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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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Agu OS, Tabil LG, Mupondwa E, Emadi B. Microwave absorber utilization to improve grinding and particle surface structure characteristics of torrefied switchgrass particles for bioenergy applications. Heliyon 2024; 10:e32423. [PMID: 38961901 PMCID: PMC11219346 DOI: 10.1016/j.heliyon.2024.e32423] [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: 01/12/2024] [Revised: 05/21/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Torrefaction treatment improves biomass grindability by transforming the fibrous herbaceous to a more brittle and lighter coal-like material. Microwave-assisted torrefaction is a promising technology for biomass conversion into energy, fuels, and chemicals. The study applied microwave absorbers in the torrefaction process to improve the thermochemical characteristics and grindability of switchgrass. Switchgrass in two particle sizes was torrefied in a microwave reactor with biochar added as a microwave absorber under inert conditions. After torrefaction, the geometric mean particle and size distribution and selected physical characteristics were evaluated, and the grindability of the torrefied ground and chopped with and without biochar were compared with those of untreated switchgrass. The geometric diameter results decreased, and the specific energy required for grinding torrefied switchgrass with biochar was significantly reduced with extended residence times and at a torrefaction temperature of 300 °C. After grinding, the lowest grinding energy of 32.82 kJ at 300 °C/20 min was recorded with torrefied ground switchgrass/biochar. The 10% biochar added/250 °C resulted in deep cell wall disarrangement, whereas at a torrefaction temperature of 300 °C, large surface deformation and carbonized weight fractions were observed.
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Affiliation(s)
- Obiora S. Agu
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Lope G. Tabil
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Edmund Mupondwa
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
- Bioproducts and Bioprocesses, Science and Technology Branch, Agriculture and Agri-Food Canada, Government of Canada, Saskatoon Research and Development Center, 107 Science Place, Saskatoon, SK, S7N 0X2, Canada
| | - Bagher Emadi
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
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D'Amico G, Muwaquet Rodriguez S. Effectiveness of tricalcium silicate-based cements: Systematic review and meta-analysis. Saudi Dent J 2024; 36:208-213. [PMID: 38419984 PMCID: PMC10897538 DOI: 10.1016/j.sdentj.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction Tricalcium silicate-based cements exhibit several beneficial properties for dental health and biocompatibility, which can induce biomineralisation. Objectives To assess the sealing ability and intratubular penetration of tricalcium silicate-based sealers using warm and cold obturation techniques. Materials and Methods An electronic search was conducted in PubMed, Scopus, and Web of Science databases for endodontically treated teeth with bioceramics and their sealing capacity in root canal obturation published up to February 2023. Results Of the 90 articles, 16 met the inclusion criteria, and only 10 were used for the meta-analysis, of which four addressed intratubular penetration, four addressed sealing capacity, and two addressed both variables. In the sealing capacity group, the meta-analysis concluded a standardised mean difference (SMD) of -1.31 in favour of the test group (warm) with a certain nonsignificant trend (p = 0.081); regarding intratubular penetration, the meta-analysis concluded an SMD = 2.34 in favour of the test group (warm) with significantly greater penetration (p = 0.032). Conclusion The warm obturation technique introduced significantly greater intratubular penetration than the cold technique, along with a remarkably superior sealing capacity compared to the cold technique, approaching statistical significance.
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Affiliation(s)
- Gaia D'Amico
- Dentistry degree at the European University of Valencia, Valencia, Spain
| | - Susana Muwaquet Rodriguez
- Restorative dentistry and endodontics, Faculty of Medicine and Dentistry, European University of Valencia, Spain. Catholic University of Valencia, Valencia, Spain. Lecturer
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Teoh YY, Liew KY, Siao J, Wong S, Chandler N, Bogen G. The effects of chelation on the intratubular penetration depth of mineral trioxide aggregate. AUST ENDOD J 2023; 49:483-491. [PMID: 37200356 DOI: 10.1111/aej.12766] [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: 02/04/2022] [Revised: 08/29/2022] [Accepted: 04/26/2023] [Indexed: 05/20/2023]
Abstract
The penetration depth and extent of mineral trioxide aggregate (MTA) crystallisation into dentinal tubules at 2, 4 and 6 weeks after chelation and MTA obturation were investigated. Standardised 12 mm human root specimens (45) were prepared with NiTi rotary files using 4% NaOCl irrigation. They were randomly allocated to three irrigants (n = 15: 4% NaOCl, 15% ethylenediaminetetraacetic acid or Edgemix) and obturated with sodium fluorescein tagged ProRoot MTA. One millimetre thick apical, middle and coronal sections were examined using confocal laser scanning microscopy to determine MTA penetration depth and area. Depths varied from 352 to 1821 μm at 6 weeks depending on section level and were unaffected by chelation. No differences (p > 0.05) were found in mean maximum penetration depth or dentine area (%) between the 3 irrigants at all time intervals. MTA mineralisation penetrated up to 90% of dentinal tubules and can extend to the cementum in roots with patent, non-infected tubules.
