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Juntha S, Tungsawat P, Wongwatanasanti N, Suksaphar W, Lertnantapanya S. Evaluation of Setting Time, Flowability, Film Thickness, and Radiopacity of Experimental Monocalcium Silicate-Based Root Canal Sealers. Int J Dent 2024; 2024:8541653. [PMID: 38681823 PMCID: PMC11055647 DOI: 10.1155/2024/8541653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction This study aimed to evaluate the efficacy of a formulation of premixed calcium silicate-based sealer (CSBS) with monocalcium silicate (Mono-CS) as the main component. Its properties were compared with those of a control group (iRoot SP) according to ISO 6876/2012 standards for root canal sealers. Materials and Methods The CSBS formulation consisted of two components (powder and liquid). The powder was a mixture of Mono-CS, a radiopacifier, and a thickening agent, and the liquid components were nonaqueous liquid agent and setting accelerator. Three formulation groups with different powder-liquid ratios were prepared: group A, 2 : 1; group B, 3 : 1; and group C, 2 : 1, which also contained calcium chloride as a setting accelerator. The setting time, flow rate, film thickness, and radiopacity of the three CSBS groups and the control group were evaluated and compared. Each test was repeated five times for each group. Results The minimum values of setting time (i.e., working time, initial setting time, and final setting time) were ranked in order of significance as group B, the control group, group C, and group A. The control group had the lowest film thickness at 20 μm, with a nonsignificant difference to group C. The flow rates in group A, group C, and the control group were >20 mm. Furthermore, the experimental groups showed a similar amount of radiopacity as the control group (p > 0.05). Conclusion Mono-CS and calcium chloride can be used in the formulation of root canal sealers, and their properties, including working time, initial setting time, final setting time, flow rate, film thickness, and radiopacity, are consistent with those of iRoot SP and ISO 6876/2012 standards.
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Affiliation(s)
- Sukanya Juntha
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
| | - Pakit Tungsawat
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
| | | | - Warattama Suksaphar
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
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Alves LS, Ormiga F, de Lima CO, Lopes RT, Gusman H. Root canal dentin wear during final irrigation in endodontic retreatment with passive ultrasonic irrigation and easy clean instruments. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:246-251. [PMID: 38634025 PMCID: PMC11019816 DOI: 10.4103/jcde.jcde_137_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/29/2023] [Accepted: 01/05/2024] [Indexed: 04/19/2024]
Abstract
Context Complementary procedures have been proposed to improve the endodontic retreatments. Aim The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment. Methods Thirty-six mesial roots of the lower first molars were divided into four groups (n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group. Results Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers (P < 0.05). Conclusion Both complementary cleaning procedures promoted dentin wear and must be used cautiously.
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Affiliation(s)
- Louise Schmitt Alves
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ricardo Tadeu Lopes
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Al Akam H, Kim HC, Jeong JW. Retreatment Strategies for Cases Containing Calcium Silicate-Based Root Canal Sealers: A Comprehensive Review. Dent J (Basel) 2024; 12:41. [PMID: 38392245 PMCID: PMC10888468 DOI: 10.3390/dj12020041] [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: 01/02/2024] [Revised: 02/04/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
This review explores the field of retreatment strategies for cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocompatibility, bioactivity, and sealing ability. Therefore, effective retreatment strategies are indispensable. This article aims to identify the challenges associated with the removal of calcium silicate-based sealers themselves and removal of gutta-percha with the sealers during retreatment, evaluate current techniques and materials, and provide future directions for research in this field. Regarding the strategies of removal of root canal sealers, calcium silicate-based sealers are still relatively new materials for clinicians compared with traditional sealers such as epoxy- or eugenol-based sealers. First, no clinically established solvents have been reported. Second, calcium silicate-based sealers are currently utilized by clinicians in either the cold sealer-based technique or the warm vertical condensation technique. Third, the setting process of calcium silicate-based sealers generates byproducts, primarily calcium hydroxide and secondarily hydroxyapatite, that could interact with dentine. Lastly, there is a lack of clinical studies evaluating the efficacy of retreatment protocols for teeth filled with calcium silicate-based sealers. Therefore, it is important to investigate the chemo-mechanical properties of calcium silicate-based sealers themselves and their reactions to solvents and/or mechanical instruments and identify the interfacial properties of calcium silicate-based sealers with respect to dentine and gutta-percha. In addition, researchers in the clinical field need to actively gather and report data on retreatments of teeth filled with calcium silicate-based sealers.
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Affiliation(s)
- Hussain Al Akam
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX 77054, USA
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Yangsan 50612, Republic of Korea
| | - Ji Wook Jeong
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX 77054, USA
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Shin B, Seo JH, Kim W, Ahn YJ, Kim HY, Shon WJ. The flow behavior and sealing ability of calcium silicate root canal cement containing dimethyl sulfoxide: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106156. [PMID: 38041883 DOI: 10.1016/j.jmbbm.2023.106156] [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: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION To develop a calcium silicate (CaSi)-based cement containing dimethyl sulfoxide (DMSO) and cement deliver device for new root canal filling technique, and to assess the flow behavior, leakage, and root canal filling quality of CaSi containing DMSO. METHODS CaSi containing DMSO (CSC-DMSO) and CaSi containing PEG (CSC-PEG) were prepared, and the flow characteristics of both cements were compared in gypsum and resin channels using a high-speed camera. Eight root canals were obturated by CSC-DMSO or CSC-PEG using a cement delivery device, and root canal filling quality was assessed in terms of filling length using periapical radiographs. The filling length was evaluated by 'apico-coronal extension,' measuring length in reference to apical constriction. Microleakage was measured for thirty human molars that were randomly filled with CSC-DMSO, CSC-PEG, or gutta-percha and AH plus. Preliminary obturation of CSC-DMSO with cement delivery device in human teeth was analyzed in terms of filling length and void, using periapical radiographs. Statistical analysis was performed with the Kruskal Wallis test for simulated root canal fillings and one-way ANOVA for leakage test. RESULTS The flow speed of CSC-DMSO reduced in gypsum channels compared to resin channels, but CSC-PEG did not exhibit significant differences in the channels. The median absolute value of apico-coronal extension was significantly lower in CSC-DMSO compared to CSC-PEG (p < 0.05). Microleakage did not statistically differ between the groups (p > 0.05). In the preliminary obturation, the mean apico-coronal extension of CSC-DMSO was -0.297 ± 0.724 mm, while CSC-PEG was not feasible due to excess apical extrusions. CONCLUSIONS CSC-DMSO could be considered as an alternative filling material for root canal obturation.
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Affiliation(s)
- Bokyung Shin
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ji-Hwan Seo
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Wonjung Kim
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Yu Jin Ahn
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ho-Young Kim
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea.
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Cheung MC, Peters OA, Parashos P. Global survey of endodontic practice and adoption of newer technologies. Int Endod J 2023; 56:1517-1533. [PMID: 37800848 DOI: 10.1111/iej.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
AIM To investigate current endodontic practices, adoption of technologies and continuing education attendance within specialist endodontic practice globally and to identify geographic trends. METHODOLOGY A web-based survey of endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA on routine treatment preferences, armamentarium and education attendance was conducted. Chi-squared, independent sample t-tests, Cochran's Q test and McNemar's test were performed. RESULTS The survey was completed by 543 endodontists or endodontic post-graduate students. Almost all respondents used the dental operating microscope (DOM, 91.3%), engine-driven nickel-titanium instruments (NiTi, 97.6%), electronic apex locators (EAL, 93.0%), cone-beam computed tomography (CBCT, 91.2%) and calcium silicate-based materials (CSBMs, 93.7%). Dental dam was always used by 99.1%. Over half used irrigation adjuncts (81.8%), warm vertical compaction (74.6%) and heat-treated NiTi (60.2%). Geographic comparison between AP (Asia-Pacific, n = 78), AM (Americas, n = 402) and EM (Europe and Middle East, n = 63) was performed. AM and EM preferred single-visit treatment more (p < .001) and used higher sodium hypochlorite concentrations than AP. AM had more access to CBCT in the workplace (86.6%) than AP (65.4%, p < .001) and used CBCT for routine preoperative assessment (39.6%) more than EM (7.3%, p < .001). Almost all of EM used irrigation adjuncts (95.2%), more than AM (78.1%, p = .001). AP used steroid/antibiotic medicaments most (p < .001) and had the highest attendance at continuing education programmes. CONCLUSION Several endodontic-specific armamentaria have reached almost complete adoption within global specialist endodontic practice, whilst the continued uptake of newer technologies should be followed over time. Some practising philosophies varied significantly across different geographic regions.
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Affiliation(s)
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Zanza A, Reda R, Testarelli L. Endodontic Orthograde Retreatments: Challenges and Solutions. Clin Cosmet Investig Dent 2023; 15:245-265. [PMID: 37899987 PMCID: PMC10612510 DOI: 10.2147/ccide.s397835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Abstract
Endodontic orthograde retreatments are considered one of the possible treatment options in case of post-treatment diseases considering the promising results present in the literature. Despite this, a plethora of articles have been published on this topic, and drawing conclusions could be challenging. For this reason, this review aims to summarize the crucial points on each aspect of non-surgical endodontic retreatments, discussing and comparing the current protocols, techniques, materials, and indications. Taking into consideration data from the literature, in terms of diagnosis, CBCT should be considered the first choice, since it can thoroughly affect the diagnosis and treatment plan. Regarding the procedural phases, some conclusions can be drawn: when present, coronal restoration materials such as crowns, partial prostheses, post, and core should be removed; the use of magnification devices, ultrasonic instruments, and an in-depth interpretation of radiographic images with both 2D and 3D images are strongly recommended during the orifice location; additional protocols such as irrigants activation, ultrasonic cleaning, and rotary or reciprocating instrumentation of treated canals are strongly recommended for filling materials removal and to achieve a high-quality chemo-mechanical disinfection; perforations should be treated as soon as possible, and the material of choice to treat them is the MTA or other calcium-silicate-based repair materials; the presence of ledges does not intrinsically reduce the success rate of RCRts if properly managed; in case of instrument fragments, their removal should be considered as the first treatment option, however many variables should be considered to select the proper technique or consider the option of bypassing.
