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Alzoubi F, Alajmi S, Alkandari A, Alqahtani S, Alanezi A, Setzer FC. Post-operative pain in non-surgical root canal treatment after sealer-based obturation versus warm vertical compaction: A randomized clinical trial. Int Endod J 2024; 57:1168-1179. [PMID: 38813933 DOI: 10.1111/iej.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/04/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
AIM Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS). METHODOLOGY This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. CLINICALTRIALS gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively. RESULTS The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05). CONCLUSIONS Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.
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Affiliation(s)
- Fahad Alzoubi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | - Samhan Alajmi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | | | - Saad Alqahtani
- Kuwait Institute for Medical Specializations, Sulaibkhat, Kuwait
| | - Amer Alanezi
- Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait
| | - Frank C Setzer
- Department of Endodontics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Costa JLDSG, Barros APO, Junior AJ, Gelio MB, Dantas AAR, Kuga MC. Influence of residues from bioceramic sealer on the bond interface with universal adhesive in different application modes. Eur J Oral Sci 2024; 132:e12994. [PMID: 38780370 DOI: 10.1111/eos.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
This study evaluated the effect on adhesive layer thickness, bond strength, and adhesive failure pattern of the application of universal adhesive (Scotchbond Universal) using either manual or rotary brush in dentin previously impregnated with bioceramic sealer (Sealer Plus BC) using a manual brush, at 24 h and 1 year. Eighty-eight bovine crowns were divided into four groups (n = 22) according to the intervention: (i) use of bioceramic sealer and adhesive application using manual brush, (ii) use of bioceramic sealer and adhesive application using rotary brush, (iii) use of resin sealer and adhesive application using manual brush, and (iv) use of resin sealer and adhesive application using rotary brush. Subsequently, specimens were restored with a composite resin (Filtek Z-250). Adhesive layer thickness was evaluated using confocal microscopy. Bond strength was assessed using the microtensile bond strength test, and adhesive failure pattern was evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA/Tukey tests. Specimens where a rotary brush had been used exhibited lower adhesive layer thickness. Specimens treated with resin sealer and using a manual brush showed lower bond strength values and a higher occurrence of adhesive failures at 24 h and 1 year than specimens treated with bioceramic sealer and using rotary brush for adhesive application.
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Affiliation(s)
- Joatan Lucas de Sousa Gomes Costa
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minais Gerais, Brazil
| | | | - Adirson Jorge Junior
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Andréa Abi Rached Dantas
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
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Ashkar I, Sanz JL, Forner L, Ghilotti J, Melo M. A Literature Review of the Effect of Heat on the Physical-Chemical Properties of Calcium Silicate-Based Sealers. J Endod 2024; 50:1044-1058.e5. [PMID: 38729300 DOI: 10.1016/j.joen.2024.04.017] [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: 03/07/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Recently, calcium silicate-based sealers (CSSs) have gained popularity in endodontic practice due to their biocompatibility and antimicrobial properties. They are considered viable alternatives to epoxy resin-based sealers. With the increased use of CSSs and warm vertical compaction techniques in root canal treatment, evaluating the impact of heat on CSSs properties is essential, therefore this review aimed to present a qualitative synthesis of available in vitro studies assessing the impact of heat on the physical-chemical properties of CSSs. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines, a systematic advanced electronic search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases in November 2023 and updated in April 2024. In vitro studies that evaluated the physical-chemical properties of CSSs were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias-included studies. RESULTS The search identified a total of 6421 preliminary results and 10 studies were included for qualitative assessment. Eleven different physiochemical properties were assessed by the included studies. Setting time and flow were the most evaluated property among the studies. A qualitative synthesis of the evidence on each property is presented. CONCLUSIONS Based on the in vitro studies assessed in the present systematic review, results reveal that exposing CSSs to heat can accelerate their setting time, reduce their flow, and increase their film thickness. Concerns persist regarding solubility, viscosity, radiopacity, dimensional change, microhardness, porosity, and compressive strength, requiring further research. Certain CSSs, such as MTA Fillapex and Endosequence BC sealer HiFlow, show minimal changes under heat, making them potential candidates for warm filling techniques.
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Affiliation(s)
- Israa Ashkar
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - James Ghilotti
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
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Costa JLDSG, Barros APO, Gelio MB, Galvani LD, Vaz LG, Kuga MC. Influence of bioceramic sealer residues on the adhesion interface with a universal adhesive in the etch-and-rinse strategy, based on the application protocol and evaluation time. Dent Mater J 2024; 43:565-572. [PMID: 38825448 DOI: 10.4012/dmj.2024-046] [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] [Indexed: 06/04/2024]
Abstract
The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.
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Affiliation(s)
| | | | - Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University-UNESP
| | - Lucas David Galvani
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP
| | - Luis Geraldo Vaz
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University-UNESP
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Valerio L, Oda LY, Copelli FA, Rodrigues CT, Carneiro E, Duarte MAH, Cavenago BC. Effect of the filling technique on the filling removal from oval-shaped canals. Clin Oral Investig 2024; 28:453. [PMID: 39060471 DOI: 10.1007/s00784-024-05853-6] [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: 03/08/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES This ex vivo study aimed to evaluate the influence of different filling techniques on the filling removal from oval root canals filled with bioceramic sealer. METHODS Thirty-six mandibular incisors with single oval canals were filled with bioceramic sealer following the techniques (n = 12): single-cone, modified McSpadden, or continuous wave of condensation, and scanned by micro-computed tomography (micro-CT). The filling was removed using the Clearsonic ultrasound tip and Reciproc system up to the R40 instrument, and the working time was recorded. The teeth were scanned again by micro-CT. Percentage of remnant volume (mm³) of the filling material, dentin thickness, and root canal transportation were measured. The data was analyzed using parametric and non-parametric tests with a significance level of 5%. RESULTS It took more time to remove the filling material using the continuous wave of condensation technique (p < 0.05), followed by the modified McSpadden and single-cone techniques. There was no difference (p > 0.05) when comparing the percentage of remaining filling material among the three groups, nor did it among the segments of each tooth. There was also no difference in the analysis of dentin thickness and transportation when comparing the groups (p > 0.05). CONCLUSIONS The filling technique did not influence the amount of remaining filling material, dentin thickness, and transportation. The working time was longer with thermoplastic filling techniques. CLINICAL RELEVANCE Endodontic retreatment in teeth filled with bioceramic sealers increases with their use. Several techniques are used to fill the root canals, thus, it is important to know whether the filling technique influences the non-surgical endodontic retreatment.
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Affiliation(s)
- Lislaine Valerio
- Postgraduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Lisa Yurie Oda
- Postgraduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
- , Av. Prefeito Lothário Meissner no. 632, Curitiba, Paraná, 80210-170, Brazil.
| | | | | | - Everdan Carneiro
- Department of Endodontics, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
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La Rosa GRM, Canova FS, Leotta ML, Pedullà E. Effects of heating on bioceramic sealers: a scoping review of chemo-physical properties and clinical implications. Odontology 2024:10.1007/s10266-024-00969-3. [PMID: 38977543 DOI: 10.1007/s10266-024-00969-3] [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: 05/10/2024] [Accepted: 06/20/2024] [Indexed: 07/10/2024]
Abstract
This scoping review aims to summarize current research to assess the impact of heating on the chemo-physical properties of bioceramic sealers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines, a comprehensive literature search was conducted in April 2024 across PubMed and Scopus databases. Inclusion criteria referred to all study types evaluating the effect of heating temperature on bioceramic sealers' properties, with no language or time restrictions applied. Studies were independently screened by two reviewers, and relevant data were extracted and synthesized qualitatively. Out of 91 initially identified studies, 19 met the eligibility criteria for inclusion in the qualitative synthesis. The selected studies ranged from 2014 to 2024 and comprised laboratory-based investigations. Various bioceramic sealers, including EndoSequence BC Sealer, BioRoot RCS, and TotalFill BC, were analyzed across different heating techniques. The findings revealed divergent responses of bioceramic sealers to heat, with some demonstrating stability while others exhibited alterations in properties such as flow, setting time, and chemical composition. The impact of heat on bioceramic sealers depends on the sealer's composition and laboratory setting. While some sealers are affected significantly, others remain stable. Clinicians should carefully consider these factors when bioceramic sealers are used with warm obturation techniques, but caution is needed as real-world conditions may vary. Integrating laboratory results with clinical evidence is essential for improving treatment efficacy and patient care.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Francesco Saverio Canova
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maria Laura Leotta
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Kirthiga M, Thomas G, Jose S, Joseph S, Krishna M. Marginal Adaptation of BioRoot RCS, MTA-Fillapex, EpoxySeal, and Sealapex to Radicular Dentin: An In Vitro Study. Cureus 2024; 16:e64380. [PMID: 39131018 PMCID: PMC11316956 DOI: 10.7759/cureus.64380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction The primary goal of endodontic therapy is to achieve a three-dimensional filling of the root canal. The sealer plays a crucial role in filling the residual gaps between the gutta-percha and the canal wall, which prevents fluids and bacteria from entering the canal and causing complications. This study evaluates and compares the sealing ability of four root canal sealers to the root dentin. Methods and materials In this study, forty single-rooted mandibular premolar teeth with fully-formed apices were collected. The teeth were decoronated and instrumented. Later, the teeth were randomly divided into four groups, each comprising ten specimens, based on the sealer used for obturation. The first group was obturated with BioRoot RCS (Septodont, Septodont Holding, Paris, France), the second group with MTA-Fillapex (Angelus, Angelus Indústria de Produtos Odontológicos S/A, Brazil), the third group with EpoxySeal (Safe Endo, SafeEndo Dental India Pvt. Ltd., Gujarat, India), and the fourth group with Sealapex (Kerr, Kerr Corporation, Brea, CA). Following obturation, the teeth were sectioned vertically using a diamond disc, and the marginal adaptation of these sealers to the root dentin was assessed using scanning electron microscopy (SEM). The values were then statistically analyzed. Results EpoxySeal showed the maximum amount of marginal adaptation (5.22±0.47), followed by BioRoot RCS (5.48±0.58) and MTA-Fillapex (8.24±0.74), and the least amount of marginal adaptation was shown by Sealapex (11.64±1.35). Based on the analysis of variance (ANOVA), a statistically significant difference (p≤0.001) was observed. According to Tukey's post hoc test, the mean difference between all groups showed statistical significance (p≤0.05) except between BioRoot RCS and EpoxySeal. Conclusion Within the limitations of this in vitro study, it is concluded that EpoxySeal and BioRoot RCS exhibited superior marginal adaptation to the root dentin. BioRoot RCS can be recommended as a sealer of choice owing to its additional properties, such as antimicrobial and hydrophilic affinity during setting.
