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Chanapairin B, Kulvitit S, Sathorn C. Post retention strength of apical and conventional coating obturation methods using bioceramic sealer: a laboratory investigation. BMC Oral Health 2024; 24:3. [PMID: 38167313 PMCID: PMC10763468 DOI: 10.1186/s12903-023-03778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Once bioceramic sealer (BCS) enters the dentinal tubules, it cannot be reliably removed. BCS-occupied dentinal tubules reduce fibre post retention strength. Coating gutta-percha with BCS only on the apical portion may improve post retention strength due to increased retention strength between the dentin and resin cement interface. The aim of the study was to test this hypothesis. METHODS Root canals of 27 extracted human mandibular premolars were instrumented and randomly assigned to three obturation methods: conventional coating (CC), non-coating (NC), and apical coating (AC). The root canals were obturated with gutta-percha to 4 mm from the working length under an operating microscope. After the BCS was completely set, post spaces were prepared, and quartz fibre posts were cemented. The apical 4.5 mm of the roots were removed. Two samples were prepared at the apical, middle, and coronal root levels (one for scanning electron microscope (SEM) study and another for the push out bond strength (PBS) test). After the PBS test, the samples were examined with a stereo microscope to determine the failure mode: dentine-cement (DC), post-cement (PC) and mixed. The PBS data were analysed by One way ANOVA for the specific obturation method effects. Repeated ANOVA was used for the specific effects of the root levels on PBS in different obturation methods. RESULTS At all three root levels, more continuous hybrid layers and denser resin tags were found in the NC and AC than the CC group. The AC and NC groups' PBS was significantly higher than the CC group at the apical 1/3 (p = 0.002 and p = 0.001) and coronal 1/3 (p = 0.016 and p = 0.041). The PBS in the CC group at the middle 1/3 was significantly higher than the apical 1/3 (p = 0.022). DC failure mode was most commonly found in the CC group, while PC failure mode was found most frequently in the NC and AC groups. CONCLUSIONS The apical coating obturation method significantly increased PBS over the conventional coating method, potentially reducing fiber post dislodgement. However, this study was only preliminary. Clinical studies are required to confirm the results.
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Affiliation(s)
- Benjarat Chanapairin
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sirinya Kulvitit
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence in Genomics and Precision Dentistry, Faculty of Dentistry, Chulalongkorn university, Bangkok, 10330, Thailand.
| | - Chankhrit Sathorn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- School of Dentistry, La Trobe University, Melbourne, VIC, Australia
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Yu Y, Yuan CY, Yin XZ, Wang XY. Assessment of isthmus filling using two obturation techniques performed by students with different levels of clinical experience. J Dent Sci 2024; 19:169-176. [PMID: 38303796 PMCID: PMC10829546 DOI: 10.1016/j.jds.2023.05.010] [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: 04/19/2023] [Revised: 05/07/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Root canal filling is a necessary skill for dental students and an important aspect of endodontic education. This study aimed to evaluate the effect of students' clinical experiences on isthmus filling using different techniques and sealers. Materials and methods One hundred eight three-dimensional-printed resin replicas of isthmus were divided into six groups and either continuous wave of condensation (CWC) or single-cone obturation (SC) was performed. One of three sealers (AH Plus Jet®, GuttaFlow2, iRoot SP) was used together with a size-fitted gutta-percha master cone. All the obturations were completed by students with three different levels of clinical experience including senior postgraduate students (SPS), junior postgraduate students (JPS), and undergraduate students (US). The percentages of filled areas (PFA) at 2, 4, 6, and 8 mm from the apex were analyzed using a light microscope. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis 1-way ANOVA with Dunn's tests (α = 0.05). Results The CWC group exhibited a higher PFA than the SC group (P < 0.05). The PFA was higher in the SPS group than in the JPS group or the US group with CWC (P < 0.05). The three clinical experience groups showed similar PFAs with SC (P > 0.05); however, when using SC with iRoot SP, the PFA was higher than with either of the other two sealers (P < 0.05). Conclusion CWC was found to be technique-sensitive and required clinical training. With SC, clinical experience did not improve the quality of isthmus filling without additional training. CWC was superior to SC for type IV isthmuses. When using SC, better filling quality was obtained with a bioceramic sealer.
