Influence of bioceramic intracanal medication on the bond strength of bioceramic root canal sealer

To investigate the influence of the remaining volume of a new intracanal medication based on bioceramic compounds on the bond strength (BS) and formation of an adhesive interface between calcium silicate-based and epoxy resin-based root canal sealers. For this purpose, the specimens were distributed according to the intracanal medication (n = 26): Bio-C Temp (BCT) and Ultracal XS (UXS). The roots were scanned in microCT, and after 7 days, the medication was removed. Then a new scan was performed to evaluate the volume of medication remaining. Subsequently, 40 specimens were redistributed into 2 subgroups (n = 10) and filled according to the sealer used: AH Plus (AHP) and Bio-C Sealer (BCS), to assess the bond strength by using the push-out test, and the adhesive interface by confocal laser fluorescence microscopy (CLSM) and scanning electron microscopy (SEM). The t test showed a smaller remainder of BCT (1.77 ± 0.86) compared with UXS (10.47 ± 5.78), irrespective of the root third evaluated. The BS showed that teeth with BCT + BCS had higher bond strength values (3.70 ± 1.22) when compared to the other groups: BCT + AHP (2.15 ± 1.07), UXS + BCS (3.18 ± 1.09) and UXS + AHP (2.11 ± 1.02) (p<0.001). The cervical third had higher BS when compared with the middle and apical thirds (p < 0.001), and higher number of adhesive failures. The adhesive interface in SEM and CLSM images showed better adaptation for the association between BCT + BCS. Intracanal medication and silicate-based endodontic sealer appeared to interact chemically by forming a biomineralizing layer, allowing for an increase in the bond strength and forming an adhesive interface between the materials, with no or less gap formation.

The Novel Role of Solvents in Non-Surgical Endodontic Retreatment

Non-surgical endodontic retreatment is a reliable conservative option for managing post-treatment apical periodontitis. However, effective microbial control, based on the maximization of filling removal and disinfection protocols, is not yet predictable. Traditional gutta-percha solvents, which are indistinctively used for both the core and sealer filling materials, became obsolete due to unprecedented advances in endodontic technology. Nonetheless, microtomography, scanning electronic microscopy findings, and histobacteriological analysis tend to confirm the persistence of filling materials and the lack of association between root canal enlargement and superior disinfection. There is a controversy regarding the most suitable clinical protocols surrounding the shaping procedures and the supplementary disinfection steps. Based on the literature and the previous work of the team, the authors aimed to summarize the current knowledge regarding specific solvent formulations that target filling materials. Additionally, the advantage of an additional irrigation step to optimize disinfection was highlighted. This adjunctive procedure serves a dual role in the dissolution of filling materials, and in conferring an antibiofilm effect. Further research is needed to understand the novel contribution of these strategies upon clinical practice outcomes.

The Effects of Various Final Irrigants on the Bond Strength of Root Dentin Exposed to Chloroform: An In vitro Study

Aim:

The aim of the study was to assess the reaction of different final irrigants to the bond strength of root dentin exposed to chloroform.

Materials and Methods:

Fifty extracted maxillary central incisors were selected. Working length was determined, and canal was instrumented with ProTaper rotary system (Dentsply Maillefer) till F4 file. The specimens were then divided into five groups (n = 10). Group 1: not disclosed to any root canal solvent, Group 2: disclosed to chloroform for 5 min, Group 3: chloroform for 5 min followed by absolute alcohol, Group 4: chloroform for 5 min followed by chlorhexidine (CHX), And Group 5 – chloroform for 5 min followed by saline. The canals were obturated with F4 gutta-percha cones with AH Plus sealer. The samples will be sectioned horizontally into 1 ± 0.1 mm thick slices. The push-out bond strength was performed in a universal testing machine. Results were statistically analyzed by one-way analysis of variance.

Results:

There existed a significant difference between the mean push-out bond strength of different groups. Irrigation with chloroform negatively affected the bonding between root canal sealer and root dentine. Absolute alcohol significantly improved the bond strength values.

Conclusion:

Exposure with chloroform during the retreatment will decrease the bonding between sealer (AH Plus) and root dentine. The use of absolute alcohol as a final irrigant improved the bonding between sealer and dentin. CHX and saline showed no improvement in bond strength.

Efficacy and Cytotoxicity of Binary Mixtures as Root Canal Filling Solvents

OBJECTIVES

This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity.

METHODS

Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups (n = 15) of standardized stainless-steel molds filled with softened gutta-percha cones and twelve (n = 15) filled with AH Plus were immersed in the corresponding mixture or individual solvent, in an ultrasonic bath, for either 2 or 5 min. The effect of the solvents was assessed qualitatively by a topographical analysis (scanning electron microscopy) and chemical analysis (Fourier transform infrared spectroscopy), and quantitatively by a weight loss and viscoelastic property (dynamic mechanical analysis) evaluation. The cytotoxicity was assessed on MG63 human osteoblastic cells.

RESULTS

The mixtures did not show the formation of new compounds. Both presented significantly higher efficacies compared to their individual solvents, suggesting a synergistic effect. Their dissolution efficacy was similar to that of chloroform, showing high cytocompatibility.

CONCLUSIONS

The proposed strategy, incorporating ultrasound agitation and profiting from the synergy of adequate solvents, might enhance root canal cleanliness allowing a single-step procedure to dissolve gutta-percha and the sealer remnants, while assuring cytocompatibility with the periapical tissues.

