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Radwanski M, Rozpedek-Kaminska W, Galita G, Siwecka N, Sokolowski J, Majsterek I, Özcan M, Lukomska-Szymanska M. Cytotoxicity and genotoxicity of bioceramic root canal sealers compared to conventional resin-based sealer. Sci Rep 2024; 14:4124. [PMID: 38374199 PMCID: PMC10876547 DOI: 10.1038/s41598-024-54726-1] [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: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
The aim of this study was to evaluate cytotoxicity and genotoxicity of calcium-silicate based sealers and comparing them with a gold standard-an epoxy-based sealant. Two experimental cell lines were used, gingival fibroblasts (hGF) and monocyte/macrophage peripheral blood cell line (SC). The cytotoxicity (XTT assay) and genotoxicity (comet assay) were evaluated both after 24-h and 48-h incubation. Additionally, after 48-h incubation, the cell apoptosis and cell cycle progression was detected. BioRoot Flow induced a significant decrease in hGF cells viability compared to the negative control groups both after 24-h (p < 0.001) and 48-h incubation (p < 0.01). In group with SC cells, after 24-h incubation significant increase in cells viability was detected for AH Plus Bioceramic Sealer in comparison to negative control (p < 0.05). BioRoot Flow and BioRoot RCS can be considered potentially genotoxic for the hGF cells after 48-h incubation (> 20% DNA damage). BioRoot Flow and BioRoot RCS, may have potential genotoxic effects and induce apoptosis in hGF cells which may irritate periapical tissues, resulting in a delayed healing. The findings of the study would be useful in selection of an appropriate sealant for root canal filling without causing cytotoxicity and genotoxicity.
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Affiliation(s)
| | | | - Grzegorz Galita
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Natalia Siwecka
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Mutlu Özcan
- Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland.
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2
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Artaza L, F Campello A, Soimu G, Alves FRF, Rôças IN, Siqueira JF. Clinical and radiographic outcome of the root canal treatment of infected teeth with associated sinus tract: A retrospective study. AUST ENDOD J 2021; 47:599-607. [PMID: 33991021 DOI: 10.1111/aej.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/20/2021] [Accepted: 04/22/2021] [Indexed: 12/01/2022]
Abstract
This retrospective study evaluated the outcome of the endodontic treatment/retreatment of teeth with intraoral sinus tracts. Seventy-two teeth from 70 individuals were included. One operator treated all teeth over about 20 years. Time for the sinus tract to heal was recorded. Treatment outcome was evaluated after at least 1 year and classified as healed, healing or diseased. The overall healed rate of periradicular lesions was 73.6% (74.1% for treatment and 72.2% for retreatment). In 6 (8.3%) teeth, lesions were healing. Thirteen teeth (18.1%) exhibited persistent disease. In 68/72 (94.4%) cases, the sinus tract healed in less than 1 month. No preoperative/intraoperative variable affected the outcome (P > 0.05). Missing restorations had a negative impact (P < 0.05). Healing of both the sinus tract quickly after treatment and the periradicular lesion later were usually achieved. Closure of the sinus tract in the first month was a good predictor of lesion healing.
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Affiliation(s)
- Liliana Artaza
- Department of Endodontics, University of Salvador (USAL-AOA), Buenos Aires, Argentina
| | - Andrea F Campello
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Giuliana Soimu
- Department of Endodontics, Maimonides University (UMAI), Buenos Aires, Argentina
| | - Flávio R F Alves
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - Isabela N Rôças
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - José F Siqueira
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil
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De‐Deus G, Simões‐Carvalho M, Belladonna FG, Versiani MA, Silva EJNL, Cavalcante DM, Souza EM, Johnsen GF, Haugen HJ, Paciornik S. Creation of well‐balanced experimental groups for comparative endodontic laboratory studies: a new proposal based on micro‐CT and
in silico
methods. Int Endod J 2020; 53:974-985. [DOI: 10.1111/iej.13288] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | | | - F. G. Belladonna
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - M. A. Versiani
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Brazil
| | - D. M. Cavalcante
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
| | - G. F. Johnsen
- Department of Biomaterial Faculty of Dentistry University of Oslo Oslo Norway
| | - H. J. Haugen
- Department of Biomaterial Faculty of Dentistry University of Oslo Oslo Norway
| | - S. Paciornik
- Department of Chemical and Materials Engineering Pontifícia Universidade Católica do Rio de Janeiro Rio de Janeiro Brazil
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Sealing Ability of Endodontic Cements: An In Vitro Study. Int J Dent 2020; 2020:5862598. [PMID: 32104179 PMCID: PMC7040419 DOI: 10.1155/2020/5862598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/10/2020] [Indexed: 11/23/2022] Open