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Affiliation(s)
- M Kirthiga
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, IND
| | - George Thomas
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, IND
| | - Sunil Jose
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, IND
| | - Sona Joseph
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, IND
| | - Manju Krishna
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, IND
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Ochoa-Rodríguez VM, Coaguila-Llerena H, Fernandes L, B. Solcia AB, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Faria G. Evaluation of Solubility, and Volumetric and Morphological Alterations of Bioceramic Filling Material for Primary Teeth: A New Methodological Approach. Int J Dent 2024; 2024:5945033. [PMID: 38957372 PMCID: PMC11217577 DOI: 10.1155/2024/5945033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/19/2024] [Accepted: 05/28/2024] [Indexed: 07/04/2024] Open
Abstract
Objective To evaluate the solubility and the volumetric and morphological alterations of bioceramic filling material (Bio-CP) for primary teeth. Materials and Methods Bio-CP, Calen thickened with zinc oxide (Calen-ZO), and with zinc oxide eugenol (ZOE) were placed in 1- or 2-mm-diameter polyethylene tubes and immersed in water or phosphate-buffered saline (PBS) for 30 days. The solubility (mass loss) was assessed using methodology modified from ISO 6876. Filling capacity, volumetric changes, and presence of voids were assessed by microcomputed tomography (micro-CT). The surface distribution of the chemical elements and the crystalline phases was evaluated by energy scattering X-ray scanning electron microscopy (SEM-EDX) and X-ray diffraction (XRD) to detect hydroxyapatite precipitate and components. The Shapiro-Wilk, Kruskal-Wallis, and Dunn's or two-way ANOVA and Tukey post hoc test were used (α = 0.05). Results The solubility was ZOE > Calen-ZO = Bio-CP. Calen-ZO and Bio-CP were more soluble in water than in PBS. All the materials showed greater solubility in 2-mm tube diameter in both PBS and distilled water, except for Bio-CP in distilled water, which showed no difference between both tube diameters (1 and 2 mm). Only Calen-ZO and ZOE were analyzed by micro-CT, because Bio-CP separated into two phases during scanning. Calen-ZO had greater volumetric loss and presence of voids than ZOE in water, but there was no difference in PBS. The hydroxyapatite precipitate on the surface of Bio-CP and Calen-ZO was detected after immersion in PBS. Conclusion Although Bio-CP had acceptable solubility and filling capacity, its composition did not allow a proper volumetric and void assessment. From a clinical perspective, Bio-CP has the potential to become a suitable material for root canal filling in primary teeth. Nonetheless, its composition must first be revised to achieve better chemical stability prior to its recommendation.
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Affiliation(s)
- Víctor M. Ochoa-Rodríguez
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
| | - Hernán Coaguila-Llerena
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
- Department of EndodonticsSchool of DentistryPeruvian University of Applied Sciences—UPC, Lima, Peru
| | - Leandro Fernandes
- Department of Dental Materials and ProsthesisAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
| | - Ana B. B. Solcia
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
| | - Juliane M. Guerreiro-Tanomaru
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
| | - Mário Tanomaru-Filho
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
| | - Gisele Faria
- Department of Restorative DentistryAraraquara School of DentistrySão Paulo State University—UNESP, Araraquara, São Paulo, Brazil
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Carney KA, Colloc TNE, Kilgariff JK. Management of rarely seen internal tunnelling root resorption associated with a maxillary permanent incisor. Br Dent J 2024; 236:955-961. [PMID: 38942857 PMCID: PMC11213701 DOI: 10.1038/s41415-024-7504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 06/30/2024]
Abstract
This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.
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Affiliation(s)
- Kirsty A Carney
- Post Dental Core Training Fellow, Dundee Dental Hospital and Research School, Dundee, Scotland, UK.
| | - Thibault N E Colloc
- Clinical Lecturer and Honorary Specialty Registrar in Endodontics, Dundee Dental Hospital and Research School, Dundee, Scotland, UK
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and Research School, Dundee, Scotland, UK
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10
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Rajagopal S, Sharma S. Designing Novel Endodontic Implants and Evaluation of the Stress Distribution in Maxillary Anteriors Using Finite Element Analysis. Cureus 2024; 16:e62562. [PMID: 39027789 PMCID: PMC11257767 DOI: 10.7759/cureus.62562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Endodontic implants, or didontic implants, offer a promising solution for stabilizing compromised teeth with a guarded prognosis and prolonging their clinical survival rate. Despite their potential benefits, they retired out of practice due to failures that arose from the lack of a biocompatible seal and engaging in dentin. Novel designs, based on evidence-based research with the help of bioceramics, present an opportunity to overcome these challenges and hence, enhance the clinical efficacy of endodontic implants. Thus the aim of this study is to design novel endodontic implants and evaluate their stress distribution in maxillary incisors using finite element analysis (FEA). Materials and methodology FEA is a biomechanical study to assess the stress distribution and extent of displacement to assess the clinical efficacy of novel endodontic implants in maxillary anterior teeth. Three 3D models (Model 1, Model 2, and Model 3) are designed to be meshed, and material elastic properties of the tooth and periapical tissues are applied. Boundary conditions were established, and a constant axial load value of 600 N was applied at a 45° angle. The FEA analysis was done under the loading conditions to assess the stress patterns for the three 3D models in comparison to the intact tooth on the ANSYS software (ANSYS Inc, Pennsylvania). Results FEA simulations revealed the distribution of stress within the tooth structure under functional occlusal forces, as Von Misses stresses were analyzed to assess the likelihood of material yielding and failure, which was comparable to that of an intact tooth. The maximum stress of deformation was as follows: intact: 1.7589e-5 MAX; Model 1: 3.3804e-6 MAX; Model 2: 2.638e-5 MAX; and Model 3: 2.1986e-5 MAX. The area of stress concentrations did not occur at the interface of the coronal or apical seal, which prevented catastrophic failures. Conclusion By leveraging advanced design principles and materials, these implants offer a promising alternative to traditional approaches, particularly in trauma cases with a poor prognosis for the survival of the teeth leading to loss of tooth. Further clinical studies are warranted to validate the efficacy and long-term success of these novel endodontic implants in diverse patient populations.
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Affiliation(s)
- Shruthi Rajagopal
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sonali Sharma
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Abu-Zeid ST, Alamoudi RA. Comparative Analysis of Interfacial Adaptation and Depth Penetration of Recent HiFlow versus Regular Bioceramic Sealers in Conjunction with BC Gutta-Percha Points Using Two Different Obturation Techniques-A Preliminary Report of an Ex Vivo Study. J Funct Biomater 2024; 15:134. [PMID: 38786645 PMCID: PMC11122194 DOI: 10.3390/jfb15050134] [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: 04/18/2024] [Revised: 05/11/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
This study aimed to assess the adaptability and penetration depth capacity of recent bioceramic systems, including regular EndoSequence (BC) versus HiFlow (BCH) sealers in the presence of BC points. A total of 54 single-rooted teeth were instrumented and obturated with either the cold or warm compaction technique (n = 9), using either BC, BCH, or AH Plus (AHP) combined with BC points. The adaptation, film thickness, and gaps/voids were evaluated by scanning electron microscopy. The sealer/dentin interface was evaluated by Raman spectroscopy, and depth penetration was evaluated by a confocal laser scanning microscope. According to the normality test, the data were statistically analyzed by ANOVA or Kruskal-Wallis and Mann-Whitney U tests at p < 0.05. BCH sealer showed the significantly thinnest film with the greatest flow (p > 0.001), with further improvement when subjected to the warm compaction technique. Moreover, it exhibited close adaptation with deep penetration into radicular dentin, forming a tag-like structure. The Raman spectra also indicated close contact with the dentin surface. The use of BC sealer with BC points exhibited homogenous, single-unit obturation, either with a cold or warm technique. Furthermore, the use of the warm compaction technique with BCH sealer achieved a gap-free interface associated with tag-like structures, which exhibit the monoblock phenomenon.
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Affiliation(s)
- Sawsan T. Abu-Zeid
- Endodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 22252, Saudi Arabia;
- Endodontic Department, Faculty of Dentistry, Cairo University, Giza 12345, Egypt
| | - Ruaa A. Alamoudi
- Endodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 22252, Saudi Arabia;
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12
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Lin GSS, Chin YJ, Choong RS, Wafa SWWSST, Dziaruddin N, Baharin F, Ismail AF. Treatment Outcomes of Pulpotomy in Primary Teeth with Irreversible Pulpitis: A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:574. [PMID: 38790569 PMCID: PMC11119415 DOI: 10.3390/children11050574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
AIM This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. METHODS This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. RESULTS Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. CONCLUSIONS Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Restorative Dentistry, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Kuantan 25200, Pahang, Malaysia
| | - Yu Jie Chin
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (Y.J.C.); (R.S.C.); (N.D.)
| | - Rob Son Choong
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (Y.J.C.); (R.S.C.); (N.D.)
| | | | - Nabihah Dziaruddin
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (Y.J.C.); (R.S.C.); (N.D.)
| | - Fadzlinda Baharin
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu 16150, Kelantan, Malaysia;
| | - Ahmad Faisal Ismail
- Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Kuantan 25200, Pahang, Malaysia;
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13
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Juntha S, Tungsawat P, Wongwatanasanti N, Suksaphar W, Lertnantapanya S. Evaluation of Setting Time, Flowability, Film Thickness, and Radiopacity of Experimental Monocalcium Silicate-Based Root Canal Sealers. Int J Dent 2024; 2024:8541653. [PMID: 38681823 PMCID: PMC11055647 DOI: 10.1155/2024/8541653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction This study aimed to evaluate the efficacy of a formulation of premixed calcium silicate-based sealer (CSBS) with monocalcium silicate (Mono-CS) as the main component. Its properties were compared with those of a control group (iRoot SP) according to ISO 6876/2012 standards for root canal sealers. Materials and Methods The CSBS formulation consisted of two components (powder and liquid). The powder was a mixture of Mono-CS, a radiopacifier, and a thickening agent, and the liquid components were nonaqueous liquid agent and setting accelerator. Three formulation groups with different powder-liquid ratios were prepared: group A, 2 : 1; group B, 3 : 1; and group C, 2 : 1, which also contained calcium chloride as a setting accelerator. The setting time, flow rate, film thickness, and radiopacity of the three CSBS groups and the control group were evaluated and compared. Each test was repeated five times for each group. Results The minimum values of setting time (i.e., working time, initial setting time, and final setting time) were ranked in order of significance as group B, the control group, group C, and group A. The control group had the lowest film thickness at 20 μm, with a nonsignificant difference to group C. The flow rates in group A, group C, and the control group were >20 mm. Furthermore, the experimental groups showed a similar amount of radiopacity as the control group (p > 0.05). Conclusion Mono-CS and calcium chloride can be used in the formulation of root canal sealers, and their properties, including working time, initial setting time, final setting time, flow rate, film thickness, and radiopacity, are consistent with those of iRoot SP and ISO 6876/2012 standards.
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Affiliation(s)
- Sukanya Juntha
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
| | - Pakit Tungsawat
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
| | | | - Warattama Suksaphar
- College of Dental Medicine, Rangsit University, Bangkok, Pathum Thani, Thailand
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Afkhami F, Chen Y, Walsh LJ, Peters OA, Xu C. Application of Nanomaterials in Endodontics. BME FRONTIERS 2024; 5:0043. [PMID: 38711803 PMCID: PMC11070857 DOI: 10.34133/bmef.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/20/2024] [Indexed: 05/08/2024] Open
Abstract
Recent advancements in nanotechnology have introduced a myriad of potential applications in dentistry, with nanomaterials playing an increasing role in endodontics. These nanomaterials exhibit distinctive mechanical and chemical properties, rendering them suitable for various dental applications in endodontics, including obturating materials, sealers, retro-filling agents, and root-repair materials. Certain nanomaterials demonstrate versatile functionalities in endodontics, such as antimicrobial properties that bolster the eradication of bacteria within root canals during endodontic procedures. Moreover, they offer promise in drug delivery, facilitating targeted and controlled release of therapeutic agents to enhance tissue regeneration and repair, which can be used for endodontic tissue repair or regeneration. This review outlines the diverse applications of nanomaterials in endodontics, encompassing endodontic medicaments, irrigants, obturating materials, sealers, retro-filling agents, root-repair materials, as well as pulpal repair and regeneration. The integration of nanomaterials into endodontics stands poised to revolutionize treatment methodologies, presenting substantial potential advancements in the field. Our review aims to provide guidance for the effective translation of nanotechnologies into endodontic practice, serving as an invaluable resource for researchers, clinicians, and professionals in the fields of materials science and dentistry.
