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Liu J, Wu H, Qiu J, Yang S, Xiang D, Zhang X, Kuang J, Xiao M, Yu Q, Cheng X. Novel bioactive nanospheres show effective antibacterial effect against multiple endodontic pathogens. Heliyon 2024; 10:e28266. [PMID: 38560113 PMCID: PMC10979287 DOI: 10.1016/j.heliyon.2024.e28266] [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: 12/20/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Aim The current study evaluated the antibacterial activity of a newly developed quaternary ammonium polymethacrylate (QAPM)-containing bioactive glasses (BGs) via a two-step method by our group, namely BGs-HAEMB, and explored its cytotoxicity and biocompatibility. Methods The antibacterial effects of the BGs-HAEMB against planktonic bacteria, bacterial biofilm formation, and experimental root canal biofilms of persistent pathogens (Enterococcus faecalis, Streptococcus sanguis and Porphyromonas endodontalis) associated with endodontic infection were evaluated in vitro by agar diffusion tests, direct contact tests and live/dead staining. The cytotoxicity and biocompatibility of BGs-HAEMB were evaluated by CCK-8 assays in vitro and a skin implantation model in vivo. Results Compared to three clinically used endodontic sealers (Endofill, AH Plus, and iRoot SP), BGs-HAEMB exhibited the relatively strongest antibacterial effect against E. faecalis, S. sanguis and P. endodontalis after sitting for 14 and 28 days (P < 0.01). SEM images and CLSM images also showed that for each tested bacteria, BGs-HAEMB killed the most microorganism among all the experimental groups, regardless of treatment for 7 days or 28 days (P < 0.05). Besides, the BGs-HAEMB-treated groups showed a relatively low cytotoxicity (RGRs ranging from 88.6% to 102.9%) after 1, 3, and 7 days of exposure. Meanwhile, after 28 days of implantation, the inflammatory grade in BGs-HAEMB treated group was assessed as Grade I, in which the average numbers of inflammatory cells (6.7 ± 2.1) were less than 25. Conclusions BGs-HAEMB exerted a long-term and stable antibacterial effect. The remarkable biocompatibility of BGs-HAEMB in vitro and in vivo confirmed its possible clinical application as a potential alternative in the development of the next generation of endodontic sealers.
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Affiliation(s)
- Jin Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
- Department of Stomatology, Huangshan City People's Hospital, Huangshan, 245000, Anhui, PR China
| | - Haoze Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Jun Qiu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Sirui Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Doudou Xiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Xinhua Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Jinxin Kuang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Min Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
| | - Xiaogang Cheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi'an, 710032, Shaanxi, PR China
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Pauletto G, Padoin Y, de Pellegrin SF, Bier CAS. The use of sonic and ultrasonic activation of endodontic sealer to improve sealer filling quality in the root canal: a scoping review. Odontology 2024:10.1007/s10266-024-00901-9. [PMID: 38381264 DOI: 10.1007/s10266-024-00901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
This scoping review aimed to map whether the use of sonic and ultrasonic methods to activate the endodontic sealer improves the sealer filling quality in the root canal, considering the bond strength and intratubular penetration to the root dentin as evaluation criteria. The study protocol was prospectively registered and is available online ( https://osf.io/x5fma/ ). Reporting was based on PRISMA Extension for Scoping Reviews. The search was performed in Embase, PubMed, Scopus, and Web of Science. We selected studies without time and language restrictions that used sonic or ultrasonic methods to activate endodontic sealer, whose outcomes were bond strength and intratubular penetration. Three researchers independently selected the articles and collected data. Of 1422 articles, 19 were read in full and 13 studies were included. The vast majority of studies opted for direct activation of the endodontic sealer. The most investigated sealers were the epoxy resin-based sealers, and the ultrasonic activation method was the most explored. For the bond strength outcome, there was a trend toward higher values when the sealer was activated ultrasonically, but the findings seem to be divergent. The sonic activation was not effective for its intended purpose. For the outcome of intratubular penetration, the vast majority of studies indicate that the use of sonic and ultrasonic methods to activate the endodontic sealer is capable of increasing intratubular penetration. The use of sonic and ultrasonic methods to directly activate the endodontic sealer can increase the intratubular penetration of the sealer, but their benefits on the bond strength are uncertain.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil.
| | - Yasmin Padoin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Sidnei Flores de Pellegrin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, Brazil
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Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Influence of bioceramic sealers on dentinal tubule penetration and antimicrobial effectiveness: a systematic review and meta-analysis of in vitro studies. Odontology 2024:10.1007/s10266-024-00904-6. [PMID: 38374511 DOI: 10.1007/s10266-024-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate whether bioceramic sealers have better penetration capacity in dentinal tubules and antimicrobial activity when compared to AH Plus® sealer. This SRM was recorded in the Open Science Framework database and followed the guidelines of the PRISMA 2020. Five databases were searched by two independent reviewers. Only in vitro studies that evaluated the effects of bioceramic sealers on dentinal tubule penetration and antimicrobial activity outcomes compared to AH Plus® sealer were included. Meta-analysis was conducted using R software, using the effect measure of the standardized mean difference (SMD) and inverse variance method. A modified Joanna Briggs Institute's Checklist was used for the risk of bias assessment. A total of 1486 studies were identified, and only 54 studies that fulfilled our eligibility criteria were included in this review. There was no statistical difference between the sealers evaluated for dentinal tubule penetration, in the thirds evaluated: coronal SMD 0.58 [0.14; 1.31], p = 0.12; middle SMD 0.07 [0.54; 0.39], p = 0.75; and apical SMD 0.08 [0.73; 0.56], p = 0.80. Both sealers demonstrated similar antimicrobial action (SMD [3.42; 5.32], p = 0.67 and SMD 0.67 [1.89; 0.55], p = 0.28). The studies presented a low risk of bias. Based on the in vitro studies included and according to the limitations of the present review, the data suggest that bioceramic and AH Plus® sealers present similar penetration capacity in dentinal tubules and antimicrobial effect, making them suitable materials to be considered in clinical practice.
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Affiliation(s)
- Marcelo Augusto Seron
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
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Kwak SW, Koo J, Song M, Jang IH, Gambarini G, Kim HC. Physicochemical properties and biocompatibility of various bioceramic root canal sealers: in vitro study. J Endod 2023:S0099-2399(23)00283-2. [PMID: 37225037 DOI: 10.1016/j.joen.2023.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The aim of this study was to compare the physicochemical properties and biocompatibility of various calcium silicate-based bioceramic sealers (CSBSs). METHODS Four recently developed CSBSs, including AH Plus Bioceramic Sealer (AHB), EndoSequence BC Sealer (ESB), TotalFill BC Sealer (TTB), and Bio-C Sealer (BIC), were compared with the epoxy resin-based sealer AH Plus (AHP). Their physical properties, including flow, setting time, radiopacity, dimensional stability, and pH, were evaluated according to International Organization for Standardization (ISO) 6876. Their cytotoxicity in human periodontal ligament fibroblast (hPDLF) was assessed through the MTT assay and compared. Additionally, cell attachment to the sealer surface was analysed using green fluorescent protein and confocal laser scanning microscopy (CLSM) to evaluate cell viability. Data were analysed using one-way analysis of variance to determine the difference between groups for categorical variables, followed by Tukey's post-hoc test at the significance level of 95%. RESULTS The flow, setting time, and radiopacity of all tested CSBSs satisfied the ISO 6876/2012 standards. Further, these CSBS showed shrinkage after immersion in distilled water for 30 days and complied with the ISO 6876/2001 requirements. The pH of AHB, ESB, TTB, and BIC was greater than 11 whereas AHP had a pH of 6.69 after 4 weeks. CSBS showed excellent biocompatibility compared with that of AHP (P < .05). CLSM showed that alive hPDLFs were attached well to all the tested CSBS but not to AHP. CONCLUSIONS CSBS have similar physical characteristics within the ISO standards and higher biocompatibility than epoxy resin-based sealers.
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Affiliation(s)
- Sang Won Kwak
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Jina Koo
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Il Ho Jang
- Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Gianluca Gambarini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea.
