1
|
Fristad I, Haug S, Bårdsen A. Biological properties versus solubility of endodontic sealers and cements. Biomater Investig Dent 2024; 11:40863. [PMID: 38903777 PMCID: PMC11187977 DOI: 10.2340/biid.v11.40863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Endodontic sealers and cements used in root canal treatment have different compositions and properties. Common to all materials is that their primary goal is to fill gaps and voids, making a permanent seal of the root canal system. Furthermore, aspects such as antibacterial properties, cytotoxicity, setting time, solubility and biocompatibility are also crucial and ought to be considered. Over the years, a shift in the view on the importance of these aspects has ocurred. Whereas the antibacterial properties were considered important when the technical factors in endodontics were less developed, the sealing ability and biocompatibility have later been considered the most critical factors. The introduction of tricalcium silicate cements and sealers has led to a renewed interest in material properties, as these cements seem to have good sealing ability and at the same time combine favourable antimicrobial effects with excellent biocompatibility. This review discusses how the various properties of root canal sealers and cements may conflict with the primary aim of providing a permanent seal of the root canal system.
Collapse
Affiliation(s)
- Inge Fristad
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Sivakami Haug
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| |
Collapse
|
2
|
Chang PJ, Chen MS, Cheng CH, Chiou YJ, Chen CY, Su CY, Lin CK. Effects of Calcination Temperature on the Synthesis of One-Pot Sol-Gelled Barium Titanate Powder and Its Performance as an Endodontic Radiopacifier. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2701. [PMID: 38893964 PMCID: PMC11173394 DOI: 10.3390/ma17112701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
Barium titanate (BaTiO3, BTO), conventionally used for dielectric and ferroelectric applications, has been assessed for biomedical applications, such as its utilization as a radiopacifier in mineral trioxide aggregates (MTA) for endodontic treatment. In the present study, BTO powders were prepared using the sol-gel process, followed by calcination at 400-1100 °C. The X-ray diffraction technique was then used to examine the as-prepared powders to elucidate the effect of calcination on the phase composition and crystalline size of BTO. Calcined BTO powders were then used as radiopacifiers for MTA. MTA-like cements were investigated to determine the optimal calcination temperature based on the radiopacity and diametral tensile strength (DTS). The experimental results showed that the formation of BTO phase was observed after calcination at temperatures of 600 °C and above. The calcined powders were a mixture of BaTiO3 phase with residual BaCO3 and/or Ba2TiO4 phases. The performance of MTA-like cements with BTO addition increased with increasing calcination temperature up to 1000 °C. The radiopacity, however, decreased after 7 days of simulated oral environmental storage, whereas an increase in DTS was observed. Optimal MTA-like cement was obtained by adding 40 wt.% 1000 °C-calcined BTO powder, with its resulting radiopacity and DTS at 4.83 ± 0.61 mmAl and 2.86 ± 0.33 MPa, respectively. After 7 days, the radiopacity decreased slightly to 4.69 ± 0.51 mmAl, accompanied by an increase in DTS to 3.13 ± 0.70 MPa. The optimal cement was biocompatible and verified using MG 63 and L929 cell lines, which exhibited cell viability higher than 95%.
Collapse
Affiliation(s)
- Pei-Jung Chang
- Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 106, Taiwan;
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
| | - May-Show Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chi-Han Cheng
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Yuh-Jing Chiou
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
- Department of Chemical Engineering and Biotechnology, Tatung University, Taipei 104, Taiwan
| | - Chin-Yi Chen
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
- Department of Materials Science and Engineering, Feng Chia University, Taichung 407, Taiwan
| | - Cherng-Yuh Su
- Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 106, Taiwan;
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
- Department of Mechanical Engineering, National Taipei University of Technology, Taipei 106, Taiwan
| | - Chung-Kwei Lin
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (M.-S.C.); (Y.-J.C.); (C.-Y.C.)
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan;
| |
Collapse
|
3
|
Penha ESD, Filho NADF, Medeiros LADMD, Rosendo RA, Silva MADD, Barbosa WT, García-Carrodeguas R, Rodríguez MA, Münchow EA, Lacerda-Santos R, Fook MVL. Analysis of Tissue Repair of a New Cement Based on Calcium and Strontium Aluminates: A Triple-Blinded, Randomized, Controlled Trial in an Animal Model. Eur J Dent 2024. [PMID: 38776981 DOI: 10.1055/s-0044-1786875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The focus of this triple-blind randomized study was to evaluate the biocompatibility of a new root canal filling sealer (RCFS) based on tristrontium aluminate and dodecacalcium hepta-aluminate in living tissue. MATERIAL AND METHODS Forty-five Wistar rats (Rattus norvegicus) were divided into three groups: control (polyethylene), sealer (Bio-C Sealer, Londrina, PR, Brazil), and experimental (tristrontium aluminate and dodecacalcium hepta-aluminate). The tissues were analyzed under an optical microscope to assess different cellular events at different time intervals (7, 15, and 30 days). STATISTICAL ANALYSIS Data were analyzed using the Kruskal-Wallis and Dunn (p < 0.05) tests. RESULTS In the initial period, a moderate inflammatory infiltrate was observed, similar between the endodontic cements groups (p = 0.725). The intensity of the infiltrate decreased with time, with no significant difference among the groups (p > 0.05). The number of young fibroblasts was elevated in all groups evaluated at 7 days. The experimental group showed the highest number of cells at all time intervals, but the difference with the sealer group at 7 (p = 0.001) and 15 days (p = 0.002) and the control group at 30 days was not significant (p = 0.001). Regarding tissue repair events, the amount of collagen fibers increased over the experimental intervals, with no significant difference between the sealer and control groups (p > 0.05). CONCLUSION The experimental RCFS based on calcium and strontium aluminates proved to be biocompatible for use in close contact with periapical tissue, inducing a low inflammatory reaction and favoring rapid tissue repair.
Collapse
Affiliation(s)
- Elizandra Silva da Penha
- Department of Dentistry, Dental School, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | | | | | - Rosana Araújo Rosendo
- Department of Dentistry, Dental School, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | | | - Willams Teles Barbosa
- SENAI Institute of Innovation (ISI) in Forming and Joining (CIMATEC ISI F&J), Salvador, Bahia, Brazil
| | | | | | - Eliseu Aldrighi Münchow
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Marcus Vinícius Lia Fook
- Department of Materials Engineering, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
| |
Collapse
|
4
|
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.