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Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry,
The University of Queensland, Brisbane,QLD4006, Australia
| | - Yuan Chen
- Sydney Dental School, Faculty of Medicine and Health,
The University of Sydney, Camperdown, NSW 2006, Australia
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Laurence J. Walsh
- School of Dentistry,
The University of Queensland, Brisbane,QLD4006, Australia
| | - Ove A. Peters
- School of Dentistry,
The University of Queensland, Brisbane,QLD4006, Australia
| | - Chun Xu
- School of Dentistry,
The University of Queensland, Brisbane,QLD4006, Australia
- Sydney Dental School, Faculty of Medicine and Health,
The University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre,
The University of Sydney, Camperdown, NSW 2006, Australia
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Karam M, Faraj M, Mhanna R, Khalil I, Habib M, Makhlouf M, Zogheib C. Effect of heat application on the physicochemical properties of new endodontic sealers: an in vitro and SEM study. Odontology 2024; 112:512-525. [PMID: 38070028 DOI: 10.1007/s10266-023-00871-4] [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: 07/18/2023] [Accepted: 10/24/2023] [Indexed: 03/12/2024]
Abstract
Understanding the properties of endodontic sealers is vital for treatment planning. Calcium silicate-based sealers are important in modern endodontics. This study investigates the effect of heat on the physicochemical properties of new calcium silicate sealers, addressing concerns raised by clinicians seeking to combine their benefits with the gutta-percha obturation technique. Five endodontic sealers (AH Plus Bioceramic®, Total Fill® BC®, One-fil® Bioceramic, K-Biocer, Any-seal®) were evaluated. Each sealer (n = 16/group) was either kept at 37 °C or subjected to heat at 60 or 200 °C for 30 s. ISO 6876-2012 standards were used to measure setting time, flow, film thickness, and dimensional changes over time. SEM and EDS were utilized for surface and chemical analysis. Data analysis employed IBM SPSS Statistics version 26 with a 5% significance level for two-sided tests. The sealers' setting times were shortened by heat, except for Total Fill® BC with extended setting time. All sealers had significantly longer setting times than manufacturer specifications. Film thickness increased with temperature, while flow values decreased. K-Biocer sealer showed the highest flow (16.89 ± 0.57 mm) at 200 °C, while Total Fill® sealer had the lowest (15.32 ± 0.62 mm). Shrinkage was significant at 60 °C and 200 °C, with greater shrinkage at 200 °C. Heat caused surface deformations in all sealers. The 200 °C groups exhibited more voids in AH Plus Bioceramic®, Any-seal®, and One-fil® sealers, and higher void area in Total Fill®, One-fil®, and K-Biocer sealers (p value < 0.001). EDX analysis confirmed heat-induced chemical and elemental changes in all tested sealers. Elevated temperature affects the physicochemical properties and structure of the tested endodontic sealers. The consideration of endodontic sealer compatibility is essential when warm gutta-percha obturation techniques are used.
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Affiliation(s)
- Mariana Karam
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Marwa Faraj
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Biochemistry and Molecular Genetics Program, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rami Mhanna
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Issam Khalil
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marc Habib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Michèle Makhlouf
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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16
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Azizi H, Hadad A, Levy DH, Ben Itzhak J, Kim HC, Solomonov M. Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review. Dent J (Basel) 2024; 12:85. [PMID: 38667997 PMCID: PMC11048901 DOI: 10.3390/dj12040085] [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: 01/02/2024] [Revised: 03/02/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to review the considerations for choosing a suitable sealer according to various endodontic scenarios. An electronic search of PubMed, Scopus, and the Web of Science was undertaken for the keywords of 'sealer choosing', 'appropriate sealer', 'suitable sealer', 'sealer for clinical scenario', and 'sealer for clinical situations'. However, the literature review revealed a lack of studies with practical clinical recommendations regarding the choice of appropriate endodontic root canal sealers for particular clinical situations of root canal treatment. Therefore, a narrative review was undertaken under the basis of the characteristics of an epoxy resin-based sealer (ERS) versus a calcium silicate-based sealer (CSS). Based on the evidence found through the review, the choice of an appropriate sealer in a variety of clinical scenarios was proposed. An ERS is recommended for one-visit non-vital cases, teeth with periodontal involvement, cracked teeth, and internal root resorption without root perforation. A CSS is recommended for vital or non-vital cases in multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations.
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Affiliation(s)
- Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Henry Levy
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 46241, Republic of Korea;
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Ortega MA, Rios L, Fraile-Martinez O, Liviu Boaru D, De Leon-Oliva D, Barrena-Blázquez S, Pereda-Cerquella C, Garrido-Gil MJ, Manteca L, Buján J, García-Honduvilla N, García-Montero C, Rios-Parra A. Bioceramic versus traditional biomaterials for endodontic sealers according to the ideal properties. Histol Histopathol 2024; 39:279-292. [PMID: 37747049 DOI: 10.14670/hh-18-664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Odontology, as a scientific discipline, continuously collaborates with biomaterials engineering to enhance treatment characteristics and patients' satisfaction. Endodontics, a specialized field of dentistry, focuses on the study, diagnosis, prevention, and treatment of dental disorders affecting the dental pulp, root, and surrounding tissues. A critical aspect of endodontic treatment involves the careful selection of an appropriate endodontic sealer for clinical use, as it significantly influences treatment outcomes. Traditional sealers, such as zinc oxide-eugenol, fatty acid, salicylate, epoxy resin, silicone, and methacrylate resin systems, have been extensively used for decades. However, advancements in endodontics have given rise to bioceramic-based sealers, offering improved properties and addressing new challenges in endodontic therapy. In this review, a classification of these materials and their ideal properties are presented to provide evidence-based guidance to clinicians. Physicochemical properties, including sealing ability, stability over time and space, as well as biological properties such as biocompatibility and antibacterial characteristics, along with cost-effectiveness, are essential factors influencing clinicians' decisions based on individual patient evaluations.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
- Cancer Registry and Pathology Department, Principe de Asturias University Hospital, Alcala de Henares, Spain
| | - Laura Rios
- Universidad San Pablo CEU, Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Diego Liviu Boaru
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Diego De Leon-Oliva
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Silvestra Barrena-Blázquez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Claude Pereda-Cerquella
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Maria J Garrido-Gil
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | | | - Julia Buján
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
| | - Antonio Rios-Parra
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Cancer Registry and Pathology Department, Principe de Asturias University Hospital, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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18
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Surana P, Singh Dhull K, Arya A, Samreen S, Rajan M, Parihar AS. Bio-ceramics application in Dentistry. Bioinformation 2024; 20:136-139. [PMID: 38497078 PMCID: PMC10941772 DOI: 10.6026/973206300200136] [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: 02/01/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Bioceramics have gained significant attention in dentistry due to their unique properties, including biocompatibility, osseointegration, and tissue regeneration. Therefore, it is of interest to report the various applications of bioceramics in dentistry, their advantages, limitations, and future considerations. Bio-ceramics such as zirconia and hydroxyapatite offer high biocompatibility and durability for dental application. They support bone integration for implants, resist wear, and mimic natural tooth aesthetics. Used in crowns, bridges, and fillings, bio-ceramics enhance healing and are pivotal in restorative and reconstructive dental procedures.
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Affiliation(s)
- Pratik Surana
- Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Centre, Durg, Chhattisgarh, India
| | - Kanika Singh Dhull
- Department of Pedodontics & Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, India
| | - Ashtha Arya
- Departmentof Conservative Dentistry and Endodontics, SGT Dental College, Hospital and Research Institute, SGT University, Gurugram, Haryana - 122505, India
| | - Sara Samreen
- Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Centre, Durg, Chhattisgarh, India
| | - Milind Rajan
- Department of Pedodontics and Preventive Dentistry, MA Rangoonwala Dental College, Pune - 411001, Maharashtra, India
| | - Anuj Singh Parihar
- Department of Periodontology, People's Dental Academy, Bhopal, Madhya Pradesh, 462037, India
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19
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Reddy KH, Swetha B, Priya BD, Mohan TM, Malini DL, Sravya MS. Effect of collagen cross-linking agents on the depth of penetration of bioceramic sealer and release of hydroxyproline: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:170-174. [PMID: 38463481 PMCID: PMC10923233 DOI: 10.4103/jcd.jcd_309_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/29/2023] [Accepted: 10/07/2023] [Indexed: 03/12/2024]
Abstract
Context During endodontic treatment, sealers seal off dentinal tubules and prevent microbial attack. Bioceramic sealers have excellent bioactivity, but its high alkalinity is found to have detrimental effects on radicular collagen. Collagen cross linkers have the ability to chemically modify collagen and can prevent the detrimental effects of the sealer. Aim This research was aimed to assess the effect of collagen cross-linking agents on the integrity of radicular collagen matrix and depth of penetration of sealer. Materials and Methods Mandibular premolars (n = 48) were taken. Teeth were decoronated; canals were prepared till ProTaper size F2 and were irrigated with 5 mL of 2.5% NaOCl, followed by 3 mL of 17% ethylenediaminetetraacetic acid between instrumentation and finally rinsed with saline following which teeth were divided into three groups based on the surface treatments: Group 1: 6.5% proanthocyanin (PA), Group 2: chlorhexidine (CHX), and Group 3: saline. Teeth were obturated using gutta-percha and bioceramic sealer and stored in artificial saliva. Hydroxyproline (HYP) release was assessed after 14 and 21 days using spectrophotometer. Sealer penetration was assessed using the scanning electron microscope. Statistical Analysis Wilcoxon signed-rank test and Kruskal-Wallis test for release of HYP and paired t-test and ANOVA for sealer penetration were performed. Results Significantly lower release of HYP was seen in proanthocyanin-treated group. Sealer penetration was better for both the proanthocyanin- and CHX-treated groups when compared to saline. Conclusion Surface treatment with collagen cross-linkers caused a decrease in the amount of HYP released, indicating lesser degradation of collagen. Sealer penetration was better due to the removal of smear layer following the surface treatments.
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Affiliation(s)
- K. Hanisha Reddy
- Associate Professor, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Bollineni Swetha
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - B. Devi Priya
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - T Murali Mohan
- Professor and HOD, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Duvvuri Lakshmi Malini
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - M. Sai Sravya
- Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
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20
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Duan X, Tan Y, Zhang D, Wu H. Effects of Superfine Tricalcium Silicate Powder on the Physicochemical and Mechanical Properties of Its Premixed Cement as a Root Canal Filling Material. MATERIALS (BASEL, SWITZERLAND) 2024; 17:347. [PMID: 38255515 PMCID: PMC10820792 DOI: 10.3390/ma17020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Calcium silicate-based cement is a promising material for filling root canals. However, it has several drawbacks to its clinical application, including difficult operation and low curing strength. In this study, we successfully prepared an ultrafine tricalcium silicate powder and investigated the effects of this ultrafine powder on the performance of the premixed tricalcium silicate cement, including the curing process, setting time, hydration products, microstructure, injectivity, fluidity, and compressive strength. The results demonstrate that the addition of ultrafine tricalcium silicate powder alters the hydration product content and product morphology of the premixed cement. By increasing the content of the ultrafine powder, the injectable property of the cement can be increased to more than 95%, the fluidity can be increased from 18 mm to 35 mm, and the curing time can be shortened from 13 h to 11 h. Notably, the addition of the ultrafine powder greatly enhances the compressive strength of the hardened cement, which increases from 20.6 MPa to 51.0 MPa. These results indicate that altering the particle size distribution of the powder is an effective method for enhancing the physicochemical and mechanical properties of tricalcium silicate cement as a root canal filling material.
