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Zamparini F, Lenzi J, Duncan HF, Spinelli A, Gandolfi MG, Prati C. The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: A systematic review and meta-analysis. Int Endod J 2024; 57:1021-1042. [PMID: 38606520 DOI: 10.1111/iej.14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/03/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Limited evidence is available regarding the superior clinical properties of bioceramic sealers comparted with traditional standard sealers. OBJECTIVES This review aimed to answer the following research questions: 'In healthy patients requiring a root canal treatment (P), what is the efficacy of premixed bioceramic sealers (I) compared with traditional root canal epoxy resin-based sealers (C) in terms of survival, success rates (PICO1) sealer extrusion and resorption (PICO2) post-obturation pain (PICO3) (O)?' METHODS Authors independently searched three electronic databases: PubMed (including MEDLINE), Web of Science, Embase and Scopus up to 31 October 2023. This was accompanied by both grey literature and manual search. Detailed selection criteria were applied, namely mature permanent teeth requiring root canal treatment, premixed bioceramic sealer with gutta-percha as an intervention group, a standard filling technique as control group and full-text available in English. A random-effect meta-analysis was used to synthesize the body of evidence regarding the use of bioceramic sealers in root canal treatment and their impact on post-obturation pain. Effect sizes were represented as relative risks on a logarithmic scale for binary outcomes and as mean differences for continuous outcomes. RESULTS A total of 941 articles were identified. Fifteen Comparative clinical studies were finally included. Eleven were randomized clinical trials, and four were prospective clinical trials with control group. The follow-up of these studies was not greater than 2 years. No publication bias was observed in any study. No significant differences were observed between the two groups in terms of survival and success rates. A small non-significant lower risk of extrusion was observed for bioceramics. A small, non-significantly lower post-operative-pain within 24-h was observed when bioceramics were used. DISCUSSION The majority of current evidence shows inconsistencies in reporting and is of short-term duration. Robust prospective long-term trials are needed in this area to better support future recommendations. CONCLUSION This systematic review is the first to analyse several clinical outcomes using premixed sealers. Included studies differed in terms of clinical protocol and operator expertise, but reported a similar outcome when comparing bioceramic versus standard sealers. Tooth survival, treatment outcome, post-operative pain and periapical extrusion were similar and presented no significant differences between the two sealer types. REGISTRATION PROSPERO database (CRD42023449151).
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Affiliation(s)
- Fausto Zamparini
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Henry Fergus Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Andrea Spinelli
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Giovanna Gandolfi
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Costa JLDSG, Barros APO, Junior AJ, Gelio MB, Dantas AAR, Kuga MC. Influence of residues from bioceramic sealer on the bond interface with universal adhesive in different application modes. Eur J Oral Sci 2024; 132:e12994. [PMID: 38780370 DOI: 10.1111/eos.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
This study evaluated the effect on adhesive layer thickness, bond strength, and adhesive failure pattern of the application of universal adhesive (Scotchbond Universal) using either manual or rotary brush in dentin previously impregnated with bioceramic sealer (Sealer Plus BC) using a manual brush, at 24 h and 1 year. Eighty-eight bovine crowns were divided into four groups (n = 22) according to the intervention: (i) use of bioceramic sealer and adhesive application using manual brush, (ii) use of bioceramic sealer and adhesive application using rotary brush, (iii) use of resin sealer and adhesive application using manual brush, and (iv) use of resin sealer and adhesive application using rotary brush. Subsequently, specimens were restored with a composite resin (Filtek Z-250). Adhesive layer thickness was evaluated using confocal microscopy. Bond strength was assessed using the microtensile bond strength test, and adhesive failure pattern was evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA/Tukey tests. Specimens where a rotary brush had been used exhibited lower adhesive layer thickness. Specimens treated with resin sealer and using a manual brush showed lower bond strength values and a higher occurrence of adhesive failures at 24 h and 1 year than specimens treated with bioceramic sealer and using rotary brush for adhesive application.
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Affiliation(s)
- Joatan Lucas de Sousa Gomes Costa
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minais Gerais, Brazil
| | | | - Adirson Jorge Junior
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Andréa Abi Rached Dantas
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
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Costa JLDSG, Barros APO, Gelio MB, Galvani LD, Vaz LG, Kuga MC. Influence of bioceramic sealer residues on the adhesion interface with a universal adhesive in the etch-and-rinse strategy, based on the application protocol and evaluation time. Dent Mater J 2024; 43:565-572. [PMID: 38825448 DOI: 10.4012/dmj.2024-046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.
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Affiliation(s)
| | | | - Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University-UNESP
| | - Lucas David Galvani
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP
| | - Luis Geraldo Vaz
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University-UNESP
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Tanomaru-Filho M, Lucchesi MB, Santos-Junior AO, Tavares KIMC, Pinto JC, Guerreiro-Tanomaru JM. Filling ability of ready-to-use or powder-liquid calcium silicate-based sealers after ultrasonic agitation. Braz Dent J 2024; 35:5802. [PMID: 39045989 PMCID: PMC11262770 DOI: 10.1590/0103-6440202405802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/23/2024] [Indexed: 07/25/2024] Open
Abstract
This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability.
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Affiliation(s)
- Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Maíra Bonassi Lucchesi
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
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Inada RNH, Silva ECA, Lopes CS, Queiroz MB, Torres FFE, da Silva GF, Cerri PS, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Biocompatibility, bioactivity, porosity, and sealer/dentin interface of bioceramic ready-to-use sealers using a dentin-tube model. Sci Rep 2024; 14:16768. [PMID: 39039132 PMCID: PMC11263578 DOI: 10.1038/s41598-024-66616-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/02/2024] [Indexed: 07/24/2024] Open
Abstract
This study evaluated the biocompatibility, bioactivity, porosity, and sealer/dentin interface of Sealer Plus BC (SP), Bio-C Sealer (BIOC), TotalFill BC Sealer (TF), and AH Plus (AHP). Dentin tubes filled with the sealers and empty tubes (control group) were implanted in the subcutaneous tissue of rats for different periods (n = 6 per group/period). Number of inflammatory cells (ICs), capsule thickness, von Kossa reaction, interleukin-6 (IL-6) and osteocalcin (OCN) were evaluated. Porosity and voids in the interface dentin/sealers were assessed by micro-computed tomography. The data were submitted to ANOVA/Tukey's tests (α = 0.05). Greater capsule thickness, ICs and IL-6 immunolabeling cells were observed in AHP. No significant difference in thickness of capsule, ICs, and IL-6- immunolabeling cells was detected between SP and TF, in all periods, and after 30 and 60 days between all groups. At 60 days all groups had reduction in capsule thickness, ICs and IL-6 immunolabeling cells. Von Kossa-positive and birefringent structures were observed in the capsules around the sealers. BIOC, SP, and TF exhibited OCN-immunolabeling cells. All sealers had porosity values below 5%, besides low and similar interface voids. BIOC, SP and TF are biocompatible, bioactive, and have low porosity and voids. The dentin-tube model used is an alternative for evaluating bioceramic materials.
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Affiliation(s)
- Rafaela Nanami Handa Inada
- School of Dentistry, Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil
| | - Evelin Carine Alves Silva
- School of Dentistry, Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil
| | - Camila Soares Lopes
- School of Dentistry, Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil
| | - Marcela Borsatto Queiroz
- School of Dentistry, Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil
| | | | | | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil
| | | | - Mário Tanomaru-Filho
- School of Dentistry, Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, 14801‑903, Brazil.
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Scalabrin SA, Hashizume LN, Weissheimer T, Só GB, Pereira JR, Kuga MC, da Rosa RA, Só MVR. Effect of ultrasonic activation on setting time, pH and calcium ion release, solubility, and chemical structure of calcium silicate sealers. Braz Dent J 2024; 35:5824. [PMID: 39045990 PMCID: PMC11262761 DOI: 10.1590/0103-6440202405824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/11/2024] [Indexed: 07/25/2024] Open
Abstract
This study evaluated the setting time, pH, calcium ion release, solubility, and chemical structure of four calcium silicate sealers after ultrasonic activation (UA). Five sealers were evaluated: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC), and BioRoot RCS (BR). Ten groups were created based on the use or not of ultrasonic activation: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; and BR/UA. Setting time was performed based on ISO 6876:2012 and ASTM C266-07 specifications. Solubility at 24hs, based on ISO 6876:2012. pH and calcium release were evaluated at 1, 24, 72, and 168hs. Raman spectroscopy was used to evaluate structural changes. Quantitative data were analyzed using One-Way ANOVA and Tukey post-hoc test (α=5%). Raman spectroscopy results were qualitatively analyzed. Setting times and solubility of all sealers were not affected by UA (p>0.05). The highest solubility was found for BCS, BCS/UA; and BR, BR/UA (p<0.05). After 24hs, calcium silicate sealers had higher pH than SP and SP/UA (p<0.05). BR and BR/UA had the highest pH at all time points. SP and SP/UA had stable pH at all time points. SP and SP/UA had the lowest calcium release values at all time points (p<0.05). EBC and EBC/UA calcium release significantly differ at 24,72 and 168hs (p<0.05). No chemical changes were observed during Raman spectroscopy. In conclusion, ultrasonic activation affected calcium ion release only for EndoSequence BC Sealer. Ultrasonic activation did not influence the initial and final setting time, solubility, pH, and chemical structure of any investigated sealers.
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Affiliation(s)
- Simone Argenta Scalabrin
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Lina Naomi Hashizume
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, Araraquara Dental School, São Paulo State University,, Araraquara SP, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
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Sharki AM, Ali AH. Three-Dimensional Measurement of Obturation Quality of Bioceramic Materials in Filling Artificial Internal Root Resorption Cavities Using Different Obturation Techniques: An In Vitro Comparative Study. J Endod 2024; 50:997-1003. [PMID: 38588977 DOI: 10.1016/j.joen.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Pathologic conditions such as internal root resorption (IRR) may complicate root canal filling. This study aimed to evaluate and compare the obturation quality by measuring the percentage of obturation volume (POV) in root canals with artificial IRR obturated with different materials and techniques using cone beam computed tomography (CBCT). METHODS Forty single canal extracted mandibular premolars were decoronated to standardize their length to 14 mm. Following instrumentation, the roots were cut horizontally, and artificial IRR cavities were made at the level of 7 mm from the apex. The root halves were joined using cyanoacrylate adhesive. The samples were randomly assigned to 4 groups (n = 10), and the canals were filled as follows: single-cone technique (SC), bulk-fill Bio-C Sealer (BF), and Bio-C Repair for the coronal and middle third (BCR) + cold lateral condensation technique (CLC) for the apical third and continuous wave compaction technique (CWC). The pre- and postobturation volumes and the POV were measured in the total canal and for the apical, middle, and coronal thirds separately using CBCT and Mimics Medical software. The results were analyzed statistically using one-way ANOVA and Tukey HSD test, and statistical significance was set at P < .05. RESULTS BF group resulted in significantly lower total, coronal, middle and apical POV values compared to SC, BCR + CLC, and CWC groups (P < .05), respectively. Also, at the apical third, the BCR + CLC group showed significantly lower POV than the SC and CWC groups (P < .05), respectively. The intra-group comparison showed that BF and BCR + CLC groups had a significantly lower POV in the apical third compared to the middle third (P < .05). Conversely, the CWC group had a significantly higher apical POV than the middle third (P < .05). CONCLUSIONS The maximum POV was obtained using the CWC technique, Bio-C Repair, and SC technique with Bio-C Sealer, making their application in IRR more preferable than the BF Bio-C Sealer.
