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Kandemir Demirci G, Çöven FO, Güneri P, Karavana SY, Nalbantsoy A, Köse T, Kaval ME. The solubility, pH value, chemical structure, radiopacity, and cytotoxicity of four different root canal sealers: an in vitro study. Clin Oral Investig 2023; 27:5413-5425. [PMID: 37486382 DOI: 10.1007/s00784-023-05160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet sealers. MATERIALS AND METHODS Cytotoxicity analysis with direct and extraction tests at 3 different concentrations (1:1, 1:2, 1:4 v/v%) and time (24 h, 48 h, and 72 h) on Saos-2, PdLF, and THP-1 cell lines, chemical structure with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis, solubility, pH, and radiopacity values of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet were evaluated. For statistical analyses of the groups, repeated measures, factorial, and one-way ANOVA tests were used. The statistical significance level was set at p < .05. RESULTS Resin-based sealers showed higher cytotoxicity values than the bioceramic-based sealers (p < 0.05). Time and concentrations were effective on the cell viabilities for cell lines. Higher peaks of calcium were detected bioceramic-based sealers and higher amount of zirconium was detected in AH Plus BC (p < 0.05). AH Plus BC showed similar radiopacity value with AH Plus, AH Plus Jet, whereas TotalFill BC showed the lowest radiopacity (p < 0.05). Bioceramic-based sealers had higher pH values in all experiment periods, and the difference between resin- and bioceramic-based sealer groups was significant (p < 0.05). However, the solubility values of the tested root canal sealers revealed no differences (p > 0.05). CONCLUSIONS The newly produced AH Plus BC Sealer showed similar properties with TotalFill BC, and their biological properties were better than AH Plus and AH Plus Jet. CLINICAL RELEVANCE AH Plus BC could be a possible alternative to other bioceramic- or resin-based sealers.
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Affiliation(s)
| | - Furkan Ozan Çöven
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, İzmir, Turkey
| | - Sinem Yaprak Karavana
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Ege University, İzmir, Turkey
| | - Ayşe Nalbantsoy
- Department of Bioengineering, Faculty of Engineering, Ege University, İzmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Mehmet Emin Kaval
- Department of Endodontology, School of Dentistry, Ege University, 35100, İzmir, Turkey
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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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The Effect of Sealer Application Methods on Voids Volume after Aging of Three Calcium Silicate-Based Sealers: A Micro-Computed Tomography Study. Tomography 2022; 8:778-788. [PMID: 35314641 PMCID: PMC8938853 DOI: 10.3390/tomography8020064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/12/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
During obturation, air voids are undesirable as they may provide shelter for microorganisms or passage for fluids. This study aimed to compare the occurrence of voids between three calcium silicate-based sealers (CSBSs) (MTA-Fillapex, BioRoot-RCS, Bio-C) and the change in their volume after aging. In addition, we aimed to compare voids when using two sealer application methods: lentulo-spiral (LS) and gutta-percha (GP) cone. Thirty extracted mandibular premolars (n = 30) were endodontically prepared and obturated using single GP cone (SGPC) technique. Each sealer was applied to 10 teeth (n = 10) using LS or GP. Micro-computed tomography (micro-CT) was used to quantify the volume of root filling and voids before and after 8-week storage in a phosphate-rich medium. The percentage of root filling and voids were compared between the groups using a Mann–Whitney U test and Kruskal–Wallis test with a Bonferroni correction. Before aging, the percentages of root filling volume after obturation were comparable with no significant differences between sealers (p = 0.325) or application methods (p = 0.950). After aging, the voids’ volume increased significantly in all sealers (p ≤ 0.05). However, no significant differences were found between sealers (p = 0.302). In conclusion, voids in CSBSs may not reduce in size with aging; hence, SGPC should be carefully selected for suitable cases.