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Lin GSS, Luddin N, Ghani HA, Lai JCH, Noorani TY. Dislodgment Resistance, Adhesive Pattern, and Dentinal Tubule Penetration of a Novel Experimental Algin Biopolymer-Incorporated Bioceramic-Based Root Canal Sealer. Polymers (Basel) 2023; 15:polym15051317. [PMID: 36904558 PMCID: PMC10007138 DOI: 10.3390/polym15051317] [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: 01/18/2023] [Revised: 02/15/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
The currently available bioceramic-based sealers still demonstrate low bond strength with a poor seal in root canal despite desirable biological properties. Hence, the present study aimed to determine the dislodgment resistance, adhesive pattern, and dentinal tubule penetration of a novel experimental algin-incorporated bioactive glass 58S calcium silicate-based (Bio-G) sealer and compared it with commercialised bioceramic-based sealers. A total of 112 lower premolars were instrumented to size 30. Four groups (n = 16) were assigned for the dislodgment resistance test: control, gutta-percha + Bio-G, gutta-percha + BioRoot RCS, and gutta-percha + iRoot SP, with exclusion of the control group in adhesive pattern and dentinal tubule penetration tests. Obturation was done, and teeth were placed in an incubator to allow sealer setting. For the dentinal tubule penetration test, sealers were mixed with 0.1% of rhodamine B dye. Subsequently, teeth were cut into a 1 mm-thick cross section at 5 mm and 10 mm levels from the root apex, respectively. Push-out bond strength, adhesive pattern, and dentinal tubule penetration tests were performed. Bio-G showed the highest mean push-out bond strength (p < 0.05), while iRoot SP showed the greatest sealer penetration (p < 0.05). Bio-G demonstrated more favourable adhesive patterns. No significant association was noted between dislodgment resistance and dentinal tubule penetration (p > 0.05).
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Malaysia
- Correspondence: (G.S.S.L.); (T.Y.N.)
| | - Norhayati Luddin
- Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Huwaina Abd Ghani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Josephine Chang Hui Lai
- Department of Chemical Engineering and Sustainable Energy, Faculty of Engineering, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (G.S.S.L.); (T.Y.N.)
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Jerez-Olate C, Araya N, Alcántara R, Luengo L, Bello-Toledo H, González-Rocha G, Sánchez-Sanhueza G. In vitro antibacterial activity of endodontic bioceramic materials against dual and multispecies aerobic-anaerobic biofilm models. AUST ENDOD J 2022; 48:465-472. [PMID: 34741571 DOI: 10.1111/aej.12587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2021] [Accepted: 10/24/2021] [Indexed: 12/14/2022]
Abstract
The aim of this in vitro study was to evaluate the antibacterial activity of calcium silicate repair cements and sealers against a dual-species planktonic aerobic model with different aging times and the ability to inhibit the formation of a mature 21-day-old multispecies anaerobic biofilm. The antibacterial activity of ProRoot MTA, MTA Angelus, Biodentine, BioRoot RCS and TotalFill BC sealer against a dual-species aerobic planktonic model, as well as measuring how materials were affected by aging, was evaluated using the Modified Direct Contact Test. Subsequently, the ability to inhibit the formation of a mature multispecies anaerobic biofilm was evaluated using scanning electron microscopy complemented with confocal laser scanning microscopy. Biodentine and BioRoot RCS had higher antibacterial action, and Biodentine was able to maintain its antibacterial action after a prolonged aging period in vitro. Calcium silicate repair cement MTA ProRoot and Biodentine had higher antibiofilm action.
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Affiliation(s)
- Christian Jerez-Olate
- Department of Restorative Dentistry, Discipline of Endodontics, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Nancy Araya
- Department of Restorative Dentistry, Discipline of Endodontics, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Raúl Alcántara
- Department of Restorative Dentistry, Discipline of Endodontics, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Luis Luengo
- Department of Public Health and Preventive Dentistry, School of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Helia Bello-Toledo
- Department of Microbiology, Faculty of Biological Sciences, Universidad de Concepción, Concepción, Chile.,Millennium Nucleus for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile.,Research Laboratory on Antibacterial Agents, Concepción, Chile
| | - Gerardo González-Rocha
- Department of Microbiology, Faculty of Biological Sciences, Universidad de Concepción, Concepción, Chile.,Millennium Nucleus for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile.,Research Laboratory on Antibacterial Agents, Concepción, Chile
| | - Gabriela Sánchez-Sanhueza
- Department of Restorative Dentistry, Discipline of Endodontics, Faculty of Dentistry, Universidad de Concepción, Concepción, Chile.,Research Laboratory on Antibacterial Agents, Concepción, Chile
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Guo X, Sun Y, Wang Z, Ren B, Xu HHK, Peng X, Li M, Wang S, Wang H, Wu Y, Weir MD, Zhou X, Lan F, Cheng L. The Preventive Effect of A Magnetic Nanoparticle-Modified Root Canal Sealer on Persistent Apical Periodontitis. Int J Mol Sci 2022; 23:13137. [PMID: 36361925 PMCID: PMC9655100 DOI: 10.3390/ijms232113137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 08/23/2023] Open
Abstract
Persistent apical periodontitis is a critical challenge for endodontists. Developing root canal filling materials with continuous antibacterial effects and tightly sealed root canals are essential strategies to avoid the failure of root canal therapy and prevent persistent apical periodontitis. We modified the EndoREZ root canal sealer with the antibacterial material dimethylaminododecyl methacrylate (DMADDM) and magnetic nanoparticles (MNPs). The mechanical properties of the modified root canal sealer were tested. The biocompatibility of this sealer was verified in vitro and in vivo. Multispecies biofilms were constructed to assess the antibacterial effects of the modified root canal sealer. We applied magnetic fields and examined the extent of root canal sealer penetration in vitro and in vivo. The results showed that EndoREZ sealer containing 2.5% DMADDM and 1% MNP had biological safety and apical sealing ability. In addition, the modified sealer could increase the sealer penetration range and exert significant antibacterial effects on multispecies biofilms under an external magnetic field. According to the in vivo study, the apices of the root canals with the sealer containing 2.5% DMADDM and 1% MNP showed no significant resorption and exhibited only a slight increase in the periodontal ligament space, with a good inhibitory effect on persistent apical periodontitis.
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Affiliation(s)
- Xiao Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yan Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA
| | - Xian Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Suping Wang
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yao Wu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Michael D. Weir
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Fang Lan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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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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Li J, Chen L, Zeng C, Liu Y, Gong Q, Jiang H. Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis. Head Face Med 2022; 18:28. [PMID: 36045447 PMCID: PMC9429671 DOI: 10.1186/s13005-022-00332-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background During the obturation procedure, sealer extrusion occurs in some cases. iRoot SP is a kind of bioceramic sealer with superior physicochemical and biological properties. This article reports the outcome of iRoot SP extrusion in root canal treatment and the potential factors associated with the outcome. Methods Ninety-nine patients and one hundred and eighty-five teeth treated between 2014 and 2020 were included in this retrospective study. All of the cases were filled with a single-cone technique and the iRoot SP sealer. The minimum follow-up visit period was 1 year. The outcome was evaluated by clinical examination and radiographic examination at recall and was classified as healed, healing (success), or not healed (failure). Results The overall success rate of all teeth was 96.8%. The success rate of adequately filled teeth was 97.3%, while that of iRoot SP extrusion was 95.8%; the difference was not statistically significant. Factors such as gender, age, tooth position, follow-up visit period, size of periapical lesion, treatment type and extruding sealer amount had no influence on the outcome of iRoot SP extruded teeth. Conclusions The results suggested that iRoot SP extrusion has no adverse effect on the outcome of root canal treatment, which may contribute to the endodontic treatment.
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Affiliation(s)
- Jing Li
- Stomatology Department, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Liuchi Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China
| | - Chunmei Zeng
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yiwen Liu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Qimei Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China.
| | - Hongwei Jiang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China.
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Chaudhari PS, Chandak MG, Jaiswal AA, Mankar NP, Paul P. A Breakthrough in the Era of Calcium Silicate-Based Cements: A Critical Review. Cureus 2022; 14:e28562. [PMID: 36185838 PMCID: PMC9517689 DOI: 10.7759/cureus.28562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
Abstract
Calcium silicate-based cements (CSCs) or mineral trioxide aggregate (MTA) lookalike materials are blocks of cement or root canal sealers produced from calcium (Ca) and silicate. They have superior sealing ability, bioactivity, and marginal adaptability, making them appropriate for various dental treatment applications. Mineral trioxide aggregate is widely used in numerous endodontic repair techniques. The capacity of this cement to promote tissue regeneration and stimulate mineralization accounts for its widespread usage in pulp capping, apexification, apical surgeries, and revascularization. Several studies have been conducted to investigate changes in the components of MTA-based types of cement directed to improve their presentation clinically. To improve flowability, new Ca silicate-based formulations have been introduced commercially. In these new formulations, essential features such as adequate radiopacity and setting time, color stability, alkaline pH, and calcium ion release and biocompatibility must be considered. Owing to an increased range of indications of CSCs, including some for restorative dentistry, and with the emergence of novel silicate calcium-based materials with considerable changes in their compositions, it is necessary to examine the available scientific literature that evaluates their usage in these applications. Therefore, this review paper aims to assess the existing knowledge of CSCs, emphasizing their potential uses in restorative and endodontic dentistry. This report strives to update doctors' understanding of CSCs, allowing for a better therapeutic approach.
