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Ashkar I, Sanz JL, Forner L, Ghilotti J, Melo M. A Literature Review of the Effect of Heat on the Physical-Chemical Properties of Calcium Silicate-Based Sealers. J Endod 2024:S0099-2399(24)00281-4. [PMID: 38729300 DOI: 10.1016/j.joen.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Recently, calcium silicate-based sealers (CSSs) have gained popularity in endodontic practice due to their biocompatibility and antimicrobial properties. They are considered viable alternatives to epoxy resin-based sealers. With the increased use of CSSs and warm vertical compaction techniques in root canal treatment, evaluating the impact of heat on CSSs properties is essential, therefore this review aimed to present a qualitative synthesis of available in vitro studies assessing the impact of heat on the physical-chemical properties of CSSs. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines, a systematic advanced electronic search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases in November 2023 and updated in April 2024. In vitro studies that evaluated the physical-chemical properties of CSSs were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias-included studies. RESULTS The search identified a total of 6421 preliminary results and 10 studies were included for qualitative assessment. Eleven different physiochemical properties were assessed by the included studies. Setting time and flow were the most evaluated property among the studies. A qualitative synthesis of the evidence on each property is presented. CONCLUSIONS Based on the in vitro studies assessed in the present systematic review, results reveal that exposing CSSs to heat can accelerate their setting time, reduce their flow, and increase their film thickness. Concerns persist regarding solubility, viscosity, radiopacity, dimensional change, microhardness, porosity, and compressive strength, requiring further research. Certain CSSs, such as MTA Fillapex and Endosequence BC sealer HiFlow, show minimal changes under heat, making them potential candidates for warm filling techniques.
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Affiliation(s)
- Israa Ashkar
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - James Ghilotti
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
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Ito R, Watanabe S, Kouno A, Yamauchi S, Okiji T. Heat-Induced Changes in the Physical Properties of a New Premixed Calcium Silicate-Containing Root Canal Sealer: An In Vitro Study. Dent J (Basel) 2024; 12:106. [PMID: 38668018 PMCID: PMC11048785 DOI: 10.3390/dj12040106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/25/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, and film thickness were tested with or without heating at 100 °C for 30 or 60 s, in accordance with ISO6876:2012 standards. Ultrastructural and elemental analyses were performed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Data were analyzed using one-way analysis of variance (ANOVA) with a Tukey post hoc test (α = 0.05). All sealers exhibited significantly shorter setting time and flow after heating at 100 °C for 30 and 60 s (p < 0.05). After heating, AHB showed a significantly higher film thickness compared to that of the other materials (p < 0.05). None of the tested properties of heat-applied AHB and ES met ISO standards, except the setting time in ES. The SEM/EDS results for AHB and ES were not affected by heating. The detected changes in physical properties can negatively impact the performance of premixed calcium silicate-containing sealers, particularly AHB, when warm vertical compaction is employed.
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Affiliation(s)
| | - Satoshi Watanabe
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (R.I.); (A.K.); (S.Y.); (T.O.)
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Azizi H, Hadad A, Levy DH, Ben Itzhak J, Kim HC, Solomonov M. Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review. Dent J (Basel) 2024; 12:85. [PMID: 38667997 PMCID: PMC11048901 DOI: 10.3390/dj12040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/02/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to review the considerations for choosing a suitable sealer according to various endodontic scenarios. An electronic search of PubMed, Scopus, and the Web of Science was undertaken for the keywords of 'sealer choosing', 'appropriate sealer', 'suitable sealer', 'sealer for clinical scenario', and 'sealer for clinical situations'. However, the literature review revealed a lack of studies with practical clinical recommendations regarding the choice of appropriate endodontic root canal sealers for particular clinical situations of root canal treatment. Therefore, a narrative review was undertaken under the basis of the characteristics of an epoxy resin-based sealer (ERS) versus a calcium silicate-based sealer (CSS). Based on the evidence found through the review, the choice of an appropriate sealer in a variety of clinical scenarios was proposed. An ERS is recommended for one-visit non-vital cases, teeth with periodontal involvement, cracked teeth, and internal root resorption without root perforation. A CSS is recommended for vital or non-vital cases in multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations.
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Affiliation(s)
- Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Henry Levy
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 46241, Republic of Korea;
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Kapralos V, Camilleri J, Koutroulis A, Valen H, Ørstavik D, Sunde PT. Endodontic sealers after exposure to chlorhexidine digluconate: An assessment of physicochemical properties. Dent Mater 2024; 40:420-430. [PMID: 38123383 DOI: 10.1016/j.dental.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Final root canal irrigation should ideally maintain the physicochemical stability of root canal sealers. We seek to assess the effect of contact with 2% chlorhexidine digluconate (CHX) on the physicochemical properties of AH Plus, BioRoot™ RCS, and Pulp Canal Sealer (PCS). METHODS Mixed sealers were placed in cylindrical teflon molds and allowed to set for 1.5x the manufacturers' setting time. Half of the specimens had their free surface in contact with CHX for the first minute of their setting period. Solubility, radiopacity, surface roughness, microhardness and wettability of the sealers were assessed up to 28 days after setting. Elemental analysis of sealer surfaces and their leachates together with pH measurements were also performed. Appropriate parametric and non-parametric analysis with post hoc tests were performed (p < 0.05). RESULTS Exposure to CHX had no effect on solubility and radiopacity of all sealers. CHX altered the surface roughness of PCS and BioRoot RCS (p < 0.05). Contact with CHX reduced the microhardness of AH Plus and PCS (p < 0.05). AH Plus was more hydrophilic after CHX contact, whereas PCS became more hydrophobic (p < 0.05). AH Plus and PCS surfaces appeared to adsorb CHX as exhibited by chlorine peaks after contact with CHX. Sealer leachates' alkalinity was not affected. CHX increased elution of silicon and zirconium for BioRoot and zinc for PCS leachates. SIGNIFICANCE In our study, CHX affected sealers' physicochemical properties to various extents. Further studies are needed to confirm the obtained results by investigating various final irrigation strategies and correlating to biological properties.
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Affiliation(s)
- Vasileios Kapralos
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway.
| | - Josette Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Andreas Koutroulis
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855 Oslo, Norway
| | - Dag Ørstavik
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
| | - Pia Titterud Sunde
- Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317 Oslo, Norway
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Jeon MJ, Ko H, Shin SJ, Kim M. Cytotoxicity and genotoxicity of various types of endodontic sealers in Chinese hamster ovary (CHO-K1) cells. Dent Mater J 2023; 42:774-779. [PMID: 37793827 DOI: 10.4012/dmj.2023-012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
This study aimed to evaluate the cytotoxicity and genotoxicity of five endodontic sealers (AH Plus, MTA Fillapex, Endoseal MTA, Sealapex, and Zinc oxide eugenol) in Chinese hamster ovary cells. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay to check cell viability at 1, 3, and 7 days. Genotoxicity was assessed by cytokinesis-block micronucleus, single-cell gel electrophoresis, and γH2AX immunofluorescence assays. Cell viability of all endodontic sealers, except Endoseal MTA, on day 1 was less than 100%. Endoseal MTA showed the highest cell viability on day 7. AH Plus and Endoseal MTA showed less DNA damage than other sealers. After complete setting, AH Plus and Endoseal MTA showed low genotoxicity, which could reduce DNA damage in periapical cells, making them suitable as endodontic sealers.
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Affiliation(s)
- Mi-Jeong Jeon
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University
| | - Hyunjung Ko
- Department of Conservative Dentistry, University of Ulsan, Asan Medical Center
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University
| | - Miri Kim
- Department of Conservative Dentistry, University of Ulsan, Asan Medical Center
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Katakidis A, Kodonas K, Fardi A, Gogos C. A scientometric, bibliometric, and thematic map analysis of hydraulic calcium silicate root canal sealers. Restor Dent Endod 2023; 48:e41. [PMID: 38053781 PMCID: PMC10695731 DOI: 10.5395/rde.2023.48.e41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.
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Affiliation(s)
- Anastasios Katakidis
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Kodonas
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Fardi
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Gogos
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Yang X, Zheng T, Yang N, Yin Z, Wang W, Bai Y. A Review of the research methods and progress of biocompatibility evaluation of root canal sealers. AUST ENDOD J 2023; 49 Suppl 1:508-514. [PMID: 36480411 DOI: 10.1111/aej.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/22/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
The function of root canal sealer was to achieve an appropriate three-dimensional filling effect by filling the root canal and some irregular lumen, thereby inhibiting the residual bacteria. There were many types of sealers, but research to find the most suitable ones was still ongoing. In recent years, researchers had continuously improved the performance of sealers by developing new sealers or adding active ingredients to the sealers. However, most sealers exhibit varying degrees of cytotoxicity and tissue responses, which affect clinical therapy efficacy. This review describes different technical approaches, and recent research progress in the biocompatibility evaluation of root canal sealers and provides brief insights into this field by summarising the performance studies of different root canal sealers.
