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Ferreira EHRG, Rosas CAP, Limoeiro AGDS, Lima SN, Silva RA, Seckler INB, De Martin AS, Nascimento WM, Bueno CEDS. Effect of obturation technique on dentinal tubule penetration of two tricalcium silicate-based sealers: Ex vivo study. AUST ENDOD J 2024; 50:148-156. [PMID: 38146083 DOI: 10.1111/aej.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
The aim of this study was to assess by confocal laser microscope the depth of dentinal tubule penetration of two tricalcium silicate-based sealers promoted by two obturation techniques in curved canals compared with AHPlus. One hundred and twenty canals were divided into six groups (n = 20): BCSC-Bio-C Sealer (BC) and single-cone technique (SC); BCCW-BC and continuous condensation wave (CW); TFSC-Total Fill (TF) and SC; TFCW-TF and CW; AHSC-AH Plus (AH) and SC; AHCW-AH and CW. Data were analysed using the three-way ANOVA and Tukey's test (α = 5%). Penetration depth was significantly greater for TFCW than TFSC and greater for AHCW than AHSC (p < 0.05). There was no significant difference between BCCW and BCSC (p > 0.05). The penetration of TF was significantly greater (p < 0.05). The CW technique promoted greater intratubular penetration, except for the BC sealer.
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Affiliation(s)
| | | | | | - Samuel Nogueira Lima
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, Brazil
| | - Rafael Amado Silva
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, Brazil
| | | | | | - Wayne Martins Nascimento
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, Brazil
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Pauletto G, Padoin Y, de Pellegrin SF, Bier CAS. The use of sonic and ultrasonic activation of endodontic sealer to improve sealer filling quality in the root canal: a scoping review. Odontology 2024:10.1007/s10266-024-00901-9. [PMID: 38381264 DOI: 10.1007/s10266-024-00901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
This scoping review aimed to map whether the use of sonic and ultrasonic methods to activate the endodontic sealer improves the sealer filling quality in the root canal, considering the bond strength and intratubular penetration to the root dentin as evaluation criteria. The study protocol was prospectively registered and is available online ( https://osf.io/x5fma/ ). Reporting was based on PRISMA Extension for Scoping Reviews. The search was performed in Embase, PubMed, Scopus, and Web of Science. We selected studies without time and language restrictions that used sonic or ultrasonic methods to activate endodontic sealer, whose outcomes were bond strength and intratubular penetration. Three researchers independently selected the articles and collected data. Of 1422 articles, 19 were read in full and 13 studies were included. The vast majority of studies opted for direct activation of the endodontic sealer. The most investigated sealers were the epoxy resin-based sealers, and the ultrasonic activation method was the most explored. For the bond strength outcome, there was a trend toward higher values when the sealer was activated ultrasonically, but the findings seem to be divergent. The sonic activation was not effective for its intended purpose. For the outcome of intratubular penetration, the vast majority of studies indicate that the use of sonic and ultrasonic methods to activate the endodontic sealer is capable of increasing intratubular penetration. The use of sonic and ultrasonic methods to directly activate the endodontic sealer can increase the intratubular penetration of the sealer, but their benefits on the bond strength are uncertain.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil.
| | - Yasmin Padoin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Sidnei Flores de Pellegrin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil
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3
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Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Influence of bioceramic sealers on dentinal tubule penetration and antimicrobial effectiveness: a systematic review and meta-analysis of in vitro studies. Odontology 2024:10.1007/s10266-024-00904-6. [PMID: 38374511 DOI: 10.1007/s10266-024-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate whether bioceramic sealers have better penetration capacity in dentinal tubules and antimicrobial activity when compared to AH Plus® sealer. This SRM was recorded in the Open Science Framework database and followed the guidelines of the PRISMA 2020. Five databases were searched by two independent reviewers. Only in vitro studies that evaluated the effects of bioceramic sealers on dentinal tubule penetration and antimicrobial activity outcomes compared to AH Plus® sealer were included. Meta-analysis was conducted using R software, using the effect measure of the standardized mean difference (SMD) and inverse variance method. A modified Joanna Briggs Institute's Checklist was used for the risk of bias assessment. A total of 1486 studies were identified, and only 54 studies that fulfilled our eligibility criteria were included in this review. There was no statistical difference between the sealers evaluated for dentinal tubule penetration, in the thirds evaluated: coronal SMD 0.58 [0.14; 1.31], p = 0.12; middle SMD 0.07 [0.54; 0.39], p = 0.75; and apical SMD 0.08 [0.73; 0.56], p = 0.80. Both sealers demonstrated similar antimicrobial action (SMD [3.42; 5.32], p = 0.67 and SMD 0.67 [1.89; 0.55], p = 0.28). The studies presented a low risk of bias. Based on the in vitro studies included and according to the limitations of the present review, the data suggest that bioceramic and AH Plus® sealers present similar penetration capacity in dentinal tubules and antimicrobial effect, making them suitable materials to be considered in clinical practice.