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Affiliation(s)
| | - Yanni Tan
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, China; (X.D.); (D.Z.); (H.W.)
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21
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Hamdy TM, Galal MM, Ismail AG, Saber S. Physicochemical properties of AH plus bioceramic sealer, Bio-C Sealer, and ADseal root canal sealer. Head Face Med 2024; 20:2. [PMID: 38172921 PMCID: PMC10765876 DOI: 10.1186/s13005-023-00403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer). METHODS Solubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer. RESULTS The least film thickness, highest alkalinity, and highest calcium ion release were all displayed by AH Plus Bioceramic Sealer. High solubility, high alkalinity, intermediate calcium ion release, and intermediate film thickness were all displayed by Bio-C Sealer. While ADseal root canal sealer displayed the greatest film thickness, least solubility, alkalinity, and calcium ion release. CONCLUSIONS Both AH Plus Bioceramic Sealer and Bio-C Sealer represented adequate properties to be considered a good sealer that could be used as a potential alternative to resin-based root canal sealers.
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Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Shehabeldin Saber
- Endodontic Department, Faculty of Dentistry, The British University in Egypt, Cairo, 11841, Egypt
- Center for Innovative Dental Sciences, The British University in Egypt, Cairo, 11841, Egypt
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, 11566, Egypt
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Chanapairin B, Kulvitit S, Sathorn C. Post retention strength of apical and conventional coating obturation methods using bioceramic sealer: a laboratory investigation. BMC Oral Health 2024; 24:3. [PMID: 38167313 PMCID: PMC10763468 DOI: 10.1186/s12903-023-03778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Once bioceramic sealer (BCS) enters the dentinal tubules, it cannot be reliably removed. BCS-occupied dentinal tubules reduce fibre post retention strength. Coating gutta-percha with BCS only on the apical portion may improve post retention strength due to increased retention strength between the dentin and resin cement interface. The aim of the study was to test this hypothesis. METHODS Root canals of 27 extracted human mandibular premolars were instrumented and randomly assigned to three obturation methods: conventional coating (CC), non-coating (NC), and apical coating (AC). The root canals were obturated with gutta-percha to 4 mm from the working length under an operating microscope. After the BCS was completely set, post spaces were prepared, and quartz fibre posts were cemented. The apical 4.5 mm of the roots were removed. Two samples were prepared at the apical, middle, and coronal root levels (one for scanning electron microscope (SEM) study and another for the push out bond strength (PBS) test). After the PBS test, the samples were examined with a stereo microscope to determine the failure mode: dentine-cement (DC), post-cement (PC) and mixed. The PBS data were analysed by One way ANOVA for the specific obturation method effects. Repeated ANOVA was used for the specific effects of the root levels on PBS in different obturation methods. RESULTS At all three root levels, more continuous hybrid layers and denser resin tags were found in the NC and AC than the CC group. The AC and NC groups' PBS was significantly higher than the CC group at the apical 1/3 (p = 0.002 and p = 0.001) and coronal 1/3 (p = 0.016 and p = 0.041). The PBS in the CC group at the middle 1/3 was significantly higher than the apical 1/3 (p = 0.022). DC failure mode was most commonly found in the CC group, while PC failure mode was found most frequently in the NC and AC groups. CONCLUSIONS The apical coating obturation method significantly increased PBS over the conventional coating method, potentially reducing fiber post dislodgement. However, this study was only preliminary. Clinical studies are required to confirm the results.
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Affiliation(s)
- Benjarat Chanapairin
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sirinya Kulvitit
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence in Genomics and Precision Dentistry, Faculty of Dentistry, Chulalongkorn university, Bangkok, 10330, Thailand.
| | - Chankhrit Sathorn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- School of Dentistry, La Trobe University, Melbourne, VIC, Australia
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Ja'apar SAN, Ichwan SJA, Mustaffa M. In vivo cytotoxicity analysis of bioceramic root canal sealers on zebrafish embryo. J Dent Res Dent Clin Dent Prospects 2023; 17:242-249. [PMID: 38584992 PMCID: PMC10998162 DOI: 10.34172/joddd.2023.39163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/13/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study evaluated the cytotoxicity of four bioceramic root canal sealers (RCSs) in vivo. The embryonic zebrafish characteristics, such as mortality, survival, hatching, and general morphology, served as the parameters for assessing cytotoxicity. Methods The RCSs, namely GuttaFlow Bioseal, MTA Fillapex, CeraSeal Bioceramic, and iRoot SP, were mixed according to the manufacturer's guidelines. The extract solution was prepared by immersing the set RCS into 1X dilution of E3 solution. Then, the extract solution was delivered into a Petri dish where zebrafish embryos were allowed to develop. Cytotoxicity was evaluated 24, 48, 72, and 96 hours after fertilization. Results The Kruskal-Wallis test showed that except for GuttaFlow Bioseal, the mortality, survival, and hatching of zebrafish embryos for the remaining three bioceramic RCSs were significantly different from the negative controls (P<0.05). Significant differences were also evident in the mortality, survival, and hatching of zebrafish embryos between GuttaFlow Bioseal and three other RCSs (P<0.05). Conclusion GuttaFlow Bioseal was less cytotoxic than other bioceramics RCSs; MTA Fillapex, CeraSeal Bioceramic root canal sealer, and iRoot SP root canal sealer exhibited comparable cytotoxicity.
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Affiliation(s)
- Siti Aisyah Nadirah Ja'apar
- Department of Biotechnology, Kulliyyah of Sciences, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Solachuddin Jauhari Arief Ichwan
- Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry (KOD), IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
- Dentistry Programme, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE1410, Brunei
| | - Musliana Mustaffa
- Department of Restorative Dentistry, KOD, IIUM, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
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Kim HJ, Lee JS, Gwak DH, Ko YS, Lim CI, Lee SY. In Vitro Comparison of Differences in Setting Time of Premixed Calcium Silicate-Based Mineral Trioxide Aggregate According to Moisture Content of Gypsum. MATERIALS (BASEL, SWITZERLAND) 2023; 17:35. [PMID: 38203889 PMCID: PMC10779729 DOI: 10.3390/ma17010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
Recently, a paste-type premixed calcium silicate-based mineral trioxide aggregate (MTA) product that quickly solidifies through a pozzolanic reaction was introduced to replace existing MTA, which has the disadvantage of a long setting time. In this study, we evaluated the effect of moisture content in the root canal on the setting time of premixed calcium silicate-based MTA in a simulated root canal environment using Endoseal MTA and Well-Root ST, among commercially available products. The setting time was measured according to ISO 6876/2012. A mold made using grades 2, 3, and 4 dental gypsum according to the classification of ISO 6873/2013 was used to reproduce the difference in moisture environment. Differences in moisture content were measured using micro-computed X-ray tomography (micro-CT). The micro-CT results showed that the moisture content was the highest and lowest in the grade 2 and 4 gypsum molds, respectively. Moreover, the setting time indicated by the manufacturer was the shortest for the grade 2 gypsum mold. Hence, the differences in moisture content significantly affect the setting time of MTA. This result can help set future experimental conditions and develop premixed calcium silicate-based MTA products.
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Affiliation(s)
| | | | | | | | | | - Seung-Youl Lee
- Medical Device Research Division, National Institute of Food and Drug Safety Evaluation, Cheongju 28159, Republic of Korea; (H.-J.K.); (J.-S.L.); (D.-H.G.); (Y.-S.K.); (C.-I.L.)
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25
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Capuano N, Amato A, Dell’Annunziata F, Giordano F, Folliero V, Di Spirito F, More PR, De Filippis A, Martina S, Amato M, Galdiero M, Iandolo A, Franci G. Nanoparticles and Their Antibacterial Application in Endodontics. Antibiotics (Basel) 2023; 12:1690. [PMID: 38136724 PMCID: PMC10740835 DOI: 10.3390/antibiotics12121690] [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: 10/26/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Root canal treatment represents a significant challenge as current cleaning and disinfection methodologies fail to remove persistent bacterial biofilms within the intricate anatomical structures. Recently, the field of nanotechnology has emerged as a promising frontier with numerous biomedical applications. Among the most notable contributions of nanotechnology are nanoparticles, which possess antimicrobial, antifungal, and antiviral properties. Nanoparticles cause the destructuring of bacterial walls, increasing the permeability of the cell membrane, stimulating the generation of reactive oxygen species, and interrupting the replication of deoxyribonucleic acid through the controlled release of ions. Thus, they could revolutionize endodontics, obtaining superior results and guaranteeing a promising short- and long-term prognosis. Therefore, chitosan, silver, graphene, poly(lactic) co-glycolic acid, bioactive glass, mesoporous calcium silicate, hydroxyapatite, zirconia, glucose oxidase magnetic, copper, and zinc oxide nanoparticles in endodontic therapy have been investigated in the present review. The diversified antimicrobial mechanisms of action, the numerous applications, and the high degree of clinical safety could encourage the scientific community to adopt nanoparticles as potential drugs for the treatment of endodontic diseases, overcoming the limitations related to antibiotic resistance and eradication of the biofilm.
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Affiliation(s)
- Nicoletta Capuano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy;
| | - Federica Dell’Annunziata
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.R.M.); (A.D.F.); (M.G.)
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Veronica Folliero
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Pragati Rajendra More
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.R.M.); (A.D.F.); (M.G.)
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.R.M.); (A.D.F.); (M.G.)
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Massimo Amato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.R.M.); (A.D.F.); (M.G.)
- Complex Operative Unity of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Alfredo Iandolo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (N.C.); (F.D.); (F.G.); (V.F.); (F.D.S.); (S.M.); (M.A.)
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Pedullà E, Iacono F, Pitrolo M, Barbagallo G, La Rosa GRM, Pirani C. Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment. AUST ENDOD J 2023; 49:623-630. [PMID: 37667824 DOI: 10.1111/aej.12795] [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: 05/13/2023] [Revised: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Abstract
The aim of the study was to evaluate the impact of kinematics and irrigation protocols on the extrusion of apical debris during removal of different obturation techniques. A total of 144 single-rooted teeth were instrumented and obturated with Thermafil+AH Plus, Thermafil+AH Plus Bioceramic and single gutta-percha cone+AH Plus Bioceramic. Samples were divided according to the retreatment kinematics: continuous rotation or Jeni motion. Each sub-group was subjected to conventional irrigation or irrigation activated by EDDY. Extruded debris was collected in Eppendorf tubes, weighted and retreatment time was digitally recorded. Data were analysed with two-way ANOVA (p < 0.05). Debris extrusion was not significantly different between all groups. EDDY activation system and CanalPro Jeni required significantly longer time compared with other groups to remove Thermafil+AH Plus and single cone+AH Plus Bioceramic. Within current limitations, obturation technique, irrigation protocol and kinematics tested had no influence on apical extrusion debris, while they significantly impacted the retreatment time.