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Affiliation(s)
- Xiliang Yang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Tianxia Zheng
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Nuoya Yang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Zihan Yin
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Wuliang Wang
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
| | - Yuhong Bai
- Department of Oral, College of stomatology, North China University of Science and Technology, Tangshan City, China
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Horhat RM, Bumbu BA, Orel L, Velea-Barta O, Cirligeriu L, Chicin GN, Pricop M, Rivis M, Dinu S, Horhat DI, Bratosin F, Fericean RM, Negrean RA, Nica LM. Assessing the Sealing Performance and Clinical Outcomes of Endodontic Treatment in Patients with Chronic Apical Periodontitis Using Epoxy Resin and Calcium Salicylate Seals. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1137. [PMID: 37374341 DOI: 10.3390/medicina59061137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Recognizing the significance of a hermetic apical seal for successful root canal treatment, the present investigation aimed to evaluate two sealing materials through an in vitro analysis, as well as to ascertain the clinical outcomes of patients treated with these two sealers in an in vivo setting. Materials and Methods: For the in vitro part of the study, two control groups of thirty monoradicular teeth were obturated with two sealers. Then, the sealers' performance was tested based on a predefined protocol. Group A included 30 patients treated with an epoxy oligomer resin-based sealer (Adseal, MetaBiomed), while Group S comprised 30 patients treated with a polymeric calcium salicylate-based sealer (Sealapex, Kerr). Samples were sectioned and evaluated under the microscope to determine the sealer's tightness by measuring the dye penetration into the root canal filling. For the in vivo part, a prospective study was designed to include 60 patients with chronic apical periodontitis in two endodontic treatment groups, using the same two sealers. Results: The in vitro analysis found that dye penetration in Group A was 0.82 mm (±0.428), while in Group S, the dye penetration was statistically significantly deeper, being 1.23 mm (±0.353). In the in vivo part of the study, the periapical index (PAI) significantly decreased 6 months after endodontic treatment, with 80.0% of patients in Group A having a PAI score of 2 compared to only 56.7% in Group S (p-value = 0.018). Similarly, tooth mobility scores significantly decreased after treatment, but with no difference between groups. The marginal bone loss decreased significantly more in the Adseal group compared to the Sealapex group (23.3% vs. 50.0%, p-value = 0.032). At the same time, 40.0% of patients in Group S had failed tooth healing compared to only 13.3% in Group A (p-value = 0.048). Conclusions: The in vitro study showed that Adseal had a better sealing capacity and a lower degree of dye penetration compared to Sealapex. However, on clinical evaluation in the in vivo study, both patient groups exhibited significant improvements in periapical index, tooth mobility scores, and pain reduction following endodontic treatment. Nevertheless, patients treated with Adseal showed a significantly greater improvement in PAI values, tooth mobility, and teeth healing after treatment. Overall, Adseal, as an endodontic sealer, may provide better sealing capabilities and enhanced clinical outcomes in the treatment of chronic apical periodontitis.
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Affiliation(s)
- Razvan Mihai Horhat
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Advanced and Digital Endodontic, Restorative and Prosthodontic Treatment (TADERP) Research Center, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Bogdan Andrei Bumbu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Laura Orel
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Oana Velea-Barta
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Laura Cirligeriu
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Advanced and Digital Endodontic, Restorative and Prosthodontic Treatment (TADERP) Research Center, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Gratiana Nicoleta Chicin
- Faculty of General Medicine, "Vasile Goldis" Western University of Arad, Bulevardul Revolutiei 94, 310025 Arad, Romania
- National Institute of Public Health, Strada Doctor Leonte Anastasievici 1-3, 050463 Bucharest, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mircea Rivis
- Department of Anesthesiology and Oral Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Stefania Dinu
- Department of Pediatric Dentistry, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Delia Ioana Horhat
- ENT Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | | | - Luminita Maria Nica
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Advanced and Digital Endodontic, Restorative and Prosthodontic Treatment (TADERP) Research Center, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Janini ACP, Pelepenko LE, Boldieri JM, dos Santos VAB, da Silva NA, Raimundo IM, Gomes BPFA, Marciano MA. Biocompatibility analysis in subcutaneous tissue and physico-chemical analysis of pre-mixed calcium silicate–based sealers. Clin Oral Investig 2023; 27:2221-2234. [PMID: 36977761 DOI: 10.1007/s00784-023-04957-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To evaluate the biocompatibility, physical and chemical properties of three pre-mixed calcium silicate-based sealers and an epoxy resin-based material were assessed. Pre-mixed sealers supposedly obtain water from the root canal moist to hydrate and set. MATERIALS AND METHODS Polyethylene tubes were filled with the materials Bio-C Sealer Ion+, Bio-C Sealer, EndoSequence BC Sealer and AH Plus Jet, or left empty and surgically implanted in the subcutaneous tissue of Wistar rats. The animals were euthanised and the tubes and tissue were removed for histological analysis and scanning electron microscopy (SEM) coupled with energy-dispersive spectrometry (EDS). Materials' surface chemical characterisation was assessed using Raman spectroscopy and SEM/EDS. Flow, setting time (in two conditions), solubility, radiopacity and pH were also analysed. ANOVA and Bonferroni correction were performed for comparisons (P < 0.05). RESULTS Inflammatory response observed in the tissues subsided from 7 to 30 days. Tungsten migration could be detected in the surrounding tissue following AH Plus Jet implantation. All calcium silicate-based sealers exhibited zirconium oxide (radiopacifier) and tricalcium silicate peaks before and after implantation. All materials exhibited flow values above 17 mm. An approximately tenfold difference was observed between the plaster- and metal-mould setting times of the calcium silicate cements indicating its sensitivity to moist variations and solubility above 8% was also observed for these materials. CONCLUSIONS Pre-mixed materials exhibited variable setting time and solubility with a decreasing inflammatory response. CLINICAL RELEVANCE The variable moist-dependant setting time with high solubility poses a concern for the clinical use of these pre-mixed sealers.
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Clinical Outcome of Non-Surgical Root Canal Treatment Using a Matched Single-cone Obturation Technique with a calcium hydroxide-based sealer: A Retrospective Analysis. J Endod 2022; 48:1486-1492. [DOI: 10.1016/j.joen.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022]
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Boderé PJ, Calberson F, De Bruyne M, De Moor R, Meire M. Protocols for cleaning the incisor access cavity contaminated with epoxy resin sealer. Eur J Oral Sci 2022; 130:e12894. [PMID: 36065089 DOI: 10.1111/eos.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022]
Abstract
This study compared different methods for cleaning the sealer-contaminated access cavity of upper incisors. After standard endodontic access, the canals of 50 extracted maxillary incisors were chemomechanically prepared and obturated with gutta-percha and epoxy resin sealer. Teeth were randomly assigned to one of five different pulp chamber cleaning protocols (n = 10): air/water spray, ethanol-saturated cotton pellet (CP), ethanol-saturated microbrush reaching the root filling (MB), MB + air polishing (PROPHYflex; KaVo), or MB + etching with 37% phosphoric acid. Each tooth was split and the sealer-covered area of the pulp chamber was determined on images taken before and after cleaning using image analysis software. The sealer-covered area was compared across groups using one-way ANOVA. Greatest mean sealer-covered area reduction was observed for MB + etching (98.0%), MB + air polishing (95.2%), and MB alone (92.8%), yielding a significantly higher sealer-covered area reduction than after air/water spray (8.3%) and ethanol-saturated cotton pellet (53.4%). The upper incisor access cavity is best cleaned with an ethanol-saturated microbrush reaching up to the root filling, followed by air/water spraying and etching. The use of cotton pellets should be discouraged.
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Affiliation(s)
- Pieter-Jan Boderé
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Filip Calberson
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Mieke De Bruyne
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Roeland De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Maarten Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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Effect of chlorhexidine digluconate on antimicrobial activity, cell viability and physicochemical properties of three endodontic sealers. Dent Mater 2022; 38:1044-1059. [PMID: 35491276 DOI: 10.1016/j.dental.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Assess the biological and physicochemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) leachates with and without chlorhexidine (CHX). METHODS The sealers were studied in no contact and 1-minute contact with CHX. For biological properties (antibacterial activity and cytotoxicity), leachates were formed in saline of freshly mixed, 1-, 7- and 28 days set sealers. The antibacterial properties of sealer leachates were investigated for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus. The 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to evaluate murine fibroblast cell viability after exposure to the leachates. The physical properties (water uptake, sorption, solubility, porosity, surface characteristics) of sealers and the pH of the immersion liquid (saline or distilled water) were also assessed over a 28-days period. RESULTS CHX improved the antibacterial properties of the sealer leachates and reduced cell viability for all sealer leachates, except for freshly mixed PCS. BioRoot RCS leachates presented the highest antibacterial properties and cell viability with and without CHX contact. PCS was the material most affected by CHX in terms of physical properties, whereas for AH Plus, solubility was increased. CHX did not affect the physical properties of BioRoot RCS, except for solubility that was decreased. CHX contact did not change sealers' alkalinity in distilled water whereas it increased it for AH Plus and BioRoot RCS in saline. SIGNIFICANCE CHX improved the antibacterial efficacy of sealer leachates and either compromised or did not affect cell viability. CHX affected to various extent sealers' physicochemical properties.
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13
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De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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14
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Impact of Immersion Media on Physical Properties and Bioactivity of Epoxy Resin-Based and Bioceramic Endodontic Sealers. Polymers (Basel) 2022; 14:polym14040729. [PMID: 35215641 PMCID: PMC8878582 DOI: 10.3390/polym14040729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 01/27/2023] Open
Abstract
This study assessed the effects of immersion media [distilled water (dw), phosphate buffered saline (pbs) and simulated body fluid (sbf)] in the physical properties [fluid uptake/sorption/solubility and alkalinization activity (pH)] and bioactivity of a bioceramic sealer: the BioRoot RCS (BioRoot) (Septodont). The epoxy-resin sealer AH Plus (Dentsply) was used as comparison. Sealers were immersed in dw, pbs and sbf to evaluate the fluid uptake/sorption/solubility and pH’s media. Bioactivity was assessed with SEM/EDS, FTIR-ATR and XRD. BioRoot solubility was as follows: sbf > pbs = dw. BioRoot had alkaline pH, and AH Plus had neutral pH, regardless of the medium. BioRoot presented mineral precipitates and peaks indicating hydroxyapatite-precursors in pbs and sbf. AH Plus physical properties were not affected by immersion media and it had no bioactivity. pbs and sbf should be preferred to investigate bioceramic sealers over distilled water, because they were able to highlight the sealer properties. BioRoot maintained the alkaline environment and favored hard tissue deposition.