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Affiliation(s)
- Yu-Yao Teoh
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Khai Yi Liew
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Jethro Siao
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Shaun Wong
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Nicholas Chandler
- Department of Oral Rehabilitation, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - George Bogen
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
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Karobari MI, Batul R, Snigdha NTS, AL-Rawas M, Noorani TY. Evaluation of push-out bond strength, dentinal tubule penetration and adhesive pattern of bio-ceramic and epoxy resin-based root canal sealers. PLoS One 2023; 18:e0294076. [PMID: 37956149 PMCID: PMC10642786 DOI: 10.1371/journal.pone.0294076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Root canal sealing materials play a crucial role in an endodontic procedure by forming a bond between the dentinal walls and the gutta-percha. The current study aims to analyse the dentinal tubule penetration and adhesive pattern, including the push-out bond strength of six commercially available root canal sealers. METHODOLOGY Eighty-four mandibular first premolars were split into seven groups (and n = 12), Group 1: Dia-Root, Group 2: One-Fil, Group 3: BioRoot RCS, Group 4: AH Plus, Group 5: CeraSeal, Group 6: iRoot SP, Group 7: GP without sealer (control). Two groups were made, one for dentinal tubule penetration and the other for push-out bond strength; the total sample size was one hundred sixty-eight. Root canal treatment was performed using a method called the crown down technique, and for obturation, the single cone technique was used. A confocal laser scanning microscope (Leica, Microsystem Heidel GmbH, Version 2.00 build 0585, Germany) was used to evaluate dentinal tubule penetration, and Universal Testing Machine was utilised to measure the push-out bond strength (Shimadzu, Japan) using a plunger size of 0.4 mm and speed of 1mm/min. Finally, the adhesive pattern of the sealers was analysed by HIROX digital microscope (KH-7700). Statistical analysis was carried out by a one-way Anova test, Dunnet's T3 test, and Chi-square test. RESULTS Highest dentinal tubule penetration was noticed with One-Fil (p<0.05), followed by iRoot SP, CeraSeal, AH Plus, Dia-Root also, the most negligible value was recorded for BioRoot RCS. Meanwhile, BioRoot RCS (p<0.05) demonstrated the greater value of mean push-out bond strength, followed by One-fil, iRoot SP, CeraSeal, AH Plus and Dia-Root. Regarding adhesive pattern, most of the samples were classified as type 3 and type 4 which implies greater sealing ability and better adherence to the dentinal wall. However, BioRoot RCS revealed the most type 4 (p<0.05), followed by AH Plus, One-Fil, CeraSeal and Dia-Root. CONCLUSION The highest dentinal tubule penetration was shown by One-Fil compared to other groups. Meanwhile, BioRoot RCS had greater push-out bond strength and more adhesive pattern than other tested materials.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Dental Research Unit, Center for Global health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Niher Tabassum Siddiqua Snigdha
- Department of Paediatric Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Matheel AL-Rawas
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Tahir Yusuf Noorani
- Dental Research Unit, Center for Global health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Timis L, Gorea M, Har N, Cimpean S, Delean A, Bud MG, Campian RS. Biomineralization ability of an experimental bioceramic endodontic sealer based on nanoparticles of calcium silicates. Med Pharm Rep 2023; 96:434-440. [PMID: 37970195 PMCID: PMC10642743 DOI: 10.15386/mpr-2660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/29/2023] [Indexed: 11/17/2023] Open
Abstract
Background and aims The ultimate goal of endodontic therapy is to prevent periradicular disease or to promote the healing of the periradicular lesions. The use of nontoxic, biocompatible, and bioactive materials designed for root canal obturation is preferred due to their increased potential to induce healing and bone regeneration, thereby restoring the functionality of the tooth and the adjacent tissues. The aim of this study was to analyze the biomineralization ability of an experimental endodontic sealer based on synthesized nanoparticles of calcium silicates. Methods Six plastic moulds were filled with the freshly prepared experimental endodontic sealer and kept for 3 days at room temperature in a moist environment. After hardening, four samples were subsequently immersed in simulated body fluid (SBF) and introduced in incubator at 37°C and 100% relative humidity; two of them were kept for 7 days and the other two for 14 days. Two samples were not immersed in SBF and were used for comparison. The biomineralization potential was assessed by XRPD, SEM and EDS analysis. Results Following immersion in SBF, XRPD analysis identified apatite crystals for experimental material both after 7 and 14 days. SEM images displayed the specific microstructure for bioceramic materials alongside with the presence of apatite crystals on their surface. EDS identified the presence of phosphorus and calcium elements, underlining the biomineralization potential of the experimental material. Conclusion Interaction between experimental material and SBF succeeded in inducing precipitation of apatite on its surface, evidenced by XRDP, SEM and EDS analysis.
