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Omidi S, Dehghani M, Alimohamadi M, Charati JY, Hashemi RS. Evaluation of dimensional changes in EndoSeal mineral trioxide aggregate and AH Plus sealers using micro-computed tomography imaging. Dent Res J (Isfahan) 2024; 21:33. [PMID: 39188394 PMCID: PMC11346603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 12/07/2023] [Accepted: 03/06/2024] [Indexed: 08/28/2024] Open
Abstract
Background Optimal dimensional stability is required for successful root canal treatment. A sealant called EndoSeal mineral trioxide aggregate (MTA) was recently introduced to the market due to its favorable physical and chemical properties. On the other hand, AH Plus (AHP) is considered the gold-standard seal. Materials and Methods In this ex vivo quasi-experimental study, 24 single-canal premolars extracted from humans were cleaned and shaped with a motorized and rotary file, then that is divided into two groups. The teeth of each group were filled with gutta F3 and each type of sealant. The teeth were scanned by a micro-computed tomography device after 24 h. After 7 days of storage in phosphate-buffered saline solution, the samples were re-scanned. Data were analyzed using SPSS software (version 21). Descriptive data were presented as frequency, percentage, mean, and standard deviation. The Shapiro-Wilk and Kolmogorov-Smirnov tests were used to investigate the normality of the data. The Mann-Whitney test was used to compare the two groups, and the differences were ultimately not significant. The level of significance was set at 0.05 (P < 0.05). Results The mean differences between sealer volumes before and after the intervention were not significantly different between the two groups indicating that the EndoSeal MTA sealer is not inferior to the gold-standard root canal sealer, AHP. Conclusion EndoSeal MTA can be considered a reliable sealer in endodontic treatments and be subjected to further investigation.
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Affiliation(s)
- Salma Omidi
- Department of Endodontics, Dental School, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mostafa Dehghani
- Dental Research Center, Dental School, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mona Alimohamadi
- Department of Oral and Maxillofacial Radiology, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Health Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reihaneh Sadat Hashemi
- Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Malta CP, Santi SS, Barcelos RCS, Zanatta FB, Bier CAS, Morgental RD. Premixed calcium silicate-based root canal sealers have better biological properties than AH Plus: A systematic review and meta-analysis of in vivo animal studies and in vitro laboratory studies. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:345-359. [PMID: 38779200 PMCID: PMC11108423 DOI: 10.4103/jcde.jcde_24_24] [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: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
Objectives The aim was to determine whether premixed calcium silicate-based root canal sealers have better biological properties than AH Plus. Materials and Methods Searches of studies published up to January 2023 were performed in the PubMed/MEDLINE and EMBASE and via other methods (databases of the International Endodontic Journal, Journal of Endodontics, and gray literature). The inclusion criteria were in vivo animal and in vitro studies that analyzed the response in the dorsal subcutaneous tissue of rats, cell viability, and genotoxicity. Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias (RoB) tool for in vivo studies and modified CONSORT checklist for in vitro were appraised. Meta-analysis was performed using the Stata. Results Fifty-two studies were included. In the RoB, in vivo studies fulfilled 20%-50% of the items and in vitro 60%-100%. The studies included in the meta-analysis demonstrated better histocompatibility with the premixed calcium silicate-based sealers at 30 days and greater cell viability with these sealers when used in undiluted extracts in experimental period of 72 h and in extracts with 1:2 and 1:4 dilution in 24 and 72 h. In contrast, no difference between materials was found concerning genotoxicity. Conclusion Premixed calcium silicate-based root canal sealers have better histocompatibility and are less cytotoxic than the epoxy resin-based sealer AH Plus, demonstrating favorable biological behavior.
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Affiliation(s)
- Cristiana Pereira Malta
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Samantha Simoni Santi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Fabrício Batistin Zanatta
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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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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Keles A, Askerbeyli Ors S, Purali N, Kucukkaya Eren S. Effect of different sealer activation techniques on dentinal tubule penetration. AUST ENDOD J 2023; 49:470-475. [PMID: 36723389 DOI: 10.1111/aej.12738] [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: 09/26/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 02/02/2023]
Abstract
The aim of this study was to evaluate the influence of different activation techniques on dentin tubule penetration of root canal sealer. Seventy-five teeth with single canals were chemomechanically prepared. A calcium silicate-based sealer was stained with a fluorescent dye (rhodamine B), placed into the canals and activated according to the following groups: control (no activation), EDDY, EndoActivator, ultrasonic and XP-Endo Finisher. Then, the samples were obturated. The percentages of sealer penetration at various depth levels of root sections were measured with confocal laser scanning microscopy. XP-Endo Finisher presented the highest penetration at 50 μm (p < 0.05). XP-Endo Finisher showed similar penetration with EDDY at 100 and 200 μm (p > 0.05) while presented higher penetration than the other groups (p < 0.05). At 500 μm, XP-Endo Finisher presented higher penetration than EndoActivator (p < 0.05) while similar penetration with the other groups (p > 0.05). XP-Endo Finisher can be recommended for activation during sealer placement for better penetration into dentin tubules.
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Affiliation(s)
- Ahmet Keles
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli Ors
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Nuhan Purali
- Departmant of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Selen Kucukkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Jeon MJ, Ko H, Shin SJ, Kim M. Cytotoxicity and genotoxicity of various types of endodontic sealers in Chinese hamster ovary (CHO-K1) cells. Dent Mater J 2023; 42:774-779. [PMID: 37793827 DOI: 10.4012/dmj.2023-012] [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: 10/06/2023]
Abstract
This study aimed to evaluate the cytotoxicity and genotoxicity of five endodontic sealers (AH Plus, MTA Fillapex, Endoseal MTA, Sealapex, and Zinc oxide eugenol) in Chinese hamster ovary cells. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay to check cell viability at 1, 3, and 7 days. Genotoxicity was assessed by cytokinesis-block micronucleus, single-cell gel electrophoresis, and γH2AX immunofluorescence assays. Cell viability of all endodontic sealers, except Endoseal MTA, on day 1 was less than 100%. Endoseal MTA showed the highest cell viability on day 7. AH Plus and Endoseal MTA showed less DNA damage than other sealers. After complete setting, AH Plus and Endoseal MTA showed low genotoxicity, which could reduce DNA damage in periapical cells, making them suitable as endodontic sealers.
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Affiliation(s)
- Mi-Jeong Jeon
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University
| | - Hyunjung Ko
- Department of Conservative Dentistry, University of Ulsan, Asan Medical Center
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Hospital, College of Dentistry, Yonsei University
| | - Miri Kim
- Department of Conservative Dentistry, University of Ulsan, Asan Medical Center
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Katakidis A, Kodonas K, Fardi A, Gogos C. A scientometric, bibliometric, and thematic map analysis of hydraulic calcium silicate root canal sealers. Restor Dent Endod 2023; 48:e41. [PMID: 38053781 PMCID: PMC10695731 DOI: 10.5395/rde.2023.48.e41] [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: 07/11/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.
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Affiliation(s)
- Anastasios Katakidis
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Kodonas
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Fardi
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Gogos
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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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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Chew ST, Eshak Z, Al-Haddad A. Evaluation of interfacial adaptation and penetration of bioceramic-based sealers in oval root canals: A confocal laser scanning microscope study. Microsc Res Tech 2023; 86:754-761. [PMID: 37078493 DOI: 10.1002/jemt.24323] [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: 09/24/2022] [Revised: 02/06/2023] [Accepted: 03/26/2023] [Indexed: 04/21/2023]
Abstract
To assess the interfacial adaptation and penetration depth of three different bioceramic-based sealers (CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG) compared to an epoxy resin-based sealer (AH Plus) in oval root canals. Fourty extracted single-rooted mandibular premolar with oval canal were prepared and randomly allocated according to the obturation into; CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG and AH Plus. The roots were sectioned at 3, 6 and 9 mm from the apex. The sealer adaptation and the penetration depth were evaluated under confocal laser scanning microscope. One-way ANOVA and Repeated measure ANOVA were used to statistically analyze the data. Nishika Canal Sealer BG showed significantly higher sealer adaptation than EndoSeal MTA (P < .001) at apical and middle thirds. Meanwhile, AH Plus showed significantly higher sealer adaptation than EndoSeal MTA (P = 0.011) at middle third. For sealer penetration, Nishika Canal Sealer BG showed the longest sealer penetration that was significant compared to AH Plus (P < .001) and EndoSeal MTA (P < .001) whereas CeraSeal was significantly higher than EndoSeal MTA (P = 0.029) at coronal third. For AH Plus, there was a significant less sealer penetration at coronal third compared to apical and middle thirds (P < .05). Whereas for EndoSeal MTA, the coronal third has significant less penetration compared to the middle third (P = 0.032). Endoseal has the lowest adaptation and penetration depth. Nishika Canal Sealer BG has better adaptation and penetration depth using single cone obturation technique in oval canal. RESEARCH HIGHLIGHTS: All the tested root canal sealers have some percentage of gaps and vary in their penetration capability into dentinal tubules. Nishika Canal Sealer BG has significantly better sealer adaptation to root dentinal walls than that of EndoSeal MTA at the apical and middle third but not significantly different from other type of sealers used. Nishika Canal Sealer BG has significantly better penetration depth than AH Plus and EndoSeal MTA at the coronal third of radicular dentin.
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Affiliation(s)
- Soo Teng Chew
- Department of Restorative Dentistry, Faculty of Dentistry, National University of Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Zolkapli Eshak
- Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, University Teknologi MARA Puncak Alam, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
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Küçükkaya Eren S. Clinical applications of calcium silicate-based materials: a narrative review. Aust Dent J 2023; 68 Suppl 1:S96-S109. [PMID: 37885314 DOI: 10.1111/adj.12986] [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] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.
