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Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Influence of bioceramic sealers on dentinal tubule penetration and antimicrobial effectiveness: a systematic review and meta-analysis of in vitro studies. Odontology 2024; 112:672-699. [PMID: 38374511 DOI: 10.1007/s10266-024-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate whether bioceramic sealers have better penetration capacity in dentinal tubules and antimicrobial activity when compared to AH Plus® sealer. This SRM was recorded in the Open Science Framework database and followed the guidelines of the PRISMA 2020. Five databases were searched by two independent reviewers. Only in vitro studies that evaluated the effects of bioceramic sealers on dentinal tubule penetration and antimicrobial activity outcomes compared to AH Plus® sealer were included. Meta-analysis was conducted using R software, using the effect measure of the standardized mean difference (SMD) and inverse variance method. A modified Joanna Briggs Institute's Checklist was used for the risk of bias assessment. A total of 1486 studies were identified, and only 54 studies that fulfilled our eligibility criteria were included in this review. There was no statistical difference between the sealers evaluated for dentinal tubule penetration, in the thirds evaluated: coronal SMD 0.58 [0.14; 1.31], p = 0.12; middle SMD 0.07 [0.54; 0.39], p = 0.75; and apical SMD 0.08 [0.73; 0.56], p = 0.80. Both sealers demonstrated similar antimicrobial action (SMD [3.42; 5.32], p = 0.67 and SMD 0.67 [1.89; 0.55], p = 0.28). The studies presented a low risk of bias. Based on the in vitro studies included and according to the limitations of the present review, the data suggest that bioceramic and AH Plus® sealers present similar penetration capacity in dentinal tubules and antimicrobial effect, making them suitable materials to be considered in clinical practice.
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Affiliation(s)
- Marcelo Augusto Seron
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
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Banci HA, Strazzi-Sahyon HB, Bento VAA, Sayeg JMC, Bachega MDO, Pellizzer EP, Sivieri-Araujo G. Influence of antimicrobial photodynamic therapy on the bond strength of endodontic sealers to intraradicular dentin: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2022; 41:103270. [PMID: 36596331 DOI: 10.1016/j.pdpdt.2022.103270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/17/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin. METHODS This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05). RESULTS Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome. CONCLUSION It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
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Affiliation(s)
- Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Mateus Cavalaro Sayeg
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Mariana de Oliveira Bachega
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
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Bolbolian M, Hamzei A, Mohammadi N, Tofangchiha M. Evaluation of dentin penetration of three different endodontic sealers in the presence and absence of the smear layer. Folia Med (Plovdiv) 2022; 64:953-960. [PMID: 36876563 DOI: 10.3897/folmed.64.e66695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/04/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION A sealer's ability to effectively and stably penetrate the dentinal tubules is an essential factor for selecting an effective root canal obturation material. Evaluation of the sealers' penetration into the dentinal tubules provides valuable data in the endodontic treatment outcome.
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Penetration of Three Endodontic Sealers in Simulated Lateral Canals during the Lateral Condensation Technique: An In Vitro Study. Int J Dent 2022; 2022:2686247. [PMID: 36440093 PMCID: PMC9683939 DOI: 10.1155/2022/2686247] [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: 09/10/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to compare the penetration depths of AH Plus, BioRoot RCS, and GuttaFlow 2 into simulated lateral canals when used with the cold gutta-percha lateral compaction technique. Materials and Methods Twelve resin training blocks (4 canals perch each resin block) were used. Each primary artificial canal had two lateral canals (apical and coronal). The main canals were instrumented with WaveOne Gold and irrigated with distilled water. The resin blocks were divided into three groups (N = 4 each/16 artificial canals), according to the type of root canal sealer; Group I: AH Plus, Group II: BioRoot RCS, and Group III: GuttaFlow 2. All canals were obturated with the cold lateral condensation technique. The linear extension of each endodontic sealer into the apical and coronal lateral canals was measured using a digital stereomicroscope and measuring software. Data were statistically analyzed using a one-way analysis of variance. The percentages of filling of the lateral canals were calculated and statistically compared using the Mann–Whitney test. Results The experimental sealers exhibited variable penetration depths into the lateral canals. All sealers showed significantly better penetration ability into the apical lateral canals than the coronal lateral canals (P < 0.05). AH Plus (3.184 ± 0.012 mm/99.5%) and GuttaFlow 2 (3.176 ± 0.017 mm/99.25%) were significantly better than BioRoot RCS (3.096 ± 0.026 mm/96.75%) in filling the apical lateral canals (P < 0.05). BioRoot RCS was the best sealer to fill coronal lateral canals (3.322 ± 0.085 mm/83.05%). Conclusion During the lateral condensation technique, the filling of the lateral canals is affected by the type of root canal sealer and the location of the lateral canals All the sealers tested have a good ability to fill the apical lateral, while BioRoot RCS was effective in filling both the coronal and apical lateral canals.