Collapse
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
| | | | | |
Collapse
|
5
|
Radwanski M, Rozpedek-Kaminska W, Galita G, Siwecka N, Sokolowski J, Majsterek I, Özcan M, Lukomska-Szymanska M. Cytotoxicity and genotoxicity of bioceramic root canal sealers compared to conventional resin-based sealer. Sci Rep 2024; 14:4124. [PMID: 38374199 PMCID: PMC10876547 DOI: 10.1038/s41598-024-54726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
The aim of this study was to evaluate cytotoxicity and genotoxicity of calcium-silicate based sealers and comparing them with a gold standard-an epoxy-based sealant. Two experimental cell lines were used, gingival fibroblasts (hGF) and monocyte/macrophage peripheral blood cell line (SC). The cytotoxicity (XTT assay) and genotoxicity (comet assay) were evaluated both after 24-h and 48-h incubation. Additionally, after 48-h incubation, the cell apoptosis and cell cycle progression was detected. BioRoot Flow induced a significant decrease in hGF cells viability compared to the negative control groups both after 24-h (p < 0.001) and 48-h incubation (p < 0.01). In group with SC cells, after 24-h incubation significant increase in cells viability was detected for AH Plus Bioceramic Sealer in comparison to negative control (p < 0.05). BioRoot Flow and BioRoot RCS can be considered potentially genotoxic for the hGF cells after 48-h incubation (> 20% DNA damage). BioRoot Flow and BioRoot RCS, may have potential genotoxic effects and induce apoptosis in hGF cells which may irritate periapical tissues, resulting in a delayed healing. The findings of the study would be useful in selection of an appropriate sealant for root canal filling without causing cytotoxicity and genotoxicity.
Collapse
Affiliation(s)
| | | | - Grzegorz Galita
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Natalia Siwecka
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Mutlu Özcan
- Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213, Lodz, Poland.
| |
Collapse
|
6
|
Cintra LTA, Cantiga-Silva C, Banci HA, Faria FD, da Silva Machado NE, Cardoso CDBM, de Oliveira PHC, Estrela LRDA, Sivieri-Araujo G, Berbert FLCV, Garcia AJA, Leonardo RDT. Influence of photoactivation on tissue response to different dyes used in photodynamic therapy and laser ablation therapy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 251:112843. [PMID: 38262341 DOI: 10.1016/j.jphotobiol.2024.112843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
Laser ablation therapy (LA) uses Indocyanine Green dye (ICG) which efficiently absorbs laser energy and the increased temperature results in an instantaneous flame that chars tissue and microbes. Photodynamic therapy (PDT) uses different dyes that are activated by light to kill bacteria. This study evaluated the biocompatibility of the dye Curcumin (CUR), Methylene Blue (MB), and Indocyanine Green (ICG) before and after laser activation (ACT). Polyethylene tubes containing one of the dyes were implanted in the subcutaneous tissue of 32 rats (4 tubes per rat) which were divided into 8 groups: C - control (saline solution); C + ACT (Red Laser 660 nm); CUR; CUR + ACT (480 nm blue LED); MB; MB + ACT (Red Laser 660 nm); ICG; ICG + ACT (810 nm Infrared Laser). After 7 and 30 days (n = 8/time), the rats were euthanized and the tubes with the surrounding tissue were removed and processed for histological analysis of inflammation using H&E stain, and collagen fiber maturation using picrosirius red (PSR). A two-way analysis of variance statistical test was applied (p < 0.05). At 7 days, regardless of laser activation, the CUR group showed a greater inflammatory infiltrate compared to the ICG and control groups, and the MB group had a greater inflammation only in relation to the control (p < 0.05). At 30 days, CUR and MB groups showed a greater inflammatory infiltrate than the control (p < 0.05). ICG group was equal to the control in both periods, regardless of the laser activation (p > 0.05). Laser activation induced the proliferation of collagen immature fibers at 7 days, regardless of the dye (p < 0.05). The CUR group showed a lower percentage of immature and mature fibers at 7 days, compared to ICG and control (p < 0.05) and, at 30 days, compared to control (p < 0.05). Regardless of laser activation, the ICG showed the results of collagen maturation closest to the control (p > 0.05). It was concluded that all dyes are biocompatible and that laser activation did not interfere with biocompatibility. In addition, the maturity of collagen was adequate before and after the laser activation. These results demonstrate that the clinical use of dyes is safe even when activated with a laser.
Collapse
Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | | | | | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| |
Collapse
|
7
|
Al-Askary RA, AL-Ashou WM, Al-Jubori SH. Remineralization ability of different root canal sealers. Saudi Dent J 2023; 35:1014-1022. [PMID: 38170034 PMCID: PMC10759546 DOI: 10.1016/j.sdentj.2023.08.004] [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: 06/14/2023] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 01/05/2024] Open
Abstract
Aims This research was designed to contrast the biocompatibility and remineralization ability of different sealers (BioRoot, MTA-FillApex and GuttaFlow-Bioseal). Method Twenty rabbits were used in this study, they were randomly divided into 4 groups equally depending on the observation time"3,7,14, and 28 days" post-implantation. Each rabbit was generally anesthetized,"7cm"long incision was made on the skin of the right and left sides of the ventral aspect of the mandible of each rabbit, 4 bony cavities of approximately"5mm"in depth and"2mm"in diameter (2 cavities on the left side and 2 cavities on the right side of mandible of each rabbit) were made in the cortical surface of the buccal alveolar bone. The sealers mixed depend on manufactural instructions and immediately insert into the prepared cavities (in the right side the BioRoot and MTA-FillApex were placed while on the left side, GuttaFlow-Bioseal was placed in one cavity and the other cavity was left unfilled as control).The same volume of each sealer was placed in the corresponding cavity using disposable syringes. After each observation period, the animals were sacrificed and bone biopsy from the tested area was taken and examined histologically using Olympus light microscopy at"400X"magnification. Results The obtained data were analyzed through non-parametric statistical tests using SPSS software version"22".Kruskal-Wallis test and Mann - Whitney test were utilized at"0.05"levels of significance to evaluate the results. GuttaFlow-Bioseal displayed excellent biocompatibility in comparison to other groups indicated by low inflammatory tissue reaction at all evaluation intervals. While the BioRoot group represented better osteo-conductivity although statistically not significant than GuttaFlow-Bioseal group. Conclusion BioRoot and GuttaFlow-Bioseal showed higher osteo-conductivity and biocompatibility than MTA-FillApex. However, all sealer used in this study were well tolerated by bone tissue and might accelerate bone repair.
Collapse
Affiliation(s)
- Raghad A Al-Askary
- Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Wiaam M.O. AL-Ashou
- Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Sawsan H. Al-Jubori
- Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| |
Collapse
|
8
|
Melo ADP, de Rosatto CMP, Ferraz DC, de Souza GL, Moura CCG. Evaluation of Cytotoxicity, Cell Attachment, and Elemental Characterization of Three Calcium Silicate-Based Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6705. [PMID: 37895687 PMCID: PMC10608491 DOI: 10.3390/ma16206705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
We investigated three calcium silicate-based sealers with respect to their chemical characterization, cytotoxicity, and attachment to RAW264.7 cells. BioRoot RCS (BR), Bio-C Sealer (BC), and Sealer Plus BC (SPBC) were assessed using Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence spectroscopy (XRF), and energy-dispersive X-ray spectroscopy (EDX) (n = 4) for elemental characterization, and using scanning electron microscopy (SEM) to evaluate cell morphology and adhesion. Cytotoxicity was determined at different dilutions (1:1, 1:2, and 1:5) using the succinate dehydrogenase activity (MTT assay). Statistical analysis was performed for normal distribution using the Shapiro-Wilk test and for homoscedasticity using Levene's test, and one-way ANOVA, Tukey's/Dunnett's post hoc tests for cell viability and XRF (α = 0.05). Calcium silicate hydrate and calcium hydroxide were detected by FTIR in all groups. EDX detected a higher calcium content for BR and SPBC and aluminum only in the premixed sealers. XRF detected the highest calcium release in BR (p < 0.05). The surface morphology showed irregular precipitates for all the sealers. SPBC at a 1:2 dilution resulted in the lowest cell viability compared to BR (p < 0.05) and BC (p < 0.05). The calcium silicate-based sealers produced a statistically significant reduction in cellular viability at a 1:1 dilution compared to the control group (p < 0.0001). All the sealers maintained viability above 70%.