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Affiliation(s)
- Ammar M Sharki
- Aesthetic and restorative dentistry department, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ahmed H Ali
- Assistant Professor Dr., Aesthetic and Restorative Dentistry Department, College of Dentistry, University of Baghdad, Baghdad, Iraq.
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Fristad I, Haug S, Bårdsen A. Biological properties versus solubility of endodontic sealers and cements. Biomater Investig Dent 2024; 11:40863. [PMID: 38903777 PMCID: PMC11187977 DOI: 10.2340/biid.v11.40863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Endodontic sealers and cements used in root canal treatment have different compositions and properties. Common to all materials is that their primary goal is to fill gaps and voids, making a permanent seal of the root canal system. Furthermore, aspects such as antibacterial properties, cytotoxicity, setting time, solubility and biocompatibility are also crucial and ought to be considered. Over the years, a shift in the view on the importance of these aspects has ocurred. Whereas the antibacterial properties were considered important when the technical factors in endodontics were less developed, the sealing ability and biocompatibility have later been considered the most critical factors. The introduction of tricalcium silicate cements and sealers has led to a renewed interest in material properties, as these cements seem to have good sealing ability and at the same time combine favourable antimicrobial effects with excellent biocompatibility. This review discusses how the various properties of root canal sealers and cements may conflict with the primary aim of providing a permanent seal of the root canal system.
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Affiliation(s)
- Inge Fristad
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Sivakami Haug
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Nagpal R, Taneja S, Bhalla VK. The effect of bioactive glass-based, bioceramic based and epoxy amine resin based root canal sealers on post-obturation pain: A double blinded randomized controlled trial. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:591-597. [PMID: 38989484 PMCID: PMC11232765 DOI: 10.4103/jcde.jcde_115_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 07/12/2024]
Abstract
Aim The aim of this study was to compare the effect of two calcium silicate-based and an epoxy resin-based root canal sealers on postoperative pain and analgesic intake following single-visit root canal treatment. Materials and Method Ninety patients with at least one first or second molar tooth diagnosed as symptomatic irreversible pulpitis and symptomatic apical periodontitis were selected and allocated into three groups (n=30) according to the sealer used. Root canals were prepared using Protaper Gold instruments (Dentsply Sirona) in a crown down technique and irrigated with 2.5% NaOCl (Calyx, India) and saline solution. Root canal filling was then accomplished with a single cone obturation technique and treated in a single visit by the same endodontist. Patients were told to use a Visual Analog Scale (VAS) to rate their postoperative pain severity as none, minimal, moderate, or severe after 6 h, 24 h, 48 h, 5 days and 7 days following obturation using the appropriate sealers. The need for analgesic intake was also recorded. The data were statistically analyzed. Results Results showed a significant difference among the studied groups. Bio-C Sealer Ion+ reported the least pain score followed by Nishika Canal Sealer BG and AH plus sealer at all the time intervals recorded. The intergroup analysis, revealed was a significant difference in postoperative pain at 6 h (p=0.000) and 24 h (p = 0.028), but not at 48 h, 5 day or 7 days (P > 0.05). VAS ratings for all the three groups decreased over time. Also, there were significant differences between the means of analgesic intake among 3 groups (p=0.022). Analgesic intake in group BIO-C Sealer Ion+ is significantly lesser than AH Plus and Nishika Canal Sealer BG group. Conclusion Calcium silicate-based sealer (Nishika Canal Sealer BG and Bio-C Sealer Ion+) resulted in significantly lower levels of pain as compared to epoxy resin-based sealer (AH Plus) at 6h and 24-h interval, there was no significant difference in postoperative pain occurrence at 48-h, 5 day and 7-day period. The analgesic intake in Bio-C Sealer Ion+ group is significantly lesser than Nishika Canal Sealer BG and AH Plus group.
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Affiliation(s)
- Ritesh Nagpal
- Department of Conservative Dentistry and Endodontics, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Sonali Taneja
- Department of Conservative Dentistry and Endodontics, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Vidhi Kiran Bhalla
- Department of Conservative Dentistry and Endodontics, ITS Dental College, Ghaziabad, Uttar Pradesh, India
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Silva ECA, Pradelli JA, da Silva GF, Cerri PS, Tanomaru-Filho M, Guerreiro-Tanomaru JM. Biocompatibility and bioactive potential of NeoPUTTY calcium silicate-based cement: An in vivo study in rats. Int Endod J 2024; 57:713-726. [PMID: 38467586 DOI: 10.1111/iej.14054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
AIM To evaluate the inflammatory reaction and the ability to induce mineralization activity of a new repair material, NeoPUTTY (NPutty; NuSmile, USA), in comparison with Bio-C Repair (BC; Angelus, Brazil) and MTA Repair HP (MTA HP; Angelus, Brazil). METHODOLOGY Polyethylene tubes were filled with materials or kept empty (control group, CG) and implanted in subcutaneous tissue of rats for 7, 15, 30, and 60 days (n = 6/group). Capsule thickness, number of inflammatory cells (ICs), fibroblasts, collagen content, and von Kossa analysis were performed. Unstained sections were evaluated under polarized light and by immunohistochemistry for osteocalcin (OCN). Data were submitted to two-way anova followed by Tukey's test (p ≤ .05), except for OCN. OCN data were submitted to Kruskal-Wallis and Dunn and Friedman post hoc tests followed by the Nemenyi test at a significance level of 5%. RESULTS At 7, 15, and 30 days, thick capsules containing numerous ICs were seen around the materials. At 60 days, a moderate inflammatory reaction was observed for NPutty, BC while MTA HP presented thin capsules with moderate inflammatory cells. In all periods, NPutty specimens contained the highest values of ICs (p < .05). From 7 to 60 days, the number of ICs reduced significantly while an increase in the number of fibroblasts and birefringent collagen content was observed. At 7 and 15 days, no significant difference was observed in the immunoexpression of OCN (p > .05). At 30 and 60 days, NPutty showed the lowest values of OCN (p < .05). At 60 days, a similar immunoexpression was observed for BC and MTA HP (p > .05). In all time intervals, capsules around NPutty, BC, and MTA HP showed von Kossa-positive and birefringent structures. CONCLUSIONS Despite the greater inflammatory reaction promoted by NeoPutty than BC and MTA HP, the reduction in the thickness of capsules, the increase in the number of fibroblasts, and the reduction in the number of ICs indicate that this bioceramic material is biocompatible Furthermore, NeoPutty presents the ability to induce mineralization activity.
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Affiliation(s)
- Evelin Carine Alves Silva
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Jéssica Arielli Pradelli
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Paulo Sérgio Cerri
- Department of Morphology, School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo, Brazil
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Ashkar I, Sanz JL, Forner L, Ghilotti J, Melo M. A Literature Review of the Effect of Heat on the Physical-Chemical Properties of Calcium Silicate-Based Sealers. J Endod 2024:S0099-2399(24)00281-4. [PMID: 38729300 DOI: 10.1016/j.joen.2024.04.017] [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: 03/07/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Recently, calcium silicate-based sealers (CSSs) have gained popularity in endodontic practice due to their biocompatibility and antimicrobial properties. They are considered viable alternatives to epoxy resin-based sealers. With the increased use of CSSs and warm vertical compaction techniques in root canal treatment, evaluating the impact of heat on CSSs properties is essential, therefore this review aimed to present a qualitative synthesis of available in vitro studies assessing the impact of heat on the physical-chemical properties of CSSs. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines, a systematic advanced electronic search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases in November 2023 and updated in April 2024. In vitro studies that evaluated the physical-chemical properties of CSSs were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias-included studies. RESULTS The search identified a total of 6421 preliminary results and 10 studies were included for qualitative assessment. Eleven different physiochemical properties were assessed by the included studies. Setting time and flow were the most evaluated property among the studies. A qualitative synthesis of the evidence on each property is presented. CONCLUSIONS Based on the in vitro studies assessed in the present systematic review, results reveal that exposing CSSs to heat can accelerate their setting time, reduce their flow, and increase their film thickness. Concerns persist regarding solubility, viscosity, radiopacity, dimensional change, microhardness, porosity, and compressive strength, requiring further research. Certain CSSs, such as MTA Fillapex and Endosequence BC sealer HiFlow, show minimal changes under heat, making them potential candidates for warm filling techniques.
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Affiliation(s)
- Israa Ashkar
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - James Ghilotti
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
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Lee YJ, Cho KM, Park SH, Lee Y, Kim JW. Nanoleakage of apical sealing using a calcium silicate-based sealer according to canal drying methods. Restor Dent Endod 2024; 49:e20. [PMID: 38841379 PMCID: PMC11148404 DOI: 10.5395/rde.2024.49.e20] [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: 11/29/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study investigated the nanoleakage of root canal obturations using calcium silicate-based sealer according to different drying methods. Materials and Methods Fifty-two extracted mandibular premolars with a single root canal and straight root were selected for this study. After canal preparation with a nickel-titanium rotary file system, the specimens were randomly divided into 4 groups according to canal drying methods (1: complete drying, 2: blot drying/distilled water, 3: blot drying/NaOCl, 4: aspiration only). The root canals were obturated using a single-cone filling technique with a calcium silicate-based sealer. Nanoleakage was evaluated using a nanoflow device after 24 hours, 1 week, and 1 month. Data were collected twice per second at the nanoscale and measured in nanoliters per second. Data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney U-tests (p < 0.05). Results The mean flow rate measured after 24 hours showed the highest value among the time periods in all groups. However, the difference in the flow rate between 1 week and 1 month was not significant. The mean flow rate of the complete drying group was the highest at all time points. After 1 month, the mean flow rate in the blot drying group and the aspiration group was not significantly different. Conclusions Within the limitations of this study, the canal drying method had a significant effect on leakage and sealing ability in root canal obturations using a calcium silicate-based sealer. Thus, a proper drying procedure is critical in endodontic treatment.