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Santos ASD, de Sá MAB, Duarte MAH, Horta MCR, Silveira FF, Nunes E. Endodontic cement penetration after removal of calcium hydroxide dressing using XP-endo finisher. Braz Oral Res 2022; 36:e068. [PMID: 36507755 DOI: 10.1590/1807-3107bor-2022.vol36.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 02/02/2022] [Indexed: 12/15/2022] Open
Abstract
We aimed to evaluate the penetration of endodontic cement following the removal of calcium hydroxide (Ca(OH)2) dressing using the XP-endo Finisher in association with different irrigating solutions. Sixty premolars were instrumented and applied with a Ca(OH)2 dressing. To remove Ca(OH)2, the teeth were divided into six groups, each with a different volume of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as solution stirring time with XP-endo Finisher (0, 30, and 60 sec). Root canals were filled using the lateral condensation technique. Fluorescein dye was added to the cement for microscopic laser scanning analysis. In the generated images, linear measurements were taken in micrometers, and their averages were calculated. To analyze the perimeter penetration ratio of the cement, the total perimeter of the canal and the segment of the total perimeter of the canal where the endodontic cement penetrated into the dentinal tubules were measured in micrometers. We found that using an XP-endo Finisher in irrigation was more effective than using a needle and syringe during the extension and penetration of endodontic cement. Shaking with XP-endo Finisher with 17% EDTA increased the extent and perimeter of the penetration of the endodontic cement into the dentinal tubules. However, using the XP-endo Finisher with EDTA only was more efficient than using the instrument interchangeably in NaOCl and EDTA. Although XP-endo Finisher contributes to the removal of Ca(OH)2, none of the protocols or instruments used removed all Ca(OH)2 from the root system.
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Affiliation(s)
- Alyssa Sales Dos Santos
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Maria Aparecida Barbosa de Sá
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Marco Antônio Húngaro Duarte
- Universidade de São Paulo - USP, School of Dentistry of Bauru, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Martinho Campolina Rebello Horta
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Frank Ferreira Silveira
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Eduardo Nunes
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
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Keskin G, Çiloğlu M. Efficacy of antimicrobial photodynamic therapy and Er,Cr:YSGG laser-activated irrigation on dentinal tubule penetration of MTA-based root canal sealer: a confocal microscopy study. Photodiagnosis Photodyn Ther 2021; 36:102584. [PMID: 34666196 DOI: 10.1016/j.pdpdt.2021.102584] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) and laser-activated irrigation (LAI) are adjunctive therapies developed to enhance the effectiveness of root canal disinfection. Sealer penetration into dentinal tubules is significant for preventing re-infection, and the sealer's penetration ability is affected by the chemo-mechanical preparation of the root canal. This study aimed to evaluate the efficacy of aPDT and LAI on dentinal tubule penetration of MTA-based root canal sealer. METHODS Forty single-rooted mandibular premolars were divided into four groups (n = 10): control, methylene blue 50 mg/L (MB50), curcumin 500 mg/L (C500), and Er,Cr:YSGG and sodium hypochlorite (LAI). The smear removal efficiency of the groups on intraradicular dentin was evaluated with a scanning electron microscope (SEM). Confocal laser scanning microscopy (CLSM) was performed to determine the depth of penetration of MTA Fillapex into dentinal tubules. Data were analyzed statistically. RESULTS The maximum penetration depth of the C500 group was significantly higher than that of the other groups in all three levels of root sections (p<0.05). Regarding mean penetration depth, the highest values were obtained from the C500 group. However, there was no statistically significant difference between the C500 and MB50 groups in the middle and coronal thirds of the root (p>0.05). The LAI group showed the lowest penetrated area percentage in the middle and coronal third of the root (p<0.05). The C500 and LAI groups were more effective in removing the smear layer than the control and MB50 groups. CONCLUSION aPDT could enhance the penetration of MTA-based root canal sealer into dentin tubules.
