Leakage of 4 resin-based root-canal sealers used with a single-cone technique

Correlation among Root Canal Configuration, Quality of Filling, and Its Sealability

Objective  This study aimed to evaluate the existence of possible correlations among root canal configuration, quality of filling, and its sealability.

Materials and Methods  Sixty human mandibular central incisors were selected for this study. The teeth were prepared with the Profile 04 system up to instrument 35/0.04 and irrigated with 2.5 mL of 2.5% sodium hypochlorite at each instrument change. Root canal filling was performed by the lateral compaction technique, using gutta-percha and an epoxy resin-based sealer (AH Plus) labeled with 0.1% Rhodamine B dye. Afterward, the specimens were submitted to fluid filtration tests to assess the sealability of the filling. Cross-sections were obtained at −3, −6, and −8 mm from the root apex and submitted to a metallographic treatment to determine the root canal configuration and the percentage of gutta-percha filled areas. The data were statistically analyzed by the Grubbs test. Pairs of correlations were analyzed by applying the Spearman test at a level of significance of 5%.

Results  No correlation was observed among the analyzed variables as follows: root canal configuration versus filling quality (Spearman’s rho = 0.031); filling quality versus sealability (Spearman’s rho = 0.219); and root canal configuration versus sealability (Spearman’s rho = 0.184).

Conclusion  The root canal configuration did not affect the quality of the filling and its sealability.

The effect of smear layer removal on E. faecalis leakage and bond strength of four resin-based root canal sealers

BACKGROUND

The aim of the study was to assess bacterial sealability and bonding ability of methacrylate-based Resilon (RS, SybronEndo), Endo Rez (ER, Ultradent Products Inc), and epoxy-based AH Plus (AH, Dentsply/DeTrey), MTA Fill Apex (MTAF, Angelus Soluções Odontológicas) root canal sealers, and the effect of the smear layer removal on the sealability.

METHODS

One hundred thirty root segments were instrumented up to apical size #60 and rinsed with 2.5% NaOCl. Half of the roots were rinsed with 5ml 17% EDTA to remove the smear layer. All the roots were filled with AH, ER, MTAF sealers and gutta-percha, or RS with Resilon cones. After storage at 37°C for 7 days the samples were mounted into bacterial leakage assay for 50 days. Another 100 roots were instrumented and rinsed as described above, split longitudinally, cut into the cervical, middle and apical parts. The sealers were injected through the plastic mould on the dentin surface. After 7 days of incubation at 37°C, bond strength was tested using a notched-edge test fixture (Crosshead, Ultradent Products Inc.) and a universal testing machine (Lloyd Instruments).

RESULTS

AH revealed the longest mean time for bacterial resistance by 29.4 and 36.8 days (with and without smear layer, respectively) followed by RS (15.1 and 24.7 days, respectively). The difference between materials was significant (p<0.001). Bond strength values ranged from 0.2± 0.1 to 3.5± 0.7 MPa and increased from the apical to the cervical third. In the apical third, AH showed the highest mean (SD) bond values 1.4 (0.4) MPa and 1.7 (0.6) MPa (with and without smear, respectively, followed by RS, 0.5 (0.1) MPa and 0.8 (0.1) MPa, respectively. The difference between materials was significant (p=0.001).

CONCLUSION

The effect of the smear layer removal on the sealability was material-dependent.

Capacidade de selamento e penetração intratubular do MTA Fillapex e do AH Plus em dentes humanos

Resumo Introdução O MTA é um importante material de uso na odontologia, com boas propriedades biológicas. As respostas experimentais aos cimentos endodônticos que utilizam este composto no selamento e preenchimento do sistema de canais radiculares, aliados a uma boa instrumentação e limpeza, podem ser importantes no processo de reparo periapical. Objetivo Avaliar in vitro a profundidade de penetração de dois diferentes cimentos endodônticos nos túbulos dentinários e a infiltração bacteriana em obturações com os cimentos AH Plus e MTA Fillapex. Material e método 34 pré-molares monorradiculados humanos foram selecionados, suas coroas removidas e suas raízes padronizadas em 16 mm, a seguir foram, então, divididos aleatoriamente em dois grupos de 15 espécimes e instrumentados com o sistema rotatório Pro Taper. Um grupo foi obturado com o cimento AH Plus (Grupo AH) e outro com MTA Fillapex (Grupo FI). Nestes grupos, avaliaram-se a infiltração coronária de bactérias para Enterococcus Faecalis e a profundidade de penetração nos túbulos dentinários. Para a aferição da infiltração bacteriana, usou-se o teste exato de Fisher; para a penetração intratubular, usou-se o teste-t. Resultado Para a infiltração bacteriana, considerando o número de amostras infiltradas para AH e MTA Fillapex, houve diferença estatística significativa (p=0,0341). Na avaliação da penetração intratubular, a diferença entre os dois grupos de cimentos foi considerada estatisticamente significativa (p=0,0006). Conclusão Ambos os cimentos apresentaram infiltração bacteriana, sendo que o MTA Fillapex teve pior desempenho. A capacidade de penetração nos túbulos dentinários do AH Plus foi significativamente maior que a do MTA Fillapex.