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Affiliation(s)
- S Küçükkaya Eren
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
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Shokrzadeh M, Motafeghi FS, Lotfizadeh A, Ghorbani M, Haddadi Kohsar A. Cytotoxicity and Mineralization Activity of Calcium Silicate-Based Root Canal Sealers Compared to Conventional Resin-Based Sealer in Human Gingival Fibroblast Cells. Int J Dent 2023; 2023:4376579. [PMID: 37293576 PMCID: PMC10247329 DOI: 10.1155/2023/4376579] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 06/10/2023] Open
Abstract
Background Root canal obturation is performed by gutta-percha cones and sealer. Therefore, these materials, specially sealers, must be biocompatible. This study investigated the cytotoxicity and mineralization activity of two calcium silicate-based sealers (Endoseal MTA and Ceraseal) and an epoxy resin-based sealer (AH26). Materials and Methods In this experiment, the cytotoxicity of Endoseal MTA, Ceraseal, and AH26 on human gingival fibroblast cells was examined using Methyl-Thiazol-Tetrazolium assay at time intervals of 24, 48, 72, and 120 hr. The mineralization activity of sealers was evaluated by Alizarin red staining assay. Prism, ver.3, software was used to perform statistical tests. One-way analysis of variance analysis, followed by Tukey's test, was used to determine the group differences. P-values < 0.05 were considered statistically significant. Results Cytotoxicity of sealers decreased gradually (P < 0.0001). AH26 showed the highest level of cytotoxicity (P < 0.001). In terms of cytotoxicity, no considerable differences were observed between the two-calcium silicate-based sealers (P > 0.05). AH26 showed the lowest mineralization activity (P < 0.0001). Among the calcium silicate-based sealers, mineralization and formation of calcium nodules were more frequently observed in the Endoseal MTA group (P < 0.001). Conclusion The examined calcium silicate-based sealers had less cytotoxicity and higher mineralization activity than the resin-based sealer (AH26). There was negligible difference between the cytotoxicity of the two-calcium silicate-based, but the cell mineralization caused by Endoseal MTA was higher.
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Affiliation(s)
- Mohammad Shokrzadeh
- Department of Toxicology-Pharmacology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Sadat Motafeghi
- Department of Toxicology-Pharmacology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Anahita Lotfizadeh
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Azam Haddadi Kohsar
- Department of Endodontics, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
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11
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Saber S, Raafat S, Elashiry M, El-Banna A, Schäfer E. Effect of Different Sealers on the Cytocompatibility and Osteogenic Potential of Human Periodontal Ligament Stem Cells: An In Vitro Study. J Clin Med 2023; 12:jcm12062344. [PMID: 36983344 PMCID: PMC10056919 DOI: 10.3390/jcm12062344] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
Background: There is tendency for unavoidable sealer extrusion in some clinical cases. This might adversely affect host stem cells and affect healing. This study aimed to investigate the effect of different sealers on the cytocompatibility and osteogenic potential of human periodontal ligament stem cells (hPDLSCs). Methods: The cytotoxic effect of the extracted elutes of VDW.1Seal (VDW.1), Endosequence BC Sealer HiFlow (ES), GuttaFlow-2 (GF), and ADSeal (AD-S) on the hPDLSCs was determined using the MTT assay. Cell proliferation and migration were assessed by the scratch wound healing assay. Osteogenic differentiation potential was assessed. Measurement of pH values and calcium ions release was performed. Results: GF had a significantly higher percentage of viable cells. The cell migration assay showed that GF demonstrated the lowest open wound area percentage. GF and AD-S showed the highest calcium nodule deposition. GF demonstrated higher ALP activity than ES. Expression of RUNX2 and OC genes was similar for all sealers, while OPG gene expression was significantly higher for VDW.1 and GF. ES and AD-S displayed the highest pH values on day 1. Calcium ion release of ES and VDW.1 was significantly the highest. Conclusions: GuttaFlow-2 and VDW.1Seal sealers have favorable behavior toward host stem cells.
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Affiliation(s)
- Shehabeldin Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt;
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
- Correspondence:
| | - Shereen Raafat
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt;
- Pharmacology Department, Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City 11837, Egypt
| | - Mohamed Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
| | - Ahmed El-Banna
- Department of Biomaterials, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt;
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, 48149 Münster, Germany;
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12
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Exploring the Most Effective Apical Seal for Contemporary Bioceramic and Conventional Endodontic Sealers Using Three Obturation Techniques. Medicina (B Aires) 2023; 59:medicina59030567. [PMID: 36984568 PMCID: PMC10051965 DOI: 10.3390/medicina59030567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Background and Objective: Despite a plethora of studies conducted to date, researchers continue to investigate the best sealer and obturation technique combinations. The aim of this study is to compare the apical seal provided by two bioceramic sealers (Endoseal and Endosequence) with that provided by a calcium hydroxide sealer (Sealapex), and to evaluate the effect of different obturation techniques (cold lateral condensation, continuous wave compaction and single cone) on the apical seal under a stereomicroscope. Materials and Methods: A total of 110 single-rooted mandibular premolar teeth were decoronated, cleaned and shaped using the Endosequence filing system to tip size 30/0.04 taper. Canals were irrigated with 5.25% NaOCl and 17% EDTA. The samples were randomly divided into 11 groups (9 experimental and 2 control groups) according to the designated sealer and technique. Samples were stored in an incubator for 7 days at 37 °C under 100% humidity. Samples were coated with nail varnish except for apical 2 mm and vertically placed in 0.2% rhodamine B dye solution for 48 h. Samples were split longitudinally and viewed under a stereomicroscope at 40× magnification. Results: Insignificant results were obtained between obturation techniques (p = 0.499) whereas statistically significant results were attained based on the type of endodontic sealer (p < 0.001). The overall lowest mean apical microleakage and best sealing ability was demonstrated by Sealapex (2.59 ± 1.20 mm) and amongst techniques by continuous wave compaction (3.90 ± 2.51 mm). Conclusions: Endosequence produced the best apical seal with the continuous wave compaction technique, whereas Endoseal did so with the bioceramic-coated single-cone technique. For the Sealapex sealer, the most effective apical seal was observed using cold lateral condensation. The quality and effectiveness of apical seal differed with the type of endodontic sealer and obturation technique used, and vice versa.
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Single Cone Obturation versus Cold Lateral Compaction Techniques with Bioceramic and Resin Sealers: Quality of Obturation and Push-Out Bond Strength. Int J Dent 2023; 2023:3427151. [PMID: 36704662 PMCID: PMC9873427 DOI: 10.1155/2023/3427151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/26/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Objectives This study compared the obturation quality and push-out bond strength of single cone obturation (SCO) and cold lateral compaction (CLC) with AH-Plus and Sure Seal Root (SSR). Materials and Methods This in vitro experimental study was conducted on 88 single-rootedsingle-canal teeth with straight roots that were randomly divided into four groups (n = 22). All teeth were decoronated and underwent cleaning and shaping. Obturation was performed with AH-Plus and SCO technique in group 1 (SAH), AH-Plus and CLC technique in group 2 (LAH), SSR and SCO technique in group 3 (SS), and SSR and CLC technique in group 4 (LS). The roots were then sectioned into 3-mm thick slices and underwent digital photography at x25 magnification to assess the quality of obturation in the coronal, middle, and apical thirds by Image J software. The PBS was measured by a universal testing machine. The mode of failure was also determined under a stereomicroscope. Results The PBS was significantly higher in the LSS group than LAH and SAH groups, and also in the SSS group than the SAH group in all sections. The PBS in the LSS group was significantly higher than SSS in the coronal and middle thirds. Voids were significantly lower in LAH than in the SAH group in all sections. In LSS, voids in the coronal third were significantly lower than in LAH. In the middle third, voids in SSS were significantly lower than in SAH. The groups had no significant difference in the mode of failure (P > 0.05). The mean percentage of gutta-percha in the use of AH-Plus sealer was significantly higher than SSR (P < 0.05). The mean percentage of gutta-percha in the coronal third was lower than that in the middle and apical thirds (P < 0.05). Conclusion SSR showed higher PBS and less voids than AH-Plus. High PBS of the CLC/SSR group showed that CLC should still be preferred to SCO, and in the case of using SCO, SSR should be preferred to AH-Plus.
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An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy. Int J Dent 2022; 2022:6858088. [PMID: 36349079 PMCID: PMC9637478 DOI: 10.1155/2022/6858088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
Regarding the common use of calcium silicate cements (CSCs) in root canal therapy, their position in the context of past and present dentistry agents can provide a better understanding of these materials for their further improvement. In this context, the present review article addresses a wide range of recent investigations in the field of CSC-based products and describes details of their composition, properties, and clinical applications. The need for maintaining or reconstructing tooth structure has increased in contemporary endodontic treatment approaches. This research thus discusses the attempts to create comprehensive data collection regarding calcium ion release, bond strength, alkalinizing activity and bioactivity, and the ability to stimulate the formation of hydroxyapatite as a bioactive feature of CSCs. Sealing ability is also highlighted as a predictor for apical and coronal microleakage which is crucial for the long-term prognosis of root canal treatment integrity. Other claimed properties such as radiopacity, porosity, and solubility are also investigated. Extended setting time is also mentioned as a well-known drawback of CSCs. Then, clinical applications of CSCs in vital pulp therapies such as pulpotomy, apexification, and direct pulp capping are reviewed. CSCs have shown their benefits in root perforation treatments and also as root canal sealers and end-filling materials. Nowadays, conventional endodontic treatments are replaced by regenerative therapies to save more dynamic and reliable hard and soft tissues. CSCs play a crucial role in this modern approach. This review article is an attempt to summarize the latest studies on the clinical properties of CSCs to shed light on the future generation of treatments.
