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de Oliveira PHC, da Silva Rodrigues MJ, da Silva CC, de Barros Moraes Cardoso C, Faria FD, Cosme-Silva L, Ervolino E, Gomes-Filho JE, Sivieri-Araújo G, Cintra LTA. Influence of melatonin supplementation on tissue response of endodontic sealers in Wistar rats. Odontology 2024:10.1007/s10266-024-00982-6. [PMID: 39060895 DOI: 10.1007/s10266-024-00982-6] [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: 03/15/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE This study evaluated the influence of melatonin supplementation on tissue's response of endodontic sealers in Wistar rats. METHODOLOGY Forty-eight rats received subcutaneous implants of four polyethylene tubes: one empty (control) and three filled with endodontic sealers (AH Plus, Endofill and Sealapex). Half of the animals were supplemented with melatonin (ME) and the remaining treated with water (WA) for 15 days before the implantation until euthanasia, forming the groups: control-WA, AH Plus-WA, Endofill-WA, Sealapex-WA, Control-ME, AH Plus-ME, Endofill-ME and Sealapex-ME. After 5, 15 and 30 days, (n = 8) tubes were removed and evaluated in H&E., immunohistochemistry, PSR, VK and POL. The results were statistically analyzed (p < 0.05). RESULTS In animals treated with water, Endofill-WA evoked more intense inflammatory infiltrate compared to AH Plus-WA and Control-WA in a 30-day period (p < 0.05). In animals supplemented with melatonin, there was any difference among endodontic sealers' response in any period of analysis (p > 0.05). Comparing the individual response of each sealer, over a 30-day period, Endofill-ME and Sealapex-ME showed less inflammatory infiltrate compared to Endofill-WA and Sealapex-WA, respectively (p < 0.05). Immunostaining for IL-6 and TNF-α was less intense for all groups in animals supplemented with melatonin, in most periods, except for the Endofill sealer (p < 0.05). Furthermore, Endofill-ME at 5 days and AH-Plus-ME at 30 days showed a higher percentage of mature collagen fibers compared to the Endofill-WA and AH Plus-WA, respectively (p < 0.05). Positive structures for von Kossa staining and birefringent to polarized light were observed only for Sealapex-WA and Sealapex-ME in all periods. CONCLUSIONS It can be concluded that melatonin influences the tissue response to endodontic sealers, modulating the inflammatory and reparative process.
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Affiliation(s)
- Pedro Henrique Chaves de Oliveira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Michael Júnio da Silva Rodrigues
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Cristiane Cantiga da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Carolina de Barros Moraes Cardoso
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Flávio Duarte Faria
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Leopoldo Cosme-Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
- Departament of Endodontics, School of Dentistry, Alagoas Federal University (UFAL), Maceió, AL, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araújo
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
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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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Koutroulis A, Valen H, Ørstavik D, Kapralos V, Camilleri J, Sunde PT. Antibacterial Activity of Root Repair Cements in Contact with Dentin-An Ex Vivo Study. J Funct Biomater 2023; 14:511. [PMID: 37888176 PMCID: PMC10607193 DOI: 10.3390/jfb14100511] [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: 08/28/2023] [Revised: 09/18/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
This study assessed the antibacterial characteristics of the dentin/material interface and dentin surfaces exposed to experimental hydraulic calcium silicate cement (HCSC) with or without bioactive glass (BG) replacement (20% or 40%) or mixed with a silver nanoparticle (SNP) solution (1 or 2 mg/mL), and Biodentine, TotalFill BC RRM putty and Intermediate Restorative Material (IRM). Human root dentin segments with test materials were assessed at 1 or 28 days. In one series, the specimens were split to expose the dentin and material surfaces. A 24 h direct contact test was conducted against three-day established Enterococcus faecalis and Pseudomonas aeruginosa monospecies biofilms. In another series, the dentin/material interface of intact specimens was exposed to biofilm membranes for 3 days and the antibacterial activity was assessed via confocal microscopy. The interface was additionally characterised. All one-day material and dentin surfaces were antibacterial. Dentin surfaces exposed to HCSC with 40% BG-replacement, Biodentine and IRM had decreased antibacterial properties compared to those of the other cements. The HCSC mixed with a 2 mg/mL SNP solution had the highest antimicrobial effect in the confocal assay. The interfacial characteristics of HCSCs were similar. The test materials conferred antibacterial activity onto the adjacent dentin. The BG reduced the antibacterial effect of dentin exposed to HCSC; a 2 mg/mL SNP solution increased the antibacterial potential for longer interaction periods (three-day exposure).