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Affiliation(s)
- Marcelo Augusto Seron
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
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Carneiro VF, Alcalde MP, do Vale MS, Vivan RR, Duarte MAH, Vasconcelos BC. Effect of ultrasonic agitation on marginal adaptation, intratubular penetration and bonding strength of calcium-silicate-based endodontic sealers: A laboratory study. AUST ENDOD J 2023; 49:690-699. [PMID: 37363860 DOI: 10.1111/aej.12769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
The effect of ultrasonic activation (UA) on marginal adaptation, intratubular penetration and bond strength provided by three calcium silicate-based sealers was evaluated. Ninety-six distobuccal root canals of maxillary molars were randomly divided into 8 groups (n = 12) according to the sealer and UA application: EndoSequence BC sealer (ESBC), Sealer Plus BC (SPBC) and Bio-C Sealer (BCS), using AH Plus (AH) as a control group. The specimens were sectioned at 2, 4 and 6 mm from the apex. The data were statistically analysed using Kruskall-Wallis, Dunn, Mann-Whitney and chi-squared tests. UA improved the marginal adaptation of ESBC (6 mm), SPBC (all levels), BCS (2/4 mm) and AH (4 mm) (p < 0.05); the bond strength of SBPC (2 mm) and BCS (6 mm) were also improved (p < 0.05). The UA of endodontic silicate-based sealers improved the marginal adaptation in all levels and the bond strength of SBPC and BCS sealer.
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Affiliation(s)
- V F Carneiro
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - M P Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M S do Vale
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - R R Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - M A H Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - B C Vasconcelos
- Post-Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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Barbero-Navarro I, Velázquez-González D, Irigoyen-Camacho ME, Zepeda-Zepeda MA, Mauricio P, Ribas-Perez D, Castano-Seiquer A. Assessment of the Penetration of an Endodontic Sealer into Dentinal Tubules with Three Different Compaction Techniques Using Confocal Laser Scanning Microscopy. J Funct Biomater 2023; 14:542. [PMID: 37998111 PMCID: PMC10672033 DOI: 10.3390/jfb14110542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Adequate root canal sealing is essential for the success of endodontic treatment. There are numerous techniques available; identifying simple and efficient techniques is important to provide good patient care. The purpose of the study was to compare the maximum penetration depth and the percentage of sealant penetration of an endodontic sealer into dentine tubules using cold lateral condensation, continuous wave, and hybrid techniques, and to contrast the effectiveness of two different tapered gutta-percha master cones (0.02 and 0.04). A sample of sixty single root teeth was used. Six experimental groups were formed from the three filling techniques and the two tapered master cones. Images were acquired using a confocal laser scanning microscope. In the apical root third, the penetration percentage was higher in the hybrid compared with the continuous wave technique. The results indicated a higher penetration depth of hybrid compared with cold lateral condensation in the middle and coronal thirds, and in the apical third, a higher penetration was identified in the hybrid group compared with the continuous wave group. No significant differences in penetration were found comparing 0.02 with 0.04 taper gutta-percha groups. The coronal cross-sections presented a higher penetration than the apical third sections. In conclusion, the hybrid technique a had higher maximum sealer penetration than the continuous wave in the apical third, and the coronal third hybrid and continuous wave had a higher penetration than cold lateral condensation.
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Affiliation(s)
- Ignacio Barbero-Navarro
- Dental School, University Institute Egas Moniz (IUEM), 2800-064 Almada, Portugal; (I.B.-N.)