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Affiliation(s)
- Yang Yu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Chong-Yang Yuan
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xing-Zhe Yin
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Kwak SW, Koo J, Song M, Jang IH, Gambarini G, Kim HC. Physicochemical properties and biocompatibility of various bioceramic root canal sealers: in vitro study. J Endod 2023:S0099-2399(23)00283-2. [PMID: 37225037 DOI: 10.1016/j.joen.2023.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The aim of this study was to compare the physicochemical properties and biocompatibility of various calcium silicate-based bioceramic sealers (CSBSs). METHODS Four recently developed CSBSs, including AH Plus Bioceramic Sealer (AHB), EndoSequence BC Sealer (ESB), TotalFill BC Sealer (TTB), and Bio-C Sealer (BIC), were compared with the epoxy resin-based sealer AH Plus (AHP). Their physical properties, including flow, setting time, radiopacity, dimensional stability, and pH, were evaluated according to International Organization for Standardization (ISO) 6876. Their cytotoxicity in human periodontal ligament fibroblast (hPDLF) was assessed through the MTT assay and compared. Additionally, cell attachment to the sealer surface was analysed using green fluorescent protein and confocal laser scanning microscopy (CLSM) to evaluate cell viability. Data were analysed using one-way analysis of variance to determine the difference between groups for categorical variables, followed by Tukey's post-hoc test at the significance level of 95%. RESULTS The flow, setting time, and radiopacity of all tested CSBSs satisfied the ISO 6876/2012 standards. Further, these CSBS showed shrinkage after immersion in distilled water for 30 days and complied with the ISO 6876/2001 requirements. The pH of AHB, ESB, TTB, and BIC was greater than 11 whereas AHP had a pH of 6.69 after 4 weeks. CSBS showed excellent biocompatibility compared with that of AHP (P < .05). CLSM showed that alive hPDLFs were attached well to all the tested CSBS but not to AHP. CONCLUSIONS CSBS have similar physical characteristics within the ISO standards and higher biocompatibility than epoxy resin-based sealers.
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Affiliation(s)
- Sang Won Kwak
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Jina Koo
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Il Ho Jang
- Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Gianluca Gambarini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea.
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In vitro evaluation of the sealing ability of combined use of iRoot BP Plus and iRoot SP for root-end filling. Clin Oral Investig 2023:10.1007/s00784-023-04896-5. [PMID: 36746820 DOI: 10.1007/s00784-023-04896-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the sealing ability of combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) for root-end filling. MATERIAL AND METHODS A total of 120 extracted human teeth were used in this study and were randomly divided into four groups. The BP-RRM+SP-RCS group included teeth retro-filled with combined use of BP-RRM and SP-RCS (n=45), and the BP-RRM group included teeth retro-filled by BP-RRM alone (n=45). Teeth without root-end preparation and filling were equally divided into positive control (n=15) and negative control (n=15). The apical sealing ability was evaluated by micro-CT analysis, dye penetrant examination, bacterial leakage test, and glucose leakage test. RESULTS Micro-CT analysis showed that the total void fraction of BP-RRM+SP-RCS group was significantly lower than that of BP-RRM group, particularly at the coronal 1/3 segment of the retro-filled roots. Consistently, the maximum linear depth of dye leakage in BP-RRM+SP-RCS group was less than that of BP-RRM group. Bacterial leakage test showed that the microbial leakage in BP-RRM+SP-RCS group was significantly less than that in BP-RRM group. However, no significant difference in glucose leakage between BP-RRM+SP-RCS group and BP-RRM group was observed. CONCLUSION Combined use of BP-RRM and SP-RCS for root-end filling promotes apical sealing in vitro. CLINICAL RELEVANCE Combined use of BP-RRM and SP-RCS for root-end filling exhibited better apical sealing as compared to BP-RRM alone in vitro, and this may help reducing technical sensitivity and promoting clinical efficiency during endodontic microsurgery.