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Affiliation(s)
- Andreas Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (D.Ø.); (V.K.)
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), 0855 Oslo, Norway;
| | - Dag Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (D.Ø.); (V.K.)
| | - Vasileios Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (D.Ø.); (V.K.)
| | - Josette Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Pia Titterud Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (D.Ø.); (V.K.)
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Alchawoosh A, Hashimoto K, Kawashima N, Noda S, Nozaki K, Okiji T. Hydraulic calcium silicate-based root canal sealers mitigate proinflammatory cytokine synthesis and promote osteogenesis in vitro. J Dent Sci 2023; 18:1731-1739. [PMID: 37799856 PMCID: PMC10547950 DOI: 10.1016/j.jds.2022.12.019] [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: 11/28/2022] [Revised: 12/26/2022] [Indexed: 01/09/2023] Open
Abstract
Background/purpose The mineralized tissue-inductive ability and anti-inflammatory properties of hydraulic calcium silicate-based (HCSB) sealers have not been fully elucidated. This study aimed to evaluate the effects of the HCSB sealers Bio-C sealer (BioC), Well-Root ST (WST), and EndoSequence BC sealer (BC), on osteoblastic differentiation/mineralization and proinflammatory cytokine synthesis by macrophages. Materials and methods Diluted extracts of set sealers or calcium chloride solutions of approximately equivalent Ca2+ concentrations were applied to a mouse osteoblastic cell line (Kusa-A1 cells) and lipopolysaccharide-stimulated mouse macrophage cell line (RAW264.7 cells). Expressions of osteoblastic markers in Kusa-A1 cells and proinflammatory cytokines in RAW264.7 cells were evaluated by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assays. Mineralized nodules were detected by Alizarin red S staining. Cell proliferation was assessed by WST-8 assay and cell attachment on set sealers was examined by scanning electron microscopy. Results The three sealer extracts significantly upregulated osteocalcin and osteopontin mRNA, and promoted significant mineralized nodule formation in Kusa-A1 cells. The three sealer extracts significantly downregulated the mRNA expressions of interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor (TNF)-α and protein levels of IL-6 and TNF-α in RAW264.7 cells. Calcium chloride solutions induced osteoblastic differentiation/mineralization. AH Plus Jet (a control sealer) extract did not. The three HCSB sealers did not interfere with the growth and attachment of Kusa-A1 cells. Conclusion BioC, WST, and BC were biocompatible, upregulated osteoblastic differentiation/mineralization, and downregulated proinflammatory cytokine expression. Ca2+ released from HCSB sealers might be involved, at least in part, in the induction of osteoblastic differentiation/mineralization.
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Affiliation(s)
- Aseel Alchawoosh
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - 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, Tokyo, Japan
| | - 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, Tokyo, Japan
| | - 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, Tokyo, Japan
| | - Kosuke Nozaki
- Department of Advanced Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - 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, Tokyo, Japan
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Penetration of Three Endodontic Sealers in Simulated Lateral Canals during the Lateral Condensation Technique: An In Vitro Study. Int J Dent 2022; 2022:2686247. [PMID: 36440093 PMCID: PMC9683939 DOI: 10.1155/2022/2686247] [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: 09/10/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to compare the penetration depths of AH Plus, BioRoot RCS, and GuttaFlow 2 into simulated lateral canals when used with the cold gutta-percha lateral compaction technique. Materials and Methods Twelve resin training blocks (4 canals perch each resin block) were used. Each primary artificial canal had two lateral canals (apical and coronal). The main canals were instrumented with WaveOne Gold and irrigated with distilled water. The resin blocks were divided into three groups (N = 4 each/16 artificial canals), according to the type of root canal sealer; Group I: AH Plus, Group II: BioRoot RCS, and Group III: GuttaFlow 2. All canals were obturated with the cold lateral condensation technique. The linear extension of each endodontic sealer into the apical and coronal lateral canals was measured using a digital stereomicroscope and measuring software. Data were statistically analyzed using a one-way analysis of variance. The percentages of filling of the lateral canals were calculated and statistically compared using the Mann–Whitney test. Results The experimental sealers exhibited variable penetration depths into the lateral canals. All sealers showed significantly better penetration ability into the apical lateral canals than the coronal lateral canals (P < 0.05). AH Plus (3.184 ± 0.012 mm/99.5%) and GuttaFlow 2 (3.176 ± 0.017 mm/99.25%) were significantly better than BioRoot RCS (3.096 ± 0.026 mm/96.75%) in filling the apical lateral canals (P < 0.05). BioRoot RCS was the best sealer to fill coronal lateral canals (3.322 ± 0.085 mm/83.05%). Conclusion During the lateral condensation technique, the filling of the lateral canals is affected by the type of root canal sealer and the location of the lateral canals All the sealers tested have a good ability to fill the apical lateral, while BioRoot RCS was effective in filling both the coronal and apical lateral canals.