Abstract
The root canal system must be obturated using a hermetic seal to prevent the penetration of microorganisms and bacterial toxins into the endodontic system. The principles of adhesive dentistry have been increasingly used in endodontics. In fact, resin-based sealers are increasingly used. The objective of this study was to evaluate, in vitro, the sealing ability of resin cement in comparison with calcium hydroxide-based cement. Materials and Methods. Eighty root canals were prepared with the Tilos system and were randomly divided into four groups according to the filling material. The best combination was evaluated on the basis of its sealing ability. The dye infiltration degree was evaluated using both a stereomicroscope after diaphanization and the dye rise test. Results. A significant difference was observed between the four obturation systems with regard to the number of infiltrated walls (p=0.014) and the infiltration depth (p=0.025). The group of teeth obturated with EndoREZ® and EndoREZ® gutta cones differ significantly from the group obturated with EndoREZ® cement and gutta-percha cones in terms of apical sealing (p=0.011). A significant difference was also observed between the group of teeth obturated using EndoREZ® gutta cones and EndoREZ® cement and the group of teeth obturated with EndoREZ® cement (p=0.026). Conclusion. When used with EndoREZ® gutta cones, EndoREZ® cement showed the best sealing ability, particularly in the apical region. When used with gutta-percha cones, Acroseal and EndoREZ® cements exhibited similar sealing abilities.
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Andriukaitiene L, Song X, Yang N, Lassila LVJ, Vallittu PK, Kerosuo E. The effect of smear layer removal on E. faecalis leakage and bond strength of four resin-based root canal sealers. BMC Oral Health 2018; 18:213. [PMID: 30545332 PMCID: PMC6293555 DOI: 10.1186/s12903-018-0655-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 11/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to assess bacterial sealability and bonding ability of methacrylate-based Resilon (RS, SybronEndo), Endo Rez (ER, Ultradent Products Inc), and epoxy-based AH Plus (AH, Dentsply/DeTrey), MTA Fill Apex (MTAF, Angelus Soluções Odontológicas) root canal sealers, and the effect of the smear layer removal on the sealability. METHODS One hundred thirty root segments were instrumented up to apical size #60 and rinsed with 2.5% NaOCl. Half of the roots were rinsed with 5ml 17% EDTA to remove the smear layer. All the roots were filled with AH, ER, MTAF sealers and gutta-percha, or RS with Resilon cones. After storage at 37°C for 7 days the samples were mounted into bacterial leakage assay for 50 days. Another 100 roots were instrumented and rinsed as described above, split longitudinally, cut into the cervical, middle and apical parts. The sealers were injected through the plastic mould on the dentin surface. After 7 days of incubation at 37°C, bond strength was tested using a notched-edge test fixture (Crosshead, Ultradent Products Inc.) and a universal testing machine (Lloyd Instruments). RESULTS AH revealed the longest mean time for bacterial resistance by 29.4 and 36.8 days (with and without smear layer, respectively) followed by RS (15.1 and 24.7 days, respectively). The difference between materials was significant (p<0.001). Bond strength values ranged from 0.2± 0.1 to 3.5± 0.7 MPa and increased from the apical to the cervical third. In the apical third, AH showed the highest mean (SD) bond values 1.4 (0.4) MPa and 1.7 (0.6) MPa (with and without smear, respectively, followed by RS, 0.5 (0.1) MPa and 0.8 (0.1) MPa, respectively. The difference between materials was significant (p=0.001). CONCLUSION The effect of the smear layer removal on the sealability was material-dependent.
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Affiliation(s)
- Laura Andriukaitiene
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromso, Norway
- Present address: Vilnius, Vilnius, Lithuania
| | - Xiaobo Song
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Nannan Yang
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Lippo V. J. Lassila
- Department of Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland
| | - Pekka K. Vallittu
- Department of Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, Turku, Finland
| | - Eero Kerosuo
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromso, Norway
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Yanpiset K, Banomyong D, Chotvorrarak K, Srisatjaluk RL. Bacterial leakage and micro-computed tomography evaluation in round-shaped canals obturated with bioceramic cone and sealer using matched single cone technique. Restor Dent Endod 2018; 43:e30. [PMID: 30135849 PMCID: PMC6103543 DOI: 10.5395/rde.2018.43.e30] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/27/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. MATERIALS AND METHODS Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. RESULTS All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. CONCLUSIONS In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.