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Affiliation(s)
- Lucia Timis
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maria Gorea
- Department of Chemical Engineering, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Nicolae Har
- Department of Geology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Sanda Cimpean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ada Delean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marius Gheorghe Bud
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Septimiu Campian
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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El Hachem C, Chedid JCA, Nehme W, Kaloustian MK, Ghosn N, Rabineau M, Kharouf N, Haikel Y, Mancino D. The Contribution of Various In Vitro Methodologies to Comprehending the Filling Ability of Root Canal Pastes in Primary Teeth. Bioengineering (Basel) 2023; 10:818. [PMID: 37508845 PMCID: PMC10376379 DOI: 10.3390/bioengineering10070818] [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: 06/03/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
A void-free obturation during root canal treatment on primary teeth is currently very difficult to attain. In this study, the pulpectomy filling abilities of Bio-C Pulpecto (Angelus, Basil, Londrina, Paraná, Brazil) and of zinc oxide eugenol, or "ZOE" (DenPro, Prevest, New York, NY, USA), were compared using several in vitro techniques. Therefore, 30 primary anterior teeth were used in the present in vitro study. Analysis of variance (ANOVA), including a multiple comparison procedure (Holm-Sidak method, Dunn's Method, or Tukey test), was used. On micro-CT, Bio-C Pulpecto exhibited higher void percentages than did ZOE (10.3 ± 3.8%, and 3.5 ± 1.3%), respectively (p < 0.05). With digital microscopy, higher total void percentages were found in the BC (13.2 ± 26.7%) group compared to the ZOE (2.7 ± 2.8%) group (p < 0.05). With the CLSM, mean tubular penetration depths were higher for Bio-C Pulpecto than for ZOE in all canal thirds (p < 0.05). SEM images demonstrated no tags into dentinal tubules in either group throughout the three thirds. Moreover, higher statistically significant flowability was found for Bio-C (2.657 ± 0.06 mm) compared to ZOE (1.8 ± 0.13 mm) (p < 0.05). The findings of this study indicate that neither ZOE nor Bio-C Pulpecto appears to meet the criteria for an ideal root canal filling paste for primary teeth. This study laid the groundwork for future research by determining how micro-CT, digital microscopy, SEM, and CLSM contribute to our understanding of the filling process of primary teeth. More thorough research on the mechanism of root canal obturation on primary teeth is required to achieve a long-term successful root canal therapy in young children.
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Affiliation(s)
- Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Jean Claude Abou Chedid
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Walid Nehme
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, 155 5th Street, San Francisco, CA 94103, USA
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Nabil Ghosn
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Morgane Rabineau
- Faculté de Chirurgie Dentaire, Fédération de Médecine Translationnelle de Strasbourg and Fédération des Matériaux et Nanoscience d'Alsace, Université de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
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Chew ST, Eshak Z, Al-Haddad A. Evaluation of interfacial adaptation and penetration of bioceramic-based sealers in oval root canals: A confocal laser scanning microscope study. Microsc Res Tech 2023; 86:754-761. [PMID: 37078493 DOI: 10.1002/jemt.24323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/06/2023] [Accepted: 03/26/2023] [Indexed: 04/21/2023]
Abstract
To assess the interfacial adaptation and penetration depth of three different bioceramic-based sealers (CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG) compared to an epoxy resin-based sealer (AH Plus) in oval root canals. Fourty extracted single-rooted mandibular premolar with oval canal were prepared and randomly allocated according to the obturation into; CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG and AH Plus. The roots were sectioned at 3, 6 and 9 mm from the apex. The sealer adaptation and the penetration depth were evaluated under confocal laser scanning microscope. One-way ANOVA and Repeated measure ANOVA were used to statistically analyze the data. Nishika Canal Sealer BG showed significantly higher sealer adaptation than EndoSeal MTA (P < .001) at apical and middle thirds. Meanwhile, AH Plus showed significantly higher sealer adaptation than EndoSeal MTA (P = 0.011) at middle third. For sealer penetration, Nishika Canal Sealer BG showed the longest sealer penetration that was significant compared to AH Plus (P < .001) and EndoSeal MTA (P < .001) whereas CeraSeal was significantly higher than EndoSeal MTA (P = 0.029) at coronal third. For AH Plus, there was a significant less sealer penetration at coronal third compared to apical and middle thirds (P < .05). Whereas for EndoSeal MTA, the coronal third has significant less penetration compared to the middle third (P = 0.032). Endoseal has the lowest adaptation and penetration depth. Nishika Canal Sealer BG has better adaptation and penetration depth using single cone obturation technique in oval canal. RESEARCH HIGHLIGHTS: All the tested root canal sealers have some percentage of gaps and vary in their penetration capability into dentinal tubules. Nishika Canal Sealer BG has significantly better sealer adaptation to root dentinal walls than that of EndoSeal MTA at the apical and middle third but not significantly different from other type of sealers used. Nishika Canal Sealer BG has significantly better penetration depth than AH Plus and EndoSeal MTA at the coronal third of radicular dentin.
