Microleakage evaluation of intraorifice sealing materials in endodontically treated teeth

Microleakage Evaluation of Temporary Restorations Used in Endodontic Treatment-An Ex Vivo Study

(1) Background: Coronal microleakage can lead to endodontic treatment failure. This study aimed to compare the sealing ability of different temporary restorative materials used during endodontic treatment. (2) Methods: Eighty sheep incisors were collected, uniformized in length, and access cavities were performed, except for in the negative control group, where the teeth were left intact. The teeth were divided into six different groups. In the positive control group, the access cavity was made and left empty. In the experimental groups, access cavities were restored with three different temporary materials (IRM^®, Ketac™ Silver, and Cavit™) and with a definitive restorative material (Filtek Supreme™). The teeth were submitted to thermocycling, and two and four weeks later, they were infiltrated with ^99mTcNaO₄, and nuclear medicine imaging was performed. (3) Results: Filtek Supreme™ obtained the lowest infiltration values. Regarding the temporary materials, at two weeks, Ketac™ Silver presented the lowest infiltration, followed by IRM^®, whereas Cavit™ presented the highest infiltration. At four weeks, Ketac™ Silver remained with the lowest values, whereas Cavit™ decreased the infiltration, comparable to IRM^®. (4) Conclusion: Regarding temporary materials, Ketac™ Silver had the lowest infiltration at 2 and 4 weeks, whereas the highest infiltration was found in the Cavit™ group at two weeks and in the IRM^® group at 4 weeks.

Evaluation of coronal microleakage of intra-orifice barrier materials in endodontically treated teeth: A systematic review

Background

Endodontic success depends on complete sealing of the root canal orifice to prevent re-infection and re-Contamination of the treated teeth through microleakage. Intra-orifice barrier material provides a seal against micro-organisms, its by-products thus, preventing microleakage and subsequent endodontic failure. Several studies have been done to evaluate microleakage after placing various materials as IOB, but still there is no standardization for the same. Thus, this systematic review was conducted to evaluate the microleakage associated with mineral trioxide aggregate (MTA), composite, and glass ionomer cement (GIC) when used as IOB material.

Materials and Methods

Protocol was formulated in accordance with PRISMA checklist 2020 and registered on PROSPERO (CRD42021226225). Electronic search from databases such as Medline/PubMed, Scopus, EBSCOhost, Embase, Google Scholar, and Cochrane were performed from the year 2000-2020. In vitro and ex vivo studies evaluating coronal microleakage after placing IOB material using methylene blue dye penetration test under a stereomicroscope were included. A total of 5 studies were included in the systematic review. After assessing the risk of bias using customized criteria referred from JBI critical appraisal tool, characteristics of the included studies, reason for exclusion of the studies, and data extraction sheet were prepared.

Results

All studies included in this systematic review reported that placement of an IOB material significantly reduces microleakage as compared to control groups. MTA used as an IOB showed less microleakage than composite and GIC.

Conclusion

MTA as IOB material demonstrated the least microleakage in vitro studies. However, in this systematic review, only in vitro studies were included. Thus, more studies in the form of randomized control trials are required to give a conclusive and definitive result.

The differences of microleakage smart dentin replacement, glass ionomer cement and a flowable resin composite as orifice barrier in root canal treated

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Effect of an Intraorifice Barrier on Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

The main cause of unsuccess in endodontically treated teeth (ETT) is due to bacterial recontamination. The placement of an intraorifice barrier (IOB) has been proposed for preventing this event in cases that the restoration is in an inadequate condition, enhancing the possibilities for predictable long-term success in endodontic therapy. Objectives. To evaluate through a systematic review and meta-analysis if it would be necessary to place an IOB in ETT. Materials and Methods. The present review is in accordance with the PRISMA 2020 Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in four databases up to July 10^th, 2021: MEDLINE, Scopus, Embase, and Web of Science. Eligible studies were the ones which evaluated the use of an IOB in ETT in reducing microleakage with any material of choice and with any methods employed. Only in vitro studies published in English were included. Results. A total of thirty in vitro studies were included in the qualitative synthesis, and seven of those were included in the quantitative analyses evaluating the following materials: bioceramic cement, glass-ionomer cement (GIC), and resin-based composite (RBC). Most of the included studies placed an IOB at a 3 mm depth. Reduction in microleakage was observed when an IOB was placed, regardless of the material employed (p ≤ 0.01). Among the materials, GIC and RBC performed similarly (p > 0.05), with the bioceramic subgroup being statistically superior to the GIC subgroup (p ≤ 0.05). Conclusions. Although well-designed randomized clinical trials are required, the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics as IOB seems to be the best available material for this purpose.