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Castillo-Villagomez P, Madla-Cruz E, Lopez-Martinez F, Rodriguez-Delgado I, Flores-Treviño JJ, Malagon-Santiago GI, de La Garza-Ramos MA. Antimicrobial effectiveness of root canal sealers against Enterococcus faecalis. Biomater Investig Dent 2022; 9:47-51. [PMID: 35571873 PMCID: PMC9103261 DOI: 10.1080/26415275.2022.2071719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
We evaluated four root canal sealers to determine their antimicrobial effectiveness against E. faecalis. The direct contact test was used to measure the effectiveness of the study materials and close contact between bacteria on the kinetics of bacterial growth. The agar diffusion test (ADT) was also performed for comparison. Using one-way ANOVA and the F-test, significant differences between the sealers were confirmed. Whereas BioRoot endodontic sealer had an antimicrobial effect statistically similar to the zinc oxide-eugenol control (p=.99), EndoSequence sealer and AH Plus sealer both had a significantly lower antimicrobial effect than the control (p=.0000266 and p=.0000068, respectively).
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Affiliation(s)
- Paola Castillo-Villagomez
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Elizabeth Madla-Cruz
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Fanny Lopez-Martinez
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Idalia Rodriguez-Delgado
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Jorge Jaime Flores-Treviño
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Guadalupe Ismael Malagon-Santiago
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
| | - Myriam Angelica de La Garza-Ramos
- Facultad de Odontología, Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Universidad Autónoma de Nuevo León, Colonia Mitras Centro, Monterrey, Nuevo León, Mexico, CP, USA
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Bosaid F, Aksel H, Azim AA. Influence of acidic pH on antimicrobial activity of different calcium silicate based-endodontic sealers. Clin Oral Investig 2022; 26:5369-5376. [PMID: 35511289 DOI: 10.1007/s00784-022-04504-y] [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: 11/18/2021] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the antibacterial activity of calcium silicate-based sealers (CSBSs) against Enterococcus faecalis biofilm in a neutral or acidic condition. MATERIALS AND METHODS Dentin cylinders (4 mm length) were prepared and infected with 3-week-old E. faecalis. The samples were filled with BioRoot RCS (BR), EndoSequence BC (ES), and NeoMTA Plus (NMTA) and incubated in either neutral or acidic conditions for 7 days (n=10/group). Sterile or infected samples alone were used as the positive and negative control. The root canal sealers were removed after 7 days, and the remaining bacteria on dentinal walls were determined by colony-forming units (CFUs/ml), and three samples from each group were visualized under a confocal laser scanning microscope (CLSM). The pH was also measured (n=3/group) after 4 h and 7 days of incubation at 37°C in both conditions. RESULTS In the neutral condition, all sealers significantly decreased the log-CFU values (p<0.05), while in the acidic condition, the log-CFU reduction was less for ES and NMTA, but a higher reduction was observed in BR (p<0.05). The antibacterial activity of CSBSs was similar in neutral conditions (p>0.05), and BR showed a greater antibacterial effect than ES and NMTA in the acidic condition (p<0.05). The pH of BR, ES, and NMTA ranged from 8.2 to 8.8 in the neutral condition in the presence of dentin after 7 days. However, acidic conditions reduced the pH values to 7.8 for BR, 6.0 for ES, and 5.8 for NMTA. CONCLUSIONS All CSBSs showed similar antibacterial activity in neutral conditions, while acidic pH had a reducing antibacterial effect on CSBSs. CLINICAL RELEVANCE Inflammatory pH decreased the antibacterial properties of CSBSs depending on the sealer type.
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Affiliation(s)
- Fatima Bosaid
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, 240 Squire Hall, Buffalo, NY, 14214, USA
| | - Hacer Aksel
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, 240 Squire Hall, Buffalo, NY, 14214, USA.
| | - Adham A Azim
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, 240 Squire Hall, Buffalo, NY, 14214, USA. .,Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, 155 5th St, San Francisco, CA, 94103, USA.
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Rodrigues EM, Viola KS, Maldonado LG, Rossa Junior C, Guerreiro-Tanomaru JM, Tanomaru Filho M. Cytotoxicity and bioactive potential of new root repair materials for use with BMP-2 transfected human osteoblast cells. Braz Oral Res 2022; 36:e063. [PMID: 36507750 DOI: 10.1590/1807-3107bor-2022.vol36.0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/08/2022] [Indexed: 12/15/2022] Open
Abstract
Modified formulations of calcium silicate repair materials with additives have been developed to enhance handling, consistency, biocompatibility and bioactivity. Considering the relevance of osteoblastic cell response to mineralized tissue repair, human osteoblastic cells (Saos-2 cells overexpressing BMP-2) were exposed to mineral trioxide aggregate (MTA) (with calcium tungstate - CaWO4), MTA HP Repair, Bio-C Repair and Bio-C Pulpo. Cell viability was assessed by 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) and neutral red (NR), and cell death, by flow cytometry. Gene expression of bone morphogenetic protein 2 (BMP-2), runt-related transcription factor 2 (RUNX-2), and alkaline phosphatase (ALP) osteogenic markers were evaluated by real-time polymerase chain reaction (RT-qPCR). ALP activity and alizarin red staining (ARS) were used to detect mineralization nodule deposition. Bioactive cements presented no cytotoxic effect, and did not induce apoptosis at the higher dilution (1:12). MTA, Bio-C Repair and Bio-C Pulpo exhibited higher ALP activity than the control group (P < 0.05) after 7 days. MTA, MTA HP and Bio-C Pulpo affected the formation of mineralized nodules (p < 0.05). Exposure to all cement extracts for 1 day increased BMP-2 gene expression. RUNX-2 mRNA was greater in MTA, MTA HP and Bio-C Repair. MTA, MTA HP and Bio-C Pulpo increased the ALP mRNA expression, compared with BMP-2 unexposed cells (P < 0.05). Calcium silicate cements showed osteogenic potential and biocompatibility in Saos-2 cells transfected BMP-2, and increased the mRNA expression of BMP-2, RUNX-2, and ALP osteogenic markers in the BMP-2 transfected system, thereby promoting a cellular response to undertake the mineralized tissue repair.
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Affiliation(s)
- Elisandra Márcia Rodrigues
- Universidade Estadual Paulista - Unesp, Schoool of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Kennia Scapin Viola
- Universidade Estadual Paulista - Unesp, Schoool of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Laura Gonzalez Maldonado
- Universidade Estadual Paulista - Unesp, Schoool of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Carlos Rossa Junior
- Universidade Estadual Paulista - Unesp, Schoool of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | | | - Mario Tanomaru Filho
- Universidade Estadual Paulista - Unesp, Schoool of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Effect of chlorhexidine digluconate on antimicrobial activity, cell viability and physicochemical properties of three endodontic sealers. Dent Mater 2022; 38:1044-1059. [PMID: 35491276 DOI: 10.1016/j.dental.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Assess the biological and physicochemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) leachates with and without chlorhexidine (CHX). METHODS The sealers were studied in no contact and 1-minute contact with CHX. For biological properties (antibacterial activity and cytotoxicity), leachates were formed in saline of freshly mixed, 1-, 7- and 28 days set sealers. The antibacterial properties of sealer leachates were investigated for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus. The 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to evaluate murine fibroblast cell viability after exposure to the leachates. The physical properties (water uptake, sorption, solubility, porosity, surface characteristics) of sealers and the pH of the immersion liquid (saline or distilled water) were also assessed over a 28-days period. RESULTS CHX improved the antibacterial properties of the sealer leachates and reduced cell viability for all sealer leachates, except for freshly mixed PCS. BioRoot RCS leachates presented the highest antibacterial properties and cell viability with and without CHX contact. PCS was the material most affected by CHX in terms of physical properties, whereas for AH Plus, solubility was increased. CHX did not affect the physical properties of BioRoot RCS, except for solubility that was decreased. CHX contact did not change sealers' alkalinity in distilled water whereas it increased it for AH Plus and BioRoot RCS in saline. SIGNIFICANCE CHX improved the antibacterial efficacy of sealer leachates and either compromised or did not affect cell viability. CHX affected to various extent sealers' physicochemical properties.
