This second part (Part II) of a two-part comprehensive review of bioactive and biomimetic restorative materials reviews the calcium aluminate-based restorative dental materials. Part II explores the development, composition, properties, and application of the bioactive calcium aluminate-based materials that have been developed for several indications in restorative dentistry.
CLINICAL SIGNIFICANCEBioactive materials have evolved over the past three decades from relatively specialized, highly biocompatible, but low-strength dental materials to now emerge in product compositions for expanded clinical uses in restorative dentistry. Further developments to meet additional restorative clinical needs are anticipated in the newly emerging category of dental materials. (J Esthet Restor Dent 26:27-39, 2014) CALCIUM ALUMINATE CEMENTS Similar to the calcium silicate cements (CSCs), the calcium aluminate cements (CAC) are also derived from the class of cements called "hydraulic" or natural cements. Their hydrating solution is water with 30 to 90 ppm lithium to accelerate the hardening process. A typical CAC contains prereacted constituents as follows: Al2O3 = 43%; CaO = 19%; H2O = 15%; ZrO2 = 19% (silicon, iron, magnesium, titanium, and alkali oxides less than 10%). The calcium aluminate undergoes very rapid hydration with a setting reaction at a pH of 11.4 to 12.5 and the formation of the reaction products Katoite and Gibbsite. Mechanistically, water dissolves the calcium aluminate powder with the subsequent formation of calcium ions calcium ions (Ca 2+ ), aluminum hydroxyl ions (Al(OH)4 -, and hydroxyl ions (OH -). This activity is then followed almost immediately by precipitation of new solid phases (Katoite and Gibbsite) as the solution reaches saturation. These precipitates grow until they meet, and a connected cluster of hydroxide particles is formed continually. Crystallization of the phases proceeds and the hydrates grow in size from nanometers (nm) to microns (μm). This segment is the second part (Part II) of a two-part comprehensive review of bioactive and biomimetic restorative materials. Part I considered the calciumsilicate-based dental materials. Part II will now review the calcium aluminate-based restorative dental materials.