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Suwartini T, Santoso J, Widyarman AS, Ratnasari D. Efficacy of Bioceramic and Calcium Hydroxide-Based Root Canal Sealers against Pathogenic Endodontic Biofilms: An In vitro Study. Contemp Clin Dent 2022; 13:322-330. [PMID: 36687000 PMCID: PMC9855266 DOI: 10.4103/ccd.ccd_198_21] [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: 03/08/2021] [Revised: 06/16/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background Complete eradication of root canal pathogens cannot be predictably achieved by chemomechanical preparation and root canal disinfection. Therefore, an obturation material that has superior antimicrobial activity and sealing ability is required to inactivate residual microbes and prevent them from reentering the root canal system. Recently developed bioceramic root canal sealers are hydraulic cement which form calcium hydroxide during the hydration process. Like calcium hydroxide sealers, they exert an antimicrobial effect by releasing hydroxyl ions and increasing the pH. Objective The objective of this study was to evaluate and compare the antimicrobial activity of a calcium hydroxide-based sealer and two bioceramic sealers against Porphyromonas gingivalis, Enterococcus faecalis, and Candida albicans biofilms. Materials and Methods The sealers were dissolved in sterile saline to obtain supernatants. Biofilm formation assays, colony counting, and real-time polymerase chain reaction (PCR) were performed to evaluate the antimicrobial activity of each supernatant. The data were analyzed using one-way analysis of variance. Results All sealers exerted effects against all three microbial biofilms. The biofilm formation assays showed that the bioceramic sealers were more effective against P. gingivalis and E. faecalis biofilms. In contrast, colony counting and real-time PCR showed that the calcium hydroxide sealer was significantly more effective than the bioceramic sealers. All tests showed that the calcium hydroxide sealer was more effective against C. albicans, with the colony count and real-time PCR results showing statistically significant differences. Conclusion The calcium hydroxide-based sealer was more effective than the bioceramic sealers in eradicating pathogenic root canal biofilms.
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Affiliation(s)
- Tien Suwartini
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Jessica Santoso
- Conservative Dentistry Postgraduate Program, Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Armelia Sari Widyarman
- Department of Microbiology, Division of Oral Biology, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Dina Ratnasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
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Pilot Evaluation of Sealer-Based Root Canal Obturation Using Epoxy-Resin-Based and Calcium-Silicate-Based Sealers: A Randomized Clinical Trial. MATERIALS 2022; 15:ma15155146. [PMID: 35897577 PMCID: PMC9332451 DOI: 10.3390/ma15155146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this randomized controlled clinical trial was to assess the short-term clinical effectiveness of sealer-based root canal obturation using calcium-silicate-based sealer (CSBS) and epoxy-resin-based sealer (ERBS). A total of eighty patients (eighty teeth) were enrolled and seventy-two patients (seventy-two teeth) were randomly assigned into four different sealer groups: AH Plus (AH, Dentsply Sirona), ADseal (AD, Meta Biomed), CeraSeal (CS, Meta Biomed), or EndoSeal TCS (ES, Maruchi). At the first visit, root canal treatment was performed using ProTaper. Next, the NiTi file system and passive ultrasonic irritation was applied with 2.5% NaOCl. At the second visit, the teeth were obturated with a sealer-based obturation technique using the assigned sealer. The quality of filling obturation was evaluated with postoperative radiographs in terms of the presence of voids and sealer extrusion. The patients were recalled at 1-week, 1-month, and 3-month intervals, and pain levels were measured using visual analog scales (VAS), and clinical examination performed with percussion and palpation. Radiographs were also taken. The results were statistically compared by using the χ2 test or Fisher exact test. Among the 80 teeth included, 72 teeth received allocated intervention and 71 teeth were included in the analysis (98.6% recall). There was no significant difference among the sealers in void and sealer extrusion (p > 0.05). Postoperative pain was not indicated prominently regardless of the type of sealer. For a 3-month follow-up period, all cases were maintained successfully except for one case from AD. According to the findings, there was no significant difference between CSBS and ERBS in terms of postoperative pain or the healing process, and the variation in filling quality appears to be linked to the properties of each product.
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Jin HR, Jang YE, Kim Y. Comparison of Obturation Quality between Calcium Silicate-Based Sealers and Resin-Based Sealers for Endodontic Re-treatment. MATERIALS (BASEL, SWITZERLAND) 2021; 15:72. [PMID: 35009220 PMCID: PMC8745997 DOI: 10.3390/ma15010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The objective of this micro-computed tomography (micro-CT)-based study was to compare the filling quality of endodontic treatment and endodontic Re-treatment between two sealers with matched obturation techniques: calcium silicate-based sealer (Endoseal TCS) with a single-cone technique (SCT) and resin-based sealer (AH Plus) with a continuous wave technique (CWT). METHODS Forty maxillary premolars were selected and assigned into four groups, according to the obturation methods of the first endodontic treatment and Re-treatment (n = 10). The AP/AP group was first treated with AH Plus/CWT, then re-treated with AH Plus/CWT. The AP/ET group was first treated with AH Plus/CWT, then re-treated with Endoseal TCS/SCT. The ET/AP group was first treated with Endoseal TCS/SCT, then re-treated with AH Plus/CWT, and the ET/ET group was first treated with Endoseal TCS/SCT, then re-treated with Endoseal TCS/SCT. The specimens were scanned using micro-CT at three time points: after the first endodontic treatment, after gutta-percha (GP) cone removal, and after Re-treatment. The void volume of root canal obturation and the volume of the remaining filling materials were calculated. Data were analyzed using Student's t-tests and ANOVA. RESULTS The Endoseal TCS groups (ET/AP and ET/ET) showed a lower percentage of voids than the AH plus groups (AP/AP and AP/ET) on the whole canal and the apical third, after first obturation (p < 0.05). The AH plus group showed significantly fewer remnants than the Endoseal TCS group after GP removal (p < 0.05). Re-treated canals and initially treated canals had similar void volumes (p > 0.05). There was no significant difference in void volume after Re-treatment, regardless of whether the same or different sealers were used for the first treatment and Re-treatment (p < 0.05). CONCLUSIONS Endoseal TCS sealer and AH Plus sealer had a similar Re-treatment efficacy, regardless of which sealer was used in the previous treatment.
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Affiliation(s)
| | | | - Yemi Kim
- Correspondence: ; Tel.: +82-2-2650-5763; Fax: +82-2-2650-5764
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Song D, Yang SE. Comparison of Dentinal Tubule Penetration between a Calcium Silicate-Based Sealer with Ultrasonic Activation and an Epoxy Resin-Based Sealer: A Study Using Confocal Laser Scanning Microscopy. Eur J Dent 2021; 16:195-201. [PMID: 34674198 PMCID: PMC8890920 DOI: 10.1055/s-0041-1735429] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the degree of dentinal penetration between an epoxy resin-based sealer applied by using two different filling methods and an ultrasonically activated calcium silicate-based sealer via confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS Forty-five extracted permanent maxillary premolars with type II canals (Vertucci's classification) were subjected to the experiment. The root canals were instrumented and distributed randomly into the following three groups: AH Plus + continuous wave technique (AHC group); AH Plus + single cone technique (AHS group); and Endoseal MTA + single cone technique with ultrasonic activation (EMS) group. Each sealer was labeled with rhodamine B dye to allow visualization under CLSM. The sealer penetration depth in each sample was observed at 2 mm and 5 mm from the apex by using CLSM. The data were statistically analyzed by using analysis of variance or Kruskal-Wallis H test according to normality of variable (α = 0.05). RESULTS In all groups, the maximum sealer penetration depth, mean fluorescence intensity, and sum fluorescence intensity values were higher at the 5-mm level than at the 2-mm level. At the 5-mm level, the EMS group showed the lowest value (p = 0.02). At the 2-mm level, there were no statistically significant differences among any of the groups. The AHC group showed higher values than the other groups, but there was no statistically significant difference in the apical area where access of instruments was difficult. CONCLUSION The AHC group showed the highest dentinal tubule penetration, but had questionable filing efficacy in the apical area, which is of particular importance for the success of root canal treatment. Therefore, in areas such as the apical 2 mm of premolars with type II canals, which are difficult to access by using instruments such as heat carriers, other appropriate approaches may be required accordingly.
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Affiliation(s)
- Dani Song
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Eun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Cho YS, Kwak Y, Shin SJ. Comparison of Root Filling Quality of Two Types of Single Cone-Based Canal Filling Methods in Complex Root Canal Anatomies: The Ultrasonic Vibration and Thermo-Hydrodynamic Obturation versus Single-Cone Technique. MATERIALS 2021; 14:ma14206036. [PMID: 34683625 PMCID: PMC8539525 DOI: 10.3390/ma14206036] [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: 08/05/2021] [Revised: 09/20/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the effectiveness of ultrasonic vibration and thermo-hydrodynamic obturation (VibraTHO) using two types of root canal sealers, in comparison to the single-cone (SC) technique and a calcium silicate-based root canal sealer in complex root canal anatomies. Thirty single-rooted human maxillary premolars with two canals that had a complex root canal anatomy of transverse anastomoses or ramifications were prepared and assigned to the following three experimental groups, according to the filling method: SE group, SC technique with Endoseal TCS; VE group, VibraTHO with Endoseal TCS; and VG group, VibraTHO with GuttaFlow 2. Each tooth was scanned using micro-computed tomography, and the volume percentages of the filling material were calculated. The analysis of variance was used to analyze the statistical differences between the three groups (p < 0.05). The mean volume of the filling material was higher in the VG and VE groups than that in the SE group (p < 0.05) along the apical to middle-to-coronal thirds, and significant differences were observed between each root canal area (p < 0.05), with the only exception being at the apical thirds between the VE and SE groups. The VibraTHO technique using GuttaFlow 2 can be a more effective root canal filling method for anatomically complex root canal systems than the SC technique with Endoseal TCS. On the other hand, the VibraTHO technique using Endoseal TCS has a limited effect on improving the quality of the root filling at the apical portion of anatomically complex root canal systems, compared to the SC technique with Endoseal TCS.