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Affiliation(s)
- Yoon-Joo Lee
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Kyung-Mo Cho
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Se-Hee Park
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Yoon Lee
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Jin-Woo Kim
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Azizi H, Hadad A, Levy DH, Ben Itzhak J, Kim HC, Solomonov M. Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review. Dent J (Basel) 2024; 12:85. [PMID: 38667997 PMCID: PMC11048901 DOI: 10.3390/dj12040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/02/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to review the considerations for choosing a suitable sealer according to various endodontic scenarios. An electronic search of PubMed, Scopus, and the Web of Science was undertaken for the keywords of 'sealer choosing', 'appropriate sealer', 'suitable sealer', 'sealer for clinical scenario', and 'sealer for clinical situations'. However, the literature review revealed a lack of studies with practical clinical recommendations regarding the choice of appropriate endodontic root canal sealers for particular clinical situations of root canal treatment. Therefore, a narrative review was undertaken under the basis of the characteristics of an epoxy resin-based sealer (ERS) versus a calcium silicate-based sealer (CSS). Based on the evidence found through the review, the choice of an appropriate sealer in a variety of clinical scenarios was proposed. An ERS is recommended for one-visit non-vital cases, teeth with periodontal involvement, cracked teeth, and internal root resorption without root perforation. A CSS is recommended for vital or non-vital cases in multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations.
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Affiliation(s)
- Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Henry Levy
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 46241, Republic of Korea;
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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da Costa RP, Alves Dos Santos GN, Petean IBF, Silva-Sousa AC, Camargo RV, Lopes-Olhê FC, Silva-Sousa YTC, Mazzi-Chaves JF, Sousa-Neto MD. Impact of low-fusion gutta-percha cones used in variations of the continuous wave condensation technique with filling sealers based on bioceramic compounds on the quality of root canal filling. Odontology 2024:10.1007/s10266-024-00924-2. [PMID: 38514512 DOI: 10.1007/s10266-024-00924-2] [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: 12/19/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024]
Abstract
To evaluate the impact on the quality of filling with of low-fusion and conventional gutta-percha cones. Thirty-six maxillary canines were prepared and divided into three groups: I-conventional cone with Downpack at 200 °C at 4 mm from the WL; II-low-fusion cone with Downpack at 100 °C up to 4 mm from the WL; III-low-fusion cone with Downpack at 100 °C up to 7 mm from the WL. Temperature variations were measured in thirds on the external surface of the root. The bond strength was evaluated using the push-out test. The adhesive interface was analyzed by scanning electron microscopy. The bond strength and the temperature variation data were analyzed using analysis of variance and the failure type using the chi-square test. The low-fusion cone group with 7 mm Downpack showed higher bond strength (4.2 ± 2.7) compared with conventional cones (2.8 ± 1.6) and low-fusion cones with 4 mm Downpack (2.9 ± 1.6) (p < 0.05), with occurrence of a higher number of adhesive failures to the filling material and mixed failures. Relative to temperature variation, there was less temperature change in the apical third, in the low-fusion cone with Downpack 7 mm (1.0 ± 1.0) (p < 0.05). The use of low-fusion cones allowed the continuous wave condensation technique to be performed at a lower depth of Downpack at 100 °C at 7 mm, with less heating in the apical third, without compromising the quality of filling. Using gutta-percha cones with low fusion, which permits a lower condensation temperature and reduced Downpack depth, maintains the quality of filling, in order to minimize possible damage to the periapical tissues.
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Affiliation(s)
- Rui Pereira da Costa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Igor Bassi Ferreira Petean
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Rafael Verardino Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil.
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Quaresma SAL, Alves Dos Santos GN, Silva-Sousa AC, Camargo RV, Lopes-Olhê FC, Silva-Sousa YTC, Mazzi-Chaves JF, Sousa-Neto MD. Physicochemical properties of calcium silicate cement based endodontic sealers. J Mech Behav Biomed Mater 2024; 151:106400. [PMID: 38262184 DOI: 10.1016/j.jmbbm.2024.106400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
AIM To mensure the physicochemical properties of three ceramic cement endodontic sealers AH Plus Bioceramic, Bio-C Sealer and Bio-C Sealer Ion+ with an epoxy resin sealer, AH Plus. MATERIAL AND METHODS These properties were measured: hardening time (HT), dimensional change (DC), solubility (SL), flow (FL) and radiopacity (RD). The distilled water obtained from the SL test was analyzed with atomic absorption spectrometry. A sample calculation was made considering n = 5 repetitions for each experimental sealer evaluated. Statistical analysis was performed using one-way ANOVA and post hoc Tukey tests (p < 0.05). RESULTS For the HT, AH Plus (484 ± 2.76 min) and AH Plus Bioceramic (424 ± 1.23 min) set more slowly than of Bio-C Sealer (370 ± 4.50 min) and Bio-C Sealer Ion+ (380 ± 1.42 min) (p < 0.05). AH Plus Bioceramic (12.56 ± 2.71 %) was more soluble than Bio-C Sealer (6.69 ± 1.67 %), Bio-C Sealer Ion+ (5.67 ± 2.16 %) and AH Plus (0.15 ± 0.01 %) (p < 0.05). AH Plus (0.03 ± 0.01 %) had slight expansion while the cement-based sealers had shrinkage: AH Plus Bioceramic (-1.60 ± 0.63 %) and Bio-C Sealer (-1.38 ± 0.69 %), Bio-C Sealer Ion+ (-5.19 ± 1.23 %) (p < 0.05). Bio-C Sealer Ion+ (59.80 ± 0.86 mm) and Bio-C Sealer (58.60 ± 0.98 mm) had the highest flow compared with AH Plus (56.90 ± 0.56 mm) and AH Plus Bioceramic (49.50 ± 0.63 mm) (p < 0.05). AH Plus (9.17 ± 0.06 mmAl) and AH Plus Bioceramic (8.27 ± 0.84 mmAl) showed radiopacity values when compared with those of Bio-C Sealer (4.90 ± 0.08 mmAl) and Bio-C Sealer Ion+ (4.14 ± 0.05 mmAl) (p > 0.05). CONCLUSION Ion release is inhered to these cement-based sealers and this result in calcium ion release.
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Affiliation(s)
- Sérgio André Lopes Quaresma
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Rafael Verardino Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
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Kapralos V, Camilleri J, Koutroulis A, Valen H, Ørstavik D, Sunde PT. Endodontic sealers after exposure to chlorhexidine digluconate: An assessment of physicochemical properties. Dent Mater 2024; 40:420-430. [PMID: 38123383 DOI: 10.1016/j.dental.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Final root canal irrigation should ideally maintain the physicochemical stability of root canal sealers. We seek to assess the effect of contact with 2% chlorhexidine digluconate (CHX) on the physicochemical properties of AH Plus, BioRoot™ RCS, and Pulp Canal Sealer (PCS). METHODS Mixed sealers were placed in cylindrical teflon molds and allowed to set for 1.5x the manufacturers' setting time. Half of the specimens had their free surface in contact with CHX for the first minute of their setting period. Solubility, radiopacity, surface roughness, microhardness and wettability of the sealers were assessed up to 28 days after setting. Elemental analysis of sealer surfaces and their leachates together with pH measurements were also performed. Appropriate parametric and non-parametric analysis with post hoc tests were performed (p < 0.05). RESULTS Exposure to CHX had no effect on solubility and radiopacity of all sealers. CHX altered the surface roughness of PCS and BioRoot RCS (p < 0.05). Contact with CHX reduced the microhardness of AH Plus and PCS (p < 0.05). AH Plus was more hydrophilic after CHX contact, whereas PCS became more hydrophobic (p < 0.05). AH Plus and PCS surfaces appeared to adsorb CHX as exhibited by chlorine peaks after contact with CHX. Sealer leachates' alkalinity was not affected. CHX increased elution of silicon and zirconium for BioRoot and zinc for PCS leachates. SIGNIFICANCE In our study, CHX affected sealers' physicochemical properties to various extents. Further studies are needed to confirm the obtained results by investigating various final irrigation strategies and correlating to biological properties.
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Affiliation(s)
- Vasileios Kapralos
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 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
| | - Andreas Koutroulis
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855 Oslo, Norway
| | - Dag Ørstavik
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
| | - Pia Titterud Sunde
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
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Sah S, Mangat P, Kumar A, Sah N, Shivakumar GC, Di Blasio M, Cervino G, Minervini G. Stereomicroscopic evaluation of sealing ability of four different root canal sealers: an in-vitro study. BMC Oral Health 2024; 24:258. [PMID: 38378554 PMCID: PMC10877889 DOI: 10.1186/s12903-024-03913-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
AIM To compare and evaluate the sealing ability of four different commercially available sealers to provide seal against the dye penetration test using a stereomicroscope-an in-vitro study. MATERIAL/METHOD 80 extracted single rooted mandibular premolar with single canal were used in this study. The samples were divided in 4 groups (20 in each) based on sealer. Group I (Diaproseal), Group II (apexit Plus), Group III (MTA Fillapex) and Group IV (Bio-C). The samples were analyzed using a stereomicroscope and data analysis was done with one-way Anova And post hoc Tukey's test. RESULT The mean dye penetration score was 1.2400 ± 0.778 mm for Group I. 2.6000 ± 0.897 mm for Group II, 4.2000 ± 0.923 mm for Group III and 4.225 ± 2.055 mm for Group IV. One-way Anova analysis shows that intergroup comparison was statistically significant between the four groups. The post hoc Tukey's test reveals that the difference was statistically non-significant between group III and group IV. CONCLUSION It was concluded that between the four groups the Group I (Diaproseal) showed the least dye penetration followed by Group II (Apexit Pus), Group III (MTA Fillapex) and then Group IV (Bio-C), where there was no significant difference between the Group III (MTA Fillapex) and Group IV (Bio-C).
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Affiliation(s)
- Sonam Sah
- Department of Conservative Dentistry and Endodontic Teerthanker Mahaveer Dental College and Research Centre Moradabad, Moradabad, UP, India.
| | - Panna Mangat
- Department of Conservative Dentistry and Endodontics Kalka Dental College and Hospital, Meerut, UP, India
| | - Ajay Kumar
- Unit of Oral Medicine and Radiology, Faculty of Dental Sciences, I.M.S, B.H.U. Varanasi, Varanasi, UP, India
| | - Neha Sah
- Unit of oral and maxillofacial surgery, faculty of dental sciences, I.M.S, B.H.U. Varanasi, Varanasi, UP, India
| | - Ganiga Channaiah Shivakumar
- Department of Oral Medicine & Radiology, Peoples College of Dental Sciences, Peoples University, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Parma, 43126, Italy.
| | - Gabriele Cervino
- School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, 1, Messina, 98125, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, 80121, Italy.