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Affiliation(s)
- Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | | | - Martina Pitrolo
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | | | - Giusy Rita Maria La Rosa
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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27
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Al-Hiyasat AS, Sawallha AM, Taha NA. The effect of sealer type and obturation technique on the fracture resistance of endodontically treated roots. Clin Oral Investig 2023; 27:7359-7367. [PMID: 37923945 DOI: 10.1007/s00784-023-05326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/10/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study evaluated the effect of sealer type with various obturation techniques on the fracture resistance of root filled teeth. MATERIALS AND METHODS Eighty mandibular premolars were collected, and root canals of 70 of them were prepared by Mtwo system up to 40/04. Thirty teeth were obturated using TotalFill BC sealer, and 30 using AH Plus sealer, with one of the obturation techniques (N = 10), namely cold lateral compaction (CLC), warm vertical compaction (WVC), and single cone (SC). Ten teeth were left without obturation as a positive control, and the other 10 teeth were not prepared serving as a negative control. Teeth were stored for 3 weeks, and the crowns were separated and the roots were subjected to fracture test using a universal testing machine. RESULTS Data was analyzed by ANOVA followed by Tukey's test. Fracture resistance of the TotalFill groups was significantly higher than the AH Plus groups in each obturation technique, and SC had the highest fracture resistance regardless of sealer used (P < 0.05). Obturation of the root canal by TotaFill BC sealer increased the calcium/phosphorous ratio in the dentin of the root. CONCLUSIONS Obturation with TotalFill BC sealer improved the fracture resistance of the roots more than AH Plus sealer, and obturation with SC resulted in higher fracture resistance than CLC and WVC. CLINICAL RELEVANCE Obturation of the root canal with Bioceramic sealer with single cone obturation technique could reduce the incidence of vertical root fracture.
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Affiliation(s)
- Ahmad S Al-Hiyasat
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
| | - Anas M Sawallha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nessrin A Taha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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28
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Karatas E, Hadis M, Palin WM, Milward MR, Kuehne SA, Camilleri J. Minimally invasive management of vital teeth requiring root canal therapy. Sci Rep 2023; 13:20389. [PMID: 37990070 PMCID: PMC10663499 DOI: 10.1038/s41598-023-47682-9] [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: 09/18/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
The present study aimed to investigate the possible use of a non-instrumentation technique including blue light irradiation for root canal cleaning. Extracted human single rooted teeth were selected. Nine different groups included distilled water, NaOCl, intra-canal heated NaOCl, and NaOCl + EDTA irrigation after either instrumentation or non-instrumentation, and a laser application group following non-instrumentation technique. The chemical assessment of the root canal dentine was evaluated using energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy. Surface microstructural analyses were performed by using scanning electron microscopy (SEM). The antimicrobial efficacy of different preparation techniques was evaluated using microbial tests. Light application didn't change the calcium/phosphorus, carbonate/phosphate and amide I/phosphate ratios of the root canal dentin. The root canal dentin preserved its original chemistry and microstructure after light application. The instrumentation decreased the carbonate/phosphate and amide I/phosphate ratios of the root canal dentin regardless of the irrigation solution or technique (p < 0.05). The application of light could not provide antibacterial efficacy to match the NaOCl irrigation. The NaOCl irrigation both in the non-instrumentation and instrumentation groups significantly reduced the number of bacteria (p < 0.05). The use of minimally invasive root canal preparation techniques where the root canal is not instrumented and is disinfected by light followed by obturation with a hydraulic cement sealer reduced the microbial load and preserved the dentin thus may be an attractive treatment option for management of vital teeth needing root canal therapy.
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Affiliation(s)
- E Karatas
- Ataturk University, Erzurum, Turkey
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M Hadis
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - W M Palin
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M R Milward
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - S A Kuehne
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK.
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Karobari MI, Batul R, Snigdha NTS, AL-Rawas M, Noorani TY. Evaluation of push-out bond strength, dentinal tubule penetration and adhesive pattern of bio-ceramic and epoxy resin-based root canal sealers. PLoS One 2023; 18:e0294076. [PMID: 37956149 PMCID: PMC10642786 DOI: 10.1371/journal.pone.0294076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Root canal sealing materials play a crucial role in an endodontic procedure by forming a bond between the dentinal walls and the gutta-percha. The current study aims to analyse the dentinal tubule penetration and adhesive pattern, including the push-out bond strength of six commercially available root canal sealers. METHODOLOGY Eighty-four mandibular first premolars were split into seven groups (and n = 12), Group 1: Dia-Root, Group 2: One-Fil, Group 3: BioRoot RCS, Group 4: AH Plus, Group 5: CeraSeal, Group 6: iRoot SP, Group 7: GP without sealer (control). Two groups were made, one for dentinal tubule penetration and the other for push-out bond strength; the total sample size was one hundred sixty-eight. Root canal treatment was performed using a method called the crown down technique, and for obturation, the single cone technique was used. A confocal laser scanning microscope (Leica, Microsystem Heidel GmbH, Version 2.00 build 0585, Germany) was used to evaluate dentinal tubule penetration, and Universal Testing Machine was utilised to measure the push-out bond strength (Shimadzu, Japan) using a plunger size of 0.4 mm and speed of 1mm/min. Finally, the adhesive pattern of the sealers was analysed by HIROX digital microscope (KH-7700). Statistical analysis was carried out by a one-way Anova test, Dunnet's T3 test, and Chi-square test. RESULTS Highest dentinal tubule penetration was noticed with One-Fil (p<0.05), followed by iRoot SP, CeraSeal, AH Plus, Dia-Root also, the most negligible value was recorded for BioRoot RCS. Meanwhile, BioRoot RCS (p<0.05) demonstrated the greater value of mean push-out bond strength, followed by One-fil, iRoot SP, CeraSeal, AH Plus and Dia-Root. Regarding adhesive pattern, most of the samples were classified as type 3 and type 4 which implies greater sealing ability and better adherence to the dentinal wall. However, BioRoot RCS revealed the most type 4 (p<0.05), followed by AH Plus, One-Fil, CeraSeal and Dia-Root. CONCLUSION The highest dentinal tubule penetration was shown by One-Fil compared to other groups. Meanwhile, BioRoot RCS had greater push-out bond strength and more adhesive pattern than other tested materials.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Dental Research Unit, Center for Global health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Niher Tabassum Siddiqua Snigdha
- Department of Paediatric Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Matheel AL-Rawas
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Tahir Yusuf Noorani
- Dental Research Unit, Center for Global health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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30
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Timis L, Gorea M, Har N, Cimpean S, Delean A, Bud MG, Campian RS. Biomineralization ability of an experimental bioceramic endodontic sealer based on nanoparticles of calcium silicates. Med Pharm Rep 2023; 96:434-440. [PMID: 37970195 PMCID: PMC10642743 DOI: 10.15386/mpr-2660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/29/2023] [Indexed: 11/17/2023] Open
Abstract
Background and aims The ultimate goal of endodontic therapy is to prevent periradicular disease or to promote the healing of the periradicular lesions. The use of nontoxic, biocompatible, and bioactive materials designed for root canal obturation is preferred due to their increased potential to induce healing and bone regeneration, thereby restoring the functionality of the tooth and the adjacent tissues. The aim of this study was to analyze the biomineralization ability of an experimental endodontic sealer based on synthesized nanoparticles of calcium silicates. Methods Six plastic moulds were filled with the freshly prepared experimental endodontic sealer and kept for 3 days at room temperature in a moist environment. After hardening, four samples were subsequently immersed in simulated body fluid (SBF) and introduced in incubator at 37°C and 100% relative humidity; two of them were kept for 7 days and the other two for 14 days. Two samples were not immersed in SBF and were used for comparison. The biomineralization potential was assessed by XRPD, SEM and EDS analysis. Results Following immersion in SBF, XRPD analysis identified apatite crystals for experimental material both after 7 and 14 days. SEM images displayed the specific microstructure for bioceramic materials alongside with the presence of apatite crystals on their surface. EDS identified the presence of phosphorus and calcium elements, underlining the biomineralization potential of the experimental material. Conclusion Interaction between experimental material and SBF succeeded in inducing precipitation of apatite on its surface, evidenced by XRDP, SEM and EDS analysis.
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Affiliation(s)
- Lucia Timis
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maria Gorea
- Department of Chemical Engineering, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Nicolae Har
- Department of Geology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Sanda Cimpean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ada Delean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marius Gheorghe Bud
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Septimiu Campian
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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31
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Saber S, Galal MM, Ismail AG, Hamdy TM. Thermal, chemical and physical analysis of VDW.1Seal, Fill Root ST, and ADseal root canal sealers. Sci Rep 2023; 13:14829. [PMID: 37684307 PMCID: PMC10491594 DOI: 10.1038/s41598-023-41798-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
This study aimed to evaluate the thermal, chemical, and physical properties of VDW.1Seal, Fill Root ST, and ADseal sealers. Thermal properties were analyzed using Thermogravimetric analysis (TGA) and Differential thermal analysis (DTA). Attenuated total reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) analysis was performed as a complementary test to confirm TGA/DTA analysis. The chemical composition of the set sealer material was identified using an X-ray powder diffraction (XRD) system. Other physical properties of each sealer were investigated; ten specimens were used to measure the solubility (at 24 h and 28 days), and another ten specimens were used to assess pH changes and calcium ion release (after 7 and 14 days). Film thickness was done according to ISO 6876 specs. The data were analyzed using the two-way ANOVA test. Results showed that for all sealers, TGA analysis revealed a direct relationship between sealer mass loss and temperature rise. In addition, the decomposition of the tested sealers started at 145 °C, 135 °C and 91 °C for VDW.1Seal, ADseal sealer, and Fill Root ST, respectively. XRD analysis revealed a higher degree of crystallinity for VDW.1Seal and ADseal. ADseal showed the least solubility; VDW.1Seal exhibited the highest alkalinity, calcium ion release, and the lowest film thickness.
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Affiliation(s)
- Shehabeldin Saber
- Endodontic Department, Faculty of Dentistry, The British University in Egypt, 81-11-11 El-Rehab, Cairo, 11841, Egypt.
- Center for Innovative Dental Sciences, The British University in Egypt, El Sherouk City, Egypt.
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
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Kandemir Demirci G, Çöven FO, Güneri P, Karavana SY, Nalbantsoy A, Köse T, Kaval ME. The solubility, pH value, chemical structure, radiopacity, and cytotoxicity of four different root canal sealers: an in vitro study. Clin Oral Investig 2023; 27:5413-5425. [PMID: 37486382 DOI: 10.1007/s00784-023-05160-6] [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: 01/31/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet sealers. MATERIALS AND METHODS Cytotoxicity analysis with direct and extraction tests at 3 different concentrations (1:1, 1:2, 1:4 v/v%) and time (24 h, 48 h, and 72 h) on Saos-2, PdLF, and THP-1 cell lines, chemical structure with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis, solubility, pH, and radiopacity values of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet were evaluated. For statistical analyses of the groups, repeated measures, factorial, and one-way ANOVA tests were used. The statistical significance level was set at p < .05. RESULTS Resin-based sealers showed higher cytotoxicity values than the bioceramic-based sealers (p < 0.05). Time and concentrations were effective on the cell viabilities for cell lines. Higher peaks of calcium were detected bioceramic-based sealers and higher amount of zirconium was detected in AH Plus BC (p < 0.05). AH Plus BC showed similar radiopacity value with AH Plus, AH Plus Jet, whereas TotalFill BC showed the lowest radiopacity (p < 0.05). Bioceramic-based sealers had higher pH values in all experiment periods, and the difference between resin- and bioceramic-based sealer groups was significant (p < 0.05). However, the solubility values of the tested root canal sealers revealed no differences (p > 0.05). CONCLUSIONS The newly produced AH Plus BC Sealer showed similar properties with TotalFill BC, and their biological properties were better than AH Plus and AH Plus Jet. CLINICAL RELEVANCE AH Plus BC could be a possible alternative to other bioceramic- or resin-based sealers.