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Özdemir O, Koçak S, Hazar E, Sağlam BC, Coşkun E, Koçak MM. Dentinal tubule penetration of gutta-percha with syringe-mix resin sealer using different obturation techniques: A confocal laser scanning microscopy study. AUST ENDOD J 2021; 48:258-265. [PMID: 34259369 DOI: 10.1111/aej.12546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/13/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate dentinal tubule penetration of the root canal filling material using various techniques such as cold lateral compaction, new generation thermoplastic core carrier and continuous-wave obturation. The root canals of premolar teeth were instrumented, and the teeth were allocated randomly to three groups (n = 15/group). After the obturation with three different techniques, three sections of 2-mm thickness at 2, 5 and 8-mm from the apex were examined under a confocal laser scanning microscope. The data were analysed of variance with a significance level of P < 0.05. There was no significant difference between techniques when parameters were evaluated in total (penetration depth P = 0.418, penetration area P = 0.701). The mean value of the cold lateral compaction group for maximum penetration depth was obtained higher than continuous wave (P = 0.004), whilst there was no significant difference between the thermoplastic core carrier and the other groups.
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Affiliation(s)
- Olcay Özdemir
- Department of Pediatric Dentistry, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Ecehan Hazar
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Ezgi Coşkun
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Kharouf N, Zghal J, Addiego F, Gabelout M, Jmal H, Haikel Y, Bahlouli N, Ball V. Tannic acid speeds up the setting of mineral trioxide aggregate cements and improves its surface and bulk properties. J Colloid Interface Sci 2021; 589:318-326. [PMID: 33472151 DOI: 10.1016/j.jcis.2020.12.115] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/01/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022]
Abstract
HYPOTHESIS The setting time and mechanical properties of cements are a major technical concern for a long time in civil engineering. More recently those practical problems became a major concern for biomedical applications -in bone surgery and in dentistry- in particular concerning the setting time which should be minimized. The possibility to add organic additives to interact with the different constituting ions in cements constitutes a way to modify the setting kinetics. We made the assumption that a hydrolysable polyphenol like tannic acid could modify the setting time and the physical properties of Mineral Trioxide Aggregate (MTA). EXPERIMENTS Tannic acid is added in variable proportions to the water used to set MTA. The formation of the hybrid organic-mineral cements is investigated using a combination of structural, chemical and mechanical methods. X-ray tomography was also used to investigate the changes in porosity and pore size distribution upon incorporation of tannic acid in MTA based cements. The hydrophilicity of the cements was evaluated by measuring the permeation kinetics of small water droplets. FINDINGS We found that tannic acid allowed to reduce markedly the setting time of MTA based cements. The obtained cements have an increased hydrophilicity and display excellent resistance to compression. The number of pores but not the average pore size is also affected. The possible roles of tannic acid in modifying the cement properties are discussed.
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Affiliation(s)
- Naji Kharouf
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Jihed Zghal
- ICube Laboratory, University of Strasbourg- CNRS, 2 rue Boussingault, 67000 Strasbourg, France; ECAM Strasbourg Europe, 2 Rue de Madrid, 67300 Schiltigheim, France
| | - Frédéric Addiego
- Luxembourg Institute of Science and Technology (LIST), Department Materials Research and Technology (MRT), ZAE Robert Steichen, 5 Rue Bommel, L-4940 Hautcharage, Luxembourg
| | - Manon Gabelout
- R&D/Innovation, ITENA CLINICAL, 31 Avenue Georges Clemenceau, 93420 Villepinte, France
| | - Hamdi Jmal
- ICube Laboratory, University of Strasbourg- CNRS, 2 rue Boussingault, 67000 Strasbourg, France
| | - Youssef Haikel
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France
| | - Nadia Bahlouli
- ICube Laboratory, University of Strasbourg- CNRS, 2 rue Boussingault, 67000 Strasbourg, France
| | - Vincent Ball
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg Cedex, France.
