Clinical and Radiographical Evaluation of a Resin-based Root Canal Sealer: A 5-Year Follow-up

Flowable Urethane Dimethacrylate-Based Filler for Root Canal Obturation in Primary Molars: A Pilot SEM and microCT Assessment

Pulpectomy in deciduous teeth involves endodontic access opening, root canal debridement and obturation with an appropriate filling material. EndoREZ (ER) is the urethane dimethacrylate-based filler, which can be used for root canal obturation in permanent and primary teeth. This observation aimed to evaluate the behavior of the ER as a filler in root canals of two primary molars after the physiological resorption process using the scanning electron microscopy (SEM) and micro-computed tomography (µCT) in second lower molars after their natural exfoliation. The SEM analysis revealed a non-uniform, porous and lacunary structure of ER, visually similar to the resorbed surface of the dentine. The µCT observations demonstrated the differences in the resorption level of the root and material surfaces. The preliminary observations suggest that ER is resorbed faster than root tissues and can therefore be a suitable material for the root canal filling in primary teeth. However, more investigations are needed to support these preliminary findings.

Ability of new obturation materials to improve the seal of the root canal system: a review

New obturation biomaterials have been introduced over the past decade to improve the seal of the root canal system. However, it is not clear whether they have really produced a three-dimensional impervious seal that is important for reducing diseases associated with root canal treatment. A review of the literature was performed to identify models that have been employed for evaluating the seal of the root canal system. In vitro and in vivo models are not totally adept at quantifying the seal of root canals obturated with classic materials. Thus, one has to resort to clinical outcomes to examine whether there are real benefits associated with the use of recently introduced materials for obturating root canals. However, there is no simple answer because endodontic treatment outcomes are influenced by a host of other predictors that are more likely to take precedence over the influence of obturation materials. From the perspective of clinical performance, classic root filling materials have stood the test of time. Because many of the recently introduced materials are so new, there is not enough evidence yet to support their ability to improve clinical performance. This emphasizes the need to translate anecdotal information into clinically relevant research data on new biomaterials.

Clinical and radiographic evaluation of a resin-based root canal sealer: 10-year recall data

Objectives. This retrospective clinical and radiographical study evaluated the 10-year outcome of one-visit endodontic treatment with gutta-percha and a methacrylate resin-based sealer. Methods. From an initial sample size of 180 patients, 89 patients with 175 root canals responded to a recall. Treatment outcome was based on predetermined clinical and radiographic criteria. Results. Root canals had been adequately filled to the working length in 80 teeth (89.88%), short in 6 instances (6.74%), while 3 (3.37%) with extrusion immediate postoperatively, showed no sealer in periradicular tissues. The difference in the outcomes of treatments with respect to age, gender, preoperative pulp or periapical status, the size of periapical lesions and the type of permanent restorations were not statistically significantly different (P > 0.05). Overall, 7 (7.86%) cases were considered clinically and radiographically a failure. A life table analysis showed a cumulative probability of success of 92.13% after 10 years with a 95% confidence interval of 83.0 to 94.0. Conclusions. The results of this retrospective clinical and radiographical study suggest that the tested methacrylate-resin based sealer used with gutta-percha performed similarly to other root canal sealers over a period 10 years. Clinical Implications. Considering the success rate after 10 years of this methacrylate resin-based sealer can be recommended as an alternative to other commonly used root canal sealers.

Subcutaneous connective tissue reaction to methacrylate resin-based and zinc oxide and eugenol sealers

INTRODUCTION

An evaluation was made of the connective tissue reaction in rats after subcutaneous implantation of methacrylate resin-based sealers (EndoREZ [Ultradent Products, Inc, South Jordan, UT] with a polymerization accelerator and RealSeal [Sybron Dental Specialties, Orange, CA]) and Pulp Canal Sealer (Sybron Dental Specialties), a zinc oxide and eugenol-based sealer used as the control.

METHODS

Silicone tubes containing the test materials were implanted in 24 Wistar rats. Solid silicone rods of the same size served as the negative controls. After 10, 30, and 90 days, the animals (n = 8 per period) were euthanized and the implants with surrounding tissues dissected and processed for routine histological evaluation. A four-category evaluation system was used to measure and record the microscopic observations according to the thickness of a fibrous capsule, the vascular changes, and the various types of inflammatory cells.