Effect of Glass Fiber Post Adaptation on Push-Out Bond Strength to Root Dentin

The aim of this study was to evaluate the effect of different glass fiber posts (GFPs) diameters on the push-out bond strength to dentin. Forty unirradicular human teeth were endodontically treated and used for cementation of GFPs (White Post DC, FGM) with different diameters (n=10): P1 - ø 1.6 mm coronal x 0.85 mm apical; P2 - ø 1.8 mm coronal x 1.05 mm apical; P5 - ø 1.4 mm coronal x 0.65 mm apical; and PC - customized post number 0.5 with composite resin (Tetric Ceram A2, Ivoclair Vivadent). All GFPs were cemented into the root canal using a dual-curing luting composite (Variolink II, Ivoclar Vivadent). One slice (1.7 mm) of each root third of cemented GFP (cervical, middle, and apical) was submitted to push-out testing. Failure modes of all specimens were classified as: adhesive failure between resin cement and post; adhesive failure between dentin and resin cement; cohesive failure within resin cement, post or dentin; and mixed failure. The data were analyzed with two-way ANOVA and Tukey's test (a=0.05). The highest bond strength values were presented for the P2 and PC groups. There was no statistically significant difference between the GFP thirds in each group. The groups P2, P5, and PC showed predominantly adhesive failure. For P1, the most prevalent type of failure was adhesive between resin cement and post. It may be concluded that a glass fiber post that is well adapted to the root canal presents higher bond strength values, regardless of GFP third.

Influence of solvents on the bond strength of resin sealer to intraradicular dentin after retreatment

This study evaluated the removal of filling material with ProTaper Universal Rotary Retreatment system (PTR) combined with solvents and the influence of solvents on the bond strength (PBS) of sealer to intraradicular dentin after canal reobturation. Roots were endodontically treated and distributed to five groups (n = 12). The control group was not retreated. In the four experimental groups, canals were retreated with PTR alone or in combination with xylol, orange oil, and eucalyptol. After filling material removal, two specimens of each group were analysed by SEM and µCT to verify the presence of filling remnants on root canal walls. The other roots were reobturated and sectioned in 1-mm-thick dentin slices that were subjected to the push-out test. Data were analysed by two-way ANOVA and Tukey's test (α = 0.05). SEM and µCT analysis revealed that all retreatment techniques left filling remnants on canal walls. The control group (3.47 ± 1.21) presented significantly higher (p < 0.05) PBS than the experimental groups. The groups retreated with PTR alone (2.59 ± 0.99) or combined with xylol (2.54 ± 0.77) and orange oil (2.32 ± 0.93) presented similar bond strength (p > 0.05), and differed significantly from the group with eucalyptol (1.89 ± 0.63). The solvents reduced the PBS of the sealer to dentin and no retreatment technique promoted complete removal of filling material.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Effect of Endodontic Retreatment on Push-out Bond Strength and Quality of Fiber Postbonding Interface of Resin Cements

AIM

The aim of this study is to evaluate the impact of endodontic retreatment on push-out bond strength and dentin interface of two resin cements used for fiber postcementation during endodontic retreatment.

MATERIALS AND METHODS

The root canals of 40 extracted human canines were prepared, obturated and divided into four groups (n = 10). Gutta-percha was partially removed and fiber posts were immediately cemented in groups 1 and 2 using Panavia F with ED Primer and RelyX™ U200, respectively. In groups 3 and 4, the root canal access was sealed with temporary restorative cement, specimens were stored for 30 days, endodontically retreated, and fiber posts were cemented using the resin cements applied to groups 1 and 2, respectively. Push-out tests and scanning electron microscopy analyses of different areas were performed. Data from push-out bond strengths were analyzed by one-way analysis of variance and Tukey's tests.

RESULTS

Higher bond strength values were detected in the apical third for group 1 than group 3 (p < 0.05). No differences were observed in other comparisons between the same third of different groups (p > 0.05). Comparisons between different thirds in the same group revealed a higher bond strength in the apical third for group 1. Scanning electron microscopy showed formation of hybrid layer and extensive resin tags in group 1. No hybrid layer was observed in groups 2 and 4.

CONCLUSION

Endodontic retreatment had adverse effects on the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third, but not on RelyX™ U200.

CLINICAL SIGNIFICANCE

A significant interaction was detected between endodontic retreatment and resin cement, which indicated that endodontic retreatment might adversely affect the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third.

Adhesive interface and bond strength of endodontic sealers to root canal dentine after immersion in phosphate-buffered saline

This study evaluated the bond strength (BS) and the adhesive interface of four endodontic sealers to root canal dentine, before, and after immersion in phosphate buffered saline (PBS) to simulate an in vivo environment. Eighty roots were instrumented using ProTaper rotatory files, under irrigation with 17% EDTA and 1% NaOCl. Posteriorly were divided into four groups (n = 20) according to the sealer used: Endofill, AH Plus, Sealapex, and MTA Fillapex. Each group was divided into two subgroups (n = 10) and stored at 37°C immersed in water for 7 days and in PBS for 60 days. From each subgroup, 1 mm thick sections were obtained. One section of each region (coronal, middle, and apical) was submitted to the push-out test and failures were observed. Twelve sections of each subgroup (four from each region) were evaluated under SEM. Three-way ANOVA evaluation for BS showed significant differences between groups and regions (P < 0.0001), but not between subgroups (P > 0.05). AH Plus had significantly higher BS than the others sealers, regardless of the analyzed subgroup (Tukey's test, P < 0.5). The most common failures were adhesive to dentine and cohesive of the sealer. The SEM evaluation (Kruskal-Wallis, Mann-Whitney) showed homogeneous adhesive interface formed and sealer tags in all groups with significant statistical differences with AH Plus, regardless of PBS immersion. AH Plus was superior to the other sealers for both BS and quality of interface formation. Immersion in PBS did not interfere on BS or adhesive interface of the sealers tested.