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Comparison of Cytotoxicity of AH Plus and DC Canal SE Sealer After Final Setting. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Impact of Immersion Media on Physical Properties and Bioactivity of Epoxy Resin-Based and Bioceramic Endodontic Sealers. Polymers (Basel) 2022; 14:polym14040729. [PMID: 35215641 PMCID: PMC8878582 DOI: 10.3390/polym14040729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 01/27/2023] Open
Abstract
This study assessed the effects of immersion media [distilled water (dw), phosphate buffered saline (pbs) and simulated body fluid (sbf)] in the physical properties [fluid uptake/sorption/solubility and alkalinization activity (pH)] and bioactivity of a bioceramic sealer: the BioRoot RCS (BioRoot) (Septodont). The epoxy-resin sealer AH Plus (Dentsply) was used as comparison. Sealers were immersed in dw, pbs and sbf to evaluate the fluid uptake/sorption/solubility and pH’s media. Bioactivity was assessed with SEM/EDS, FTIR-ATR and XRD. BioRoot solubility was as follows: sbf > pbs = dw. BioRoot had alkaline pH, and AH Plus had neutral pH, regardless of the medium. BioRoot presented mineral precipitates and peaks indicating hydroxyapatite-precursors in pbs and sbf. AH Plus physical properties were not affected by immersion media and it had no bioactivity. pbs and sbf should be preferred to investigate bioceramic sealers over distilled water, because they were able to highlight the sealer properties. BioRoot maintained the alkaline environment and favored hard tissue deposition.
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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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Kapralos V, Valen H, Koutroulis A, Camilleri J, Ørstavik D, Sunde PT. The dentine-sealer interface: modulation of antimicrobial effects by irrigation. Int Endod J 2022; 55:544-560. [PMID: 35080277 DOI: 10.1111/iej.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
AIM Assess whether sodium hypochlorite (NaOCl) or chlorhexidine (CHX) and two irrigation protocols may alter the antibacterial properties of dentine and three endodontic sealers using a novel ex vivo tooth model. METHODOLOGY Prior to antibacterial testing, the tooth model was validated by means of scanning electron microscopy (SEM) to evaluate the separation between dentine and sealer surfaces. Root blocks prepared from extracted human roots were pretreated with 17% EDTA + 0.9% saline and subsequently treated with 1% NaOCl (G1), 2% CHX (G2) or no irrigant (G3). Two irrigation protocols were further investigated, "1% NaOCl + 17% EDTA" (P1) and "1% NaOCl + 17% EDTA + 2% CHX" (P2). Following irrigation, the root blocks were either filled with AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS), or left empty. All groups were incubated for 1, 7 and 28 days. Direct contact tests for planktonic E. faecalis and 48 hours E. faecalis biofilms were performed at the level of dentine and sealer surfaces. Statistical analysis was performed on the bacterial survival between irrigants (G1, G2 and G3) and between irrigation protocols (P1 and P2) (p<0.05). RESULTS The model was considered reproducible as SEM examination of dentine samples indicated consistent separation between dentine and sealer surfaces. Irrigation with CHX (G2) and irrigation protocol (P2) enhanced the antibacterial properties of dentine without sealer application as well as dentine in contact with all three sealers tested, especially against planktonic E. faecalis. G2 and P2 also improved the antibacterial effect of AH Plus surfaces for all three incubation times. No irrigation groups (G1, G2) or irrigation protocols (P1, P2) altered the antibacterial properties of BioRoot RCS surfaces against planktonic bacteria or biofilms. Only BioRoot RCS surfaces eliminated the planktonic E. faecalis in all irrigation groups (G1, G2, G3) and protocols (P1, P2) investigated while PCS surfaces eliminated E. faecalis in biofilms in all groups up to 7 days. CONCLUSIONS The tooth model was reproducible. CHX improved the antibacterial activity upon both sealer and dentine surfaces. Among sealers, BioRoot RCS was less affected by NaOCl and CHX, and exhibited high antibacterial properties regardless the irrigation applied.
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Affiliation(s)
- V Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855, Oslo, Norway
| | - A Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - D Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - P T Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
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20
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Wang Z, Shen Y, Haapasalo M. Antimicrobial and Antibiofilm Properties of Bioceramic Materials in Endodontics. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7594. [PMID: 34947188 PMCID: PMC8706218 DOI: 10.3390/ma14247594] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
Microbes are prevalent in the root canals of necrotic teeth, and they are the cause of primary and post-treatment apical periodontitis. Bacteria can dwell within the infected root canal system as surface-adherent biofilm structures, which exhibit high resistance to antimicrobial agents. Bioceramic materials, with their biocompatible nature and excellent physico-chemical properties, have been widely used in dental applications, including endodontics. This review focuses on the application of bioceramic technology in endodontic disinfection and the antibiofilm effects of endodontic bioceramic materials. Different bioceramic materials have shown different levels of antibiofilm effects. New supplements have emerged to potentially enhance the antibiofilm properties of bioceramics aiming to achieve the goal of microbial elimination in the root canal system.
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Affiliation(s)
| | | | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Z.W.); (Y.S.)
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21
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Roy PK, Mizan MFR, Hossain MI, Han N, Nahar S, Ashrafudoulla M, Toushik SH, Shim WB, Kim YM, Ha SD. Elimination of Vibrio parahaemolyticus biofilms on crab and shrimp surfaces using ultraviolet C irradiation coupled with sodium hypochlorite and slightly acidic electrolyzed water. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.108179] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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22
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Long-term porosity and retreatability of oval-shaped canals obturated using two different methods with a novel tricalcium silicate sealer. Clin Oral Investig 2021; 26:1045-1052. [PMID: 34392407 DOI: 10.1007/s00784-021-04088-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/17/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the percentage volume of voids and gaps in oval-shaped canals obturated using two different methods with a tricalcium silicate-based sealer after short- or long-term storage. The long-term effect of storage on the efficiency of removing filling material was also investigated. MATERIALS AND METHODS Forty premolar teeth with oval-shaped canals were instrumented to Reciproc R25 and obturated using single cone obturation (SCO) or warm vertical compaction (WVC) techniques with gutta-percha and HiFlow sealer. The specimens were stored at 100% humidity and 37°C for 2 weeks or 6 months and scanned using micro-computed tomography. Initial retreatment was performed up to a Reciproc R40, and the operating time was recorded. The residual material in the canal received a supplementary procedure using XP-endo Finisher R (XPFR) files. After each retreatment procedure, the specimens were rescanned. RESULTS The percentage volume of voids and gaps in the SCO group was higher than that of the WVC group at both 2 weeks and 6 months (P < 0.05). The percentage volume of the filling material removed after initial retreatment and XPFR cleaning was significantly higher in the 6-month group than in the 2-week groups (P < 0.05). The proportion of the residual material decreased significantly when XPFR files were used, compared to the initial retreatment group (P < 0.05) in both storage times. CONCLUSION The efficiency of retreatment in the oval-shaped canal was closely related to the storage time rather than the filling technique using a tricalcium silicate sealer. The XPFR instrument proved effective in the removal of the remaining materials from the oval-shaped canal. CLINICAL RELEVANCE Obturation of the oval-shaped canal with TSBS using the SCO technique in the coronal area needs to be optimized. The retreatment was less efficacious in freshly filled canals than aged filled canals.