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Affiliation(s)
- Yong-Sik Cho
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Private Practice—Yonsei Doctors’ Dental Clinic, 201, 28 Daesan-ro, Ilsandong-gu, Goyang-si 10359, Korea
| | - Youngjun Kwak
- Private Practice—Yonsei Nature Dental Clinic, 2F, 281 Yangnyeong-ro, Dongjak-gu, Seoul 06919, Korea;
| | - Su-Jung Shin
- Gangnam Severance Hospital, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 211 Eonjuro, Gangnam-gu, Seoul 06273, Korea
- Correspondence: ; Tel.: +82-2-2019-3572; Fax: +82-2-3463-4052
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Milani AS, Kuzegari S, Zand V, Mokhtari H, Rahbar M. Ability of Calcium Silicate and Epoxy Resin-based Sealers to Fill the Artificial Lateral Canals in the Presence or Absence of Smear Layer. MAEDICA 2021; 16:458-462. [PMID: 34925604 PMCID: PMC8643567 DOI: 10.26574/maedica.2021.16.3.458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background:The lateral canals are pathways for bacteria and their products to pass between the root canal and the periradicular tissue. Objectives: The present study aims to compare the filling ability of the lateral canals with three calcium silicate based sealers, including MTA Fillapex, Endoseal MTA and Sure-Seal Root, and AH26 epoxy resin sealer in the presence and absence of the smear layer. Materials and methods:Six lateral canals were prepared using an engine reamer in 80 single-rooted human teeth. The root canals were cleaned, then the teeth were randomly divided into two groups. In group A, the smearlayer was removed using 17% EDTA and 5.25% NaOCl, and in group B, the canals were irrigated with normal saline. Groups A and B were divided into four subgroups each, according to the sealer used: A1, B1 (MTA Fillapex sealer), A2, B2 (Endoseal MTA sealer), A3, B3 (Sure-Seal Root sealer), and A4, B4 (AH26 sealer). Obturation of canals was conducted by the warm vertical technique and then teeth were incubated for 72 hours. Teeth were made clear and the filling of lateral canals were evaluated under stereomicroscope. Results:In group A, the highest lateral canals filling rate was in subgroup A2 and the lowest in subgroup A1, and the difference was statistically significant. However, in both groups, the highest lateral canals filling rate was in subgroups B2 and B3 and the lowest in subgroup B1. However, the difference was not statistically significant. In addition, no significant difference was observed in the lateral canals filling rate considering their position in the root. Conclusion:Providing the removal of the smear layer, calcium silicate-based sealers, Endoseal MTA and Sure-Seal Root had a higher ability to fill the lateral canals than AH26 and MTA fillapex sealers.
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Affiliation(s)
- Amin Salem Milani
- Endodontic Department, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Kuzegari
- Endodontic Department, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zand
- Endodontic Department, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Mokhtari
- Endodontic Department, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Rahbar
- Esthetic and Restorative Dentistry Department, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
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Dastorani M, Malekpour B, AminSobhani M, Alemrajabi M, Mahdian A, Malekpour B. Comparison of bacterial microleakage of three bioactive endodontic sealers in simulated underwater diving and aviation conditions. BMC Oral Health 2021; 21:345. [PMID: 34266421 PMCID: PMC8283829 DOI: 10.1186/s12903-021-01699-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial microleakage is an important cause of apical periodontitis and endodontic treatment failure. This study aimed to assess the bacterial microleakage of nano-mineral trioxide aggregate (nano-MTA) as a sealer, Endoseal MTA, and GuttaFlow Bioseal sealers in atmospheric pressure, and simulated underwater diving and aviation conditions. METHODS In this in vitro, experimental study, 180 extracted single-rooted teeth were cleaned and shaped, and were then randomly divided into three groups for single-cone obturation using Endoseal MTA, GuttaFlow Bioseal, or nano-MTA as a sealer. Each group was then randomly divided into three subgroups, and subjected to ambient atmospheric pressure, 2 atm pressure (to simulate underwater diving), and 0.5 atm pressure (to simulate aviation) using a custom-made pressure chamber. The teeth then underwent microbial leakage test using Streptococcus mutans (S. mutans), and the percentage of samples showing microleakage was recorded for up to 1 month, and analyzed using the Chi-square test. RESULTS The three sealer groups were significantly different regarding bacterial microleakage (P < 0.05). The nano-MTA group showed significantly higher microleakage after 15 days than the other two groups (P = 0.006). The effect of pressure on bacterial microleakage was not significant in any sealer group (P > 0.05). CONCLUSION Within the limitations of this in vitro study, it may be concluded that single-cone obturation technique using nano-MTA as a sealer results in lower resistance to bacterial microleakage compared with the use of GuttaFlow Bioseal, and Endoseal MTA. Pressure changes in simulated underwater diving and aviation conditions had no significant effect on bacterial microleakage. Trial Registration Number This is not a human subject research.
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Affiliation(s)
- Mehdi Dastorani
- Department of Endodontics, School of Dentistry, AJA University of Medical Sciences, End of 13th East St., Ajodanieh, Tehran, Iran
| | - Behnam Malekpour
- School of Dentistry, AJA University of Medical Sciences, End of 13th East St., Ajodanieh, Tehran, Iran
| | - Mohsen AminSobhani
- Department of Endodontics, School of Dentistry, AJA University of Medical Sciences, End of 13th East St., Ajodanieh, Tehran, Iran
| | - Mohammadsadegh Alemrajabi
- Department of Oral Medicine, School of Dentistry, AJA University of Medical Science, End of 13th East St., Ajodanieh, Tehran, Iran
| | - Arezoo Mahdian
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Qom Abad, Ghasrodasht St., 713451836 Shiraz, Iran
| | - Behrooz Malekpour
- School of Dentistry, AJA University of Medical Sciences, End of 13th East St., Ajodanieh, Tehran, Iran
- Department of Prosthodontics, Isfahan (Khorasgan) Branch, Isfahan Azad University, University Blvd, Arqavanieh, Jey Street, P.O.Box: 81595-158, Isfahan, Iran
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Characterization, Antimicrobial Effects, and Cytocompatibility of a Root Canal Sealer Produced by Pozzolan Reaction between Calcium Hydroxide and Silica. MATERIALS 2021; 14:ma14112863. [PMID: 34071745 PMCID: PMC8199352 DOI: 10.3390/ma14112863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 01/12/2023]
Abstract
This study aimed to evaluate a newly developed pozzolan-based bioceramic sealer (PZBS) regarding setting time, radiopacity, antibacterial effect, and cytocompatibility. The PZBS was manufactured by mixing calcium hydroxide and silica. The pozzolan reaction was verified by identification of calcium silicate hydrate (C-S-H) using X-ray diffraction analysis. The initial setting time and radiopacity were measured using the ISO 6876/2012 protocol in comparison with other commercially available calcium silicate (CS) sealers. The antibacterial effect of PZBS on biofilms cultured in the bovine root canal was evaluated by measurement of colony-forming units and volume of biofilms in comparison with other calcium hydroxide pastes. The morphological features of the biofilms were observed by scanning electron microscopy (SEM). The cytocompatibility of PZBS was assessed by the viability of bone marrow–derived mesenchymal stem cells and scratch wound healing rate in comparison with other CS sealers. The morphology of the cells cultured on the tested sealers was observed by SEM. The detection of the CS peak confirmed the formation of C-S-H. The initial setting time of PZBS was around 11 h, which was twice as long as the other tested sealers. The radiopacity of PZBS was 4.3 mm/Al, which satisfied the ISO criteria. The antibacterial effect and cytocompatibility of PZBS were comparable to those of the commercially available intracanal medicaments and CS endodontic sealers, respectively. The PZBS has the potential to be used for root canal obturation, and is expected to exert a favorable antibacterial effect.
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Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study. MATERIALS 2021; 14:ma14102661. [PMID: 34069521 PMCID: PMC8161030 DOI: 10.3390/ma14102661] [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: 04/19/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/02/2022]
Abstract
Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.
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Investigation of characteristics as endodontic sealer of novel experimental elastin-like polypeptide-based mineral trioxide aggregate. Sci Rep 2021; 11:10537. [PMID: 34006881 PMCID: PMC8131355 DOI: 10.1038/s41598-021-90033-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/29/2021] [Indexed: 01/11/2023] Open
Abstract
Although mineral trioxide aggregates (MTA) have been adopted as an endodontic sealer because of excellent sealing effect and bioactive property and been modified with improvement of its characteristics, the developed MTA sealers have not yet satisfied all the ideal requirements of endodontic sealers. The aim of this study was to assess the characteristics of elastin-like polypeptide (ELP)-incorporated MTA for use as an endodontic sealer and compare them with those of commercial MTA sealers. Two commercial MTA sealers and three experimental ELP-incorporated MTA sealers with 0.3, 0.4, and 0.5 liquid/powder (L/P) ratio for 10 wt% ELP liquid were evaluated. The push-out bond strength, flow rate, sealer penetrability and wash-out resistance were tested and the sealer-dentin interface was observed using a scanning electron microscope (SEM). Our study revealed the ELP-incorporated MTA sealer, especially in 0.4 L/P ratio, exhibited the higher push-out bond strength and flow rate (P < 0.05), and equal or superior sealer penetration and remarkable wash-out resistance compared to commercial MTA sealers. The groups of ELP-based experimental sealers also exhibited more intimate contact with dentin compared to the commercial MTA sealers. Our research will suggest the possible adoption of the ELP-incorporated MTA as endodontic sealer for clinical use.
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Park MG, Kim IR, Kim HJ, Kwak SW, Kim HC. Physicochemical properties and cytocompatibility of newly developed calcium silicate-based sealers. AUST ENDOD J 2021; 47:512-519. [PMID: 33894082 DOI: 10.1111/aej.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2021] [Indexed: 01/23/2023]
Abstract
The purpose of this study was to compare the physical properties and cytocompatibility of contemporary calcium silicate-based sealers. Four calcium silicate-based sealers (BrightEndo MTA sealer, CeraSeal, EndoSeal TCS and One-Fil) were compared to an epoxy resin-based sealer (AH Plus). Flow, setting time, radiopacity and dimensional change were evaluated according to ISO 6876 standards. Cytotoxicity on human periodontal ligament fibroblast (hPDLF) cells was compared for biological properties using MTT assay. The surface of the sealer was analysed using scanning electron microscopy to evaluate cell attachment. Flow and radiopacity of all sealers met ISO standards, while setting time and dimensional stability did not meet the ISO standards. Calcium silicate-based sealers showed favourable cytocompatibility, and hPDLF cells were well attached to the calcium silicate-based sealers. Calcium silicate-based sealers have clinically acceptable flow and radiopacity, and cytocompatibility. However, these sealers had longer setting time and higher dimensional change than those required by ISO 6876.