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Shin B, Seo JH, Kim W, Ahn YJ, Kim HY, Shon WJ. The flow behavior and sealing ability of calcium silicate root canal cement containing dimethyl sulfoxide: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106156. [PMID: 38041883 DOI: 10.1016/j.jmbbm.2023.106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION To develop a calcium silicate (CaSi)-based cement containing dimethyl sulfoxide (DMSO) and cement deliver device for new root canal filling technique, and to assess the flow behavior, leakage, and root canal filling quality of CaSi containing DMSO. METHODS CaSi containing DMSO (CSC-DMSO) and CaSi containing PEG (CSC-PEG) were prepared, and the flow characteristics of both cements were compared in gypsum and resin channels using a high-speed camera. Eight root canals were obturated by CSC-DMSO or CSC-PEG using a cement delivery device, and root canal filling quality was assessed in terms of filling length using periapical radiographs. The filling length was evaluated by 'apico-coronal extension,' measuring length in reference to apical constriction. Microleakage was measured for thirty human molars that were randomly filled with CSC-DMSO, CSC-PEG, or gutta-percha and AH plus. Preliminary obturation of CSC-DMSO with cement delivery device in human teeth was analyzed in terms of filling length and void, using periapical radiographs. Statistical analysis was performed with the Kruskal Wallis test for simulated root canal fillings and one-way ANOVA for leakage test. RESULTS The flow speed of CSC-DMSO reduced in gypsum channels compared to resin channels, but CSC-PEG did not exhibit significant differences in the channels. The median absolute value of apico-coronal extension was significantly lower in CSC-DMSO compared to CSC-PEG (p < 0.05). Microleakage did not statistically differ between the groups (p > 0.05). In the preliminary obturation, the mean apico-coronal extension of CSC-DMSO was -0.297 ± 0.724 mm, while CSC-PEG was not feasible due to excess apical extrusions. CONCLUSIONS CSC-DMSO could be considered as an alternative filling material for root canal obturation.
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Affiliation(s)
- Bokyung Shin
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ji-Hwan Seo
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Wonjung Kim
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Yu Jin Ahn
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ho-Young Kim
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea.
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Hamdy TM, Galal MM, Ismail AG, Saber S. Physicochemical properties of AH plus bioceramic sealer, Bio-C Sealer, and ADseal root canal sealer. Head Face Med 2024; 20:2. [PMID: 38172921 PMCID: PMC10765876 DOI: 10.1186/s13005-023-00403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer). METHODS Solubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer. RESULTS The least film thickness, highest alkalinity, and highest calcium ion release were all displayed by AH Plus Bioceramic Sealer. High solubility, high alkalinity, intermediate calcium ion release, and intermediate film thickness were all displayed by Bio-C Sealer. While ADseal root canal sealer displayed the greatest film thickness, least solubility, alkalinity, and calcium ion release. CONCLUSIONS Both AH Plus Bioceramic Sealer and Bio-C Sealer represented adequate properties to be considered a good sealer that could be used as a potential alternative to resin-based root canal sealers.
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Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Shehabeldin Saber
- Endodontic Department, Faculty of Dentistry, The British University in Egypt, Cairo, 11841, Egypt
- Center for Innovative Dental Sciences, The British University in Egypt, Cairo, 11841, Egypt
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, 11566, Egypt
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Souza PHFD, Oliveira Santos-Junior A, Pinto JC, Tavares KIMC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study. Braz Dent J 2023; 34:29-35. [PMID: 38133470 PMCID: PMC10759957 DOI: 10.1590/0103-6440202305474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.
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Affiliation(s)
- Pedro Henrique Fiorin de Souza
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
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Al-Sabawi NA, Al-Jubori SH. Physical-chemical properties and acellular bioactivity of newly prepared nano-tricalcium silicate-58s bioactive glass-based endodontic sealer. J Oral Biosci 2023; 65:305-315. [PMID: 37716424 DOI: 10.1016/j.job.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVES To evaluate the physiochemical properties and apatite-forming ability of a newly prepared nano-tricalcium silicate-58s bioactive glass-based endodontic sealer (C3S-BG-P) and compare its results with the Nishika BG canal sealer and BioRoot™ RCS. METHODS The physicochemical properties (setting time, flow, solubility, film thickness, and radiopacity) of C3S-BG-P, Nishika BG canal sealer, and BioRoot™ RCS were evaluated in accordance with ANSI/ADA 57/2000 (reaffirmed 2012) and ISO 6876:2012 for root canal sealing materials. The in vitro apatite-forming ability was evaluated after 28 days of immersion of disc-shaped specimens in phosphate-buffered saline (PBS) using field emission scanning electron microscopy and energy-dispersive X-ray spectroscopy. RESULTS The results of physiochemical tests indicated that all the tested sealers complied with the ADA and ISO standards; however, the solubility of the BioRoot did not meet the two standards. C3S-BG-P revealed significantly superior properties in all physicochemical tests compared to Nishika and BioRoot; however, the solubility of Nishika was significantly lower than that of C3S-BG-P. Furthermore, all tested sealers exhibited apatite precipitation on their surfaces after 28 days of immersion in PBS. CONCLUSIONS C3S-BG-P had superior physicochemical properties, which mitigated the disadvantages of calcium silicate-based sealers. Moreover, it exhibited apatite precipitation after immersion in PBS. Further in vivo studies utilizing animal models or clinical studies are necessary to support the rationale of the newly developed sealer for clinical application.
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Affiliation(s)
- Nawal A Al-Sabawi
- Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq.
| | - Sawsan Hameed Al-Jubori
- Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq.
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22
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Rodrigues Cândido Lopes G, Paz Dotto ME, Hideo Nomura L, Peressoni Vieira Schuldt D, Garcia LDFR, da Silveira Teixeira C. Impact of Heating Exposure on the Micro-Push-Out Bond Strength of Bioceramic Sealers. Int J Dent 2023; 2023:3327275. [PMID: 37942468 PMCID: PMC10630006 DOI: 10.1155/2023/3327275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction The aim of this study was to evaluate the effect of heating of bioceramic and epoxy resin-based sealers on their micro-push-out bond strength (BS) to root canal dentin. Methods After criterial selection, 30 human teeth were decoronated and 1-mm thick slices (n = 60) were obtained perpendicularly along tooth axis, from cervical and middle root thirds, with a diamond disc attached to a cutting machine. In each slice, three 1.0-mm diameter orifices were made. After rinsing with 17% EDTA and 2.5% NaOCl, each orifice was filled with Bio-C Sealer or BioRoot RCS or AH Plus, according to the manufacturers' instructions. After filling, half of the slices (n = 30) were heated at 100°C for 1 min, and the other half were kept at room temperature. After 7 days-controlled storage, micro-push-out test was performed in a Universal Testing Machine. Failures were analyzed using a stereomicroscope. Statistical analysis was performed with One-Way ANOVA and post hoc Tukey (α = 5%) tests. Results AH Plus demonstrated higher BS values after heating (p=0.001) when compared to nonheated. The other sealers did not show a statistically significant difference (p > 0.05). When heated, the average BS values for AH Plus were higher than for BioRoot RCS and Bio-C Sealer (p < 0.001). Cohesive failure mode was the most frequent, followed by adhesive and mixed ones. Conclusion Heating provided a higher push-out BS to root dentin for AH Plus and did not influence BioRoot RCS or Bio-C sealer.
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Affiliation(s)
- Guilherme Rodrigues Cândido Lopes
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Maria Eduarda Paz Dotto
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Lincon Hideo Nomura
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Cleonice da Silveira Teixeira
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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23
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Melo ADP, de Rosatto CMP, Ferraz DC, de Souza GL, Moura CCG. Evaluation of Cytotoxicity, Cell Attachment, and Elemental Characterization of Three Calcium Silicate-Based Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6705. [PMID: 37895687 PMCID: PMC10608491 DOI: 10.3390/ma16206705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
We investigated three calcium silicate-based sealers with respect to their chemical characterization, cytotoxicity, and attachment to RAW264.7 cells. BioRoot RCS (BR), Bio-C Sealer (BC), and Sealer Plus BC (SPBC) were assessed using Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence spectroscopy (XRF), and energy-dispersive X-ray spectroscopy (EDX) (n = 4) for elemental characterization, and using scanning electron microscopy (SEM) to evaluate cell morphology and adhesion. Cytotoxicity was determined at different dilutions (1:1, 1:2, and 1:5) using the succinate dehydrogenase activity (MTT assay). Statistical analysis was performed for normal distribution using the Shapiro-Wilk test and for homoscedasticity using Levene's test, and one-way ANOVA, Tukey's/Dunnett's post hoc tests for cell viability and XRF (α = 0.05). Calcium silicate hydrate and calcium hydroxide were detected by FTIR in all groups. EDX detected a higher calcium content for BR and SPBC and aluminum only in the premixed sealers. XRF detected the highest calcium release in BR (p < 0.05). The surface morphology showed irregular precipitates for all the sealers. SPBC at a 1:2 dilution resulted in the lowest cell viability compared to BR (p < 0.05) and BC (p < 0.05). The calcium silicate-based sealers produced a statistically significant reduction in cellular viability at a 1:1 dilution compared to the control group (p < 0.0001). All the sealers maintained viability above 70%.
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Affiliation(s)
| | | | | | | | - Camilla Christian Gomes Moura
- Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia 38405-318, MG, Brazil; (A.d.P.M.); (C.M.P.d.R.); (D.C.F.); (G.L.d.S.)
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24
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Saber S, Galal MM, Ismail AG, Hamdy TM. Thermal, chemical and physical analysis of VDW.1Seal, Fill Root ST, and ADseal root canal sealers. Sci Rep 2023; 13:14829. [PMID: 37684307 PMCID: PMC10491594 DOI: 10.1038/s41598-023-41798-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
This study aimed to evaluate the thermal, chemical, and physical properties of VDW.1Seal, Fill Root ST, and ADseal sealers. Thermal properties were analyzed using Thermogravimetric analysis (TGA) and Differential thermal analysis (DTA). Attenuated total reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) analysis was performed as a complementary test to confirm TGA/DTA analysis. The chemical composition of the set sealer material was identified using an X-ray powder diffraction (XRD) system. Other physical properties of each sealer were investigated; ten specimens were used to measure the solubility (at 24 h and 28 days), and another ten specimens were used to assess pH changes and calcium ion release (after 7 and 14 days). Film thickness was done according to ISO 6876 specs. The data were analyzed using the two-way ANOVA test. Results showed that for all sealers, TGA analysis revealed a direct relationship between sealer mass loss and temperature rise. In addition, the decomposition of the tested sealers started at 145 °C, 135 °C and 91 °C for VDW.1Seal, ADseal sealer, and Fill Root ST, respectively. XRD analysis revealed a higher degree of crystallinity for VDW.1Seal and ADseal. ADseal showed the least solubility; VDW.1Seal exhibited the highest alkalinity, calcium ion release, and the lowest film thickness.
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Affiliation(s)
- Shehabeldin Saber
- Endodontic Department, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt.