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Affiliation(s)
- Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kanet Chotvorrarak
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Push-Out Bond Strength of Experimental Apatite Calcium Phosphate Based Coated Gutta-Percha. Int J Biomater 2018; 2018:1731857. [PMID: 30154852 PMCID: PMC6093004 DOI: 10.1155/2018/1731857] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/15/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives To evaluate the push-out bond strength of experimental apatite calcium phosphate coated gutta-percha (HAGP) compared to different commercially available coated gutta-percha root obturation points. Methods Extracted teeth were selected and instrumented using ProTaper rotary files. The canals were assigned into five equal groups and obturated using matching single cone technique as follows: EndoREZ cones and EndoREZ sealer, Bioceramic Endosequence gutta-percha (BCGP) with Endosequence BC sealer, Active GP with Endosequence BC sealer (ActiV GP), conventional GP with Endosequence BC sealer, and HAGP with Endosequence BC sealer. Each root was sectioned transversally at the thickness of 1±0.1 mm to obtain 5 sections (n=25 per group). The specimens were subjected to push-out test using a Universal Test Machine at a loading speed of 0.5 mm/ min. Failure modes after push-out test was examined under stereomicroscope and the push-out data were analyzed using ANOVA and the post hoc Dunnett T3 test (p = 0.05). Results The highest mean bond strength was yielded by HAGP followed by BCGP, ActiV GP, conventional GP, and EndoREZ. There were significant differences between EndoREZ and all other groups (p<0.001). The prominent failure mode of HAGP was mixed mode, whereas EndoREZ exhibited adhesive failure mode. Conventional GP, ActiV GP, and BCGP showed cohesive failure mode. Conclusion HAGP showed promising results to be used as root canal filling material in combination with bioceramic sealer.
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8
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Alves AMH, Pozzobon MH, Bortoluzzi EA, da Silveira Teixeira C, Souza BDM, da Fonseca Roberti Garcia L, Felippe WT. Bacterial penetration into filled root canals exposed to different pressures and to the oral environment—in vivo analysis. Clin Oral Investig 2017; 22:1157-1165. [DOI: 10.1007/s00784-017-2199-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
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9
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Johnsen GF, Dara S, Asjad S, Sunde PT, Haugen HJ. Anatomic Comparison of Contralateral Premolars. J Endod 2017; 43:956-963. [DOI: 10.1016/j.joen.2017.01.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/04/2017] [Accepted: 01/09/2017] [Indexed: 11/29/2022]
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10
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Al-Maswary AA, Alhadainy HAH, Al-Maweri SA. Coronal Microleakage of the Resilon and Gutta-Percha Obturation Materials with Epiphany SE Sealer: An in-vitro Study. J Clin Diagn Res 2016; 10:ZC39-42. [PMID: 27437358 DOI: 10.7860/jcdr/2016/17545.7750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The coronal leakage of bacteria and other irritants to the root canal system is one of the main factors that may result in clinical failure and affect the long term success of endodontic treatment. The Resilon/Epiphany obturation system has been developed as an alternative to gutta-percha and traditional sealers. AIM This study aimed to evaluate and compare the coronal leakage between Resilon obturation material and gutta-percha using the same sealer. MATERIALS AND METHODS In this in-vitro study, 72 freshly extracted single-rooted human teeth were used, and were sectioned at CEJ with 13mm length. The roots were randomly divided into four groups. In Group I, 30 roots were obturated using Resilon and Epiphany SE sealer, Group II, 30 roots were obturated using gutta-percha and Epiphany SE. Group III and Group IV, 12 roots were used as control groups (positive and negative). The coronal leakage was measured using the dye penetration technique. Data were statistically analysed by a One-Way ANOVA test. RESULTS There was a significant difference between the two experimental groups where Resilon revealed less microleakage than gutta-percha group (p <0.05). CONCLUSION Resilon is a suitable replacement for gutta-percha on the basis of its increased resistance to microleakage, but it failed to provide complete hermetic coronal sealing.