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Affiliation(s)
- Soo Teng Chew
- Department of Restorative Dentistry, Faculty of Dentistry, National University of Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Zolkapli Eshak
- Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, University Teknologi MARA Puncak Alam, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
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Shieh K, Yang J, Zhu EH, Peters OA, Hosseinpour S. Dentinal Tubule Penetrability and Bond Strength of Two Novel Calcium Silicate-Based Root Canal Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093309. [PMID: 37176191 PMCID: PMC10179649 DOI: 10.3390/ma16093309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Once the chemo-mechanical preparation of root canals is finished, achieving a complete seal of the root canal system becomes crucial in determining the long-term success of endodontic treatment. The important goals of root canal obturation are to minimize leakage and achieve an adequate seal. Thus, a material that possesses satisfactory mechanical characteristics, is biocompatible, and has the ability to penetrate the dentine tubules adequately is needed. AIM This study aimed to compare the penetrability and bond strength between two calcium silicate-based sealers and an epoxy resin-based sealer, as well as examine the relationship between penetrability and bond strength for the different sealers. METHOD AND MATERIALS Thirty-nine recently extracted single-rooted human premolar teeth were instrumented and divided evenly into three groups (n = 13), according to the sealer used for obturation: AH Plus Jet, EndoSequence, and AH Plus Bioceramic Sealer. Three teeth (30 slices) were randomly selected out of each for analysis using confocal laser scanning microscopy to assess penetrability. The remaining ten teeth (90 slices) in each group were subject to push-out tests using a universal testing machine. All teeth were sectioned into nine transverse slices of 0.9 mm thickness for their respective tests (apical, middle, coronal). RESULTS AH Plus Jet exhibited significantly lower penetrability and significantly higher bond strength compared to EndoSequence BC sealer (p = 0.002) and AH Plus Bioceramic Sealer (p = 0.006). There was no significant difference between EndoSequence BC sealer and AH Plus Bioceramic Sealer in terms of either penetrability or bond strength. No correlation was found between penetrability and bond strength. CONCLUSIONS Within the limitation of this study and regardless of the location in the canal, the bioceramic based root canal sealers appeared to perform better than the epoxy resin-based sealer in terms of dentinal penetration rate. Further studies are required to compare other biomechanical properties of bioceramic sealers including setting characteristics and bacterial leakage.
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Affiliation(s)
- Karissa Shieh
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Jack Yang
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Elsa Heng Zhu
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
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Ashkar I, Sanz JL, Forner L, Melo M. Calcium Silicate-Based Sealer Dentinal Tubule Penetration-A Systematic Review of In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2734. [PMID: 37049028 PMCID: PMC10096084 DOI: 10.3390/ma16072734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
The aim of this systematic review was to perform a qualitative synthesis of in vitro studies which evaluate and compare the penetration of calcium silicate-based sealers into dentinal tubules. A systematic advanced search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases on the 1 December 2022. In vitro studies that compared the tubular penetration of at least two calcium silicate-based sealers in extracted human teeth were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias included studies. The search identified a total of 680 preliminary records, among which 12 studies were eligible for review. The most used methodology to evaluate sealer penetration was the use of a fluorochrome together with the tested sealers and the analysis of their penetration under confocal laser microscopy. Regarding the results of the included studies, calcium silicate-based sealers exhibit a favorable dentinal tubule penetration. Tubular penetration, however, can be affected by factors such as the irrigation protocol, sealer activation, the filling method used, and root canal morphology. EndoSequence BC Sealer showed the highest sealer penetration among the tested sealers. The influence of different fluorochromes on the results of dentinal tubule penetration studies should also be further explored. The in vitro nature of the included studies limits the applicability of the results into the clinical setting. Prospero registration: CRD42022383896.