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Alharbi A, Reville N, Molinier S, Bastier PL, de Gabory L. Characterization of fungus ball CT-hyperdensities within maxillary and sphenoid sinuses. Dentomaxillofac Radiol 2022; 51:20180384. [PMID: 35762348 PMCID: PMC10043618 DOI: 10.1259/dmfr.20180384] [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: 10/17/2018] [Revised: 05/10/2022] [Accepted: 06/03/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES CT-scan hyperdensities (HD) are described in more than 60% of all paranasal sinus fungus ball (FB) cases. Two types can be distinguished according to their density: calcium and metal types. We aimed to establish the prevalence and density of the HD observed in sphenoid and maxillary sinus FB and their relation to dental factors. METHODS This retrospective study included 64 patients operated in a tertiary referral center for unilateral maxillary or sphenoid FB diagnosed by histology or mycology. Pre-operative CT scans were analyzed by three independent observers (two ENT and one radiologist). RESULTS There were 45 maxillary FB and 19 sphenoid FB. 63 FB showed HD. Metal-type HD were observed in 28 maxillary FB but not in sphenoid sinuses. Among maxillary FB, the prevalence of endodontic treatment was significantly more significant on the FB side than on the healthy side (p = 0.02). The prevalence of endodontic treatment on the pathological side was more significant in the metal-type group than in the group without metal-type HD (p = 0.01). Isolated calcium-type HD were evidenced in 17 maxillary FB and 18 sphenoid FB (p = 0.019). CONCLUSION This study highlights the existence of two different types of HD in FBs of the paranasal sinuses with an association between metal-type HD and endodontic treatments.
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Affiliation(s)
| | - Nicolas Reville
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France
| | - Sandrine Molinier
- Radiology and Medical Imaging Department, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre-Louis Bastier
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France
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Koutroulis A, Valen H, Ørstavik D, Kapralos V, Camilleri J, Sunde PT. Surface characteristics and bacterial adhesion of endodontic cements. Clin Oral Investig 2022; 26:6995-7009. [PMID: 35931891 DOI: 10.1007/s00784-022-04655-y] [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: 03/17/2022] [Accepted: 07/23/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the effect of inclusion of silver nano-particles (SNP) or bioactive glass (BG) on the surface characteristics and bacterial adhesion of prototype tricalcium silicate (TCS)-based cements alongside two commercial cements, under different aging periods and exposure conditions. MATERIALS AND METHODS A basic formulation of radio-opacified TCS without (TZ-base) and with additions of SNP (0.5, 1, or 2 mg/ml) or BG (10 or 20%) was used. Biodentine and intermediate restorative material (IRM) served as reference materials. Material disks were immersed in ultrapure water or fetal bovine serum (FBS) for 1, 7, or 28 days. Surface roughness (n = 3), microhardness (n = 9), and wettability (n = 6) were analyzed by standard procedures. Adhesion of Enterococcus faecalis was assessed by fluorescence microscopy (n = 5). Data from these assays were evaluated for normality and comparisons among groups were conducted with statistical procedures (p < 0.05 for significance). RESULTS The surface morphology of SNP- and BG-containing cements had higher roughness values than TZ-base after 28 days (p < 0.05). No differences in microhardness were observed among prototype cements (p > 0.05). Biodentine presented smooth surface characteristics and the highest hardness values (p < 0.05). The FBS-immersion resulted in surface reactions in prototype materials and Biodentine, depicted with scanning electron microscopy. All 1- and 7-day prototype cements showed negligible bacterial adhesion, while in Biodentine and IRM, noticeable E. faecalis adherence was observed from day 1 (p < 0.05). CONCLUSIONS Incorporation of SNP or BG did not improve the antibacterial effect of the experimental cement; all 28-day aged materials failed to inhibit bacterial adherence. The measured physical parameters did not appear to be related to the degree of bacterial adhesion. Exposure of TCS-based cements in FBS resulted in surface reactions, which did not affect bacterial adhesion. CLINICAL RELEVANCE Changes in the surface characteristics of prototype TCS-based cements by inclusion of SNP and BG or exposure to different environments did not affect bacterial adhesion. All experimental materials showed inferior physical properties and higher antibacterial effect than Biodentine.