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Affiliation(s)
- Min-Gyu Park
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea
| | - In-Ryoung Kim
- Department of Oral Anatomy, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Hyung Joon Kim
- Dental and Life Science Institute, Pusan National University, Yangsan, Korea.,Department of Oral Physiology, Pusan National University School of Dentistry, Yangsan, Korea.,Periodontal Diseases Signaling Network Research Center, Pusan National University, Yangsan, Korea
| | - Sang Won Kwak
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Dental Research Institute, Pusan National University School of Dentistry, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
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Singla M, Panghal S. Comparative evaluation of sealing ability of three bioactive obturation materials: A bacterial leakage study. ENDODONTOLOGY 2021. [DOI: 10.4103/endo.endo_90_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Influence of New Silicate Cement Mineral Trioxide Aggregate (MTA Repair HP) on Metalloproteinase MMP-2 and MMP-9 Expression in Cultured THP-1 Macrophages. Int J Mol Sci 2020; 22:ijms22010295. [PMID: 33396675 PMCID: PMC7795909 DOI: 10.3390/ijms22010295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to investigate the new silicate cement mineral trioxide aggregate (MTA Repair HP) with respect to its effect on the inflammation process involving the tooth and periodontal tissues. The composition of MTA Repair HP was supplemented with plasticizer agents which can have a negative effect on the modulation of tooth inflammation. The silicate-based material in question is widely used in regeneration of the pulp-dentin complex, treatment of perforations of various locations in the tooth, as well as in surgical treatment of the complications of periapical tissue. The improved bioceramic restorative cement can affect the expression of metalloproteinases MMP-2 and MMP-9 in monocytes/macrophages involved in modulation of inflammation and regenerative processes of the tooth and periodontal tissues. The novel aspect of the present study lies in the application of the model of THP-1 monocyte/macrophage and applying the biomaterial in direct contact with the cells. Hence, it provides a representation of clinical conditions with respect to regenerative pulp and periodontal treatment with the use of MTA Repair HP. A lack of macrophage activation (as measured with flow cytometry) was found. Moreover, the study identified a lack of expression stimulation of the studied metalloproteinases (with the use of Western blotting and fluorescent microscopy). Similarly, no increase in MMP-2 and MMP-9 concentration was found (measured by ELISA method) in vitro when incubated with MTA Repair HP. Based on the results it can be concluded that new MTA Repair HP does not increase the inflammatory response in monocytes/macrophages associated with the activity of the described enzymes. It can also be speculated that they do not affect the process of dentin regeneration in which MMP-2 and MMP-9 play significant roles.
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Real-time nanoleakage and the flow characteristics of calcium silicate root canal filling materials. J Mech Behav Biomed Mater 2020; 112:104111. [PMID: 33002747 DOI: 10.1016/j.jmbbm.2020.104111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 11/21/2022]
Abstract
This study aimed to investigate the real-time nanoleakage and flow characteristics of calcium silicate-based (Ca-Si) root canal filling materials. Extracted human teeth (n = 30) were decoronated and standardized in their inner and outer dimensions. After root canal enlargement, the roots were filled with gutta-percha (GP) and AH26 sealer, GP and EndoSeal MTA sealer, or Biodentine. The roots were connected to a Nanoflow device (IB Systems) under hydrostatic pressure (40 cm∙H2O) and fluid flow was traced through the filled roots. Data were detected at the nanoscale twice per second and automatically recorded in units of nL/s. Leakage was quantified as the mean slope until the curve plateaued over time, and all static flow intervals lasting longer than 1 s were analyzed to identify any increase in flow and duration. Data were statistically analyzed using the Kruskal-Wallis test. The calculated leakage values were 0.0670 ± 0.0516 nL/s for GP/AH26, 0.1397 ± 0.1579 nL/s for GP/EndoSeal MTA, and 0.0358 ± 0.0538 nL/s for Biodentine, with no statistically significant differences among the root filling materials (P > 0.05). An analysis of real-time flow data for 1000 s to identify spot trends and the overall tendency of flow until a plateau was reached revealed a stepwise increase in the roots filled with Ca-Si material, whereas the GP/AH26-filled roots showed a linear increase. Real-time measurements under hydrostatic pressure with the Nanoflow device enabled precise fluid flow tracing through the root canal filling material. In terms of nanoleakage, the tested root canal filling materials showed no significant differences, while the real-time flow patterns of roots filled with Ca-Si material showed different characteristics from those of GP/AH26-filled roots.
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Main and Accessory Canal Filling Quality of a Premixed Calcium Silicate Endodontic Sealer According to Different Obturation Techniques. MATERIALS 2020; 13:ma13194389. [PMID: 33019753 PMCID: PMC7579472 DOI: 10.3390/ma13194389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/26/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
The present study aimed to investigate the effects of different obturation techniques on the main and accessory canal filling quality of a premixed calcium silicate endodontic sealer (Endoseal TCS). We also highlighted the validity of the methods used for evaluating the canal filling quality. Thirty single-rooted premolars were used for the main canal filling and 75 were used for accessory canal filling. The canals were instrumented and randomly divided into three groups according to the filling techniques: (1) single-cone technique (SC), (2) single-cone with ultrasonic activation (SU), and (3) warm vertical compaction (WV). Voids in relation to the root canal fillings were assessed using cross-section images from microcomputed tomography (μCT) scans or transversely sectioned tooth specimens (n = 10). After demineralization and clearing of the teeth, the incidence, number, and completeness of the accessory canal fillings were evaluated (n = 25). One-way analysis of variance (ANOVA) and Tukey's post hoc test was used for the evaluation of the voids in the main root canal and the incidence and number of filled accessory canals. Pearson's chi-squared (χ2) test was used for the evaluation of the filling completeness (α = 0.05). In the stereomicroscopic evaluation of the sectioned specimen, the SC group had significantly higher void occurrence than the other groups (p < 0.05), although there was no difference between groups in the μCT evaluation. However, there was no difference between the SU and WV. There was no difference between all the groups regarding the incidence, number, and completeness of the accessory canal fillings. When the premixed calcium silicate sealer is used with SC, the ultrasonic activation is recommended to obtain a better main canal filling quality. In contrast, the obturation techniques did not affect the accessory canal filling. We also recommend using the sectioning method when the void formation in the root canal filling materials is evaluated.
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Katakidis A, Sidiropoulos K, Koulaouzidou E, Gogos C, Economides N. Flow characteristics and alkalinity of novel bioceramic root canal sealers. Restor Dent Endod 2020; 45:e42. [PMID: 33294407 PMCID: PMC7691256 DOI: 10.5395/rde.2020.45.e42] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/26/2020] [Accepted: 05/08/2020] [Indexed: 11/27/2022] Open
Abstract
Objective This study aimed to examine the physical properties (pH and flow) of 2 novel bioceramic sealers. Materials and Methods The tested sealers were a calcium hydroxide sealer (Sealapex) and 2 bioceramic sealers (BioRoot RCS and TotalFill BC Sealer). Flow measurements were conducted according to ISO 6876/2012, with a press method of 0.05 mL of sealer. The pH of fresh samples was tested immediately after manipulation, while set samples were stored for 3 times the recommended setting time. The predetermined time intervals ranged from 3 minutes to 24 hours for fresh samples and from 10 minutes to 7 days and 4 weeks for the set samples. Analysis of variance was performed, with p = 0.05 considered indicating significance. Results The mean flow values were 26.99 mm for BioRoot, 28.19 for Sealapex, and 30.8 mm for TotalFill BC Sealer, satisfying the ISO standard. In the set samples, BioRoot RCS had higher pH values at 24 hours to 1 week after immersion in distilled water. At 2 weeks, both bioceramic sealers had similar pH values, greater than that of Sealapex. In the fresh samples, the bioceramic sealers had significantly higher initial pH values than Sealapex (p < 0.05). At 24 hours post-immersion, all sealers showed an alkaline pH, with the highest pH observed for TotalFill. Conclusions The TotalFill BC Sealer demonstrated the highest flow. The bioceramic sealers initially presented higher alkaline activity than the polymeric calcium hydroxide sealer. However, at 3 and 4 weeks post-immersion, all sealers had similar pH values.
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Affiliation(s)
- Anastasios Katakidis
- Section of Pathology and Therapeutics of Dental Tissues, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Sidiropoulos
- Section of Pathology and Therapeutics of Dental Tissues, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elisabeth Koulaouzidou
- Section of Pathology and Therapeutics of Dental Tissues, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Gogos
- Section of Pathology and Therapeutics of Dental Tissues, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Economides
- Section of Pathology and Therapeutics of Dental Tissues, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Shin JH, Ryu JJ, Lee SH. Antimicrobial activity and biocompatibility of the mixture of mineral trioxide aggregate and nitric oxide-releasing compound. J Dent Sci 2020; 16:29-36. [PMID: 33384775 PMCID: PMC7770295 DOI: 10.1016/j.jds.2020.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background/purpose Antimicrobial activity and biocompatibility of root canal sealer are related to the success of endodontic treatments. This study investigated the efficacy of mixture of mineral trioxide aggregate (MTA) and a NO-releasing compound for the antimicrobial activity, biocompatibility, and physical properties. Materials and methods MTA was mixed with diethylenetriamine-NO (MTA-NO), and the extracts from MTA and the MTA-NO mixture before and after setting was obtained were investigated the antimicrobial activity against Enterococcus faecalis and Porphyromonas endodontalis. After setting MTA and MTA-NO, pulp cell was incubated in the presence of MTA and MTA-NO disk using Transwell® cell culture insert, and the proliferation assay and mineralization-stimulated factors of the cells were analyzed by MTT assay and real-time RT-PCR, respectively. The physical properties of MTA and the MTA-NO mixture, such as surface hardness and flowability was also analyzed. Results The MTA-NO mixture showed stronger antimicrobial activity against E. faecalis and P. endodontalis than that by MTA. Both MTA and MTA-NO mixture increase the ratio of cell proliferation and induced the expression of alkaline phosphatase, collagen type I, osteocalcin, and osteopontin. Moreover, the induction of gene expression by MTA-NO mixture was higher than that by MTA alone. No significant difference was observed for surface hardness and flowability between MTA and MTA-NO mixture. Conclusion The addition of a NO-releasing compound to the endodontic treatment using MTA root canal sealer might reduce the risk of bacterial infection and help to regenerate the dental pulp tissue.
