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Wylie ME, Parashos P, Fernando JR, Palamara J, Sloan AJ. Biological considerations of dental materials as orifice barriers for restoring root-filled teeth. Aust Dent J 2023; 68 Suppl 1:S82-S95. [PMID: 37607102 DOI: 10.1111/adj.12970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
There is ample published literature regarding the technical aspects of restoring root-filled teeth, but little concerning the biological impacts, consequences, and criteria for the selection of direct restorative materials following endodontic treatment. The provision of an effective coronal seal in addition to a sound root filling is known to be important in the prevention of root canal infection. This review seeks to explore the evidence concerning the selection of dental materials in the restoration of root-filled teeth, specifically with a close examination of the properties of commonly used materials as orifice barriers. © 2023 Australian Dental Association.
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Affiliation(s)
- M E Wylie
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - J R Fernando
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Oral Health Research, Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jea Palamara
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - A J Sloan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Mehta S, Ramugade M, Abrar S, Sapkale K, Giuliani V, Burbano Balseca MJ. Evaluation of coronal microleakage of intra-orifice barrier materials in endodontically treated teeth: A systematic review. J Conserv Dent 2022; 25:588-595. [PMID: 36591578 PMCID: PMC9795687 DOI: 10.4103/jcd.jcd_377_22] [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: 06/28/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 01/03/2023] Open
Abstract
Background Endodontic success depends on complete sealing of the root canal orifice to prevent re-infection and re-Contamination of the treated teeth through microleakage. Intra-orifice barrier material provides a seal against micro-organisms, its by-products thus, preventing microleakage and subsequent endodontic failure. Several studies have been done to evaluate microleakage after placing various materials as IOB, but still there is no standardization for the same. Thus, this systematic review was conducted to evaluate the microleakage associated with mineral trioxide aggregate (MTA), composite, and glass ionomer cement (GIC) when used as IOB material. Materials and Methods Protocol was formulated in accordance with PRISMA checklist 2020 and registered on PROSPERO (CRD42021226225). Electronic search from databases such as Medline/PubMed, Scopus, EBSCOhost, Embase, Google Scholar, and Cochrane were performed from the year 2000-2020. In vitro and ex vivo studies evaluating coronal microleakage after placing IOB material using methylene blue dye penetration test under a stereomicroscope were included. A total of 5 studies were included in the systematic review. After assessing the risk of bias using customized criteria referred from JBI critical appraisal tool, characteristics of the included studies, reason for exclusion of the studies, and data extraction sheet were prepared. Results All studies included in this systematic review reported that placement of an IOB material significantly reduces microleakage as compared to control groups. MTA used as an IOB showed less microleakage than composite and GIC. Conclusion MTA as IOB material demonstrated the least microleakage in vitro studies. However, in this systematic review, only in vitro studies were included. Thus, more studies in the form of randomized control trials are required to give a conclusive and definitive result.
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Affiliation(s)
- Shaili Mehta
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Manoj Ramugade
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Sayed Abrar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Kishor Sapkale
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Valentina Giuliani
- Department of Experimental and Clinical Medicine, University of Florence, Italy
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Sakalli B, Basmaci F, Dalmizrak O. Evaluation of the penetration of intracoronal bleaching agents into the cervical region using different intraorifice barriers. BMC Oral Health 2022; 22:266. [PMID: 35773675 PMCID: PMC9248123 DOI: 10.1186/s12903-022-02300-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background The present study aimed to make a comparison between the effects of 35% hydrogen peroxide gel (HP) and sodium perborate with distilled water (SP) bleaching agents on the sealing characteristics of glass ionomer cement (GIC), TheraBase, ProRoot MTA and Biodentine intraorifice barriers. Methods One hundred and twelve single-rooted mandibular human premolar teeth extracted from young patients (14–25 years) were chosen. Root cement and cementoenamel junction (CEJ) of teeth were examined under a stereomicroscope at 10 × magnification to ensure there was no cement defect or dentin gap in CEJ. After the endodontic access cavities were opened on the occlusal surfaces of the teeth, the working length was determined. Instrumentation of each root canal was performed with a ProTaper Gold rotary system in the determined working length and filled with gutta-percha + AH Plus with a single cone technique using. Root fillings were removed 3 mm short of the CEJ and sealed with one of the following intraorifice barrier materials (n = 30/group): 1. GIC; 2. TheraBase; 3. ProProot-MTA; 4. Biodentine. In each of the sub-groups, either HP or SP was used to perform intracoronal bleaching on days 1, 4, and 7. All outer surfaces of the specimens except the 3 mm cervical region were covered with nail polish and modeling wax layers. Specimens were immersed in a 5 ml Eppendorf tube that contained 2 mL of distilled water. The penetration of peroxide release was measured using the colorimetric ferric thiocyanate method. Statistical analysis of the data was performed with Three-way ANOVA and Tukey’s test (P = 0.05). Results In the HP groups, GIC showed the greatest peroxide release when compared with other tested groups on day 1 (P < 0.05). Biodentine and ProRoot MTA displayed a significantly lower peroxide leakage when compared to GIC and TheraBase on days 1 and 4 (P < 0.05). While GIC and TheraBase were used, HP observed higher peroxide penetration when compared with SP on days 1 and 4 (P < 0.05). Conclusions Peroxide diffusion was significantly influenced by the kind of intracoronal bleaching agents and intraorifice barrier materials used.