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Affiliation(s)
- Gül Keskin
- Department of Pediatric Dentistry, Gaziantep University, Gaziantep 27310, Turkey.
| | - Mehmet Çiloğlu
- Department of Pediatric Dentistry, Gaziantep University, Gaziantep 27310, Turkey
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Caceres C, Larrain MR, Monsalve M, Peña-Bengoa F. Dentinal Tubule Penetration and Adaptation of Bio-C Sealer and AH-Plus: A Comparative SEM Evaluation. Eur Endod J 2021; 6. [PMID: 34047295 PMCID: PMC8461482 DOI: 10.14744/eej.2020.96658] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare and evaluate the dentinal tubule penetration and adaptation of a premixed bioceramic sealer and an epoxy-resin based sealer in the three radicular thirds. METHODS 30 wide roots, with single straight canals and totally formed apexes, were endodontically prepared and divided into two groups (n=14) according to the sealer used for root canal filling: AH-Plus (AHP) and Bio-C Sealer (BIOC). Two samples were left as controls. After the canals were filled, the samples were cut and viewed under Scanning Electron Microscopy by taking images to analyse the tubular penetration and adaptation of the sealers. The results were statistically analysed with the Shapiro Wilk, Levene and Mann-Whitney tests (P<0.05). RESULTS BIOC showed significantly higher penetration in dentinal tubules than AHP in the cervical, middle and apical thirds of the root canal (P<0.05) and better adaptation to the dentinal tubule walls. CONCLUSION Under the parameters of this study, BIOC exhibits higher penetration and better adaptation to the dentinal tubules compared to AHP.
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Affiliation(s)
- Carolina Caceres
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Maria Rosa Larrain
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Macarena Monsalve
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Fernando Peña-Bengoa
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
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Could the Calcium Silicate-Based Sealer Presentation Form Influence Dentinal Sealing? An In Vitro Confocal Laser Study on Tubular Penetration. MATERIALS 2021; 14:ma14030659. [PMID: 33572611 PMCID: PMC7867024 DOI: 10.3390/ma14030659] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 12/14/2022]
Abstract
Dentinal tubule penetration influences root canal treatment sealing. The aim of this study was to compare dentinal penetration of two clinical presentations of silicate-based sealers using confocal laser. Sixty single-rooted human teeth from 50-70 year-old patients extracted for orthodontic/periodontal reasons were used. Canals were prepared using Mtwo system up to 35/0.04, with 5.25% NaOCl irrigation and final irrigation using 17% EDTA. Teeth were randomly assigned into study groups (ni = 20): EndoSequence BC sealer (ES, group 1), BioRoot RCS (BR, group 2); and a control group (nc = 20) with AH Plus (AHP). Root canals were obturated with 35/0.04 gutta-percha (single-cone technique). The samples were obtained from apical, middle, and coronal thirds. Dentinal tubule penetration depth and percentage of penetration around the canal perimeter were measured. The statistical analysis was performed using Mann Whitney U test and Wilcoxon t-test (95% confidence interval). ES exhibited a significantly higher penetration than AHP in apical and middle thirds (p < 0.05), and in middle and coronal thirds relative to BR (p < 0.05). The percentage of penetration around the canal perimeter was significantly higher for ES compared to BR in all thirds, but only in the apical third for AHP (p < 0.05). The pre-mixed silicate-based sealer exhibited better penetration than the powder/liquid one.