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15
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Silva LABD, Bonifácio KC, Liévana FS, Martins GG, Flores DSH, Leonardo MR, Silva RABD, Paula-Silva FWG. Apical Periodontitis Healing Following Treatment is Impacted by Root Canal Sealer Composition: An in Vivo and in Vitro Investigation. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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16
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Lin X, Chi D, Gong Q, Tong Z. An in vitro study on the effects of serum proteins on Enterococcus faecalis adhesion to three types of root sealers and gutta-percha. BMC Oral Health 2021; 21:622. [PMID: 34876112 PMCID: PMC8650416 DOI: 10.1186/s12903-021-01992-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The extrusion of overfilled materials that extend beyond the apical foramina into the periradicular tissue may serve as a reservoir for bacterial adhesion and further affect recovery from periapical diseases. The aim of this study was to evaluate the effects of serum proteins on Enterococcus faecalis adhesion and survival on the surface of a calcium hydroxide-based root canal sealer (Apexit Plus), an epoxy resin sealer (AH-Plus) and a bioceramic sealer (iRoot SP). METHODS Apexit Plus, AH-Plus and iRoot SP were evenly coated on gutta-percha, using gutta-percha alone as the control. After root canal sealer setting, the number of E. faecalis adhering to the root canal sealers and gutta-percha was counted in fetal bovine serum (FBS) or tryptic soy broth supplemented with 1% glucose (TSBG) by viable cell plate counts. The morphology of 7-day-old E. faecalis biofilms in FSB and TSBG was observed by scanning electron microscopy (SEM). Furthermore, E. faecalis biofilms on the three root canal sealers were labeled with a LIVE/DEAD BacLight™ Bacterial Viability Kit, and the ratios of viable to dead cells were analyzed using laser scanning microscopy operative software (Zen software). RESULTS In the assays, after 1 and 7 days, the number of E. faecalis adhering to the root canal sealers or gutta-percha in FBS were significantly lower than those in TSBG (P < 0.05). In FBS, E. faecalis adhesion to iRoot SP and gutta-percha was reduced to a greater extent than that adhered to Apexit Plus and AH-Plus. Few E. faecalis accumulated on iRoot SP in FBS, whereas many bacteria assembled on iRoot SP and formed biofilms in TSBG. The ratio of viable cells in the E. faecalis biofilm on iRoot SP was the lowest. CONCLUSIONS Calcium hydroxide-based root canal sealers, epoxy resin sealers and bioceramic sealers may provide a substrate for E. faecalis adhesion, and the bioceramic sealer in this study showed the least E. faecalis adhesion in the presence of serum proteins compared to the other two sealers.
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Affiliation(s)
- Xinwei Lin
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-Sen University, No 56, Lingyuan West Road, Guangzhou, 510055, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Danlu Chi
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-Sen University, No 56, Lingyuan West Road, Guangzhou, 510055, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qimei Gong
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-Sen University, No 56, Lingyuan West Road, Guangzhou, 510055, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhongchun Tong
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-Sen University, No 56, Lingyuan West Road, Guangzhou, 510055, Guangdong, China. .,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.
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17
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Abu Zeid S, Edrees HY, Mokeem Saleh AA, Alothmani OS. Physicochemical Properties of Two Generations of MTA-Based Root Canal Sealers. MATERIALS 2021; 14:ma14205911. [PMID: 34683503 PMCID: PMC8538924 DOI: 10.3390/ma14205911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022]
Abstract
This study evaluated the physicochemical properties and the effect of solubility on the surface morphology and composition of the root canal sealers MTA-Bioseal, MTA-Fillapex, and Adseal. Discs (n = 10) of freshly mixed sealer were prepared and then analyzed by Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDX). The discs were immersed for 1, 7, 14, and 28 days in deionized water. The solubility %; pH change of the solution; and released calcium, phosphate, and silicon were measured for each period. The flowability and film thickness were also evaluated. Changes in the surface morphology and composition after 28 days of immersion were evaluated by SEM/EDX. The data were statistically analyzed by one-way ANOVA at p < 0.05. The FTIR and EDX results revealed similar compositions of MTA-Bioseal and MTA-Fillapex, but with different concentrations. The two MTA-based sealers had higher solution alkalinity (pH > 10) than Adseal (pH ≈ 8.5). MTA-Fillapex exhibited the highest solubility % and the largest calcium and silicon ion release. MTA-Bioseal had the highest phosphate ion release. After 28 days, the sealer surfaces showed large micropores, with larger pores in MTA-Fillapex. Adseal had an intermediate flowability but exhibited the greatest film thickness. Finally, the highest solubility and largest amount of silicon release was exhibited by MTA-Fillapex, which might predispose it to the development of large micropores, compromising the apical seal of obturation.
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Affiliation(s)
- Sawsan Abu Zeid
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.Y.E.); (A.A.M.S.); (O.S.A.)
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt
- Correspondence:
| | - Hadeel Yaseen Edrees
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.Y.E.); (A.A.M.S.); (O.S.A.)
| | - Abeer Abdulaziz Mokeem Saleh
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.Y.E.); (A.A.M.S.); (O.S.A.)
| | - Osama S. Alothmani
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.Y.E.); (A.A.M.S.); (O.S.A.)
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18
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Thein HSS, Hashimoto K, Kawashima N, Noda S, Okiji T. Evaluation of the anti-inflammatory effects of surface-reaction-type pre-reacted glass-ionomer filler containing root canal sealer in lipopolysaccharide-stimulated RAW264.7 macrophages. Dent Mater J 2021; 41:150-158. [PMID: 34602587 DOI: 10.4012/dmj.2021-139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A prototype surface-reaction-type pre-reacted glass-ionomer (S-PRG) filler containing root canal sealer (S-PRG sealer) exhibits bioactive potential by releasing multiple ions. This study explored the suppressive effects and modes of action of S-PRG sealer extracts on proinflammatory cytokine expression in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Expression of proinflammatory cytokines was evaluated by RT-qPCR and ELISA. Expression of phosphorylated nuclear factor-kappa B (p-NF-kB) p65 was evaluated by western blotting. S-PRG sealer extracts significantly downregulated mRNA expression levels of interleukin (IL)-1α, IL-6, and TNF-α in LPS-stimulated RAW264.7 cells; the extracts also reduced the levels of IL-6 protein and p-NF-kB. In order to verify that Zn2+ was responsible for downregulation of proinflammatory cytokine expression, N,N,N',N'-tetrakis(2-pyridylmethyl) ethylenediamine (TPEN) was used as a heavy metal chelator with strong affinity for Zn2+. These effects were mitigated by TPEN. The application of ZnCl2 reproduced the actions of S-PRG sealer extracts. These data suggest that S-PRG sealer has anti-inflammatory potential involving heavy metal ions such as Zn2+.
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Affiliation(s)
- Htoo Shwe Sin Thein
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Paediatric Dentistry, University of Dental Medicine Mandalay
| | - Kentaro Hashimoto
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Nobuyuki Kawashima
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Sonoko Noda
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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19
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Injectable calcium phosphate and styrene–butadiene polymer-based root canal filling material. ASIAN BIOMED 2021. [DOI: 10.2478/abm-2021-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background
Three-dimensional obturation of the root canal system is mandatory for a successful root canal treatment. Using a filling material with optimal properties may enable the root canal to be sealed well and therefore obtain the desired obturation.
Objective
To develop a new injectable paste endodontic filling material using calcium phosphate powder and a styrene–butadiene emulsion polymer.
Methods
The powder phase comprised an equivalent molar ratio of tetracalcium phosphate, anhydrous dicalcium phosphate, bismuth oxide, and calcium chloride. The liquid phase comprised a styrene–butadiene rubber emulsion in distilled water. The powder and the liquid were mixed to achieve a paste consistency. The paste was subjected to various tests including flow, setting time, dimensional change, solubility, and radiopacity to indicate its suitability as a root canal filling material. All these tests were conducted according to the American National Standards Institute–American Dental Association for endodontic sealing materials. After passing these tests, the paste was submitted to an injectability test.
Results
The material showed acceptable flowability with 19.1 ± 1.3 min setting time and 0.61 ± 0.16% shrinkage after 30 days of storage. We found the highest solubility at 24 h (6.62 ± 0.58%), then the solubility decreased to 1.09 ± 0.08% within 3 days. The material was more radiopaque than a 3 mm step on an aluminum wedge. Furthermore, the material showed good injectability of 93.67 ± 1.80%.
Conclusions
The calcium phosphate powder in styrene–butadiene emulsion met basic requirements for a root canal filling material with promising properties.
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20
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Kaka HB, Salman RF. Injectable calcium phosphate and styrene-butadiene polymer-based root canal filling material. ASIAN BIOMED 2021; 15:19-26. [PMID: 37551301 PMCID: PMC10388755 DOI: 10.1515/abm-2021-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background Three-dimensional obturation of the root canal system is mandatory for a successful root canal treatment. Using a filling material with optimal properties may enable the root canal to be sealed well and therefore obtain the desired obturation. Objective To develop a new injectable paste endodontic filling material using calcium phosphate powder and a styrene-butadiene emulsion polymer. Methods The powder phase comprised an equivalent molar ratio of tetracalcium phosphate, anhydrous dicalcium phosphate, bismuth oxide, and calcium chloride. The liquid phase comprised a styrene-butadiene rubber emulsion in distilled water. The powder and the liquid were mixed to achieve a paste consistency. The paste was subjected to various tests including flow, setting time, dimensional change, solubility, and radiopacity to indicate its suitability as a root canal filling material. All these tests were conducted according to the American National Standards Institute-American Dental Association for endodontic sealing materials. After passing these tests, the paste was submitted to an injectability test. Results The material showed acceptable flowability with 19.1 ± 1.3 min setting time and 0.61 ± 0.16% shrinkage after 30 days of storage. We found the highest solubility at 24 h (6.62 ± 0.58%), then the solubility decreased to 1.09 ± 0.08% within 3 days. The material was more radiopaque than a 3 mm step on an aluminum wedge. Furthermore, the material showed good injectability of 93.67 ± 1.80%. Conclusions The calcium phosphate powder in styrene-butadiene emulsion met basic requirements for a root canal filling material with promising properties.
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Affiliation(s)
- Hala B. Kaka
- Department of Conservative Dentistry, College of Dentistry, Hawler Medical University, Erbil44001, Iraq
| | - Raid F. Salman
- Department of Conservative Dentistry, Endodontics, College of Dentistry, Hawler Medical University, Erbil44001, Iraq
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21
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Silva EJNL, Cardoso ML, Rodrigues JP, De-Deus G, Fidalgo TKDS. Solubility of bioceramic- and epoxy resin-based root canal sealers: A systematic review and meta-analysis. AUST ENDOD J 2021; 47:690-702. [PMID: 33523574 DOI: 10.1111/aej.12487] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
This systematic review and meta-analysis evaluated whether epoxy resin-based root canal sealers present an increased solubility than calcium silicate-based root canal sealers. A systematic search was performed in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey. The inclusion criteria consisted of in vitro studies that compared the solubility of epoxy resin-based and calcium silicate-based sealers. The quality assessment and data extraction of the selected articles were performed. The meta-analysis of the pooled data and the subgroups according to the root thirds were carried out using the RevMan software (P < 0.05). After the duplicate removal and eligibility criteria assessment, a total of 22 studies were included all of them were considered as having a low risk of bias. The meta-analysis demonstrated overall lower solubility of AH Plus. AH Plus presented lower solubility than Bio-C Sealer, BioRoot RCS, MTA Fillapex, Sealer Plus and Total Fill BC Sealer.