- Dental School, University of Seville, 41009 Seville, Spain;
| | | | | | | | - Paulo Mauricio
- Interdisciplinary Research Centre, University Institute Egas Moniz (IUEM), 2800-064 Almada, Portugal
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El Hachem C, Chedid JCA, Nehme W, Kaloustian MK, Ghosn N, Rabineau M, Kharouf N, Haikel Y, Mancino D. The Contribution of Various In Vitro Methodologies to Comprehending the Filling Ability of Root Canal Pastes in Primary Teeth. Bioengineering (Basel) 2023; 10:818. [PMID: 37508845 PMCID: PMC10376379 DOI: 10.3390/bioengineering10070818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
A void-free obturation during root canal treatment on primary teeth is currently very difficult to attain. In this study, the pulpectomy filling abilities of Bio-C Pulpecto (Angelus, Basil, Londrina, Paraná, Brazil) and of zinc oxide eugenol, or "ZOE" (DenPro, Prevest, New York, NY, USA), were compared using several in vitro techniques. Therefore, 30 primary anterior teeth were used in the present in vitro study. Analysis of variance (ANOVA), including a multiple comparison procedure (Holm-Sidak method, Dunn's Method, or Tukey test), was used. On micro-CT, Bio-C Pulpecto exhibited higher void percentages than did ZOE (10.3 ± 3.8%, and 3.5 ± 1.3%), respectively (p < 0.05). With digital microscopy, higher total void percentages were found in the BC (13.2 ± 26.7%) group compared to the ZOE (2.7 ± 2.8%) group (p < 0.05). With the CLSM, mean tubular penetration depths were higher for Bio-C Pulpecto than for ZOE in all canal thirds (p < 0.05). SEM images demonstrated no tags into dentinal tubules in either group throughout the three thirds. Moreover, higher statistically significant flowability was found for Bio-C (2.657 ± 0.06 mm) compared to ZOE (1.8 ± 0.13 mm) (p < 0.05). The findings of this study indicate that neither ZOE nor Bio-C Pulpecto appears to meet the criteria for an ideal root canal filling paste for primary teeth. This study laid the groundwork for future research by determining how micro-CT, digital microscopy, SEM, and CLSM contribute to our understanding of the filling process of primary teeth. More thorough research on the mechanism of root canal obturation on primary teeth is required to achieve a long-term successful root canal therapy in young children.
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Affiliation(s)
- Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Jean Claude Abou Chedid
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Walid Nehme
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, 155 5th Street, San Francisco, CA 94103, USA
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Nabil Ghosn
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Morgane Rabineau
- Faculté de Chirurgie Dentaire, Fédération de Médecine Translationnelle de Strasbourg and Fédération des Matériaux et Nanoscience d'Alsace, Université de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
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Shieh K, Yang J, Zhu EH, Peters OA, Hosseinpour S. Dentinal Tubule Penetrability and Bond Strength of Two Novel Calcium Silicate-Based Root Canal Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093309. [PMID: 37176191 PMCID: PMC10179649 DOI: 10.3390/ma16093309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Once the chemo-mechanical preparation of root canals is finished, achieving a complete seal of the root canal system becomes crucial in determining the long-term success of endodontic treatment. The important goals of root canal obturation are to minimize leakage and achieve an adequate seal. Thus, a material that possesses satisfactory mechanical characteristics, is biocompatible, and has the ability to penetrate the dentine tubules adequately is needed. AIM This study aimed to compare the penetrability and bond strength between two calcium silicate-based sealers and an epoxy resin-based sealer, as well as examine the relationship between penetrability and bond strength for the different sealers. METHOD AND MATERIALS Thirty-nine recently extracted single-rooted human premolar teeth were instrumented and divided evenly into three groups (n = 13), according to the sealer used for obturation: AH Plus Jet, EndoSequence, and AH Plus Bioceramic Sealer. Three teeth (30 slices) were randomly selected out of each for analysis using confocal laser scanning microscopy to assess penetrability. The remaining ten teeth (90 slices) in each group were subject to push-out tests using a universal testing machine. All teeth were sectioned into nine transverse slices of 0.9 mm thickness for their respective tests (apical, middle, coronal). RESULTS AH Plus Jet exhibited significantly lower penetrability and significantly higher bond strength compared to EndoSequence BC sealer (p = 0.002) and AH Plus Bioceramic Sealer (p = 0.006). There was no significant difference between EndoSequence BC sealer and AH Plus Bioceramic Sealer in terms of either penetrability or bond strength. No correlation was found between penetrability and bond strength. CONCLUSIONS Within the limitation of this study and regardless of the location in the canal, the bioceramic based root canal sealers appeared to perform better than the epoxy resin-based sealer in terms of dentinal penetration rate. Further studies are required to compare other biomechanical properties of bioceramic sealers including setting characteristics and bacterial leakage.