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Affiliation(s)
- Alessio Zanza
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Rodolfo Reda
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
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Frasquetti KS, Piasecki L, Kowalczuck A, Carneiro E, Westphalen VPD, Neto UXDS. Effect of Different Root Canal Drying Protocols on the Bond Strength of Two Bioceramic Sealers. Eur J Dent 2023; 17:1229-1234. [PMID: 36535659 PMCID: PMC10756819 DOI: 10.1055/s-0042-1758807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This study evaluated in vitro the effect of two different drying protocols on the dentin bond strength of two different bioceramic sealers (Sealer Plus BC [SP] and Bio C Sealer [BCS]). Bond strength and failure mode were evaluated according to the sealer, drying protocol, and root canal third. MATERIALS AND METHODS Sixty extracted human mandibular single-rooted premolars were selected after anatomical standardization. The crowns were sectioned and root canals were prepared. Roots were randomly divided into four groups (n = 15 each). Each group was assigned a combination of one of the evaluated sealers (SP or BCS) and one of the drying protocols: canals dried with paper points (PP) or irrigation with saline followed by aspiration with silicon cannulas (IA). Obturations were performed using a single-cone technique. The teeth were temporized and stored for 7 days (100% humidity, 37°C). Roots were cut to obtain 2 mm thick discs for each third (coronal, middle, and apical). Push-out tests were performed on a universal testing machine, and the bond strength (MPa) of each specimen was calculated by dividing the load (N) by the interface area. Failure type was assessed under ×4 magnification. STATISTICAL ANALYSIS Data were statistically analyzed with a significance set at 5%. An analysis of variance test followed by the Games-Howell post-hoc test was used to compare the mean values between the groups and the interaction of the variables. RESULTS The predominant failure type was cohesive, followed by mixed failure and adhesive in all groups. The apical third presented the highest bond strength (p < 0.05) regardless of the group, followed by the middle and coronal thirds. Overall, the SP PP group had the highest mean bond strength (p < 0.01), but the SP sealer was negatively affected by the IA drying protocol in the coronal and middle thirds. The BCS presented similar results within the third stage, regardless of the drying protocol. CONCLUSIONS Sealer Plus BC had a higher bond strength than Bio C Sealer, but it was negatively affected by the irrigation-aspiration protocol in the coronal and middle thirds. For the apical third, there was no difference between the groups; thus, a similar bond strength was observed regardless of the drying protocol or sealer.
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Affiliation(s)
- Karine Santos Frasquetti
- Postgraduate Program in Endodontics, School of Health and Biosciences of PUCPR, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, New York, United States
| | - Alexandre Kowalczuck
- Postgraduate Program in Endodontics, School of Health and Biosciences of PUCPR, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Postgraduate Program in Endodontics, School of Health and Biosciences of PUCPR, Curitiba, Paraná, Brazil
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Sümbüllü M, Ali A, Büker M, Arslan H. The efficiency of different irrigation activation techniques in the removal of calcium silicate-based endodontic sealer from artificially created groove. AUST ENDOD J 2023; 49 Suppl 1:238-244. [PMID: 36441606 DOI: 10.1111/aej.12722] [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: 02/28/2022] [Revised: 10/07/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022]
Abstract
This study evaluated the removal of a calcium silicate-based sealer (EndoSeal MTA) with needle irrigation (NI), passive ultrasonic irrigation (PUI), XP-endo Finisher (XPF) and EDDY. A total of 56 human mandibular premolars were instrumented up to size 40.04 taper. The roots were separated longitudinally, and grooves were prepared with an ultrasonic tip at one-half of each root canal. The grooves were covered with EndoSeal MTA and re-attached roots were investigated based on the activation techniques applied. The results showed that significantly more material (p < 0.05) was removed in the EDDY group compared to the NI, PUI and XPF groups in the apical region. In the coronal region, no significant difference was observed between EDDY, XPF and PUI (p > 0.05), whereas all the latter were significantly more effective than NI (p < 0.05). These findings show that the removal of EndoSeal MTA can be more effective with EDDY compared to XPF, PUI and NI in the apical region.
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Affiliation(s)
- Meltem Sümbüllü
- Department of Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Afzal Ali
- Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, India
| | - Mine Büker
- Department of Endodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Hakan Arslan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medeniyet University, Istanbul, Turkey
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Düzgün S, Topçuoğlu HS, Kahraman Ö, Eminsoy AT. Efficacy of different irrigation agitation systems in the removal of root canal sealers from artificial standardised grooves. AUST ENDOD J 2023; 49 Suppl 1:339-344. [PMID: 36810934 DOI: 10.1111/aej.12741] [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: 09/10/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
The present study aims to assess the efficacy of different irrigation agitation systems in removing calcium silicate-based sealers from artificial standardised apical grooves. After the root canal instrumentation of 96 teeth, artificial apical grooves were created in half of each root. The samples were divided into two main groups according to the sealer type (AH Plus Jet [APJ] and Sure-Seal Root™ [SSR]) (n = 48). The root halves were then reassembled and divided into four experimental groups based on the final irrigation technique used: Conventional Syringe Irrigation (CSI), Ultrasonic Irrigant Agitation (UIA), Sonic Agitation (SA) and Manual Dynamic Agitation (MDA). The roots were then dissembled to assess the amount of root canal sealer. UIA significantly removed more of SSR sealer than CSI, MDA and SA while there was no statistical difference between CSI, MDA, SA and UIA groups in the APJ group. None of the irrigation agitation systems used had completely removed the APJ and SSR sealers. However, UIA was more effective in removing SSR sealer from the standardised apical groove than were CSI, MDA and SA.
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Affiliation(s)
- Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Ömür Kahraman
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ayşe Tuğba Eminsoy
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Da Silva V, Loroño G, Valencia de Pablo O, Estevez R, Conde AJ, Rossi-Fedele G, Cisneros R. The supplementary use of XP-endo Finisher R after Reciproc enhances the removal of a bioceramic sealer in oval root canals. AUST ENDOD J 2023; 49 Suppl 1:156-161. [PMID: 36282012 DOI: 10.1111/aej.12705] [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: 06/07/2021] [Revised: 02/05/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022]
Abstract
This study compared the performance of Reciproc and Reciproc Blue endodontic files in retreatment time and re-establishment of apical patency, plus removal of a bioceramic sealer from the canal surface with the supplementary use of the XP-endo Finisher R. Following preparation, slightly curved oval root canals in mandibular incisors were filled using a corresponding gutta-percha point and a bioceramic sealer. Apical patency achievement was assessed and the time required to reach the original working length was recorded. The samples were split longitudinally and were photographed to assess the material remaining on the canal walls. No significant differences were observed regarding patency achievement or retreatment times when comparing Reciproc and Reciproc Blue. Significant less material remained on the canal walls when Reciproc was followed by XP-endo compared with Reciproc alone, and when the data for Reciproc and Reciproc Blue were pooled.
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Affiliation(s)
- Vanessa Da Silva
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Gaizka Loroño
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | | | - Roberto Estevez
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Antonio J Conde
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rafael Cisneros
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
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Jamleh A, Nassar M, Alfadley A, Alanazi A, Alotiabi H, Alghilan M, Alfouzan K. Retreatment of oval-shaped root canals filled with TotalFill bioceramic or AH plus sealer. Sci Rep 2023; 13:9357. [PMID: 37291272 PMCID: PMC10250336 DOI: 10.1038/s41598-023-36608-0] [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] [Accepted: 06/07/2023] [Indexed: 06/10/2023] Open
Abstract
This study investigated retreatment of oval canals filled with gutta-percha and different sealers using WaveOne Gold (WOG). Single oval canals were prepared to size 30, 0.04 and obturated with gutta percha and AH Plus (AHP) or TotalFill bioceramic (TFBC) sealer. After 6-month incubation, the canals were retreated with WOG Primary (25, 0.07) under simulated body temperature, and the developed load and torque were simultaneously measured. The time and regaining the apical patency were checked. Micro-computed tomography scanning was performed to calculate the remaining obturating materials. An independent t-test and chi-square test were performed at a 95% confidence level. A shorter retreatment time was needed in TFBC than in AHP (P = 0.003). However, a higher maximum apical load was reported with AHP (P = 0.000). Meanwhile, comparable maximum coronal load and maximum torque values were observed. Apical patency was regained in all TFBC roots and only 75% of the AHP samples (P = 0.217). The remaining obturating materials were comparable in TFBC (13.02 ± 8.12%) and AHP (10.11 ± 8.46%) (P = 0.398). WOG was able to remove 89.89% and 86.98% of obturating materials in TFBC and AHP, respectively. The TFBC presented lower apical loads and faster retreatment compared to AHP.
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Affiliation(s)
- Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia.