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

Objective

To analyze possible correlations among tubular dentine cement penetration, adhesiveness and apical leakage in fillings performed with gutta percha and an endodontic cement based on epoxy amine resin.

Material and Methods

Sixty similar, extracted human mandibular central incisors were irrigated, instrumented and filled following the same protocol. First, apical leakage was quantified by fluid filtration tests. Then, these same specimens were sectioned for analysis of tubular dentine cement penetration and the middle thirds were submitted to push-out tests to analyze the adhesiveness of the fillings.

Results

In brief, the means and standard deviations with a confidence interval of 95% were as follows: tubular dentine cement penetration (8.875±4.540), adhesiveness (4.441±2.683) and apical leakage (0.318±0.215). The data were confronted using the Pearson's test (P>0.05), and it was possible to prove that there was no correlation between (1) tubular dentine cement penetration and apical leakage (r²: 0.08276), (2) tubular dentine cement penetration and adhesiveness (r²: -0.2412) and (3) adhesiveness and apical leakage (r²: 0.1340).

Conclusion

After analysis of these data, it could be observed that there exists no correlation among the variables analyzed in this study.

Lack of correlation between obturation limits and apical leakage

The aim of this paper was to evaluate a possible correlation between obturation limits and leakage. Thirty-six extracted human mandibular incisors were used, characterized by straight and single canals, non-anatomical complexities, absence of previous endodontic treatment, complete root formation and patent foramen. For standardization of the specimens for the leakage analysis, foraminal instrumentation was performed up to a Flexofile #25 (Dentsply-Maillefer, Ballaigues, Switzerland). All specimens were instrumented and filled following the same protocol, and the obturation limits were measured using Axiovision 4.5 Software (Carl Zeiss Vision, Hallbergmoos, Germany). The specimens were then separated into three groups (n=12) according to the following variables: Group I--obturation limits ranging from 0 mm to 0.76 mm of the main apical foramen. Group II--obturation limits ranging from 0.77 mm to 0.98 mm of the main apical foramen. Group III--obturation limits ranging from 0.99 mm to 1.68 mm of the main apical foramen. Apical leakage was quantified by fluid filtration. The analyses were confronted using Pearson's test (p>0.05). Groups I, II and III showed Pearson correlation values (r2) of -0.152, -0.186 and 0.058, respectively. No correlation was found between the obturation limits and apical leakage.

Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-, methacrylate resin- and epoxy resin-based sealers

AIM

To assess and compare the water sorption, solubility and apical sealing ability of iRoot SP and three other widely used root canal sealers.

MATERIALS AND METHODS

Solubility was assessed by immersing standardized samples of calcium silicate- (iRoot SP), calcium hydroxide- (Sealapex), methacrylate resin- (EndoREZ) and epoxy resin- (AH Plus) based sealers in distilled water and measuring weight gain and weight loss at 6 h, 24 h and daily for 14 days. Roots of extracted mandibular premolars (n = 80) were prepared with 0.04-taper nickel-titanium rotary files to a final size 40. Roots were then randomly divided into four experimental groups (n = 18) and two control groups (n = 4), root canal sealers were applied and apical leakage was assessed using the fluid filtration method. Data was analyzed using Kruskal Wallis analysis of variance and Mann-Whitney U-tests, with the level of significance set at p ≤ 0.05.

RESULTS

EndoREZ exhibited the highest water sorption, followed by iRoot SP, Sealapex and AH Plus. Sealapex exhibited significantly higher solubility than the other sealers, whereas no significant differences in solubility levels were observed between the other three sealers tested. AH Plus exhibited significantly lower microleakage than Sealapex and EndoREZ, whereas no difference in microleakage was found between AH Plus and iRoot SP.