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da Silva Machado AP, Câncio Couto de Souza AC, Lima Gonçalves T, Franco Marques AA, da Fonseca Roberti Garcia L, Antunes Bortoluzzi E, Acris de Carvalho FM. Does the ultrasonic activation of sealer hinder the root canal retreatment? Clin Oral Investig 2021; 25:4401-4406. [PMID: 33392803 DOI: 10.1007/s00784-020-03752-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate if the ultrasonic activation of sealer hinders the root canal retreatment. MATERIALS AND METHODS Thirty mandibular premolars were prepared using the ProTaper Universal system (Dentsply) until the instrument F3 (0.30/0.09). The canals were distributed into 2 groups (n = 15), according to the filling technique: NUact group - sealer without ultrasonic activation + gutta-percha cones and Uact group - sealer with ultrasonic activation + gutta-percha cones. The canals were re-instrumented with Largo burs, followed by the instrument R50 (0.50/0.05) of the Reciproc system. The time required to perform re-instrumentation was recorded (s). The roots were longitudinally cleaved, and the total area of root canal and remaining filling material were quantified (%). The ANOVA test was applied to the data and complemented by Student's t test (P < 0.05). RESULTS Uact group had higher percentage of remaining filling material than NUact group (P < 0.05). When the root thirds were considered, there was statistically significant difference only for Uact group at the apical third (P < 0.05). There was no difference between groups regarding the time required to perform re-instrumentation (P > 0.05). CONCLUSIONS Ultrasonic activation of sealer leads to a higher percentage of remaining filling material attached to the root canal walls. However, it did not affect the retreatment time. CLINICAL SIGNIFICANCE Ultrasonic activation increases sealer penetration into dentinal tubules, improving its resistance to dislodgement. However, there is no scientific evidence to prove if ultrasonic activation of sealer hinders its removal when root canal retreatment is necessary.
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Affiliation(s)
| | | | | | - André Augusto Franco Marques
- Superior School of Health Sciences, State University of Amazonas, Manaus, AM, Brazil
- School of Dentistry, Federal University of Amazonas, Manaus, AM, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil.
| | - Eduardo Antunes Bortoluzzi
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
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Furtado TC, de Bem IA, Machado LS, Pereira JR, Só MVR, da Rosa RA. Intratubular penetration of endodontic sealers depends on the fluorophore used for CLSM assessment. Microsc Res Tech 2020; 84:305-312. [PMID: 32914923 DOI: 10.1002/jemt.23589] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/31/2020] [Accepted: 08/26/2020] [Indexed: 11/11/2022]
Abstract
Root canal filling aims at eliminating empty spaces into the root canal system using biologically compatible materials. Three-dimensional root canal obturation must prevent or minimize the reinfection caused by microorganisms' leakage. This study aimed at evaluating whether fluorophore (Rhodamine or Fluo-3) influences the CLSM images of intratubular penetration of four endodontic sealers. Eighty bovine teeth were prepared using K files up to a size #70 and irrigated with 2.5% sodium hypochlorite. All roots were divided into eight groups (n = 10) according to the sealer and fluorophore used: AH Plus/Rhodamine, AH Plus/Fluo-3, Sealer Plus/Rhodamine, Sealer Plus/Fluo-3, Sealer Plus BC/Rhodamine, Sealer Plus BC/Fluo-3, Endosequence/Rhodamine, and Endosequence/Fluo-3. All roots were filled using cold lateral compaction technique. After 7 days, the roots were transversely sectioned, and three slices, one of each canal third, were obtained. Intratubular penetration was evaluated using CLSM. Sealer Plus BC/Rhodamine and Endosequence BC/Rhodamine presented higher intratubular penetration than AH Plus/Fluo-3 and Sealer Plus/Fluo-3 (p ˂ .05). The intragroup analysis showed similar intratubular penetration, regardless of the root third, except for the apical third in AH Plus/Fluo-3 and Sealer Plus BC/Fluo-3 groups. The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones using CLSM. Bioceramic sealers should not be used associated with Rhodamine for CLSM evaluation. RESEARCH HIGHLIGHTS: The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones when CLSM is used for assessment. Bioceramic sealers should not be used associated with Rhodamine.