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Abdulmohsen Alfadley
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Azhar Alanazi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- Endodontic Division, Dental Services, Central Region, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hadeel Alotiabi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Maryam Alghilan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Alfouzan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Farrayeh A, Akil S, Eid A, Macaluso V, Mancino D, Haïkel Y, Kharouf N. Effectiveness of Two Endodontic Instruments in Calcium Silicate-Based Sealer Retreatment. Bioengineering (Basel) 2023; 10:bioengineering10030362. [PMID: 36978753 PMCID: PMC10045724 DOI: 10.3390/bioengineering10030362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
The objective of the present in vitro work was to investigate the effectiveness and time required for the removal of calcium silicate-based sealer using two rotary retreatment systems. Sixty extracted, single-canal, lower premolars were used. After obturation using the single-cone technique with calcium silicate-based sealer, samples were divided into four groups according to the technique of desobturation: Group 1 (G1): D-Race; Group 2 (G2): D-Race followed by the use of XP–Endo Finisher R; Group 3 (G3): Protaper Universal Retreatment; and Group 4 (G4): Protaper Universal Retreatment followed by the use of XP–Endo Finisher R. Cone beam computed tomography (CBCT) images were used to calculate the remaining filling materials at the middle and apical thirds. Times required to perform each method were recorded. Scanning electron microscopy (SEM) and digital microscopy were used to evaluate the remaining filling materials. Data were statistically analyzed using the t-test and one way ANOVA on ranks tests. No statistically significant difference was found between G1 and G3 after CBCT observations (p > 0.05). Xp-Endo Finisher R significantly increased the ability to remove materials regardless of the initially used retreatment system (p < 0.05). Statistically significant longer time was found in G3 and G4 compared to G1 and G2, respectively (p < 0.05), to reach the full working length. No retreatment system was able to totally remove the calcium silicate-based sealer from the root canal at the middle and apical thirds (p > 0.05). Digital microscopy demonstrated that the residual materials were the remaining sealers on the canal walls. SEM showed the mineral depositions of calcium silicate materials onto the canal walls and into the dentinal tubules. However, that calcium silicate materials provide mineral deposition into the dentinal tubules might indicate that the traditional irrigants could not be sufficient to remove calcium silicate-based materials from the root canal, and other agents should be used to make retreatment considerably easier.
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Affiliation(s)
- Antoun Farrayeh
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | - Samar Akil
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | - Ammar Eid
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | | | - Davide Mancino
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Youssef Haïkel
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.: +33-(0)6-6752-2841
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Rezaei G, Liu X, Jalali P. Efficacy of Different Solvents for Achieving Patency in Teeth Obturated Using Bioceramic Sealer. J Endod 2023; 49:219-223. [PMID: 36526108 DOI: 10.1016/j.joen.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The retreatment of teeth obturated with bioceramic sealers has been shown to be challenging. The purpose of this study was to compare the efficacy of 10% formic acid (FA), 20% hydrochloric acid (HCl), and chloroform for achieving patency in teeth obturated with a bioceramic sealer. METHODS Forty-five extracted single-canal teeth were instrumented and obturated 1.5 mm short of the working length using gutta-percha and EndoSequence BC Sealer (Brasseler USA, Savannah, GA). Two weeks later, gutta-percha was removed, and apical patency was attempted with a 10 C-file and a solvent (FA, HCl, or chloroform). The time to gain patency through EndoSequence BC Sealer was recorded. Five additional teeth were irrigated with the solvents, and scanning electron microscopy was used to evaluate the effect of solvents on the dentin. The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis. RESULTS Patency was achieved in all canals, except for 1 in the chloroform group. Regarding the time to achieve patency, no significant difference was noted between chloroform and FA (P > .05). However, there was a significant difference between chloroform and HCl (P < .05) and between FA and HCl (P < .05). The erosion of dentinal tubules was more evident when HCl was used compared with the other irrigants. CONCLUSIONS Twenty percent HCl was superior to 10% FA and chloroform in achieving patency in teeth obturated with EndoSequence BC Sealer. Regardless of the solvent used, patency may be achieved for most of the cases obturated with gutta-percha and EndoSequence BC Sealer.
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Affiliation(s)
- Ghazaleh Rezaei
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
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Madarati AA, Sammani AMN, Alnazzawi AA, Alrahlah A. Efficiency of the new reciprocating and rotary systems with or without ultrasonics in removing root-canals filling with calcium silicate-based sealer (MTA). BMC Oral Health 2023; 23:5. [PMID: 36597070 PMCID: PMC9811723 DOI: 10.1186/s12903-022-02684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To compare the efficiency of endodontic rotary and reciprocating systems in removing calcium silicate-sealer based fillings and to investigate the impact of passive ultrasonic irrigation (PUI) on their efficiency. MATERIALS AND METHODS 160 root-canals were instrumented, filled with gutta-percha and calcium silicate based-sealer and divided into 10 equal groups. Five groups in which the reciprocating systems (WaveOne-Gold, Reciproc-Blue and R-Motion) and rotary systems (Fanta-AF-One and Tango-Endo) were used to remove root-canals' fillings. In the other five groups the fillings were removed by the same systems then additionally with PUI. The times to complete retreatments procedures were recorded. Micro-computed tomography's analysis of the root-canals fillings' volume before and after retreatments was used to determine the remaining filling materials (RFMs) volumes. RESULTS The RFMs after using rotary systems (10.1%) was greater than after using reciprocating systems (3.8%) (P < 0.001). The RFMs after using WOG (2%) and RB systems (2.6%) were less than those in the RM (6.8%), TE (9.5%) and FAFO (10.7%) systems [P < 0.05]. The times required to remove the filling materials using the TE (3.7 min), FAFO (4.1 min) and RM (4.1 min) systems were shorter than those required by the RB (5.4 min) and WOG (4.9 min) systems [P < 0.05]. Using PUI resulted in less RFMs (1.44%) when compared to using only rotary or reciprocating systems (6.27%) [P < 0.001]. CONCLUSIONS Endodontic reciprocation systems were more effective, but needed longer times than rotary systems in removing calcium silicate based- sealers fillings. The PUI significantly improved removal of the root-canals' filling materials. CLINICAL RELEVANCE Reciprocating systems and PUI are recommended whenever root-canals retreatment is considered regardless of using calcium silicate-based sealers.
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Affiliation(s)
- Ahmad A. Madarati
- grid.412892.40000 0004 1754 9358Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia ,Riyadh, 13311 Kingdom of Saudi Arabia
| | - Aya M. N. Sammani
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ahmad A. Alnazzawi
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ali Alrahlah
- grid.56302.320000 0004 1773 5396Restorative Dental Sciences Department, Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Kumar N, Maher N, Amin F, Ghabbani H, Zafar MS, Rodríguez-Lozano FJ, Oñate-Sánchez RE. Biomimetic Approaches in Clinical Endodontics. Biomimetics (Basel) 2022; 7:biomimetics7040229. [PMID: 36546929 PMCID: PMC9775094 DOI: 10.3390/biomimetics7040229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.
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Affiliation(s)
- Naresh Kumar
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
| | - Nazrah Maher
- Department of Science of Dental Materials, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Faiza Amin
- Department of Science of Dental Materials, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hani Ghabbani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Ricardo E. Oñate-Sánchez
- Department of Special Care in Dentistry, Hospital Morales Meseguer, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
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Eğemen A, Belli S. The Effect of Primary Root Canal Treatment on Dentinal Tubule Penetration of Calcium Silicate-based Sealers during Endodontic Retreatment. J Endod 2022; 48:1169-1177. [PMID: 35667566 DOI: 10.1016/j.joen.2022.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effect of previous root canal treatment on dentinal tubule penetration of calcium silicate-based sealers during endodontic retreatment and to compare 2 different (commonly used and modified) tubule penetration depth measurement techniques. METHODS The crowns of mandibular premolar teeth were removed, and root canals were prepared (ProTaper Universal; Dentsply Sirona, York, PA) and obturated using AH Plus (AH; Dentsply DeTrey, Konstanz, Germany), MTA Fillapex (MTAF; Angelus, Londrina, Brazil), and WellRoot ST (WRST; Vericom, Gyeonggi-do, South Korea); 0.1% red Rhod-2 dye (Chemodex, St Gallen, Switzerland) was added to the sealers. After storage for 3 weeks (37°C, 100% humid), the following sealer combination subgroups were created (the sealer used during the primary root canal treatment/the sealer used during the retreatment, n = 8): AH/AH, AH/MTAF, and AH/WRST; MTAF/AH, MTAF/MTAF, and MTAF/WRST; and WRST/AH, WRST/MTAF, and WRST/WRST. Green Fluo-3 dye (0.1%) was added to the sealers during retreatment. Sealer penetration depths were measured at 8 points and averaged, and the ratio of the retreatment sealer to the initial sealer was recorded as the mean tubule penetration depth ratio in the first technique, whereas the percentage of the circumferential penetration area ratios of the retreatment and initial sealers was calculated in the second technique. Statistical analyses were performed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS The mean penetration depth of AH and MTFA was found to be higher at the coronal third region in the control groups (P < .05). Both methods showed a significant difference among the groups at the coronal and median regions (P < .05). The AH/WRST, MTAH/AH, MTAF/MTAF, MTAF/WRSTS, and WRST/WRST groups showed deeper tubule penetration (first technique, P = .01). Both techniques showed that the penetration depth of the sealers was the same at the apical region (P > .05), whereas a difference was found among the techniques at the coronal and median regions. The sealers used in the previous root canal treatment limited the penetration depth of the sealers used during the retreatment process (P < .05). When MTAF was used as the initial sealer, the penetration depth of the second sealer did not change, whereas if WRST was the initial sealer, the penetration depth of the sealers at the median and apical regions is negatively affected during the retreatment process (P < .05). CONCLUSIONS Previous root canal treatment affects the penetration depth of calcium silicate-based sealers. The use of AH Plus and MTA Fillapex during the retreatment process showed an advantage. Both measurement techniques showed similar performances at the apical region, whereas the results varied at the coronal and midcoronal regions; therefore, a more stable sealer penetration measurement technique is still necessary.
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Affiliation(s)
- Ayşenur Eğemen
- Department of Endodontics, Selçuk University, Konya, Turkey
| | - Sema Belli
- Department of Endodontics, Selçuk University, Konya, Turkey.
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Madarati AA, Sammani AMN, Alnazzawi AA, Alrahlah A, Pedullà E. Efficiency of reciprocating systems reciprocated at different angles in removing root-canals fillings with an MTA-type sealer: an Ex-vivo study. BMC Oral Health 2022; 22:357. [PMID: 35978330 PMCID: PMC9387022 DOI: 10.1186/s12903-022-02390-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/10/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. METHODS 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals' fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials' (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. RESULTS The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P < 0.05). The longest time required to remove the filling materials was recorded with the RB-270/30 group (6.06 min) [P = 0.00]. The times required when the WOG, RB and RM files reciprocated at 90/30 angles (3.59, 3 and 3.05 mins, respectively) were shorter than those when files were reciprocated at 150/30 angles (5.25, 4.98 and 3.67 min, respectively) [P < 0.05]. CONCLUSIONS The WOG and RB systems removed more MTA-type sealer-based root-canals fillings than the RM system. Lower counterclockwise reciprocating angles improve the retreatment ability of reciprocating systems, especially the WOG system and can reduce the time required for retreatment procedures.