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Exploring the Most Effective Apical Seal for Contemporary Bioceramic and Conventional Endodontic Sealers Using Three Obturation Techniques. Medicina (B Aires) 2023; 59:medicina59030567. [PMID: 36984568 PMCID: PMC10051965 DOI: 10.3390/medicina59030567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Background and Objective: Despite a plethora of studies conducted to date, researchers continue to investigate the best sealer and obturation technique combinations. The aim of this study is to compare the apical seal provided by two bioceramic sealers (Endoseal and Endosequence) with that provided by a calcium hydroxide sealer (Sealapex), and to evaluate the effect of different obturation techniques (cold lateral condensation, continuous wave compaction and single cone) on the apical seal under a stereomicroscope. Materials and Methods: A total of 110 single-rooted mandibular premolar teeth were decoronated, cleaned and shaped using the Endosequence filing system to tip size 30/0.04 taper. Canals were irrigated with 5.25% NaOCl and 17% EDTA. The samples were randomly divided into 11 groups (9 experimental and 2 control groups) according to the designated sealer and technique. Samples were stored in an incubator for 7 days at 37 °C under 100% humidity. Samples were coated with nail varnish except for apical 2 mm and vertically placed in 0.2% rhodamine B dye solution for 48 h. Samples were split longitudinally and viewed under a stereomicroscope at 40× magnification. Results: Insignificant results were obtained between obturation techniques (p = 0.499) whereas statistically significant results were attained based on the type of endodontic sealer (p < 0.001). The overall lowest mean apical microleakage and best sealing ability was demonstrated by Sealapex (2.59 ± 1.20 mm) and amongst techniques by continuous wave compaction (3.90 ± 2.51 mm). Conclusions: Endosequence produced the best apical seal with the continuous wave compaction technique, whereas Endoseal did so with the bioceramic-coated single-cone technique. For the Sealapex sealer, the most effective apical seal was observed using cold lateral condensation. The quality and effectiveness of apical seal differed with the type of endodontic sealer and obturation technique used, and vice versa.
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Lin GSS, Luddin N, Ghani HA, Lai JCH, Noorani TY. Dislodgment Resistance, Adhesive Pattern, and Dentinal Tubule Penetration of a Novel Experimental Algin Biopolymer-Incorporated Bioceramic-Based Root Canal Sealer. Polymers (Basel) 2023; 15:polym15051317. [PMID: 36904558 PMCID: PMC10007138 DOI: 10.3390/polym15051317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/15/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
The currently available bioceramic-based sealers still demonstrate low bond strength with a poor seal in root canal despite desirable biological properties. Hence, the present study aimed to determine the dislodgment resistance, adhesive pattern, and dentinal tubule penetration of a novel experimental algin-incorporated bioactive glass 58S calcium silicate-based (Bio-G) sealer and compared it with commercialised bioceramic-based sealers. A total of 112 lower premolars were instrumented to size 30. Four groups (n = 16) were assigned for the dislodgment resistance test: control, gutta-percha + Bio-G, gutta-percha + BioRoot RCS, and gutta-percha + iRoot SP, with exclusion of the control group in adhesive pattern and dentinal tubule penetration tests. Obturation was done, and teeth were placed in an incubator to allow sealer setting. For the dentinal tubule penetration test, sealers were mixed with 0.1% of rhodamine B dye. Subsequently, teeth were cut into a 1 mm-thick cross section at 5 mm and 10 mm levels from the root apex, respectively. Push-out bond strength, adhesive pattern, and dentinal tubule penetration tests were performed. Bio-G showed the highest mean push-out bond strength (p < 0.05), while iRoot SP showed the greatest sealer penetration (p < 0.05). Bio-G demonstrated more favourable adhesive patterns. No significant association was noted between dislodgment resistance and dentinal tubule penetration (p > 0.05).
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Malaysia
- Correspondence: (G.S.S.L.); (T.Y.N.)
| | - Norhayati Luddin
- Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Huwaina Abd Ghani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Josephine Chang Hui Lai
- Department of Chemical Engineering and Sustainable Energy, Faculty of Engineering, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (G.S.S.L.); (T.Y.N.)