Collapse
Affiliation(s)
| | | | | | | | - Camilla Christian Gomes Moura
- Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia 38405-318, MG, Brazil; (A.d.P.M.); (C.M.P.d.R.); (D.C.F.); (G.L.d.S.)
| |
Collapse
|
9
|
Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Victorino FR, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Postoperative pain after root canal filling with bioceramic sealers: a systematic review and meta-analysis of randomized clinical trials. Odontology 2023; 111:793-812. [PMID: 37378833 DOI: 10.1007/s10266-023-00830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to assess postoperative pain (PP) after endodontic treatment with bioceramic root canal sealer compared to AH Plus® sealer. This SRM was carried out in accordance with the items on the PRISMA 2020 checklist and Cochrane guidelines and registered in PROSPERO (CRD42021259283). Only randomized clinical trials (RCTs) were included. Meta-analysis was conducted using R software, the standardized means difference (SMD) measure of effect was calculated for quantitative variables, and the odds ratio (OR) for binary variables. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Qualitative and quantitative analysis included 18 and 17 studies, respectively. For quantitative variables, the bioceramic root canal sealer presented less occurrence of postoperative pain than the AH Plus® sealer in 24 h (SMD - 0.17 [- 0.34; - 0.01], p = 0.0340). For binary variables, there was no difference observed between the sealers evaluated, except for sealer extrusion where the bioceramic group had lower post-filling material extrusion (OR 0.52 [0.32; 0.84], p = 0.007). Regarding the risk of bias analysis, low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence ranged from moderate to low. The results showed that bioceramics sealers reduced postoperative endodontic pain only after 24 h and showed less sealer extrusion compared to the AH Plus® sealer. However, more robust and standardized clinical trials are needed to confirm the results with less heterogeneity and higher quality of evidence.
Collapse
Affiliation(s)
- Marcelo Augusto Seron
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gabriel Pereira Nunes
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, 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
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Luciano Tavares Angelo Cintra
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gustavo Sivieri-Araujo
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
dos Santos GSB, Carvalho CN, Tavares RRDJ, Silva PGDB, Candeiro GTDM, Maia EM. Tissue repair capacity of bioceramic endodontic sealers in rat subcutaneous tissue. Braz Dent J 2023; 34:25-32. [PMID: 37466522 PMCID: PMC10355271 DOI: 10.1590/0103-6440202305161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 03/07/2023] [Indexed: 07/20/2023] Open
Abstract
This study aimed to evaluate the tissue repair capacity of four bioceramic endodontic sealers by quantifying type I and III collagen fibers. The following sealers were tested: EndoSequence BC Sealer (Brasseler, Brasseler, Savannah, USA), Bio C Sealer (Angelus, Londrina, Brazil), Bioroot RCS (Septodont, Santa Catarina, Brazil), and Sealer Plus BC (MKLife, Porto Alegre, Brazil). Polyethylene tubes 1.5 mm in diameter and 1 cm in length containing the endodontic sealers were implanted in the subcutaneous tissue of five rats (Rattus norvegicus albinus, Wistar lineage). After 14 days, the animals were euthanized, and collagen fibers were quantified from the histological tissue sections. Given a non-normal distribution of the data, a gamma regression with log link function was employed and implemented through the generalized linear models module, was used to test whether there was a significant difference between the sealers. The pairwise comparison was performed using Least significant difference. There were significant differences between the sealers for type I (p=0.001), type III (p=0.023), and total collagen (p=0.002). Overall, Bioroot sealer was statistically superior to the other sealers, except in the analysis of type III collagen, in which there was no difference between the Bioroot sealer and Bio C Sealer sealer and the control group (p>0.05). Bioroot RCS bioceramic endodontic sealer stimulates a greater production of collagen.
Collapse
|
12
|
Tedesco M, Vitali FC, Bortoluzzi EA, Garcia LDFR, Teixeira CDS. Analysis of physicochemical properties of endodontic sealers containing rhodamine B. J Mech Behav Biomed Mater 2023; 140:105699. [PMID: 36753848 DOI: 10.1016/j.jmbbm.2023.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The use of fluorescent dyes in microscopy studies is frequent. Therefore, it is important to investigate whether these compounds may alter the physicochemical properties of materials in which they are incorporated to avoid methodological biases. This study evaluated the physicochemical properties of two endodontic sealers containing dry or diluted rhodamine B. Six groups were evaluated: AH Plus and MTA Fillapex in their original composition and mixed with 0.1% dry or diluted rhodamine. Push-out test was applied to assess the bond strength to root dentin. ANSI-ADA No. 57 and ISO No. 6876:2012 specifications were followed to evaluate flowability, setting time, and solubility of the sealers. pH changes were assessed after 24 h, 7, and 30 days. Intergroup comparisons were analyzed by ANOVA complemented by Tukey's post-hoc test; comparisons among periods were analyzed by Wilcoxon and Friedman tests. The incorporation of dry rhodamine decreased the bond strength and prolonged the setting time of AH Plus. The incorporation of diluted rhodamine decreased the setting time and increased the flowability of MTA Fillapex. Diluted rhodamine promoted pH reduction of AH Plus after 24 h and dry rhodamine after 7 days. Rhodamine incorporation promoted pH reduction after 30 days for MTA Fillapex. Solubility was not affected. In conclusion, the incorporation of diluted rhodamine changed the properties of MTA Fillapex, and the incorporation of dry rhodamine changed the properties of AH Plus. Previous dilution of rhodamine did not severely compromise the physicochemical properties of AH Plus and may be suggested to assess its penetrability.
