiro Tanomaru J.M.
        • Tanomaru Filho M.
        • de Moraes I.G.
        Radiopacity of Portland cement associated with different radiopacifying agents.
        J Endod. 2009; 35: 737-740
        • Mjör I.A.
        Human coronal dentine: structure and reactions.
        Oral Surg Oral Med Oral Pathol. 1972; 33: 810-823
        • Turgut M.D.
        • Attar N.
        • Onen A.
        Radiopacity of direct esthetic restorative materials.
        Oper Dent. 2003; 28: 508-514