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Affiliation(s)
- Ahmad A. Madarati
- grid.412892.40000 0004 1754 9358Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia ,Present Address: Riyadh (12252), Kingdom of Saudi Arabia
| | - Aya M. N. Sammani
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ahmad A. Alnazzawi
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ali Alrahlah
- grid.56302.320000 0004 1773 5396Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Eugenio Pedullà
- grid.8158.40000 0004 1757 1969Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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De-Deus G, Santos GO, Monteiro IZ, Cavalcante DM, Simões-Carvalho M, Belladonna FG, Silva EJNL, Souza EM, Licha R, Zogheib C, Versiani MA. Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals. Int Endod J 2022; 55:795-807. [PMID: 35383977 DOI: 10.1111/iej.13744] [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: 05/05/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To assess the interfacial adaptation (gap-containing areas) of two root canal sealers (EndoSequence BC Sealer and AH Plus) to a conventional gutta-percha (GP) cone (GP-sealer interface) in oval-shaped canals filled using the single cone technique. METHODOLOGY Sixteen teeth with oval-shaped canals were selected, scanned in a micro-computed tomographic device, and pair-matched according to the volume, aspect ratio and configuration of root canals. Root canals were then sequentially prepared with WaveOne Gold Primary and Large instruments, followed by filling with WaveOne Large GP points associated with either the premixed calcium-silicate EndoSequence BC Sealer or the epoxy resin-based AH Plus sealer (n = 8 per group) using the single cone technique. After 7 days stored in phosphate-buffered saline solution at 37°C, the specimens were rescanned and the reconstructed images segmented in order to differentiate the filling materials (sealer and GP cone) to the dentine. A total of 453 cross-sectional slices were assessed and categorized according to the presence or absence of gaps at the GP-sealer interface. Mann-Whitney U-test verified the differences between groups and were considered significant at alpha = 5%. RESULTS Gaps were non-homogenously distributed in two-dimensional axial cross-section images and none of the specimens showed completely gap-free areas along the entire GP-sealer interface. Root canals filled with EndoSequence BC Sealer and AH Plus displayed 171 (37.75%) and 136 (30.02%) slices with gaps in the GP-sealer interface and these frequencies were statistically significant (p = .000). CONCLUSIONS Although none of the specimens had a gap-free area along the entire GP-sealer interface, oval canals filled with AH Plus showed less gaps than the ones filled with EndoSequence BC Sealer.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - Gustavo O Santos
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | | | | | | | | | | | - Erick M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Raphael Licha
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marco A Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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Kaloustian MK, Hachem CE, Zogheib C, Nehme W, Hardan L, Rached P, Kharouf N, Haikel Y, Mancino D. Effectiveness of the REvision System and Sonic Irrigation in the Removal of Root Canal Filling Material from Oval Canals: An In Vitro Study. Bioengineering (Basel) 2022; 9:bioengineering9060260. [PMID: 35735503 PMCID: PMC9219995 DOI: 10.3390/bioengineering9060260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the effectiveness of the Endostar REvision system (Poldent, Warsaw, Poland) in the removal of filling materials from oval root canals using sonic irrigation as an additional cleaning method. Thirty human-extracted mandibular premolars with oval canals were prepared using the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland) up to instrument F1 (20/.07), and then filled by the continuous wave vertical compaction technique using pulp canal sealer EWT (Sybron Dental Specialties, Orange, CA, USA). The teeth were randomly divided into two groups (n = 15) according to the instrumentation system and the additional cleaning method, as follows: REvision (30/.08, 25/.06) with EQ-S sonic activation (Meta Biomed, Chungcheongbuk-do, Korea), REvision (30/.08, 25/.06) without additional activation. All specimens were sectioned longitudinally at 3 and 7 mm from the apex, and analyzed using digital microscopy (KEYENCE, Osaka, Japan) to measure the total area of the residual obturation materials, followed by SEM analysis. The data on the percentage of remaining filling material were analyzed by Kruskal−Wallis one-way Analysis of Variance on ranks. None of the retreatment protocols completely removed the filling material from the root canals (p > 0.05); the retreatment technique using sonic activation showed statistically less residual filling materials than the retreatment technique using irrigants without activation at the coronal third (p < 0.05), whilst no significant difference was found between both tested groups at the apical and middle thirds (p > 0.05). The REvision system showed promising results in the removal of filling materials from oval canals.
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Affiliation(s)
- Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Walid Nehme
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon;
| | - Pamela Rached
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.:+33-66752-2841
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
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Medium- and Long-Term Re-Treatment of Root Canals Filled with a Calcium Silicate-Based Sealer: An Experimental Ex Vivo Study. MATERIALS 2022; 15:ma15103501. [PMID: 35629528 PMCID: PMC9145273 DOI: 10.3390/ma15103501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
Abstract
This study investigated the possibility of re-treating a calcium silicate-based sealer (CSBS), compared to an epoxy-resin sealer (RBS), using rotary instrumentation at different times from obturation (1 month/1 year). Thirty-six human mandibular premolars, extracted as a result of orthodontic or periodontal problems, were instrumented and randomly divided into three groups of 12: BR and BR*, which were filled with CSBS and re-treated after one month and one year of storage, respectively, and AH, which was filled with RBS and re-treated after one month. The same re-treatment protocol was used for all teeth, and the times required for the procedure was recorded. The re-treated specimens were longitudinally sectioned and examined at the stereomicroscope (SM) at 20× magnification. Image J Software was used to process the microphotographs. The percentage of residual filling materials in the root canal and the apical third, the ability to reach working length WL and patency, and the time taken to complete the re-treatment were recorded and analyzed by ANOVA and post hoc Bonferroni test (p = 0.05). Scanning electron microscopy (SEM) and coupled energy-dispersive spectroscopy (EDS) were applied to representative samples to evaluate canal cleanliness and chemical elements. Patency and WL were re-established in all of the teeth. Residual filling materials were retained in all specimens of the three groups. The mean percentage of residual materials was significantly different between BR and BR* (p-value = 0.048), with BR* showing the highest values. The mean time to complete re-treatment was significantly lower for AH, followed by BR (p = 0.0001) and BR* (p = 0.0078). Conclusions: After both medium and long storage periods, the CSBS can be concluded to have been successfully removed from canals with simple anatomy.
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Assessment of Bioceramic Sealer Retreatability and Its Influence on Force and Torque Generation. MATERIALS 2022; 15:ma15093316. [PMID: 35591647 PMCID: PMC9101237 DOI: 10.3390/ma15093316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023]
Abstract
This study assesses the retreatability of TotalFill bioceramic (TFBC) and AH Plus (AHP) sealers and their impact on retreatment force and torque. Twenty-six premolar teeth with single oval canals were instrumented, obturated using the matched gutta-percha cone technique with one of the tested sealers, and then temporized. After a 6-month incubation at 37 °C and 100% humidity, the canals were retreated with the XP Shaper system. During retreatment, the generated force and torque were measured. Micro-CT scanning was run before and after the retreatment procedure to analyze the remaining obturating materials in the canals. The apically directed maximum force in AHP was higher than that in TFBC. The coronally directed maximum force and the maximum torque were comparable between the groups. A higher amount of remaining obturating materials was found in the AHP compared to that in the TFBC. Based on these findings, endodontic sealer had an influence on retreatability, and the TFBC showed less remaining obturating materials and lower retreatment forces in the apical direction compared to the AHP in extracted teeth with oval canals.
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22
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Liu H, Li H, Zhang L, Wang Z, Qian J, Yu M, Shen Y. In vitro evaluation of the antibacterial effect of four root canal sealers on dental biofilms. Clin Oral Investig 2022; 26:4361-4368. [PMID: 35137277 DOI: 10.1007/s00784-022-04399-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To dynamically evaluate the effect of four root canal sealers on the killing of biofilms within dentinal tubules. MATERIALS AND METHODS Dentin blocks were prepared for infection of the dentinal tubules. Enterococcus faecalis VP3-181 and multi-species bacteria from two donors were cultured. After 3 days of incubation, the infected dentin specimens were rinsed with sterile water for 1 min and subjected to treatment. Additionally, multi-species bacteria from donor 1 were incubated for 3 weeks to allow biofilm maturation and then the specimens were subjected to treatment. Gutta-percha-treated dentin specimens comprised the control group. A root canal sealer (bioceramic sealers: EndoSequence BC Sealer, ProRoot Endo Sealer, or GuttaFlow Bioseal; and a traditional silicone-based sealer: Guttaflow 2) was spread onto the canal walls of the dentin. The specimens were examined with confocal laser scanning microscopy at 7, 30, or 60 days. RESULTS In the 3-day-old biofilm group, the proportion of killed bacteria decreased significantly from the first 7 days of treatment to 60 days of treatment for all sealers (p < 0.05). In the 3-week-old biofilm group, 60 days of exposure to bioceramic sealers resulted in more significant dead bacteria than 7-day exposures of the biofilms (p < 0.05). Bioceramic sealers were more effective in killing bacteria than the GuttaFlow 2 sealer (p < 0.05). CONCLUSIONS Calcium silicate-based sealers showed good antimicrobial effects against biofilms within dentinal tubules, especially in the first week in young biofilms. There is no substantive antibacterial activity observed for the examined root canal sealers against young dentinal tubule biofilms. CLINICAL RELEVANCE The bioceramic root canal sealers examined demonstrate minimal additional antibacterial effects after long-term exposure to young biofilms.
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Affiliation(s)
- He Liu
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China.,Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Heng Li
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Lei Zhang
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Zhejun Wang
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Junrong Qian
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Miao Yu
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, People's Republic of China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada.