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Affiliation(s)
| | - Furkan Ozan Çöven
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, İzmir, Turkey
| | - Sinem Yaprak Karavana
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Ege University, İzmir, Turkey
| | - Ayşe Nalbantsoy
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Mehmet Emin Kaval
- Department of Endodontology, School of Dentistry, Ege University, 35100, İzmir, Turkey
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Gaeta C, Marruganti C, Mignosa E, Malvicini G, Verniani G, Tonini R, Grandini S. Comparison of physico-chemical properties of zinc oxide eugenol cement and a bioceramic sealer. AUST ENDOD J 2023; 49 Suppl 1:187-193. [PMID: 36409203 DOI: 10.1111/aej.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/22/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to compare the physico-chemical properties of EssenSeal with AH PLUS bioceramic and Pulp Canal Sealer EWT. Flow, solubility, film thickness, radiopacity and setting time were evaluated according to ISO 6876 (2012) specifications. External and cross-section surface characteristics were analysed under a scanning electron microscope. Statistical analysis was performed using Shapiro-Wilk's test, one-way ANOVA and the Tukey HSD test. All the sealers conformed to the ISO 6876 (2012) standards, except for the setting time for AH plus bioceramic, which exceeded more than 10% of the time indicated by the manufacturer. Statistically significant differences were found between the three study sealers regarding the physico-chemical properties tested (p < 0.05). EssenSeal demonstrated characteristics respecting the ISO 6876 (2012) standards and can be considered a predictable alternative in root canal sealing.
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Affiliation(s)
- Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Emanuele Mignosa
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giulia Verniani
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Simone Grandini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Pelozo LL, Souza-Gabriel AE, Alves Dos Santos GN, Camargo RV, Lopes-Olhê FC, Sousa-Neto MD, Mazzi-Chaves JF. Canal Drying Protocols to Use with Calcium Silicate-based Sealer: Effect on Bond Strength and Adhesive Interface. J Endod 2023; 49:1154-1160. [PMID: 37516237 DOI: 10.1016/j.joen.2023.07.015] [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: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the influence on bond strength and interface quality of different canal drying protocols in roots filled with Bio-C Sealer (BCS; Angelus, Londrina, Paraná, Brazil). METHODS Ninety-six roots of upper canines were prepared with an R50 file (Reciproc; VDW GmbH, Munich, Germany) and irrigated with 2.5% sodium hypochlorite and 17% EDTA under ultrasonic agitation. Roots were divided according to the drying protocol as follows: dry, the White Mac tip (Ultradent, Indaiatuba, SP, Brazil) for 5 seconds followed by aspiration with a capillary tip for 5 seconds and paper points; slightly moist, the White Mac tip followed by capillary aspiration without paper points; wet, the White Mac tip followed by a single paper point. The roots were filled with BCS or AH Plus (AHP; Dentsply Maillefer, Ballaigues, Switzerland) (n = 16) and sectioned for the push-out test after 3 months. Failure modes were assessed, and the interface morphology was analyzed under scanning electron microscopy. After 6 months, the other half of the roots were evaluated. Data were analyzed by analysis of variance/Tukey test at 5%. The chi-square test was used in the failure analysis and the Kruskal-Wallis/Dwass-Steel-Critchlow-Fligner for interface analysis. RESULTS The AHP-filled roots had the highest bond strength when the canal was dried (P < .05). No difference was found for periods (P > .05). For BCS, the highest bond strength was found in the slightly moist canals (P < .05). A predominance of adhesive failures was observed. The dried canals filled with AHP had the highest percentage of good adaptation, whereas BCS had no difference. CONCLUSIONS The best drying protocol for AHP is using the White Mac tip followed by capillary tip aspiration and paper points until complete dryness, and for BCS, it is using the White Mac tip followed by capillary aspiration without paper points.
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Affiliation(s)
- Lais Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Rafael Verardino Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Boreak NM, Qadi MA, Khormi FH, Faqiri LM, Zaylai SO, Jad YA, Hamdi BA, Juraybi A. Evaluation of Cytotoxicity of Calcium Silicate-based Mineral Trioxide Aggregate Sealers: A Systematic Review of In Vitro Studies. J Contemp Dent Pract 2023; 24:610-619. [PMID: 38193186 DOI: 10.5005/jp-journals-10024-3551] [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] [Indexed: 01/10/2024]
Abstract
AIM This review aimed to evaluate the in vitro studies done with regard to the cytotoxicity associated with mineral trioxide aggregate (MTA)-based root canal sealers. BACKGROUND Root canal sealers are used during endodontic treatment as fillers to seal the gaps between the canal gutta-percha cone and canal walls. It is necessary to understand the cytotoxicity of these materials on human-derived cells as these materials interact with human cells periapically. REVIEW RESULTS Six in vitro studies were chosen for review. In these selected studies, along with MTA-based root canal sealers, other sealers were tested for cytotoxicity on human periodontal ligament (PDL) stem cells, human PDL fibroblasts, and human osteoblast cells. Regarding cytotoxicity, the studies were diverse, and most were based on 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-2H-tetrazolium bromide) (MTT) assay. In general, the studies suggested that root canal sealers cause mild to severe cytotoxic effects and that several factors influence this effect, such as material setting time, concentration, and duration of exposure. CONCLUSION All studies in the review indicated that MTA. Fillapex must be used cautiously as it exhibited the highest cytotoxic effect compared to other MTA-based and non-MTA-based sealers. CLINICAL SIGNIFICANCE Endodontic sealers do serve the purpose of bridging the gaps between the gutta-percha cone and the canal wall but knowing its biocompatibility becomes important as the material is extruded beyond the apical foramen where it comes in contact with the surrounding tissues. The effect of sealers on the surrounding tissues affects the healing and prognosis of the treatment.
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Affiliation(s)
- Nezar Mohammed Boreak
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia, Phone: +966 599016688, e-mail:
| | - Mazen Ahmed Qadi
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Faisal Hadi Khormi
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Luay Mutaen Faqiri
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Sadeem Omar Zaylai
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Yaser Ali Jad
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Bassam Ali Hamdi
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
| | - Asayil Juraybi
- Department of Restorative Dentistry, School of Dentistry, Jazan University, Saudi Arabia
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Mahajan D, Manocha D, Patel P, Saraiya MB, Chaniyara K. A Systematic Review on Comparison of Periapical Healing and Post-Operative Pain between Bioceramic and Epoxy Resin Based Sealers. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S862-S866. [PMID: 37693967 PMCID: PMC10485546 DOI: 10.4103/jpbs.jpbs_145_23] [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: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 09/12/2023] Open
Abstract
To compare the incidence of postoperative discomfort and periapical healing in endodontically treated teeth following the use of resin-based or bioceramic sealers. In vivo, clinical trials were included in the study. The selection criteria, data extraction, and analysis were performed to evaluate the quality and publication bias of the selected studies. The primary outcome measure was the comparison of postoperative discomfort between the two sealer types. Seven studies were included in the systematic review, with a modest level of evidence found in the quality assessment. There are no significant differences in the postoperative discomfort levels between resin-based and bioceramic sealers. However, the overall quality of the clinical trials was moderate, highlighting the need for further well-designed clinical trials with appropriate measures of randomization, allocation concealment, and blinding to establish a definitive conclusion on the incidence of Postoperative discomfort associated with the use of these sealers.
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Affiliation(s)
- Deepali Mahajan
- Associate Endodontist at Singh Dental Care, Amritsar, Punjab, India
| | - Devansh Manocha
- Associate Dentist at Smile Design Orthodontic Clinic, Vadodara, Gujarat, India
| | - Priyesha Patel
- Associate Dentist at Shreeji Dental Clinic, Vadodara, Gujarat, India
| | - Maulik B. Saraiya
- Department of Prosthodontics, Manubhai Patel Dental College, Vadodara, Gujarat, India
| | - Keral Chaniyara
- Department of Oral Surgery, Manubhai Patel Dental College, Vadodara, Gujarat, India
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Hassan R, Roshdy NN. Effect of continuous chelation on the dentinal tubule penetration of a calcium silicate-based root canal sealer: a confocal laser microscopy study. BMC Oral Health 2023; 23:377. [PMID: 37296374 PMCID: PMC10257323 DOI: 10.1186/s12903-023-02995-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effect of various irrigation protocols on the penetration depth of a calcium silicate-based sealer into dentinal tubules using confocal laser scanning microscopy (CLSM). METHODS Twenty single-rooted mandibular premolars were endodontically prepared and divided into the following two groups according to the irrigation protocol used (n = 10): Group I: NaOCl + EDTA and Group II: continuous chelation (NaOCl/Dual Rinse). Obturation was performed with the warm vertical compaction technique using TotalFill HiFlow bioceramic sealer mixed with a fluorophore dye. Samples were observed using CLSM at 10× to measure the percentage of sealer penetration and its maximum depth into the dentinal tubules. Data were analysed using one-way ANOVA followed by Tukey's post-hoc test. The significance level was set at p < 0.05 within all tests. RESULTS Comparing the overall results of all sections tested, no statistically significant differences existed between the groups regarding the percentage of sealer penetration (p = 0.612) and maximum depth of penetration (p > 0.05). CONCLUSIONS With both types of irrigation used, dentinal tubule penetration was higher in the coronal section than in the apical section. Continuous chelation using NaOCl/Dual Rinse HEDP performed better in the coronal segments, while irrigation using NaOCl + EDTA promoted a higher percentage of sealer penetration in the apical segment.
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Affiliation(s)
- Reham Hassan
- Egyptian Russian University, Badr city, Egypt.
- Faculty of Dentistry, Minia University, Minia, Egypt.
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Kwak SW, Koo J, Song M, Jang IH, Gambarini G, Kim HC. Physicochemical properties and biocompatibility of various bioceramic root canal sealers: in vitro study. J Endod 2023:S0099-2399(23)00283-2. [PMID: 37225037 DOI: 10.1016/j.joen.2023.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The aim of this study was to compare the physicochemical properties and biocompatibility of various calcium silicate-based bioceramic sealers (CSBSs). METHODS Four recently developed CSBSs, including AH Plus Bioceramic Sealer (AHB), EndoSequence BC Sealer (ESB), TotalFill BC Sealer (TTB), and Bio-C Sealer (BIC), were compared with the epoxy resin-based sealer AH Plus (AHP). Their physical properties, including flow, setting time, radiopacity, dimensional stability, and pH, were evaluated according to International Organization for Standardization (ISO) 6876. Their cytotoxicity in human periodontal ligament fibroblast (hPDLF) was assessed through the MTT assay and compared. Additionally, cell attachment to the sealer surface was analysed using green fluorescent protein and confocal laser scanning microscopy (CLSM) to evaluate cell viability. Data were analysed using one-way analysis of variance to determine the difference between groups for categorical variables, followed by Tukey's post-hoc test at the significance level of 95%. RESULTS The flow, setting time, and radiopacity of all tested CSBSs satisfied the ISO 6876/2012 standards. Further, these CSBS showed shrinkage after immersion in distilled water for 30 days and complied with the ISO 6876/2001 requirements. The pH of AHB, ESB, TTB, and BIC was greater than 11 whereas AHP had a pH of 6.69 after 4 weeks. CSBS showed excellent biocompatibility compared with that of AHP (P < .05). CLSM showed that alive hPDLFs were attached well to all the tested CSBS but not to AHP. CONCLUSIONS CSBS have similar physical characteristics within the ISO standards and higher biocompatibility than epoxy resin-based sealers.