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Affiliation(s)
- Andreas Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Blindern, P.O. Box 1109, 0317, Oslo, Norway.
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Dag Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Blindern, P.O. Box 1109, 0317, Oslo, Norway
| | - Vasileios Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Blindern, P.O. Box 1109, 0317, Oslo, Norway
| | - Josette Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pia Titterud Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Blindern, P.O. Box 1109, 0317, Oslo, Norway
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Pilot Evaluation of Sealer-Based Root Canal Obturation Using Epoxy-Resin-Based and Calcium-Silicate-Based Sealers: A Randomized Clinical Trial. MATERIALS 2022; 15:ma15155146. [PMID: 35897577 PMCID: PMC9332451 DOI: 10.3390/ma15155146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this randomized controlled clinical trial was to assess the short-term clinical effectiveness of sealer-based root canal obturation using calcium-silicate-based sealer (CSBS) and epoxy-resin-based sealer (ERBS). A total of eighty patients (eighty teeth) were enrolled and seventy-two patients (seventy-two teeth) were randomly assigned into four different sealer groups: AH Plus (AH, Dentsply Sirona), ADseal (AD, Meta Biomed), CeraSeal (CS, Meta Biomed), or EndoSeal TCS (ES, Maruchi). At the first visit, root canal treatment was performed using ProTaper. Next, the NiTi file system and passive ultrasonic irritation was applied with 2.5% NaOCl. At the second visit, the teeth were obturated with a sealer-based obturation technique using the assigned sealer. The quality of filling obturation was evaluated with postoperative radiographs in terms of the presence of voids and sealer extrusion. The patients were recalled at 1-week, 1-month, and 3-month intervals, and pain levels were measured using visual analog scales (VAS), and clinical examination performed with percussion and palpation. Radiographs were also taken. The results were statistically compared by using the χ2 test or Fisher exact test. Among the 80 teeth included, 72 teeth received allocated intervention and 71 teeth were included in the analysis (98.6% recall). There was no significant difference among the sealers in void and sealer extrusion (p > 0.05). Postoperative pain was not indicated prominently regardless of the type of sealer. For a 3-month follow-up period, all cases were maintained successfully except for one case from AD. According to the findings, there was no significant difference between CSBS and ERBS in terms of postoperative pain or the healing process, and the variation in filling quality appears to be linked to the properties of each product.