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23
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Antimicrobial Activity of Calcium Silicate-Based Dental Materials: A Literature Review. Antibiotics (Basel) 2021; 10:antibiotics10070865. [PMID: 34356786 PMCID: PMC8300656 DOI: 10.3390/antibiotics10070865] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022] Open
Abstract
Endodontic biomaterials have significantly improved dental treatment techniques in several aspects now that they can be used for vital pulp treatments, as temporary intracanal medication, in definitive fillings, in apical surgeries, and for regenerative procedures. Calcium silicate-based cement is a class of dental material that is used in endodontics in direct contact with the dental structures, connective tissue, and bone. Because the material interacts with biological tissues and stimulates biomineralization processes, its properties are of major importance. The main challenge in endodontic treatments is the elimination of biofilms that are present in the root canal system anatomical complexities, as it remains even after chemical-mechanical preparation and disinfection procedures. Thus, an additional challenge for these biomaterials is to exert antimicrobial activity while maintaining their biological properties in parallel. This article reviews the literature for studies considering the antimicrobial properties of calcium silicate-based dental biomaterials used in endodontic practice. Considering the reviewed studies, it can be affirmed that the reduced antimicrobial effect exhibited by calcium silicate-based endodontic materials clearly emphasizes that all clinical procedures prior to their use must be carefully performed. Future studies for the evaluation of these materials, and especially newly proposed materials, under poly-microbial biofilms associated with endodontic diseases will be necessary.
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24
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Toubes KSD, Tonelli SQ, Girelli CFM, Azevedo CGDS, Thompson ACT, Nunes E, Silveira FF. Bio-C Repair - A New Bioceramic Material for Root Perforation Management: Two Case Reports. Braz Dent J 2021; 32:104-110. [PMID: 33913996 DOI: 10.1590/0103-6440202103568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022] Open
Abstract
These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.
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Affiliation(s)
- Kênia Soares de Toubes
- Department of Dentistry, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Stephanie Quadros Tonelli
- Department of Dentistry, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - Eduardo Nunes
- Department of Dentistry, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Frank Ferreira Silveira
- Department of Dentistry, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
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25
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Caceres C, Larrain MR, Monsalve M, Peña-Bengoa F. Dentinal Tubule Penetration and Adaptation of Bio-C Sealer and AH-Plus: A Comparative SEM Evaluation. Eur Endod J 2021; 6. [PMID: 34047295 PMCID: PMC8461482 DOI: 10.14744/eej.2020.96658] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare and evaluate the dentinal tubule penetration and adaptation of a premixed bioceramic sealer and an epoxy-resin based sealer in the three radicular thirds. METHODS 30 wide roots, with single straight canals and totally formed apexes, were endodontically prepared and divided into two groups (n=14) according to the sealer used for root canal filling: AH-Plus (AHP) and Bio-C Sealer (BIOC). Two samples were left as controls. After the canals were filled, the samples were cut and viewed under Scanning Electron Microscopy by taking images to analyse the tubular penetration and adaptation of the sealers. The results were statistically analysed with the Shapiro Wilk, Levene and Mann-Whitney tests (P<0.05). RESULTS BIOC showed significantly higher penetration in dentinal tubules than AHP in the cervical, middle and apical thirds of the root canal (P<0.05) and better adaptation to the dentinal tubule walls. CONCLUSION Under the parameters of this study, BIOC exhibits higher penetration and better adaptation to the dentinal tubules compared to AHP.
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Affiliation(s)
- Carolina Caceres
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Maria Rosa Larrain
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Macarena Monsalve
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Fernando Peña-Bengoa
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
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26
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Zancan RF, Di Maio A, Tomson PL, Duarte MAH, Camilleri J. The presence of smear layer affects the antimicrobial action of root canal sealers. Int Endod J 2021; 54:1369-1382. [PMID: 33763882 DOI: 10.1111/iej.13522] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
AIM To assess the chemical and microstructural characteristics of dentine after the use of two irrigation protocols and correlate this with the antimicrobial properties of hydraulic calcium silicate cement (HCSC) sealers and changes to the dentine structure/chemistry after sealer placement. METHODOLOGY Two irrigation protocols - Protocol A using 2% NaOCl used 5 mL/5 min and Protocol B with 2% NaOCl (5 mL/5 min) followed by 17% EDTA (5 mL/3 min) - were used to prepare dentine. The chemical and microstructural changes following irrigation were assessed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy (n = 5) on dentine obtained from the mid-root and coronal parts of extracted human teeth. Four sealers (AH Plus, BioRoot, MTA Fillapex, TotalFill) were characterized by SEM/EDS (n = 3). The ability of the sealers to eradicate intratubular Enterococcus faecalis biofilms was assessed by live/dead dye and confocal laser scanning microscopy to measure the percentage of living cells. The effect of combined irrigation and root filling on dentine was assessed by SEM and EDS analysis (n = 5). Statistical analysis was undertaken using one-way anova and a number of post hoc tests to detect intergroup differences. The F-test was used for comparison of variances in the microbiology testing. RESULTS The use of NaOCl alone left the smear layer intact, with traces of chlorine remaining on dentine. The use of BioRoot sealer restored the calcium levels of dentine which had been depleted by the irrigation with EDTA. BioRoot exhibited antimicrobial properties against intratubular bacteria even in the presence of smear layer (Protocol A). Smear layer removal improved the bactericidal effect of all sealers and Ca2+ leaching. The use of a chelating agent was important for the intratubular sealer penetration for AH Plus but not the other sealers. CONCLUSION The removal of smear layer was necessary for penetration of AH Plus into the dentinal tubules. BioRoot was a more effective sealer in reducing the bacterial load in the dentinal tubules than the other materials tested and the presence of smear layer did not affect its activity.
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Affiliation(s)
- R F Zancan
- Department of Restorative Dentistry, Dental Materials and Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - A Di Maio
- School of Biosciences, University of Birmingham, Birmingham, UK
| | - P L Tomson
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M A H Duarte
- Department of Restorative Dentistry, Dental Materials and Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - J Camilleri
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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27
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Penha da Silva PJ, Marceliano-Alves MF, Provenzano JC, Dellazari RLA, Gonçalves LS, Alves FRF. Quality of Root Canal Filling Using a Bioceramic Sealer in Oval Canals: A Three-Dimensional Analysis. Eur J Dent 2021; 15:475-480. [PMID: 33535249 PMCID: PMC8382469 DOI: 10.1055/s-0040-1722095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives
The oval canals may be associated with inadequate debridement, which can affect the quality of the root canal filling, thus the treatment outcome. The aim of the present work was to compare the quality of oval canals fillings using EndoSequence BC sealer with the single-cone technique or cold lateral compaction.
Materials and Methods
Thirty-eight human single-rooted premolars with oval canals were instrumented to 1 mm from the apical foramen with hand nickel–titanium files, followed by circumferential filing with Hedstrom files. Teeth were paired into two groups based on their micro-computed tomography (CT) morphological parameters. Both groups were filled using EndoSequence BC sealer. The first used a single cone and the other with the cold lateral compaction technique. The voids volume was evaluated by micro-CT and the percentage was calculated for the total length and for the apical 5 mm of each canal. The Mann–Whitney U test was used to assess whether the surface area and obturation length differed significantly between the groups and to compare the percentage of voids for each technique.
Results
Both techniques resulted in less than 16% voids, with no statistically significant difference between them for the total canal length and for the apical 5 mm (
p
> 0.05).
Conclusions
The quality of the obturation performed with the single-cone technique was similar to that achieved with lateral compaction using EndoSequence BC sealer in oval canals.
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Affiliation(s)
| | | | | | | | | | - Flávio R F Alves
- Department of Endodontics, Iguaçu University, Nova Iguaçu, Brazil
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28
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Kapralos V, Rukke HV, Ørstavik D, Koutroulis A, Camilleri J, Sunde PT. Antimicrobial and physicochemical characterization of endodontic sealers after exposure to chlorhexidine digluconate. Dent Mater 2020; 37:249-263. [PMID: 33293036 DOI: 10.1016/j.dental.2020.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/20/2020] [Accepted: 11/18/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Assess the antibacterial, physical and chemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) in contact with 2% chlorhexidine digluconate (CHX) used as final irrigant prior to root canal obturation. METHODS The antimicrobial properties were investigated by direct contact tests for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus in vitro. The setting time, wettability, microhardness and surface roughness were also assessed. The sealers were studied in no contact, 1-minute (short-term) and continuous contact (long-term) with CHX. Chemical characterization of sealers was performed by scanning electron microscopy, X-ray diffraction analysis and Fourier-transform infrared spectroscopy after CHX or saline used as the last irrigant in an ex vivo tooth model and in endo training blocks. RESULTS CHX increased the antibacterial activity of all the sealers investigated against planktonic bacteria and biofilms with PCS exerting the highest antimicrobial activity with and without the presence of CHX. The setting of AH Plus and BioRoot RCS was retarded, while for PCS accelerated in the presence of CHX. AH Plus and PCS were more hydrophilic after contact with CHX, whilst BioRoot RCS was hydrophobic in a time-dependent manner. The microhardness of sealers was compromised and the surface roughness increased after CHX exposure for AH Plus and BioRoot RCS, and decreased for PCS. CHX did not affect the sealers' chemistry, but PCS that exhibited two extra phases. SIGNIFICANCE CHX improved the antibacterial efficacy of endodontic sealers but further evidence is needed to confirm its suitability as a final irrigant prior to root canal obturation.
