Effects of vacuuming on dye penetration patterns in root canals and glass tubes

In vitro study assessing apical leakage of sealer-only backfills in root canals of primary teeth

AIM

To assess the sealing ability of zinc oxide-eugenol (ZOE), Apexit, and Sealapex used as sealer-only backfills in root canals of primary teeth using the high-pressure replica technique.

METHODOLOGY

Two hundred and seventy root canals of deciduous molars as well as primary anterior teeth were randomly assigned to three groups (n=90). Root canals were prepared to size 35 and filled with either zinc oxide-eugenol (ZOE), Apexit, or Sealapex using a lentulo filler. Twenty-four hours after setting of the materials the roots were nail-varnished (except for the apical tip), and half of the specimens (n=45) were penetrated by a coloured (rhodamine B) epoxy resin. The resin was infiltated into the pores and cavities of the teeth in a high-pressure vessel. The remaining groups (n=45) were stored in 100% humidity, and infiltration of the resin followed after 40d. Apical leakage was assessed by means of a grinding technique using eight steps of 0.5mm each.

RESULTS

ZOE and Apexit failed to seal the root canals in both subgroups. This was significantly different from the root canals filled with Sealapex where in both subgroups some 30% of the specimens revealed a tight seal up to a distance of 2.9mm of the apex.

CONCLUSIONS

Under the conditions of this study it can be concluded that Sealapex shows less leakage than ZOE and Apexit. With regard to the three materials tested, Sealapex should be a viable alternative for sealer-only obturation of pulpectomized primary teeth. The high-pressure replica technique seems to be suitable for assessing leakage of root canal filling materials.

Influence of reduced air pressure methods on dye penetration in standardized voids

OBJECTIVE

The objective of this study was to evaluate the influence of the moment when reduced pressure is applied on dye penetration patterns.

STUDY DESIGN

Nine hundred and sixty glass capillary tubes of different inner diameter (0.3 mm and 0.8 mm), divided into 48 groups, were submerged into dye in 3 different positions (horizontally, opening upwards, and opening downwards) under different vacuum conditions (passive, 5 kPa, 35 kPa, 70 kPa reduced pressure). When reduced pressure was applied half of the groups were submerged into dye before and half of the groups after the application of reduced pressure. Linear dye penetration was measured. Univariate analysis was performed with Mann-Whitney U test and Kruskal-Wallis test to select variables to be included in the regression model. A multiple logistic regression analysis with backward elimination was performed to assess the influence of different covariates on linear dye penetration.

RESULTS

The multivariate linear regression showed that the moment of vacuuming had the greatest positive effect on linear dye penetration value (beta = 10.6, P < .0001). Also the level of pressure reduction had a positive effect on the outcome variable (beta = 0.2, P < .0001) while the vertical positioning of the tubes has negatively affected the outcome variable both for the open end upside (beta = -1.01, P = .024) and the open end downside (beta = -1.05, P = .019). Diameter of the tubes (P = .442) and immersion time (P = .727) had no effect on the outcome of linear dye penetration.

CONCLUSIONS

Even minimum air pressure reduction applied before immersion of the specimens allowed the dye to extensively penetrate the voids.

Sealing Ability of New Adhesive Root Canal Filling Materials Measured by New Dye Penetration Method

The sealing ability of new adhesive root canal filling materials was evaluated using a new dye penetration method. Twenty-eight single-rooted mandibular premolars were randomly divided into four groups of seven teeth each and filled by lateral condensation using one of these combinations: Resilon point with Epiphany sealer (RE); gutta-percha point with Sealapex sealer (GS); gutta-percha point with dentin activator and Superbond sealer (GDS); or gutta-percha point with Accel primer, dentin activator, and Superbond sealer (GADS). Amount of 0.06% methylene blue dye solution (MB) that leaked from the coronal portion to the apical area was measured with a spectrophotometer at one, four, eight, 15, and 30 days in an accumulative manner. The total amount of leaked MB on day 30 was significantly higher for GDS than the other combinations (p < 0.05).

Reliability of the Dye Penetration Studies

The purpose of this study was to compare the classical dye-penetration method to a dye-extraction method, with a fluid-filtration method as control. Forty teeth were prepared with a ProFile device and divided into four groups (n = 10 per group) according to the sealer used for the lateral condensation: Pulp Canal Sealer, Sealapex, AH Plus, and Ketac-Endo. The apical seal was evaluated on the same teeth with all three methods, successively: a fluid-filtration method, a dye-penetration method with 2% methylene blue, and a new method where the roots were dissolved in 65% nitric acid to extract the methylene blue before reading the absorbance of the solution. The classical dye penetration did not show any difference among the sealers and showed no correlation with the two other techniques. The fluid filtration (p < 0.01) and the dye extraction (p < 0.01) showed that Sealapex displayed the highest apical leakage. The correlation between the results obtained with these two methods was significant (p = 0.001 and r = 0.7). This study showed the limitation of the classical dye-penetration studies and that the dye-extraction, i.e. dissolution, method gave the same results as fluid filtration but saved much laboratory time.