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Saltareli FM, Leoni GB, de Lima Ferraz Aguiar N, de Faria NS, Oliveira IR, Bachmann L, Raucci-Neto W. Apatite-like forming ability, porosity, and bond strength of calcium aluminate cement with chitosan, zirconium oxide, and hydroxyapatite additives. Microsc Res Tech 2020; 84:1192-1204. [PMID: 33351220 DOI: 10.1002/jemt.23678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/26/2020] [Accepted: 12/10/2020] [Indexed: 11/08/2022]
Abstract
This study evaluated the effect of chitosan, zirconium oxide, and hydroxyapatite on the apatite-like forming ability, porosity, and bond-strength of calcium-aluminate cements (C). Three hundred bovine root-slices were assigned to one of five groups, according to the material: MTA, C, C + chitosan (Cchi), C + zirconium oxide (Czio), and C + hydroxyapatite (Chap), and within each group, two subgroups, according to the immersion: deionized water or phosphate-buffered saline (PBS) up to 14 days. Assessments (n = 10) of apatite-like forming ability were performed using scanning-electron microscopy, energy-dispersive x-ray spectroscopy, Fourier-transform infrared spectroscopy, and x-ray diffraction. PBS was evaluated for pH and Ca2+ release (n = 10). Bond-strength was analyzed by push-out test (n = 10) and porosity by micro-CT (n = 10). Chemical and push-out data were analyzed by ANOVA and Tukey's tests (α = .05). Porosity data were analyzed by the Kruskal-Wallis and SNK tests (α = .05). Similar Ca/P ratios were observed between all groups (p > .05). The pH of MTA and Cchi were higher than that of other cements at d 3 and 6 (p < .05). Cchi had a higher release of Ca2+ up to 6 days (p < .05). All cements had lower porosity after PBS (p < .05). Cchi and Chap had similar porosity reduction (p > .05), and were higher than MTA, C, and Czio (p < .05). Cchi had higher bond-strength than the other groups (p < .05). PBS samples had higher bond-strength (p < .05). All cements had hydroxyapatite deposition and the chitosan blend had the lowest porosity and the highest bond-strength.
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Affiliation(s)
| | | | - Nayara de Lima Ferraz Aguiar
- School of Dentistry of Ribeirão Preto, Restorative Dentistry Department, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Ivone Regina Oliveira
- Institute for Research and Development, University of Vale do Paraíba, São José dos Campos, SP, Brazil
| | - Luciano Bachmann
- Physics Department, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Walter Raucci-Neto
- School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Milanovic I, Milovanovic P, Antonijevic D, Dzeletovic B, Djuric M, Miletic V. Immediate and Long-Term Porosity of Calcium Silicate-Based Sealers. J Endod 2020; 46:515-523. [PMID: 32094001 DOI: 10.1016/j.joen.2020.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 01/05/2020] [Accepted: 01/08/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Open pores between endodontic sealer and root canal walls present potential niches for bacterial growth and migration pathways. The aim was to assess the internal and external porosity of calcium silicate-based sealers and to ascertain the long-term effect of storage in simulated body fluid on sealer porosity. METHODS Sixteen single-rooted teeth were filled with gutta-percha and 1 of 4 root canal sealers: BioRoot RCS, EndoSequence BC, MTA Fillapex, or AH Plus. Obturated roots, stored in Hank's balanced salt solution, were scanned after 7 days and after 6 months by using micro-computed tomography at an isotropic resolution of 9.9 μm. Total, open, and closed porosity were calculated in the coronal, middle, and apical thirds. Data were statistically analyzed by using general linear model and paired t test (α = 0.05). RESULTS Significantly higher percentage of open than closed porosity was found in all groups. Initially, significantly greater open and total porosity were found for MTA Fillapex than for AH Plus. After 6 months, the percentage of open and total porosity increased in BioRoot RCS and MTA Fillapex and decreased in AH Plus and EndoSequence BC. Both initially and after storage, coronal region of all sealers had significantly greater total porosity than middle and apical regions, which were comparable. CONCLUSIONS None of the root fillings were void-free, with predominant open porosity persisting after long-term storage.
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Affiliation(s)
- Ivana Milanovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Antonijevic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Dzeletovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Miletic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
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Guerrero F, Berástegui E. Porosity analysis of MTA and Biodentine cements for use in endodontics by using micro-computed tomography. J Clin Exp Dent 2018; 10:e237-e240. [PMID: 29721224 PMCID: PMC5923892 DOI: 10.4317/jced.54688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/17/2018] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study is to compare the porosity of two repair cements, White ProRoot® MTA and Biodentine®. These samples were analyzed by using micro-computed microtomography. Material and Methods Sixteen samples were used in the study that were divided according to the composition of the materials used. White ProRoot® MTA (n = 8) and Biodentine® (n = 8) were the samples prepared according to the manufacturer’s instructions. They were placed in silicone molds of 5 ± 0.1mm in height and an internal diameter of 5 ± 0.1mm, 24 hours after its preparation, the samples were scanned through a micro-CT, the porosity results were analyzed statistically by independent “t” tests. Results It is evident that Biodentine® has better porosity properties than ProRoot® MTA. The results of the study quantify a smaller number of pores per surface, a smaller volume in each pore per mm3 and a lower total porosity present in samples of Biodentine® unlike ProRoot® MTA samples which is larger in both. Conclusions The results obtained in computerized microtomography endodontic biomaterial samples concluded that Biodentine® has a lower porosity than ProRoot® MTA. Key words:Porosity, microleakage, micro-CT, endodontic cements.