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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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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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Malta C, Silva Barcelos R, Segat H, Burger M, Souza Bier C, Morgental R. Toxicity of bioceramic and resinous endodontic sealers using an alternative animal model: Artemia salina. J Conserv Dent 2022; 25:185-188. [PMID: 35720815 PMCID: PMC9205353 DOI: 10.4103/jcd.jcd_401_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 01/19/2022] [Indexed: 11/21/2022] Open
Abstract
Aims: The present study assessed the toxicity of a novel calcium silicate-based root canal sealer (Bio-C Sealer) in comparison to Endosequence BC Sealer and AH Plus through a lethality assay involving brine shrimp (Artemia salina). Methods: Brine shrimp cysts were incubated for 24 h for the hatching of the larvae, which were then exposed to different concentrations (2.5, 5, 10, 20, 40, 80, and 100 μg/mL) of the test endodontic sealers for 24 h, followed by the determination of the survival rate. Statistical Analysis Used: One-way repeated-measures ANOVA and the Newman–Keuls post hoc test were used to compare the different materials as well as different concentrations of the same material. Dunnett's test was used to compare the different concentrations and different sealers to the control. The lethal concentration of each endodontic sealer necessary to kill 50% of the brine shrimp larvae (LC50) was also determined. Results: The toxicity of Bio-C (10, 20, 40, 80, and 100 μg/mL) and Endosequence BC Sealer (20, 80, and 100 μg/mL) was lower than that of AH Plus. No significant difference was found between Bio-C and Endosequence BC Sealer or among the different intragroup concentrations of these sealers. In the AH Plus group, concentrations ≥5.0 μg/mL exhibited greater toxicity compared to the concentration of 2.5 μg/mL and the control. AH Plus had the lowest LC50 (59.95 μg/mL), whereas Bio-C and Endosequence BC Sealer had LC50 values >200 μg/mL. Conclusions: Bio-C Sealer proved to be less toxic than AH Plus and exhibited similar toxicity to that of Endosequence BC Sealer.
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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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Atmeh AR, AlMadi M, AlShwaimi E. Alkaline conditions can affect the volume and chemical characteristics of dental gutta-percha. AUST ENDOD J 2021; 48:144-150. [PMID: 34351038 DOI: 10.1111/aej.12553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/19/2021] [Accepted: 07/18/2021] [Indexed: 02/04/2023]
Abstract
The effects of alkaline pH on the size and surface characteristics of gutta-percha were studied. Forty ProTaper Universal-F2 gutta-percha cones (GPC) were stored individually for 8-weeks. GPC were distributed into 2 groups (n = 20) based on the storage solutions' pH (pH7, pH12). The GPC volume was measured after 1,2,3,4 and 8-weeks using water displacement method and compared to the baseline volume. The surfaces of representative GPCs were analysed using Raman spectroscopy and assessed later using Scanning Electron Microscopy with Energy-Dispersive X-Ray Spectroscopy (EDS). Samples t test was used to compare the change in volume of GPC and a repeated measures Analysis of Variance (ANOVA) was used to compare the effects of storage durations. After 8-weeks, GPCs aged in high-pH exhibited significant drop in their volume (16%) compared with GPCs aged in water (2.5%). The surface of GPCs stored in water or high-pH both demonstrated structural and chemical alterations in comparison with non-aged GPCs.
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Affiliation(s)
- Amre R Atmeh
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Madi AlMadi
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Emad AlShwaimi
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Nonsurgical Management of Apical Root Perforation Using Mineral Trioxide Aggregate. Case Rep Dent 2021; 2021:5583909. [PMID: 33815850 PMCID: PMC8012114 DOI: 10.1155/2021/5583909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/05/2021] [Accepted: 03/14/2021] [Indexed: 12/16/2022] Open
Abstract
This study illustrates a conservative approach to nonsurgical management of apical root perforation in maxillary first molars. A patient was referred for retreatment of a maxillary left first molar. Her chief complaint was dull pain while biting in her maxillary left first molar. Periapical radiography showed radiolucency related to the mesiobuccal root and overextended gutta-percha through a perforation in the apical part of the distobuccal root. A CBCT scan was acquired and revealed the location and size of the apical perforation. The clinical examination showed that the tooth has been endodontically treated and the canals were filled, tender to percussion and palpation. Thus, the nonsurgical root canal retreatment was done and the perforation site was repaired by using mineral trioxide aggregate (MTA). At the one-year follow-up, after the management of apical root perforation, we observed periapical tissue healing and no pain due to percussion and palpation, without any clinical/radiological signs or symptoms. The prognosis of this case has a higher success rate with the development of new materials such as MTA. The MTA not only can seal the site of the perforation but also has the ability to induce calcification. Many factors can contribute to the success rate of perforated cases, including time, size, and location of the perforation. With the use of this material and good tools like a microscope, there are those with having higher chances of repair and eventually higher success rates.