RESULTS

Initially, a severe inflammatory reaction was observed of the soft tissues in direct contact with both EndoREZ/Accelerator and Real Seal. The severity decreased over time and was resolved at the end of the experiment. Pulp Canal Sealer showed a severe tissue reaction for all observation periods. The negative controls showed an initial mild to moderate inflammatory reaction. After 30 days, healthy fibrous connective tissue was observed, which increased over time. After 10 days, no statistically significant differences between the experimental groups were observed. After 90 days, EndoREZ and RealSeal were statistically significantly less toxic than Pulp Canal Sealer (p > 0.05).

CONCLUSIONS

After 90 days, both methacrylate resin-based sealers were considered biologically acceptable when implanted in subcutaneous connective tissues of the rat. Pulp Canal Sealer remained toxic for the duration of the study.

Clinical and radiographic evaluation of a resin-based root canal sealer: an eight-year update

INTRODUCTION

This retrospective clinical and radiographic study evaluated the 8-year outcome of one-visit endodontic treatment of root canals filled with gutta-percha and a methacrylate resin-based sealer (EndoREZ).

METHODS

From an initial sample size of 180 patients, subsequently 145 and 120 patients were evaluated after 14-18 months and 5 years, respectively. Of the remaining patient pool of 120 patients evaluated after 5 years, 112 patients with 212 root canals responded to the 8-year recall. The outcome of treatments was assessed on the basis of clinical and radiographic criteria. Endodontic success was rated on the basis of absence of clinical symptoms, the presence of a normal or slightly widened periodontal ligament space, and absence or substantial reduction in size of preexisting periradicular radiolucencies. Teeth that did not meet these criteria were considered endodontic failures.

RESULTS

The root canals had been adequately filled to the working length in 90 teeth (80.35%) and were short in 19 instances (16.96%). None of the roots showing apical extrusion of the sealer immediately postoperatively had radiographic evidence of the sealer in the periradicular tissues after 8 years. At recall, all patients were comfortable and free of clinical symptoms. A life table analysis showed a cumulative probability of success of 86.5% after 8 years, with a 95% confidence interval of 79.0-92.0.

CONCLUSIONS

The results of this retrospective clinical and radiographic study suggest that the tested methacrylate resin-based sealer used in conjunction with gutta-percha cones performed similarly to conventional endodontic sealers during a period of up to 8 years.

Resin materials for root canal obturation

With the appearance of more in vivo and ex vivo publications, methacrylate based resin sealers are becoming more popular in endodontics. Their ease of use and favorable clinical performance offer an attractive alternative to conventional endodontics. This article reviews the development of resin-based sealers and biocompatibility tests. The many, mostly opposing views are analyzed to put what has been published thus far in perspective. A critical analysis of the facts leads to the consensus that methacrylate based resin sealers are here to stay and offer a suitable alternative to conventional endodontic treatment.

Effect of immediate and delayed post preparation on apical microleakage by using methacrylate-based EndoREZ sealer with or without accelerator

The purpose of this study was to evaluate the effect of immediate and delayed post space preparation on the apical sealing ability of EndoREZ, a methacrylate-based dual-cured resin sealer, with or without accelerator. Fifty extracted human teeth were endodontically prepared and randomly divided into 6 groups. Teeth in experimental groups 1, 2, 3, and 4 (n = 10) were filled with resin-coated gutta-percha and either EndoREZ with accelerator (A+) or EndoREZ without accelerator (A-) by the lateral compaction technique. In group1 (A+) and group2 (A-), the post space was prepared immediately at the time of obturation. In groups 3 (A+) and 4 (A-), the post space was prepared after storage in 100% humidity at 37 degrees C for 1 week. Groups 5 and 6 (n = 5) represented positive and negative control groups, respectively. Leakage was determined by computerized fluid filtration device. Complete leakage was observed in group 5, and no leakage was evident in group 6 (P = 1.000). In experimental groups, mean apical microleakage values (microL/cmH(2)O/min(-1)) were as follows: group 1, 2.77 +/- 0.79(a); group 2, 2.88 +/- 1.38(a); group 3, 19.95 +/- 7.85(c); group 4, 6.20 +/- 2.09(b) (different letters indicate significantly different groups, P < .005). Immediate post space preparation achieved better sealing than delayed post preparation at the apical end, regardless of whether the EndoREZ accelerator was used. There was no significant difference between the (A+) and (A-) in immediate post space preparation. However, more leakage was found when using (A+) than (A-) in delayed post preparation. Under the conditions of this study, it was concluded that EndoREZ accelerator seems not to provide clinicians with any advantage for rapid transition from endodontic treatment to post-endodontic restorative procedures immediately after completion of root canal therapy.