Collapse
Affiliation(s)
- Maybell Tedesco
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, School of Dentistry, University of Louisville, Louisville, KY, USA
| | | | | |
Collapse
|
13
|
Janini ACP, Pelepenko LE, Boldieri JM, dos Santos VAB, da Silva NA, Raimundo IM, Gomes BPFA, Marciano MA. Biocompatibility analysis in subcutaneous tissue and physico-chemical analysis of pre-mixed calcium silicate–based sealers. Clin Oral Investig 2023; 27:2221-2234. [PMID: 36977761 DOI: 10.1007/s00784-023-04957-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To evaluate the biocompatibility, physical and chemical properties of three pre-mixed calcium silicate-based sealers and an epoxy resin-based material were assessed. Pre-mixed sealers supposedly obtain water from the root canal moist to hydrate and set. MATERIALS AND METHODS Polyethylene tubes were filled with the materials Bio-C Sealer Ion+, Bio-C Sealer, EndoSequence BC Sealer and AH Plus Jet, or left empty and surgically implanted in the subcutaneous tissue of Wistar rats. The animals were euthanised and the tubes and tissue were removed for histological analysis and scanning electron microscopy (SEM) coupled with energy-dispersive spectrometry (EDS). Materials' surface chemical characterisation was assessed using Raman spectroscopy and SEM/EDS. Flow, setting time (in two conditions), solubility, radiopacity and pH were also analysed. ANOVA and Bonferroni correction were performed for comparisons (P < 0.05). RESULTS Inflammatory response observed in the tissues subsided from 7 to 30 days. Tungsten migration could be detected in the surrounding tissue following AH Plus Jet implantation. All calcium silicate-based sealers exhibited zirconium oxide (radiopacifier) and tricalcium silicate peaks before and after implantation. All materials exhibited flow values above 17 mm. An approximately tenfold difference was observed between the plaster- and metal-mould setting times of the calcium silicate cements indicating its sensitivity to moist variations and solubility above 8% was also observed for these materials. CONCLUSIONS Pre-mixed materials exhibited variable setting time and solubility with a decreasing inflammatory response. CLINICAL RELEVANCE The variable moist-dependant setting time with high solubility poses a concern for the clinical use of these pre-mixed sealers.
Collapse
|
14
|
Martorano AS, Messias NS, Bighetti-Trevisan RL, de Oliveira PT, de Castro Raucci LMS, Raucci Neto W. In vitro inflammatory modulation of bioceramic endodontic sealer in macrophages stimulated by bacterial lipopolysaccharide. Int Endod J 2023; 56:213-226. [PMID: 36314853 DOI: 10.1111/iej.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
AIM To evaluate the effects of AH Plus (Dentsply), Sealer 26 (Dentsply), and Sealer Plus BC (Produtos Médicos e Odontológicos) on cytotoxicity and inflammation in macrophage cultures exposed to bacterial lipopolysaccharide (LPS). METHODOLOGY After initial setting, the sealers were conditioned with serum-free culture medium for 24 h (1 ml/cm2 ). Macrophages from the RAW 264.7 strain were exposed to sealer extracts in a 1:16 ratio in a culture medium with or without LPS. Cell morphology, viability, mitochondrial activity, oxidative stress and gene expression of interleukin 1β (IL-1β) and tumour necrosis factor-alpha (TNF-α) were evaluated. Data on mitochondrial activity, oxidative stress and TNF-α were analysed using a two-way analysis of variance (anova) test, followed by the Student-Newman-Keuls post-test. IL-1β data were analysed using one-way anova, followed by SNK, and the t-test was used for intragroup comparison. The significance level was set at 5%. RESULTS In the absence of LPS, only AH Plus and Sealer 26 showed a reduction in cell density, while in the presence of LPS, Sealer 26 had the lowest density compared to the other groups. In terms of mitochondrial activity, at 24 and 48 h, Sealer Plus BC had significantly higher mean values than Sealer 26 and AH Plus (p < .05). Sealer 26 exhibited the lowest levels of oxidative stress and IL-1β and TNF-α expression, regardless of the presence of LPS (p < .05). CONCLUSIONS Although all sealers interfere with the response of macrophages to LPS, contact with epoxy resin-based sealers can impair cell activity in vitro, while bioceramic sealer seems to favour the inflammatory functions of these cells.
Collapse
|
15
|
da Silva AR, Bortoluzzi EA, Vitali FC, Bolan M, Cardoso M. Evaluation of pH and calcium ions release of two tricalcium silicate-based sealers through roots of primary teeth. J Conserv Dent 2023; 26:42-46. [PMID: 36908737 PMCID: PMC10003284 DOI: 10.4103/jcd.jcd_355_21] [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: 07/06/2021] [Revised: 09/06/2021] [Accepted: 10/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background This study aimed to evaluate the pH and calcium ions (Ca2+) release from two tricalcium silicate-based sealers (Sealer Plus BC and Bio-C Pulpecto) through roots of primary teeth. Methods Forty root canals of primary incisors were prepared and distributed into four groups according to the filling material: GPlusBC (Sealer Plus BC); GBioC (Bio-C Pulpecto); GUltra (Ultracal); and GC (no filled). pH measurement was performed with a digital pH meter, and the Ca2+ release was measured in an atomic absorption spectrophotometer at baseline, 24 h and 1, 2, 3, and 4 weeks later. The data were analyzed using two-way ANOVA and Tukey's post hoc tests. Results The results did not reveal significant differences between the groups in terms of pH in 24 h, 1-, and 2-weeks' periods. After 4 weeks, there was a significant difference, with the highest mean pH values in GUltra, followed, respectively, by GPlusBC and GBioC. Regarding the Ca2+ release, the GUltra showed greatest mean values at all evaluated times, and the other groups showed no difference between them. Conclusion Both sealers were able to promote the elevation of the pH and Ca2+ release through roots of primary teeth, which brings favorable properties for their use as a filling material.
Collapse
Affiliation(s)
- Apoliana Reis da Silva
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | - Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Michele Bolan
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| |
Collapse
|
16
|
Benetti F, Ferreira LL, Dos Reis-Prado AH, Faria FD, Ervolino E, Berbert FLCV, Leonardo RDT, Dias J, Gomes-Filho JE, Cintra LTA. Interleukin-6, tumor necrosis factor-α, and CD5 immunolabeling of new experimental endodontic sealer and repair material. Odontology 2023; 111:93-104. [PMID: 35751826 DOI: 10.1007/s10266-022-00723-7] [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: 03/03/2022] [Accepted: 06/07/2022] [Indexed: 01/06/2023]
Abstract
The aim of this study was to evaluate the biocompatibility and immunoinflammatory response of the Sealepox and Sealepox-RP, based on interleukin (IL)-6, tumor necrosis factor (TNF)-α, and CD5 immunolabelling. The ProRoot MTA (PRMTA) was used for comparison. Polyethylene tubes (1.0-mm internal, 1.6-mm external diameter, and 10.0-mm length; ISO 10993) with or without (control) materials were randomly implanted in the dorsum of 35 rats (4 per rat). After 7, 15, 30, 60, and 90 days (n = 7), the tubes were removed for histological and immunohistochemical analysis. The Kruskal-Wallis and Dunn's test for non-parametric data and, ANOVA and Tukey test for parametric data were used (P < 0.05). Hematoxylin and eosin staining revealed that the concentration of inflammatory cells decreased over time with no differences between groups in all periods (P > 0.05). Regarding IL-6 immunostaining, there was no difference at 7 days (P > 0.05); all groups decreased over time, being faster for the PRMTA group and also, with no differences between groups in the last period (P > 0.05). For TNF-α, at 7 days there was no difference between groups (P > 0.05); there was an increase at 15 days for PRMTA and, at 30 and 60 days, for PRMTA and Sealepox compared to the control (P < 0.05). At 90 days, Sealepox RP showed the lowest immunostaining being similar to the control (P > 0.05). Regarding CD5 cells, at 7 days, there was high immunostaining for PRMTA compared to the control (P < 0.05); and significant reduction over time with difference for all groups at 30 and 60 days. (P < 0.05); Sealepox was similar to the control in all periods (P > 0.05). Sealepox RP showed the highest immunostaining at 15 days, being different from the control and PRMTA (P < 0.05); in the other periods it was similar to the control (P > 0.05). It can be concluded that Sealepox and Sealepox-RP were biocompatible and demonstrated similar immunoinflammatory response regarding IL-6, TNF-α, and CD5 compared to PRMTA.