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Affiliation(s)
- Joo-Hee Shin
- Department of Dentistry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Sung-Hoon Lee
- Department of Oral Microbiology and Immunology, College of Dentistry, Dankook University, Cheonan, Republic of Korea
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Lim M, Jung C, Shin DH, Cho YB, Song M. Calcium silicate-based root canal sealers: a literature review. Restor Dent Endod 2020; 45:e35. [PMID: 32839716 PMCID: PMC7431927 DOI: 10.5395/rde.2020.45.e35] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/23/2022] Open
Abstract
Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.
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Affiliation(s)
- Miyoung Lim
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chanyong Jung
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Yong-bum Cho
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
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Kim JC, Moe MMK, Kim SK. A micro-computed tomographic evaluation of root canal filling with a single gutta-percha cone and calcium silicate sealer. Restor Dent Endod 2020; 45:e18. [PMID: 32483535 PMCID: PMC7239679 DOI: 10.5395/rde.2020.45.e18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/15/2019] [Accepted: 12/19/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to evaluate the void of root canal filling over time when a calcium silicate sealer was used in the single gutta-percha cone technique. Materials and Methods Twenty-four J-shaped simulated root canals and twenty-four palatal root canals from extracted human maxillary molars were instrumented with ProFile Ni-Ti rotary instruments up to size 35/0.06 or size 40/0.06, respectively. Half of the canals were filled with Endoseal MTA and the other half were with AH Plus Jet using the single gutta-percha cone technique. Immediately after and 4 weeks after the root canal filling, the samples were scanned using micro-computed tomography at a resolution of 12.8 μm. The scanned images were reconstructed using the NRecon software and the void percentages were calculated using the CTan software, and statistically analyzed by 1-way analysis of variance, paired t-test and Tukey post hoc test. Results After 4 weeks, there were no significant changes in the void percentages at all levels in both material groups (p > 0.05), except at the apical level of the AH Plus Jet group (p < 0.05) in the simulated root canal showing more void percentage compared to other groups. Immediately after filling the extracted human root canals, the Endoseal MTA group showed significantly less void percentage compared to the AH Plus Jet group (p < 0.05). Conclusions Under the limitations of this study, the Endoseal MTA does not seem to reduce the voids over time.
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Affiliation(s)
- Jong Cheon Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Maung Maung Kyaw Moe
- Department of Conservative Dentistry, University of Dental Medicine, Mandalay, Myanmar
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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Comparative Evaluation of Physicochemical Properties and Apical Sealing Ability of a Resin Sealer Modified with Pachymic Acid. Eur Endod J 2020; 5:23-27. [PMID: 32342034 PMCID: PMC7183805 DOI: 10.14744/eej.2019.68442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 09/04/2019] [Indexed: 02/05/2023] Open
Abstract
Objective: The addition of pachymic acid (PA) to AH Plus (an epoxy resin sealer) offsets the cytotoxicity of the latter. Prior to the clinical implementation of this formulation, a thorough knowledge of its physicochemical properties and sealing ability becomes mandatory. Hence, this in vitro study aimed to characterize and evaluate the physicochemical properties and apical sealing ability of AH Plus (AHP) with and without the addition of PA. Methods: Flow, setting time, film thickness, solubility and radiopacity of AHP (group 1) and AHP modified with PA (AHP/PA, group 2) were evaluated in accordance with the guidelines put forth by ISO 6876:2012. The percentage was determined under each parameter. Apical sealing ability was assessed using fluid filtration device. An independent samples t-test was used for inter- and intra-group comparisons of mean fluid flow (MFF). Results: Incorporating PA to AHP decreased its flow, setting time and film thickness by 24.34%, 2.14% and 31.71% respectively. The solubility of group 2 increased on day 1 by 85.71% and decreased on days 3, 7 and 14 by 46.67%, 34.79% and 13.8% respectively. The radiopacity of AHP was not altered by the addition of PA. MFF rates of group 2 was significantly higher than group 1 on day 1, but not significantly different on day 7. Conclusion: AHP/PA exhibited physicochemical properties that were within the requirements of ISO and with time, and showed fluid flow similar to AHP.
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Moazami F, Naseri M, Malekzadeh P. Different Application Methods for Endoseal MTA Sealer: A Comparative Study. IRANIAN ENDODONTIC JOURNAL 2020; 15:44-49. [PMID: 36704323 PMCID: PMC9723208 DOI: 10.22037/iej.v15i1.27568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/02/2019] [Accepted: 10/19/2019] [Indexed: 01/28/2023]
Abstract
Introduction The aim of present ex vivo study was to investigate the filling quality and voids, using Endoseal mineral trioxide aggregate (Endoseal MTA) with a single-cone technique with and without ultrasonic application and to compare these methods with lateral compaction technique. Methods and Materials Thirty-six extracted human anterior single-root teeth were prepared and assigned to 3 groups: Group 1: EMS group was Endoseal MTA+ single-cone; Group 2: EMSU group was Endoseal MTA+ single-cone with ultrasonic activation; and Group 3: LC group was Endoseal MTA+ lateral condensation technique. Teeth were sectioned transversely in coronal, middle and apical of the teeth and the existence of voids and their areas in the slices were measured and scored under a dental microscope. One-way analysis of variance and Post Hoc test were used for statistical analysis and also to detect any significance (α=0.05). Results EMS group showed significantly more void area than lateral compaction group (P<0.05), but the difference between the EMSU group and the other two groups were not significant (P>0.05). Also, EMS group had significantly higher void score than the other two groups (P<0.017). Conclusion Endoseal MTA as a premixed calcium silicate sealer has a better performance when used with gutta-percha cone-mediated ultrasonic activation, so we suggest gentle ultrasonic activation for applying Endoseal MTA in the clinical use.
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Affiliation(s)
- Fariborz Moazami
- Department of Endodontics, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadhasan Naseri
- Department of Endodontics, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding author: Mohammadhasan Naseri, Ghasrdasht street, Ghomabad street, Dental School, Shiraz, Iran. Tel: +98-921 0067643, E-mail:
| | - Parastoo Malekzadeh
- Department of Endodontics, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
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Biocompatibility and Mineralization Activity of Three Calcium Silicate-Based Root Canal Sealers Compared to Conventional Resin-Based Sealer in Human Dental Pulp Stem Cells. MATERIALS 2019; 12:ma12152482. [PMID: 31387241 PMCID: PMC6696455 DOI: 10.3390/ma12152482] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to compare the cytotoxic effects and mineralization activity of three calcium silicate-based root canal sealers to those of a conventional resin-based sealer. Experiments were performed using human dental pulp stem cells grown in a monolayer culture. The root canal sealers tested in this study were EndoSequence BC Sealer (Brasseler), BioRoot RCS (Septodont), Endoseal MTA (Maruchi), and AH Plus (Dentsply DeTrey). Experimental disks 6 mm in diameter and 3 mm in height were made and stored in a 100% humidity chamber at 37 °C for 72 h to achieve setting. The cytotoxicity of various root canal sealers was evaluated using a methyl-thiazoldiphenyl-tetrazolium (MTT) assay. To evaluate cell migration ability, a scratch wound healing method was used, and images of the scratch area were taken using a phase-contrast microscope. Cell morphology was evaluated by a scanning electron microscope after direct exposure for 72 h to each sealer disk. In the cell viability assay, there were no significant differences between the EndoSequence BC, BioRoot RCS, Endoseal MTA, and control groups in any experimental period (p > 0.05). In the cell migration assay, there were no significant differences between the EndoSequence BC, Endoseal MTA, and control groups in any experimental period (p > 0.05). BioRoot RCS exhibited slower cell migration relative to EndoSequence BC and Endoseal MTA for up to 72 h (p < 0.05). Conversely, it showed a similar wound healing percentage at 96 h (p > 0.05). In an evaluation of cell morphology, cells in direct contact with EndoSequence BC, BioRoot RCS, and Endoseal MTA disks showed superior spreading compared to those in contact with the AH Plus disk. In an Alizarin red staining assay, EndoSequence BC, BioRoot RCS, and Endoseal MTA showed a significant increase in mineralized nodule formation compared to the AH Plus group (p < 0.05). In conclusion, all calcium silicate-based root canal sealers tested in this study showed good biological properties and mineralization activity compared to conventional resin-based sealer.
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Lee JK, Kim S, Lee S, Kim HC, Kim E. In Vitro Comparison of Biocompatibility of Calcium Silicate-Based Root Canal Sealers. MATERIALS 2019; 12:ma12152411. [PMID: 31362338 PMCID: PMC6695985 DOI: 10.3390/ma12152411] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 01/02/2023]
Abstract
The aim of this study was to assess the effect of three calcium silicate-based sealers (EndoSeal MTA, Nano-ceramic Sealer, and Wellroot ST) and two epoxy resin-based sealers (AH-Plus, AD Seal) on various aspects, such as cell viability, inflammatory response, and osteogenic potential, of human periodontal ligament stem cells (hPDLSCs). AH-Plus showed the lowest cell viability on hPDLSCs in all time periods in fresh media. In set media, hPDLSCs showed no significant differences in cell viability among all the tested materials. Wellroot ST showed the highest level of cell adhesion and the morphology of attached cells. AH-plus presented a significantly higher expression of IL-6 and IL-8 than the other sealers. AD Seal and three calcium silicate sealers showed high expression of the mesenchymal stem cell markers. ALP mRNA expression showed a significant increase in time-dependent manner on all of three calcium silicate-based sealers, which do not seem to interfere with the differentiation of hPDLSCs into osteoblasts. Based on the results from this study, calcium silicate-based sealers appear to be more biocompatible and less cytotoxic than epoxy resin-based sealers. Meanwhile, further and long-term clinical follow-up studies are required.