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Affiliation(s)
| | | | - Sadeq Ali Al-Maweri
- Assistant Professor, Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges , Saudi Arabia; Department of Oral Medicine and Diagnosis, Sana'a University, Yemen
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11
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Methodology for Morphometric Analysis of Modern Human Contralateral Premolars. J Comput Assist Tomogr 2016; 40:617-25. [DOI: 10.1097/rct.0000000000000417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Amezcua O, Gonzalez ÁC, Borges ÁH, Bandeca MC, Estrela CRDA, Estrela C. Sealing ability of root-end filling materials. J Contemp Dent Pract 2015; 16:210-4. [PMID: 26057920 DOI: 10.5005/jp-journals-10024-1663] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aim of this research was to compare the apical sealing ability of different root-end filling materials (SuperEBA(®), ProRoot MTA(®), thermoplasticized gutta-percha + AH-Plus(®), thermoplasticized RealSeal(®)), by means of microbial indicators. MATERIALS AND METHODS Thus, 50 human single-rooted teeth were employed, which were shaped until size 5 0, retro - prepared with ultrasonic tips and assigned to 4 groups, retro-filled with each material or controls. A platform was employed, which was split in two halves: upper chamber-where the microbial suspension containing the biological indicators was introduced (E. faecalis + S. aureus + P. aeruginosa + B. subtilis + C. albicans); and a lower chamber containing the culture medium brain, heart influsion, where 3 mm of the apical region of teeth were kept immersed. Lectures were made daily for 60 days, using the turbidity of the culture medium as indicative of microbial contamination. Statistical analyses were carried out at 5% level of significance. RESULTS The results showed microbial leakage at least in some specimens in all of the groups. RealSeal(®) has more microbial leakage, statistically significant, compared to ProRoot(®) MTA and SuperEBA(®). No significant differences were observed when compared ProRoot(®) MTA and SuperEBA(®). The gutta-percha + AH Plus results showed no statistically significant differences when compared with the other groups. CONCLUSIONS All the tested materials showed microbial leakage. Root-end fillings with Super-EBA or MTA had the lowest bacterial filtration and RealSeal shows highest bacterial filtration.
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Affiliation(s)
- Octávio Amezcua
- Department of Endodontics, University of Guadalajara, Jalisco, México
| | | | | | | | | | - Carlos Estrela
- Professor, Department of Stomatologic Sciences, Federal University of Goiás, Praça Universitária s/n, Setor Universitário CEP: 74605-220, Gaiânia, GO, Brazil, e-mail:
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Hegde V, Arora S. Sealing ability of a novel hydrophilic vs. conventional hydrophobic obturation systems: A bacterial leakage study. J Conserv Dent 2015; 18:62-5. [PMID: 25657530 PMCID: PMC4313482 DOI: 10.4103/0972-0707.148898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/15/2014] [Accepted: 12/09/2014] [Indexed: 11/13/2022] Open
Abstract
Aim: Comparative assessment of apical sealing ability of a novel Smart-Seal System, Resilon, and conventional Gutta-Percha system using a bacterial leakage model. Materials and Methods: Seventy freshly extracted human single rooted teeth with fully formed apices were randomly divided into three groups (20 each) and two control groups (5 positive and 5 negative). Teeth were de-coronated, and roots were standardized to a working length of 16 mm. Root canal preparation was done with rotary pro-taper file system in all groups. Group A was obturated using Smart-Seal system (Hydrophilic), Group B using Resilon/Epiphany system (Hydrophilic), and Group C using Gutta-Percha (GP)/AH plus system (Hydrophobic) in a single cone technique. Using Enterococcus faecalis, a split chamber bacterial leakage model was developed to evaluate the sealing ability of three obturation systems. Samples will be monitored every 24 hours for 60 days. Results: All three groups have shown leakage. Novel Smart-Seal System and Resilon have shown similar results and relatively lesser samples leaked in comparison to GP obturations at the end of the observation period. There was no significant difference amongst Resilon and Smart-Seal System (P > 0.05) but there was a significant difference amongst them when compared to GP obturations (P < 0.05). Conclusion: Hydrophilic obturations of the root canal shows a better resistance to bacterial leakage as compared to hydrophobic obturations.