- Center for Innovative Dental Sciences, The British University in Egypt, El Sherouk City, Egypt.
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
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Ferreira CMA, de Lima CO, Pinto KP, Barbosa AFA, Fidalgo G, Sena G, Colaço MV, Barroso RC, Sassone LM, Silva EJNL. pH influences the volumetric change of calcium silicate- and epoxy resin-based root canal sealers: An ex vivo micro-CT study. AUST ENDOD J 2023; 49 Suppl 1:194-201. [PMID: 36401559 DOI: 10.1111/aej.12716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/01/2022] [Accepted: 11/06/2022] [Indexed: 09/17/2023]
Abstract
This study assessed the influence of pH variation on the volumetric change of EndoSequence BC Sealer compared to AH Plus Jet. Eighteen single-rooted teeth were uniformly prepared and filled with one of the sealers. After 24-h storing, samples were scanned in a micro-CT device. Then, roots were immersed in 20 ml phosphate-buffered saline (PBS) with pH of 5, 7 or 12 at 37°C for 7 and 30 days and rescanned. Statistical analysis was performed using Shapiro-Wilk's test, one-way ANOVA and Tukey's or Student's t-tests (p < 0.05). Differences between sealers were observed only at neutral pH and after 30 days of acidic pH exposure, with a higher loss of EndoSequence (p < 0.05). After 7 days, alkaline pH reduced and increased the volumetric loss of EndoSequence and AH Plus, respectively, compared to neutral pH (p < 0.05). It can be concluded that the pH directly influenced the volumetric change of both tested root canal sealers in different ways.
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Affiliation(s)
| | - Carolina Oliveira de Lima
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Karem Paula Pinto
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Gabriel Fidalgo
- Laboratory of Applied Physics to Biomedical Science, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Gabriela Sena
- Laboratory of Applied Physics to Biomedical Science, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
- Nuclear Engineering Program, COPPE/Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcos Vinicius Colaço
- Laboratory of Applied Physics to Biomedical Science, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Regina Cely Barroso
- Laboratory of Applied Physics to Biomedical Science, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Luciana Moura Sassone
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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26
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Ferreira CMA, de Lima CO, Pinto KP, Barbosa AFA, de Souza JB, De-Deus G, Sassone LM, Silva EJNL. Volumetric changes in root canal sealers in ex vivo and a novel animal model approach. Int Endod J 2023; 56:1108-1117. [PMID: 37254682 DOI: 10.1111/iej.13940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/08/2023] [Accepted: 05/28/2023] [Indexed: 06/01/2023]
Abstract
AIM This study aimed to evaluate the volumetric change of root canal sealers through micro-computed tomographic analysis using a novel in vivo model and to compare the results with those obtained using an ex vivo test. METHODOLOGY Eighteen single-rooted teeth were cut to 5 mm length from the root apex. The root canals were uniformly enlarged and filled with EndoSequence BC Sealer or AH Plus Jet root canal sealers. Samples were stored at 37°C and 95% relative humidity for 24 h and then scanned with a micro-CT device. Twelve samples (n = 6 for each sealer) were implanted in the subcutaneous tissue of Wistar rats, while six samples (n = 3 for each sealer) were immersed in 20 mL of phosphate-buffered saline (PBS) at 37°C at neutral pH. After 7 and 30 days, teeth were removed from subcutaneous tissue or PBS and rescanned. Statistical analysis of volume changes was performed using Shapiro-Wilk's test and independent t-test (p < .05). RESULTS AH Plus Jet had smaller volume changes (-2.2 to +0.77%) than EndoSequence BC Sealer (-2.0 to +4.0%) (p < .05), in the two tested models. The volume of the root canal sealers decreased over time (p < .05), in vivo. AH Plus Jet results varied between the in vivo and ex vivo results (p < .05), while EndoSequence BC Sealer presented similar volume losses for both experimental models (p > .05). CONCLUSION EndoSequence BC Sealer lost more volume than AH Plus Jet. The experimental conditions influenced the volumetric change of AH Plus Jet but not the EndoSequence BC Sealer. The ex vivo model should be further explored as a methodological alternative to assess the volumetric changes of root canal sealers without causing harm to animals.
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Affiliation(s)
| | - Carolina Oliveira de Lima
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Karem Paula Pinto
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Jenif Braga de Souza
- Laboratory of Experimental Surgery, School of Medical Sciences, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - Luciana Moura Sassone
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Emmanuel J N L Silva
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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27
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Falkowska J, Chady T, Dura W, Droździk A, Tomasik M, Marek E, Safranow K, Lipski M. The Washout Resistance of Bioactive Root-End Filling Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5757. [PMID: 37687450 PMCID: PMC10488592 DOI: 10.3390/ma16175757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023]
Abstract
Fast-setting bioactive cements were developed for the convenience of retrograde fillings during endodontic microsurgery. This in vitro study aimed to investigate the effect of irrigation on the washout of relatively fast-setting materials (Biodentine, EndoCem Zr, and MTA HP) in comparison with MTA Angelus White and IRM in an apicectomy model. Washout resistance was assessed using artificial root ends. A total of 150 samples (30 for each material) were tested. All samples were photographed using a microscope, and half of them were also scanned. The samples were irrigated and immersed in saline for 15 min. Then the models were evaluated. Rinsing and immersing the samples immediately after root-end filling and after 3 min did not disintegrate the fillings made of all tested materials except Biodentine. Root-end fillings made of Biodentine suffered significant damage both when rinsing was performed immediately and 3 min after the filling. Quantitative assessment of washed material resulted in a slight loss of IRM, EndoCem MTA Zr, and MTA HP. MTA Angelus White showed a slightly greater washout. Rinsing and immersion of Biodentine restorations resulted in their significant destruction. Under the conditions of the current study, the evaluated materials, excluding Biodentine, showed good or relatively good washout resistance.
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Affiliation(s)
- Joanna Falkowska
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (W.D.); (E.M.)
| | - Tomasz Chady
- Faculty of Electrical Engineering, West Pomeranian University of Technology in Szczecin, Sikorsky 37 St., 70-313 Szczecin, Poland;
| | - Włodzimierz Dura
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (W.D.); (E.M.)
| | - Agnieszka Droździk
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (A.D.); (M.T.)
| | - Małgorzata Tomasik
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (A.D.); (M.T.)
| | - Ewa Marek
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (W.D.); (E.M.)
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland;
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Al. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (W.D.); (E.M.)
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Küçükkaya Eren S. Clinical applications of calcium silicate-based materials: a narrative review. Aust Dent J 2023; 68 Suppl 1:S96-S109. [PMID: 37885314 DOI: 10.1111/adj.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.
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Affiliation(s)
- S Küçükkaya Eren
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
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29
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Pinto APDS, França FMG, Basting RT, Turssi CP, Rodrigues Júnior JJ, Amaral FLB. Effect of endodontic sealers on push-out bond strength of CAD-CAM or prefabricated fiber glass posts. Braz Oral Res 2023; 37:e052. [PMID: 37255072 DOI: 10.1590/1807-3107bor-2023.vol37.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 06/02/2022] [Indexed: 06/01/2023] Open
Abstract
This study aimed to evaluate the effect of endodontic sealer (ES) on bond strength (BS) of prefabricated or milled-CAD-CAM (computer-aided design and computer-aided manufacturing) glass-fiber-posts (GFP). Canals of 90 single-rooted teeth were prepared for filling by the single-cone technique with gutta-percha and one of the following ES: AH Plus (epoxy resin), Endofill (zinc-oxide and eugenol), and Bio-C Sealer (calcium-silicate). After post-space preparation, tooth-specimens were equally divided in half according to type of GFP to be used. In the half to receive milled-CAD-CAM posts, tooth specimens were molded with acrylic resin to obtain replicas. These were scanned to enable the laboratory to produce the milled-CAD-CAM GFPs (Fiber CAD Lab, Angelus) by the subtractive technique. The other half of samples received prefabricated GFPs (Exacto, Angelus) (n=15). The GFPs were cemented with dual-cure resin cement (Panavia F2.0, Kuraray). Each root was sectioned into two slices per root region (cervical, middle, apical) that were subjected to the push-out BS test, in a universal testing machine. Failure mode (FM) was classified by scores. The BS data were submitted to generalized linear model analyses, while FM was analyzed using the chi-square test (a=0.05). BS showed no significant difference among the three ES (p > 0.05). BS was significantly higher for prefabricated (mean 10.84 MPa) versus milled-CAD-CAM GFPs (mean 6.94 MPa) (p <0.0001), irrespective of ES. The majority showed mixed failures. It could be concluded that type of ES did not affect BS of GFPs to dentin, and prefabricated-GFPs had higher bond-strength than customized-milled-CAD-CAM GFPs.
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Affiliation(s)
- Andréa Pereira de Souza Pinto
- Instituto de Pesquisas São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Department of Restorative Dentistry, Campinas, SP, Brazil
| | - Fabiana Mantovani Gomes França
- Instituto de Pesquisas São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Department of Restorative Dentistry, Campinas, SP, Brazil
| | - Roberta Tarkany Basting
- Instituto de Pesquisas São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Department of Restorative Dentistry, Campinas, SP, Brazil
| | - Cecilia Pedroso Turssi
- Instituto de Pesquisas São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Department of Restorative Dentistry, Campinas, SP, Brazil
| | | | - Flávia Lucisano Botelho Amaral
- Instituto de Pesquisas São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Department of Restorative Dentistry, Campinas, SP, Brazil
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30
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Ashkar I, Sanz JL, Forner L, Melo M. Calcium Silicate-Based Sealer Dentinal Tubule Penetration-A Systematic Review of In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2734. [PMID: 37049028 PMCID: PMC10096084 DOI: 10.3390/ma16072734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
The aim of this systematic review was to perform a qualitative synthesis of in vitro studies which evaluate and compare the penetration of calcium silicate-based sealers into dentinal tubules. A systematic advanced search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases on the 1 December 2022. In vitro studies that compared the tubular penetration of at least two calcium silicate-based sealers in extracted human teeth were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias included studies. The search identified a total of 680 preliminary records, among which 12 studies were eligible for review. The most used methodology to evaluate sealer penetration was the use of a fluorochrome together with the tested sealers and the analysis of their penetration under confocal laser microscopy. Regarding the results of the included studies, calcium silicate-based sealers exhibit a favorable dentinal tubule penetration. Tubular penetration, however, can be affected by factors such as the irrigation protocol, sealer activation, the filling method used, and root canal morphology. EndoSequence BC Sealer showed the highest sealer penetration among the tested sealers. The influence of different fluorochromes on the results of dentinal tubule penetration studies should also be further explored. The in vitro nature of the included studies limits the applicability of the results into the clinical setting. Prospero registration: CRD42022383896.