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Affiliation(s)
- Taiane Correa Furtado
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Igor Abreu de Bem
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Silveira Machado
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jefferson Ricardo Pereira
- Department of Prosthodontics, School of Dentistry, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Marcus Vinícius Reis Só
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Eymirli A, Uzunoğlu Özyürek E, Serper A. Sealer penetration: effect of separated file's cross-section, taper and motion characteristics. Clin Oral Investig 2020; 25:1077-1084. [PMID: 32562075 DOI: 10.1007/s00784-020-03404-3] [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: 11/10/2019] [Accepted: 06/10/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The separated root canal instruments may affect the quality of root canal filling, hence the success of endodontic treatment. The aim of this study was to evaluate the effects of separated file fragments of nickel-titanium rotary systems with different cross-section, taper and motion characteristics on the apical sealer penetration in oval-shaped root canals via confocal laser scanning microscope (CLSM). MATERIALS AND METHODS Distal roots of 60 mandibular molars with oval-shaped root canals were randomly divided into 4 groups as follows: group 1, FlexMaster Nickel Titanium Rotary File System (NTRFS) (separated instrument: 30/.06); group 2, ProTaper Next NTRFS (X3); group 3, ProTaper Universal NTRFS (F3); group 4, Revo-S NTRFS (AS30/.06). Root canals were filled with gutta-percha and AH plus labelled with 0.1% rhodamine B using a warm vertical compaction technique. Each specimen was horizontally sectioned at 1st, 3rd and 5th mm from apical foramen. Amount of maximum and average penetration depths, penetration percentage and sealer penetrated area were measured and analysed with one-way repeated measures of ANOVA and the Bonferroni post hoc tests. p < 0.05 was considered significant. RESULTS The penetration depth, percentage and penetrated area of the sealer increased from apical to coronal in all systems. The maximum and average penetration depths and penetration areas were higher in FlexMaster and Revo-S groups at the 3rd mm (p < 0.05). At the 5th mm, the Revo-S group had a higher penetration percentage, when compared with ProTaper Next and ProTaper Universal groups (p < 0.05). CONCLUSIONS In the 1st mm, separated fragments of any system did not allow the penetration of the sealer, while it was observed that the files with constant taper showed more positive results in terms of sealer penetration at apical 3rd and 5th mm. CLINICAL RELEVANCE In the presence of a separated file, the taper of the file might significantly affect the amount of penetrated sealer into the dentinal tubules as compared with the cross-section and motion characteristics of the file.