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Affiliation(s)
- Vibha Hegde
- Department of Conservative and Endodontic, Yerala Medical Trust Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
| | - Shashank Arora
- Department of Conservative and Endodontic, Yerala Medical Trust Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
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14
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Navarro-Escobar E, Baca P, Ruiz-Linares M, Arias-Moliz MT, Perez-Heredia M, Ferrer-Luque CM. Bacterial leakage in root canals filled with AH Plus and dentine bonding agents. Acta Odontol Scand 2014; 72:819-24. [PMID: 24791609 DOI: 10.3109/00016357.2014.913196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to compare the efficacy of different dentine adhesives in delaying the coronal bacterial leakage of Enterococcus faecalis in filled root canals. Materials and methods. Ninety-five lower incisors of patients >65 years of age were instrumented using the ProTaper system and were irrigated with 1 mL of 2.5% sodium hypochlorite (NaOCl) alternated with 1 mL 17% EDTA between each file change. Final irrigation was performed with 5 mL of 17% EDTA and then flushed with 5 mL of distilled water. The teeth were randomly divided into five experimental groups (n = 15/group) and one of the following dentine adhesives was applied: (1) AdheSE; (2) Excite DSC; (3) Clearfil Protect Bond; (4) One Coat 7.0; or (5) Control group without adhesive. After filling the root canals, the samples were mounted on a double chamber device to evaluate the bacterial filtration of E. faecalis during a period of 240 days. The results underwent non-parametric Kaplan-Meier survival analysis and comparisons among groups were done using the Log-Rank test. RESULTS At 240 days, E. faecalis was detected in samples of all groups in the lower chamber. The highest survival value was obtained by One Coat 7.0, giving statistically significant differences from the other groups, whereas Clearfil Protect Bond, AdheSE and Excite DSC showed similar behaviours, likewise similar to the Control group. CONCLUSIONS One Coat 7.0 adhesive system provides the longest survival value to delay E. faecalis coronal leakage in filled root canals.
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Physicochemical properties and surfaces morphologies evaluation of MTA FillApex and AH plus. ScientificWorldJournal 2014; 2014:589732. [PMID: 24883413 PMCID: PMC4032737 DOI: 10.1155/2014/589732] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/07/2014] [Indexed: 11/17/2022] Open
Abstract
The solubility, pH, electrical conductivity, and radiopacity of AH Plus and MTA FillApex were evaluated. In addition, the surfaces morphologies of the sealers were analyzed by using scanning electron microscopy. For pH test, the samples were immersed in distilled water at different periods of time. The same solution was used for electrical conductivity measurement. The solubility and radiopacity were evaluated according to ANSI/ADA. Statistical analyses were carried out at 5% level of significance. MTA FillApex presented higher mean value for solubility and electrical conductivity. No significant difference was observed in the mean values for pH reading. AH Plus presented higher radiopacity mean values. MTA FillApex presented an external surface with porosities and a wide range of sizes. In conclusion, the materials fulfill the ANSI/ADA requirements when considering the radiopacity and solubility. AH Plus revealed a compact and homogeneous surface with more regular aspects and equal particle sizes.
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16
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Oliveira SGDD, Gomes DJ, Costa MHDN, Sousa ERD, Lund RG. Coronal microleakage of endodontically treated teeth with intracanal post exposed to fresh human saliva. J Appl Oral Sci 2014; 21:403-8. [PMID: 24212985 PMCID: PMC3881841 DOI: 10.1590/1679-775720130184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 06/19/2013] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the coronal microleakage of
endodontically treated teeth prepared to receive an intracanal post and teeth with
an intracanal post but without a prosthetic crown and exposed to contamination by
fresh human saliva. Material and Methods A mechanical-chemical preparation following the step-back technique was carried
out in 35 extracted single-rooted human teeth. The teeth were randomly divided
into five groups: G1=root canals instrumented, obturated, and prepared to receive
an intracanal post (N=10); G2=root canals with cemented posts but without coronal
sealing (N=10); PC1=positive control root canals instrumented and open (N=5);
PC2=positive control 2 root canals without instrumentation and open (N=5); and
NC=negative control healthy teeth (N=5). The crowns were removed except for the
control group of intact teeth. The root canals were obturated and sterilized with
cobalt 60 gamma irradiation and were then adapted in an apparatus using a Brain
Heart Infusion (BHI) medium and fresh human saliva for contamination. Microbial
growth was indicated by the presence of turbidity in the BHI liquid medium. Results Data were submitted to the Kaplan-Meier Survival Analysis and the Holm-Sidak
statistic method, which observed an index of 90% of microleakage in root canals
after 24 hours for G1 and 70% of microleakage in samples at the end of 40 days for
G2. Conclusion The results show that root canals with an intracanal post but without a prosthetic
crown can be recontaminated when exposed to fresh human saliva in a short
period.