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Carrillo CA, Kirkpatrick T, Freeman K, Makins SR, Aldabbagh M, Jeong JW. Retrievability of Calcium Silicate-based Root Canal Sealers during Retreatment: An Ex Vivo Study. J Endod 2022; 48:781-786. [DOI: 10.1016/j.joen.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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Lee T, Kahm SH, Kim K, Yang S. The Retrievability of Calcium Silicate-Based Sealer during Retreatment and the Effectiveness of Additional Passive Ultrasonic Irrigation: A Microcomputed Tomographic Study. SCANNING 2022; 2022:3933305. [PMID: 35136463 PMCID: PMC8803455 DOI: 10.1155/2022/3933305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/08/2022] [Indexed: 06/10/2023]
Abstract
This study investigated the retreatability of EndoSeal MTA (Maruch, Wonju, Korea) according to the presence or absence of a canal isthmus and the additional use of passive ultrasonic irrigation (PUI) through microcomputed tomography (micro-CT) imaging. An epoxy resin sealer (AH Plus (Dentsply DeTrey, Konstanz, Germany)) was used as a reference for comparison. Forty-five artificial mandibular molars (TRUETOOTH #19, DELABS, Santa Barbara, CA) with a mesial canal with an isthmus and a distal canal without an isthmus were obturated using gutta-percha and one of the following sealers (n = 15 each): AH Plus, EndoSeal MTA, and EndoSeal MTA + PUI. Micro-CT scanning was performed to assess the void volume (as a percentage) at three root levels. After the root fillings were removed, second micro-CT scanning was conducted to evaluate the amount of remaining root filling material. The Kruskal-Wallis H test and post hoc analysis were used for between-group comparisons. The Mann-Whitney U test was used for comparisons between canals with and without an isthmus (p < 0.05). In the EndoSeal MTA group, the void volume and remaining filling materials were higher irrespective of the presence or absence of an isthmus. In apical lesions in the EndoSeal MTA group, the void ratio was significantly lower, and there was a significantly higher amount of remaining filling material. Regardless of the presence of an isthmus, the amount of remaining filling material of the EndoSeal + PUI group was reduced to a similar degree as the AH plus group. When performing retreatment for root canals filled with EndoSeal MTA, removal of the filling material can be more difficult in the apical region. The additional use of PUI can improve the efficacy of removal.
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Affiliation(s)
- TaeYeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Se Hoon Kahm
- Department of Dentistry, Eunpyeong St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | | | - SungEun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Sharma S, Raghu R, Shetty A, Rajasekhara S, Lakshmisetty H, Bharath G. An in vitro comparative evaluation of retreatability of a bioceramic and resin sealer using cone-beam computed tomography analysis. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rajda M, Miletić I, Baršić G, Krmek SJ, Šnjarić D, Baraba A. Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis. MATERIALS 2021; 14:ma14216670. [PMID: 34772195 PMCID: PMC8587586 DOI: 10.3390/ma14216670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/27/2022]
Abstract
The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann-Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm3, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm3) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.
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Affiliation(s)
- Marko Rajda
- Dental Health Center—Center, Runjaninova 4, 10000 Zagreb, Croatia;
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Gorana Baršić
- Department for Quality, Department for Measurement and Control, Faculty of Mechanical Engineering and Naval Architecture, IvanaLučića 5, 10002 Zagreb, Croatia;
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Damir Šnjarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
- Correspondence:
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Ajina MA, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J 2021; 55 Suppl 1:119-152. [PMID: 34674279 DOI: 10.1111/iej.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Despite enjoying high favourable outcome rates, root canal treatment is not always successful. Root canal retreatment is a widely practised option for managing a non-healing root treated tooth. A basic distinction between retreatment and initial treatment is the requirement to remove the existing root filling material occupying the root canal space. Only then, can the technical deficiencies and possible causes of failure be addressed. Hence, the successful removal of the root filling material is critical to achieving the objectives of retreatment. Many different materials and techniques have been used for root canal filling, which have been documented in a plethora of studies; these are mainly laboratory studies investigating the removal of root filling materials. To help guide future research, which may then better inform clinical practice in relation to retreatment procedures, the focus of this narrative review is on the research methods and experimental models employed to study the removal of root filling materials. The current available literature demonstrates great variation in the research methodologies used to study the removal of root filling material, including direct visualization by splitting tooth samples or clearing, three-dimensional radiographic imaging including using microcomputed tomography or cone-beam computed tomography, and a combination of these techniques. Depending on the research method employed, variation also exists in quantification of root filling material removal; these include measurements of surface area, volume or weight, and criteria-based (semi-quantitative) assessment. Experimental models, using human teeth or resin models, differ with respect to standardization techniques and replication of the clinical scenario including initial sample preparation, canal filling, allocation and technical aspects of retreatment procedures. Future models should replicate, as closely as possible, the clinical scenario. Currently, microcomputed tomography provides a highly detailed, non-invasive and non-destructive method of objectively assessing and quantifying root filling removal.
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Affiliation(s)
- Mahdi A Ajina
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Shah
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Bun San Chong
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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28
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Colmenar D, Tamula T, Zhu Q, Ahn C, Primus C, Komabayashi T. Micro CT pilot evaluation of removability of two endodontic sealers. J Oral Sci 2021; 63:306-309. [PMID: 34408113 DOI: 10.2334/josnusd.21-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This study compared the removability of AH Plus and EndoSequence BC sealers using in vitro micro-computed tomography. METHODS Ten single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size X5 (50/0.06) (Dentsply-Sirona). Canals were obturated with a single cone gutta-percha and either AH Plus (Dentsply-Sirona) (Group A) or EndoSequence BC (Brasseler) (Group B). ProTaper Universal Retreatment files (Dentsply-Sirona) were used to remove obturation materials after 90 days at 37oC/100% humidity. Each tooth was scanned using micro-computed tomography (SkyScan 1272; Bruker) at an isotropic resolution of 6 μm from which the percent of material removed was calculated. Two-sample t-tests and one-way ANOVA were used for analysis. RESULTS The percent removal of materials in the coronal third was 92.9% ± 7.3% (Group A) and 93.2% ± 6.1% (Group B). Removal in the middle third was 94.9% ± 8.5% (Group A) and 96.5% ± 6.1% (Group B). Apical third removal was 76.2% ± 27.9% (Group A) and 70.1% ± 30.8% (Group B). No statistically significant differences were determined between the two sealers or among the sectional thirds within each group (P > 0.05). CONCLUSION AH Plus and EndoSequence BC sealers exhibit the same removability at all canal levels of 70% to 96%, with better removal coronally.
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Affiliation(s)
| | - Tenzin Tamula
- University of New England College of Dental Medicine
| | - Qiang Zhu
- Division of Endodontology, University of Connecticut School of Dental Medicine
| | - Chul Ahn
- Department of Clinical Sciences, University of Texas Southwestern Medical Center
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de Souza DS, S Silva AS, Ormiga F, Lopes RT, Gusman H. The effectiveness of passive ultrasonic irrigation and the easy-clean instrument for removing remnants of filling material. J Conserv Dent 2021; 24:57-62. [PMID: 34475681 PMCID: PMC8378483 DOI: 10.4103/jcd.jcd_590_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 02/03/2023] Open
Abstract
Objective This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) and the easy clean instrument by micro-computed tomography (CT) for removing remnant filling materials during endodontic retreatment. Materials and Methods Forty mesial roots of mandibular molars were divided into four groups (n = 10) according to the agitation system and sealer used: Group 1: PUI/AH Plus; Group 2: PUI/TotalFill; Group 3: Easy Clean/AH Plus; and Group 4: Easy Clean/TotalFill. The groups were compared by micro-CT analysis according to the volumes of the obturation and the remaining material before and after the agitation systems were used. Results There was no difference between the groups for total filling volume and initial and final remaining filling volume (P > 0.05). Conclusions Both the PUI and easy-clean instrument are effective for removing remnants of filling material with no difference between the groups.
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Affiliation(s)
| | - Aline S S Silva
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Ricardo T Lopes
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
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Baranwal HC, Mittal N, Garg R, Yadav J, Rani P. Comparative evaluation of retreatability of bioceramic sealer (BioRoot RCS) and epoxy resin (AH Plus) sealer with two different retreatment files: An in vitro study. J Conserv Dent 2021; 24:88-93. [PMID: 34475687 PMCID: PMC8378486 DOI: 10.4103/jcd.jcd_657_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 11/26/2022] Open
Abstract
Aim: The aim of the study was to evaluate and compare the retreatability of BioRoot RCS and AH Plus sealer with two different retreatment file systems using cone-beam computed tomography (CBCT) for assessing the filling remnants. Materials and Methods: A total of sixty mandibular premolars with single and oval root canals were prepared till size F3 and obturated with GP/AH Plus (Group 1) and GP/BioRoot RCS (Group 2). Canals were then retreated using two different retreatment file systems – ProTaper Universal Retreatment (PTUR) system and NeoEndo Retreatment system. The ability to re-establish working length (WL) and apical patency was recorded, and the percentage volume of residual filling material was evaluated using CBCT at the coronal, middle, and apical thirds. Data from the study were analyzed using one-way analysis of variance with Pearson's Chi-squared analysis and the Kruskal–Wallis test. Results: No statistically significant difference was found in the amount of residual sealer (AH Plus and BioRoot RCS) after retreatment throughout the whole study (P > 0.05) at various root canal levels. Furthermore, the BioRoot RCS group retreated with the PTUR system showed a higher frequency of failure in re-establishing WL and regaining apical patency than the other groups. Conclusion: Complete removal of root canal sealers could not be achieved regardless of the type of sealer used and the retreatment technique employed. Furthermore, in clinical settings, the retreatability of novel BioRoot RCS may be deemed feasible.