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Affiliation(s)
- Ayhan Eymirli
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
| | - Ahmet Serper
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
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Brezhnev A, Neelakantan P, Tanaka R, Brezhnev S, Fokas G, Matinlinna JP. Antibacterial Additives in Epoxy Resin-Based Root Canal Sealers: A Focused Review. Dent J (Basel) 2019; 7:E72. [PMID: 31266165 PMCID: PMC6784478 DOI: 10.3390/dj7030072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 01/16/2023] Open
Abstract
Dental materials used in root canal treatment have undergone substantial improvements over the past decade. However, one area that still remains to be addressed is the ability of root canal fillings to effectively entomb, kill bacteria, and prevent the formation of a biofilm, all of which will prevent reinfection of the root canal system. Thus far, no published review has analysed the literature on antimicrobial additives to root canal sealers and their influence on physicochemical properties. The aim of this paper was to systematically review the current literature on antimicrobial additives in root canal sealers, their anti-fouling effects, and influence on physicochemical properties. A systematic search was performed in two databases (PubMed and Scopus) to identify studies that investigated the effect of antimicrobial additives in epoxy resin-based root canal sealers. The nature of additives, their antimicrobial effects, methods of antimicrobial testing are critically discussed. The effects on sealer properties have also been reviewed. A total of 31 research papers were reviewed in this work. A variety of antimicrobial agents have been evaluated as additives to epoxy resin-based sealers, including quaternary ammonium compounds, chlorhexidine, calcium hydroxide, iodoform, natural extracts, antibiotics, antifungal drugs, and antimicrobial agent-functionalised nanoparticles. Antimicrobial additives generally improved the antimicrobial effect of epoxy resin-based sealers mainly without deteriorating the physicochemical properties, which mostly remained in accordance with ISO and ANSI/ADA specifications.
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Affiliation(s)
- Alexander Brezhnev
- Applied Oral Sciences-Dental Materials Science, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Prasanna Neelakantan
- Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Ray Tanaka
- Applied Oral Sciences-Oral and Maxillofacial Radiology, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Sergey Brezhnev
- Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - George Fokas
- Department of Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Jukka P Matinlinna
- Applied Oral Sciences-Dental Materials Science, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Yanpiset K, Banomyong D, Chotvorrarak K, Srisatjaluk RL. Bacterial leakage and micro-computed tomography evaluation in round-shaped canals obturated with bioceramic cone and sealer using matched single cone technique. Restor Dent Endod 2018; 43:e30. [PMID: 30135849 PMCID: PMC6103543 DOI: 10.5395/rde.2018.43.e30] [Citation(s) in RCA: 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: 01/21/2018] [Accepted: 05/27/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. MATERIALS AND METHODS Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. RESULTS All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. CONCLUSIONS In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.
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Affiliation(s)
- Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kanet Chotvorrarak
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Prasad PK, Sankhala A, Tiwari A, Parakh S, Madan GR, Singh A. Influence of ultrasonics on the penetration depth of AH plus, acroseal, and EndoREZ root canal sealers: An in vitro study. J Conserv Dent 2018; 21:221-225. [PMID: 29674829 PMCID: PMC5890417 DOI: 10.4103/jcd.jcd_406_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study is to evaluate the effect of ultrasonic activation on the penetration depth of AH Plus, Acroseal, and EndoREZ sealers into dentinal tubules using Confocal laser microscopy. Methods A total of 60 single-rooted teeth were prepared and divided into three groups on the basis of the type of sealer used (G1: AH Plus, G2: Acroseal and G3:EndoREZ). Each group was further subdivided into two equal subgroups on the basis of ultrasonic activation of sealers and nonactivation. Teeth were obturated and coronally sealed with GIC. Horizontal sections at 2 mm, 4 mm, and 6 mm from the apex were obtained, and the depth of sealer penetration into the dentinal tubules was measured using confocal laser scanning microscopy. Statistical analysis was performed using Students unpaired t-test, ANOVA, and Tukey's multiple comparison test. Results Within the three groups, ultrasonically activated subgroups showed significantly (P < 0.05) higher depth of sealer penetration. Among the groups, Group 1 showed significantly (P < 0.05) higher depth of sealer penetration than Group 2 and Group 3 while the difference between Group 2 and Group 3 was not significant (P > 0.05). Conclusion The use of ultrasonic activation with AH Plus sealer showed better results.