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Janini ACP, Pelepenko LE, Boldieri JM, dos Santos VAB, da Silva NA, Raimundo IM, Gomes BPFA, Marciano MA. Biocompatibility analysis in subcutaneous tissue and physico-chemical analysis of pre-mixed calcium silicate–based sealers. Clin Oral Investig 2023; 27:2221-2234. [PMID: 36977761 DOI: 10.1007/s00784-023-04957-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To evaluate the biocompatibility, physical and chemical properties of three pre-mixed calcium silicate-based sealers and an epoxy resin-based material were assessed. Pre-mixed sealers supposedly obtain water from the root canal moist to hydrate and set. MATERIALS AND METHODS Polyethylene tubes were filled with the materials Bio-C Sealer Ion+, Bio-C Sealer, EndoSequence BC Sealer and AH Plus Jet, or left empty and surgically implanted in the subcutaneous tissue of Wistar rats. The animals were euthanised and the tubes and tissue were removed for histological analysis and scanning electron microscopy (SEM) coupled with energy-dispersive spectrometry (EDS). Materials' surface chemical characterisation was assessed using Raman spectroscopy and SEM/EDS. Flow, setting time (in two conditions), solubility, radiopacity and pH were also analysed. ANOVA and Bonferroni correction were performed for comparisons (P < 0.05). RESULTS Inflammatory response observed in the tissues subsided from 7 to 30 days. Tungsten migration could be detected in the surrounding tissue following AH Plus Jet implantation. All calcium silicate-based sealers exhibited zirconium oxide (radiopacifier) and tricalcium silicate peaks before and after implantation. All materials exhibited flow values above 17 mm. An approximately tenfold difference was observed between the plaster- and metal-mould setting times of the calcium silicate cements indicating its sensitivity to moist variations and solubility above 8% was also observed for these materials. CONCLUSIONS Pre-mixed materials exhibited variable setting time and solubility with a decreasing inflammatory response. CLINICAL RELEVANCE The variable moist-dependant setting time with high solubility poses a concern for the clinical use of these pre-mixed sealers.
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Girelli CFM, de Lima CO, Silveira FF, Lacerda MFLS, Nunes E. Marginal gaps and voids using two warm compaction techniques and different sealers: a micro-CT study. Clin Oral Investig 2023:10.1007/s00784-023-04866-x. [PMID: 36695972 DOI: 10.1007/s00784-023-04866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the percentage of marginal gaps and voids in oval-shaped canals obturated by using two warm compaction techniques with a Bio-C sealer and AH Plus Jet. MATERIALS AND METHODS Forty canines with oval canals were scanned by microcomputed tomography (micro-CT), and root canal preparation was performed with an XP-endo Shaper system and irrigated with 5.25% sodium hypochlorite. Then, the specimens were paired into four groups (n=10) according to the root canal filling technique and endodontic sealer: Bio-C sealer and continuous wave of condensation, Bio-C sealer and Tagger's hybrid, AH Plus Jet and continuous wave of condensation, and AH Plus Jet and Tagger's hybrid. After root canal filling, a new scan was performed. The percentage of marginal gaps and voids was calculated with the ImageJ software, and the data were analyzed statistically using two-way ANOVA and Tukey tests, with a significance level of 5%. RESULTS The percentage of marginal gaps was significantly lower in the Bio-C sealer than in AH Plus Jet (p=0.021) regardless of the technique. However, no difference was found in the percentage of voids between root canal filling techniques and the endodontic sealer (p>0.05). CONCLUSION Both sealers and techniques demonstrated good quality of root canal filling. However, the use of the Bio-C sealer enhanced the filling ability by reducing marginal gaps, regardless of the root canal filling technique. CLINICAL RELEVANCE This study highlights the better performance of the Bio-C sealer in the quality of the root canal filling, reducing marginal gaps when compared to AH Plus Jet independent of the technique.
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Affiliation(s)
| | - Carolina Oliveira de Lima
- Department of Dentistry, Federal University of Juiz de Fora, R. São Paulo, 745 - Centro, Governador Valadares, Minas Gerais, 35010-180, Brazil
| | - Frank Ferreira Silveira
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
| | | | - Eduardo Nunes
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
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Llena C, Herrero A, Lloret S, Barraza M, Sanz JL. Effect of calcium silicate-based endodontic sealers on tooth color: A 3-year in vitro experimental study. Heliyon 2023; 9:e13237. [PMID: 36755620 PMCID: PMC9900268 DOI: 10.1016/j.heliyon.2023.e13237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/13/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
Objective To analyze the change in tooth color produced by two hydraulic and one resin-based sealers by means of spectrophotometry for 3 years. Methods Forty maxillary anterior teeth were selected (n = 10 per group). Root canals were prepared by rotary instrumentation and irrigation was performed with NaOCl, which was also used in the final irrigation, followed by saline and activated with Endoactivator. Root canals were then filled using single cone technique. Negative control (NC): gutta-percha filling; Positive control: gutta-percha and AH Plus; experimental groups: gutta-percha and Bioroot RCS/TotalFill BC Sealer. Gutta-percha was cut 2 mm below the cementoenamel junction, the pulp chamber was sealed with flowable composite. The teeth were kept in PBS. Color was measured in the cervical and incisal halves before root canal treatment (RCT), one and six months after RCT, and after one, two and three years, with the Vita EasyShade spectrophotometer; positioned using an individualized splint. ΔEab and ΔE00 were calculated. Two-way ANOVA repeated measures test followed by Bonferroni post-test were performed to analyze the ΔL, Δa*, Δb*, ΔEab, and ΔE00, considering treatment groups and evaluation periods. Statistical significance was set at p < 0.05. Results In the incisal half, in decreasing order of darkening, the groups at three years were ordered according to the ΔEab: AH Plus > NC > TotalFill > Bioroot. ΔE00 values were: 1.38 ± 0.61 NC, 2.37 ± 0.70 AH Plus, 1.86 ± 0.60 BioRoot and 1.53 ± 0.85 TotalFill. In the cervical half, the ΔEab values, showed the same descending order, except for Bioroot and TotalFill which alternated the order. The ΔE00 values were 1.86 ± 0.61 NC, 3.01 ± 0.70 AH Plus,1.89 ± 0.58 Bioroot and 1.65 ± 0.41 TotalFill, with no significant differences between groups and times in both locations. Conclusions All groups presented some degree of discoloration. Lightness and b* component were the most influential. Calcium silicate-based cements (Bioroot RCS and TotalFill BC Sealer) produced acceptable levels of discoloration at the end of follow-up.
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Kumar A, Kour S, Kaul S, Malik A, Dhani R, Kaul R. Cytotoxicity evaluation of Bio-C, CeraSeal, MTA - Fillapex, and AH Plus root canal sealers by microscopic and 3-(4, 5 dimethythiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. J Conserv Dent 2023; 26:73-78. [PMID: 36908731 PMCID: PMC10003288 DOI: 10.4103/jcd.jcd_320_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/25/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Abstract
Aim The aim of this study was to compare the cytotoxic effect of calcium silicate-based Bio-C, CeraSeal, and mineral trioxide aggregate (MTA)-based (MTA-Fillapex) sealers to a widely used resin-based sealer (AH Plus) using 3-(4, 5 dimethythiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and microscopic examination. Materials and Methods A total of (n = 36) samples divided into four groups with three sealer samples per time period of 0 h, 24 h, and 7 days after mixing were extracted in cell culture medium using Dulbecco's Modified Eagle's Medium. The cytotoxicity of these sealers was evaluated using an MTT assay on L929 mouse fibroblasts, and changes in the cell morphology were observed under an inverted phase-contrast microscope (×20). The values obtained were analyzed statistically using one-way ANOVA, Tukey's post hoc, and Bonferroni's test. Results Bio-C and CeraSeal showed a reduction in cytotoxicity from severe at 0 h to no cytotoxicity at 24 h and 7 day time period. AH Plus showed severe cytotoxicity at all time periods. MTA-Fillapex showed severe cytotoxicity at 0 h which decreased to moderate at 24 h and 7 days. The differences between groups were statistically significant (P < 0.05). Conclusions The sealers with resin constituents (AH Plus and MTA-Fillapex) showed severe-to-moderate cytotoxicity at different time periods, whereas calcium silicate-based sealers (Bio-C and CeraSeal) were relatively biocompatible as their cytotoxicity decreased significantly from severe initially to noncytotoxic with time.
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Affiliation(s)
- Ajay Kumar
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Sukhbir Kour
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Shalan Kaul
- Department of Paediatric and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Azhar Malik
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Rachna Dhani
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Rudra Kaul
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
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Koo J, Kwak SW, Kim HC. Differences in setting time of calcium silicate-based sealers under different test conditions. J Dent Sci 2022. [DOI: 10.1016/j.jds.2022.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111853. [PMID: 36430988 PMCID: PMC9697500 DOI: 10.3390/life12111853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
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Janini ACP, Pelepenko LE, Gomes BPFA, Marciano MA. Physico-chemical properties of calcium silicate-based sealers in powder/liquid and ready-to-use forms. Braz Dent J 2022; 33:18-25. [PMID: 36287495 PMCID: PMC9645167 DOI: 10.1590/0103-6440202204832] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/26/2022] [Indexed: 12/05/2022] Open
Abstract
Calcium silicate-based root canal sealers have been developed in powder/liquid or premixed ready-to-use forms. The evaluation of the physico-chemical properties of a prototype powder/liquid MTApex Sealer (Ultradent) in comparison to a ready-to-use material EndoSequence BC Sealer (Brasseler) was performed. The paste/paste epoxy resin-based AH Plus (Dentsply) served as control for comparisons. The sealers were evaluated (n = 6) regarding setting time (in dry and moist environments), flow and radiopacity, following the ISO-6876/2012 standard. Also, the pH was assessed. Material's surface and chemical characterization was evaluated using scanning-electron-microscopy (SEM) and energy-dispersive-spectrometry (EDS). Mixed ANOVA, Shapiro-Wilk, Levene, and post-hoc analysis with Bonferroni correction were performed at a significance level of 5%. MTApex Sealer exhibited the highest flow and EndoSequence BC Sealer had a significantly longer setting time in dry compared to the moist environment; however, for MTApex Sealer and AH Plus no significant changes occurred when additional moisture was provided. All materials exceeded 7 mm Al of radiopacity and showed a decreasing alkalinity over the 21 day-analysis. SEM/EDS evaluation resulted in peaks of calcium, silicon, and the respective radiopacifier. The prototype powder/liquid MTApex Sealer had the highest flow and similar setting time in both dry and moist environments; opposingly, EndoSequence BC Sealer was crucially influenced by external moisture. This suggests that the powder/liquid materials' setting seems to be more predictable.
