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Alhajj MN, Daud F, Al-Maweri SA, Johari Y, Ab-Ghani Z, Jaafar M, Naito Y, Prananingrum W, Ariffin Z. Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2022; 34:1166-1178. [PMID: 36239133 DOI: 10.1111/jerd.12974] [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: 07/05/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. METHODS A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05. RESULTS A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias. CONCLUSION The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers. CLINICAL SIGNIFICANCE The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.
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Affiliation(s)
- Mohammed Nasser Alhajj
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.,Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Fadhilah Daud
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Yanti Johari
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zuryati Ab-Ghani
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mariatti Jaafar
- School of Materials and Mineral Resources, Engineering Campus, Universiti Sains Malaysia, Penang, Malaysia
| | - Yoshihito Naito
- Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences, The University of Tokushima, Tokushima, Japan
| | - Widyasri Prananingrum
- Department of Dental Material Science and Technology, Hang Tuah University, Surabaya, Indonesia
| | - Zaihan Ariffin
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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Chaudhari PS, Chandak MG, Jaiswal AA, Mankar NP, Paul P. A Breakthrough in the Era of Calcium Silicate-Based Cements: A Critical Review. Cureus 2022; 14:e28562. [PMID: 36185838 PMCID: PMC9517689 DOI: 10.7759/cureus.28562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
Abstract
Calcium silicate-based cements (CSCs) or mineral trioxide aggregate (MTA) lookalike materials are blocks of cement or root canal sealers produced from calcium (Ca) and silicate. They have superior sealing ability, bioactivity, and marginal adaptability, making them appropriate for various dental treatment applications. Mineral trioxide aggregate is widely used in numerous endodontic repair techniques. The capacity of this cement to promote tissue regeneration and stimulate mineralization accounts for its widespread usage in pulp capping, apexification, apical surgeries, and revascularization. Several studies have been conducted to investigate changes in the components of MTA-based types of cement directed to improve their presentation clinically. To improve flowability, new Ca silicate-based formulations have been introduced commercially. In these new formulations, essential features such as adequate radiopacity and setting time, color stability, alkaline pH, and calcium ion release and biocompatibility must be considered. Owing to an increased range of indications of CSCs, including some for restorative dentistry, and with the emergence of novel silicate calcium-based materials with considerable changes in their compositions, it is necessary to examine the available scientific literature that evaluates their usage in these applications. Therefore, this review paper aims to assess the existing knowledge of CSCs, emphasizing their potential uses in restorative and endodontic dentistry. This report strives to update doctors' understanding of CSCs, allowing for a better therapeutic approach.
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Prado M, Martiniano K, Pereira A, Cortellazzi K, Marciano M, Abuna G, de-Jesus-Soares A. Do intracanal medications used in regenerative endodontics affect the bond strength of powder-to-liquid and ready-to-use cervical sealing materials? J Conserv Dent 2021; 24:464-469. [PMID: 35399766 PMCID: PMC8989169 DOI: 10.4103/jcd.jcd_428_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022] Open
Abstract
Aim: This study evaluated the effect of four intracanal medications commonly used in regenerative endodontic procedures on the bond strength of four calcium silicate-based materials, in which two are powder-to-liquid products (MTA and MTA-HP) and the other are ready-to-use materials (EndoSequence Root Repair Material Fast Set Putty [ERRM] and Bioceramic Repair [BIO-C Repair]). Methods: Ten bovine central incisors were selected and 4 slices (1.0 ± 0.1 mm) were prepared from each root. Next, four 0.8-mm wide holes were drilled in each slice and specimens were filled with one of the following intracanal medications: triple antibiotic paste, double antibiotic paste, calcium hydroxide with distilled water, and calcium hydroxide with 2% chlorhexidine gel. After 21 days, holes were filled with one of the materials: MTA, MTA-HP, ERRM, or BIO-C Repair. After storage, push-out test and failure analysis were performed. Data were submitted to analysis of variance in a 4 × 4 factorial scheme. Tukey's test was used for multiple comparisons. Results: The use of different interappointment dressings did not influence the results (P > 0.05). ERRM and BIO-C Repair presented significantly higher values than MTA and MTA-HP (P < 0.0001). Specimens showed a 100% occurrence of adhesive failures. Conclusion: The use of different intracanal medications presented similar impact on bond strength of calcium silicate-based materials. Ready-to-use ERRM and BIO-C Repair materials presented the best push-out values to dentine, whereas powder-to-liquid MTA and MTA-HP cements showed the lowest results.
