Comparison of the sealing ability of three filling techniques in canals shaped with two different rotary systems: a bacterial leakage study

Evaluation of bacterial leakage and marginal adaptation of the bioceramics pulp dressing materials: an invitro study

OBJECTIVE

To compare the sealing ability and marginal adaptation of three calcium silicate-based cement (Biodentine, Pro root MTA, MTA Angelus) using a bacterial leakage model and scanning electron microscope (SEM).

METHODS

Recently extracted lower first premolars were randomly categorized into three experimental groups (n = 15 samples), positive control (n = 5 samples), and negative control group (n = 5 sample). Samples from the experimental groups and positive control group were subject to cavity Class I occlusal preparation followed by modified coronal pulpotomy. Different types of bioceramic dressing material were placed in 3 mm thickness accordingly, group 1 (Biodentine), group 2 (MTA Angelus), and group 3 (ProRoot MTA). No dressing material was placed in the positive control group (group 4). All samples were placed in the incubator for 24 h at 37℃, 100% humidity, for the materials to be completely set. The final restoration was placed using the Z350 resin composite. A double layer of nail varnish was applied over all the sample surfaces except the occlusal site. Whereas the samples' surfaces in the negative control, were completely covered. A 3 mm length was measured from the root apex of the samples from each group, before proceeding with the resection. The bacterial leakage test was performed using Enterococcus faecalis TCC 23,125, and a sample from each experimental group was randomly chosen for SEM. Data analysis was conducted under the One-way ANOVA test, completed by Tukey's post hoc test.

RESULTS

There is a significant difference in sealing ability and marginal adaptation between the groups. (p < 0.05). The study showed that Pro Root MTA had the superior sealing ability and marginal adaptation compared to Biodentine and MTA Angelus.

CONCLUSION

The ProRoot MTA as a coronal pulpotomy pulp dressing material, was found to have a better marginal adaptation and sealing ability compared to three other bioceramics materials. The material would be the better choice during clinical settings and procedures.

Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.

Apical dye leakage of two single-cone root canal core materials (hydrophilic core material and gutta-percha) sealed by different types of endodontic sealers: An in vitro study

Aim of the Study:

The aim of this study was to compare the apical sealing ability of two single-cone filling materials when sealed with different types of root canal sealers.

Materials and Methods:

Eighty extracted maxillary and mandibular canines were selected and their crowns were cut. The root canals were prepared using ProTaper Universal rotary system until size F4 and then divided into seven experimental groups (n = 10 each) and two control groups (n = 5 each). Samples of Groups 1, 2, and 3 were filled with single-cone gutta-percha and AH Plus, MTA Fillapex, and EndoSequence BC, respectively. Samples of Groups 4, 5, and 6 were filled similar to the previous groups with the exception of using a single-cone CPoint. Samples of Group 7 were filled with cold gutta-percha lateral condensation technique. To assess apical microleakage, the apical linear dye penetration was measured microscopically and data were statistically analyzed.

Results:

All experimental groups showed significantly different dye apical leakage values (P = 0.000). No significant differences were found between Groups 1, 2, 4, 6, and 7 (P < 0.05). The lowest mean leakage value was observed in Group 6 (0.95 ± 0.56 mm) while Groups 3 (2.68 ± 0.71 mm) and 5 (2.61 ± 0.71 mm) showed significantly higher mean leakage values.

Conclusions:

The lowest apical leakage value was observed with single-cone CPoint/EndoSequence BC but without significant differences when compared with single-cone gutta-percha/AH Plus, single-cone gutta-percha/MTA Fillapex, single-cone CPoint/AH Plus, and lateral condensation technique. Higher apical leakage values were observed with single-cone gutta-percha/EndoSequence BC and CPoint/MTA Fillapex.