The effect of an intraorifice barrier and base under coronal restorations on the healing of apical periodontitis: a randomized controlled trial

AIM

To evaluate the effect of intraorifice barriers and bases on the healing of apical periodontitis following root canal treatment in mandibular molars.

METHODOLOGY

A total of 120 permanent mandibular molars with necrotic pulps and periapical radiolucencies (PAI score ≥ 3) were recruited. Root canal treatment was performed in all teeth using a standard protocol, following which they were randomly allocated to one of the three treatment groups: intraorifice barrier group: coronal 3-mm gutta-percha was removed and replaced with glass-ionomer cement (GIC) barrier. The floor of the pulp chamber was then sealed with 2-mm-thick GIC base followed by final composite resin restoration; base group: received 2-mm-thick GIC base before placement of composite resin restoration; and control group: had pulp chamber entirely filled with composite resin only. Follow-up was done at 3, 6, 9 and 12 months. Combination of clinical and radiographic parameters were used to assess treatment outcome. The data were analysed using Kruskal-Wallis, chi-square and Wilcoxon signed-rank tests and logistic regression analysis.

RESULTS

At the end of 12 months, the base group had the most favourable healing (97.1%), whilst the control group had the least favourable healing (83.8%). The intraorifice barrier group had healing of 92.1%. However, there was no significant difference in healing between groups at the end of the follow-up period (P > 0.05). Additional subgroup analysis revealed a nonsignificant effect of periodontal status and root filling level on periapical healing.

CONCLUSION

The use of an additional barrier under permanent restorations did not significantly improve the outcome of primary root canal treatment in posterior teeth after 12 months. However, its influence in the long term requires further evaluation.

Modifications in Canal Anatomy of Curved Canals of Mandibular First Molars by two Glide Path Instruments using CBCT

BACKGROUND

The creation of glide path reduces the risk of instrument breakage. Glide path is created before using NiTi rotary instrumentation Aim: This study compared the changes in the root canal anatomy after creation of glide path using Path Files (PF) and V Glide Path 2 (VGP2) using Cone Beam Computed Tomography (CBCT).

MATERIALS AND METHODS

Hundred extracted mandibular first molars with curved mesial roots, curvature angles ranging within 20-30 degrees were assigned into two groups (n = 50 each). Glide path was prepared using PF (Group I) and VGP2 (Group II). CBCT images were obtained before and after instrumentation. The technical outcomes were compared at 0, 1, 2, 3, 5 and 7mm intervals. The data was analyzed using t-test and Chi-square test.

RESULT

There was a statistical difference between the root canal curvatures and working time between the two groups (p < 0.05). Canals transported towards the distal side in Group II but there was a slight mesial transportation in Group I at 0mm. Group I exhibited a better centric ability except at 1mm interval (p > 0.05). The changes in the volume were statistically significant only at 2mm interval (p < 0.05). The difference in the cross sectional area was not statistically significant at any interval (p > 0.05).

CONCLUSION

Within the limits of this study the rotary Nickel Titanium Path Files appeared to be suitable instruments for safe and easy creation of glide path.

Fluid flow evaluation of coronal microleakage intraorifice barrier materials in endodontically treated teeth

Objective:

The objective of this study was to compare the coronal microleakage intraorifice barrier materials, called CoroSeal (CS), fissur sealant (FS), flowable composite FC, and policarboksilate cement (PC), by using the computerized fluid filtration method.

Materials and Methods:

Fifty freshly extracted, single-canal human maxillary central teeth were used in this study. The teeth were decoronated to a standardized root length of 15 mm. After preparation and irrigation, all the teeth were obturated with gutta-percha and AH-Plus. In all teeth, the coronal 2 mm of root filling was removed and replaced with one of the intraorifice barriers. According to intraorifice barriers, teeth were divided randomly into 4 experimental groups (n = 10) and 2 control groups (n = 5). Group 1: CS; Group 2: FS; Group 3: FC; and Group 4: PC.