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Affiliation(s)
- Ju Kyung Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 50612, Korea
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Sukjoon Lee
- BK21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 50612, Korea.
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea.
- Department of Electrical & Electronic Engineering, Yonsei University College of Engineering, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea.
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A novel antibacterial resin-based root canal sealer modified by Dimethylaminododecyl Methacrylate. Sci Rep 2019; 9:10632. [PMID: 31337813 PMCID: PMC6650501 DOI: 10.1038/s41598-019-47032-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/09/2019] [Indexed: 02/05/2023] Open
Abstract
Persistent apical periodontitis, mainly caused by microorganisms infections, represents a critical challenge for endodontists. Dimethylaminododecyl methacrylate (DMADDM) is a well-studied and potent antibacterial agent used in various studies described in the literature. The aim of this study is to develop a novel antibacterial root canal sealer by incorporating DMADDM into EndoREZ and investigate the properties of the resulting material. Different mass fractions (0, 1.25%, 2.5%, and 5%) of DMADDM were incorporated into EndoREZ and the cytotoxicity, apical sealing ability and solubility of the resulting material were evaluated. Furthermore, a direct contact test, determination of colony-forming units, a crystal violet assay, scanning electronic microscopy and live/dead bacteria staining were performed to evaluate the antibacterial effect of the sealer to multispecies bacteria (Enterococcus faecalis, Streptococcus gordonii, Actinomyces naeslundii, and Lactobacillus acidophilus), in planktonic cells or biofilms. Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction were carried out to assess the composition of the multispecies biofilms. No difference on the cytotoxicity, apical sealing ability and solubility between sealers containing DMADDM (1.25%, 2.5%) and EndoREZ (0%) could be determined. However, when the mass fraction of DMADDM increased to 5%, significantly different properties were found compared to the 0% (p < 0.05) group. Moreover, incorporating DMADDM into the sealer could greatly improve the antibacterial properties of EndoREZ. In addition, the composition ratio of E. faecalis could be decreased in multispecies microecology in sealers containing DMADDM. Therefore, a EndoREZ sealer material containing DMADDM could be considered useful in clinical applications for preventing and treating persistent apical periodontitis.
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Adl A, Sadat Shojaee N, Pourhatami N. Evaluation of the Dislodgement Resistance of a New Pozzolan-Based Cement (EndoSeal MTA) Compared to ProRoot MTA and Biodentine in the Presence and Absence of Blood. SCANNING 2019; 2019:3863069. [PMID: 31210836 PMCID: PMC6532292 DOI: 10.1155/2019/3863069] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/22/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This in vitro study investigated the dislodgement resistance of EndoSeal MTA, a new pozzolan-containing calcium silicate-based material, in comparison with ProRoot MTA and Biodentine in the presence and absence of contamination with blood. METHODS Standard furcal perforations were created in 180 human mandibular first molars. The teeth were randomly allocated to 12 groups of 15 each. ProRoot MTA, Biodentine, and EndoSeal MTA were used to repair the perforations. In half of the samples, the walls of the perforated areas were contaminated with blood, whereas saline was injected into the other half. A push-out test was performed using a universal testing machine after 24 hours or 7 days. To evaluate failure patterns, the samples were split into half and were examined under a stereomicroscope at a 20x magnification. Data were analyzed using three-way analysis of variance, Tukey test, and Student's t-test. RESULTS At both time intervals and in the presence and absence of contamination with blood, ProRoot MTA and Biodentine had significantly higher retention values than EndoSeal MTA (p < 0.001). Contamination with blood had no effect on EndoSeal MTA; however, it negatively affected the dislodgement resistance of Biodentine at 24 hours and ProRoot MTA at both time intervals (p < 0.05). Time significantly affected only the bond strength of the uncontaminated groups (p > 0.001). The most common type of failure was mixed for ProRoot MTA and Biodentine, whereas it was cohesive for EndoSeal MTA. CONCLUSIONS ProRoot MTA and Biodentine showed higher values of bond strength than EndoSeal MTA and may thus be better options for the repair of root perforations.
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Affiliation(s)
- Alireza Adl
- Department of Endodontics, Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nooshin Sadat Shojaee
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Pourhatami
- Postgraduate Student of Endodontics, Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Razdan A, Benetti AR, Bjørndal L. Do in vitro solubility studies on endodontic sealers demonstrate a high level of evidence? A systematic review. Acta Odontol Scand 2019; 77:253-263. [PMID: 30849267 DOI: 10.1080/00016357.2018.1538535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. MATERIAL AND METHODS This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. RESULTS The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. CONCLUSIONS Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.
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Affiliation(s)
- Ankur Razdan
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ana Raquel Benetti
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Bjørndal
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kim K, Kim DV, Kim SY, Yang S. A micro-computed tomographic study of remaining filling materials of two bioceramic sealers and epoxy resin sealer after retreatment. Restor Dent Endod 2019; 44:e18. [PMID: 31149616 PMCID: PMC6529792 DOI: 10.5395/rde.2019.44.e18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 11/14/2022] Open
Abstract
Objective This study evaluated the presence of residual root canal filling material after retreatment using micro-computed tomography (micro-CT). Materials and Methods Extracted human teeth (single- and double-rooted, n = 21/each; C-shaped, n = 15) were prepared with ProFile and randomly assigned to three subgroups for obturation with gutta-percha and three different sealers (EndoSeal MTA, EndoSequence BC sealer, and AH Plus). After 10 days, the filling material was removed and the root canals were instrumented one size up from the previous master apical file size. The teeth were scanned using micro-CT before and after retreatment. The percentage of remaining filling material after retreatment was calculated at the coronal, middle, and apical thirds. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni post hoc correction. Results The tested sealers showed no significant differences in the percentage of remaining filling material in single- and double-rooted teeth, although EndoSeal MTA showed the highest value in C-shaped roots (p < 0.05). The percentage of remaining filling material of AH Plus and EndoSeal MTA was significantly higher in C-shaped roots than in single- or double-roots (p < 0.05), while that of BC sealer was similar across all root types. EndoSeal MTA showed the highest values at the apical thirds of single- and double-roots (p < 0.05); otherwise, no significant differences were observed among the coronal, middle, and apical thirds. Conclusions Within the limitations of this study, a large amount of EndoSeal MTA remained after retreatment, especially in C-shaped root canals.
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Affiliation(s)
- KyungJae Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Da Vin Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - SungEun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kim Y, Kim BS, Kim YM, Lee D, Kim SY. The Penetration Ability of Calcium Silicate Root Canal Sealers into Dentinal Tubules Compared to Conventional Resin-Based Sealer: A Confocal Laser Scanning Microscopy Study. MATERIALS 2019; 12:ma12030531. [PMID: 30754612 PMCID: PMC6385034 DOI: 10.3390/ma12030531] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to compare the penetration ability of calcium silicate root canal sealers and conventional resin-based sealer using confocal laser scanning microscopy (CLSM). A total of 60 recently extracted single-rooted human premolars were used in this study. The root canals were prepared to a size 40/0.06 taper with ProFile rotary instruments and irrigated with NaOCl and EDTA. After drying all canals, the specimens were randomly divided into three experimental groups (n = 20): Group 1, gutta-percha (GP)/AH Plus with continuous wave compaction; group 2, GP/BioRoot RCS with a single-cone technique; and group 3, GP/Endoseal MTA with a single-cone technique. All experimental samples were sectioned perpendicular to their long axis using a low-speed diamond wheel at the apical, middle, and coronal third levels. The penetration abilities of all samples were evaluated using CLSM. A Kruskal⁻Wallis analysis and a series of Mann⁻Whitney U post hoc tests were performed. A higher intensity level was found in the coronal area and a lower intensity level in the apical area in all the experimental groups. The AH Plus group showed higher sum fluorescence intensity in the apical and coronal thirds compared with the BioRoot RCS and Endoseal MTA groups, whereas the BioRoot RCS group showed a higher intensity level in the middle third, similar to the AH Plus group. The maximum sealer penetration depth was low in the apical area and high in the coronal area in the AH Plus and Endoseal MTA groups. In the BioRoot RCS group, maximum sealer penetration was observed in the middle third. In conclusion, there were significant differences in sealer penetration pattern and distance according to the root level and sealer type.
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Affiliation(s)
- Yemi Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Ban-Suk Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
| | - Yong-Min Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
| | - Donghee Lee
- College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
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Endodontic sealers based on calcium silicates: a systematic review. Odontology 2018; 107:421-436. [DOI: 10.1007/s10266-018-0400-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 11/19/2018] [Indexed: 01/21/2023]
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Makkar H, Verma SK, Panda PK, Jha E, Das B, Mukherjee K, Suar M. In Vivo Molecular Toxicity Profile of Dental Bioceramics in Embryonic Zebrafish ( Danio rerio). Chem Res Toxicol 2018; 31:914-923. [PMID: 30058326 DOI: 10.1021/acs.chemrestox.8b00129] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The investigation of the biocompatibility of potential and commercially available dental material is a major challenge in dental science. This study demonstrates that the zebrafish model is a novel in vivo model for investigating the biocompatibility of dental materials. Two commercially available dental materials, mineral trioxide aggregate (MTA) and Biodentine, were assessed for their biocompatibility. The biocompatibility analysis was performed in embryonic zebrafish with the help of standard toxicity assays measuring essential parameters such as survivability and hatching. The mechanistic and comparative analysis of toxicity was performed by oxidative stress analysis by measuring ROS induction and apoptosis in zebrafish exposed to dental materials at different concentrations. The molecular investigation at the protein level was done by a computational approach using in silico molecular docking and pathway analysis. The toxicity analysis showed a significant reduction in hatching and survivability rates along with morphological malformations with an increase in the concentration of exposed materials. ROS and apoptosis assay results revealed a greater biocompatibility of Biodentine as compared to that of MTA which was concentration-dependent. In silico analysis showed the significant role of the tricalcium silicate-protein ( Sod1, tp53, RUNX2B) interaction in an exhibition of toxicity. The study provides a new vision and standard in dental material sciences for assessing the biocompatibility of potential novel and commercially available dental materials.