Sealing ability of MTA, CPM, and MBPc as root-end filling materials: a bacterial leakage study

Objectives To evaluate the sealing ability of three root-end filling materials (white MTA, CPM, and MBPc) using an Enterococcus faecalis leakage model. Material and Methods Seventy single-root extracted human teeth were instrumented and root-ends were resected to prepare 3 mm depth cavities. Root-end preparations were filled with white MTA, CPM, and MBPc cements. Enterococcus faecalis was coronally introduced and the apical portion was immersed in BHI culture medium with phenol red indicator. The bacterial leakage was monitored every 24 h for 4 weeks. The statistical analysis was performed using the Wilcoxon-Gehan test (p<0.05). Results All cements showed bacterial leakage after 24 hours, except for the negative control group. The MBPc showed significantly less bacterial leakage compared with the MTA group (p<0.05). No significant differences were found between the CPM and the other groups. Conclusions The epoxy resin-based cement MBPc had lower bacterial leakage compared with the calcium silicate-based cements MTA and CPM.

Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study

OBJECTIVES

The objectives of the study were to evaluate the radiographic technical quality of root canal treatment before and after the implementation of a nickel-titanium rotary (NiTiR) preparation followed by a matching-taper single-cone (mSC) obturation and to detect the procedural errors associated with this technique.

MATERIALS AND METHODS

A random sample of 535 patients received root canal treatment at the Department of Conservative Dentistry and Periodontology at the University of Würzburg: 254 teeth were treated in 2002-2003 by using stainless steel instruments (SSI) for preparation and a lateral compaction (LC) technique (classic group (CG)). Two hundred eighty-one teeth were root filled in 2012-2013 employing NiTiR instruments for the root canal shaping and a mSC technique (advanced group (AG)). The quality assessments were based on the radiographic criteria of the European Society of Endodontology. The presence of voids was recorded separately for the apical, central and cervical thirds of the root canals. Procedural errors, such as ledges, apical transportations, perforations and fractured instruments, were detected. The root canal fillings in the CG and AG were compared using chi-squared and Fisher's exact tests. Multivariable logistic regression was performed to investigate the association between the independent variables (patient age, tooth type and type of treatment) and the dependent variables (density and length).

RESULTS

Adequate length was achieved significantly more often in the AG compared to the CG for molars (p = 0.017), mandibular teeth (p = 0.013) and primary root canal treatments (p = 0.024). No significant difference was detected between the AG and CG regarding adequate length in general (p = 0.051) or adequate overall quality of root canal filling (p = 0.1). In the AG, a significant decrease in procedural errors was evident (p = 0.019) and decreases in the densities of the root canal fillings in the cervical (p = 0.01) and central (p = 0.01) thirds of the root canals were also observed. Moreover, root canals in elderly patients exhibited fewer voids (p = 0.009).

CONCLUSIONS

Rotary root canal preparation followed by a matching-taper single-cone filling technique provides a reliable shaping of the root canal, with fewer procedural errors and a more acceptable filling quality in terms of length and homogeneity in the apical third. Less favourable results were achieved in the central and cervical parts of the root canals.

CLINICAL RELEVANCE

The matching-taper single-cone technique seems to effectively obturate well-tapered root canals after adequate rotary instrumentation. Irregularly shaped canals require additional lateral or warm vertical condensation to avoid voids.

Comparison between gutta-percha and resin-coated gutta-percha using different obturation techniques

BACKGROUND

The aim of this study was to evaluate and compare the obturation quality between canals obturated with gutta-percha/AH Plus sealer (GP group) and resin-coated GP/EndoREZ® sealer (ER group).

METHODS

A total sample of 90 mandibular premolar teeth was divided into 2 groups (2 × 45 canals): the GP group and ER group. Each group was further divided into 3 subgroups (n = 15): cold lateral compaction (CLC), warm lateral compaction (WLC) and single cone (SC). The teeth were subsequently embedded in resin and sectioned horizontally at 1, 3, 6 and 9 mm. All sections were then viewed with a stereomicroscope at ×40 magnification. The area occupied by core filling materials was determined using Cell^D software.

RESULTS

With CLC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at the 1- and 3-mm levels. Similarly, with WLC, the percentage of core filling material in the ER group was significantly higher than in the GP group at the 1-, 3- and 9-mm levels. With SC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at all levels.

CONCLUSIONS

It can be concluded that the resin-coated GP/EndoREZ® sealer is superior to the gutta-percha/AH Plus in the percentage of core filling material.