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Affiliation(s)
- Sang Won Kwak
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Jina Koo
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Il Ho Jang
- Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea
| | - Gianluca Gambarini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University, School of Dentistry, Dental Research Institute, Yangsan, Korea; Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Korea.
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dos Santos GSB, Carvalho CN, Tavares RRDJ, Silva PGDB, Candeiro GTDM, Maia EM. Tissue repair capacity of bioceramic endodontic sealers in rat subcutaneous tissue. Braz Dent J 2023; 34:25-32. [PMID: 37466522 PMCID: PMC10355271 DOI: 10.1590/0103-6440202305161] [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: 07/24/2022] [Accepted: 03/07/2023] [Indexed: 07/20/2023] Open
Abstract
This study aimed to evaluate the tissue repair capacity of four bioceramic endodontic sealers by quantifying type I and III collagen fibers. The following sealers were tested: EndoSequence BC Sealer (Brasseler, Brasseler, Savannah, USA), Bio C Sealer (Angelus, Londrina, Brazil), Bioroot RCS (Septodont, Santa Catarina, Brazil), and Sealer Plus BC (MKLife, Porto Alegre, Brazil). Polyethylene tubes 1.5 mm in diameter and 1 cm in length containing the endodontic sealers were implanted in the subcutaneous tissue of five rats (Rattus norvegicus albinus, Wistar lineage). After 14 days, the animals were euthanized, and collagen fibers were quantified from the histological tissue sections. Given a non-normal distribution of the data, a gamma regression with log link function was employed and implemented through the generalized linear models module, was used to test whether there was a significant difference between the sealers. The pairwise comparison was performed using Least significant difference. There were significant differences between the sealers for type I (p=0.001), type III (p=0.023), and total collagen (p=0.002). Overall, Bioroot sealer was statistically superior to the other sealers, except in the analysis of type III collagen, in which there was no difference between the Bioroot sealer and Bio C Sealer sealer and the control group (p>0.05). Bioroot RCS bioceramic endodontic sealer stimulates a greater production of collagen.
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Fundaoğlu Küçükekenci F. The effect of different acidic irrigation solutions on the pushout bond strength of root canal filling. J Dent Res Dent Clin Dent Prospects 2023; 17:18-22. [PMID: 37650017 PMCID: PMC10462916 DOI: 10.34172/joddd.2023.36920] [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: 10/16/2022] [Accepted: 12/30/2022] [Indexed: 09/01/2023] Open
Abstract
Background This study investigated the effects of different acidic solutions used as the final irrigation on the push-out bond strength (PBS) of resin-based and bioceramic-based root canal sealers. Methods 100 single root and canal human incisors were selected and decorated. Root canal shaping was done with ProTaper Next rotary files up to X4 and rinsed with 5 mL of 5.25% NaOCl between each file. Then, teeth were divided into five main groups according to the final irrigation (n=20). Group 1: glycolic acid; Group 2: phosphoric acid; Group 3: citric acid; Group 4: EDTA and group 5: saline. Then, each group was divided into two subgroups according to the canal sealer used (n=10). The groups filled with bioceramic-based sealer (bioserra) were named A, and the groups filled with resin-based sealer (AH Plus) were called B. PBS test was applied to one of the two samples obtained from the coronal third of each root. The data were statistically analyzed using a two-way analysis of variance and Tukey's HSD test (α=0.05). Results Statistically, the highest PBS value was obtained in group 2A (4.81±0.03 MPa), which was irrigated with phosphoric acid and filled with bioserra, and the lowest PBS value was obtained in group 5B (1.10±0,03), which was irrigated with saline and filled with AH Plus (P<0.05). There was a statistical difference between all groups except group 1A and group 3A (P<0.05). Conclusion The bioceramic-based root canal sealer (bioserra) bond strength is superior to resin-based (AH Plus). Phosphoric acid, glycolic acid, and citric acid can be an alternative to EDTA.
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Tedesco M, Vitali FC, Bortoluzzi EA, Garcia LDFR, Teixeira CDS. Analysis of physicochemical properties of endodontic sealers containing rhodamine B. J Mech Behav Biomed Mater 2023; 140:105699. [PMID: 36753848 DOI: 10.1016/j.jmbbm.2023.105699] [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: 12/14/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The use of fluorescent dyes in microscopy studies is frequent. Therefore, it is important to investigate whether these compounds may alter the physicochemical properties of materials in which they are incorporated to avoid methodological biases. This study evaluated the physicochemical properties of two endodontic sealers containing dry or diluted rhodamine B. Six groups were evaluated: AH Plus and MTA Fillapex in their original composition and mixed with 0.1% dry or diluted rhodamine. Push-out test was applied to assess the bond strength to root dentin. ANSI-ADA No. 57 and ISO No. 6876:2012 specifications were followed to evaluate flowability, setting time, and solubility of the sealers. pH changes were assessed after 24 h, 7, and 30 days. Intergroup comparisons were analyzed by ANOVA complemented by Tukey's post-hoc test; comparisons among periods were analyzed by Wilcoxon and Friedman tests. The incorporation of dry rhodamine decreased the bond strength and prolonged the setting time of AH Plus. The incorporation of diluted rhodamine decreased the setting time and increased the flowability of MTA Fillapex. Diluted rhodamine promoted pH reduction of AH Plus after 24 h and dry rhodamine after 7 days. Rhodamine incorporation promoted pH reduction after 30 days for MTA Fillapex. Solubility was not affected. In conclusion, the incorporation of diluted rhodamine changed the properties of MTA Fillapex, and the incorporation of dry rhodamine changed the properties of AH Plus. Previous dilution of rhodamine did not severely compromise the physicochemical properties of AH Plus and may be suggested to assess its penetrability.
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Affiliation(s)
- Maybell Tedesco
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, School of Dentistry, University of Louisville, Louisville, KY, USA
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Ashkar I, Sanz JL, Forner L, Melo M. Calcium Silicate-Based Sealer Dentinal Tubule Penetration-A Systematic Review of In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2734. [PMID: 37049028 PMCID: PMC10096084 DOI: 10.3390/ma16072734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
The aim of this systematic review was to perform a qualitative synthesis of in vitro studies which evaluate and compare the penetration of calcium silicate-based sealers into dentinal tubules. A systematic advanced search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases on the 1 December 2022. In vitro studies that compared the tubular penetration of at least two calcium silicate-based sealers in extracted human teeth were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias included studies. The search identified a total of 680 preliminary records, among which 12 studies were eligible for review. The most used methodology to evaluate sealer penetration was the use of a fluorochrome together with the tested sealers and the analysis of their penetration under confocal laser microscopy. Regarding the results of the included studies, calcium silicate-based sealers exhibit a favorable dentinal tubule penetration. Tubular penetration, however, can be affected by factors such as the irrigation protocol, sealer activation, the filling method used, and root canal morphology. EndoSequence BC Sealer showed the highest sealer penetration among the tested sealers. The influence of different fluorochromes on the results of dentinal tubule penetration studies should also be further explored. The in vitro nature of the included studies limits the applicability of the results into the clinical setting. Prospero registration: CRD42022383896.
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Sampaio RF, Carvalho CN, Bradaschia-Correa V, Gonçalves BLL, Arana-Chavez V, de Carvalho APL, Nogueira APA, Grazziotin-Soares R, Bauer J, Gavini G, Carvalho EM. Apical Sealing and Bioactivity of an Experimental Gutta-Percha Containing Niobium Phosphate Bioglass. Polymers (Basel) 2023; 15:polym15071679. [PMID: 37050293 PMCID: PMC10097297 DOI: 10.3390/polym15071679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/18/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
This study evaluated the apical sealing ability and bioactivity of an experimental gutta-percha containing niobium phosphate bioglass. Thirty-six human premolars were endodontically prepared and divided into three groups: GPC—filling with conventional gutta-percha; GBC—filling with bioceramic gutta-percha (EndoSequence BC); GNB—filling with experimental gutta-percha containing niobophosphate. Teeth were stored in tubes containing 2 mL of simulated body fluid (SBF) solution in an oven for 30 days. Then, the samples were immersed in lanthanum nitrate solution and analyzed for apical nanoleakage (NI) with a scanning electron microscope (SEM/EDS) and transmission electron microscope (TEM). Gutta-percha specimens were immersed for 28 days (SBF) and analyzed in SEM/EDS and X-ray diffraction (XRD) to assess bioactivity. NI data originated from the SEM/EDS were analyzed using the Kruskal–Wallis test (α = 5%). NI data originated from TEM and bioactivity were descriptively reported. Statistical analysis did not detect a significant difference between groups (p = 0.13) for NI. In the bioactivity analysis, an abundant layer of hydroxyapatite was identified only in the surface of the GNB group samples. The gutta-percha containing niobophosphate bioglass promoted an apical sealing similar to EndoSequence BC, in addition to demonstrating bioactivity through the deposition of hydroxyapatite on the surface of the material after immersion in SBF.
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Affiliation(s)
- Ruan Ferreira Sampaio
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís 65075-120, Brazil
| | - Ceci Nunes Carvalho
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís 65075-120, Brazil
| | | | - Bruna Laís Lins Gonçalves
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís 65075-120, Brazil
| | - Victor Arana-Chavez
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), Av. Prof Lineu Prestes, 2227, São Paulo 05508-000, Brazil
| | - Alexandre P. Lima de Carvalho
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FOUSP), Av. Prof Lineu Prestes, 2227, São Paulo 05508-000, Brazil
| | - Amanda Palmeira Arruda Nogueira
- Dentistry Biomaterials Laboratory (Biomma), School of Dentistry, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1966, São Luís 65080-805, Brazil
| | - Renata Grazziotin-Soares
- Endodontics Division, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia (UBC), Vancouver, BC V6T 1Z4, Canada
| | - José Bauer
- Dentistry Biomaterials Laboratory (Biomma), School of Dentistry, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1966, São Luís 65080-805, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FOUSP), Av. Prof Lineu Prestes, 2227, São Paulo 05508-000, Brazil
| | - Edilausson Moreno Carvalho
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís 65075-120, Brazil
- Correspondence: ; Tel.:+55-(98)-4020-7525
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Rebolledo S, Alcántara-Dufeu R, Luengo Machuca L, Ferrada L, Sánchez-Sanhueza GA. Real-time evaluation of the biocompatibility of calcium silicate-based endodontic cements: An in vitro study. Clin Exp Dent Res 2023; 9:322-331. [PMID: 36866428 PMCID: PMC10098287 DOI: 10.1002/cre2.714] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 03/04/2023] Open
Abstract
INTRODUCTION An ideal filling material should hermetically seal the communication pathways between the canal system and surrounding tissues. Therefore, during the last few years, the development of obturation materials and techniques to create optimal conditions for the proper healing of apical tissues has been a focus of interest. The effects of calcium silicate-based cements (CSCs) on periodontal ligament cells have been investigated, and promising results have been obtained. To date, there are no reports in the literature that have evaluated the biocompatibility of CSCs using a real-time live cell system. Therefore, this study aimed to evaluate the real-time biocompatibility of CSCs with human periodontal ligament cells (hPDLCs). METHODOLOGY hPDLC were cultured with testing media of endodontic cements for 5 days: TotalFill-BC Sealer, BioRoot RCS, Tubli-Seal, AH Plus, MTA ProRoot, Biodentine, and TotalFill-BC RRM Fast Set Putty. Cell proliferation, viability, and morphology were quantified using real-time live cell microscopy with the IncuCyte S3 system. Data were analyzed using the one-way repeated measures (RM) analysis of variance multiple comparison test (p < .05). RESULTS Compared to the control group, cell proliferation in the presence of all cements was significantly affected at 24 h (p < .05). ProRoot MTA and Biodentine lead to an increase in cell proliferation; there were no significant differences with the control group at 120 h. In contrast, Tubli-Seal and TotalFill-BC Sealer inhibited cell growth in real-time and significantly increased cell death compared to all groups. hPDLC co-cultured with sealer and repair cements showed a spindle-shaped morphology except with cements Tubli-Seal and TotalFill-BC Sealer where smaller and rounder cells were obtained. CONCLUSIONS The biocompatibility of the endodontic repair cements performed better than the sealer cements, highlighting the cell proliferation of the ProRoot MTA and Biodentine in real-time. However, the calcium silicate-based TotalFill-BC Sealer presented a high percentage of cell death throughout the experiment similar to that obtained.