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Affiliation(s)
- Karissa Shieh
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Jack Yang
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Elsa Heng Zhu
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
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Tedesco M, Vitali FC, Bortoluzzi EA, Garcia LDFR, Teixeira CDS. Analysis of physicochemical properties of endodontic sealers containing rhodamine B. J Mech Behav Biomed Mater 2023; 140:105699. [PMID: 36753848 DOI: 10.1016/j.jmbbm.2023.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The use of fluorescent dyes in microscopy studies is frequent. Therefore, it is important to investigate whether these compounds may alter the physicochemical properties of materials in which they are incorporated to avoid methodological biases. This study evaluated the physicochemical properties of two endodontic sealers containing dry or diluted rhodamine B. Six groups were evaluated: AH Plus and MTA Fillapex in their original composition and mixed with 0.1% dry or diluted rhodamine. Push-out test was applied to assess the bond strength to root dentin. ANSI-ADA No. 57 and ISO No. 6876:2012 specifications were followed to evaluate flowability, setting time, and solubility of the sealers. pH changes were assessed after 24 h, 7, and 30 days. Intergroup comparisons were analyzed by ANOVA complemented by Tukey's post-hoc test; comparisons among periods were analyzed by Wilcoxon and Friedman tests. The incorporation of dry rhodamine decreased the bond strength and prolonged the setting time of AH Plus. The incorporation of diluted rhodamine decreased the setting time and increased the flowability of MTA Fillapex. Diluted rhodamine promoted pH reduction of AH Plus after 24 h and dry rhodamine after 7 days. Rhodamine incorporation promoted pH reduction after 30 days for MTA Fillapex. Solubility was not affected. In conclusion, the incorporation of diluted rhodamine changed the properties of MTA Fillapex, and the incorporation of dry rhodamine changed the properties of AH Plus. Previous dilution of rhodamine did not severely compromise the physicochemical properties of AH Plus and may be suggested to assess its penetrability.
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Affiliation(s)
- Maybell Tedesco
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, School of Dentistry, University of Louisville, Louisville, KY, USA
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Silva GFD, Coelho LAS, Costa VAS, Conti LC, Lima ACDA, Sodré GCDS, Martins MRL, Duarte MAH, Vivan RR. Laboratory study of tissue repair of resin-based endodontic sealers in critical surgical defects. J Appl Oral Sci 2022; 30:e20220108. [PMID: 35920449 PMCID: PMC9365338 DOI: 10.1590/1678-7757-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility.
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Affiliation(s)
| | - Letycia Accioly Simões Coelho
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Vanessa Abreu Sanches Costa
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Letícia Citelli Conti
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Ana Carolina de Almeida Lima
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Gabriela Cristina de Santi Sodré
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Mateus Rinaldi Lucio Martins
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Minimal Dentinal Tubule Penetration of Endodontic Sealers in Warm Vertical Compaction by Direct Detection via SEM Analysis. J Clin Med 2021; 10:jcm10194440. [PMID: 34640456 PMCID: PMC8509604 DOI: 10.3390/jcm10194440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Sealer staining using rhodamine B dye to investigate the penetration depth of endodontic sealers was proven unsuitable for this purpose. This study aimed to investigate the sealer penetration depth into dentinal tubules by scanning electron microscopy (SEM). Root canals of 52 human upper central incisors were instrumented using the ProTaper Gold NiTi system (Dentsply Sirona, York, PA, USA) up to size F3. After irrigation with sodium hypochlorite and citric acid combined with ultrasonic activation, the root canals were either filled using the epoxy resin sealer AH Plus (Dentsply Sirona) or the calcium silicate-based sealer Total Fill BC Sealer HiFlow (TFHF, FKG Dentaire, La Chaux-de-Fonds, Switzerland) by warm vertical compaction. Root slices of 1 mm thickness were obtained at 2 to 3, 5 to 6 and 8 to 9 mm from the apex. The root slices were investigated for sealer penetration into the dentinal tubules using SEM according to four root quadrants (buccal, mesial, oral, distal). Statistical analysis was performed by the Kruskal-Wallis test (p = 0.05) as data were not normally distributed according to the Shapiro-Wilk test. AH Plus penetrated significantly deeper into the dentinal tubules compared to TFHF at each root level (p < 0.05). Dentinal sealer penetration was deeper in the bucco-oral direction compared to the mesio-distal direction. AH Plus penetrated deeper into dentinal tubules than TFHF. Warm vertical compaction exerting high pressure on the root canal filling material is not able to press sealers deep into dentinal tubules as penetration depth values did not exceed a mean of 110 µm in SEM.
