Effect of placement of calcium sulphate when used for the repair of furcation perforations on the seal produced by a resin-based material

Present status and future directions - Managing perforations

Root perforations are severe complications and are associated with compromised endodontic treatment outcomes, especially when bacterial infection is allowed to establish. Perforations may occur due to pathological processes or treatment consequences. Various dental materials have been proposed over the years for perforation repair with varying degrees of success. The use of bioactive materials, such as mineral trioxide aggregate (MTA) and other calcium-silicate cements, promotes a favourable environment for regeneration and has been used successfully for perforation repair. This is in contrast to materials used previously that often led to unpredictable outcomes. With the increasing range of new bioactive endodontic materials available, the number of potential materials being used for repair of root perforations is growing. Though promising to date, there is little evidence to support the use of most of these new materials. The aim of this narrative review is to provide the background, clinical techniques and outcome of nonsurgical and surgical perforation repair.

[Current situation and strategy on perforation repair]

Perforations are common complications of root canal therapy. In clinic, perforations that were improperly and untimely repaired can seriously affect the prognosis of teeth after root canal treatment. At present, the status of perforation repair in our country is worrisome. This paper focused on the progress of perforation repair in the country by discussing the current situation of repair methods and materials. This review aims to improve knowledge and aid clinical doctors in the sophistication of perforation repair in order to improve the retention rate of root-canal-treated teeth.

Applying liquid chromatography-tandem mass spectrometry to assess endodontic sealer microleakage

The objective of this study was to describe a new method for the quantitative analysis of a microleakage of endodontic filling materials. Forty extracted single-rooted teeth were randomly divided into three experimental groups. After root canal shaping, the experimental groups were filled using the lateral condensation technique with the Epiphany system (G1), with gutta-percha + Sealapex (G2), and with gutta-percha + AH Plus (G3). Each root was mounted on a modified leakage testing device, and caffeine solution was used as a tracer (2000 ng mL-1, pH 6.0), applied in the coronal direction towards the tooth apex, creating a hydrostatic pressure of 2.55 kPa. Presence of caffeine in the receiving solution was measured after 10, 30, and 60 days, using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). None of the groups presented microleakage at 10 days. At 30 days, G2 and G3 showed similar infiltration patterns (means: 16.0 and 13.9 ng mL-1, respectively), whereas G1 showed significantly higher values (mean: 105.2 ng mL-1). At 60 days, leakage values were 182.6 ng mL-1 for G1, 139.0 ng mL-1 for G2, and 53.5 ng mL-1 for G3. AH Plus showed the best sealing ability and HPLC-MS/MS showed high sensitivity and specificity for tracer quantification.

Use of a matrix for apexification procedure with mineral trioxide aggregate

This articles describes a technique for placement of a matrix barrier prior to use of mineral trioxide aggregate (MTA) as an artificial root-end barrier. The technique also demonstrates the use of a delivery system utilizing large-bore needles for the predictable and precise placement of the barrier materials at the apex of the tooth.

Glucose reactivity with filling materials as a limitation for using the glucose leakage model

AIM

To evaluate the reactivity of different endodontic materials and sealers with glucose and to asses the reliability of the glucose leakage model in measuring penetration of glucose through these materials.

METHODOLOGY

Ten uniform discs (radius 5 mm, thickness 2 mm) were made of each of the following materials: Portland cement, MTA (grey and white), sealer 26, calcium sulphate, calcium hydroxide [Ca(OH)(2)], AH26,Epiphany, Resilon, gutta-percha and dentine. After storing the discs for 1 week at 37 degrees C and humid conditions, they were immersed in 0.2 mg mL(-1) glucose solution in a test tube. The concentration of glucose was evaluated using an enzymatic reaction after 1 week. Statistical analysis was performed with the anova and Dunnett tests at a significant level of P < 0.05.

RESULTS

Portland cement, MTA, Ca(OH)(2) and sealer 26 reduced the concentration in the test tube of glucose significantly after 1 week (P < 0.05). Calcium sulphate reduced the concentration of glucose, but the difference in concentrations was not significant (P = 0.054).

CONCLUSIONS

Portland cement, MTA, Ca(OH)(2) and sealer 26 react with a 0.2 mg mL(-1) glucose solution. Therefore, these materials should not be evaluated for sealing ability with the glucose leakage model.

In vitro evaluation of the sealing ability of MTA used for the repair of furcation perforations with and without the use of an internal matrix

OBJECTIVE

To evaluate the effect of matrix on mineral trioxide aggregate (MTA) when used to repair furcal perforations.

STUDY DESIGN

Forty-five human molars with furcal perforations were randomly divided into 3 groups and repaired with MTA either alone or over a barrier (calcium sulfate or Collaplug). Eight teeth without perforations provided negative control samples. After assessing repair quality, 1 mol/L glucose solution was used as the tracer to detect the leakage. The concentration of leaked glucose was measured after 1, 2, 4, 7, 15, and 20 days using a glucose oxidase method.

RESULTS

No significant difference in either leakage or overfilling was found between the groups with Collaplug and MTA alone (P > .05). Although no overfilling was detected in the group with calcium sulfate, that group had the most leakage (P < .05).

CONCLUSIONS

Neither of the 2 internal matrices improved the sealing ability and reduced the incidence of overfilling simultaneously.