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Ozcan E, Eldeniz AÜ, Aydinbelge HA. Assessment of the sealing abilities of several root canal sealers and filling methods. Acta Odontol Scand 2013; 71:1362-9. [PMID: 23394208 DOI: 10.3109/00016357.2012.762990] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the sealing abilities of two root canal sealers (epoxy resin-based AH Plus(®) and polydimethylsiloxane-based GuttaFlow(®)) and of five root filling techniques (lateral condensation, matched taper single gutta-percha point, laterally condensed-matched taper gutta-percha point, Thermafil(®) and continuous wave of condensation), using a bacterial leakage model. MATERIALS AND METHODS One hundred and seventy-four single-rooted human teeth were randomly divided into 10 test groups (n = 15) and two control groups (n = 12). The roots that were filled with the test material, using the different root filling techniques, were mounted in a two-chamber bacterial leakage model and Enterococcus faecalis was added to the upper chambers. The lower chambers of all of the specimens were checked every day during the test period (100 days). The day of turbidity was recorded for each sample. Statistical analysis was performed using the Kaplan-Meier and log-rank tests. RESULTS There was no significant difference between the epoxy resin-based and the polydimethylsiloxane-based sealers, irrespective of the filling techniques used (p > 0.05). The continuous wave of condensation technique was found to be superior to the other techniques (p < 0.05). The difference between the other groups was insignificant (p > 0.05). CONCLUSIONS AH Plus and GuttaFlow sealers showed similar levels of sealing ability. The continuous wave of condensation technique had the best sealing capability when compared to the other techniques.
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Affiliation(s)
- Erhan Ozcan
- Selçuk University, Faculty of Dentistry, Department of Endodontics , Konya , Turkey
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18
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Lotfi M, Ghasemi N, Rahimi S, Vosoughhosseini S, Saghiri MA, Shahidi A. Resilon: a comprehensive literature review. J Dent Res Dent Clin Dent Prospects 2013; 7:119-30. [PMID: 24082982 PMCID: PMC3779370 DOI: 10.5681/joddd.2013.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 03/23/2013] [Indexed: 11/17/2022] Open
Abstract
Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilon's physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.
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Affiliation(s)
- Mehrdad Lotfi
- Professor, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Ghasemi
- Postgraduate Student, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Professor, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
- Dental and Periodontal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Vosoughhosseini
- Associate Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Ali Saghiri
- Research Associated, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public health, Madison, WI, USA
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19
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Scelza MZ, Coil J, Alves GG. Effect of time of extraction on the biocompatibility of endodontic sealers with primary human fibroblasts. Braz Oral Res 2013; 26:424-30. [PMID: 23018229 DOI: 10.1590/s1806-83242012000500008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 07/03/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of this work was to evaluate the effects of different times of extraction on the cytotoxicity of six representatives of different root canal sealer groups-Real Seal SE, AH Plus, GuttaFlow, Sealapex, Roth 801, and ThermaSeal Plus-with human gingival fibroblasts. The materials were prepared according to manufacturers' specifications, and were incubated in culture medium (DMEM) at 37ºC for 1, 7, 14, 21, and 28 days, with daily washing, to simulate periodontal ligament clearance. Human fibroblasts were exposed to the final extracts at 24 hours, and cell viability was determined by MTT assay, with exposure to unconditioned DMEM as a negative control. Statistical analysis comparing cytotoxicities at each exposure time was performed by ANOVA with Scheffé adjustment for multiple comparisons at a 95% confidence level. Results indicated that GuttaFlow was significantly less cytotoxic than all other sealers (p < 0.05) at 1 day of extraction. After 7 days of extraction, cell viability for GuttaFlow was significantly increased as compared with that of all groups except sealer AH Plus. At day 14, cytotoxicity of Sealapex was significantly higher than that of all other sealers (p < 0.05). At days 21 and 28, there were no significant differences in cytotoxicity among sealer groups. All materials presented some level of cytotoxicity to fibroblasts, while GuttaFlow was the least cytotoxic sealer tested. However, the cytotoxicity of all materials seemed to decrease similarly in a time-dependent manner.
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Affiliation(s)
- Miriam Zaccaro Scelza
- Laboratory of Experimental Cell Culture, Department of Endodontics, Univ Federal Fluminense, Niteroi, RJ, Brazil.
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20
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Comparative Resistance of AH26 and a New Sealer Prototype to a Bacterial Challenge. Int J Dent 2012; 2012:365231. [PMID: 22505898 PMCID: PMC3296140 DOI: 10.1155/2012/365231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 12/13/2011] [Indexed: 11/18/2022] Open
Abstract
Objective. This study compared the leakage resistance of a New Sealer Prototype (NSP) with a traditional sealer (AH 26) in Resilon-filled roots subjected to a bacterial challenge. Study Design. 41 roots were instrumented to ISO size 50 apically. Group 1 (n = 20) contained Resilon and AH 26 sealer and roots in group 2 (n = 21) contained Resilon and NSP. Roots were embedded in a dual-chamber model with the upper chamber containing Streptococcus mutans inoculum. Evidence of bacterial penetration was observed for 1 month. Fisher's Test was used to analyze the data. Results. 8 of 20 roots (40%) in the AH 26 group demonstrated leakage whereas 3 of 21 roots (14%) in the NSP group leaked. The difference in leakage rates was not statistically significant (P = 0.053). Conclusion. The traditional sealer (AH 26) demonstrated increased leakage rates compared to the New Sealer Prototype (NSP), but the difference did not reach statistical significance in this study.