Collapse
Affiliation(s)
- Francine Benetti
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Luciana Louzada Ferreira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Alexandre Henrique Dos Reis-Prado
- Department of Restorative Dentistry, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Flávio Duarte Faria
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP, Brazil
| | - João Dias
- University Institute Egas Moniz (IUEM), Monte de Caparica, Almada, Portugal
| | - João Eduardo Gomes-Filho
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), R: José Bonifácio, 1193. Vila Mendonça, Araçatuba, São Paulo, Brazil. .,School of Dentistry, Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| |
Collapse
|
17
|
Estrela C, Cintra LTA, Duarte MAH, Rossi-Fedele G, Gavini G, Sousa-Neto MD. Mechanism of action of Bioactive Endodontic Materials. Braz Dent J 2023; 34:1-11. [PMID: 36888836 PMCID: PMC10027099 DOI: 10.1590/0103-6440202305278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/06/2023] [Indexed: 03/08/2023] Open
Abstract
A continuous search for bioactive materials capable of supporting the replacement of damaged pulp tissue, with effective sealing potential and biocompatibility, has represented the attention of studies over the last decades. This study involves a narrative review of the literature developed by searching representative research in PUBMED/MEDLINE and searches in textbooks associated with the mechanism of action of bioactive materials (calcium hydroxide, mineral trioxide aggregate (MTA), and calcium silicate cements). The reflective analysis of the particularities of the chemical elements of these materials, considering the tissue and antibacterial mechanism of action, allows a better understanding of the characteristics and similarities in their tissue responses. Calcium hydroxide paste remains the antibacterial substance of choice as intracanal dressing for the treatment of root canal system infections. Calcium silicate cements, including MTA, show a favorable biological response with the stimulation of mineralized tissue deposition in sealed areas when in contact with connective tissue. This is due to the similarity between the chemical elements, especially ionic dissociation, the potential stimulation of enzymes in tissues, and the contribution towards an alkaline environment due to the pH of these materials. The behavior of bioactive materials, especially MTA and the new calcium silicate cements in the biological sealing activity, has been shown to be effective. Contemporary endodontics has access to bioactive materials with similar properties, which can stimulate a biological seal in lateral and furcation root perforations, root-end fillings and root fillings, pulp capping, pulpotomy, apexification, and regenerative endodontic procedures, in addition to other clinical conditions.
Collapse
Affiliation(s)
- Carlos Estrela
- School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | | | - Giulio Gavini
- School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
18
|
Radwanski M, Leski M, Puszkarz AK, Sokolowski J, Hardan L, Bourgi R, Sauro S, Lukomska-Szymanska M. A Micro-CT Analysis of Initial and Long-Term Pores Volume and Porosity of Bioactive Endodontic Sealers. Biomedicines 2022; 10:biomedicines10102403. [PMID: 36289666 PMCID: PMC9599172 DOI: 10.3390/biomedicines10102403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/21/2022] Open
Abstract
The evaluation of the porosities within the interface of root canals obturated with endodontics materials is extremely important for the long-term success of endodontic treatments. The aim of this study was to compare initial and long-term volume of pores (total, open, closed) and porosity (total, regional) of three bioactive endodontic sealers: GuttaFlow Bioseal, Total Fill BC Sealer, and BioRoot RCS. Root canals were obturated with three “bioactive” sealers using the single-cone technique. The volume of open and closed pores and porosity were calculated using a micro-computed tomography (MCT) method. The measurements were performed after 7 days (initial) and after 6 months (long-term) of incubation. Statistical significance was considered at p < 0.05. The total volume of pores remained unchanged after the 6-month storage. GuttaFlow Bioseal exhibited significantly higher long-term volume in open pores than Total Fill BC Sealer. The total porosity in all the tested sealers presented no statistically significant change after the 6-month storage, except for BioRoot RCS. The total porosity values of this latter material significantly increased after long-term incubation, especially in the apical region. In conclusion, the use of bioactive sealers with excessive tendency to create porosities both in shorth- and long-term periods of storage may compromise the long-term success of endodontic treatments.
Collapse
Affiliation(s)
- Mateusz Radwanski
- Department of Endodontics, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Michal Leski
- Department of Endodontics, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Adam K. Puszkarz
- Institute of Material Science of Textiles and Polymer Composites, Faculty of Material Technologies and Textile Design, Lodz University of Technology, 116 Żeromskiego Street, 90-924 Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrera C/Del Pozo ss/n, Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
- Correspondence: ; Tel.: +48-605-721-200 or +48-426-757-429
| |
Collapse
|
19
|
Maharti ID, Suprastiwi E, Agusnar H, Herdianto N, Margono A. Characterization, Physical Properties, and Biocompatibility of Novel Tricalcium Silicate-Chitosan Endodontic Sealer. Eur J Dent 2022; 17:127-135. [PMID: 36063844 PMCID: PMC9949928 DOI: 10.1055/s-0042-1745774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE The purpose of this study was to compare the characteristics, physical properties, and biocompatibility of the novel tricalcium silicate-chitosan (TCS-C) sealer with AH Plus and Sure-Seal Root. MATERIALS AND METHODS The TCS-C powder was prepared by mixing tricalcium silicate with 2% water-soluble chitosan at a 5:1 ratio, followed by sufficient addition of 10 g/mL ratio of double-distilled water to form a homogeneous cement. Material characterizations (the Fourier Transform InfraRed [FTIR] and X-ray diffraction [XRD]), physical property investigations (flow and film thickness), and cytotoxicity tests in 3T3 mouse embryo fibroblast cell (MTT assay method) were performed on sealers, and the results were compared with those of the commercial products. STATISTICAL ANALYSIS Statistical analysis was performed on flow and film thickness. The normality of the data was tested using the Shapiro-Wilk test. Statistical analysis was performed with one-way analysis of variance (ANOVA). The level of significance was set at p < 0.05. RESULTS The TCS-C showed a mean flow of 31.98 ± 0.68 mm, compared with Sure Seal Root at 26.38 ± 0.69 mm and AH Plus at 26.50 ± 0.12 mm. The TCS-C showed a mean film thickness of 60 ± 10.0 mm compared with Sure-Seal Root at 50 ± 10.0 mm and AH Plus at 40 ± 15.8 mm. The TCS-C exhibited low to no cytotoxicity in fibroblast cell at all concentrations and exposure times. CONCLUSION Adding water-soluble chitosan may improve the physical and biologic properties of tricalcium silicate cement. The novel TCS-C sealer did not fully meet the physical properties of an endodontic sealer, but it was not cytotoxic to fibroblast cells.