Sealing Efficacy of Single-cone Obturation Technique with MTA and CEM Cement: An in Vitro Bacterial Leakage Study

Background and aims. Various materials and methods have been introduced for obturating cleaned and shaped root canal systems. This in vitro study aimed to evaluate the sealing ability of single-cone obturation technique with mineral trioxide aggregate and calcium-enriched mixture based on bacterial leakage approach.

Materials and methods. Sixty-four single-canal teeth were prepared and randomly divided into 5 groups, consisting of three experimental groups (n = 16) and two control groups (n = 8).In group 1, root canal obturation was performed using gutta-percha with 0.02 taper and AH26 sealer by lateral compaction technique. In groups 2 and 3, single Protaper gutta-percha cone was used for obturation with MTA and CEM cement, respectively. A bacterial leakage apparatus was utilized for leakage assessment for 60 days. Leakage comparison between the experimental groups was performed by one-way ANOVA using SPSS 16 statistical software.

Results. The mean bacterial leakage intervals in groups 1, 2 and 3 were 33.68 ± 9.39, 40.68 ± 11.03 and 39.56 ± 9.03 days, respectively. One-way ANOVA indicated no significant differences in bacterial leakage between the three experimen-tal groups (P = 0.109).

Conclusion. Single-cone obturation with well-fitted gutta-percha and MTA and CEM cement is an appropriate alternative for traditional lateral compaction technique.

Assessment of the sealing abilities of several root canal sealers and filling methods

OBJECTIVE

To evaluate the sealing abilities of two root canal sealers (epoxy resin-based AH Plus(®) and polydimethylsiloxane-based GuttaFlow(®)) and of five root filling techniques (lateral condensation, matched taper single gutta-percha point, laterally condensed-matched taper gutta-percha point, Thermafil(®) and continuous wave of condensation), using a bacterial leakage model.

MATERIALS AND METHODS

One hundred and seventy-four single-rooted human teeth were randomly divided into 10 test groups (n = 15) and two control groups (n = 12). The roots that were filled with the test material, using the different root filling techniques, were mounted in a two-chamber bacterial leakage model and Enterococcus faecalis was added to the upper chambers. The lower chambers of all of the specimens were checked every day during the test period (100 days). The day of turbidity was recorded for each sample. Statistical analysis was performed using the Kaplan-Meier and log-rank tests.

RESULTS

There was no significant difference between the epoxy resin-based and the polydimethylsiloxane-based sealers, irrespective of the filling techniques used (p > 0.05). The continuous wave of condensation technique was found to be superior to the other techniques (p < 0.05). The difference between the other groups was insignificant (p > 0.05).

CONCLUSIONS

AH Plus and GuttaFlow sealers showed similar levels of sealing ability. The continuous wave of condensation technique had the best sealing capability when compared to the other techniques.

Percentage of gutta-percha-filled areas in canals instrumented with nickel-titanium systems and obturated with matching single cones

INTRODUCTION

The purpose of this study was to compare different single-cone obturation techniques in terms of the percentage of gutta-percha-filled areas (PGFA), sealer-filled areas (PSFA), and voids.

METHODS

Sixty extracted mandibular incisors with straight canals were allocated into 6 groups: (A) FlexMaster, (B) Mtwo, (C) ProTaper, (D) Reciproc, (E) WaveOne, and (F) control. In groups A-E, obturation was performed by using matching single-cone gutta-percha. In group F (control), manual instrumentation and obturation were performed by using cold lateral compaction with standardized gutta-percha cones. The teeth were sectioned at 2, 4, 6, and 8 mm from the apex. The total area of each canal segment was measured, and the areas were converted to PGFA, PSFA, and percentage of voids. Data were subjected to the Kruskal-Wallis and post hoc Dunn test.

RESULTS

At the 2-mm level, group B produced significantly higher PGFA than all other groups, whereas group B produced significantly higher PGFA than groups C, D, and E (P < .05). At the 4-mm level, groups A and B produced significantly higher PGFA than all other groups, whereas group F produced significantly higher PGFA and lower PSFA than groups C, D, and E (P < .05). At the 6-mm level, group F produced significantly higher PGFA and lower PSFA (P < .05) than all other groups, whereas groups A and B produced significantly higher PGFA and lower PSFA than groups C, D, and E (P < .05). At the 8-mm level, group F produced significantly higher PGFA and lower PSFA (P < .05) than all other groups.