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Affiliation(s)
- Ana C P Janini
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Lauter E Pelepenko
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Marina A Marciano
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
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Bilvinaite G, Drukteinis S, Brukiene V, Rajasekharan S. Immediate and Long-Term Radiopacity and Surface Morphology of Hydraulic Calcium Silicate-Based Materials. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6635. [PMID: 36233978 PMCID: PMC9572346 DOI: 10.3390/ma15196635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to evaluate and compare the radiopacity and surface morphology of AH Plus Bioceramic Sealer (AHPB), Bio-C Sealer (BIOC), Biodentine (BD), BioRoot RCS (BR), Grey-MTAFlow (GMF), White-MTAFlow (WMF), TotalFill BC Sealer (TF), and TotalFill BC Sealer HiFlow (TFHF) at different time moments—30 min, 24 h, and 28 days. Ten specimens of each material were prepared according to the ISO-6876:2012 standard and radiographed next to an aluminum step wedge using a digital sensor. The specimens were stored in a gelatinized Hank’s balanced salt solution at 37 °C between assessments. The mean grayscale values of each specimen were converted into equivalent aluminum thickness by a linear regression model. Characterization of the surface morphology was performed by using a scanning electron microscope at ×4.0k and ×10.0k magnifications. The radiographic analysis revealed that all the tested materials exceeded the ISO-specified limit of 3 mm Al, with the highest radiopacity presented by AHPB and the lowest by BD. None of the tested materials demonstrated considerable variances between the 30 min and the 24 h radiopacity level (p < 0.05), and statistically significant long-term radiopacity changes were exhibited by BR, TFHF, and TF (p > 0.05). All the specimens demonstrated a common feature of limited precipitate formation, with numerous unreacted particles still presented on the surface after 24 h, whereas the particle rearrangement and the deposition of precipitates were clearly observed after 28 days.
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Affiliation(s)
- Goda Bilvinaite
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania
| | - Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania
| | - Vilma Brukiene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania
| | - Sivaprakash Rajasekharan
- Department of Paediatric Dentistry, School of Oral Health Sciences, Ghent University, B-9000 Ghent, Belgium
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Saavedra FM, Pelepenko LE, Boyle WS, Zhang A, Staley C, Herzberg MC, Marciano MA, Lima BP. In vitro physicochemical characterization of five root canal sealers and their influence on an ex vivo oral multi-species biofilm community. Int Endod J 2022; 55:772-783. [PMID: 35383959 PMCID: PMC9321831 DOI: 10.1111/iej.13742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/14/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the physicochemical properties of five root canal sealers and assess their effect on an ex vivo dental plaque-derived polymicrobial community. METHODOLOGY Dental plaque-derived microbial communities were exposed to the sealers (AH Plus [AHP], GuttaFlow Bioseal [GFB], Endoseal MTA [ESM], Bio-C sealer [BCS] and BioRoot RCS [BRR]) for 3, 6 and 18 h. The sealers' effect on the biofilm biomass and metabolic activity was quantified using crystal violet (CV) staining and MTT assay, respectively. Biofilm community composition and morphology were assessed by denaturing gradient gel electrophoresis (DGGE), 16S rRNA sequencing and scanning electron microscopy. The ISO6876:2012 specifications were followed to determine the setting time, radiopacity, flowability and solubility. Obturated acrylic teeth were used to assess the sealers' effect on pH. Surface chemical characterization was performed using SEM with coupled energy-dispersive spectroscopy. Data normality was assessed using the Shapiro-Wilk test. One-way anova and Tukey's tests were used to analyze data from setting time, radiopacity, flowability and solubility. Two-way anova and Dunnett's tests were used for the data analysis from CV, MTT and pH. 16S rRNA sequencing data were analyzed for alpha (Shannon index and Chao analysis) and beta diversity (Bray-Curtis dissimilarities). Differences in community composition were evaluated by analysis of similarity (p < .05). RESULTS The sealers significantly influenced microbial community composition and morphology. All sealers complied with ISO6876:2012 requirements for setting time, radiopacity and flowability. Although only AHP effectively reduced the biofilm biomass, all sealers, except BRR, reduced biofilm metabolic activity. CONCLUSION Despite adequate physical properties, none of the sealers tested prevented biofilm growth. Significant changes in community composition were observed. If observed in vivo, these changes could affect intracanal microbial survival, pathogenicity and treatment outcomes.
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Affiliation(s)
- Flavia M. Saavedra
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Lauter E. Pelepenko
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | - William S. Boyle
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Anqi Zhang
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB)School of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Christopher Staley
- Division of Basic & Translational ResearchDepartment of SurgeryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Mark C. Herzberg
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Marina A. Marciano
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | - Bruno P. Lima
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
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De-Deus G, Santos GO, Monteiro IZ, Cavalcante DM, Simões-Carvalho M, Belladonna FG, Silva EJNL, Souza EM, Licha R, Zogheib C, Versiani MA. Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals. Int Endod J 2022; 55:795-807. [PMID: 35383977 DOI: 10.1111/iej.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To assess the interfacial adaptation (gap-containing areas) of two root canal sealers (EndoSequence BC Sealer and AH Plus) to a conventional gutta-percha (GP) cone (GP-sealer interface) in oval-shaped canals filled using the single cone technique. METHODOLOGY Sixteen teeth with oval-shaped canals were selected, scanned in a micro-computed tomographic device, and pair-matched according to the volume, aspect ratio and configuration of root canals. Root canals were then sequentially prepared with WaveOne Gold Primary and Large instruments, followed by filling with WaveOne Large GP points associated with either the premixed calcium-silicate EndoSequence BC Sealer or the epoxy resin-based AH Plus sealer (n = 8 per group) using the single cone technique. After 7 days stored in phosphate-buffered saline solution at 37°C, the specimens were rescanned and the reconstructed images segmented in order to differentiate the filling materials (sealer and GP cone) to the dentine. A total of 453 cross-sectional slices were assessed and categorized according to the presence or absence of gaps at the GP-sealer interface. Mann-Whitney U-test verified the differences between groups and were considered significant at alpha = 5%. RESULTS Gaps were non-homogenously distributed in two-dimensional axial cross-section images and none of the specimens showed completely gap-free areas along the entire GP-sealer interface. Root canals filled with EndoSequence BC Sealer and AH Plus displayed 171 (37.75%) and 136 (30.02%) slices with gaps in the GP-sealer interface and these frequencies were statistically significant (p = .000). CONCLUSIONS Although none of the specimens had a gap-free area along the entire GP-sealer interface, oval canals filled with AH Plus showed less gaps than the ones filled with EndoSequence BC Sealer.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - Gustavo O Santos
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | | | | | | | | | | | - Erick M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Raphael Licha
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marco A Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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Rosatto CMPD, Souza GLD, Ferraz DC, Silva MJB, Tanomaru Filho M, Moura CCG. Physicochemical properties and osteoclastogenesis for three premixed calcium silicate-based sealers post set. Braz Oral Res 2022; 36:e065. [PMID: 36507752 DOI: 10.1590/1807-3107bor-2022.vol36.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Solubility, pH, ion release, cytotoxicity, and osteoclastogenesis inhibition in bone marrow-derived monocyte macrophages (BMMs) were evaluated in EndoSequence BC Sealer (END), Bio-C Sealer (BC), and Sealer Plus BC (SPBC). pH was determined after immersion of the sealers in deionized water (DW) and Minimum Essential Medium Alpha (α-MEM). Solubility was obtained by mass loss. Ion release was measured by using X-ray fluorescence spectroscopy (XRF). Cytotoxicity was evaluated by MTT assay. Inhibition of osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP). Data were analyzed using the t-test, ANOVA and Tukey/Dunnett's post-hoc tests (α = 0.05). END had the highest pH in DW (p < 0.05), and BC, in α-MEM (p < 0.05). Solubility in DW was the lowest for SPBC (p < 0.005). The highest calcium release was observed for BC in DW at 12 h (p < 0.05), and in α-MEM at 12 and 24 h (p < 0.05). The lowest toxicity was detected for END (p < 0.05). BC had the highest inhibitory effect on osteoclasts (p < 0.05). Overall, the highest solubility and pH values were found in DW. However, the calcium silicate-based sealer showed higher solubility than the ISO standards. Calcium release was the highest for BC. END showed the highest cell viability, and BC, the highest osteoclast inhibition.
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Affiliation(s)
| | - Gabriela Leite de Souza
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Endodontics, Uberlândia, MG, Brazil
| | - Danilo Cassiano Ferraz
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Marcelo José Barbosa Silva
- Universidade Federal de Uberlândia - UFU, Institute of Biomedical Sciences, Department of Immunology, Uberlândia, MG, Brazil
| | - Mario Tanomaru Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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Nesello R, Silva IA, Bem IAD, Bischoff K, Souza MA, Só MVR, Rosa RAD. Effect of bioceramic root canal sealers on the bond strength of fiber posts cemented with resin cements. Braz Dent J 2022; 33:91-98. [PMID: 35508041 PMCID: PMC9645158 DOI: 10.1590/0103-6440202204529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 02/25/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the influence of calcium silicate-based sealers on
the bond strength of fiber posts using conventional and self-adhesive resin
cement. Sixty single-rooted teeth were selected. The canals were prepared with a
reciprocating instrument 40.06. The roots were randomly distributed in six
groups (n = 10) according to the strategies for root canal filling and fiber
posts cementation: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX
ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; and Sealer Plus
BC/RelyX U200. The roots were transversally sectioned, and one slice per
post-third was obtained. The push-out test was performed at a crosshead speed of
1mm/min. The failure patterns were described after assessment with a
stereomicroscope with a 10× magnification. Bond strength was calculated and
analyzed using the ANOVA and Tukey test. AH Plus did not influence the bond
strength of fiber posts cemented with conventional (RelyX ARC) or with
self-adhesive resin cement (RelyX U200). The lowest bond strength values were
obtained when calcium silicate-based sealers were associated with conventional
resin cement (Bio C Sealer/RelyX ARC and Sealer Plus BC/RelyX ARC). Except for
Sealer Plus BC/RelyX ARC, all groups presented lower bond strength at the apical
portion compared to the cervical portion of the post. Adhesive failures between
cement and post and cement and dentin were predominant (55.3%). Calcium
silicate-based sealers decreased the bond strength of fiber posts cemented with
conventional resin cement.