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Affiliation(s)
- Bugce Sakalli
- Department of Endodontics, Faculty of Dentistry, Near East University, Near East Boulevard, Mersin 10, Turkey.
| | - Fatma Basmaci
- Department of Endodontics, Faculty of Dentistry, Near East University, Near East Boulevard, Mersin 10, Turkey
| | - Ozlem Dalmizrak
- Department of Medical Biochemistry, Faculty of Medicine, Near East University, Mersin 10, Turkey
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Effect of an Intraorifice Barrier on Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2789073. [PMID: 35097115 PMCID: PMC8794661 DOI: 10.1155/2022/2789073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022]
Abstract
The main cause of unsuccess in endodontically treated teeth (ETT) is due to bacterial recontamination. The placement of an intraorifice barrier (IOB) has been proposed for preventing this event in cases that the restoration is in an inadequate condition, enhancing the possibilities for predictable long-term success in endodontic therapy. Objectives. To evaluate through a systematic review and meta-analysis if it would be necessary to place an IOB in ETT. Materials and Methods. The present review is in accordance with the PRISMA 2020 Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in four databases up to July 10th, 2021: MEDLINE, Scopus, Embase, and Web of Science. Eligible studies were the ones which evaluated the use of an IOB in ETT in reducing microleakage with any material of choice and with any methods employed. Only in vitro studies published in English were included. Results. A total of thirty in vitro studies were included in the qualitative synthesis, and seven of those were included in the quantitative analyses evaluating the following materials: bioceramic cement, glass-ionomer cement (GIC), and resin-based composite (RBC). Most of the included studies placed an IOB at a 3 mm depth. Reduction in microleakage was observed when an IOB was placed, regardless of the material employed (p ≤ 0.01). Among the materials, GIC and RBC performed similarly (p > 0.05), with the bioceramic subgroup being statistically superior to the GIC subgroup (p ≤ 0.05). Conclusions. Although well-designed randomized clinical trials are required, the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics as IOB seems to be the best available material for this purpose.
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Tucker RL, Ha WN. A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs. J Vet Dent 2021; 38:34-45. [PMID: 34192968 DOI: 10.1177/08987564211024905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vital pulp therapy (VPT) and direct pulp capping (DPC) are procedures regularly performed in dogs for the management of acute tooth fractures and as part of management for traumatic malocclusions. The purpose of this review is to apply an evidence-based medicine approach to systematically review and evaluate the scientific literature evaluating the efficacy of mineral trioxide aggregate (MTA) to other commercially available materials used for VPT in the permanent teeth of dogs. The 9 studies meeting inclusion criteria were reviewed and each studies evidence was classified using a grading system modified from the Oxford Centre for Evidence-Based Medicine. For the studies meeting inclusion criteria, MTA consistently performed as well or better than other commercially available products in terms of calcific barrier formation and biocompatibility. This review found a lack of consistency between the studies making a direct comparison of the results unreliable. Future studies would benefit from the implementation of a standard scoring system for histology, equivalent and longer study duration times and the correlation of histological and radiographic data.
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Affiliation(s)
- Rebecca Lee Tucker
- Advanced Animal Dentistry, Veterinary Specialist Services, Underwood, Queensland, Australia
| | - William Nguyen Ha
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Serin Kalay T. Effects of intracoronal bleaching agents on the surface properties of mineral trioxide aggregate. Odontology 2019; 107:465-472. [PMID: 30895486 DOI: 10.1007/s10266-019-00418-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
Bleaching agents may affect surface properties of mineral trioxide aggregate (MTA) as a coronal barrier. The purpose of this study was to investigate surface properties of MTA after exposure to intracoronal bleaching agents. MTA was set in acrylic molds with a 4 mm high central hole and a 6 mm diameter. Specimens were divided into four groups (n = 10); three groups were exposed to bleaching agents three times on every fourth day (carbamide peroxide-CP, hydrogen peroxide-HP, sodium perborate-SP) and a control group-C. The surface roughness and Vickers surface microhardness were measured. Differences between groups were analyzed using a Kruskal-Wallis test and intergroup comparisons were assessed with a Mann-Whitney U test with a Bonferroni correction (p < 0.0001). The microstructure and elemental composition were observed using a scanning electron microscope (SEM) and an energy-dispersive X-ray microanalysis (EDX) system. In terms of microhardness, the decrease in the HP group was significantly greater than that of the CP and SP groups; CP group significantly greater than that of the SP group, however, there was no significant difference between the SP and C groups. Surface roughness values were compared between groups, and no significant differences were observed between the CP and HP groups, and they exhibited significantly higher roughness values than the SP and C groups. SEM/EDX showed that the bleaching agents affected the elemental distribution. Bleaching agents adversely affected the surface roughness, surface microhardness and elemental distribution of MTA, with exposure to SP causing fewer changes on the surface properties than CP or HP.
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Affiliation(s)
- Tugba Serin Kalay
- Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, 61080, Trabzon, Turkey.
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LEE M, KANG CM, SONG JS, SHIN Y, KIM S, KIM SO, CHOI HJ. Biological efficacy of two mineral trioxide aggregate (MTA)-based materials in a canine model of pulpotomy. Dent Mater J 2017; 36:41-47. [DOI: 10.4012/dmj.2016-121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Myeongyeon LEE
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
| | - Chung-Min KANG
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
| | - Je Seon SONG
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
| | - Yooseok SHIN
- Oral Science Research Center, College of Dentistry, Yonsei University
- Department of Conservative Dentistry, College of Dentistry, Yonsei University
| | - Seunghye KIM
- Department of Pediatric Dentistry, Institute of Oral Health Science, Ajou University School of Medicine
| | - Seong-Oh KIM
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
| | - Hyung-Jun CHOI
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University
- Oral Science Research Center, College of Dentistry, Yonsei University
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