Collapse
Affiliation(s)
- Ike D. Maharti
- Doctoral Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Endang Suprastiwi
- Department of Conservative Dentistry, Universitas Indonesia, Jakarta, Indonesia,Address for correspondence Endang Suprastiwi, drg., SpKG(K) Department of Conservative Dentistry, Faculty of Dentistry, Universitas IndonesiaJalan Salemba Raya 4, Jakarta 10430Indonesia
| | - Harry Agusnar
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Sumatera Utara, Medan, Indonesia
| | - Nendar Herdianto
- Research Center for Advanced Materials (PRMM-BRIN), Banten, Indonesia
| | - Anggraini Margono
- Department of Conservative Dentistry, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
20
|
Silva GFD, Coelho LAS, Costa VAS, Conti LC, Lima ACDA, Sodré GCDS, Martins MRL, Duarte MAH, Vivan RR. Laboratory study of tissue repair of resin-based endodontic sealers in critical surgical defects. J Appl Oral Sci 2022; 30:e20220108. [PMID: 35920449 PMCID: PMC9365338 DOI: 10.1590/1678-7757-2022-0108] [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: 03/11/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility.
Collapse
Affiliation(s)
| | - Letycia Accioly Simões Coelho
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Vanessa Abreu Sanches Costa
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Letícia Citelli Conti
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Ana Carolina de Almeida Lima
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Gabriela Cristina de Santi Sodré
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Mateus Rinaldi Lucio Martins
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Dentística, Endodontia e Materiais Odontológicos , Bauru , SP , Brasil
| |
Collapse
|
21
|
de Oliveira PHC, Gomes Filho JE, Rodrigues MJDS, da Silva CC, Cardoso CDBM, Cosme daSilva L, Ervolino E, Cintra LTA. Influence of supplement administration of omega-3 on the subcutaneous tissue response of endodontic sealers in Wistar rats. Int Endod J 2022; 55:1026-1041. [PMID: 35791796 DOI: 10.1111/iej.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
AIM Natural substances such as omega-3 have been used in the medical field due to their numerous properties and, in particular, modulating effect on the systemic and local inflammatory processes. Thus, this study evaluated the influence of omega-3 supplementation on the subcutaneous tissue response of endodontic sealers in Wistar Rats. METHODOLOGY Polyethylene tubes were implanted in the subcutaneous tissue of 48 animals (one empty for control and three filled with Sealapex, AH Plus or Endofill). The animals were treated with omega-3 (TO) or water (TW). Treatments started 15 days before implantation until euthanasia. After 5, 15 and 30 days (n = 8), animals were euthanized and polyethylene tubes and surrounding tissue were removed and processed for histological analysis. The inflammatory reaction was analysed by Haematoxylin and Eosin stain and immunolabelling for IL-6 and TNF-α. The collagen maturity was analysed by picrosirius red stain and calcium deposition by von Kossa stain and polarized light. Results were statistically analysed (p < .05). RESULTS Amongst TW sealer groups, Endofill evoked a more intense inflammatory infiltrate compared with AH Plus and control in the 30-day period (p = .009). However, in TO sealer groups, there was no difference amongst the sealers and control in all periods (p > .05). Comparing each sealer as a function of the supplementation with water or omega-3, there are differences for Endofill (p = .001) and Sealapex (p = .005) in the 30-day period, presenting lower inflammatory infiltrate in the animals treated with omega-3. A higher percentage of immature fibres was observed at 15 and 30 days in the TO group, compared with the TW group (p < .05). The deposition of calcium particles was observed only by Sealapex in all periods, despite the supplementation procedure. CONCLUSIONS Omega-3 supplementation influence the tissue reactions of endodontic sealers, modulating inflammation, the immunolabelling of IL-6 and TNF-α, the repair process and it does not interfere with calcium deposition.
Collapse
Affiliation(s)
- Pedro Henrique Chaves de Oliveira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - João Eduardo Gomes Filho
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Michael Júnio da Silva Rodrigues
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Cristiane Cantiga da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Carolina da Barros Moraes Cardoso
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Leopoldo Cosme daSilva
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil.,Department of Endodontics, School of Dentistry, Alagoas Federal University (UFAL), Maceió, Brazil
| | - Edilson Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil.,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil
| |
Collapse
|
22
|
Effect of Vitapex Combined with AH-Plus Paste on Inflammation in Middle-Aged and Elderly Patients with Periodontal-Endodontic Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7540961. [PMID: 35813417 PMCID: PMC9270133 DOI: 10.1155/2022/7540961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 02/05/2023]
Abstract
Aims. To investigate the effect of Vitapex combined with AH-plus paste on inflammation in middle-aged and elderly patients with periodontal-endodontic disease. Materials and Methods. A total of 80 teeth of middle-aged and elderly patients with the periodontal-endodontic disease who were treated in our hospital from June 2020 to June 2021 were selected as the research objects and were divided into comparison group and treatment group with 40 teeth each according to different treatment methods. Among them, the comparison group was filled with zinc oxide clove oil paste gutta-percha, and the treatment group was filled with Vitapex combined with AH-plus paste. The changes in apical cross-section sealing performance, periodontal pocket depth (PD), and gingival index (GI) of the two groups before treatment and after 6 months of follow-up were observed and compared, and X-ray analysis was performed. Results. There was no significant difference in the level of periodontal indexes and serum inflammatory indexes between the two groups before treatment (
). After treatment, the levels of PD, BI, PLI, and GI in the two groups were significantly lower than before treatment (
). The differences in IL-6, IL-10, TNF-α, and IL-1β after treatment were significant (
). There was no significant difference in the root canal area data of each cross-section between the two groups when the root canal was filled with root filling paste at different positions from the apex (
). After root canal filling with root canal paste, the cross-sectional area from different parts of the root canal in the treatment group was significantly smaller than comparison group (
). After 6 months of treatment, it was found that CEJ-BD and CEJ-AC in the treatment group were significantly lower than those in the comparison group (
). Conclusion. Vitapex combined with AH-plus paste filling can effectively treat middle-aged and elderly periodontal-endodontic disease, which provides a certain reference for the clinical treatment of middle-aged and elderly periodontal-endodontic disease.