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Affiliation(s)
- Vasileios Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Håkon Valen Rukke
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855 Oslo, Norway.
| | - Dag Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Andreas Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Josette Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
| | - Pia Titterud Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
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29
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Bardini G, Casula L, Ambu E, Musu D, Mercadè M, Cotti E. A 12-month follow-up of primary and secondary root canal treatment in teeth obturated with a hydraulic sealer. Clin Oral Investig 2020; 25:2757-2764. [PMID: 32989597 PMCID: PMC8208934 DOI: 10.1007/s00784-020-03590-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
Objectives This randomized, controlled, pilot study assessed the outcome of non-surgical primary/secondary root canal treatments either with a novel bioactive sealer and the single-cone technique or with gutta-percha, zinc oxide-eugenol sealer (ZOE), and warm vertical compaction. Materials and methods Sixty-nine patients were randomly divided into two groups that were treated using the single-cone technique with BioRootTM RCS (Septodont) (BIO group) or warm vertical compaction with gutta-percha and ZOE sealer (PCS group). Two subsamples (BIOAP and PCSAP) comprised the cases with apical periodontitis. Treatment was undertaken by four residents using a standardized instrumentation and disinfection protocol. The periapical index (PAI) was recorded, and clinical and radiographic follow-up performed at 1, 3, 6, and 12 months. Treatment success was assessed according to “periapical healing” and “tooth survival”. The test for the equality of proportions, t tests for the equality of means, and non-parametric K-sample tests for the equality of medians were applied when appropriate. Results The survival rate was similar in the BIO and PCS (p = 0.4074) and the BIOAP and PCSAP groups (p = 0.9114). The success rate was higher in the BIO groups, but not statistically significant (p = 0.0735). In both BIOAP and PCSAP groups, a progressive decrease in the PAI was observed. Conclusion At 12 months, both techniques showed reliable results. Further studies and longer follow-ups are needed. Clinical relevance This study documents the feasibility of using a bioactive sealer in conjunction with the single-cone technique to obturate the root canal and obtaining a predictable outcome. Trial registration ClinicalTrials.gov Identifie: NCT04249206
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Affiliation(s)
- Giulia Bardini
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy.
| | - Laura Casula
- Department of Medicine and Public Health, University of Cagliari, Cagliari, Italy
| | - Emanuele Ambu
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Davide Musu
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Montse Mercadè
- Department of Dentistry, University of Barcelona, Barcelona, Spain
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
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Lim M, Jung C, Shin DH, Cho YB, Song M. Calcium silicate-based root canal sealers: a literature review. Restor Dent Endod 2020; 45:e35. [PMID: 32839716 PMCID: PMC7431927 DOI: 10.5395/rde.2020.45.e35] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/23/2022] Open
Abstract
Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.
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Affiliation(s)
- Miyoung Lim
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chanyong Jung
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Yong-bum Cho
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
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31
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Šimundić Munitić M, Budimir A, Jakovljević S, Anić I, Bago I. Short-Term Antibacterial Efficacy of Three Bioceramic Root Canal Sealers Against Enterococcus Faecalis Biofilms. Acta Stomatol Croat 2020; 54:3-9. [PMID: 32523152 PMCID: PMC7233124 DOI: 10.15644/asc54/1/1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objectives The aim of the study was to evaluate the antimicrobial efficacy of three bioceramic root canal sealers against Enterococcus faecalis (E. faecalis) biofilm. Material and methods E. faecalis bacterial suspension was grown on filter paper discs on agar plates. After the incubation period, the discs were covered with four different root canal sealers: 1) Premixing bioceramic root canal sealer (TotalFill BC Sealer); 2) Dual component bioceramic sealer (BioRoot RCS); 3) Mineral trioxide agreggate based sealer (MTA Fillapex); 4) Epoxy resin-based selar (AH Plus). After contact time of 60 minutes, the sealers were removed, and the discs were transferred into sterile tubes containing phosphate buffered saline. After serial dilutions, the aliquots of the suspension were cultivated for 24 hours. After the incubation period, the colony forming units (CFUs) were counted. Results There were no significant differences in antibacterial efficacy between the Total Fill BC Sealer and the AH Plus sealer (p=0.386). Both sealers showed better antibacterial efficacy compared to the BioRoot RCS and the MTA Fillapex (p<0.001). Conclusion The Total Fill BC Sealer and AH Plus had better antibacterial efficacy than the BioRoot RCS and the MTA Fillapex sealers.
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Affiliation(s)
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb, Croatia
| | - Suzana Jakovljević
- Department of Materials, Faculty of Engineering and Naval Architecture, University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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Cytotoxicity and the Effect of Temperature on Physical Properties and Chemical Composition of a New Calcium Silicate–based Root Canal Sealer. J Endod 2020; 46:531-538. [DOI: 10.1016/j.joen.2019.12.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 12/10/2019] [Accepted: 12/22/2019] [Indexed: 11/17/2022]
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AlRahabi MK, AlKady AM. Current Trends in Practice of Residents in the Saudi Board of Endodontics Program. Eur J Dent 2020; 13:619-624. [PMID: 31891979 PMCID: PMC6938417 DOI: 10.1055/s-0039-3399456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of the current study was to collect information about some techniques and armamentarium currently used by the Saudi Board of Endodontics residents in relation to the technical steps of root canal therapy.
Materials and Methods
A web-based survey was sent to the Saudi Board of Endodontics residents, based in the western area of Saudi Arabia. The survey assessed controversial concepts, and collected information regarding new instruments and materials, used in the technical steps of nonsurgical root canal treatment. A one-sample chi-square test, with a 95% level of significance, was applied to determine whether there were significant differences between respondents’ answers.
Results
A total of 45 out of 50 residents (90%) responded to the questionnaire. The majority of Saudi Board residents of Endodontics, who participated in this survey, used the mean of working length (ML) measured by periapical X-Ray and apex locator in the presence of a radiographic lesion (63.3%), and maintained apical patency in all cases (80.0%). ProTaper Universal (40%) and ProTaper Next (41.2%) were the most common NiTi rotary systems used for root canal instrumentation. Thirty percent of respondents used adjunct device with irrigation, and 80% advocated smear layer removal. Zinc oxide–eugenol-based sealers were the most common used sealers (70%), and most residents (86.6%) did not advocate sealer extrusion.
Conclusions
This study revealed that residents of the Saudi Board of Endodontics program adopt new endodontic technologies. There is, however, a need for more investigations regarding this objective, including responses from all residents in Saudi Arabia.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Ayman M AlKady
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
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Tedesco M, Chain MC, Felippe WT, Alves AMH, Garcia LDFR, Bortoluzzi EA, Cordeiro MR, Teixeira CS. Correlation between Bond Strength to Dentin and Sealers Penetration by Push-Out Test and CLSM Analysis. Braz Dent J 2019; 30:555-562. [PMID: 31800749 DOI: 10.1590/0103-6440201902766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/19/2019] [Indexed: 11/21/2022] Open
Abstract
This study correlated the bond strength (BS) and dentin penetration of different sealers by push-out test and Confocal Laser Scanning Microscopy (CLSM) analysis. Forty-five root canals were prepared according to the crown-down technique and filled with gutta-percha associated to the following sealers (n=15): Endofill, AH Plus and MTA Fillapex. Five canals of each group were filled with the sealers added with 0.1% Rhodamine B dye. Next, the specimens were transversely sectioned and submitted to the push-out test (n=10) and CLSM analysis (n=5). The BS data showed the following means (MPa) and standard deviation: AH Plus (4.17±1.86); MTA Fillapex (3.13±1.96) and Endofill (2.10±1.03). Statistical analysis (two-way ANOVA, α=0.05) showed significant difference among sealers (p<0.001) and root canal thirds (p<0.001). The BS results of Endofill and MTA Fillapex were statistically similar (p>0.05), however, they were statistically different from AH Plus (p<0.001). The regional analysis of BS showed similarity between middle and apical thirds (p>0.05), and both were different from coronal portion (p<0.001). CLSM analysis verified tags formation in all groups and higher penetration of the specimens filled with AH Plus (p<0.05). The Kendall test (correlation between BS to dentin and sealer penetration into dentinal tubules) and the Pearson test (between failures pattern and sealer penetration into dentinal tubules) did not show correlation between the variables evaluated for all the tested sealers (p>0.05). AH Plus group had higher BS to dentin, and deeper tags formation than the other sealers. There was no significant correlation between BS and intratubular penetration of the tested sealers.