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Eğemen A, Belli S. The Effect of Primary Root Canal Treatment on Dentinal Tubule Penetration of Calcium Silicate-based Sealers during Endodontic Retreatment. J Endod 2022; 48:1169-1177. [PMID: 35667566 DOI: 10.1016/j.joen.2022.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effect of previous root canal treatment on dentinal tubule penetration of calcium silicate-based sealers during endodontic retreatment and to compare 2 different (commonly used and modified) tubule penetration depth measurement techniques. METHODS The crowns of mandibular premolar teeth were removed, and root canals were prepared (ProTaper Universal; Dentsply Sirona, York, PA) and obturated using AH Plus (AH; Dentsply DeTrey, Konstanz, Germany), MTA Fillapex (MTAF; Angelus, Londrina, Brazil), and WellRoot ST (WRST; Vericom, Gyeonggi-do, South Korea); 0.1% red Rhod-2 dye (Chemodex, St Gallen, Switzerland) was added to the sealers. After storage for 3 weeks (37°C, 100% humid), the following sealer combination subgroups were created (the sealer used during the primary root canal treatment/the sealer used during the retreatment, n = 8): AH/AH, AH/MTAF, and AH/WRST; MTAF/AH, MTAF/MTAF, and MTAF/WRST; and WRST/AH, WRST/MTAF, and WRST/WRST. Green Fluo-3 dye (0.1%) was added to the sealers during retreatment. Sealer penetration depths were measured at 8 points and averaged, and the ratio of the retreatment sealer to the initial sealer was recorded as the mean tubule penetration depth ratio in the first technique, whereas the percentage of the circumferential penetration area ratios of the retreatment and initial sealers was calculated in the second technique. Statistical analyses were performed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS The mean penetration depth of AH and MTFA was found to be higher at the coronal third region in the control groups (P < .05). Both methods showed a significant difference among the groups at the coronal and median regions (P < .05). The AH/WRST, MTAH/AH, MTAF/MTAF, MTAF/WRSTS, and WRST/WRST groups showed deeper tubule penetration (first technique, P = .01). Both techniques showed that the penetration depth of the sealers was the same at the apical region (P > .05), whereas a difference was found among the techniques at the coronal and median regions. The sealers used in the previous root canal treatment limited the penetration depth of the sealers used during the retreatment process (P < .05). When MTAF was used as the initial sealer, the penetration depth of the second sealer did not change, whereas if WRST was the initial sealer, the penetration depth of the sealers at the median and apical regions is negatively affected during the retreatment process (P < .05). CONCLUSIONS Previous root canal treatment affects the penetration depth of calcium silicate-based sealers. The use of AH Plus and MTA Fillapex during the retreatment process showed an advantage. Both measurement techniques showed similar performances at the apical region, whereas the results varied at the coronal and midcoronal regions; therefore, a more stable sealer penetration measurement technique is still necessary.
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Affiliation(s)
- Ayşenur Eğemen
- Department of Endodontics, Selçuk University, Konya, Turkey
| | - Sema Belli
- Department of Endodontics, Selçuk University, Konya, Turkey.
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Ortiz-Blanco B, Sanz JL, Llena C, Lozano A, Forner L. Dentin Sealing of Calcium Silicate-Based Sealers in Root Canal Retreatment: A Confocal Laser Microscopy Study. J Funct Biomater 2022; 13:jfb13030114. [PMID: 35997452 PMCID: PMC9397037 DOI: 10.3390/jfb13030114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of the present in vitro study was to evaluate the intratubular penetration of three bioceramic sealers in root canal retreatment. Here, 30 single-rooted human teeth were instrumented with the Protaper Universal system and filled with gutta-percha and the epoxy-resin-based sealer AH Plus mixed with rhodamine B. After two weeks in a humid environment, they were re-instrumented with Reciproc Blue and divided into three groups according to the endodontic sealer to be used in the re-filling (n = 10): G1: CeraSeal, G2: TotalFill BC Sealer, G3: TotalFill BC Sealer HiFlow. For the filling, a single cone technique was used, and the respective sealers were mixed with fluorescein. The roots were then sectioned at 2, 5, and 8 mm (apical, medial, and coronal measurement points, respectively) from the apex, and the dentinal tubule penetration depth and percentage of penetration around the canal perimeter were evaluated by means of confocal laser scanning microscopy (CLSM). Penetration between groups was compared using the Kruskal−Wallis test, and within each group using the Wilcoxon test. Statistical significance was established at p < 0.05. A non-significant reduction was found in the penetration depths and in a percentage of penetration around the canal perimeter between AH Plus and the tested calcium-silicate-based sealers (p > 0.05). Consequently, this reduction may not affect the three-dimensional seal of the root canal system in a negative manner. The penetration depth and percentage of penetration around the canal perimeter at both the root canal treatment and retreatment were significantly reduced from the coronal to apical points in all groups (p < 0.05).