Collapse
|
23
|
Rosatto CMPD, Souza GLD, Ferraz DC, Silva MJB, Tanomaru Filho M, Moura CCG. Physicochemical properties and osteoclastogenesis for three premixed calcium silicate-based sealers post set. Braz Oral Res 2022; 36:e065. [PMID: 36507752 DOI: 10.1590/1807-3107bor-2022.vol36.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Solubility, pH, ion release, cytotoxicity, and osteoclastogenesis inhibition in bone marrow-derived monocyte macrophages (BMMs) were evaluated in EndoSequence BC Sealer (END), Bio-C Sealer (BC), and Sealer Plus BC (SPBC). pH was determined after immersion of the sealers in deionized water (DW) and Minimum Essential Medium Alpha (α-MEM). Solubility was obtained by mass loss. Ion release was measured by using X-ray fluorescence spectroscopy (XRF). Cytotoxicity was evaluated by MTT assay. Inhibition of osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP). Data were analyzed using the t-test, ANOVA and Tukey/Dunnett's post-hoc tests (α = 0.05). END had the highest pH in DW (p < 0.05), and BC, in α-MEM (p < 0.05). Solubility in DW was the lowest for SPBC (p < 0.005). The highest calcium release was observed for BC in DW at 12 h (p < 0.05), and in α-MEM at 12 and 24 h (p < 0.05). The lowest toxicity was detected for END (p < 0.05). BC had the highest inhibitory effect on osteoclasts (p < 0.05). Overall, the highest solubility and pH values were found in DW. However, the calcium silicate-based sealer showed higher solubility than the ISO standards. Calcium release was the highest for BC. END showed the highest cell viability, and BC, the highest osteoclast inhibition.
Collapse
Affiliation(s)
| | - Gabriela Leite de Souza
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Endodontics, Uberlândia, MG, Brazil
| | - Danilo Cassiano Ferraz
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Marcelo José Barbosa Silva
- Universidade Federal de Uberlândia - UFU, Institute of Biomedical Sciences, Department of Immunology, Uberlândia, MG, Brazil
| | - Mario Tanomaru Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | |
Collapse
|
24
|
Padoin K, Bohrer TC, Ceolin LG, Bier CAS, Rosa RAD, Morgental RD. Does ultrasonic activation improve the bond strength and root canal filling quality of endodontic sealers? Braz Dent J 2022; 33:28-37. [PMID: 35766714 DOI: 10.1590/0103-6440202204728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the effect of ultrasonic activation (UA) of three endodontic sealers on the bond strength to root dentin and root canal filling quality. Ninety six bovine incisors were instrumented and root canal filling was carried out using AH Plus (AP), Sealer Plus (SP), or Sealer Plus BC (BC), with or without UA (n=16/group). Two 1.5-mm slices were obtained from each root third. The first slice was subjected to push-out testing and failure mode analysis, while the second was observed under a stereomicroscope for filling quality assessment. Data were analyzed by Kruskal-Wallis, Mann-Whitney and Friedman tests (α=0.05). SP showed higher bond strength and fewer voids than BC in the apical third and when root thirds data were pooled. SP also had higher bond strength compared with AH Plus in the apical third. UA improved the bond strength when BC was used but did not affect the filling quality of any sealer. There were no significant differences between the ultrasonically activated sealers regarding bond strength and filling quality. When root thirds were compared, the bond strength was similar along the root, but there was a tendency to worsen filling quality, with more voids, in the apical segment. In conclusion, UA was effective in increasing the bond strength of the calcium silicate-based sealer but did not improve its filling quality. For the epoxy resin-based sealers, these properties were not affected by UA.
Collapse
Affiliation(s)
- Karine Padoin
- Graduate Program in Dental Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Thais Camponogara Bohrer
- Graduate Program in Dental Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Lucas Galle Ceolin
- School of Dentistry, Federal University of Santa Maria(UFSM), Santa Maria, RS, Brazil
| | | | - Ricardo Abreu da Rosa
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | |
Collapse
|
25
|
Vieira FP, Gonini Júnior A, Piva E, Oliveira HDL, da Rosa WLDO, da Silva AF, Vitti RP, Zanchi CH, Cava SDS. Experimental resin-based dual-cured calcium aluminate and calcium titanate materials for vital pulp therapy. Braz Oral Res 2022; 36:e037. [PMID: 35293502 DOI: 10.1590/1807-3107bor-2022.vol36.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/03/2021] [Indexed: 11/22/2022] Open
Abstract
This paper evaluates the physicochemical and biological properties of experimental resin-based dual-cured calcium aluminate (CA) and calcium titanate (CTi) materials for vital pulp therapy (VPT). The experimental dual-cured materials were obtained as two pastes: a) Bis-EMA 10, PEG 400, DHEPT, EDAB, camphorquinone, and butylated hydroxytoluene; and b) fluoride ytterbium, Bis-EMA 10, Bis-EMA 30, benzoyl peroxide, and butylated hydroxytoluene. The materials were divided into six groups based on the added calcium component: MTA (MTA®, Angelus); CLQ (Clinker-Fillapex®, Angelus); CA (calcined at ,1200°C in pastes a and b); CA800 (calcined at 800°C in paste a); CA1200 (calcined at 1,200°C in paste a); and CTi (paste a). The real-time degree of conversion and rate of polymerization (n = 3), diametral tensile strength (n = 10), hydrogen potential (n = 15), calcium ion release (n = 10), water sorption and solubility (n = 10), and cell viability (n = 6) were evaluated. One- and two-way ANOVA and Tukey's post hoc test were used in the analysis of the parametric data, and Kruskal-Wallis and Dunn's multiple tests were used to analyze the nonparametric data (α = 0.05). CLQ, CA800 and CA1200 had the highest diametral tensile strength. The water solubility of MTA was similar to that of CA800, CA1200 and CTi. CA800 and CA1200 resulted in cell viabilities similar to those of MTA and CLQ. The experimental dual-cured CA-based material that calcined at 800°C showed physicochemical and biological properties suitable for VPT, and similar to those of MTA.
Collapse
Affiliation(s)
| | | | - Evandro Piva
- Universidade Federal de Pelotas - UFPes, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | | | | | - Adriana Fernandes da Silva
- Universidade Federal de Pelotas - UFPes, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | - Rafael Pino Vitti
- School of Dentistry, Herminio Ometto University Center, Araras, SP, Brazil
| | - Cesar Henrique Zanchi
- Universidade Federal de Pelotas - UFPes, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | - Sergio da Silva Cava
- Universidade Federal de Pelotas - UFPes, Materials Engineering Graduate Program, Advanced Crystal Growth and Photonics, Pelotas, RS, Brazil
| |
Collapse
|
26
|
Comparison of Cytotoxicity of AH Plus and DC Canal SE Sealer After Final Setting. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
27
|
Özdemir O, Kopac T. Cytotoxicity and biocompatibility of root canal sealers: A review on recent studies. J Appl Biomater Funct Mater 2022; 20:22808000221076325. [PMID: 35164598 DOI: 10.1177/22808000221076325] [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] [Indexed: 11/17/2022] Open
Abstract
Many types of endodontic root canal sealers have been employed for the purpose of filling voids and irregularities in root canals, as well as reducing/removing bacterial remnants/remains. Sealers are available in various formulations, and research work to find the most appropriate ones is still ongoing. Recently, many kinds of novel root canal sealers have been introduced under various commercial names. However, most sealers are known to exhibit different levels of cytotoxicity on tissues which would result in prolonged wound healing, inflammation, and bone resorption. Preferably, sealers need to have tolerable biological and physico-chemical properties along with biocompatibility. Additives promoting the biocompatibility and bioactivity of sealers are of major concern in clinical applications. The aim of this review was to compare, evaluate, and analyze comparatively the cytotoxic effects, biocompatibility, and antimicrobial properties of recently used root canal sealers. A comprehensive literature search was made to identify their properties involving biocompatibility and cytotoxicity. In general, the sealers reported in recent literature exhibited favorable biological features in comparison to conventional ones. They promoted better cell viability and biocompatibility. The incorporation of additives influences favorably the potential negative effects. However, it has been highlighted that there is a lack of well-designed long-term clinical applications, and more in vitro and in vivo research work would be helpful to confirm the sustainability of the sealers for further clinical practice.