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Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Milla Lessa Cardoso
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Jéssica Perrut Rodrigues
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Paediatric Dentistry, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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22
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Kurup D, Nagpal AK, Shetty S, Mandal TK, Anand J, Mitra R. Data on the push-out bond strength of three different root canal treatment sealers. Bioinformation 2021; 17:67-72. [PMID: 34393420 PMCID: PMC8340685 DOI: 10.6026/97320630017067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/31/2020] [Accepted: 01/02/2021] [Indexed: 11/23/2022] Open
Abstract
It is of interest to document data on the push - out bond strength of three different root canal treatment sealers such as MTA Fillapex (MTA based), AH plus (Epoxy Resin based) and Apexit plus (Calcium hydroxide based). Forty-five freshly extracted human maxillary central incisors with closed apices were selected randomly. All the teeth were sectioned at cement-enamel junction using a diamond disc before starting the root canal preparation to obtain root length of 12 mm. All teeth were instrumented using ProTaper rotary instruments. 5.25% sodium hypochlorite was used for irrigation between instrumentation followed by 17% EDTA, and final rinse by saline. Obturation procedures were done using the gutta-percha single cone technique. 45 roots were randomly assigned to 3 groups of 15 for obturation with gutta-percha cones and 1 of the 3 sealers (n=15). Group 1 = MTA Fillapex sealer + gutta-percha: Group 2 = AH plus sealer + gutta-percha:Group 3 = Apexit plus sealer + gutta-percha. The roots were sectioned horizontally to its canal into 3 sections: Coronal, Mid-root and Apical-thirds using a precision cutting machine, with a thickness of 3 mm. The specimens were subjected to push-out test using a universal testing machine that carried a plunger. The loading speed was 1mm/min until the dislodgment of the material occurred. The independent t- test was used to compare the mean scores among the study groups. The level of significance was set at 5% for all tests. After the push-out bond strength test, each sample was evaluated under stereomicroscope (40x) to determine the mode of failure and recorded as one of the following categories: adhesive, cohesive or mixed. The observations thus obtained were subjected to statistical analysis using Student - t test. AH Plus showed significantly higher values than MTA Fillapex and Apexit plus (p < 0.05). Amongst the push-out bond strength AH Plus sealer showed significant difference from MTA Fillapex and Apexit plus groups. There was no significant difference between MTA Fillapex and Apexit plus however (p>0.05). Microscopic analysis displayed that the majority of the modes were cohesive failures for AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus. . Thus, AH Plus had the highest bond strength and MTA Fillapex had the lowest bond strength to root dentin. Mean push-out bond strength values were ranked as follows; AH Plus >Apexit Plus > MTA Fillapex. Microscopic analysis displayed that the majority of the modes were cohesive failures of AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus.
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Affiliation(s)
- Deepak Kurup
- Department of Conservative Dentistry & Endodontics, Hazribagh college of dental sciences & hospital, Jharkhand, India
| | - Ajay Kumar Nagpal
- Department of Conservative Dentistry & Endodontics, Kanti Devi Dental College and Hospital, Mathura, India
| | - Shashit Shetty
- Department of Restorative Dental Science, College Of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Tapan Kumar Mandal
- Department of Conservative Dentistry & Endodontics, Hazribagh college of dental sciences & hospital, Jharkhand, India
| | - Juhi Anand
- Department of Conservative Dentistry & Endodontics, Hazribagh college of dental sciences & hospital, Jharkhand, India
| | - Rajdeep Mitra
- Department of Conservative Dentistry & Endodontics, Hazribagh college of dental sciences & hospital, Jharkhand, India
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23
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Yamauchi S, Watanabe S, Okiji T. Effects of heating on the physical properties of premixed calcium silicate-based root canal sealers. J Oral Sci 2020; 63:65-69. [PMID: 33298628 DOI: 10.2334/josnusd.20-0325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The purpose of this study was to examine the effect of heating on the physical properties of four types of premixed calcium silicate-based root canal sealers. Endoseal MTA, Well-Root ST, EndoSequence BC Sealer, EndoSequence BC Sealer HiFlow, and AH Plus (epoxy resin root canal sealer) were heated at 100°C for 1 min, and changes in setting time, flow, and film thickness were evaluated in accordance with ISO 6876:2012 standards. In addition, pH measurement and scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses of the set materials were performed. All root canal sealers heated at 100°C showed significant decreases in setting time and flow, particularly Endoseal MTA. In addition, the film thickness of Endoseal MTA increased significantly after heating at 100°C. The pH and SEM/EDS results were not affected by heating. Heating calcium silicate-based root canal sealers accelerated setting time, decreased flow, and increased film thickness. However, the degree of these changes varied among the products. The present findings indicate that heat-induced changes in the physical properties of calcium silicate-based root canal sealers could adversely affect the quality of warm vertical condensation technique.
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Affiliation(s)
- Shinya Yamauchi
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Satoshi Watanabe
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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24
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Physicochemical and Antibacterial Properties of Novel, Premixed Calcium Silicate-Based Sealer Compared to Powder-Liquid Bioceramic Sealer. J Clin Med 2020; 9:jcm9103096. [PMID: 32992852 PMCID: PMC7600315 DOI: 10.3390/jcm9103096] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/11/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to compare the physicochemical properties, filling ability, and antibacterial activity of a premixed calcium silicate-based sealer to those of a powder–liquid bioceramic sealer. Ceraseal (CS) and BioRoot (BR) materials were analyzed using scanning electron microscopy and energy-dispersive X-ray spectroscopy at 7 and 14 d of immersion in distilled water. The filling ability of the two sealers as well as the water contact angle, solubility, flow, roughness, crystalline microstructure, pH, and compressive strength were also evaluated. The antibacterial activity was assessed through an agar diffusion as well as through direct tests. All the results were statistically analyzed using one-way or two-way analysis of variance tests. Statistically significant lower void percentages were observed for CS at 2 and 8 mm from the working length (WL) compared to those for the BR group, whilst no significant difference was observed at 5 mm from the WL. BR sealer showed higher alkaline pH, rougher surface, lower water contact angle values, lower flowability, and higher solubility compared to CS. BR showed globular and needle-like crystalline microstructure, whilst CS had globular and flower-like crystalline microstructure up to 72 h. No statistical difference was found for the compressive strength between the two sealers. BR and CS showed no antibacterial effect against Enterococcus faecalis after 3 h, whilst both sealers showed antibacterial capacity after 24 and 72 h. BR demonstrated higher antibacterial activity after 24 h. In conclusion, the use of bioceramic sealers may play an important role in controlling bacterial growth. Moreover, CS may have superior filling ability and lower solubility than the BioRoot sealer due to its specific chemical composition and mixing method.
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Marques RPDS, Moura-Netto C, Oliveira NMD, Bresolin CR, Mello-Moura ACV, Mendes FM, Novaes TF. Physicochemical properties and filling capacity of an experimental iodoform-based paste in primary teeth. Braz Oral Res 2020; 34:e089. [PMID: 32785478 DOI: 10.1590/1807-3107bor-2020.vol34.0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/28/2020] [Indexed: 11/22/2022] Open
Abstract
In this study, we evaluated the physicochemical properties (PCP; radiopacity, flow, pH, and solubility) and the quality of root canal filling provided by an experimental industrialized paste (EP), with the same active ingredients as those of the Guedes Pinto paste, compared with the Vitapex® paste. PCP were analyzed according to the ANSI/ADA laboratory testing methods for endodontic filling and sealing materials. To analyze filling capacity, 120 artificial primary teeth (60 maxillary incisors [MIs] and 60 mandibulary molars [MMs]) were endodontically treated. The teeth were divided into eight groups based on the dental group (MIs or MMs), filling material (Vitapex® or EP), and insertion method (syringe or lentulo). The Image J® software was used to analyze the initial an final digital radiographies of each tooth, measuring and comparing root canal and void areas. The percentage of filling failure areas was obtained. Data were submitted to ANOVA and Tukey test of mean comparison. Regarding PCP, both pastes presented results according the ANSI/ADA standards. Flow capacity: Vitapex: 19.6 mm, EP: 25 mm (p < 0.01); radiopacity: Vitapex: 4.47 mmAl, EP: 6.06 mmAl (p < 0.01); pH after 28 days: Vitapex: 7.79, EP: 8.19 (p = 0.12); and solubility after 28 days: Vitapex: 2.68%, EP: 2.89% (p > 0.05). Regarding filling capacity analysis, EP demonstrated 12.5% of failure against 31.5% of Vitapex (p < 0.01). Compared to Vitapex, EP presented statistically significantly better results in flow, radiopacity, pH, and filling capacity. Molars presented more filling failures than incisors. The insertion method using a syringe and a thin tip was significantly better than that using Lentulo spiral carriers.
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Affiliation(s)
| | - Cacio Moura-Netto
- Faculty of Dental Medicine, Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | | | | | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
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Sun X, Sun A, Jia X, Jin S, Zhang D, Xiao K, Wang Q. In vitro bioactivity of AH plus with the addition of nano-magnesium hydroxide. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:313. [PMID: 32355757 PMCID: PMC7186602 DOI: 10.21037/atm.2020.02.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background AH Plus (AH) has been widely used as a root canal sealer in the endodontic field due to its superior physicochemical properties. However, clinical application of AH is limited due to its weak bioactivity. Methods In this study, we have developed an AH cement containing nano-magnesium hydroxide (NMH) as an additive to enhance the bioactivity of AH. The NMH can neutralize pH and facilitate bone formation. The objective of this study was to evaluate the effects of NMH and modified AH on osteoblasts behavior in vitro. The CCK-8, alkaline phosphatase (ALP) staining, and real-time polymerase chain reaction (PCR) assays were used to assess the proliferation and differentiation of MC3T3-E1 cells, respectively. The adhesion and spreading of MC3T3-E1 cells were investigated in vitro by scanning electron microscopy (SEM). Meanwhile, the flow and magnesium ion release of the modified AH was also concerned. Results In vitro cell assays further showed that the addition of NMH into AH cement, which was denoted as modified AH (especially AH+3%NMH), could effectively improve the proliferation and osteogenic differentiation of MC3T3-E1 cells. Conclusions Taken all together, we believe that the modified AH samples (especially AH+3%NMH) have outstanding biocompatibility and osteogenic properties and may have great potential in endodontic field.