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Affiliation(s)
- Fabricio Guerrero
- DDS, MS, PhD Student, Department of Odonto-Stomatology, Faculty of Dentistry, University of Barcelona
| | - Esther Berástegui
- MD, DDS, PhD, Professor of Endodontic, Department of Odonto-Stomatology, Faculty of Dentistry, University of Barcelona
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Ortiz FG, Jimeno EB. Analysis of the porosity of endodontic sealers through micro-computed tomography: A systematic review. J Conserv Dent 2018; 21:238-242. [PMID: 29899623 PMCID: PMC5977769 DOI: 10.4103/jcd.jcd_346_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Endodontic treatments have as their objective the appropriate sealing of the space caused by the root canal, providing a complete seal of the canal in all dimensions, creating an airtight seal against fluids. Thus, endodontic cements must possess physical properties such as solubility and long-term dimensional stability. An electronic search in the main endodontic magazines using appropriate keywords to identify studies that investigated the porosity of endodontic materials using micro-computed tomography. Of the 125 studies researched, 16 fulfilled the criteria for inclusion. Four studies analyzed the porosity of endodontic cements specifically. Twelve studies investigated and compared different techniques of root canal obturation and the repercussions from the lowering of porosity in the interior of the endodontic cement. The presence of porosity inside the endodontic cement is a constant in the treatments of root canals, even now when there is a great variety of endodontic cements.
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Affiliation(s)
- Fabricio Guerrero Ortiz
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
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Huang Y, Celikten B, de Faria Vasconcelos K, Ferreira Pinheiro Nicolielo L, Lippiatt N, Buyuksungur A, Jacobs R, Orhan K. Micro-CT and nano-CT analysis of filling quality of three different endodontic sealers. Dentomaxillofac Radiol 2017; 46:20170223. [PMID: 28845679 PMCID: PMC5965939 DOI: 10.1259/dmfr.20170223] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/23/2017] [Accepted: 08/07/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate voids in different root canal sealers using micro-CT and nano-CT, and to explore the feasibility of using nano-CT for quantitative analysis of sealer filling quality. METHODS 30 extracted mandibular central incisors were randomly assigned into three groups according to the applied root canal sealers (Total BC Sealer, Sure Seal Root, AH Plus) by the single cone technique. Subsequently, micro-CT and nano-CT were performed to analyse the incidence rate of voids, void fraction, void volume and their distribution in each sample. RESULTS Micro-CT evaluation showed no significant difference among sealers for the incidence rate of voids or void fraction in the whole filling materials (p > 0.05), whereas a significant difference was found between AH Plus and the other two sealers using nano-CT (p < 0.05). All three sealers presented less void volume in the apical third; however, higher void volumes were observed in the apical and coronal thirds in AH Plus using micro-CT (p < 0.05), while nano-CT results displayed higher void volume in AH Plus among all the sealers and regions (p < 0.05). CONCLUSIONS Bioactive sealers showed higher root filling rate, lower incidence rate of voids, void fraction and void volume than AH Plus under nano-CT analysis, when round root canals were treated by the single cone technique. The disparate results suggest that the higher resolution of nano-CT have a greater ability of distinguishing internal porosity, and therefore suggesting the potential use of nano-CT in quantitative analysis of filling quality of sealers.
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Affiliation(s)
| | | | | | | | - Nicholas Lippiatt
- BIOMATEN and Department of Biotechnology, Middle East Technical University, Ankara, Turkey
| | - Arda Buyuksungur
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Kaan Orhan
- Department of DentoMaxillofacial Radiology, Ankara University, Ankara, Turkey
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