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21
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Zoufan K, Jiang J, Komabayashi T, Wang YH, Safavi KE, Zhu Q. Cytotoxicity evaluation of Gutta Flow and Endo Sequence BC sealers. ACTA ACUST UNITED AC 2011; 112:657-61. [PMID: 21778087 DOI: 10.1016/j.tripleo.2011.03.050] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 03/17/2011] [Accepted: 03/28/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study evaluated the cytotoxicity of GuttaFlow and EndoSequence BC sealers and compared them with AH Plus and Tubli-Seal sealers. STUDY DESIGN Samples (0.5 mg) of freshly mixed or set BC, GuttaFlow, AH Plus, and Tubli-Seal sealers were eluted with 300, 600, and 1,000 μL cell culture medium for 24 and 72 hours. L929 cells were seeded into 96-well plates at 3 × 10(4) cells/well and cultured with 100 μL eluate from each eluate group. Cells cultured only with culture medium served as control. After 24 hours' incubation, the cytotoxicity was evaluated by MTT assay. Cell viability was calculated as the percentage of the control group, and the results were analyzed with a one-way analysis of variance. RESULTS For the freshly mixed sealer, cell viability in the AH Plus group was less than in all of the other 3 sealer groups. The Tubli-Seal sealer group had less cell viability than the EndoSequence BC and GuttaFlow sealer groups. For the set sealer, the Tubli-Seal and AH Plus groups had less cell viability than the EndoSequence BC and GuttaFlow sealer groups. There was no cell viability difference between the EndoSequence BC and GuttaFlow sealer groups in the either freshly mixed or set sealer group. CONCLUSIONS The GuttaFlow and EndoSequence BC sealers have lower cytotoxicity than the AH Plus and Tubli-Seal sealers.
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Affiliation(s)
- Keivan Zoufan
- Division of Endodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030-1715, USA
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Vasconcelos BCD, Bernardes RA, Duarte MAH, Bramante CM, Moraes IGD. Apical sealing of root canal fillings performed with five different endodontic sealers: analysis by fluid filtration. J Appl Oral Sci 2011; 19:324-8. [PMID: 21655776 PMCID: PMC4223782 DOI: 10.1590/s1678-77572011005000005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 10/26/2010] [Indexed: 11/21/2022] Open
Abstract
Objectives To evaluate the sealing ability of five root canal sealers, including two
experimental cements (MBP and MTA-Obtura) using the fluid filtration method.
Material and Methods Teeth were divided into 5 study groups: G1-AH Plus; G2-Acroseal; G3-Sealapex;
G4-MBP; G5-MTA-Obtura; and two controls. Chemical-mechanical preparation was
performed with ProFile rotary nickel-titanium instruments 1 mm short of the
apical foramen. The sealing ability was evaluated by fluid filtration at 15,
30, and 60 days. Results The statistical analysis showed significant difference between the materials
at different periods (p<0.05). AH Plus and MBP had similar leakage values
at 15 and 60 days, alternating with significant reduction at 30 days, while
the other materials showed progressive increase in leakage values. Acroseal
and Sealapex presented the best results at 15 days and the worst at 60 days.
Conclusions All sealers evaluated presented fluid leakage, with AH Plus and MBP showing
the best results at the end of the experimental period. Acroseal, Sealapex,
and MTA-Obtura presented increase in leakage values at longer observation
periods.
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Rechenberg DK, De-Deus G, Zehnder M. Potential systematic error in laboratory experiments on microbial leakage through filled root canals: review of published articles. Int Endod J 2011; 44:183-94. [PMID: 21219357 DOI: 10.1111/j.1365-2591.2010.01821.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To systematically evaluate whether published studies on microbial leakage through filled root canals in human teeth embedded in a two-chamber system were properly controlled. Specifically, the control for the assumption that leakage should occur through the root canal rather than other routes was investigated. METHODOLOGY A systematic search was conducted using Medline, Biosis, Cochrane, Embase, and Web of Science databases. In addition, the reference lists of review articles pertaining to the topic were searched. No language restriction was applied. Two independent reviewers screened titles and abstracts. All articles deemed appropriate by either reviewer were included in the full-text evaluation. In case of disagreement, a referee arbitrated between the reviewers. RESULTS With 93.8% agreement prior to discussion and arbitration, 67 articles were included. On average, the size of the negative control group was 30% (mean) of the n in the experimental groups (minimum=0.0%, maximum=100%, SD=27%). The majority of studies (57 of 67) used inadequate negative controls. The whole root was covered with the sealing material in these specimens, whilst the root tip was left uncovered in the experimental groups. Consequently, leakage between outer root surface and sealing material was not controlled for. The authors of the remaining 10 communications did not state clearly how negative control assessments were performed. CONCLUSIONS Experimental investigations should be performed to assess the routes of microbial leakage in two-chamber models.