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Affiliation(s)
- Xiujuan Sun
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Aoteng Sun
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Xingya Jia
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Shi Jin
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Dan Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China.,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang 110002, China
| | - Keshen Xiao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110002, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China.,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang 110002, China
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The efficacy of different cleaning protocols for the sealer-contaminated access cavity. Clin Oral Investig 2020; 24:4101-4107. [DOI: 10.1007/s00784-020-03283-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
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Mulyawati E, Soesatyo MHNE, Sunarintyas S, Handajani J. Apical Sealing Ability of Calcite-Synthesized Hydroxyapatite as a Filler of Epoxy Resin-Based Root Canal Sealer. Contemp Clin Dent 2020; 11:136-140. [PMID: 33110326 PMCID: PMC7583529 DOI: 10.4103/ccd.ccd_447_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/06/2020] [Accepted: 04/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The success of root canal treatment is influenced by hermetic root canal obturation. This study was conducted to analyze the apical sealing ability after the addition of calcite-synthesized hydroxyapatite (HA) as an epoxy resin sealer filler. METHODS Calcite-synthesized HA powder was prepared using the microwave hydrothermal process. HA resin sealer powder and epoxy resin paste (3:1) were mixed, and concentrations of 10%, 20%, 30%, 40%, and 50% were prepared. A sample of thirty maxillary incisors were prepared in the root canal and then, the crown was cut to leave 13 mm of the root and a working length of 12 mm. The root canal was prepared using the crown-down technique and irrigated using 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid alternately. The samples were divided into six groups, with each group consisting of five roots. Group I was obturated with gutta percha using an epoxy resin sealer without HA (HA-0%) as a control group. In each of the Groups II, III, IV, V, and VI, 10% HA resin sealer, 20% HA, 30% HA, 40% HA, and 50% HA were used. All the samples were incubated in a 10-ml simulated body fluid solution at 37°C for 4 weeks. Apical closure density measurement was done using a scanning electron microscope, and the results were analyzed using the Kruskal-Wallis and Mann-Whitney U-tests. RESULTS A significant increase in the apical sealing ability was observed in the HA-20% sealer group and the HA-30% and HA-40% groups compared to that in the control group. However, the HA-50% sealer group showed a decrease in the apical sealing ability, whereas the HA-10% sealer group showed no difference. The HA-30% had the highest sealing ability than other concentrations. CONCLUSION The addition of calcite-synthesized HA as a filler at concentrations of 20%, 30%, and 40% increased the apical sealing ability of the epoxy resin sealer.
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Affiliation(s)
- Ema Mulyawati
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Siti Sunarintyas
- Department of Biomaterials, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juni Handajani
- Department of Oral Biology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Hoshino RA, da Silva GF, Delfino MM, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Sasso-Cerri E, Bonetti Filho I, Cerri PS. Physical Properties, Antimicrobial Activity and In Vivo Tissue Response to Apexit Plus. MATERIALS 2020; 13:ma13051171. [PMID: 32151089 PMCID: PMC7085033 DOI: 10.3390/ma13051171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/19/2019] [Accepted: 01/23/2020] [Indexed: 11/20/2022]
Abstract
We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against Enterococcus faecalis was performed. Polyethylene tubes containing Apexit Plus or Sealapex, and without material (control group) were implanted into the subcutaneous tissue of rats. At 7, 15, 30, and 60 days of implantation, the specimens were paraffin-embedded and the number of inflammatory cells (ICs) and the amount of birefringent collagen (BC) were quantified. The von Kossa reaction followed by immunohistochemistry for detection of alkaline phosphatase (ALP) was also performed. Statistical analysis was performed with ANOVA and Tukey test (p ≤ 0.05). The flow value of Apexit Plus was greater than Sealapex, whereas the radiopacity (3.44 mm Al) was lower than Sealapex (6.82 mm Al). Apexit Plus showed lower solubility and shorter initial and final setting (p < 0.0001), whereas the antimicrobial activity was significantly greater than Sealapex. Although the number of ICs was higher in Apexit Plus (p = 0.0009) at 7 days, no significant difference was detected between Apexit Plus and Sealapex at 15, 30, and 60 days. All groups showed higher values for BC in the capsules over time. ALP-immunolabelled cells were observed, mainly around von Kossa-positive structures, either in the capsules of Apexit Plus or Sealapex. Therefore, our results revealed that Apexit Plus exhibited a greater effectiveness against Enterococcus faecalis and better physical properties than Sealapex, except for the radiopacity. In vivo findings indicate that Apexit Plus is biocompatible and presents potential bioactivity in the subcutaneous tissue.
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Affiliation(s)
- Roberto Alameda Hoshino
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Guilherme Ferreira da Silva
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Mateus Machado Delfino
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Juliane Maria Guerreiro-Tanomaru
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil;
| | - Idomeo Bonetti Filho
- Department of Restorative Dentistry, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (R.A.H.); (G.F.d.S.); (M.M.D.); (J.M.G.-T.); (I.B.F.)
| | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Dental School—São Paulo State University (UNESP), Araraquara 14801-903, Brazil;
- Correspondence: ; Tel.: +55-16-3301-6497; Fax: +55-16-3301-6433
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Baras BH, Melo MAS, Thumbigere-Math V, Tay FR, Fouad AF, Oates TW, Weir MD, Cheng L, Xu HHK. Novel Bioactive and Therapeutic Root Canal Sealers with Antibacterial and Remineralization Properties. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E1096. [PMID: 32121595 PMCID: PMC7084849 DOI: 10.3390/ma13051096] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
According to the American Dental Association Survey of Dental Services Rendered (published in 2007), 15 million root canal treatment procedures are performed annually. Endodontic therapy relies mainly on biomechanical preparation, chemical irrigation and intracanal medicaments which play an important role in eliminating bacteria in the root canal. Furthermore, adequate obturation is essential to confine any residual bacteria within the root canal and deprive them of nutrients. However, numerous studies have shown that complete elimination of bacteria is not achieved due to the complex anatomy of the root canal system. There are several conventional antibiotic materials available in the market for endodontic use. However, the majority of these antibiotics and antiseptics provide short-term antibacterial effects, and they impose a risk of developing antibacterial resistance. The root canal is a dynamic environment, and antibacterial and antibiofilm materials with long-term effects and nonspecific mechanisms of action are highly desirable in such environments. In addition, the application of acidic solutions to the root canal wall can alter the dentin structure, resulting in a weaker and more brittle dentin. Root canal sealers with bioactive properties come in direct contact with the dentin wall and can play a positive role in bacterial elimination and strengthening of the root structure. The new generation of nanostructured, bioactive, antibacterial and remineralizing additives into polymeric resin-based root canal sealers are discussed in this review. The effects of these novel bioactive additives on the physical and sealing properties, as well as their biocompatibility, are all important factors that are presented in this article.
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Affiliation(s)
- Bashayer H. Baras
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mary Anne S. Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD 21201, USA;
| | - Vivek Thumbigere-Math
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Franklin R. Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Ashraf F. Fouad
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA;
| | - Thomas W. Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Michael D. Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Lei Cheng
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610000, China
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Chang HH, Tseng YT, Huang SW, Kuo YF, Yeh CL, Wu CH, Huang YC, Jeng RJ, Lin JJ, Lin CP. Evaluation of Carbon Dioxide-Based Urethane Acrylate Composites for Sealers of Root Canal Obturation. Polymers (Basel) 2020; 12:polym12020482. [PMID: 32098145 PMCID: PMC7077711 DOI: 10.3390/polym12020482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 11/16/2022] Open
Abstract
A new root canal sealer was developed based on urethane acrylates using polycarbonate polyol (PCPO), a macrodiol prepared in the consumption of carbon dioxide as feedstock. The superior mechanical properties and biostability nature of PCPO-based urethane acrylates were then co-crosslinked with a difunctional monomer of tripropylene glycol diarylate (TPGDA) as sealers for resin matrix. Moreover, nanoscale silicate platelets (NSPs) immobilized with silver nanoparticles (AgNPs) and/or zinc oxide nanoparticles (ZnONPs) were introduced to enhance the antibacterial effect for the sealers. The biocompatibility and the antibacterial effect were investigated by Alamar blue assay and LDH assay. In addition, the antibacterial efficiency was performed by using Enterococcus faecalis (E. faecalis) as microbial response evaluation. These results demonstrate that the PCPO-based urethane acrylates with 50 ppm of both AgNP and ZnONP immobilized on silicate platelets, i.e., Ag/ZnO@NSP, exhibited great potential as an antibacterial composite for the sealer of root canal obturation.
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Affiliation(s)
- Hao-Hueng Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 100, Taiwan; (H.-H.C.); (S.-W.H.); (Y.-F.K.); (C.-L.Y.)
- Department of Dentistry, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Yi-Ting Tseng
- Institute of Polymer Science and Engineering and Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 100, Taiwan; (Y.-T.T.); (C.-H.W.); (Y.-C.H.)
| | - Sheng-Wun Huang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 100, Taiwan; (H.-H.C.); (S.-W.H.); (Y.-F.K.); (C.-L.Y.)
| | - Yi-Fang Kuo
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 100, Taiwan; (H.-H.C.); (S.-W.H.); (Y.-F.K.); (C.-L.Y.)
| | - Chun-Liang Yeh
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 100, Taiwan; (H.-H.C.); (S.-W.H.); (Y.-F.K.); (C.-L.Y.)
| | - Chien-Hsin Wu
- Institute of Polymer Science and Engineering and Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 100, Taiwan; (Y.-T.T.); (C.-H.W.); (Y.-C.H.)
| | - Ying-Chi Huang
- Institute of Polymer Science and Engineering and Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 100, Taiwan; (Y.-T.T.); (C.-H.W.); (Y.-C.H.)
| | - Ru-Jong Jeng
- Institute of Polymer Science and Engineering and Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 100, Taiwan; (Y.-T.T.); (C.-H.W.); (Y.-C.H.)