CONCLUSIONS

In view of the study findings, all tested sealers except Sealapex met the ANSI/ADA's requirements for solubility and no difference was found between AH Plus and iRoot SP in terms of apical sealing ability.

Evaluation of apical sealing ability of four different sealers using centrifuging dye penetration method: an in vitro study

AIM

The aim of this in vitro study was to evaluate the apical seal obtained with four root canal sealers AH 26, Sealapex, Endoflas FS and AH Plus, with lateral condensation.

MATERIALS AND METHODS

Sixty root canals were prepared using the step-back technique. The specimens were divided into four experimental groups of 12 teeth and two control groups of 12 teeth. The experimental groups were obturated by laterally condensed gutta-percha with one of the tested sealers and control groups were obturated without any sealer. Methylene blue dye penetration with centrifuging method was used to evaluate the apical sealing ability. The quantitative apical leakage of each specimen was measured after 2 weeks.

RESULTS

The results showed no significant differences between all groups except between AH Plus and Endoflas FS (<0.05). AH Plus showed significantly less leakage than Endoflas FS.

CONCLUSION

AH Plus showed the least leakage compared to AH 26, Sealapex and Endoflas FS.

Apical sealing of root canal fillings performed with five different endodontic sealers: analysis by fluid filtration

Objectives

To evaluate the sealing ability of five root canal sealers, including two experimental cements (MBP and MTA-Obtura) using the fluid filtration method.

Material and Methods

Teeth were divided into 5 study groups: G1-AH Plus; G2-Acroseal; G3-Sealapex; G4-MBP; G5-MTA-Obtura; and two controls. Chemical-mechanical preparation was performed with ProFile rotary nickel-titanium instruments 1 mm short of the apical foramen. The sealing ability was evaluated by fluid filtration at 15, 30, and 60 days.

Results

The statistical analysis showed significant difference between the materials at different periods (p<0.05). AH Plus and MBP had similar leakage values at 15 and 60 days, alternating with significant reduction at 30 days, while the other materials showed progressive increase in leakage values. Acroseal and Sealapex presented the best results at 15 days and the worst at 60 days.

Conclusions

All sealers evaluated presented fluid leakage, with AH Plus and MBP showing the best results at the end of the experimental period. Acroseal, Sealapex, and MTA-Obtura presented increase in leakage values at longer observation periods.

Comparative analysis of leakage in root canal fillings performed with gutta-percha and Resilon cones with AH Plus and Epiphany sealers

OBJECTIVE

The aim of this study was to compare the leakage of root canal fillings of gutta-percha or Resilon cones in association with AH Plus or Epiphany sealer.

STUDY DESIGN

Four groups of premolars (n = 64) were instrumented to size 45/.04 ProFile and filled with laterally compacted gutta-percha cones or Resilon cones in association with AH Plus or Epiphany sealer. The specimens were stored for 2 weeks at 37 degrees C and 100% humidity. After that, leakage was measured using the fluid filtration method and determined as microL/min.10 psi.

RESULTS

Homogeneity of variance and multiple comparisons tests were performed and indicated that root fillings with the combination of gutta-percha cones and AH Plus sealer showed lower leakage values (P < .05) than the other groups.

CONCLUSION

Considering the experimental conditions and the results obtained, it was concluded that fillings made with gutta-percha cones in combination with AH Plus sealer had the best performance.

Microleakage of various root filling systems by glucose filtration analysis

OBJECTIVE

The aim of this study was to evaluate the microleakage of Resilon + Epiphany, EndoRez, Activ GP, and conventional AH Plus + gutta-percha technique using the glucose filtration model.

STUDY DESIGN

One hundred twenty maxillary incisors were divided into 5 experimental and 2 control groups. After root canal shaping, the experimental groups were filled with AH Plus + gutta-percha (lateral compaction), Resilon + Epiphany (lateral compaction), AH Plus + Protaper's proprietory cone, EndoRez + sealer, or Activ GP + sealer). The specimens were mounted on a glucose model and samples were taken for 3 weeks for leakage measurement.

RESULTS

No statistically significant difference was observed between the leakage of all groups at the 3 testing periods (P > .05).

CONCLUSION

The filling materials with the monoblock concept do not seem to be superior to the conventional AH Plus + gutta-percha system regarding microleakage.

Resin materials for root canal obturation

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