Comparative evaluation of calcium ion release from three bioceramic cements in simulated immature teeth with open apices

Objective: This study aimed to evaluate the calcium ion (Ca2+) release from apical plugs formed by three different bioceramic cements in simulated immature teeth with open apices.Methods: In this in-vitro study, 66 single-rooted lower premolar teeth were divided into three groups, each containing 22 samples, as follows: Group A: ProRoot MTA, Group B: Bio-C Repair, and Group C: Dia-Root Bio MTA. Each sample was prepared to simulate immature teeth with open apices. A 4 mm apical plug was inserted at the open apex area. Calcium ion release was measured on the 7th, 15th, and 30th days using an atomic absorption spectrophotometer. Data were analyzed using Kruskal–Wallis, and Mann-Whitney U tests at the significance level of P < 0.05.Results: The apical plugs formed by different groups showed significant differences in Ca2+ release over 30 days (P<0.001). Group C had the highest release on days 7 (18.08 ± 0.57 ppm) and 15 (16.39 ± 0.75 ppm), whereas Group B showed the lowest levels (P < 0.05). On day 30, Group A had the highest Ca2+ release (2.36 ± 0.25 ppm), which was significantly greater than that of Groups B and C (P < 0.05).Conclusions: Dia-Root Bio MTA showed the highest calcium ion release on days 7 and 15, whereas ProRoot MTA exhibited the most significant release on day 30. Both Dia-Root Bio MTA and ProRoot MTA are more favorable options than Bio-C Repair for root repair in immature, non-vital teeth