- Correspondence: (R.-J.J.); (J.-J.L.); (C.-P.L.); Tel.: +886-2-3366-5884 (R.-J.J.); +886-4228-57261 (J.-J.L.); +886-2-2312-3456 (ext. 67400) (C.-P.L.)
| | - Jiang-Jen Lin
- Department of Materials Science and Engineering, National Chung Hsing University, Taichung 400, Taiwan
- Correspondence: (R.-J.J.); (J.-J.L.); (C.-P.L.); Tel.: +886-2-3366-5884 (R.-J.J.); +886-4228-57261 (J.-J.L.); +886-2-2312-3456 (ext. 67400) (C.-P.L.)
| | - Chun-Pin Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 100, Taiwan; (H.-H.C.); (S.-W.H.); (Y.-F.K.); (C.-L.Y.)
- Department of Dentistry, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: (R.-J.J.); (J.-J.L.); (C.-P.L.); Tel.: +886-2-3366-5884 (R.-J.J.); +886-4228-57261 (J.-J.L.); +886-2-2312-3456 (ext. 67400) (C.-P.L.)
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Kataia E, Khallaf M, Omar N, Aly Y, ElShafei N. Assessment of physical properties of a ZnO/E sealer modified by adding moringa oleifera: An experimental in-vitro study. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_347_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Goldberg F, Cantarini C, Alfie D, Macchi RL, Arias A. Relationship between unintentional canal overfilling and the long-term outcome of primary root canal treatments and nonsurgical retreatments: a retrospective radiographic assessment. Int Endod J 2019; 53:19-26. [PMID: 31454090 DOI: 10.1111/iej.13209] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022]
Abstract
AIM To determine retrospectively the long-term radiographic outcome of root canal treatments and root canal retreatments with unintentional root canal overfilling. METHODOLOGY A total of 220 root canal treatments (143 primary/77 retreatments) with postoperative unintentional canal overfilling and performed by two endodontists during their 45 years of private practice were included in the study. Lateral condensation techniques and nine different sealers were used. Overfilling was confirmed with a postoperative periapical radiograph and patients were scheduled regularly for recall visits. Average recall time was 4.86 years (maximum = 30 years). Two calibrated observers evaluated the radiographs and determined the long-term outcome using the PAI score pooled in a 3-category scale. The persistence or resorption of the extruded material was registered. The Kappa coefficient (K) was calculated and a logistic regression was used for further analysis. Odds ratios and their 95% CI were estimated. RESULTS The level of inter-observer agreement was 66.1%. Primary root canal treatments had a significantly (P = 0.015) greater rate of success (91.6%) than retreatments (81.8%). Tooth location (P = 0.019) was the only other factor that significantly affected the outcome. The type of extruded material, and its resorption or persistence did not relate to the outcome. Persistence of extruded material was significantly affected by tooth location and recall time after treatment. CONCLUSION The outcome of root canal treatment with unintentional canal overfilling was not associated with the type of extruded material or its resorption or persistence. The persistence of extruded material did not relate to a favourable or unfavourable outcome.
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Affiliation(s)
- F Goldberg
- Department of Endodontics, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - C Cantarini
- Department of Endodontics, School of Dentistry, USAL/AOA University, Buenos Aires, Argentina
| | - D Alfie
- Department of Endodontics, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - R L Macchi
- Department of Dental Materials, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - A Arias
- Department of Conservative Dentistry, School of Dentistry, Complutense University, Madrid, Spain
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Marashdeh MQ, Friedman S, Lévesque C, Finer Y. Esterases affect the physical properties of materials used to seal the endodontic space. Dent Mater 2019; 35:1065-1072. [PMID: 31104923 PMCID: PMC6626680 DOI: 10.1016/j.dental.2019.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 01/08/2023]
Abstract
Materials used to seal the endodontic space are subjected to enzymatic degradative activities of body fluids and bacteria. OBJECTIVES To assess effects of simulated human salivary, blood and bacterial esterases (SHSE) on physical properties of typical restorative material and root canal sealers. METHODS Specimens of set methacrylate-based resin composite (BisfilTM2B; RC), calcium-silicate sealer (EndoSequence®; BC) or epoxy-resin sealer (AH-Plus®; ER) were tested after up to 28Days exposure to phosphate buffered saline (PBS) or SHSE, using ANSI/ADA-57:2000 and ISO-6876:2012. RESULTS Regardless of media, microhardness increased with time for BC remained unchanged for ER and decreased for RC (p < 0.05). SHSE moderated the increase for BC compared to PBS (28.0 ± 4.8 vs. 38.1 ± 7.9 KHN) at 7Days, and enhanced the decrease for RC at 7Days (55.6 ± 7.1 vs. 66.3 ± 6.5 KHN) and 28Days (52.3 ± 9.2 vs. 62.6 ± 8.5 KHN). Compressive strength was enhanced only for BC by either media. BC expanded with time for both incubation conditions; SHSE moderated the expansion compared to PBS at 7Days (0.026 ± 0.01% vs. 0.049 ± 0.007%). Shrinkage of ER was similar for both incubation media and was lower than that for RC (p < 0.05). Shrinkage of RC was enhanced by SHSE compared to PBS at 7Days (0.5 ± 0.07% vs. 0.38 ± 0.08%). Weight loss was lowest for ER and highest for BC (p < 0.05). It was enhanced by SHSE compared to PBS for BC at 28Days (2.40 ± 0.2 vs. 2.96 ± 0.19 W L%), and for RC at 7Days (0.54 ± 0.09 vs. 0.80 ± 0.1 W L%). SIGNIFICANCE Simulated body fluids and bacterial esterases affected the physical properties of test materials, suggesting potential impacts on sealing ability and resistance to bacterial ingress, and tooth strength ultimately affecting their clinical performance.
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Affiliation(s)
- M Q Marashdeh
- Faculty of Dentistry, University of Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario, Canada
| | - S Friedman
- Faculty of Dentistry, University of Toronto, Ontario, Canada
| | - C Lévesque
- Faculty of Dentistry, University of Toronto, Ontario, Canada
| | - Y Finer
- Faculty of Dentistry, University of Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario, Canada.
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A novel antibacterial resin-based root canal sealer modified by Dimethylaminododecyl Methacrylate. Sci Rep 2019; 9:10632. [PMID: 31337813 PMCID: PMC6650501 DOI: 10.1038/s41598-019-47032-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/09/2019] [Indexed: 02/05/2023] Open
Abstract
Persistent apical periodontitis, mainly caused by microorganisms infections, represents a critical challenge for endodontists. Dimethylaminododecyl methacrylate (DMADDM) is a well-studied and potent antibacterial agent used in various studies described in the literature. The aim of this study is to develop a novel antibacterial root canal sealer by incorporating DMADDM into EndoREZ and investigate the properties of the resulting material. Different mass fractions (0, 1.25%, 2.5%, and 5%) of DMADDM were incorporated into EndoREZ and the cytotoxicity, apical sealing ability and solubility of the resulting material were evaluated. Furthermore, a direct contact test, determination of colony-forming units, a crystal violet assay, scanning electronic microscopy and live/dead bacteria staining were performed to evaluate the antibacterial effect of the sealer to multispecies bacteria (Enterococcus faecalis, Streptococcus gordonii, Actinomyces naeslundii, and Lactobacillus acidophilus), in planktonic cells or biofilms. Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction were carried out to assess the composition of the multispecies biofilms. No difference on the cytotoxicity, apical sealing ability and solubility between sealers containing DMADDM (1.25%, 2.5%) and EndoREZ (0%) could be determined. However, when the mass fraction of DMADDM increased to 5%, significantly different properties were found compared to the 0% (p < 0.05) group. Moreover, incorporating DMADDM into the sealer could greatly improve the antibacterial properties of EndoREZ. In addition, the composition ratio of E. faecalis could be decreased in multispecies microecology in sealers containing DMADDM. Therefore, a EndoREZ sealer material containing DMADDM could be considered useful in clinical applications for preventing and treating persistent apical periodontitis.
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Elyassi Y, Moinzadeh AT, Kleverlaan CJ. Characterization of Leachates from 6 Root Canal Sealers. J Endod 2019; 45:623-627. [DOI: 10.1016/j.joen.2019.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
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Ekici MA, Ömürlü H. In vitro comparison of the physical properties of zinc oxide eugenol-based, propolis-containing experimental root canal sealers with standard sealers. ACTA ODONTOLOGICA TURCICA 2019. [DOI: 10.17214/gaziaot.440060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Razdan A, Benetti AR, Bjørndal L. Do in vitro solubility studies on endodontic sealers demonstrate a high level of evidence? A systematic review. Acta Odontol Scand 2019; 77:253-263. [PMID: 30849267 DOI: 10.1080/00016357.2018.1538535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. MATERIAL AND METHODS This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. RESULTS The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. CONCLUSIONS Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.