A comparison of techniques for assessment of coronal dye leakage

This study was designed to compare different techniques for coronal dye leakage testing. One hundred and fifty extracted human anterior teeth were fully instrumented and randomly divided into two experimental groups of 60 teeth each, plus two groups of 15 teeth each for positive and negative controls. One group was rinsed with 5.25% NaOCl (smear layer intact), whereas the other group was flushed with 17% EDTA and 5.25% NaOCl (smear layer removed). Roots were obturated with gutta-percha using lateral condensation and AH Plus as root canal sealer. Each experimental group was divided into three subgroups of 20 teeth each for three methods of testing coronal dye leakage: passive dye penetration, penetration with vacuum applied, and fluid filtration methods. The teeth were left in 100% humidity at 37 degrees C for 5 days before being immersed in Indian ink for 2 days and cleared. The linear extent of dye penetration was measured. Mean depth of leakage for the groups with the smear layer intact was 2.5 +/- 1.0 mm for passive dye penetration, 6.7 +/- 2.8 mm for vacuum dye penetration, and 3.0 +/- 1.1 mm for fluid filtration dye penetration. In the group in which the smear layer was removed, the mean depths of leakage were: 3.2 +/- 2.1 mm for passive dye penetration, 5.8 +/- 2.8 mm for vacuum dye penetration, and 3.4 +/- 2.1 mm for fluid filtration. The vacuum method resulted in significantly (p < 0.05) more dye penetration than fluid filtration and passive dye penetration. The presence or absence of smear layer had no statistically significant effect (p > 0.05) on any of the leakage testing techniques.

Evaluation of the apical seal of root canal fillings with different methods

The purpose of the study was to compare dye penetration methods conducted passively, under negative pressure, or under high pressure conditions. Ninety human maxillary incisors were instrumented and obturated with either the lateral condensation or single cone technique. India ink was used as a dye for passive and negative pressure (60 Torr) penetration methods. For dye penetration under high pressure conditions (200 MPa), a colored epoxy resin was used. Apical leakage was linearly measured evaluating both the root surface that showed the highest degree of penetration and all four surfaces of each root. The results revealed no significant difference between passive and negative pressure penetration methods. The amount of apical leakage obtained using dye penetration under high pressure conditions was significantly lower. Lateral condensation and single cone techniques yielded similar sealing abilities. It is concluded that there is no need to use negative pressure for evaluating the sealing ability of root canal fillings in vitro.

Effect of masticatory cycles on apical leakage of obturated teeth

This study investigated the effect of apical leakage due to masticatory cycles on root canal treatment. Twenty upper maxillary molars were first obturated using the warm vertical compaction technique. Four maxillary casts were then built, with each holding four of the sample molars. The molars were embedded in resin with the roots separated from the resin by means of a light silicon. The four remaining teeth served as controls and were not submitted to occlusal forces. A mechanical device to simulate masticatory cycles subjected the teeth to 0.5 x 10(6) cycles (group A), 10(6) cycles (group B), 2 x 10(6) cycles (group C), and 3 x 10(6) cycles (group D); the control was group E. The roots were placed in 2% methylene blue dye solution for 72 h and then sectioned longitudinally so that dye penetration could be measured. The mean values of dye penetration were: 3.70 +/- 0.69 mm, group A; 5.00 +/- 1.14 mm, group B; 6.00 +/- 1.01 mm, group C; 7.23 +/- 0.66 mm, group D; and 2.74 +/- 0.75 mm, group E. The value of dye penetration increased in correlation with the number of masticatory cycles. This in vitro study suggests the significant effect of masticatory loads on apical leakage.

Physical properties of CH61, a newly developed root canal sealer

This study was performed to evaluate the physical properties (sealing, flow, radio-opacity, working time, and solubility) of a newly developed root canal sealer, CH61. It was compared with Canals, Sealapex, and AH26, which are typical commercially available root canal sealers. The sealing ability was evaluated by dye penetration. The flow was evaluated by two methods. One was flow in the vertical dimension, and the other was disk diameter. Radio-opacity, working time, and solubility were performed in accordance with the standards of the International Organization for Standardization. No dye penetration after immersion for 24 h was noted. In CH61, and there were significant differences between the values for CH61 and Canals, Sealapex, or AH26 (p < 0.001). For flow, the results differed from method to method. The radio-opacity decreased in the following order: AH26, Canals, CH61, and Sealapex. The solubility was the lowest for CH61. This study showed that CH61 had excellent sealing properties and low solubility.

Dental materials: 1995 literature review

This critical review of the published literature on dental materials for the year 1995 has been compiled by the Dental Materials Panel of the United Kingdom. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, resin composites, dentine bonding, dental amalgam, endodontic materials, casting alloys, investment materials, resin-bonded bridges and ceramo-metallic restorations, all ceramic restorations, denture base and soft lining materials, impression materials, dental implants, orthodontic materials and biomechanics). Three hundred and thirty articles published in 68 titles have been reviewed.

Root end filling materials: a review

When non-surgical attempts prove unsuccessful or are contraindicated, surgical endodontic therapy is needed to save the tooth. The procedure usually consists of exposure of the involved area, root end resection, root end preparation and insertion of a root end filling material. Numerous materials have been suggested as root end filling materials. This article is a review of the literature on the suitability of various root end filling materials based on their leakage assessment, marginal adaptation, cytotoxicity, and usage test in experimental animals and humans.