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Affiliation(s)
- Harakh Chand Baranwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Neelam Mittal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Riya Garg
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jyoti Yadav
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Prachi Rani
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Alsubait S, Alhathlol N, Alqedairi A, Alfawaz H. A micro-computed tomographic evaluation of retreatability of BioRoot RCS in comparison with AH Plus. AUST ENDOD J 2021; 47:222-227. [PMID: 33119208 DOI: 10.1111/aej.12456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/28/2022]
Abstract
This study compared the retreatability of filling material from canals filled with BioRoot RCS (Septodont, Saint-Maur-des-Fosses, France) and AH Plus (Dentsply DeTrey, Konstanz, Germany) combined with gutta-percha using micro-computed tomography for evaluation. Thirty-four mandibular premolars were divided into two groups according to the sealer used. Thirty days after obturation, canals were retreated with a ProTaper Universal retreatment system (Dentsply Maillefer, Ballaigues, Switzerland) followed by passive ultrasonic irrigation (PUI). The time taken for retreatment was recorded. The roots were scanned after obturation, after retreatment and after PUI. Data were analysed using the Mann-Whitney and Wilcoxon tests. Canals filled with BioRoot RCS exhibited significantly less remaining filling material than canals filled with AH Plus (P < 0.05). The addition of PUI resulted in a significant decrease in the residual material in both groups (P < 0.05). A significantly shorter retreatment time was reported for the AH Plus group than the BioRoot RCS group (P < 0.05).
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Affiliation(s)
- Sara Alsubait
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nuha Alhathlol
- Endodontic Residency Program, Saudi Commission for Health Specialist, Riyadh, Saudi Arabia
- Department of Clinical Dental Sciences, College of Dentistry, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdullah Alqedairi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hussam Alfawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Sfeir G, Zogheib C, Patel S, Giraud T, Nagendrababu V, Bukiet F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. MATERIALS 2021; 14:ma14143965. [PMID: 34300886 PMCID: PMC8306764 DOI: 10.3390/ma14143965] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide-eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners' clinical habits rather than manufacturers' recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Shanon Patel
- King’s College London Dental Institute, Guy’s Tower, Guy’s Hospital, St. Thomas’ Street, London SE1 9RT, UK;
| | - Thomas Giraud
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
- Correspondence: ; Tel.: +33-(0)6-4395-2183
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A comparative study of dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow, iRoot SP, and AH Plus with different obturation techniques. Clin Oral Investig 2021; 25:4163-4173. [PMID: 33638051 PMCID: PMC8137581 DOI: 10.1007/s00784-020-03747-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/15/2020] [Indexed: 12/17/2022]
Abstract
Objectives This study aimed to evaluate dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow (HiFlow), iRoot SP, and AH Plus when using the single-cone (SC) or continuous wave condensation (CWC) technique. Materials and methods Sixty-five single-rooted teeth were instrumented and randomly divided into 5 groups: group 1, AH Plus/CWC; group 2, iRoot SP/CWC; group 3, iRoot SP/SC; group 4, HiFlow/CWC; and group 5, HiFlow/SC. The ability to re-establish patency during endodontic retreatment was recorded, as was the time taken to reach the working length. Dentinal tubule penetration and remaining debris after retreatment were evaluated by confocal microscopy and scanning electron microscopy. Data were analyzed by Kruskal-Wallis test and Dunn’s multiple comparisons test (α = 0.05). Results The HiFlow/CWC and iRoot SP/CWC groups required more time to reach the working length than groups that underwent the SC technique regardless of the sealer used (P < .05). The HiFlow/CWC group showed a significantly higher percentage of sealer penetration area than that of the iRoot SP/SC at 4 mm from the apex (P < .05) and penetrated deeper into dentinal tubules than iRoot SP/SC at both 8-mm and 12-mm levels (P < .05). Moreover, the HiFlow/CWC and HiFlow/SC groups demonstrated less remaining sealer along the canal wall than AH Plus/CWC group at 4-mm level (P < .05). Conclusions HiFlow/CWC technique showed better performance in dentinal tubule penetration than that of iRoot SP/SC. Both HiFlow and iRoot SP combined with CWC technique groups required more retreatment time than the other groups. Furthermore, using HiFlow with either the CWC or SC technique left less remaining sealer at 4-mm level than using AH Plus with the CWC technique during retreatment. Clinical relevance With favorable performance in dentinal tubule penetration and retreatability in endodontic retreatment, the combined use of EndoSequence BC Sealer HiFlow with the recommended continuous wave condensation technique may be a worthwhile choice in root canal treatment.
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Natanasabapathy V, Arul B, Varghese A, Mishra A, Elango S, Padmanaban S. Retrievability of bioceramic-based sealers in comparison with epoxy resin-based sealer assessed using microcomputed tomography: A systematic review of laboratory-based studies. J Conserv Dent 2021; 24:421-434. [PMID: 35399761 PMCID: PMC8989176 DOI: 10.4103/jcd.jcd_376_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/30/2021] [Accepted: 10/16/2021] [Indexed: 12/02/2022] Open
Abstract
Aim: The objective was to evaluate the retrievability of bioceramic sealers in comparison with epoxy resin-based sealers assessed using microcomputed tomography. Materials and Methods: Four reviewers independently conducted a systematic literature search in four electronic databases. The risk of bias was assessed using modified Joanna Briggs Institute Critical Appraisal tools for Quasi-Experimental Studies. Results: Ten articles were included in this review and all had a moderate risk of bias. The results across the included articles were inconsistent with some indicating easier/difficult removal of bioceramic sealers, while others indicate no difference. The studies varied in terms of the type of bioceramic sealer used, root canal anatomy, and retreatment techniques followed. Due to heterogeneity, only a qualitative analysis was performed and no meta-analysis was conducted. Conclusion: The quality of evidence is low and no definitive conclusion could be derived regarding the retrievability of bioceramic sealer/AH plus sealer from the root canals during retreatment procedures.
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Assessment of Quality of Root Canal Filling with C Point, Guttacore and Lateral Compaction Technique: A Confocal Laser Scanning Microscopy Study. Eur Endod J 2020; 5:236-241. [PMID: 33353918 PMCID: PMC7881386 DOI: 10.14744/eej.2020.62534] [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] [Indexed: 12/03/2022] Open
Abstract
Objective: The purpose of this in vitro study was to compare the quality of root canal filling of C Point, GuttaCore and lateral compaction using confocal laser scanning microscopy. Methods: Ninety recently extracted human mandibular incisors with single canal were selected. Canals were prepared with ProTaper instruments to size F3 and obturated using C Point, GuttaCore or lateral compaction technique. Endosequence BC sealer was labeled with Rhodamine B dye to allow analysis under a confocal microscope. The percentages of gutta-percha filled area (PGFA), sealer filled area (PSFA), voids (POV) and interfacial adaptation (IA) was assessed at 2, 5 and 8 mm from the apex, using image analysis software. Kruskal–Wallis followed by Mann Whitney U tests were used for data analysis, and the P value was set at 0.05 (P=0.05). Results: No significant difference was seen among the three groups at 2 mm level for PGFA, PSFA and voids (P>0.05). At 5 and 8 mm levels, canals filled with GuttaCore had significantly higher PGFA and lower PSFA than lateral compaction and C Point. Highest POV was seen for lateral compaction group followed by C Point and GuttaCore. Conclusion: Out of the three techniques examined, best results in terms of quality of root canal filling were observed for GuttaCore. C Point system was found to be associated with internal defects such as tears and delamination which may adversely affect the long term performance of this system.
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Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, Silva ASDS, Bueno CEDS. Micro-computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod 2020; 46:1901-1906. [PMID: 32961214 DOI: 10.1016/j.joen.2020.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study was to conduct a micro-computed tomographic assessment of the effectiveness of 3 supplementary cleaning techniques in reducing the residual volume of gutta-percha and a bioceramic sealer after performing endodontic retreatment procedures in teeth with oval canals. METHODS Thirty-six mandibular premolars were instrumented with the ProTaper Next system (instruments X1-X3; Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and Bio-C Sealer (Angelus, Londrina, PR, Brazil) using the single-cone technique. The teeth were reinstrumented with the Reciproc R40 instrument (VDW, Munich, Germany) and divided into 3 groups according to the supplementary cleaning technique used (n = 12): ultrasonic-assisted irrigation (UAI), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) irrigation (EAI), or the XP-endo Finisher R system (XPR; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Micro-computed tomographic imaging was used to quantify the residual volume of filling material. One-way analysis of variance complemented by the Tukey test was used to perform the statistical analysis (P < .05). RESULTS Significant reductions were obtained in the residual filling material after supplementary cleaning (P < .05). XPR (47.5%) led to significantly greater (P < .05) filling material removal than UAI (16.6%) or EAI (22.6%). The removal values of the 2 latter systems were not significantly different. CONCLUSIONS XPR was more effective than UAI and EAI in removing filling material in mandibular premolars with oval canals. None of the tested supplementary cleaning techniques completely removed the residual filling material.
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Affiliation(s)
- Andrea Volponi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Saddock de Sá Silva
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Athkuri S, Mandava J, Chalasani U, Ravi RC, Munagapati VK, Chennareddy AR. Effect of different obturating techniques and sealers on the removal of filling materials during endodontic retreatment. J Conserv Dent 2020; 22:578-582. [PMID: 33088069 PMCID: PMC7542081 DOI: 10.4103/jcd.jcd_241_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 04/03/2020] [Accepted: 04/15/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Adequate removal of previous root filling materials is an important objective during endodontic retreatment. Aim: This study was aimed to evaluate the influence of obturation quality and sealer type on the removal of root filling materials during endodontic retreatment using micro-computed tomography (μ-CT). Materials and Methods: Ninety extracted mandibular premolars were randomly assigned to two groups (n = 45) based on the type of sealer (AH Plus and BioRoot RCS) and three sub-groups based on the obturating technique used, i.e., cold lateral condensation, warm vertical compaction, and thermoplasticized injectable techniques. Specimens were scanned using μ-CT before and after retreatment to assess the amount of filling material, and time taken for removal was recorded. Statistical Analysis: Data were analyzed using two-way analysis of variance and Tukey's multiple post hoc test at 5% significance level. Results: Filling debris percentage and retreatment time were not significantly affected by the type of sealer (P ≥ 0.05). The percentage of remaining filling material was higher in teeth obturated with thermoplasticized technique (P < 0.05). Significantly more filling material debris was observed in apical third (P < 0.05). Conclusions: The type of obturating technique used for initial root canal treatment has influenced the amount of remaining filling material and retreatment time. Retreatability of the BioRoot RCS sealer was similar to the AH Plus sealer.