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Suassuna FCM, de Araújo DKM, Amorim AMAM, Melo SLS, Heck RJ, Antonino ACD, Bento PM, Silva DFB, de Melo DP. Thermal and volumetric assessment of endodontic filling techniques using infrared thermography and micro-CT. J Oral Sci 2023; 65:34-39. [PMID: 36543226 DOI: 10.2334/josnusd.22-0285] [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: 12/23/2022]
Abstract
PURPOSE To assess root temperature during filling techniques and quantify the volume of endodontic filling materials using infrared thermography (IT) and micro-computed tomography (micro-CT). METHODS Ninety premolars were divided into three groups: lateral condensation (LC), single cone (SC) and thermomechanical compaction (TMC). For thermal analysis, 45 teeth were assessed using a FLIR T650sc IT camera during filling techniques and 45 teeth were scanned using a Nikon micro-CT to assess gutta-percha, cement, and void volumes. Descriptive and inferential statistical analyses were performed (non-parametric Mann-Whitney test, Kruskal-Wallis test, and Friedman test with Tukey's bidirectional analysis of variance). RESULTS TMC showed the highest temperature increase at 15 s after the procedure and a significant temperature decrease at 45 s after its completion. TMC showed the largest volume of gutta-percha and LC the highest void volume. CONCLUSION The temperature increase generated by gutta-percha endodontic filling techniques is within acceptable limits. A greater volume of endodontic cement was observed for the SL and LC filling techniques.
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Affiliation(s)
| | | | | | - Saulo Leonardo S Melo
- Department of Integrative Biomedical & Diagnostic Sciences School of Dentistry, Oregon Health & Science University
| | - Richard J Heck
- Department of Land Resource Science, University of Guelph
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Fan Y, Wang Z, Sun Y, Guo X, Wang H, Xu HHK, Wang S, Zhou X, Li B, Cheng L. Effect of the Modified Methacrylate-Based Root Canal Sealer in Single-Cone Technique. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3722. [PMID: 36364498 PMCID: PMC9655841 DOI: 10.3390/nano12213722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to modify EndoREZ with 2.5% dimethylaminododecyl methacrylate (DMADDM) and 1% magnetic nanoparticles (MNP) to study its sealing property, penetration and long-term antibacterial and therapeutic effect in the single-cone technique (SCT) compared with EndoREZ and iRoot SP. Thirty single-root human maxillary premolars were assigned into three groups and obturated with three different root canal sealers by SCT. Every specimen was then scanned using micro-CT to analyze void fraction, and void volumes and confocal laser scanning microscope (CLSM) was used to study the dentin penetration. The long-term antimicrobial effects were tested in vitro before and after aging 1 and 4 weeks by the single-strain Enterococcus faecalis biofilm model. In addition, the beagle canine model of apical periodontitis (AP) was utilized to judge and compare the therapeutic effect of three sealers in SCT. The void fraction and void volumes of the modified root canal sealer were not significantly different from iRoot SP (p > 0.05) but were lower than EndoREZ (p < 0.05). The modified root canal sealant displayed a greater penetration, long-term antibacterial property, and treatment effect than the other groups (p < 0.05). This indicated that after being modified with DMADDM and MNP, it showed better performance in SCT.
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Affiliation(s)
- Yu Fan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yan Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiao Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA
| | - Suping Wang
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bolei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Cimpean SI, Burtea ALC, Chiorean RS, Dudescu MC, Antoniac A, Robu A, Campian RS, Timis LI. Evaluation of Bond Strength of Four Different Root Canal Sealers. MATERIALS 2022; 15:ma15144966. [PMID: 35888436 PMCID: PMC9321937 DOI: 10.3390/ma15144966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
The purposes of the study were to evaluate the influence of the sealer’s chemical composition on the interfacial strength between root canal dentin and root filling material, for two different classes of endodontic sealers, and to assess their failure modes. Methods: Forty extracted single-rooted teeth were randomly divided into four groups using the following endodontic sealers: RealSeal SE and Resilon (RSSE); EndoSequence BC sealer and BC Point (EBCS); Endoseal MTA and gutta-percha (EDS); Bioroot RCS and gutta-percha (BRS). Teeth were embedded in acrylic resin, and the roots were sectioned horizontally into 1 mm slices. For each slice, the perimeter was measured. A push-out test was performed using an Instron universal testing machine. For each sample, bond strength was calculated. Specimens were examined by SEM investigation in order to analyze the dentin−sealer−core interface. Results were assessed using analysis of variance (ANOVA) and Tukey and Bonferroni test. Results: Statistical analysis revealed that EDS and gutta-percha had significantly higher resistance to dislodgement compared to the other three groups (p < 0.05). EBCS and BC Point showed significantly greater push-out bond strength values compared to RSSE and Resilon (p < 0.05). Conclusions: Bioceramic endodontic sealers showed a higher bond strength to root dentin than methacrylate resin-based endodontic sealer.