Positive Control Group:

No barrier material was used.

Negative Control Group:

Roots were completely coated with the nail polish, including the orifice. Leakage was evaluated by using a computerized fluid filtration model. Differences in fluid filtration among groups were subjected to statistical analysis using the Kruskal-Wallis Test and multiple comparisons test.

Results:

A value of P < 0.05 was statistically significant. Statistical analysis has indicated that the CS leaked significantly less than other groups (P < 0.05). There was a significant difference between FS and PC (P < 0.05), in contrast there was no significant difference between FS and FC (P > 0.05).

Conclusions:

Using the CS material as an intraorrifice barrier material reduced amount of microleakage as compared with FS, FC, and PC.

Comparative evaluation of intracanal sealing ability of mineral trioxide aggregate and glass ionomer cement: An in vitro study

Aims:

The purpose of this study was to compare the sealing ability of Mineral Trioxide Aggregate (MTA) and Glass Ionomer Cement (GIC) when used over gutta-percha as intracanal sealing materials. The study also evaluated the sealing ability of Zinc oxide eugenol (ZOE) cement and Acroseal sealer.

Materials and Methods:

Teeth were obturated with gutta-percha using sealer ZOE (group A, C, D) and Acroseal (group B). The groups were further divided into 2 subgroups (15 premolars each) on the basis of intracanal sealing material used: GIC subgroups (A1, B1) and MTA in subgroups (A2, B2). The clearing technique was used in this study for leakage evaluation. Seventy mandibular premolars were prepared using step-back technique and divided into experimental groups A and B (30 premolars each) and the positive and negative control groups C and D (5 premolars each).

Statistical analysis used:

Coronal microleakage was determined under stereomicroscope using 15X magnification. Data was statistically analyzed using one-way ANOVA followed by Post-Hoc Multiple comparison (Bonferroni).

Results:

MTA group leaked significantly less than GIC group (P < 0.05). Acroseal exhibited better sealing ability than ZOE sealer. Teeth with no intracanal barrier showed almost complete leakage.

Conclusions:

MTA may be preferred over GIC as an intracanal barrier.

Sealing ability, water sorption, solubility and toothbrushing abrasion resistance of temporary filling materials

AIM

To evaluate marginal seal, water sorption, solubility and loss of mass after brushing of several temporary filling materials.

METHODOLOGY

For marginal seal, Class I cavities, including endodontic access preparations, were made in human molar teeth and restored using one or other of several temporary filling materials (n = 10): zinc oxide/calcium sulphate-based cement (Cavit, 3M,ESPE, St. Paul, MN, USA), zinc oxide/eugenol cement (IRM, Dentsply Caulk, Milford, DE, USA), glass ionomer cement (Vidrion R, SSWhite, Rio de Janeiro, RJ, Brazil) or a dimethacrylate-based filling (Bioplic, Biodinâmica, Londrina, PR, Brazil). Dye penetration was assessed after thermocycling and immersion in 0.5% basic fuchsine solution. For water sorption, solubility and loss of mass analyses, disc-shaped specimens were made. Water sorption and solubility were evaluated by mass alteration after storage in distilled water for 7 days (n = 7). Loss of mass was calculated based on the difference of mass after abrasion with a toothbrush (n = 5), and surfaces were analysed by SEM. Data of water sorption, solubility and loss of mass were submitted to anova and Tukey's test, and marginal sealing data to Kruskal-Wallis test (P < 0.05).

RESULTS

Statistically significant differences were observed for marginal sealing (P < 0.0001), water sorption (P < 0.01), solubility (P < 0.01) and loss of mass (P < 0.05). Bioplic had the best marginal seal. Cavit had the greatest water sorption and solubility. Vidrion R and Bioplic had the lowest solubility. Loss of mass after brushing was higher for Cavit, followed by Bioplic, IRM and Vidrion R. Cavit and Vidrion R were worn aggressively by brushing.

CONCLUSIONS

The resin-based temporary filling Bioplic produced the best marginal seal, and was associated with the lowest water sorption, solubility and loss of mass.