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Affiliation(s)
- Maybell Tedesco
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Marcelo Carvalho Chain
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Wilson Tadeu Felippe
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Ana Maria Hecke Alves
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Mabel Rodriguez Cordeiro
- Department of Morphological Sciences, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Cleonice Silveira Teixeira
- Department of Dentistry, Endodontics Division, Health Sciences Center, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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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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Ruiz-Linares M, Baca P, Arias-Moliz MT, Ternero FJ, Rodríguez J, Ferrer-Luque CM. Antibacterial and antibiofilm activity over time of GuttaFlow Bioseal and AH Plus. Dent Mater J 2019; 38:701-706. [PMID: 31257302 DOI: 10.4012/dmj.2018-090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The sealers' antibacterial and antibiofilm activities against Enterococcus faecalis were evaluated by direct contact test (DCT) and confocal laser scanning microscopy (CLSM), respectively, after 1 day, and 1 and 4 weeks of aging. Cell viability was determined by adenosin triphosphate (ATP) assay after DCT. The parameters evaluated for the antibiofilm property were total biovolume and percentage of green cells in E.faecalis biofilms. The data from the bioluminescence ATP assay as well as the total biovolume and green percentage were analyzed by non-parametric tests, Kruskal-Wallis for global comparison and Kolmogorov-Smirnov for each two variables. Results of the DCT and CLSM for all parameters evaluated show that the antimicrobial activity of AH Plus decreased over time, whereas GuttaFlow Bioseal had an opposite property, increasing its antibacterial activity as the material aged.
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Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
| | | | | | - Jesús Rodríguez
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
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Baras BH, Sun J, Melo MAS, Tay FR, Oates TW, Zhang K, Weir MD, Xu HH. Novel root canal sealer with dimethylaminohexadecyl methacrylate, nano-silver and nano-calcium phosphate to kill bacteria inside root dentin and increase dentin hardness. Dent Mater 2019; 35:1479-1489. [DOI: 10.1016/j.dental.2019.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 12/14/2022]
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The Antimicrobial Effect of Bioceramic Sealer on an 8-week Matured Enterococcus faecalis Biofilm Attached to Root Canal Dentinal Surface. J Endod 2019; 45:1047-1052. [DOI: 10.1016/j.joen.2019.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
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Huang Y, Li X, Mandal P, Wu Y, Liu L, Gui H, Liu J. The in vitro antimicrobial activities of four endodontic sealers. BMC Oral Health 2019; 19:118. [PMID: 31215426 PMCID: PMC6582474 DOI: 10.1186/s12903-019-0817-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/07/2019] [Indexed: 11/25/2022] Open
Abstract
Background The purpose of this study was to investigate the antimicrobial activities of four endodontic sealers (GuttaFlow2, AH Plus, ProRoot MTA and RealSeal) against E. feacalis, E.coli and C.albicans. Methods The antimicrobial activities of four endodontic sealers were assessed by both agar diffusion test (ADT) and direct contact test (DCT) in this study. In ADT, the results were reported as the diameter of the growth inhibition zone. Both fresh and 1-day-setting sealers were measured. In DCT, microorganisms in suspension were exposed to the sealers for 10, 30 and 60 min and the survival of microorganisms were determined after exposure at different time points(after mixing, 1 and 7 days). The number of colony-forming unit (CFU) was counted. The results were analyzed with ANOVA and Tukey tests. Results Both ADT and DCT results showed that Guttaflow2 presented no effect against any tested microorganisms. In ADT, fresh RealSeal had the largest inhibition zone against all tested microbes, followed by AH Plus and ProRoot MTA. ProRoot MTA demonstrated inhibition zones against all the three test microbes after setting for 1 day, while the other three sealers showed no inhibition activity. In DCT, fresh AH Plus had the strongest antimicrobial effects against all the three tested microorganisms for every contact times, while its antimicrobial activity diminished significantly with time. Fresh RealSeal and ProRoot MTA also showed strong antimicrobial effect and still showed antimicrobial effect after 1-day-setting. The antibacterial effects of RealSeal against E. faecalis and antifungal effect of ProRoot MTA were observed after 7 days of setting. Conclusions GuttaFlow2 had no antimicrobial activity. Freshly mixed RealSeal and AH Plus demonstrated strong antimicrobial effects. RealSeal showed antimicrobial effects after setting in DCT. ProRoot MTA showed high antimicrobial activity and exhibited anti-inflammation potentials after setting.
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Affiliation(s)
- Yuting Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# JieFang avenue, Wuhan, Hubei Province, People's Republic of China
| | - Xiaoshuang Li
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# JieFang avenue, Wuhan, Hubei Province, People's Republic of China
| | - Preeti Mandal
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# JieFang avenue, Wuhan, Hubei Province, People's Republic of China
| | - Yan Wu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# JieFang avenue, Wuhan, Hubei Province, People's Republic of China
| | - Lin Liu
- Department of Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Huihua Gui
- Department of Cadre health care section, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jiarong Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# JieFang avenue, Wuhan, Hubei Province, People's Republic of China.
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40
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Baras BH, Melo MAS, Sun J, Oates TW, Weir MD, Xie X, Bai Y, Xu HHK. Novel endodontic sealer with dual strategies of dimethylaminohexadecyl methacrylate and nanoparticles of silver to inhibit root canal biofilms. Dent Mater 2019; 35:1117-1129. [PMID: 31128937 DOI: 10.1016/j.dental.2019.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/26/2019] [Accepted: 05/07/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Endodontic treatment failures and recontamination remain a major challenge. The objectives of this study were to: (1) develop a new root canal sealer with potent and long-lasting antibiofilm effects using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of silver (NAg); (2) determine the effects of incorporating DMAHDM and NAg each alone versus in combination on biofilm-inhibition efficacy; and (3) determine the effects on sealer paste flow, film thickness and sealing ability, compared to a commercial control sealer. METHODS Dual-cure endodontic sealers were formulated using DMAHDM mass fractions of 0%, 2.5% and 5%, and NAg mass fractions of 0.05%, 0.1% and 0.15%. The sealing ability of the sealers was measured using linear dye penetration method. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms grown on sealers were determined. RESULTS The sealer with 5% DMAHDM and 0.15% NAg yielded a flow of (22.18 ± 0.58) which was within the range of ISO recommendations and not statistically different from AH Plus control (23.3 ± 0.84) (p > 0.05). Incorporating DMAHDM and NAg did not negatively affect the film thickness and sealing properties (p > 0.05). The sealer with 5% DMAHDM and 0.15% NAg greatly reduced polysaccharide production by the biofilms, and decreased the biofilm CFU by nearly 6 orders of magnitude, compared to AH Plus and experimental controls (p < 0.05). SIGNIFICANCE A therapeutic root canal sealer was developed using 5% DMAHDM with biofilm-inhibition through contact-mediated mechanisms, plus 0.15% of NAg to release silver ions into the complex and difficult-to-reach root canal environment. The novel root canal sealer exerted potent antibiofilm effects and reduced biofilm CFU by 6 orders of magnitude without compromising sealer flow, film thickness and sealing ability. This method provided a promising approach to inhibit endodontic biofilms and prevent recurrent endodontic infections.