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The Effect of Sealer Application Methods on Voids Volume after Aging of Three Calcium Silicate-Based Sealers: A Micro-Computed Tomography Study. Tomography 2022; 8:778-788. [PMID: 35314641 PMCID: PMC8938853 DOI: 10.3390/tomography8020064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/12/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
During obturation, air voids are undesirable as they may provide shelter for microorganisms or passage for fluids. This study aimed to compare the occurrence of voids between three calcium silicate-based sealers (CSBSs) (MTA-Fillapex, BioRoot-RCS, Bio-C) and the change in their volume after aging. In addition, we aimed to compare voids when using two sealer application methods: lentulo-spiral (LS) and gutta-percha (GP) cone. Thirty extracted mandibular premolars (n = 30) were endodontically prepared and obturated using single GP cone (SGPC) technique. Each sealer was applied to 10 teeth (n = 10) using LS or GP. Micro-computed tomography (micro-CT) was used to quantify the volume of root filling and voids before and after 8-week storage in a phosphate-rich medium. The percentage of root filling and voids were compared between the groups using a Mann–Whitney U test and Kruskal–Wallis test with a Bonferroni correction. Before aging, the percentages of root filling volume after obturation were comparable with no significant differences between sealers (p = 0.325) or application methods (p = 0.950). After aging, the voids’ volume increased significantly in all sealers (p ≤ 0.05). However, no significant differences were found between sealers (p = 0.302). In conclusion, voids in CSBSs may not reduce in size with aging; hence, SGPC should be carefully selected for suitable cases.
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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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SILVA EM, ALCALDE MP, VIVAN RR, POMINI M, TANOMARU-FILHO M, DUARTE MAH. Evaluation of in vitro experimental model for analysis of bioceramic sealers. Braz Oral Res 2022; 36:e100. [DOI: 10.1590/1807-3107bor-2022.vol36.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
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Malta C, Silva Barcelos R, Segat H, Burger M, Souza Bier C, Morgental R. Toxicity of bioceramic and resinous endodontic sealers using an alternative animal model: Artemia salina. J Conserv Dent 2022; 25:185-188. [PMID: 35720815 PMCID: PMC9205353 DOI: 10.4103/jcd.jcd_401_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 01/19/2022] [Indexed: 11/21/2022] Open
Abstract
Aims: The present study assessed the toxicity of a novel calcium silicate-based root canal sealer (Bio-C Sealer) in comparison to Endosequence BC Sealer and AH Plus through a lethality assay involving brine shrimp (Artemia salina). Methods: Brine shrimp cysts were incubated for 24 h for the hatching of the larvae, which were then exposed to different concentrations (2.5, 5, 10, 20, 40, 80, and 100 μg/mL) of the test endodontic sealers for 24 h, followed by the determination of the survival rate. Statistical Analysis Used: One-way repeated-measures ANOVA and the Newman–Keuls post hoc test were used to compare the different materials as well as different concentrations of the same material. Dunnett's test was used to compare the different concentrations and different sealers to the control. The lethal concentration of each endodontic sealer necessary to kill 50% of the brine shrimp larvae (LC50) was also determined. Results: The toxicity of Bio-C (10, 20, 40, 80, and 100 μg/mL) and Endosequence BC Sealer (20, 80, and 100 μg/mL) was lower than that of AH Plus. No significant difference was found between Bio-C and Endosequence BC Sealer or among the different intragroup concentrations of these sealers. In the AH Plus group, concentrations ≥5.0 μg/mL exhibited greater toxicity compared to the concentration of 2.5 μg/mL and the control. AH Plus had the lowest LC50 (59.95 μg/mL), whereas Bio-C and Endosequence BC Sealer had LC50 values >200 μg/mL. Conclusions: Bio-C Sealer proved to be less toxic than AH Plus and exhibited similar toxicity to that of Endosequence BC Sealer.
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Aravelli S, Veeramachaneni C, Dundigalla S. Comparative evaluation of push-out bond strength of bioceramic and epoxy sealers after using various final irrigants: An in vitro study. J Conserv Dent 2022; 25:145-150. [PMID: 35720830 PMCID: PMC9205351 DOI: 10.4103/jcd.jcd_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 11/06/2022] Open
Abstract
Aim: The aim of the study is to compare the push-out bond strength of bioceramic and epoxy sealers after using various final irrigants. Materials and Methods: Hundred single-rooted teeth were divided into two groups (n = 50) according to the sealer used: Group A: Bio C (bioceramic sealer), Group B: Dia-Proseal (epoxy sealer). Each group was subdivided into five subgroups (n = 10) according to the final irrigation protocol: Group A1 and B1 – 5% glycolic acid (GA), Group A2 and B2 – 17% GA, Group A3 and B3 – 0.2% chitosan, Group A4 and B4 – 17% ethylenediaminetetraacetic acid, and Group A5 and B5 – 0.9% saline. Samples were obturated in combination with one of the mentioned sealers and were allowed to set for 1 week. Two horizontal slices were obtained from each sample and subjected to push-out test. Statistical Analysis: The data were statistically analyzed using two-way ANOVA and independent Student's t-test. Results: Both the sealers exhibited higher push-out bond strength after treatment with GA with no significant difference between 5% and 17% GA. Bio C sealer with GA as final irrigant showed higher bond strength than Dia-Proseal (P < 0.05). Conclusion: The push-out bond strength of the sealer was significantly affected by the final irrigation solution used. The highest push-out bond strength was seen with Bio C sealer after treatment with GA with no significant difference between 5% and 17% GA.
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Demirci GK, Kaval ME, Kurt SM, Serefoglu B, Güneri P, Hülsmann M, Caliskan MK. Energy-Dispersive X-Ray Spectrometry Analysis and Radiopacity of Five Different Root Canal Sealers. Braz Dent J 2021; 32:1-11. [PMID: 34877971 DOI: 10.1590/0103-6440202104638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/29/2021] [Indexed: 11/21/2022] Open
Abstract
Root canal sealers should have optimum adhesion to the root dentin, low cytotoxicity, sufficient radiopacity and high dimensional stability, which depend mainly on their chemical composition. The aims of this study were to evaluate the chemical composition of Syntex (Cerkamed, Stalowa Wola, Poland), Adseal (Meta Biomed, Cheongju-si, Korea), Sealapex (SybronEndo, Scafati, Italy), MTA Fillapex (Angelus, Londrina, Brazil) and GuttaFlow Bioseal (Coltene/Whaledent, Altstätten, Switzerland) and to determine their radiopacity comparatively. Stainless steel molds with an inner diameter of 5 mm and a depth of 2 mm were constructed. Tested root-canal sealers were mixed and poured into the molds. Following setting, digital periapical radiographs of the specimens (n=12) were taken under standard exposure conditions and the mean gray-values of specimens were measured using a computer graphics program. Then the specimens were examined by scanning electron microscopy, and Energy-dispersive X-ray analysis was performed. The data were analyzed using One-way ANOVA followed by Holm-Sidak multi-comparison test (p = 0.05). Sealapex showed higher calcium peak than MTA Fillapex, GuttaFlow Bioseal, Adseal and Syntex sealers. MTA Fillapex contained a highest amount of tungstate. Sealapex presented the highest radiopacity value among the tested materials (p < 0.05), whereas MTA Fillapex was the least radiopaque material (p < 0.05). Each root canal sealer contains different compositions of radiopacifiers including bismuth oxide, calcium tungstate and zirconium oxide. The tested root canal sealers had radiopacity values above the ISO-specified limit. Sealapex was the most radiopaque root canal sealer followed by GuttaFlow Bioseal, Syntex, Adseal and MTA Fillapex.
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Affiliation(s)
| | - Mehmet Emin Kaval
- Department of Endodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | | | - Burcu Serefoglu
- Department of Endodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Michael Hülsmann
- Department of Operative Dentistry, Periodontology and Cariology, Faculty of Dentistry, University of Göttingen, Göttingen, Germany
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Zordan-Bronzel CL, Tanomaru-Filho M, Torres FFE, Chávez-Andrade GM, Rodrigues EM, Guerreiro-Tanomaru JM. Physicochemical Properties, Cytocompatibility and Antibiofilm Activity of a New Calcium Silicate Sealer. Braz Dent J 2021; 32:8-18. [PMID: 34787254 DOI: 10.1590/0103-6440202103314] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/16/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the physicochemical properties, cytocompatibility and antibiofilm activity of a new calcium silicate-based endodontic sealer, Sealer Plus BC (MK Life, Brazil), in comparison with TotalFill BC Sealer (FKG Dentaire SA, Switzerland) and AH Plus (Dentsply, Germany). Setting time and flow were evaluated based on ISO 6876 standard. The pH was evaluated after different periods, and radiopacity by radiographic analysis (mmAl). Solubility (% mass loss) and volumetric change (by micro-CT) were assessed after 30 days of immersion in distilled water. Cytocompatibility was assessed by methyltetrazolium (MTT) and neutral red (NR) assays, after exposure of Saos-2 cells to the sealer extract for 24 h. An additional analysis was performed by using MTT assay after 1, 3 and 7 days of exposure of Saos-2 to the sealers 1:8 dilution extracts. Antibiofilm activity against Enterococcus faecalis and/or Candida albicans was evaluated by crystal violet assay and modified direct contact test. The physicochemical properties were analyzed using ANOVA/Tukey tests; MTT and NR data were analyzed by ANOVA and Bonferroni tests; the antimicrobial tests were analyzed by Kruskal-Wallis and Dunn tests (α=0.05). Sealer Plus BC had proper setting time, radiopacity, flow and alkalization capacity. Sealer Plus BC was significantly more soluble than AH Plus (p<0.05) and presented volumetric change similar to AH Plus and TotalFill BC (p>0.05). Sealer Plus BC presented antibiofilm activity and no cytotoxic effect. In conclusion, although Sealer Plus BC had higher solubility, this sealer showed proper physicochemical properties, cytocompatibility, and antibiofilm activity.
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Affiliation(s)
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Elisandra Marcia Rodrigues
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Yehia M, Mohamed M, Ibrahim L, Moukarab D. Effect of Different Treatment Regimen and Types of Endodontic Sealers on Pain and Periapical Radiographic Changes. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION: The study aims as a pilot study to evaluate the effect of different treatment regimen and different types of endodontic sealers on pain and periapical radiographic changes was studied.
MATERIALS AND METHODS: Forty patients in need of an endodontic root canal treatment on anterior teeth were selected and divided into two groups (20 patients each), according to the endodontic treatment protocol (single or multiple visits). Then, each group was subdivided into two subgroups according to sealer used 10 each (AH Plus Jet resin sealer, Total Fill Bioceramic Sealer). To record pain intensity of the patients at different intervals: 1, 2, 3, 7 days, a visual analog scale was used. Furthermore, patients were recalled after 1, 3, 6, 9 months to evaluate periapical radiographic changes.
RESULTS: Showed that as regard pain assessment both tested endodontic sealers, as well as single or multiple visits have no statistically significant difference between pain values of patients during all the observation period from immediately post-operative, after 4, 12, 24, 48, 72 h as well as after 7 days (p > 0.05). As regard lamina dura thickness, results showed that with both tested endodontic sealers as well as single or multiple visits, there was no statistically significant difference between lamina dura thickness of patients after 1 month, 3, 6 as well as after 9 months.
CONCLUSIONS: Neither number of visits of endodontic treatment nor type of sealer used for obturation affects post-operative pain and thickness of lamina dura.
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