Collapse
Affiliation(s)
- Olcay Özdemir
- Department of Pedodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.,Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
| | - Turkan Kopac
- Department of Chemistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| |
Collapse
|
28
|
Ferreira GC, Pinheiro LS, Nunes JS, de Almeida Mendes R, Schuster CD, Soares RG, Kopper PMP, de Figueiredo JAP, Grecca FS. Evaluation of the biological and physicochemical properties of calcium silicate-based and epoxy resin-based root canal sealers. J Biomed Mater Res B Appl Biomater 2021; 110:1344-1353. [PMID: 34951737 DOI: 10.1002/jbm.b.35004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 12/17/2022]
Abstract
Biocompatibility, dimensional stability, radiopacity, flow, and low solubility are the characteristics of an ideal endodontic sealer. This study evaluated and compared in vivo and in vitro biological and physicochemical properties of calcium silicate-based sealers: Sealer Plus BC (BC), MTA Fillapex (MF); and resin-based sealers: AH Plus (AHP) and Sealer Plus (SP). Apical papilla cells were exposed to sealer extracts and subjected to MTT, SRB, scratch, alkaline phosphatase enzyme activity (ALP) and Alizarin red staining (ALZ) assays. Sealers were histologically evaluated in connective tissue of Wistar rats in different periods. Radiopacity, film thickness, flow, setting time, pH and element analyses were investigated. BC had better results compared to AHP and MF at hour 72 for MTT assay (p < .05), and the highest cell viability under SRB (p < .05). All sealers presented ALP activity. BC presented the highest mineralized deposition under ALZ (p < .05). BC and MF promoted wound healing. All sealers induced an initial inflammation reaction that decreased over time. Eosinophils were observed at day 7 in MF (p < .05). Despite MF did not present final setting time, the sealers properties were in accordance to ISO 6876/2012 and ASTM C266-08. All sealers presented cell viability and biocompatibility. BC presented higher pH values and bioactivity. The materials tested showed physico-chemical properties in accordance with standards, except for MF setting time.
Collapse
Affiliation(s)
- Gabriela Cardoso Ferreira
- Post Graduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lucas Siqueira Pinheiro
- Post Graduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Júlia Silveira Nunes
- Post Graduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberta de Almeida Mendes
- Post Graduate Program in Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Patrícia Maria Poli Kopper
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Fabiana Soares Grecca
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
29
|
Zordan-Bronzel CL, Tanomaru-Filho M, Torres FFE, Chávez-Andrade GM, Rodrigues EM, Guerreiro-Tanomaru JM. Physicochemical Properties, Cytocompatibility and Antibiofilm Activity of a New Calcium Silicate Sealer. Braz Dent J 2021; 32:8-18. [PMID: 34787254 DOI: 10.1590/0103-6440202103314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/16/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the physicochemical properties, cytocompatibility and antibiofilm activity of a new calcium silicate-based endodontic sealer, Sealer Plus BC (MK Life, Brazil), in comparison with TotalFill BC Sealer (FKG Dentaire SA, Switzerland) and AH Plus (Dentsply, Germany). Setting time and flow were evaluated based on ISO 6876 standard. The pH was evaluated after different periods, and radiopacity by radiographic analysis (mmAl). Solubility (% mass loss) and volumetric change (by micro-CT) were assessed after 30 days of immersion in distilled water. Cytocompatibility was assessed by methyltetrazolium (MTT) and neutral red (NR) assays, after exposure of Saos-2 cells to the sealer extract for 24 h. An additional analysis was performed by using MTT assay after 1, 3 and 7 days of exposure of Saos-2 to the sealers 1:8 dilution extracts. Antibiofilm activity against Enterococcus faecalis and/or Candida albicans was evaluated by crystal violet assay and modified direct contact test. The physicochemical properties were analyzed using ANOVA/Tukey tests; MTT and NR data were analyzed by ANOVA and Bonferroni tests; the antimicrobial tests were analyzed by Kruskal-Wallis and Dunn tests (α=0.05). Sealer Plus BC had proper setting time, radiopacity, flow and alkalization capacity. Sealer Plus BC was significantly more soluble than AH Plus (p<0.05) and presented volumetric change similar to AH Plus and TotalFill BC (p>0.05). Sealer Plus BC presented antibiofilm activity and no cytotoxic effect. In conclusion, although Sealer Plus BC had higher solubility, this sealer showed proper physicochemical properties, cytocompatibility, and antibiofilm activity.
Collapse
Affiliation(s)
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Elisandra Marcia Rodrigues
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | |
Collapse
|
30
|
Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
Collapse
Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| |
Collapse
|
31
|
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.
Collapse
|
32
|
Alves Silva EC, Tanomaru-Filho M, da Silva GF, Delfino MM, Cerri PS, Guerreiro-Tanomaru JM. Biocompatibility and Bioactive Potential of New Calcium Silicate–based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC. J Endod 2020; 46:1470-1477. [DOI: 10.1016/j.joen.2020.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
|
33
|
Rodríguez‐Lozano FJ, López‐García S, García‐Bernal D, Tomás‐Catalá CJ, Santos JM, Llena C, Lozano A, Murcia L, Forner L. Chemical composition and bioactivity potential of the new Endosequence BC Sealer formulation HiFlow. Int Endod J 2020; 53:1216-1228. [DOI: 10.1111/iej.13327] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/08/2020] [Indexed: 12/21/2022]
Affiliation(s)
- F. J. Rodríguez‐Lozano
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
- Gerodontology and Special Care in Dentistry Unit. School of Dentistry Faculty of Medicine University of Murcia Murcia Spain
| | - S. López‐García
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
| | - D. García‐Bernal
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
| | - C. J. Tomás‐Catalá
- Biomedical Research Institute of Murcia‐Arrixaca Cellular Therapy and Hematopoietic Transplant Unit IMIB‐Arrixaca University of Murcia MurciaSpain
- Gerodontology and Special Care in Dentistry Unit. School of Dentistry Faculty of Medicine University of Murcia Murcia Spain
| | - J. M. Santos
- Institute of Endodontics Faculty of Medicine University of Coimbra Coimbra Portugal
| | - C. Llena
- Department of Stomatology University de Valencia ValenciaSpain
| | - A. Lozano
- Department of Stomatology University de Valencia ValenciaSpain
| | - L. Murcia
- Department of Genetics and Microbiology University of Murcia Murcia Spain
| | - L. Forner
- Department of Stomatology University de Valencia ValenciaSpain
| |
Collapse
|