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Affiliation(s)
- Sanda Ileana Cimpean
- Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Str., 400000 Cluj Napoca, Romania; (S.I.C.); (R.S.C.); (L.I.T.)
| | - Adela Loredana Colceriu Burtea
- Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Str., 400000 Cluj Napoca, Romania; (S.I.C.); (R.S.C.); (L.I.T.)
- Correspondence: ; Tel.: +40-722953352
| | - Radu Stefan Chiorean
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 103-105 Bdul. Muncii, 400641 Cluj-Napoca, Romania; (R.S.C.); (M.C.D.)
| | - Mircea Cristian Dudescu
- Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 103-105 Bdul. Muncii, 400641 Cluj-Napoca, Romania; (R.S.C.); (M.C.D.)
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania; (A.A.); (A.R.)
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania; (A.A.); (A.R.)
| | - Radu Septimiu Campian
- Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Str., 400000 Cluj Napoca, Romania; (S.I.C.); (R.S.C.); (L.I.T.)
| | - Lucia Iacobina Timis
- Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Str., 400000 Cluj Napoca, Romania; (S.I.C.); (R.S.C.); (L.I.T.)
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Effect of Vitapex Combined with AH-Plus Paste on Inflammation in Middle-Aged and Elderly Patients with Periodontal-Endodontic Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7540961. [PMID: 35813417 PMCID: PMC9270133 DOI: 10.1155/2022/7540961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 02/05/2023]
Abstract
Aims. To investigate the effect of Vitapex combined with AH-plus paste on inflammation in middle-aged and elderly patients with periodontal-endodontic disease. Materials and Methods. A total of 80 teeth of middle-aged and elderly patients with the periodontal-endodontic disease who were treated in our hospital from June 2020 to June 2021 were selected as the research objects and were divided into comparison group and treatment group with 40 teeth each according to different treatment methods. Among them, the comparison group was filled with zinc oxide clove oil paste gutta-percha, and the treatment group was filled with Vitapex combined with AH-plus paste. The changes in apical cross-section sealing performance, periodontal pocket depth (PD), and gingival index (GI) of the two groups before treatment and after 6 months of follow-up were observed and compared, and X-ray analysis was performed. Results. There was no significant difference in the level of periodontal indexes and serum inflammatory indexes between the two groups before treatment (
). After treatment, the levels of PD, BI, PLI, and GI in the two groups were significantly lower than before treatment (
). The differences in IL-6, IL-10, TNF-α, and IL-1β after treatment were significant (
). There was no significant difference in the root canal area data of each cross-section between the two groups when the root canal was filled with root filling paste at different positions from the apex (
). After root canal filling with root canal paste, the cross-sectional area from different parts of the root canal in the treatment group was significantly smaller than comparison group (
). After 6 months of treatment, it was found that CEJ-BD and CEJ-AC in the treatment group were significantly lower than those in the comparison group (
). Conclusion. Vitapex combined with AH-plus paste filling can effectively treat middle-aged and elderly periodontal-endodontic disease, which provides a certain reference for the clinical treatment of middle-aged and elderly periodontal-endodontic disease.
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Girelli CFM, Lacerda MFLS, Lemos CAA, Amaral MR, Lima CO, Silveira FF, Nunes E. The thermoplastic techniques or single-cone technique on the quality of root canal filling with tricalcium silicate-based sealer: An integrative review. J Clin Exp Dent 2022; 14:e566-e572. [PMID: 35912029 PMCID: PMC9328491 DOI: 10.4317/jced.59387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background The filling of the root canal system (RCS) is an important step in endodontic treatment and aims to obtain a three-dimensional sealing of the root canal spaces to prevent bacterial contamination. For this, the selection of an appropriate sealer must be performed synchronously with the choice of the root canal filling technique. This study aims, through an integrative review, to evaluate the quality of root canal filling by comparing thermoplastic and single-cone (SC) techniques.
Material and Methods The Medline/PubMed, Scopus, Web of Science and Virtual Health Library (VHL) databases were used to find articles published until November 2021. The eligibility criteria comprised articles that evaluating the quality of root canal filling comparing thermoplastic techniques with the SC technique using tricalcium silicate-based sealer. Studies that evaluated primary teeth, endodontic retreatment or perforations, different outcomes, and studies that considered artificial teeth or different sealer and material for obturation of different techniques were excluded. For articles that were not available for access, an additional contact with authors were considered. A total of 1699 articles were found. After duplicate removal, the title and abstract of 828 articles were screened. Sixteen articles were considered for full-text analysis, but only ten articles met the eligibility criteria. Data extracted from the studies were discussed and tabulated to allow the comparison of desired factors.