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Kapralos V, Rukke HV, Ørstavik D, Koutroulis A, Camilleri J, Sunde PT. Antimicrobial and physicochemical characterization of endodontic sealers after exposure to chlorhexidine digluconate. Dent Mater 2020; 37:249-263. [PMID: 33293036 DOI: 10.1016/j.dental.2020.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/20/2020] [Accepted: 11/18/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Assess the antibacterial, physical and chemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) in contact with 2% chlorhexidine digluconate (CHX) used as final irrigant prior to root canal obturation. METHODS The antimicrobial properties were investigated by direct contact tests for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus in vitro. The setting time, wettability, microhardness and surface roughness were also assessed. The sealers were studied in no contact, 1-minute (short-term) and continuous contact (long-term) with CHX. Chemical characterization of sealers was performed by scanning electron microscopy, X-ray diffraction analysis and Fourier-transform infrared spectroscopy after CHX or saline used as the last irrigant in an ex vivo tooth model and in endo training blocks. RESULTS CHX increased the antibacterial activity of all the sealers investigated against planktonic bacteria and biofilms with PCS exerting the highest antimicrobial activity with and without the presence of CHX. The setting of AH Plus and BioRoot RCS was retarded, while for PCS accelerated in the presence of CHX. AH Plus and PCS were more hydrophilic after contact with CHX, whilst BioRoot RCS was hydrophobic in a time-dependent manner. The microhardness of sealers was compromised and the surface roughness increased after CHX exposure for AH Plus and BioRoot RCS, and decreased for PCS. CHX did not affect the sealers' chemistry, but PCS that exhibited two extra phases. SIGNIFICANCE CHX improved the antibacterial efficacy of endodontic sealers but further evidence is needed to confirm its suitability as a final irrigant prior to root canal obturation.
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Affiliation(s)
- Vasileios Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Håkon Valen Rukke
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855 Oslo, Norway.
| | - Dag Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Andreas Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, 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.
| | - Pia Titterud Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
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A Novel Bioactive Endodontic Sealer Containing Surface-Reaction-Type Prereacted Glass-Ionomer Filler Induces Osteoblast Differentiation. MATERIALS 2020; 13:ma13204477. [PMID: 33050334 PMCID: PMC7599720 DOI: 10.3390/ma13204477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
Surface‑reaction‑type prereacted glass-ionomer (S‑PRG) fillers exhibit bioactive properties by the release of multiple ions. This study examined whether a novel endodontic sealer containing S‑PRG fillers (PRG+) has the capacity to induce osteoblast differentiation. Kusa‑A1 osteoblastic cells were cultured with extracts of PRG+, PRG- (an experimental sealer containing S‑PRG‑free silica fillers), AH Plus (an epoxy-resin‑based sealer), and Canals N (a zinc-oxide noneugenol sealer). Cell viability and mineralized nodule formation were determined using WST‑8 assay and Alizarin red staining, respectively. Osteoblastic-marker expression was analyzed with RT‑qPCR and immunofluorescence. Phosphorylation of extracellular signal‑regulated kinase (ERK) and p38 mitogen‑activated protein kinase (MAPK) was determined with Western blotting. Extracts of freshly mixed PRG+, PRG-, and AH Plus significantly decreased cell growth, but extracts of the set samples were not significantly cytotoxic. Set PRG+ significantly upregulated mRNAs for alkaline phosphatase and bone sialoprotein (IBSP) compared to set PRG-, and upregulation was blocked by NPS2143, a calcium‑sensing receptor antagonist. Set PRG+ significantly accelerated IBSP expression, mineralized nodule formation, and enhanced the phosphorylation of ERK and p38 compared with set PRG-. In conclusion, PRG+ induced the differentiation and mineralization of Kusa‑A1 cells via the calcium-sensing receptor-induced activation of ERK and p38 MAPK.
