Comparative evaluation of the apical sealing ability of a ceramic based sealer and MTA as root-end filling materials - An in-vitro study

Novel bioactive nanospheres show effective antibacterial effect against multiple endodontic pathogens

Aim

The current study evaluated the antibacterial activity of a newly developed quaternary ammonium polymethacrylate (QAPM)-containing bioactive glasses (BGs) via a two-step method by our group, namely BGs-HAEMB, and explored its cytotoxicity and biocompatibility.

Methods

The antibacterial effects of the BGs-HAEMB against planktonic bacteria, bacterial biofilm formation, and experimental root canal biofilms of persistent pathogens (Enterococcus faecalis, Streptococcus sanguis and Porphyromonas endodontalis) associated with endodontic infection were evaluated in vitro by agar diffusion tests, direct contact tests and live/dead staining. The cytotoxicity and biocompatibility of BGs-HAEMB were evaluated by CCK-8 assays in vitro and a skin implantation model in vivo.

Results

Compared to three clinically used endodontic sealers (Endofill, AH Plus, and iRoot SP), BGs-HAEMB exhibited the relatively strongest antibacterial effect against E. faecalis, S. sanguis and P. endodontalis after sitting for 14 and 28 days (P < 0.01). SEM images and CLSM images also showed that for each tested bacteria, BGs-HAEMB killed the most microorganism among all the experimental groups, regardless of treatment for 7 days or 28 days (P < 0.05). Besides, the BGs-HAEMB-treated groups showed a relatively low cytotoxicity (RGRs ranging from 88.6% to 102.9%) after 1, 3, and 7 days of exposure. Meanwhile, after 28 days of implantation, the inflammatory grade in BGs-HAEMB treated group was assessed as Grade I, in which the average numbers of inflammatory cells (6.7 ± 2.1) were less than 25.

Conclusions

BGs-HAEMB exerted a long-term and stable antibacterial effect. The remarkable biocompatibility of BGs-HAEMB in vitro and in vivo confirmed its possible clinical application as a potential alternative in the development of the next generation of endodontic sealers.

In vitro evaluation of the sealing ability of combined use of iRoot BP Plus and iRoot SP for root-end filling

OBJECTIVES

The aim of this in vitro study was to evaluate the sealing ability of combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) for root-end filling.

MATERIAL AND METHODS

A total of 120 extracted human teeth were used in this study and were randomly divided into four groups. The BP-RRM+SP-RCS group included teeth retro-filled with combined use of BP-RRM and SP-RCS (n=45), and the BP-RRM group included teeth retro-filled by BP-RRM alone (n=45). Teeth without root-end preparation and filling were equally divided into positive control (n=15) and negative control (n=15). The apical sealing ability was evaluated by micro-CT analysis, dye penetrant examination, bacterial leakage test, and glucose leakage test.

RESULTS

Micro-CT analysis showed that the total void fraction of BP-RRM+SP-RCS group was significantly lower than that of BP-RRM group, particularly at the coronal 1/3 segment of the retro-filled roots. Consistently, the maximum linear depth of dye leakage in BP-RRM+SP-RCS group was less than that of BP-RRM group. Bacterial leakage test showed that the microbial leakage in BP-RRM+SP-RCS group was significantly less than that in BP-RRM group. However, no significant difference in glucose leakage between BP-RRM+SP-RCS group and BP-RRM group was observed.

CONCLUSION

Combined use of BP-RRM and SP-RCS for root-end filling promotes apical sealing in vitro.

CLINICAL RELEVANCE

Combined use of BP-RRM and SP-RCS for root-end filling exhibited better apical sealing as compared to BP-RRM alone in vitro, and this may help reducing technical sensitivity and promoting clinical efficiency during endodontic microsurgery.

Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis

Background

During the obturation procedure, sealer extrusion occurs in some cases. iRoot SP is a kind of bioceramic sealer with superior physicochemical and biological properties. This article reports the outcome of iRoot SP extrusion in root canal treatment and the potential factors associated with the outcome.

Methods

Ninety-nine patients and one hundred and eighty-five teeth treated between 2014 and 2020 were included in this retrospective study. All of the cases were filled with a single-cone technique and the iRoot SP sealer. The minimum follow-up visit period was 1 year. The outcome was evaluated by clinical examination and radiographic examination at recall and was classified as healed, healing (success), or not healed (failure).

Results

The overall success rate of all teeth was 96.8%. The success rate of adequately filled teeth was 97.3%, while that of iRoot SP extrusion was 95.8%; the difference was not statistically significant. Factors such as gender, age, tooth position, follow-up visit period, size of periapical lesion, treatment type and extruding sealer amount had no influence on the outcome of iRoot SP extruded teeth.

Conclusions

The results suggested that iRoot SP extrusion has no adverse effect on the outcome of root canal treatment, which may contribute to the endodontic treatment.

Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature

BACKGROUND

The success rate of conservative endodontic management for root fracture varies greatly based on different methods used. It has been rarely reported that calcium silicate-based materials are applied in root fracture treatment.

CASE SUMMARY

A 38-year-old male patient presented with spontaneous pain from the upper left anterior teeth for 1 wk. The spontaneous pain was subsequently relieved, but pain on mastication persisted for 3 d. The patient had a dental trauma from a boxing match 15 years ago. Cone beam computed tomography showed that the maxillary left central incisor had oblique fracture lines and a radiolucent lesion around the fracture line. The tooth was diagnosed with an oblique root fracture with no healing and symptomatic apical periodontitis. In the following conservative endodontic management, the coronal and apical fragments of the canal both were chemo-mechanically prepared and obturated using a single cone gutta-percha with iRoot SP (Innovative BioCreamix Inc, Vancouver, Canada), a new calcium silicate-based bioceramic root canal sealer. At follow-ups at 1, 6, 12, and 24 mo, the patient was asymptomatic and the radiolucency around the fracture line was healing radiographically.

CONCLUSION

Conservative root canal treatment is an alternative treatment in some cases of oblique root fracture with no healing. The application of bioceramic sealers and single core obturation techniques may also be essential to obtain an excellent outcome.