CONCLUSIONS

Under the conditions of this study, lateral compaction and single-cone techniques that used constant tapered gutta-percha (FlexMaster, Mtwo) produced higher PGFA at the apical levels than variable tapered single-cone gutta-percha (ProTaper, Reciproc, WaveOne).

Comparison of the cleaning capacity of Mtwo and Pro Taper rotary systems and manual instruments in primary teeth

Background:

Root canal cleaning is an important step in endodontic therapy. In order to develop better techniques, a new generation of endodontic instruments has been designed. The aim of this study was to compare the effectiveness of manual K-files (Mani Co, Tokyo, Japan) and two rotary systems–Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper (VDW, Munich, Germany)–for root canal preparation in primary molars.

Materials and Methods:

India ink was injected to 160 mesiobuccal and distal root canals of mandibular primary molars. The teeth were randomly divided into three experimental groups and one control group. In each experimental group, either manual instruments (K-files) or rotary instruments (Mtwo or ProTaper) were used to prepare root canals. After cleaning the canals and clearing the teeth, ink removal was evaluated with a stereomicroscope. Statistical analysis was done with Kruskal–Wallis and Friedman tests.

Results:

There were no significant differences in cleaning efficiency between manual and rotary instruments. Only ProTaper files performed significantly better in the coronal and middle thirds than in the apical third of the root canal.

Conclusion:

Manual K-files and the Mtwo and ProTaper rotary systems showed equally acceptable cleaning ability in primary molar root canals.

Assessment of the wetting behavior of three different root canal sealers on root canal dentin

Aim:

The objective of the present study was to evaluate and compare the wetting behavior of three different root canal sealers on the root canal dentin surface treated with irrigants and their combination.

Materials and Methods:

Decoronation and apical third resections of 27 extracted single-rooted human mandibular premolars were done. The roots were then split longitudinally into two halves, and randomly assigned into three treatment groups (n=18). The root dentin surfaces in Group1, Group 2 and Group 3 were treated with 17% ethylene diamine tetra acetic acid (EDTA), 3% sodium hypochlorite (NaOCl) and combination of 17% EDTA and 3% NaOCl, respectively. Each group was subdivided into three subgroups of 6 specimens each, depending on the the sealer used, i.e. sub group A. zinc oxide (ZnOE), sub group B. AH plus, subgroup C. Guttaflow sealer, respectively. The contact angle was measured using First Ten Angstroms (FTA) 200 dynamic contact angle analyzer.

Results:

The contact angle values for AH Plus sealer were significantly lower when compared to the other two sealer groups.

Conclusion:

The wettability of AH Plus sealer on the root surface dentin was found to be better than Gutta-Flow and ZnOE sealer.

Potential systematic error in laboratory experiments on microbial leakage through filled root canals: review of published articles

AIM

To systematically evaluate whether published studies on microbial leakage through filled root canals in human teeth embedded in a two-chamber system were properly controlled. Specifically, the control for the assumption that leakage should occur through the root canal rather than other routes was investigated.

METHODOLOGY

A systematic search was conducted using Medline, Biosis, Cochrane, Embase, and Web of Science databases. In addition, the reference lists of review articles pertaining to the topic were searched. No language restriction was applied. Two independent reviewers screened titles and abstracts. All articles deemed appropriate by either reviewer were included in the full-text evaluation. In case of disagreement, a referee arbitrated between the reviewers.

RESULTS

With 93.8% agreement prior to discussion and arbitration, 67 articles were included. On average, the size of the negative control group was 30% (mean) of the n in the experimental groups (minimum=0.0%, maximum=100%, SD=27%). The majority of studies (57 of 67) used inadequate negative controls. The whole root was covered with the sealing material in these specimens, whilst the root tip was left uncovered in the experimental groups. Consequently, leakage between outer root surface and sealing material was not controlled for. The authors of the remaining 10 communications did not state clearly how negative control assessments were performed.

CONCLUSIONS

Experimental investigations should be performed to assess the routes of microbial leakage in two-chamber models.