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Affiliation(s)
- Bashayer H Baras
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mary Anne S Melo
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Jirun Sun
- Volpe Research Center, American Dental Association Foundation, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Xianju Xie
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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41
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Alsubait S, Albader S, Alajlan N, Alkhunaini N, Niazy A, Almahdy A. Comparison of the antibacterial activity of calcium silicate- and epoxy resin-based endodontic sealers against Enterococcus faecalis biofilms: a confocal laser-scanning microscopy analysis. Odontology 2019; 107:513-520. [PMID: 30927150 DOI: 10.1007/s10266-019-00425-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
This study assessed the antibacterial activity of BioRoot RCS in comparison with that of the Totalfill BC and AH Plus sealers against Enterococcus faecalis biofilms in dentinal tubules using confocal laser-scanning microscopy. Sixty-six root dentin halves were prepared and sterilized. Three sections were used to ensure sterilization. The remaining were inoculated with E. faecalis. Three specimens were examined to verify the viability of biofilms. The sixty specimens were randomly divided into four groups: AH Plus, BioRoot RCS, Totalfill BC sealer, and no sealer. The specimens were incubated for 1, 7, and 30 days. The specimens were stained and four corners of each disc were scanned. Statistical analysis was performed using two-way ANOVA and Tukey's post hoc test. Almost half of the bacteria were dead in BioRoot RCS group on day 1 and in Totalfill BC group on day 7. All sealers killed significantly more bacteria than the control after 30 days (P < .05). On day 7, Totalfill BC showed a significantly higher percentage of dead bacteria than BioRoot RCS (P < .05). On day 30, the BioRoot RCS group registered the highest percentage of dead cells (61.75%), which was significantly higher than the percentages of the AH Plus and Totalfill BC groups (P < .05). Calcium silicate-based root canal sealers exerted antimicrobial effects against E. faecalis biofilms. The antibacterial activity of BioRoot RCS was significantly higher than that of the Totalfill BC and AH Plus sealers after 30 days of exposure.
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Affiliation(s)
- Sara Alsubait
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | | | | | | | - Abdurahman Niazy
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Almahdy
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Gunes B, Yeter KY, Terlemez A, Seker B, Altay Y. Dentinal tubule penetration of endodontic sealers after nonthermal plasma treatment: A confocal laser scanning microscopy study. Microsc Res Tech 2019; 82:903-908. [DOI: 10.1002/jemt.23237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/10/2019] [Accepted: 01/29/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Betul Gunes
- Faculty of Dentistry, Department of EndodonticsEskisehir Osmangazi University Eskişehir Turkey
| | - Kubra Y. Yeter
- Faculty of Dentistry, Department of EndodonticsEskisehir Osmangazi University Eskişehir Turkey
| | - Arslan Terlemez
- Faculty of Dentistry, Department of EndodonticsNecmettin Erbakan University Konya Turkey
| | - Basak Seker
- Faculty of Dentistry, Department of PeriodontologyEskisehir Osmangazi University Eskişehir Turkey
| | - Yasin Altay
- Faculty of Agriculture, Department of Animal Science Biometry and GeneticEskisehir Osmangazi University Eskişehir Turkey
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Zordan‐Bronzel CL, Tanomaru‐Filho M, Rodrigues EM, Chávez‐Andrade GM, Faria G, Guerreiro‐Tanomaru JM. Cytocompatibility, bioactive potential and antimicrobial activity of an experimental calcium silicate‐based endodontic sealer. Int Endod J 2019; 52:979-986. [DOI: 10.1111/iej.13086] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/25/2019] [Indexed: 01/09/2023]
Affiliation(s)
- C. L. Zordan‐Bronzel
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
| | - M. Tanomaru‐Filho
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
| | - E. M. Rodrigues
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
| | - G. M. Chávez‐Andrade
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
| | - G. Faria
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
| | - J. M. Guerreiro‐Tanomaru
- Department of Restorative Dentistry School of Dentistry São Paulo State University (Unesp) Araraquara São Paulo Brazil
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44
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Endodontic sealers based on calcium silicates: a systematic review. Odontology 2018; 107:421-436. [DOI: 10.1007/s10266-018-0400-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 11/19/2018] [Indexed: 01/21/2023]
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45
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Solubility and pH Value of 3 Different Root Canal Sealers: A Long-term Investigation. J Endod 2018; 44:1736-1740. [DOI: 10.1016/j.joen.2018.07.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/27/2018] [Accepted: 07/28/2018] [Indexed: 11/23/2022]
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Duarte MAH, Marciano MA, Vivan RR, Tanomaru Filho M, Tanomaru JMG, Camilleri J. Tricalcium silicate-based cements: properties and modifications. Braz Oral Res 2018; 32:e70. [PMID: 30365611 DOI: 10.1590/1807-3107bor-2018.vol32.0070] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/12/2018] [Indexed: 12/23/2022] Open
Abstract
Mineral trioxide aggregate (MTA) has been widely used for different reparative procedures in endodontics. The extensive use of this cement for pulp capping, apexifications, apical surgeries, and revascularization is related to its ability to induce tissue repair and to stimulate mineralization. Several research studies have tested modifications in the composition of MTA-based cements in order to enhance their clinical performance. Novel formulations have been introduced in the market with the aim of increasing flowability. Important properties such as appropriate radiopacity and setting time, color stability, alkaline pH, release of calcium ions, and biocompatibility have to be considered in these new formulations. The latest research studies on the physical, chemical, and biological properties of tricalcium silicate-based cements are discussed in this critical review.
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Affiliation(s)
- Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Dental School of Bauru, Department of Dentistry, Endodontics, and Dental Materials, Bauru, SP, Brazil
| | - Marina Angélica Marciano
- Universidade Estadual de Campinas - Unicamp, Dental School of Piracicaba, Department of Dentistry, Endodontics, and Dental Materials, Piracicaba, SP, Brazil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Dental School of Bauru, Department of Dentistry, Endodontics, and Dental Materials, Bauru, SP, Brazil
| | - Mario Tanomaru Filho
- Universidade do Estado de São Paulo - Unesp, Dental School of Araraquara, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Juliane Maria Guerreiro Tanomaru
- Universidade do Estado de São Paulo - Unesp, Dental School of Araraquara, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Josette Camilleri
- University of Birmingham, School of Dentistry, Birmingham, United Kingdom
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47
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Dentinal tubule penetration of AH Plus, BC Sealer and a novel tricalcium silicate sealer: a confocal laser scanning microscopy study. Clin Oral Investig 2018; 23:1871-1876. [DOI: 10.1007/s00784-018-2632-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
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Almeida LHS, Moraes RR, Morgental RD, Cava SS, Rosa WLO, Rodrigues P, Ribeiro AS, Só M, Pappen FG. Synthesis of silver-containing calcium aluminate particles and their effects on a MTA-based endodontic sealer. Dent Mater 2018; 34:e214-e223. [DOI: 10.1016/j.dental.2018.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/29/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022]
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Antimicrobial effect of bioceramic cements on multispecies microcosm biofilm: a confocal laser microscopy study. Clin Oral Investig 2018; 23:1367-1372. [DOI: 10.1007/s00784-018-2551-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/27/2018] [Indexed: 11/29/2022]
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Dalmia S, Gaikwad A, Samuel R, Aher G, Gulve M, Kolhe S. Antimicrobial Efficacy of Different Endodontic Sealers against Enterococcus faecalis: An In vitro Study. J Int Soc Prev Community Dent 2018; 8:104-109. [PMID: 29780734 PMCID: PMC5946517 DOI: 10.4103/jispcd.jispcd_29_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/15/2018] [Indexed: 11/04/2022] Open
Abstract
Objective The aim of this in vitro study is to compare the antimicrobial efficacy of four different endodontic sealers against Enterococcus faecalis. Material and Method: Four different endodontic sealers, namely, resin based (AH Plus), zinc oxide-eugenol based (Tubliseal), calcium hydroxide based (Sealapex), and mineral trioxide aggregate (MTA Fillapex) based were tested for their antimicrobial efficacy against E. faecalis using agar diffusion method. Four wells were made by the removal of agar at equidistant points and filled with freshly mixed respective root canal sealers and were inoculated with E. faecalis. All the three plates were incubated for a period of 72 h at 37°C under aerobic conditions. The diameter of inhibition zones was measured at 24, 48, and 72 h time intervals. Data obtained were statistically analyzed using one-way analysis of variance and unpaired t-test. Results: All the tested sealers showed some bacterial growth inhibition of E. faecalis. Their efficacy in descending order of antibacterial activity was as follows: Sealapex > AH Plus > Tubliseal > MTA Fillapex. The efficacy of the root canal sealers decreased marginally with increase in their duration of action. Conclusion: Antimicrobial efficacy of calcium hydroxide-based sealer was highest followed by resin-based sealer and was the least with MTA based sealer.
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Affiliation(s)
- Swati Dalmia
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Abhidnya Gaikwad
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Roshan Samuel
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Gayatri Aher
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Meenal Gulve
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapnil Kolhe
- Department of Conservative Dentistry and Endodontics, MGV's K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
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