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Song D, Yang SE. Comparison of Dentinal Tubule Penetration between a Calcium Silicate-Based Sealer with Ultrasonic Activation and an Epoxy Resin-Based Sealer: A Study Using Confocal Laser Scanning Microscopy. Eur J Dent 2021; 16:195-201. [PMID: 34674198 PMCID: PMC8890920 DOI: 10.1055/s-0041-1735429] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the degree of dentinal penetration between an epoxy resin-based sealer applied by using two different filling methods and an ultrasonically activated calcium silicate-based sealer via confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS Forty-five extracted permanent maxillary premolars with type II canals (Vertucci's classification) were subjected to the experiment. The root canals were instrumented and distributed randomly into the following three groups: AH Plus + continuous wave technique (AHC group); AH Plus + single cone technique (AHS group); and Endoseal MTA + single cone technique with ultrasonic activation (EMS) group. Each sealer was labeled with rhodamine B dye to allow visualization under CLSM. The sealer penetration depth in each sample was observed at 2 mm and 5 mm from the apex by using CLSM. The data were statistically analyzed by using analysis of variance or Kruskal-Wallis H test according to normality of variable (α = 0.05). RESULTS In all groups, the maximum sealer penetration depth, mean fluorescence intensity, and sum fluorescence intensity values were higher at the 5-mm level than at the 2-mm level. At the 5-mm level, the EMS group showed the lowest value (p = 0.02). At the 2-mm level, there were no statistically significant differences among any of the groups. The AHC group showed higher values than the other groups, but there was no statistically significant difference in the apical area where access of instruments was difficult. CONCLUSION The AHC group showed the highest dentinal tubule penetration, but had questionable filing efficacy in the apical area, which is of particular importance for the success of root canal treatment. Therefore, in areas such as the apical 2 mm of premolars with type II canals, which are difficult to access by using instruments such as heat carriers, other appropriate approaches may be required accordingly.
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Affiliation(s)
- Dani Song
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Eun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Yesildal Yeter K, Gunes B, Seker B. The effect of atmospheric cold plasma on the dentinal tubule penetration of calcium silicate-based sealer used with different obturation techniques: A confocal laser scanning microscopy study. AUST ENDOD J 2021; 48:151-157. [PMID: 34494689 DOI: 10.1111/aej.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the effect of atmospheric cold plasma (ACP) on dentinal tubule penetration of EndoSequence BC. Sixty premolars were divided into four groups according to the obturation technique and plasma treatment. Root canals were filled with single cone in Group 1 (SC), single cone after ACP application in Group 2 (SC-P), warm vertical compaction in Group 3 (WVC), warm vertical compaction after ACP application in Group 4 (WVC-P). Horizontal sections were imaged using confocal laser scanning microscopy. The maximum penetration and percentage of penetration values were measured. These data were statistically analysed (P < 0.01). In the coronal region, the percentage of penetration values were higher in SC-P and WVC-P than in SC and WVC. In the middle region, SC-P and SC showed a higher penetration percentage than WVC and WVC-P. In the apical region, WVC showed a higher percentage of penetration value than SC-P, WVC-P and SC did. Maximum penetration of WVC was higher than of SC and SC-P. Within the limitations of this study, ACP improved the percentage of penetration values of EndoSequence BC when used with single-cone technique.
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Affiliation(s)
- Kubra Yesildal Yeter
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Betul Gunes
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Basak Seker
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
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Dasari L, Anwarullah A, Mandava J, Konagala RK, Karumuri S, Chellapilla PK. Influence of obturation technique on penetration depth and adaptation of a bioceramic root canal sealer. J Conserv Dent 2021; 23:505-511. [PMID: 33911361 PMCID: PMC8066675 DOI: 10.4103/jcd.jcd_450_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/29/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022] Open
Abstract
Aim: Evaluation of the impact of three different obturation techniques on the penetration depth and adaptation of a bioceramic root canal sealer(BioRoot RCS) to root dentin using scanning electron microscope and confocal laser scanning microscope. Materials and Methods: Recently extracted ninety mandibular premolar teeth of similar dimensions (±0.2 mm) with single canals and straight roots were segregated into three experimental groups (n = 30 each) based on the method of obturation used, i.e., lateral compaction technique, warm vertical compaction technique, and injectable thermoplasticized technique. After obturation, half of the root samples (n = 15) in each group were sectioned horizontally by hard tissue microtome at 3, 6, and 9 mm, respectively, from root apex for measuring sealer penetration depth with a confocal laser scanning microscope. Longitudinal sections of the samples (n = 15) were used for measuring the adaptation of sealers to radicular dentin using a scanning electron microscope. Statistical Analysis: Intergroup comparison of sealer penetration depth and adaptation to root dentin was analyzed using one-way ANOVA, and pairwise comparisons were made using Tukey's post hoc test. Results: Warm vertical condensation technique showed deeper root dentin penetration of the sealer. Better adaptation of the sealer to apical root dentin with minimal voids (P ≤ 0.05) was achieved with warm vertical condensation in comparison to the injectable gutta-percha method and lateral condensation obturating techniques. Conclusion: At all three root levels (coronal, middle, and apical), warm vertical condensation technique exhibited more sealer penetration with minimum gaps, whereas lateral condensation technique exhibited more gaps and less sealer penetration.