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Affiliation(s)
- P Krishna Prasad
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Abhishek Sankhala
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Aastha Tiwari
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Shrikant Parakh
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Gagan R Madan
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Ankita Singh
- Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
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Arikatla SK, Chalasani U, Mandava J, Yelisela RK. Interfacial adaptation and penetration depth of bioceramic endodontic sealers. J Conserv Dent 2018; 21:373-377. [PMID: 30122816 PMCID: PMC6080176 DOI: 10.4103/jcd.jcd_64_18] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Sealers play an important role in the success of root canal treatment. The efficacy of root canal sealer is enhanced by its tubular penetration and adaptation properties. Aim The aim of this study is to evaluate the interfacial adaptation and penetration depth of Bioroot RCS and MTA Plus sealers to root dentin. Materials and Methods A total of 60 single-rooted mandibular premolar teeth were prepared using Pro Taper rotary Ni-Ti files and were randomly divided into three groups (n = 20 each) according to the type of sealer used for obturation. After obturation with lateral condensation, half of the samples in each group (n = 10 each) were sectioned transversely for measuring tubular depth penetration under confocal laser scanning microscopy. Longitudinal sections were obtained for remaining half samples to evaluate the adaptation of sealer using scanning electron microscope. Data were analyzed using two-way ANOVA and Tukey post hoc tests. Statistical Analysis Used Data were analyzed using two-way ANOVA and Tukey post hoc tests. Results AH Plus sealer has shown significantly higher depth of penetration and minimum gaps than bioceramic sealers (P < 0.05) MTA Plus sealer exhibited significantly more interfacial gaps and less penetration depth than Bioroot RCS (P < 0.05). Conclusions At all root regions, AH plus sealer exhibited minimum gaps and more tubular penetration whereas MTA Plus sealer exhibited more gaps and less penetration.
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Affiliation(s)
- Sampath Kumar Arikatla
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Uma Chalasani
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Rajiv Kumar Yelisela
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Menezes M, Prado M, Gomes B, Gusman H, Simão R. Effect of photodynamic therapy and non-thermal plasma on root canal filling: analysis of adhesion and sealer penetration. J Appl Oral Sci 2017; 25:396-403. [PMID: 28877278 PMCID: PMC5595112 DOI: 10.1590/1678-7757-2016-0498] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/09/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and non-thermal plasma (NTP) on adhesion and sealer penetration in root canals. Material and Methods Sixty single-rooted premolars were used. The teeth were prepared using a crown-down technique. NaOCl and EDTA were used for irrigation and smear layer removal, respectively. The root canals were divided into three groups: control, PDT, and NTP. After treatments, the roots were filled using gutta-percha and either AH Plus (AHP) or MTA Fillapex (MTAF) sealers. Samples were sectioned at 4, 8, and 12 mm from the apex (1-mm slices)and analyzed by the push-out bond strength test (adhesion) and confocal laser scanning microscopy (sealer penetration). Data were statistically evaluated using Kruskal-Wallis, Dunn’s, and Spearman’s tests. Results Regarding AHP, bond strength was similar in the NTP group and in the control group, but significantly lower in the PDT group. As to MTAF, both therapies showed lower values than the control group. In the confocal analysis of AHP, maximum and mean penetration, and penetrated area were statistically higher in the control group than in the PDT and NTP groups. Penetrated perimeter was similar among groups. Regarding MTAF, all parameters yielded better results in the NTP than in the control group. The PDT and control groups showed similar results except for penetrated area. Conclusion PDT and plasma therapy affected the adhesion and sealer penetration of root canals filled with AH Plus and MTA Fillapex and there is no positive correlation between adhesion and sealer penetration.