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Affiliation(s)
| | | | - Pritam Kumar Panda
- Division of Paediatric Haematology and Oncology , University of Freiburg , Freiburg 79106 , Germany
| | - Ealisha Jha
- Department of Physics and Physical Oceanography , Memorial University of Newfoundland , St. John's , NL A1C 5S7 , Canada
| | | | - Kaushik Mukherjee
- Center for Craniofacial Molecular Biology , University of Southern California , Los Angeles , California 90089 , United States
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Kebudi Benezra M, Schembri Wismayer P, Camilleri J. Interfacial Characteristics and Cytocompatibility of Hydraulic Sealer Cements. J Endod 2018; 44:1007-1017. [PMID: 29398087 DOI: 10.1016/j.joen.2017.11.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/21/2017] [Accepted: 11/15/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The stability and long-term success of root canal obturation depends on the choice of sealer because the sealer bonds to the dentin and stabilizes the solid cone. Furthermore, the sealer needs to be nontoxic because sealer toxicity will certainly lead to treatment failure. The aim of this study was to assess the sealer-dentin interface of 3 hydraulic root canal sealers and to evaluate their cytocompatibility compared with AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany). METHODS Four dental root canal sealers were assessed. AH Plus, MTA Fillapex (Angelus, Londrina, Brazil), BioRoot RCS (Septodont, Saint-Maur-des-Fossés, France), and Endoseal (Maruchi, Wonju-si, Gangwon-do, South Korea) were characterized using scanning electron microscopy and energy-dispersive spectroscopy. The sealer-tooth interface was assessed by confocal microscopy and scanning electron microscopy, and biocompatibility was measured by assessing the cell metabolic function using direct contact assays and alkaline phosphatase activity. RESULTS The tricalcium silicate-based sealers presented a different microstructure and elemental composition despite their similar chemistry and classification. BioRoot RCS was free of aluminum, and all sealers presented different radiopacifying elements. The sealer penetration in the dentinal tubules and interfacial characteristics were different. The migration of silicon was evident from sealer to tooth for all sealers containing tricalcium silicate. MTA Fillapex and BioRoot RCS exhibited the best cytocompatibility in both the direct contact test and alkaline phosphatase activity. CONCLUSIONS The use of hydraulic calcium silicate-based sealers has introduced a different material type to endodontics. These materials are different than other sealers mostly because of their hydraulic nature and their interaction with the environment. Although the sealers tested had a similar chemistry, their cytocompatibility and bonding mechanisms were diverse.
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Affiliation(s)
- Mira Kebudi Benezra
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Josette Camilleri
- Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, Msida, Malta; School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
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Shin JH, Lee DY, Lee SH. Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal. J Dent Sci 2018; 13:54-59. [PMID: 30895095 PMCID: PMC6388800 DOI: 10.1016/j.jds.2017.10.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 10/24/2017] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Bacterial infection is closely associated with the failure of endodontic treatment, and use of endodontic sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. The purpose of this study was to investigate and to compare the antibacterial effect of two calcium silicate-based root canal sealers (Endoseal and EndoSequence BC sealer) as recent development sealers and with three conventional root canal sealers (AH Plus, Sealapex, and Tubli-Seal), before or after setting, on Porphyromonas endodontalis, Porphyromonas gingivalis, and Enterococcus faecalis. Materials and methods The sealers were soaked in phosphate buffered saline to elute its compositions after and before setting, and the elutes were performed the antimicrobial assay. Also, X-ray fluorescence analysis was carried out to compare compositions of two calcium silicate-based sealers. Results The conventional root canal sealers have strong antibacterial activity against the Gram-negative bacteria, P. endodontalis and P. gingivalis. Endoseal sealer showed antibacterial activity against not only the Gram-negative bacteria, but also against the Gram-positive bacteria, E. faecalis. However, Endosequence BC sealer exhibited a weak antibacterial effect on all bacteria in this study. X-ray fluorescence analysis exhibited that Endoseal contained more types and more amount of the oxide compound known to have strong antimicrobial activity such as Al2O3, Fe2O3, MgO, Na2O, NiO, and SO2 than Endoseqeunce BC. Conclusion Endoseal, which contains various types of oxide compounds, seems to be a suitable sealer for preventing bacterial infection in both treated and untreated root canals.
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Affiliation(s)
- Joo-Hee Shin
- Department of Conservative Dentistry, Korea University Medical Center Guro Hospital, Republic of Korea
| | - Dong-Yul Lee
- Department of Orthodontics, Korea University Medical Center Guro Hospital, Seoul, Republic of Korea
| | - Sung-Hoon Lee
- Department of Oral Microbiology and Immunology, College of Dentistry, Dankook University, Cheonan, Republic of Korea
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Root Canal Filling Quality of a Premixed Calcium Silicate Endodontic Sealer Applied Using Gutta-percha Cone-mediated Ultrasonic Activation. J Endod 2018; 44:133-138. [DOI: 10.1016/j.joen.2017.07.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 11/20/2022]
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Yang DK, Kim S, Park JW, Kim E, Shin SJ. Different Setting Conditions Affect Surface Characteristics and Microhardness of Calcium Silicate-Based Sealers. SCANNING 2018; 2018:7136345. [PMID: 29576841 PMCID: PMC5822761 DOI: 10.1155/2018/7136345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/09/2017] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To investigate the effect of different setting conditions on surface microhardness and setting properties of calcium silicate-based sealers. METHODS Three sealers, EndoSequence Bioceramic (BC; Brasseler USA, Savannah, GA, USA), Endoseal MTA (ES; Maruchi, Wonju, Korea), and Well-Root ST (WR; Vericom, Chuncheon, Korea), were compared. Specimens were exposed to either butyric acid (pH 5.4) or phosphate-buffered saline (PBS [pH 7.4]) for 48 h and stored at 100% humidity for 12 days. The control specimens were stored at 100% humidity for 14 days. Surface microhardness was measured, topographic changes were observed, and phase analysis was performed using X-ray diffraction. Microhardness according to storage conditions was compared using one-way analysis of variance and Tukey's multiple comparison tests (P < .05). RESULTS The BC and ES sealers exhibited decreased microhardness when stored in acid or PBS compared with control (P < .05). In the WR group, acid exposure lowered microhardness of the specimens compared with control (P < .05). Scanning electron microscopy revealed different topographies in specimens from all tested sealers exposed to acid or PBS. CONCLUSION The surface microhardness of calcium silicate-based sealers was reduced by exposure to either acid or PBS. Acid solutions, however, had a more detrimental effect than PBS.
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Affiliation(s)
- Dong-Kyu Yang
- Department of Conservative Dentistry, College of Dentistry, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Republic of Korea
| | - Sunil Kim
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - Jeong-Won Park
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Republic of Korea
| | - Euiseong Kim
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Republic of Korea
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Abstract
In vitro material testing is undertaken by conducting a series of tests following procedures outlined in international standards. All material properties are measured in water; however biological behavior is undertaken in alternative media such as Dulbecco’s modified eagle medium (DMEM) or simulated body fluid. The aim of this study was to characterize four dental root canal sealers and study their properties in different media. Four dental root canal sealers were assessed. They were characterized by a combination of techniques and the sealer properties were tested as specified by ISO 6876 (2012) and also in alternative media. The sealer biocompatibility was measured by cell function and proliferation assays of elutions. All sealers complied with ISO specifications. The material properties were effected by the type of soaking medium used and the surface micromorphology and elemental composition were dependent on the soaking solution type. Both BioRoot and MTA Fillapex showed cytotoxicity which reduced at higher dilutions. The material chemistry, presentation, environmental conditions and testing methodology used affected the sealer properties. Standards specific to sealer type are thus indicated. Furthermore the methodology used in the standard testing should be more relevant to clinical situations.
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Jafari F, Jafari S. Composition and physicochemical properties of calcium silicate based sealers: A review article. J Clin Exp Dent 2017; 9:e1249-e1255. [PMID: 29167717 PMCID: PMC5694156 DOI: 10.4317/jced.54103] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 07/12/2017] [Indexed: 11/05/2022] Open
Abstract
Background Recently a new generation of endodontic sealers has been developed based on calcium silicate as MTA Fillapex, Endoseal MTA, Total Fill BC Sealer, EndoSequence BC Sealer, iRoot SP, Endo CPM sealer, MTA-Angelus and ProRoot Endo Sealer. A review of literature was conducted to discuss the composition, physicochemical properties, and clinical perspectives of calcium silicate based sealers. Material and Methods A literature search was conducted in PubMed and web of knowledge databases with appropriate MeSh terms and keywords. A total of 71 studies were reviewed for data extraction. Results and Conclusions Calcium silicate based sealers showed suitable physical properties to be used as an endodontic sealer. However, its high solubility remains an important issue. They show good performance regarding calcium ion release, film thickness, and fowability. More researches are required about features of calcium silicate based sealers before recommending them for clinical applications. Key words:Calcium silicate, root canal filling materials, composition, physical properties.
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Affiliation(s)
- Farnaz Jafari
- Assistant Professor, Department of Endodontics, Dental School, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Sanaz Jafari
- Assistant Professor, Orthodontics Department, Dentistry Faculty, Ilam University of Medical Sciences
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