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Affiliation(s)
- D-K Rechenberg
- Department of Preventive Dentistry, Periodontology and Cariology, University of Zürich Center of Dental Medicine, Zürich
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24
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WU D, TANG Z, ZHANG G, LIU W. The sealing ability of a new silicone-based root canal filling material (GuttaFlow): an in vitro study using the percentage of gutta-percha-filled area. Dent Mater J 2011; 30:569-75. [DOI: 10.4012/dmj.2010-194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Flores DSH, Rached-Júnior FJA, Versiani MA, Guedes DFC, Sousa-Neto MD, Pécora JD. Evaluation of physicochemical properties of four root canal sealers. Int Endod J 2010; 44:126-35. [DOI: 10.1111/j.1365-2591.2010.01815.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Kqiku L, Miletic I, Gruber HJ, Anic I, Städtler P. [Microleakage of root canal fillings with GuttaFlow and Resilon compared with lateral condensation]. Wien Med Wochenschr 2010; 160:230-4. [PMID: 20632151 DOI: 10.1007/s10354-010-0790-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 02/22/2010] [Indexed: 11/25/2022]
Abstract
Epiphany/Resilon and GuttaFlow are newly developed methods for obturation of the root canal system. Epiphany/Resilon is a thermoplastic, synthetic polymer-based root canal filling material which enables the bonding to the dentin root canal wall during root canal obturation. GuttaFlow is a cold flowable filling system for the obturation of root canals, combining sealer and gutta-percha in one product. The purpose of this study was to assess the leakage of the Epiphany/Resilon or GuttaFlow root canal filling compared with lateral condensation of gutta-percha. For this study were used 45 human extracted teeth, chemo mechanically prepared, divided into three groups and obturated with gutta-percha/AH Plus, Epiphany/Resilon and GuttaFlow. For dye penetration all teeth were centrifuged for three minutes at 30 g in 2% methylene blue and dissolved in 65% nitric acid for 3 days. The extracted methylene blue was determined with Photometer. Root Canal fillings with Epiphany/Resilon showed less dye penetration than lateral condensation of gutta-percha and GuttaFlow. Epiphany/Resilon is ideally suited as a root canal filling material.
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Affiliation(s)
- Lumnije Kqiku
- Klinische Abteilung für Zahnerhaltungskunde der Universitätsklinik für Zahn-, Mund- und Kieferheilkunde Graz, Medizinische Universität Graz, Austria.
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Shokouhinejad N, Sharifian MR, Aligholi M, Assadian H, Tabor RK, Nekoofar MH. The sealing ability of resilon and gutta-parcha following different smear layer removal methods: an ex vivo study. ACTA ACUST UNITED AC 2010; 110:e45-9. [DOI: 10.1016/j.tripleo.2010.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 02/05/2010] [Indexed: 11/29/2022]
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28
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Sharifian MR, Shokouhinejad N, Aligholi M, Jafari Z. Effect of chlorhexidine on coronal microleakage from root canals obturated with Resilon/Epiphany self-etch. J Oral Sci 2010; 52:83-7. [DOI: 10.2334/josnusd.52.83] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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29
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Ordinola-Zapata R, Bramante CM, Bernardineli N, Graeff MS, Garcia RB, de Moraes IG, Debelian G. A preliminary study of the percentage of sealer penetration in roots obturated with the Thermafil and RealSeal-1 obturation techniques in mesial root canals of mandibular molars. ACTA ACUST UNITED AC 2009; 108:961-8. [DOI: 10.1016/j.tripleo.2009.07.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 06/25/2009] [Accepted: 07/06/2009] [Indexed: 11/16/2022]
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30
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Pinheiro CR, Guinesi AS, de Camargo EJ, Pizzolitto AC, Filho IB. Bacterial leakage evaluation of root canals filled with different endodontic sealers. ACTA ACUST UNITED AC 2009; 108:e56-60. [DOI: 10.1016/j.tripleo.2009.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2008] [Revised: 04/07/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
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