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Affiliation(s)
- Srividya Athkuri
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Uma Chalasani
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravi Chandra Ravi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Vamsi Krishna Munagapati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Anusha Reddy Chennareddy
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Silva EJNL, Ehrhardt IC, Sampaio GC, Cardoso ML, Oliveira DDS, Uzeda MJ, Calasans-Maia MD, Cavalcante DM, Zuolo ML, De-Deus G. Determining the setting of root canal sealers using an in vivo animal experimental model. Clin Oral Investig 2020; 25:1899-1906. [DOI: 10.1007/s00784-020-03496-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
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Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: an in-vitro study. Odontology 2020; 109:149-156. [PMID: 32623538 DOI: 10.1007/s10266-020-00535-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/26/2020] [Indexed: 01/18/2023]
Abstract
To compare the dislodgement resistance and the adhesive pattern of four different endodontic sealers to root dentine walls. Ninety lower premolars were assigned to five groups (n = 18), Group 1: no sealer (control); Group 2: EndoRez (ERZ); Group 3: Sealapex (SPX); Group 4: EndoSeal MTA (ESA) and Group 5: BioRoot RCS (BRS). They were instrumented up to size 30 taper 0.06 and obturated using single cone technique with matched-taper gutta-percha cones and one of the mentioned sealers. Six teeth from each group were then randomly subjected to 100, 1000 and 10,000 thermocycles, respectively. 1 mm slice of mid root region, measuring 6 mm from the apical foramen was prepared and subjected to push-out test under a Universal Testing Machine. Adhesive patterns of sealers were assessed using a stereomicroscope at 20 × magnification and classified using a new system. Statistical analyses were performed using two-way ANOVA, complemented by Tukey HSD and Chi-square tests. ESA and BRS showed significantly higher (p < 0.05) push-out bond strength, followed by SPX, ERZ and lastly the control, but no significant difference was noted between ESA and BRS (p > 0.05) at 100, 1000 and 10,000 thermocycles, respectively. Both ESA and BRS exhibited a significant higher rate (p < 0.05) of Type 3 and Type 4 adhesive patterns as the thermocycles increased. ESA and BRS demonstrated higher bond strength and better adhesive pattern to root dentine wall than SPX and ERZ, especially after artificial ageing.
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Rodríguez‐Lozano FJ, López‐García S, García‐Bernal D, Tomás‐Catalá CJ, Santos JM, Llena C, Lozano A, Murcia L, Forner L. Chemical composition and bioactivity potential of the new Endosequence BC Sealer formulation HiFlow. Int Endod J 2020; 53:1216-1228. [DOI: 10.1111/iej.13327] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/08/2020] [Indexed: 12/21/2022]
Affiliation(s)
- F. J. Rodríguez‐Lozano
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
- Gerodontology and Special Care in Dentistry Unit. School of Dentistry Faculty of Medicine University of Murcia Murcia Spain
| | - S. López‐García
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
| | - D. García‐Bernal
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
| | - C. J. Tomás‐Catalá
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
- Gerodontology and Special Care in Dentistry Unit. School of Dentistry Faculty of Medicine University of Murcia Murcia Spain
| | - J. M. Santos
- Institute of Endodontics Faculty of Medicine University of Coimbra Coimbra Portugal
| | - C. Llena
- Department of Stomatology University de Valencia ValenciaSpain
| | - A. Lozano
- Department of Stomatology University de Valencia ValenciaSpain
| | - L. Murcia
- Department of Genetics and Microbiology University of Murcia Murcia Spain
| | - L. Forner
- Department of Stomatology University de Valencia ValenciaSpain
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Crozeta BM, Lopes FC, Menezes Silva R, Silva-Sousa YTC, Moretti LF, Sousa-Neto MD. Retreatability of BC Sealer and AH Plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment. Clin Oral Investig 2020; 25:891-899. [PMID: 32506324 DOI: 10.1007/s00784-020-03376-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of supplementary techniques (ultrasonic tip/XP-endo Finisher R) in removing remaining filling materials (gutta-percha/AHPlus/BCSealer) from oval-shaped root canals during non-surgical endodontic retreatment. MATERIAL AND METHODS Twenty-eight distal roots of human mandibular molars with single and oval-shaped canals were initially shaped with a R40 instrument and filled with gutta-percha points and AH Plus (n = 14) or BC Sealer (n = 14) followed by an initial micro-CT scanning. Initial filling material removal was performed in all 28 samples with an R50 instrument, and all samples submitted to a second micro-CT. Supplementary techniques with ultrasonic tips or XP-endo Finisher R instruments were performed in each sealer group, and all samples submitted to a third micro-CT. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed using T, ANOVA 3-way, and Tukey tests. RESULTS Lower values of remnant filling material were found for BC Sealer (16.06 ± 14.34) compared to AH Plus (28.30 ± 10.54) (P < 0.001), and considering the supplementary technique, lower values of remnant filling material were found for the ultrasonic tip (18.95 ± 11.05) compared to XP-endo Finisher R (25.41 ± 15.81) (P = 0.025). Ultrasonic instruments significantly reduced the percentage of remaining filling material for both AH Plus (P = 0.04) and BC Sealer (P = 0.02) while XP-endo Finisher R was effective for AHPlus only (P = 0.04). The remaining filling material was observed in all samples regardless the filling material or the supplementary technique employed. CONCLUSIONS Supplementary techniques increased filling material removal; however, none of them was able to render root canals completely free from root fillings. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for bioceramic cases. CLINICAL RELEVANCE Supplementary instrumentation techniques are effective tools to reduce the amount of filling materials during root canal retreatment.
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Affiliation(s)
- Bruno Monguilhott Crozeta
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.,Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Renato Menezes Silva
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
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Almohaimede A, Almanie D, Alaathy S, Almadi E. Fracture Resistance of Roots Filled With Bio-Ceramic and Epoxy Resin-Based Sealers: In Vitro Study. Eur Endod J 2020; 5:134-137. [PMID: 32766524 PMCID: PMC7398996 DOI: 10.14744/eej.2019.33042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/22/2019] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to assess the resistance of roots to fracture after being root canal filled with two types of endodontic sealers; bio-ceramic based sealer (TotalFill) and epoxy-resin based sealer (AH Plus). Methods Fifty-nine single canal mandibular premolars were instrumented. Group I (n=14, negative control): root canals were left without instrumentation and unfilled, group II (n=15, positive control): root canals were instrumented only and left unfilled, group III and IV (n=15 each): root canals were instrumented and filled with either gutta-percha/TotalFill or gutta-percha/AH Plus, respectively. The resistance of the roots to fracture was measured with a universal testing machine "Instron Corp" through recording the maximum force in Newton (N) needed to fracture each root. To analyze the data Kruskal-Wallis test was utilized, followed by Dunn's Bonferroni post hoc test for multiple comparisons. The level of significance was set at 0.05 (P≤0.05). Results TotalFill group showed slightly better fracture resistance (734.62 N) than AH Plus group (728.29 N). However, no statistical significant difference was found between the two groups (P>0.05). The greatest mean fracture force was shown in the negative control group (913.915 N) with statistical significant difference between the other three groups (P<0.05). Conclusion Gutta-percha/TotalFill and gutta-percha/AH Plus did not reinforce the root canal treated teeth.
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Affiliation(s)
- Amal Almohaimede
- From the Department of Restorative Dental Sciences, Endodontic Division, College of Dentistry, King Saud University, Riyadh, Saudi Arabia, Kingdom of Saudi Arabia
| | - Daniah Almanie
- From the Department of Restorative Dental Sciences, Endodontic Division, College of Dentistry, King Saud University, Riyadh, Saudi Arabia, Kingdom of Saudi Arabia
| | - Sara Alaathy
- From the Department of Restorative Dental Sciences, Endodontic Division, College of Dentistry, King Saud University, Riyadh, Saudi Arabia, Kingdom of Saudi Arabia
| | - Ebtissam Almadi
- From the Department of Restorative Dental Sciences, Endodontic Division, College of Dentistry, King Saud University, Riyadh, Saudi Arabia, Kingdom of Saudi Arabia
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Garrib M, Camilleri J. Retreatment efficacy of hydraulic calcium silicate sealers used in single cone obturation. J Dent 2020; 98:103370. [PMID: 32387505 DOI: 10.1016/j.jdent.2020.103370] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/25/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Removal of obturating materials from the root canal during retreatment is usually accomplished by mechanical means and organic solvents to dissolve the gutta-percha. This strategy is ineffective on sealers. The aim of this research was to assess the efficacy of mechanical instrumentation aided by targeted chemical means for removal of hydraulic sealers. METHODS A preliminary study assessed the effect of 17% EDTA and 10/20% formic acid applied for 5 or 10 min on dentine and for 5 min on Totalfill BC sealer (FKG). Microhardness and structural integrity by scanning electron microscopy and energy dispersive spectroscopy were investigated. The optimal solutions were used as adjuncts to mechanical instrumentation to remove obturations made with single cone using a standard gutta-percha and bioceramic coated gutta-percha and Totalfill BC sealer. The removal of obturation material from the root canal system of obturated teeth was evaluated using microcomputed tomography. The canal patency and reestablishment of working length were also checked. RESULTS The preliminary study showed that 17% EDTA and 10% formic acid applied for 5 min did not damage the dentine but effected the structural integrity of the sealer. 10% formic acid used in conjunction with mechanical instrumentation was the most efficient method to remove the obturation material from the root canal, achieving over 95% removal for both gutta-percha and the bioceramic coated version and also achieve patency and reestablishment of working length. CONCLUSIONS The use of a targeted irrigation protocol with a chemical adjunct to the mechanical instrumentation is the best way to retreat teeth obturated with hydraulic calcium silicate sealer and gutta-percha.