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The Invasion of Bacterial Biofilms into the Dentinal Tubules of Extracted Teeth Retrofilled with Fluorescently Labeled Retrograde Filling Materials. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10196996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we evaluated the invasion of bacteria into the dentinal tubules of retrofilled extracted human teeth, and the influence of different fluorescently labeled retrograde filling materials on the bacterial invasion and viability, by means of confocal laser scanning microscopy (CLSM). The root apices of extracted teeth were cut, prepared, and filled retrogradely using either intermediate restorative material (IRM), mineral trioxide aggregate (MTA), or Biodentine. The roots were filled with Enterococcus faecalis bacteria from their coronal part for 21 days. Then, 3-mm-long apical segments were cut to get root axial slices, and the bacteria were fluorescently stained and evaluated by CLSM. Bacterial penetration into the dentinal tubules favored the bucco-lingual directions. The filling materials penetrated up to 957 µm into the tubuli, and the bacteria, up to 1480 µm (means: 130 and 167 μm, respectively). Biodentine fillings penetrated less and the associated bacteria penetrated deeper into the tubuli compared to MTA or IRM (p = 0.004). Deeper filling penetration was associated with shallower penetration of both dead and live, or live alone, bacteria (p = 0.015). In conclusion, the current study enables better understanding of the microbiological–pathological course after endodontic surgical procedures. It was found that even with retrograde fillings, bacteria invade deep into the dental tubules, where deeper filling penetration prevents deeper penetration of the bacteria and adversely affects the viability of the bacteria.
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Kim JC, Moe MMK, Kim SK. A micro-computed tomographic evaluation of root canal filling with a single gutta-percha cone and calcium silicate sealer. Restor Dent Endod 2020; 45:e18. [PMID: 32483535 PMCID: PMC7239679 DOI: 10.5395/rde.2020.45.e18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/15/2019] [Accepted: 12/19/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to evaluate the void of root canal filling over time when a calcium silicate sealer was used in the single gutta-percha cone technique. Materials and Methods Twenty-four J-shaped simulated root canals and twenty-four palatal root canals from extracted human maxillary molars were instrumented with ProFile Ni-Ti rotary instruments up to size 35/0.06 or size 40/0.06, respectively. Half of the canals were filled with Endoseal MTA and the other half were with AH Plus Jet using the single gutta-percha cone technique. Immediately after and 4 weeks after the root canal filling, the samples were scanned using micro-computed tomography at a resolution of 12.8 μm. The scanned images were reconstructed using the NRecon software and the void percentages were calculated using the CTan software, and statistically analyzed by 1-way analysis of variance, paired t-test and Tukey post hoc test. Results After 4 weeks, there were no significant changes in the void percentages at all levels in both material groups (p > 0.05), except at the apical level of the AH Plus Jet group (p < 0.05) in the simulated root canal showing more void percentage compared to other groups. Immediately after filling the extracted human root canals, the Endoseal MTA group showed significantly less void percentage compared to the AH Plus Jet group (p < 0.05). Conclusions Under the limitations of this study, the Endoseal MTA does not seem to reduce the voids over time.
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Affiliation(s)
- Jong Cheon Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Maung Maung Kyaw Moe
- Department of Conservative Dentistry, University of Dental Medicine, Mandalay, Myanmar
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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Rashed B, Iino Y, Ebihara A, Okiji T. Evaluation of Crack Formation and Propagation with Ultrasonic Root-End Preparation and Obturation Using a Digital Microscope and Optical Coherence Tomography. SCANNING 2019; 2019:5240430. [PMID: 31969970 PMCID: PMC6955132 DOI: 10.1155/2019/5240430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 12/19/2019] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This study is aimed at determining (1) the effect of root-end resection, ultrasonic root-end preparation, and root-end filling on the incidence of crack formation and propagation by using a digital microscope (DM) and optical coherence tomography (OCT) and (2) the performance of OCT on the detection of cracks by comparing with microcomputed tomography (micro-CT) as a reference standard. METHODOLOGY Thirty extracted lower incisors were endodontically treated and subjected to root-end resection and ultrasonic root-end cavity preparation. Then, the teeth were divided into three groups (n = 10, each), and the root-end cavity was either left unfilled or filled with mineral trioxide aggregate (MTA) or super-EBA. The resected surface was observed with OCT and DM after the root-end resection, ultrasonic root-end preparation, and root-end filling, and the frequency of incomplete and complete cracks were recorded. The observation was repeated after two weeks, one month, and two months, and micro-CT scans after two months were taken as the gold standard. RESULTS The DM results show dentinal crack formation in 47% of the samples following root-end resection and in 87% following ultrasonic preparation. After the ultrasonic preparation, no existing crack propagated to a complete crack, but new cracks were formed. MTA and super-EBA had no effect on crack formation. The Spearman correlation coefficient between OCT and DM was 0.186 (very weak correlation; p = 0.015). Sensitivity and specificity in comparison to micro-CT were 0.50 and 0.55 in OCT and 1.00 and 0.35 in DM, respectively. McNemar's test showed a significant difference between OCT and DM (p < 0.05). CONCLUSION Apical resection and ultrasonic preparation could form dentinal cracks. OCT and DM showed different detection frequencies of cracks with very weak correlation. DM showed superior sensitivity compared with OCT.