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Debunking the Concept of Dentinal Tubule Penetration of Endodontic Sealers: Sealer Staining with Rhodamine B Fluorescent Dye Is an Inadequate Method. MATERIALS 2021; 14:ma14123211. [PMID: 34200848 PMCID: PMC8230462 DOI: 10.3390/ma14123211] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/22/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the suitability of rhodamine B dye staining of an epoxy resin sealer (AH Plus) and calcium-silicate-based sealers (Total Fill BC Sealer, BioRoot RCS) to represent the penetration depth of the sealers into dentinal tubules after root canal obturation. In a three-step process, (1) leaching of rhodamine B from sealers into a buffer solution, (2) passive penetration of leached rhodamine B into dentinal tubules, and (3) conformity of rhodamine B penetration assessed by confocal laser scanning microscopy (CLSM), and sealer penetration assessed by scanning electron microscopy (SEM), in root-canal-filled teeth, were evaluated. Rhodamine B dye massively leached out of Total Fill BC Sealer and BioRoot RCS into the phosphate-buffered saline (PBS). A pinkish coloration of AH Plus was found after contact with PBS. Leached rhodamine B dye passively penetrated dentinal tubules from all three sealers when placed on root dentin. No correlation was observed between sealer penetration in SEM and rhodamine B penetration in CLSM. Staining of sealers using rhodamine B is an inadequate method with which to evaluate sealer penetration depth into dentinal tubules, as it overestimates the penetration of sealers into root dentin tubules.
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Alim Uysal BA, Kotan G, Guneser MB, Dincer AN, Senturk H, Rafiqi AM. Investigation of the effect of different chelation solutions on penetration of resin-based and bioceramic sealers with a novel method. Microsc Res Tech 2021; 84:1571-1576. [PMID: 33506518 DOI: 10.1002/jemt.23717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/08/2022]
Abstract
This study aimed to investigate the effects of different chelation solutions on the penetration of resin-based and bioceramic root canal sealers into dentinal tubules using a device that assembles conventional microplate detection with automated digital microscopy. Eighty-four single-rooted teeth were prepared with 30.07 nickel-titanium instruments and divided into four groups of 21 according to the final irrigation solutions used: saline (control), ethylenediaminetetraacetic acid (EDTA), maleic acid (MA), and etidronic acid (HEBP). The samples were obturated with AH Plus, MTA Fillapex, or EndoSequence BC Sealer using the single-cone technique. The roots were then sectioned horizontally at 2, 6, and 10 mm and examined using a Cytation 5 reader and Gen5 software. Data were compared using two-way analysis of variance followed by univariate analyses and Tukey's multiple comparison test (p < .05). The mean penetration depth in the apical thirds was higher in the MA group than in the other groups (p = .013). The mean depth in the middle and coronal thirds was almost equal in the EDTA and HEBP groups. The mean depth was significantly higher in the coronal thirds of the root canals than in any other section in all final irrigation solution groups (p < .001). EndoSequence BC Sealer displayed higher penetration depth than AH Plus and MTA Fillapex, although the differences between the examined sealers were not statistically significant. The chelation solutions increased root canal sealer penetration into the dentinal tubule.
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Affiliation(s)
- Betul Aycan Alim Uysal
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Gozde Kotan
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Burak Guneser
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Asiye Nur Dincer
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Hilal Senturk
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakif University, Istanbul, Turkey
| | - A Mateen Rafiqi
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakif University, Istanbul, Turkey
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