Evaluation of the radiopacity of different root canal sealers

Comparison of Apical Sealing Capacity of ActiV GP/Glass Ionomer Sealer Versus Resilon/RealSeal and Gutta Percha/AH plus Sealers

BACKGROUND

In recent years, concerns have arisen regarding the sealing efficacy of traditional root canal obturation materials such as gutta-percha (GP) and various sealers. The resin-based obturation complexes like RealSealTM (SybronEndo, Orange, CA) and ResilonTM (Resilon Research LLC, Madison, CT) had been developed as replacements for conventional obturation materials, gutta-percha, and various types of sealers. Additionally, ActiV GPTM (Brasseler USA, Savannah, GA), a glass-ionomer-based obturation system, has gained attention.

AIM

This in vitro study's objective was to evaluate ActiV GPTM/GI (glass ionomer) sealer's sealing capacity and compare it to that of ResilonTM/RealSeal TM as well as gutta-percha/AH PlusTM (Dentsply International Inc, York, PA) taken as a control.

METHODS AND MATERIALS

In this in vitro investigation, 90 freshly excised single-rooted human premolars of the mandible were chosen. According to the substance used to seal the root canals, the teeth were randomly separated into three separate groups (n=30). Group 1: The ActiV GPTM obturation system was used to seal and obturate the canals. Group 2: ResilonTM/RealSealTM was used to obturate and block the canals. Group 3: GP points and AH PlusTM were used to seal the canals employing the lateral condensation methodology. All of the root surfaces-aside from the last 2 mm of the root-were painted with two coats of nail polish before being submerged in 2% methylene blue for a duration of 24 hours at a temperature of 37°C. The highest amount of dye leakage was determined using a stereomicroscope at 20X magnification.

RESULTS

The extent of dye penetration at the apical region in specimens of the ActiV GPTM category was 4.93±1.48 mm. The depth of dye penetration at the apical region in specimens of the ResilonTM category was 2.78 ±1.62 mm. The extension of penetration of dye was 0.48± 0.46 mm in specimens of the GP/AH PlusTM category. The degree of microlikeage was maximum in ActiV GPTM specimens and it was minimum in GP/AH PlusTM specimens. The microlikeage in specimens of the Resilon category was greater than GP/AH plusTM while it was lower than ActiV GPTM specimens. The observations were statistically meaningful (p<0.001).

CONCLUSION

Based on the results of the dye penetration examination, it can be concluded that the root canal wall sealing capabilities of ActiV GPTM with GI Sealer were inferior to those of GP/AH PlusTM and ResilonTM with RealSealTM.

Root canal sealers affect artifacts on cone-beam computed tomography images

The purpose of this study was to evaluate the appearance of artifacts by four types of root canal filling sealers on cone-beam computed tomography (CBCT) images. Thirty standardized tooth models were given the radiopacity equivalent to human teeth, and root canal preparation was performed using WaveOne Gold. Root canal filling by a single-point method was performed using WaveOne Gold gutta-percha points and four types of root canal sealers: AH Plus (AH), CANALS (CA), BioRoot RCS (BR), and MTA Fillapex (MTA). Samples were taken by periapical radiography at 60 kV and scanned by CBCT at three tube voltages (70, 85, and 100 kV). The gray-scale values (GVs) of the periapical radiographs were measured and the aluminum equivalents were calculated. On the CBCT axial images, the artifact and dentin area GVs were measured and the rate of change in the GV (RCGV) was calculated as follows: RCGV (%) = (dentin area GV - artifact GV)/dentin area GV × 100. High-density areas with artifacts on the CBCT images were also measured. On the periapical radiographs, the aluminum equivalent was largest for AH and smallest for MTA. On the CBCT images, AH showed the largest values for both RCGV and the high-density areas, while BR and MTA showed comparable values. Correlations were found between the radiopacity on the periapical radiographs and the degree of artifacts on the CBCT images. These findings suggest that the greater the contrast in the 2D image, the higher the artifacts in the 3D image.

Radiopacity Evaluation of Gutta-Percha Points in Thinner Samples than the ANSI/ADA Recommendation

The aim of this study was to evaluate the radiopacity of different gutta-percha points (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® and Odous®) in samples of 1 mm thick as established by ANSI/ADA Specification #57 and ISO 6876/2001, in comparison with thinner samples. Twelve test specimens for each material, four for each thickness (0.3, 0.6, and 1 mm and diameter of 8 mm), were laminated and compressed between two polished glass plates until the desirable thickness. Digital radiographs were obtained along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The X-ray unit was set at 70 kVp, 10 mA and 0.4 s exposure time, at a focal distance of 36 cm. One calibrated observer quantified the average values of pixels with Adobe Photoshop® software. Data were analyzed using ANOVA and Tukey tests, at 5% significance level. At 0.6 and 1 mm thickness, all the tested materials showed radiopacity higher than 3 mm of aluminum (reference value). At 0.3 mm thickness, Odous and Tanari presented significantly less radiopacity than the reference, and the other materials showed similar radiopacity to the reference. The study concluded that the materials demonstrated different radiopacities and all had values above the minimum recommended by ANSI/ADA specification #57, being Odous and Tanari less radiopaque than the reference value in thinner samples (0.3mm).

Physical Properties and Chemical Characterization of Two Experimental Epoxy Resin Root Canal Sealers

Introduction:

The aim of this in vitro study was to evaluate the setting time, flow, film thickness, solubility, radiopacity and characterization analysis of three epoxy resin based sealers including two experimental sealers and AH-26.

Methods and Materials:

Five samples of each material were evaluated for setting time, flow, film thickness, solubility and radiopacity according to ISO 6876 Standard. Characterization of sealers was performed under the scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy, X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy. Statistical evaluation was performed using the Kruskal-Wallis test.

Results:

In this study, AH-26 showed more radiopacity and flow compared to two other experimental sealers (P<0.05). However, both sealers had lower setting time than AH-26 (P<0.05). No statistical differences were found regarding film thickness, solubility and radiopacity (P>0.05). The characterization analysis exhibited relatively similar microstructure of AH-26 sealer to the experimental root canal sealers.

Conclusion:

According to the result of this study, all tested root canal sealers had acceptable properties based on ISO 6876 standard criteria.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth

OBJECTIVE

This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis.

MATERIAL AND METHODS

The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05).

RESULTS

Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings.

CONCLUSIONS

The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.