Results Concerning the formation of gaps/voids, the thermoplastic techniques showed better results than the SC technique in 3 articles. On the other hand, 2 articles reported no statistical difference between the tested techniques. In addition, about the penetration of tricalcium silicate-based sealer in the dentinal tubules, of the 5 articles selected, in 4 there was no significant difference between the tested techniques and only one study showed better penetration of the sealer when using thermoplastic techniques.
Conclusions The thermoplastic technique was better in most selected studies regarding gaps and voids, but regarding the penetration of the sealer into the tubules, both techniques were effective. Key words:Root canal filling, thermoplastic techniques, tricalcium silicate.
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Affiliation(s)
| | | | | | | | | | | | - Eduardo Nunes
- DDS. Department of Dentistry, Pontificial Catholic University of Minas Gerais, Brazil
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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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Cho YS, Kwak Y, Shin SJ. Comparison of Root Filling Quality of Two Types of Single Cone-Based Canal Filling Methods in Complex Root Canal Anatomies: The Ultrasonic Vibration and Thermo-Hydrodynamic Obturation versus Single-Cone Technique. MATERIALS 2021; 14:ma14206036. [PMID: 34683625 PMCID: PMC8539525 DOI: 10.3390/ma14206036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/20/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the effectiveness of ultrasonic vibration and thermo-hydrodynamic obturation (VibraTHO) using two types of root canal sealers, in comparison to the single-cone (SC) technique and a calcium silicate-based root canal sealer in complex root canal anatomies. Thirty single-rooted human maxillary premolars with two canals that had a complex root canal anatomy of transverse anastomoses or ramifications were prepared and assigned to the following three experimental groups, according to the filling method: SE group, SC technique with Endoseal TCS; VE group, VibraTHO with Endoseal TCS; and VG group, VibraTHO with GuttaFlow 2. Each tooth was scanned using micro-computed tomography, and the volume percentages of the filling material were calculated. The analysis of variance was used to analyze the statistical differences between the three groups (p < 0.05). The mean volume of the filling material was higher in the VG and VE groups than that in the SE group (p < 0.05) along the apical to middle-to-coronal thirds, and significant differences were observed between each root canal area (p < 0.05), with the only exception being at the apical thirds between the VE and SE groups. The VibraTHO technique using GuttaFlow 2 can be a more effective root canal filling method for anatomically complex root canal systems than the SC technique with Endoseal TCS. On the other hand, the VibraTHO technique using Endoseal TCS has a limited effect on improving the quality of the root filling at the apical portion of anatomically complex root canal systems, compared to the SC technique with Endoseal TCS.
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Affiliation(s)
- Yong-Sik Cho
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Private Practice—Yonsei Doctors’ Dental Clinic, 201, 28 Daesan-ro, Ilsandong-gu, Goyang-si 10359, Korea
| | - Youngjun Kwak
- Private Practice—Yonsei Nature Dental Clinic, 2F, 281 Yangnyeong-ro, Dongjak-gu, Seoul 06919, Korea;
| | - Su-Jung Shin
- Gangnam Severance Hospital, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 211 Eonjuro, Gangnam-gu, Seoul 06273, Korea
- Correspondence: ; Tel.: +82-2-2019-3572; Fax: +82-2-3463-4052
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12
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Effect of Root Canal Therapy Combined with Full Crown Restoration on the Level of Inflammatory Factors and Chewing Function in Patients with Cracked Teeth and Chronic Pulpitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3299349. [PMID: 34504533 PMCID: PMC8423566 DOI: 10.1155/2021/3299349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/21/2021] [Indexed: 12/21/2022]
Abstract
Objective To explore the clinical effect of root canal therapy combined with full crown restoration in patients with cracked teeth and chronic pulpitis. Methods From May 2018 to June 2020, 87 patients with cracked teeth and chronic pulpitis in our hospital were selected; the patients were randomly divided into the control group and the research group by random number method. The control group only used root canal therapy; the research group used root canal therapy combined with full crown restoration. The therapeutic effect, levels of inflammatory factors, chewing function, periodontal index, complications, and quality of life were compared between the two groups. Results The total effective rate of the research group (97.78%) was better than the total effective rate of the control group (85.71%) (P < 0.05). Compared with before treatment, the serum levels of interleukin-1β (IL-1β), IL-6, and C-reactive protein (CRP) of the two groups of patients decreased after treatment. After treatment, compared with the control group, the serum levels of IL-1β, IL-6, and CRP in the research group decreased (P < 0.05). Compared with before treatment, the bite force of teeth and chewing efficiency of the two groups of patients increased after treatment. After treatment, compared with the control group, the bite force of teeth and chewing efficiency of the research group increased (P < 0.05). Compared with before treatment, the plaque index (PLI), probing depth (PD), gingival sulcus bleeding index (BI), and gingival index (GI) of the two groups of patients decreased after treatment. After treatment, compared with the control group, the PLI, PD, BI, and GI of the research group decreased (P < 0.05). The total incidence of complications in the research group was (11.11%), and the total incidence of complications in the control group was (16.67%); there was no significant difference between the two groups (P > 0.05). After treatment, compared with the control group, the quality of life scores of the patients in the research group were reduced (P < 0.05). Conclusion Root canal therapy and full crown restoration have a definite curative effect in patients with cracked teeth and chronic pulpitis, which can improve the inflammatory response, restore chewing function, maintain periodontal health, improve the quality of life, and do not increase the incidence of complications, so it has good application value.