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Affiliation(s)
- Marilia Menezes
- Universidade Federal do Rio de Janeiro, Departamento de Engenharia Metalúrgica e de Materiais, Rio de Janeiro, RJ, Brasil
| | - Maíra Prado
- Universidade Federal do Rio de Janeiro, Departamento de Engenharia Metalúrgica e de Materiais, Rio de Janeiro, RJ, Brasil
| | - Brenda Gomes
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Área de Endodontia, Piracicaba, SP, Brasil
| | - Heloisa Gusman
- Universidade Federal do Rio de Janeiro, Departamento de Clínica Odontológica, Área de Endodontia, Rio de Janeiro, RJ, Brasil
| | - Renata Simão
- Universidade Federal do Rio de Janeiro, Departamento de Engenharia Metalúrgica e de Materiais, Rio de Janeiro, RJ, Brasil
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Cruz ATG, Grecca FS, Piasecki L, Wichnieski C, Westphalen VPD, Carneiro E, Fariniuk LF, Neto UXDS. Influence of the Calcium Hydroxide Intracanal Dressing on Dentinal Tubule Penetration of Two Root Canal Sealers. Eur Endod J 2017; 2:1-6. [PMID: 33403323 PMCID: PMC7757940 DOI: 10.5152/eej.2017.16032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/16/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to evaluate the effect of a calcium hydroxide (CH) dressing on the tubular penetration of two endodontic sealers, AH Plus (Dentsply Maillefer, Ballaigues, Switzerland) and MTA Fillapex (Angelus, Londrina, Brazil). Methods Seventy-two mandibular premolars with a single root canal were prepared with ProFile.04 rotary instruments (Dentsply Maillefer) and divided into four groups. In two groups, an intracanal CH dressing was placed for 15 days. The obturations were performed with lateral condensation of gutta-percha in combination with one of the tested sealers. The roots were transversely sectioned at the apical and middle levels. The percentage of sealer penetration in the root canal walls and the percentage of impregnated dentin area in the transverse sections were obtained using confocal laser scanning microscopy. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Games-Howell test. Results The CH dressing reduced the mean value of tubular penetration in the middle third of teeth obturated with AH Plus (P<0.01), whereas no difference was observed at the apical sections for both sealers. Conclusion The CH dressing did not interfere with the apical penetration of both tested sealers, however, decreased the tubular penetration in the middle third of the AH Plus root canal fillings. Overall, MTA Fillapex presented higher tubular penetration than AH Plus obturations.
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Affiliation(s)
| | - Fabiana Soares Grecca
- Department of Endodontics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, University of Buffalo, New York, USA
| | - Caroline Wichnieski
- Department of Endodontics, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | | | - Everdan Carneiro
- Department of Endodontics, Pontifical Catholic University of Paraná, Curitiba, Brazil
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Baldasso FER, Kopper PMP, Morgental RD, Steier L, Figueiredo JAPD, Scarparo RK. Biological Tissue Response to a New Formulation of a Silicone Based Endodontic Sealer. Braz Dent J 2016; 27:657-663. [DOI: 10.1590/0103-6440201600719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 10/06/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract Satisfactory biological behavior is a necessary requirement for clinical application of endodontic materials. In this study, the connective tissue responses to silicone (GuttaFlow 2), epoxy resin (AH Plus) and zinc oxide and eugenol (Endofill) based sealers were compared. Twelve Wistar rats had polyethylene tubes (four per animal) containing one of the tested sealers and empty tubes (negative control) implanted in their subcutaneous tissue. The tubes were randomly placed 2 cm from the spine and at least 2 cm apart from one another. Tissue samples with implants were processed for histological analysis after 7 or 60 days (n=6 animals per period). Inflammatory cells, fibrous condensation and abscess were scored according to their intensity. Friedman, followed by Dunn's post hoc, was used to compare sealers. Differences between the two experimental periods were verified using Mann-Witney U test (p<0.05). At 7 days, most of the histological parameters showed no significant differences amongst groups. Endofill group scored higher than the others for giant cells (o<0.05) and promoted a greater number of samples presenting abscess formation. GuttaFlow 2 tended to show a less intense inflammatory infiltrate compared to the other materials. At 60 days, there were no significant differences between groups in most of the histological parameters evaluated. However, it was observed that Endofill scored higher for macrophages (p<0.05) compared to the control group, and GuttaFlow 2 tended to present lower scores than the others for neutrophils and abscess. GuttaFlow 2 showed proper biological behavior and should be considered adequate for clinical practice.
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