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Affiliation(s)
- Bayan Rashed
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- King Abdul-Aziz Airbase Hospital, Dhahran, Saudi Arabia
| | - Yoshiko Iino
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Effect of root canal sealers on the fracture resistance of endodontically treated teeth: a systematic review of in vitro studies. Clin Oral Investig 2018; 22:2475-2485. [DOI: 10.1007/s00784-018-2540-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Uzunoglu-Özyürek E, Karaaslan H, Türker SA, Özçelik B. Influence of size and insertion depth of irrigation needle on debris extrusion and sealer penetration. Restor Dent Endod 2018; 43:e2. [PMID: 29487833 PMCID: PMC5816991 DOI: 10.5395/rde.2018.43.e2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 11/08/2017] [Indexed: 12/28/2022] Open
Abstract
Objectives To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.
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Affiliation(s)
- Emel Uzunoglu-Özyürek
- Department of Endodontics, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Hakan Karaaslan
- Department of Endodontics, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Sevinç Aktemur Türker
- Department of Endodontics, Bülent Ecevit University Faculty of Dentistry, Zonguldak, Turkey
| | - Bahar Özçelik
- Department of Endodontics, Hacettepe University Faculty of Dentistry, Ankara, Turkey
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Kapralos V, Koutroulis A, Ørstavik D, Sunde PT, Rukke HV. Antibacterial Activity of Endodontic Sealers against Planktonic Bacteria and Bacteria in Biofilms. J Endod 2018; 44:149-154. [DOI: 10.1016/j.joen.2017.08.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/10/2017] [Accepted: 08/17/2017] [Indexed: 01/12/2023]
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Evaluation of the interface between gutta-percha and two types of sealers using scanning electron microscopy (SEM). Clin Oral Investig 2017; 22:1631-1639. [DOI: 10.1007/s00784-017-2216-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
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Bacterial colonization in the apical part of extracted human teeth following root-end resection and filling: a confocal laser scanning microscopy study. Clin Oral Investig 2017; 22:267-274. [PMID: 28349219 DOI: 10.1007/s00784-017-2107-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate Enterococcus faecalis colonization at the apical part of root canals following root-end resection and filling using confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS The apical 3-mm root-ends of 55 extracted single rooted human teeth were resected, and 3-mm retrograde cavities were prepared and filled using either mineral trioxide aggregate (MTA), intermediate restorative material (IRM), or Biodentine (n = 10 each); 25 teeth served as controls. The roots were placed in an experimental model, sterilized, and coronally filled with E. faecalis bacterial suspension for 21 days. Then, the apical 3-mm segments were cut to get two slabs (coronal and apical). The slabs were stained using LIVE/DEAD BacLight Bacterial Viability Kit and evaluated using CLSM. RESULTS The fluorescence-stained areas were larger in the bucco-lingual directions compared with the mesio-distal directions (p < 0.05). The mean and maximal depths of bacterial colonization into the dentinal tubules were 755 and 1643 μm, respectively, with no differences between the root-end filling materials (p > 0.05). However, more live bacteria were found in the MTA group in comparison to IRM and Biodentine groups (p < 0.05). CONCLUSIONS CLSM can be used to histologically demonstrate bacterial root-end colonization following root-end filling. This colonization at the filling-dentine interfaces and deeper into the dentinal tubules may be inhomogeneous, favoring the bucco-lingual aspects of the root. CLINICAL RELEVANCE Following root-end resection and filling bacterial colonization may lead to inflammatory reactions at the periapical tissues; the viability of the colonized bacteria may be affected by the type of root-end filling material.
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Trope M, Bunes A, Debelian G. Root filling materials and techniques: bioceramics a new hope? ACTA ACUST UNITED AC 2015. [DOI: 10.1111/etp.12074] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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