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Affiliation(s)
- Ankur Razdan
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ana Raquel Benetti
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Bjørndal
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Solubility and pH Value of 3 Different Root Canal Sealers: A Long-term Investigation. J Endod 2018; 44:1736-1740. [DOI: 10.1016/j.joen.2018.07.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/27/2018] [Accepted: 07/28/2018] [Indexed: 11/23/2022]
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40
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Khim TP, Sanggar V, Shan TW, Peng KC, Western JS, Dicksit DD. Prevention of coronal discoloration induced by root canal sealer remnants using Dentin Bonding agent: An in vitro study. J Conserv Dent 2018; 21:562-568. [PMID: 30294122 PMCID: PMC6161518 DOI: 10.4103/jcd.jcd_115_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Among the various causes of tooth discoloration after root canal treatment, percolation of sealer remnants into the dentinal tubules of the pulp chamber is the most common cause. Objectives The aim of this study is to evaluate the efficacy of dentin bonding agent (DBA) in preventing coronal discoloration caused by four different root canal sealers- MTA Fillapex, Sealapex, Zical and Z. O. B seal at different time intervals by measuring chromatic alterations using digital images analysis method. Methodology Ninety mandibular premolars were collected and sectioned at 1 mm below the cementoenamel junction. Standard access cavity preparations of dimensions (depth-3 mm, width-0.8 mm, and length-3 mm) were prepared with a No. 245 bur through the cervical access. Following the standard irrigation protocol, specimens were then randomly divided into nine groups (four groups without DBA [1-4] +4 groups with DBA [5-8] +1 negative control [9]). In Groups 1-4, four different root canal sealers (MTA Fillapex, Sealapex, Zical, and Z.O.B seal) were applied to the walls of the pulp chamber. For Groups 5-8, the samples were etched with 37% phosphoric acid and DBA application was done before the respective root canal sealer application. The cervical access in all specimens was sealed using glass ionomer cement. Digital photographs were taken under standard lighting and environmental conditions at different time intervals: preprocedural, postprocedural, and after 1, 2, 3, and 4 months. These images were analyzed using Adobe Photoshop CS6 from which laboratory values and subsequently Delta E values were obtained. Results Statistical analysis performed using repeated measures ANOVA and post hoc Tukey's tests show that the groups with DBA application had significantly lower mean Delta E values (P < 0.05) compared to the groups without DBA application. Conclusion DBAs applied to the dentinal walls of the pulp chamber before obturation can effectively reduce the sealer-induced coronal discoloration.
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Affiliation(s)
- Tan Peik Khim
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
| | | | - Tey Wei Shan
- Faculty of Dentistry, SEGi University, Selangor, Malaysia
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Zaki DY, Zaazou MH, Khallaf ME, Hamdy TM. In Vivo Comparative Evaluation of Periapical Healing in Response to a Calcium Silicate and Calcium Hydroxide Based Endodontic Sealers. Open Access Maced J Med Sci 2018; 6:1475-1479. [PMID: 30159080 PMCID: PMC6108798 DOI: 10.3889/oamjms.2018.293] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND: The composition of the root canal filling materials together with the apical limit of the root canal obturation affect the complete periapical healing after root canal therapy. AIM: This study was performed to evaluate and compare the periapical healing in response to calcium-silicate (iRoot SP) and calcium-hydroxide (Apexit) based-sealers. MATERIAL AND METHODS: Seventy-two upper premolars root canals of six dogs were used. The teeth were randomly assigned to four groups: Group one: roots were obturated using gutta-percha and Apexit-sealer; Group two: roots were obturated using gutta-percha&iRoot SP-sealer; Group three: the teeth were left open without obturation; Group four: where healthy teeth were used as a negative control. Teeth were evaluated after one, two and three months. The newly formed mineralised apical tissue and the periapical inflammatory infiltrate of the obtained photomicrographs were evaluated, and scorings were statistically-analysed. RESULTS: The mean percentage of the periapical inflammatory infiltrates and mineralisation scoring after one, two and three months evaluation period were not significantly different among the four groups (P > 0.05). CONCLUSIONS: Regardless of the sealer used, iRoot SP and Apexit promote healing of periapical tissues. IRoot SP sealer showed early insignificant more partial and almost full healing after two and three months.
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Affiliation(s)
- Dalia Y Zaki
- Restorative and Dental Materials Department, National Research Centre (NRC), El Bohouth St., 12622 Dokki, Giza, Egypt
| | - Mohamed H Zaazou
- Restorative and Dental Materials Department, National Research Centre (NRC), El Bohouth St., 12622 Dokki, Giza, Egypt
| | - Maram E Khallaf
- Restorative and Dental Materials Department, National Research Centre (NRC), El Bohouth St., 12622 Dokki, Giza, Egypt
| | - Tamer M Hamdy
- Restorative and Dental Materials Department, National Research Centre (NRC), El Bohouth St., 12622 Dokki, Giza, Egypt
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Evaluation of the biocompatibility of root canal sealers on human periodontal ligament cells ex vivo. Odontology 2018; 107:54-63. [DOI: 10.1007/s10266-018-0380-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/21/2018] [Indexed: 11/24/2022]
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Jung S, Sielker S, Hanisch MR, Libricht V, Schäfer E, Dammaschke T. Cytotoxic effects of four different root canal sealers on human osteoblasts. PLoS One 2018; 13:e0194467. [PMID: 29579090 PMCID: PMC5868789 DOI: 10.1371/journal.pone.0194467] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/02/2018] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the effect of an epoxy resin-based (AH-Plus), a zinc oxide eugenol containing (Pulp-Canal-Sealer) and two calcium silicate containing (MTA-Fillapex and BioRoot-RCS) sealers on primary human osteoblasts (hOB) in freshly mixed and set state. All sealers were mixed strictly according to the manufacturers´ instructions and identically samples were produced. In a pretest cytotoxic sealer concentrations were determined. Thus, for the main cell culture study, dilutions of sealer extract 1:1, 1:2, and 1:10 were used. To simulate a clinical scenario, extracts from freshly mixed sealer were added to the cells on day one. Extracts form set sealers were used for subsequent culturing for 24h, 7d, 14d, and 21d. Cell viability was analyzed by living-cell-count, MTT-assay, and living/dead-staining, cytotoxicity by LDH-assay, and changes by Richardson-staining. All data were statistically evaluated by one way ANOVA and a posthoc analysis with Bonferroni-Holm testing (p<0.05). AH-Plus was cytotoxic in a freshly mixed state, but not when the sealer was set. MTA-Fillapex and Pulp-Canal-Sealer were cytotoxic in a fresh as well as in a set state. BioRoot-RCS showed the lowest toxicity in both states; where as a regeneration of the cells could be observed over time (p<0.05). Contact of freshly mixed AH-Plus to osteoblasts should be avoided. Pulp Canal Sealer and MTA-Fillapex showed no biocompatibility in contact with osteoblasts at all. BioRoot-RCS had a positive influence on the cell metabolism (bioactivity) and is biocompatible.
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Affiliation(s)
- Susanne Jung
- Department of Cranio-Maxillofacial Surgery, Research Unit Vascular Biology of Oral Structures (VABOS), University Hospital Münster, Münster, Germany
| | - Sonja Sielker
- Department of Cranio-Maxillofacial Surgery, Research Unit Vascular Biology of Oral Structures (VABOS), University Hospital Münster, Münster, Germany
| | - Marcel R. Hanisch
- Department of Cranio-Maxillofacial Surgery, Research Unit Vascular Biology of Oral Structures (VABOS), University Hospital Münster, Münster, Germany
| | - Viktor Libricht
- Department of Cranio-Maxillofacial Surgery, Research Unit Vascular Biology of Oral Structures (VABOS), University Hospital Münster, Münster, Germany
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, Münster, Germany
| | - Till Dammaschke
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
- * E-mail:
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Teixeira L, Basso FG, Hebling J, Costa CADS, Mori GG, Silva-Sousa YTC, Oliveira CFD. Cytotoxicity Evaluation of Root Canal Sealers Using an In Vitro Experimental Model with Roots. Braz Dent J 2018; 28:165-171. [PMID: 28492745 DOI: 10.1590/0103-6440201701430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/20/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of the present study was to evaluate the cytotoxicity of root canal sealers under conditions closely resembling a clinical reality. A primary human fibroblast cell line was seeded in 24-well acrylic plates with Dulbecco's modified Eagle's medium supplemented with 10% serum fetal bovine (SFB) and incubated for 24 h. Root canals from premolars were filled and individually attached to nylon devices to be stabilized in the wells with the already seeded cells. Specimens were divided into groups as follows: Control: gutta-percha cones (GPC); AH Plus+GPC; Sealapex+GPC; MTA Fillapex+GPC and Endofill+GPC. After 24 and 48 h, cell viability and morphology were evaluated by MTT assay and scanning electron microscopy (SEM), respectively. Statistical analysis was performed by Mann-Whitney test, complemented by Kruskal Wallis test (p<0.05). Only Endofill presented cytotoxicity after 24 h. MTA Fillapex and Endofill reduced the production of succinic desidrogenase after 48 h. AH Plus was non-toxic at any time point. SEM showed that the AH Plus and MTA Fillapex groups presented fibroblasts with morphology close to the control group, while the Endofill group presented few cells with thin extensions cells. The present study showed that good results were present in AH Plus and Sealapex, but not the Endofill group after 48 h. The method used enabled evaluation of the cytotoxicity of the studied sealers that diffused through the root apex.
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Affiliation(s)
- Ligia Teixeira
- Dental School, UANERP - Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil.,Presidente Prudente School of Dentistry, UNOESTE - Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | | | - Josimeri Hebling
- Araraquara Dental School, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | | | - Graziela Garrido Mori
- Presidente Prudente School of Dentistry, UNOESTE - Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
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Colombo M, Poggio C, Dagna A, Meravini MV, Riva P, Trovati F, Pietrocola G. Biological and physico-chemical properties of new root canal sealers. J Clin Exp Dent 2018; 10:e120-e126. [PMID: 29670728 PMCID: PMC5899788 DOI: 10.4317/jced.54548] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/23/2017] [Indexed: 12/05/2022] Open
Abstract
Background The purpose of the present study was to compare the biological and the physico-chemical properties of bioceramic-based root canal sealers, calcium hydroxide-based, MTA-based and epoxy resin-based root canal sealers. Material and Methods Two bioceramic-based sealers, one calcium hydroxide-based sealer, one MTA-based sealer and two epoxy resin-based sealers were tested. Results EasySeal and MTA Fillapex showed severe citotoxic activity, AH Plus and SealapexTM moderate cytotoxicity, BioRoot™ RCS and TotalFill BC Sealer were both cytocompatible. Except for TotalFill BC Sealer, all root canal sealers caused inhibition zones when tested with E. faecalis. The highest inhibition zone was observed for EasySeal, followed by AH Plus. BioRoot™ RCS, SealapexTM and MTA Fillapex showed the lowest inhibition zone. All the tested materials showed different degree of antibacterial activity by using direct contact test (DCT). The highest values were observed for BioRoot™ RCS, TotalFill BC Sealer and EasySeal, followed by MTA Fillapex and SealapexTM. Except for BioRoot RCS and TotalFill BC Sealer, all the root canal sealers fulfilled the requirements of the ISO 6876 standard, demonstrating a weight loss less than 3%. Bioroot RCS, TotalFill BC Sealer and SealapexTM exhibited high alkaline pH with an increase both for BioRoot™ RCS and TotalFill BC Sealer after 24 hours. Conclusions The new bioceramic-based sealers showed acceptable physico-chemical properties, but BioRoot™ RCS and TotalFill BC Sealer seems to be too soluble, not respecting ISO 6876 requirements. Key words:Antibacterial activity, cytoxicity, pH, root canal sealers, solubility.