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Affiliation(s)
- Soledad Rebolledo
- Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Concepción, Chile
| | - Raúl Alcántara-Dufeu
- Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Concepción, Chile
| | - Luis Luengo Machuca
- Departamento de Salud Pública, Facultad de Odontología, Universidad de Concepción, Concepción, Chile
| | - Luciano Ferrada
- Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
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Coşar M, Kandemir Demirci G, Çalışkan MK. The effect of two different root canal sealers on treatment outcome and post-obturation pain in single-visit root canal treatment: A prospective randomized clinical trial. Int Endod J 2023; 56:318-330. [PMID: 36385378 DOI: 10.1111/iej.13870] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
AIM This randomized clinical trial aimed to evaluate and compare the effect of mineral trioxide aggregate (MTA)-based bioceramic- and resin-based sealers on the incidence and intensity of post-obturation pain and treatment outcome in asymptomatic vital molar teeth in single-visit root canal treatment. METHODOLOGY One hundred asymptomatic mandibular molar teeth with vital pulp were randomly assigned into two groups according to the sealer used: MTA Fillapex or AH Plus sealer. WaveOne Gold instruments were used for root canal preparations. Root canals were obturated with WaveOne Gold gutta-percha cones corresponding in size and taper to the last instrument used. MTA Fillapex was used in the first group and AH Plus was used in the second group as the root canal sealer. The effects of age, gender, tooth types and the level of root canal filling on the treatment outcome were evaluated after 1 and 2 years. Postoperative pain at 6, 12, 24, 48, 72 h, 4, 5, 6, 7 and 30 days after root canal treatment was measured with the Numerical Rating Scale. Chi-square test was used for the treatment outcome and Mann-Whitney U, chi-Square and Spearman correlation analyses were used for postoperative pain. α = .05 was the level of significance. RESULTS Twelve patients did not complete the 2-year follow-up and the study finished with 88 patients. In the MTA Fillapex group 41 correct, one short, two extruded, and in the AH Plus group 40 correct, one short and three extruded root canal fillings were detected. No significant differences were observed between the first- and second-year treatment outcomes between the groups (p > .05).There was no association between age, gender, tooth number, root canal filling length and the treatment success in all evaluated teeth (p > .05). The differences between the groups in terms of postoperative pain incidence and intensity at all time-points were not significant (p > .05). There was no correlation between the age and postoperative pain (p > .05), but pain was statistically higher in women (p < .05). CONCLUSIONS Mineral trioxide aggregate Fillapex showed similar success rate and post-obturation pain incidence and intensity as AH Plus sealer and can be used as a root canal sealer in asymptomatic mandibular molars with irreversible pulpitis.
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Affiliation(s)
- Melis Coşar
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
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Sfeir G, Bukiet F, Hage W, El Hachem R, Zogheib C. Impact of Final Irrigation Protocol on the Push-Out Bond Strength of Two Types of Endodontic Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1761. [PMID: 36902876 PMCID: PMC10004703 DOI: 10.3390/ma16051761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Aim: The aim of this study was to assess the impact of the final irrigation protocol on the push-out bond strength of calcium silicate-based sealers when compared to an epoxy resin-based sealer. Materials and Methods: Eighty-four single-rooted mandibular human premolars were shaped using the R25® instrument (Reciproc, VDW, Munich, Germany) and then divided into three subgroups of 28 roots each depending on the final irrigation protocol: EDTA (ethylene diamine tetra acetic acid) and NaOCl activation, Dual Rinse® HEDP (1-hydroxyethane 1,1-diphosphonate) activation or sodium hypochlorite (NaOCl) activation. Then, each subgroup was divided into two groups (14 each) according to the sealer used (AH Plus Jet® or Total Fill BC Sealer®) for single-cone obturation. Dislodgement resistance using a universal testing machine, samples' push-out bond strength and failure mode under magnification were determined. Results: EDTA/Total Fill BC Sealer® showed significantly greater values of push-out bond strength compared with HEDP/Total Fill BC Sealer® and NaOCl/AH Plus Jet®, with no statistical difference with EDTA/AH Plus Jet®, HEDP/AH Plus Jet® and NaOCl/Total Fill BC Sealer®, whereas HEDP/Total Fill BC Sealer® showed significantly lower values of push-out bond strength. The apical third demonstrated higher means of push-out bond strength compared with middle and apical thirds. The most common failure mode was cohesive but showed no statistical difference compared to other types. Conclusions: Irrigation solution and final irrigation protocol affect the adhesion of calcium silicate-based sealers.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst. Movement Sci, 13288 Marseille, France
| | - Wajih Hage
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Roula El Hachem
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
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Rezaei G, Liu X, Jalali P. Efficacy of Different Solvents for Achieving Patency in Teeth Obturated Using Bioceramic Sealer. J Endod 2023; 49:219-223. [PMID: 36526108 DOI: 10.1016/j.joen.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The retreatment of teeth obturated with bioceramic sealers has been shown to be challenging. The purpose of this study was to compare the efficacy of 10% formic acid (FA), 20% hydrochloric acid (HCl), and chloroform for achieving patency in teeth obturated with a bioceramic sealer. METHODS Forty-five extracted single-canal teeth were instrumented and obturated 1.5 mm short of the working length using gutta-percha and EndoSequence BC Sealer (Brasseler USA, Savannah, GA). Two weeks later, gutta-percha was removed, and apical patency was attempted with a 10 C-file and a solvent (FA, HCl, or chloroform). The time to gain patency through EndoSequence BC Sealer was recorded. Five additional teeth were irrigated with the solvents, and scanning electron microscopy was used to evaluate the effect of solvents on the dentin. The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis. RESULTS Patency was achieved in all canals, except for 1 in the chloroform group. Regarding the time to achieve patency, no significant difference was noted between chloroform and FA (P > .05). However, there was a significant difference between chloroform and HCl (P < .05) and between FA and HCl (P < .05). The erosion of dentinal tubules was more evident when HCl was used compared with the other irrigants. CONCLUSIONS Twenty percent HCl was superior to 10% FA and chloroform in achieving patency in teeth obturated with EndoSequence BC Sealer. Regardless of the solvent used, patency may be achieved for most of the cases obturated with gutta-percha and EndoSequence BC Sealer.
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Affiliation(s)
- Ghazaleh Rezaei
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
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Kapetanović Petričević G, Katić M, Brzović Rajić V, Anić I, Bago I. The Efficacy of Er:YAG Laser-Activated Shock Wave-Enhanced Emission Photoacoustic Streaming Compared to Ultrasonically Activated Irrigation and Needle Irrigation in the Removal of Bioceramic Filling Remnants from Oval Root Canals-An Ex Vivo Study. Bioengineering (Basel) 2022; 9:bioengineering9120820. [PMID: 36551026 PMCID: PMC9774814 DOI: 10.3390/bioengineering9120820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The removal of filling material is important for successful root canal retreatment. The aim of the study was to compare the efficiency of two activated irrigation techniques, the shock wave-enhanced emission photoacoustic streaming (SWEEPS) mode of the Er:YAG laser and ultrasonically activated irrigation (UAI) and a conventional syringe-needle technique (SNI), in the removal of bioceramic sealer/gutta-percha during conventional retreatment in oval root canals. The study sample consisted of distal root canals of 42 extracted human mandibular molars, which were prepared using a ProTaper Next system up to size 40/0.06 and filled with bioceramic sealer using a single-cone obturation technique. The teeth were then re-treated with a Reciproc Blue RB40 file and 3% sodium hypochlorite solution. The prepared teeth were randomly divided into three groups (n = 14 per group) and subjected to one of the three irrigation methods. Micro-CT scans were performed at different stages to assess the amount of filling material after each retreatment phase. The results of the study showed that all the tested irrigation techniques reduced a statistically significant amount of the remnant filling material at retreatment (p < 0.05), and there were no statistically significant differences in efficacy between the three methods. All tested techniques had similar efficacy in the removal of the remaining filling remnants.
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Affiliation(s)
- Gabrijela Kapetanović Petričević
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Katić
- Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10000 Zagreb, Croatia
| | - Valentina Brzović Rajić
- Department of Dental Diseases, Dentistry Clinic, University Hospital Centre, 10000 Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-1-4802128
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Influence of irrigation and laser assisted root canal disinfection protocols on dislocation resistance of a bioceramic sealer. Photodiagnosis Photodyn Ther 2022; 40:103067. [PMID: 35973550 DOI: 10.1016/j.pdpdt.2022.103067] [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: 04/12/2022] [Revised: 07/13/2022] [Accepted: 08/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is not yet clear how different irrigation protocols and intracanal laser irradiation effects bioceramic sealers. In this vitro study, we aimed to evaluate the dislocation resistance of a bioceramic root canal sealer after different laser-assisted disinfection protocols and irrigants. METHODS Sixty extracted human straight single-canal teeth were instrumented, and randomly divided into five experimental groups (n=10) according to the disinfection protocol used: group 1, conventional needle irrigation (CI) with sodium hypochlorite (NaOCl)+ethylenediaminotetraacetic acid (EDTA)+NaOCl; group 2, Photon initiated photoacoustic streaming (PIPS) of NaOCl+EDTA+NaOCl; group 3, NaOCl+EDTA+diode laser; group 4, NaOCl+EDTA+photodynamic therapy (PDT); group 5, CI with NaOCl+EDTA+Chlorhexidine (CHX); and control group without any treatment. The root canals were filled with a bioceramic root canal sealer (BioRoot RCS) using the single-cone filling technique. After three weeks of storage, the samples from each canal thirds were transversely sectioned and the push-out test was performed. RESULTS The PIPS group showed the lowest dislocation resistance values in the coronal third (p>0.05), and no difference was observed among the other groups (p<0.05). The dislocation resistance in the middle and apical thirds was the highest in the diode laser group (p<0.05). CONCLUSION Final root canal irradiation with diode laser led to improved dislocation resistance of the bioceramic sealer. PDT did not adversely affect the dislocation resistance of BioRoot RCS. The PIPS reduced the dislocation resistance values in the coronal third, but not in the middle and apical thirds.
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Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111853. [PMID: 36430988 PMCID: PMC9697500 DOI: 10.3390/life12111853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
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