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Affiliation(s)
- Lohita Dasari
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Anupreeta Anwarullah
- 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
| | - Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Srujana Karumuri
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Praveen Kumar Chellapilla
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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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: 10] [Impact Index Per Article: 3.3] [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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The Invasion of Bacterial Biofilms into the Dentinal Tubules of Extracted Teeth Retrofilled with Fluorescently Labeled Retrograde Filling Materials. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10196996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we evaluated the invasion of bacteria into the dentinal tubules of retrofilled extracted human teeth, and the influence of different fluorescently labeled retrograde filling materials on the bacterial invasion and viability, by means of confocal laser scanning microscopy (CLSM). The root apices of extracted teeth were cut, prepared, and filled retrogradely using either intermediate restorative material (IRM), mineral trioxide aggregate (MTA), or Biodentine. The roots were filled with Enterococcus faecalis bacteria from their coronal part for 21 days. Then, 3-mm-long apical segments were cut to get root axial slices, and the bacteria were fluorescently stained and evaluated by CLSM. Bacterial penetration into the dentinal tubules favored the bucco-lingual directions. The filling materials penetrated up to 957 µm into the tubuli, and the bacteria, up to 1480 µm (means: 130 and 167 μm, respectively). Biodentine fillings penetrated less and the associated bacteria penetrated deeper into the tubuli compared to MTA or IRM (p = 0.004). Deeper filling penetration was associated with shallower penetration of both dead and live, or live alone, bacteria (p = 0.015). In conclusion, the current study enables better understanding of the microbiological–pathological course after endodontic surgical procedures. It was found that even with retrograde fillings, bacteria invade deep into the dental tubules, where deeper filling penetration prevents deeper penetration of the bacteria and adversely affects the viability of the bacteria.
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Lim M, Jung C, Shin DH, Cho YB, Song M. Calcium silicate-based root canal sealers: a literature review. Restor Dent Endod 2020; 45:e35. [PMID: 32839716 PMCID: PMC7431927 DOI: 10.5395/rde.2020.45.e35] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/23/2022] Open
Abstract
Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.
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Affiliation(s)
- Miyoung Lim
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chanyong Jung
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Yong-bum Cho
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
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22
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Kataia E, Khallaf M, Omar N, Aly Y, ElShafei N. Assessment of physical properties of a ZnO/E sealer modified by adding moringa oleifera: An experimental in-vitro study. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_347_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Biocompatibility and Mineralization Activity of Three Calcium Silicate-Based Root Canal Sealers Compared to Conventional Resin-Based Sealer in Human Dental Pulp Stem Cells. MATERIALS 2019; 12:ma12152482. [PMID: 31387241 PMCID: PMC6696455 DOI: 10.3390/ma12152482] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to compare the cytotoxic effects and mineralization activity of three calcium silicate-based root canal sealers to those of a conventional resin-based sealer. Experiments were performed using human dental pulp stem cells grown in a monolayer culture. The root canal sealers tested in this study were EndoSequence BC Sealer (Brasseler), BioRoot RCS (Septodont), Endoseal MTA (Maruchi), and AH Plus (Dentsply DeTrey). Experimental disks 6 mm in diameter and 3 mm in height were made and stored in a 100% humidity chamber at 37 °C for 72 h to achieve setting. The cytotoxicity of various root canal sealers was evaluated using a methyl-thiazoldiphenyl-tetrazolium (MTT) assay. To evaluate cell migration ability, a scratch wound healing method was used, and images of the scratch area were taken using a phase-contrast microscope. Cell morphology was evaluated by a scanning electron microscope after direct exposure for 72 h to each sealer disk. In the cell viability assay, there were no significant differences between the EndoSequence BC, BioRoot RCS, Endoseal MTA, and control groups in any experimental period (p > 0.05). In the cell migration assay, there were no significant differences between the EndoSequence BC, Endoseal MTA, and control groups in any experimental period (p > 0.05). BioRoot RCS exhibited slower cell migration relative to EndoSequence BC and Endoseal MTA for up to 72 h (p < 0.05). Conversely, it showed a similar wound healing percentage at 96 h (p > 0.05). In an evaluation of cell morphology, cells in direct contact with EndoSequence BC, BioRoot RCS, and Endoseal MTA disks showed superior spreading compared to those in contact with the AH Plus disk. In an Alizarin red staining assay, EndoSequence BC, BioRoot RCS, and Endoseal MTA showed a significant increase in mineralized nodule formation compared to the AH Plus group (p < 0.05). In conclusion, all calcium silicate-based root canal sealers tested in this study showed good biological properties and mineralization activity compared to conventional resin-based sealer.
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