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Liu H, Lai WWM, Hieawy A, Gao Y, von Bergmann H, Haapasalo M, Tay FR, Shen Y. Micro-computed Tomographic Evaluation of the Quality of Root Canal Fillings in Mandibular Molars after Obturation for 54 Months. J Endod 2021; 47:1783-1789. [PMID: 34492231 DOI: 10.1016/j.joen.2021.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The present study evaluated the percentage volume of voids in root canals of mandibular molars that had been obturated for 54 months. METHODS Thirty extracted human mandibular molars were instrumented and debrided. The teeth were assigned to 3 groups (n = 10) according to the filling technique and sealer used: the single-cone technique using AH Plus sealer (AHS; Dentsply Sirona Endodontics, Tulsa, OK) or EndoSequence BC sealer (BCS; Brasseler USA Dental LLC, Savannah, GA) and the warm vertical compaction technique using AH Plus sealer (AHW). The specimens were stored at 37°C and 100% humidity. Micro-computed tomographic imaging was used to scan each specimen 1 day 54 months after obturation. Data were analyzed using 1-way analysis of variance and the paired t test. RESULTS The percentage volume of voids in the teeth 1 day after obturation in the AHS group was higher than in the BCS group and the AHW group (P < .05). After 54 months, the proportion of voids decreased in all groups (P < .05). No significant difference was observed between the AHS group and the BCS group after 54 months. Teeth in the AHW group contained fewer voids than the AHS group (P < .05). CONCLUSIONS Voids in root canal filling were reduced 54 months after obturation. The warm vertical compaction technique achieved better root canal filling quality in mandibular molars than the single-cone technique when using AHS after long-term storage at 100% humidity.
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Affiliation(s)
- He Liu
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, China; Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wendy Wing Man Lai
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ahmed Hieawy
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yuan Gao
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - HsingChi von Bergmann
- Dental Education Research Lab, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.
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14
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de Souza DS, S Silva AS, Ormiga F, Lopes RT, Gusman H. The effectiveness of passive ultrasonic irrigation and the easy-clean instrument for removing remnants of filling material. J Conserv Dent 2021; 24:57-62. [PMID: 34475681 PMCID: PMC8378483 DOI: 10.4103/jcd.jcd_590_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 02/03/2023] Open
Abstract
Objective This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) and the easy clean instrument by micro-computed tomography (CT) for removing remnant filling materials during endodontic retreatment. Materials and Methods Forty mesial roots of mandibular molars were divided into four groups (n = 10) according to the agitation system and sealer used: Group 1: PUI/AH Plus; Group 2: PUI/TotalFill; Group 3: Easy Clean/AH Plus; and Group 4: Easy Clean/TotalFill. The groups were compared by micro-CT analysis according to the volumes of the obturation and the remaining material before and after the agitation systems were used. Results There was no difference between the groups for total filling volume and initial and final remaining filling volume (P > 0.05). Conclusions Both the PUI and easy-clean instrument are effective for removing remnants of filling material with no difference between the groups.