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Affiliation(s)
- Marco Colombo
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Claudio Poggio
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Alberto Dagna
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Maria-Vittoria Meravini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Paolo Riva
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Federico Trovati
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
| | - Giampiero Pietrocola
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences - Section of Dentistry, Policlinico "San Matteo" Piazzale Golgi, Pavia, Italy
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Poggio C, Arciola CR, Dagna A, Colombo M, Bianchi S, Visai L. Solubility of Root Canal Sealers: A Comparative Study. Int J Artif Organs 2018; 33:676-81. [DOI: 10.1177/039139881003300914] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 11/17/2022]
Abstract
Introduction Root canal sealers used in odontological applications are capable of providing an apical seal, thus inhibiting potential bacterial penetration into the periradicular tissues. Since insolubility is the ideal characteristic for a root canal sealer material, in dentistry the sealability of the material depends on its solubility. Purpose This study tested the solubility of six different root canal sealers: two ZnOE-based sealers (Endomethasone C and Argoseal), two calcium hydroxide-containing sealers (Bioseal Normal and Acroseal), and two resin-based sealers (AH Plus and MM Seal). Methods Ten specimens of each material were prepared using stainless steel ring molds with the same internal diameter and the same height in order to obtain similar samples, and immersed in water. Solubility was determined by using sample weight loss (%) after 24 hours and after 2 months. The test was performed according to the International Standards Organization 6876 standard and the American Dental Association specifications No. 30 and No. 57. Data were statistically analyzed with a one-way analysis of variance test (ANOVA). Results The ANOVA test showed significant differences between the various groups. The post-hoc test showed that resin-based root canal sealers had significantly lower solubility percentages than other groups (p<0.05), and showed no difference between them (p>0.05). Conclusions All the materials fulfilled the requirements of International Standard 6876 and ANSI/ADA specifications demonstrating a weight loss of less than 3%. Under the conditions of the present study, all root canal sealers were of low solubility, but the lowest solubility percentages were recorded in resin-based root canal sealers, which can be considered virtually insoluble, and thanks to this physical property, ideal for use as endodontic sealer.
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Affiliation(s)
- Claudio Poggio
- Department of Operative Dentistry, University of Pavia, Pavia - Italy
| | - Carla Renata Arciola
- Research Unit on Implant Infections of the Rizzoli Orthopedic Institute of Bologna and Experimental Pathology Department of the University of Bologna, Bologna - Italy
| | - Alberto Dagna
- Department of Operative Dentistry, University of Pavia, Pavia - Italy
| | - Marco Colombo
- Department of Operative Dentistry, University of Pavia, Pavia - Italy
| | - Stefano Bianchi
- Department of Operative Dentistry, University of Pavia, Pavia - Italy
| | - Livia Visai
- Department of Biochemistry and Center for Tissue Engineering (CIT), University of Pavia, Pavia - Italy
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Silva MGDSE, Münchow EA, Vitti RP, Sinhoreti MAC, Piva E, Ogliari FA, Zanchi CH. Pentaerythritol Tetrasalicylate in the Chemical Composition of Root Canal Sealers. Braz Dent J 2017; 29:48-53. [PMID: 29267524 DOI: 10.1590/0103-6440201801441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 10/10/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to synthesize and evaluate physicochemical properties of a new salicylate derivative in experimental calcium-based root canal sealers. Two salicylate derivatives were synthesized for the transesterification reaction of methyl salicylate with two different alcohols (1,3-butylenoglicol disalicylate-BD and pentaerythritol tetrasalicylate -PT) in molar ratio 1:3 and 1:6, respectively. The products (BD and PT), were characterized by Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance spectroscopy (RMN). Calcium-based experimental sealers were prepared with the same catalyst paste (60% of MTA, 39% of n-ethyl-o-toluenesulfonamide, and 1% titanium dioxide) and four different concentrations of BD and PT in the base pastes (40/0 - control, 35/5, 30/10 and 20/20) with 60% of bismuth oxide. The experimental sealers were evaluated for setting time, solubility (24 h, 7, 14 and 30 days), diametral tensile strength and Young's Modulus. Data were analyzed by one- or two-way ANOVA with Tukey's test (p<0.05). The addition of PT reduced the materials setting time. After 24 h the sealer 40/0 and 35/5 had higher solubility, and after 14 and 28 days the sealer 20/20 showed the lowest solubility (p<0.05). After 7 days the sealer 20/20 stabilized its solubility. The sealer 40/0 presented the highest values and the 20/20 presented the lowest values of diametral tensile strength and Young's modulus (p<0.05). The addition of PT to calcium-based root canal sealers provides benefits to the setting time and solubility.
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Affiliation(s)
| | - Eliseu Aldrighi Münchow
- Department of Operative Dentistry, School of Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Rafael Pino Vitti
- Department of Prosthodontic, School of Dentistry, UNITAU - Universidade de Taubaté, Taubaté, SP, Brazil.,Department of Restorative Dentistry, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | | | - Evandro Piva
- Department of Operative Dentistry, School of Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Fabrício Aulo Ogliari
- Department of Polymeric Materials, School of Engineering and Materials Science, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Cesar Henrique Zanchi
- Department of Operative Dentistry, School of Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Poggio C, Dagna A, Ceci M, Meravini MV, Colombo M, Pietrocola G. Solubility and pH of bioceramic root canal sealers: A comparative study. J Clin Exp Dent 2017; 9:e1189-e1194. [PMID: 29167707 PMCID: PMC5694146 DOI: 10.4317/jced.54040] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/19/2017] [Indexed: 11/25/2022] Open
Abstract
Background This study compared the solubility and the pH of different root canal sealers in vitro. Material and Methods BioRoot™RCS, TotalFill BC Sealer, MTA Fillapex, SealapexTM, AH Plus, EasySeal, Pulp Canal Sealer™ and N2 were tested. Similar specimens were prepared using ring molds with an internal diameter of 20 ± 0,1 mm and a height of 1,5 ± 0,1 mm and digitally weighted to register the mass of each specimen before and after immersion in distilled water. Solubility was determined after 24 hours and statistically analysed using a one-way ANOVA test and post-hoc Tukey test. The pH value was measured by a digital pH meter after 3 and 24 hours from manipulation. Results BioRoot™RCS and TotalFill BC Sealer showed significantly higher solubility (P<0.05). All the remnant root canal sealers fulfilled the requirements of solubility of the International Standard Organization 6876 demonstrating a weight loss of less than 3%. BioRoot™RCS and Totalfill BC Sealer exhibited high alkaline pH over time (P<0.05); the alkalinity of the other tested cements was significantly lower. Conclusions The prolonged alkalinity of bioceramic sealer matched the increase in solubility. This may encourage their biological and antimicrobial effects, but the ongoing solubility may impact their ability to prevent apical leakage. Key words:pH, root canal sealers, solubility.
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Affiliation(s)
- Claudio Poggio
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Alberto Dagna
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Matteo Ceci
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Maria-Vittoria Meravini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Marco Colombo
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Giampiero Pietrocola
- Department of Molecular Medicine, Unit of Biochemistry, University of Pavia, Italy
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Yilmaz A, Karagoz-Kucukay I. In vitro comparison of gutta-percha-filled area percentages in root canals instrumented and obturated with different techniques. J Istanb Univ Fac Dent 2017; 51:37-42. [PMID: 28955594 PMCID: PMC5573472 DOI: 10.17096/jiufd.95769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose: To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to
the percentage of gutta- percha-filled area (PGFA). Materials and Methods: One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were
prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20)
according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC), G2: Hand files+Thermafil, G3: ProTaper+LC,
G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at
1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification.
The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. Results: The mean of the PGFA in Thermafil (G2), ProTaper-Obturator (G5) and HEROfill (G8) groups was significantly higher than the other groups.
In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and
G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. Conclusion: The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral
condensation techniques.
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Affiliation(s)
- Ayca Yilmaz
- Department of Endodontics Faculty of Dentistry Istanbul University Turkey
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Cellular Responses in Human Dental Pulp Stem Cells Treated with Three Endodontic Materials. Stem Cells Int 2017; 2017:8920356. [PMID: 28751918 PMCID: PMC5511667 DOI: 10.1155/2017/8920356] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/22/2017] [Accepted: 04/12/2017] [Indexed: 02/07/2023] Open
Abstract
Human dental pulp stem cells (HDPSCs) are of special relevance in future regenerative dental therapies. Characterizing cytotoxicity and genotoxicity produced by endodontic materials is required to evaluate the potential for regeneration of injured tissues in future strategies combining regenerative and root canal therapies. This study explores the cytotoxicity and genotoxicity mediated by oxidative stress of three endodontic materials that are widely used on HDPSCs: a mineral trioxide aggregate (MTA-Angelus white), an epoxy resin sealant (AH-Plus cement), and an MTA-based cement sealer (MTA-Fillapex). Cell viability and cell death rate were assessed by flow cytometry. Oxidative stress was measured by OxyBlot. Levels of antioxidant enzymes were evaluated by Western blot. Genotoxicity was studied by quantifying the expression levels of DNA damage sensors such as ATM and RAD53 genes and DNA damage repair sensors such as RAD51 and PARP-1. Results indicate that AH-Plus increased apoptosis, oxidative stress, and genotoxicity markers in HDPSCs. MTA-Fillapex was the most cytotoxic oxidative stress inductor and genotoxic material for HDPSCs at longer times in preincubated cell culture medium, and MTA-Angelus was less cytotoxic and genotoxic than AH-Plus and MTA-Fillapex at all times assayed.
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