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Affiliation(s)
- M Garrib
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
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Influence of endodontic sealers with different chemical compositions on bond strength of the resin cement/glass fiber post junction to root dentin. Clin Oral Investig 2020; 24:3417-3423. [PMID: 31980923 DOI: 10.1007/s00784-020-03212-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 01/15/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study evaluated the influence of endodontic sealers with different chemical compositions on bond strength of resin cement/glass fiber post junction to root dentin. MATERIALS AND METHODS Seventy-two maxillary canines roots were instrumented with Reciproc (#R50) and distributed in 6 groups (n = 12) according to endodontic sealers: G1-control (no sealer); G2-Endofill; G3-Sealapex; G4-AH Plus; G5-Sealer Plus; G6-EndoSequence BC. The glass fiber post was cemented with Panavia F in 10 of the specimens. Two specimens from each group did not receive post and were analyzed by SEM to verify presence of filling material. Three slices were obtained from each third. The first slice was subjected to push-out test and type of failure. The second slice was imaged using laser confocal microscopy for evaluation of dentin/resin cement adhesive interface. Bond strength (BS) data were analyzed using two-way ANOVA and Tukey's post hoc tests; for LCM data, we used Kruskal-Wallis and Dunn's tests. RESULTS Endofill yielded the lowest BS values (p < 0.05). The control and AH Plus groups differed from all others (p < 0.05). In all groups, adhesive to dentin failure predominated. Most specimens of control and AH Plus groups had acceptable interfaces, while those of EndoSequence BC, Sealapex, and Sealer Plus groups ranged between acceptable and poor interfaces. Overall, few filling material remnants were observed on the dentin. CONCLUSION EndoSequence BC, Sealapex, Sealer Plus, and Endofill negatively interfere with BS of glass fiber post/resin cement junction to root dentin. CLINICAL RELEVANCE In cases whose restoration planning includes a post cemented with resin cement, it is recommended that endodontic sealer be based on epoxy resin.
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Washio A, Morotomi T, Yoshii S, Kitamura C. Bioactive Glass-Based Endodontic Sealer as a Promising Root Canal Filling Material without Semisolid Core Materials. MATERIALS 2019; 12:ma12233967. [PMID: 31795433 PMCID: PMC6926972 DOI: 10.3390/ma12233967] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/24/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Abstract
Endodontic treatment for a tooth with damaged dental pulp aims to both prevent and cure apical periodontitis. If the tooth is re-infected as a result of a poorly obturated root canal, periapical periodontitis may set-in due to invading bacteria. To both avoid any re-infection and improve the success rate of endodontic retreatment, a treated root canal should be three-dimensionally obturated with a biocompatible filling material. Recently, bioactive glass, one of the bioceramics, is focused on the research area of biocompatible biomaterials for endodontics. Root canal sealers derived from bioactive glass-based have been developed and applied in clinical endodontic treatments. However, at present, there is little evidence about the patient outcomes, sealing mechanism, sealing ability, and removability of the sealers. Herein, we have developed a bioactive glass-based root canal sealer and provided evidence concerning its physicochemical properties, biocompatibility, sealing ability, and removability. We also review the classification of bioceramics and characteristics of bioactive glass. Additionally, we describe the application of bioactive glass to facilitate the development of a new root canal sealer. Furthermore, this review shows the potential application of bioactive glass-based cement as a root canal filling material in the absence of semisolid core material.
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Šimundić Munitić M, Poklepović Peričić T, Utrobičić A, Bago I, Puljak L. Antimicrobial efficacy of commercially available endodontic bioceramic root canal sealers: A systematic review. PLoS One 2019; 14:e0223575. [PMID: 31622387 PMCID: PMC6797114 DOI: 10.1371/journal.pone.0223575] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022] Open
Abstract
Background Recently, a new generation of bioceramic root canal sealers has been introduced onto the market. Many in vitro studies have investigated the antimicrobial properties of these sealers, but their comparative efficacy in antimicrobial activity is still unknown. Methodology Three electronic databases were searched: MEDLINE and Embase via the OvidSP platform, and Web of Science, up to June 25, 2019. Studies were included irrespective of study design, type of publication and language. Reporting quality was assessed by two authors independently. Meta-analysis was not performed due to studies being highly heterogeneous. Results We included 37 studies that analysed the antimicrobial effects of bioceramic sealers. Most of them used a planktonic cell model, with the exception of nine studies which used biofilms. It was not possible to make direct comparison of results from studies and to give a clear conclusion about the comparative antimicrobial activity of these materials because the studies used heterogeneous sources and ages of microorganisms, setting and contact times of sealers, and antimicrobial tests. Furthermore, some materials showed completely different results when tested with different methods. Conclusions In conclusion, multiple in vitro studies have shown that bioceramic sealers may have various degrees of antimicrobial activity. However, it is still impossible to make conclusions about their comparative efficacy and to recommend the use of one over another in clinical practice because the studies available were conducted in different ways, which makes meta-analysis futile. A uniform methodological approach, consistent definitions and studies on humans are urgently needed in this field of research so that recommendations for practice can be made.
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Affiliation(s)
- Marija Šimundić Munitić
- Department of Endodontics and Restorative Dentistry, Dental Polyclinic Split; School of Dental Medicine, University of Split, Split, Croatia
- * E-mail:
| | - Tina Poklepović Peričić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia
| | - Ana Utrobičić
- Cochrane Croatia, Central Medical Library, School of Medicine, University of Split, Split, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Livia Puljak
- Department of Evidence Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Zagreb, Croatia
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47
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Roizenblit RN, Soares FO, Lopes RT, Santos BC, Gusman H. Root canal filling quality of mandibular molars with EndoSequence
BC
and
AH
Plus sealers: A micro‐
CT
study. AUST ENDOD J 2019; 46:82-87. [DOI: 10.1111/aej.12373] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Rafael Nigri Roizenblit
- Department of Dental Clinic School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Fabiola Ormiga Soares
- Department of Dental Clinic School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Ricardo Tadeu Lopes
- Department of Nuclear Instrumentation Laboratory Technology Center Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Bernardo Camargo Santos
- Department of Nuclear Instrumentation Laboratory Technology Center Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Heloisa Gusman
- Department of Dental Clinic School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
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48
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Primus CM, Tay FR, Niu LN. Bioactive tri/dicalcium silicate cements for treatment of pulpal and periapical tissues. Acta Biomater 2019; 96:35-54. [PMID: 31146033 PMCID: PMC6717675 DOI: 10.1016/j.actbio.2019.05.050] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 12/11/2022]
Abstract
Over 2500 articles and 200 reviews have been published on the bioactive tri/dicalcium silicate dental materials. The indications have expanded since their introduction in the 1990s from endodontic restorative and pulpal treatments to endodontic sealing and obturation. Bioactive ceramics, based on tri/dicalcium silicate cements, are now an indispensable part of the contemporary dental armamentarium for specialists including endodontists, pediatric dentists, oral surgeons andfor general dentists. This review emphasizes research on how these materials have conformed to international standards for dental materials ranging from biocompatibility (ISO 7405) to conformance as root canal sealers (ISO 6876). Potential future developments of alternative hydraulic materials were included. This review provides accurate materials science information on these important materials. STATEMENT OF SIGNIFICANCE: The broadening indications and the proliferation of tri/dicalcium silicate-based products make this relatively new dental material important for all dentists and biomaterials scientists. Presenting the variations in compositions, properties, indications and clinical performance enable clinicians to choose the material most suitable for their cases. Researchers may expand their bioactive investigations to further validate and improve materials and outcomes.
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Affiliation(s)
- Carolyn M Primus
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA.
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA
| | - Li-Na Niu
- Department of Endodontics, The Dental College of Georgia, Augusta University, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Hena, China
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49
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Dentinal Tubule Penetration and Retreatability of a Calcium Silicate–based Sealer Tested in Bulk or with Different Main Core Material. J Endod 2019; 45:1036-1040. [DOI: 10.1016/j.joen.2019.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/29/2019] [Accepted: 04/18/2019] [Indexed: 11/16/2022]
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50
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Donyavi Z, Shokri A, Pakseresht Z, Tapak L, Falahi A, Abbaspourrokni H. Comparative Evaluation of Retreatability of Endodontically Treated Teeth using AH 26, Fluoride Varnish and Mineral Trioxide Aggregate-based Endodontic Sealers. Open Dent J 2019. [DOI: 10.2174/1874210601913010183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
Endodontic sealers are used to fill the gap between the root filling material and canal walls. Retrievability is an important requirement for sealers and root filling materials in non-surgical endodontic retreatment. This study sought to assess the retreatability of fluoride varnish, AH 26 and Mineral Trioxide Aggregate (MTA)-based sealers using Cone-Beam Computed Tomography (CBCT).
Materials and Methods:
This in vitro, experimental study evaluated 45 extracted single-rooted, single-canal human mandibular premolars. Teeth with cracks or fracture were excluded. The root canals were prepared using ProTaper Universal rotary system up to size F4 according to the manufacturer’s instructions. The teeth were then randomly divided into three groups of 5% fluoride varnish, AH 26 and MTA Fillapex. CBCT scans were obtained of the teeth with 200 μm voxel size. MATLAB R2012 software was used to quantify the amount of sealer remaining in the canal. Two observers evaluated the images. Data were analyzed using SPSS via the Kruskal-Wallis and Mann Whitney tests.
Results:
The amount of sealer remaining in the root canals was significantly different among the three groups (P<0.05). The amount of AH 26 sealer remaining in the root canals (1.91±1.46) was significantly greater than MTA Fillapex (0.62±0.26) and fluoride varnish, but the latter two were not significantly different in this respect (P>0.05).
Conclusion:
Considering the adequate adhesion of fluoride varnish to dentin, its cariostatic effect and low cost, it seems to be a suitable alternative to the commonly used endodontic sealers.
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