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Affiliation(s)
| | - Aline S S Silva
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Ricardo T Lopes
- Department of Nuclear Instrumentation, Center of Technology, Federal University of Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Center of Technology, Federal University of Rio de Janeiro, Brazil
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Sfeir G, Zogheib C, Patel S, Giraud T, Nagendrababu V, Bukiet F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. MATERIALS 2021; 14:ma14143965. [PMID: 34300886 PMCID: PMC8306764 DOI: 10.3390/ma14143965] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide-eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners' clinical habits rather than manufacturers' recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Shanon Patel
- King’s College London Dental Institute, Guy’s Tower, Guy’s Hospital, St. Thomas’ Street, London SE1 9RT, UK;
| | - Thomas Giraud
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
- Correspondence: ; Tel.: +33-(0)6-4395-2183
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Park MG, Kim IR, Kim HJ, Kwak SW, Kim HC. Physicochemical properties and cytocompatibility of newly developed calcium silicate-based sealers. AUST ENDOD J 2021; 47:512-519. [PMID: 33894082 DOI: 10.1111/aej.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2021] [Indexed: 01/23/2023]
Abstract
The purpose of this study was to compare the physical properties and cytocompatibility of contemporary calcium silicate-based sealers. Four calcium silicate-based sealers (BrightEndo MTA sealer, CeraSeal, EndoSeal TCS and One-Fil) were compared to an epoxy resin-based sealer (AH Plus). Flow, setting time, radiopacity and dimensional change were evaluated according to ISO 6876 standards. Cytotoxicity on human periodontal ligament fibroblast (hPDLF) cells was compared for biological properties using MTT assay. The surface of the sealer was analysed using scanning electron microscopy to evaluate cell attachment. Flow and radiopacity of all sealers met ISO standards, while setting time and dimensional stability did not meet the ISO standards. Calcium silicate-based sealers showed favourable cytocompatibility, and hPDLF cells were well attached to the calcium silicate-based sealers. Calcium silicate-based sealers have clinically acceptable flow and radiopacity, and cytocompatibility. However, these sealers had longer setting time and higher dimensional change than those required by ISO 6876.
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Affiliation(s)
- Min-Gyu Park
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea
| | - In-Ryoung Kim
- Department of Oral Anatomy, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Hyung Joon Kim
- Dental and Life Science Institute, Pusan National University, Yangsan, Korea.,Department of Oral Physiology, Pusan National University School of Dentistry, Yangsan, Korea.,Periodontal Diseases Signaling Network Research Center, Pusan National University, Yangsan, Korea
| | - Sang Won Kwak
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
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17
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Drukteinis S, Bilvinaite G, Tusas P, Shemesh H, Peciuliene V. Microcomputed Tomographic Assessment of the Single Cone Root Canal Fillings Performed by Undergraduate Student, Postgraduate Student and Specialist Endodontist. J Clin Med 2021; 10:jcm10051080. [PMID: 33807655 PMCID: PMC7961753 DOI: 10.3390/jcm10051080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022] Open
Abstract
The present study evaluated the obturation quality of root canals filled with BioRoot RCS sealer and single gutta-percha point by undergraduate student (US), postgraduate student (PS) and endodontist (ED). Twenty-one plastic models of upper premolars were enlarged with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into three groups (7 teeth/14 canals per group): US, PS and ED. After the obturation of root canals with BioRoot RCS and one HyFlex EDM size 40 gutta-percha point, plastic models were scanned using micro-computed tomography scanner (µCT) SkyScan 1272 at isotropic resolution of 10 µm. The porosity distribution was evaluated separately for the apical, middle and coronal thirds. The Kruskal–Wallis, Mann–Whitney, Friedman and Wilcoxon tests with the significance level set at 5% were used for data analysis. The µCT evaluation revealed open pores being the dominant type of porosity in all experimental groups and root canal thirds, with the highest percentage of pores in the apical third of root canal fillings. The quality and homogeneity of single cone root canals fillings remained similar between the groups in the apical and middle thirds (p > 0.05). Significant differences were observed only in the coronal third (p < 0.05).
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Affiliation(s)
- Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (G.B.); (P.T.); (V.P.)
- Correspondence: ; Tel.: +370-610-41808
| | - Goda Bilvinaite
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (G.B.); (P.T.); (V.P.)
| | - Paulius Tusas
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (G.B.); (P.T.); (V.P.)
| | - Hagay Shemesh
- Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3044, 1081 LA Amsterdam, The Netherlands;
| | - Vytaute Peciuliene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (G.B.); (P.T.); (V.P.)
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