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Kharchi AS, Tagiyeva-Milne N, Kanagasingam S. Regenerative Endodontic Procedures, Disinfectants and Outcomes: A Systematic Review. Prim Dent J 2020; 9:65-84. [PMID: 33225847 DOI: 10.1177/2050168420963302] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS This systematic review aims to identify and synthesise available evidence to determine the clinical and radiographic outcomes of REP involving any disinfection irrigant together with a non-antibiotic intracanal medicament. METHODS Experimental and observational studies evaluating the outcomes of REP in immature non-vital permanent teeth in 6-16 year olds, where the protocol used any type of disinfectant irrigant together with a non-antibiotic intracanal medicament (non-setting calcium hydroxide) were included. Data was narratively synthesised and presented in respect to the primary outcome (elimination of symptoms and infection) and secondary outcomes (increase in root length/width; positive response to vitality testing; patient-reported outcomes; adverse effects). MAIN FINDINGS 1628 studies were identified, of which five met the eligibility criteria for inclusion in the review. Studies included one randomised control trial and four observational studies. All five studies showed an absence of clinical signs and symptoms for all teeth postoperatively with radiographic resolution or absence of pathology following the disinfection stages of the REP used. Choice of secondary outcomes were inconsistent but included further root development, coronal discolouration and root canal calcifications postoperatively. There was a high risk of bias in all five studies and subsequently the quality of the evidence base was judged to be low. PRINCIPLE CONCLUSIONS REP using a non-antibiotic disinfectant approach appears capable of providing satisfactory outcomes for a non-vital immature permanent tooth. Further high-quality research is required before solid recommendations towards clinical practice guidelines for the disinfection portion of REP can be implemented.
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Affiliation(s)
- Adam S Kharchi
- Clinical teaching fellow, University of Leeds; Associate General Dental Practitioner with a Special Interest in Endodontology
| | - Nara Tagiyeva-Milne
- Co-Director, MIPH, Lecturer (Epidemiology), Liverpool School of Tropical Medicine, University of Liverpool
| | - Shalini Kanagasingam
- Senior Clinical Lecturer, Specialist Endodontist, Course Lead MSc & MClinDent Endodontology; School of Dentistry, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, UK
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Song W, Sun W, Chen L, Yuan Z. In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics. Front Bioeng Biotechnol 2020; 8:580954. [PMID: 33195142 PMCID: PMC7658386 DOI: 10.3389/fbioe.2020.580954] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Endodontic therapy aims to preserve or repair the activity and function of pulp and periapical tissues. Due to their excellent biological features, a substantial number of calcium silicate-based bioceramics have been introduced into endodontics and simultaneously increased the success rate of endodontic treatment. The present manuscript describes the in vivo biocompatibility and bioactivity of four types of calcium silicate-based bioceramics in endodontics.
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Affiliation(s)
- Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Wei Sun
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Zhenglin Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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Yaghmoor RB, Platt JA, Spolnik KJ, Chu TMG, Yassen GH. Effect of Hydrogel-Based Antibiotic Intracanal Medicaments on Push-Out Bond Strength. Eur J Dent 2020; 14:575-583. [PMID: 32726856 PMCID: PMC7535964 DOI: 10.1055/s-0040-1713956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effects of typical clinical concentration (1,000 mg/mL), low concentration (1 mg/mL) triple antibiotic pastes (TAP), and double antibiotic pastes (DAP) on the bond strength between various root cements and radicular dentin. MATERIALS AND METHODS Intact single-rooted human teeth (n = 144) were horizontally decoronated and canals instrumented. The roots were treated for 4 weeks with Ca(OH)2, 1,000 mg/mL of TAP or DAP, and 1 mg/mL of TAP or DAP. Untreated roots served as a control. After treatment, the medicaments were irrigated and each group was divided into three subgroups receiving MTA, Biodentine, or Endosequence putty cement. After 2 weeks, coronal and middle root cylinders were obtained from each root. Push-out bond strength test and failure analysis were performed for all root cylinders. STATISTICAL ANALYSIS Three-way ANOVA, pairwise comparisons and logistic regression were used for statistical analyses. A significance level of 5% was used. RESULTS For MTA applied in the coronal part of the roots, 1 mg/mL DAP and TAP and Ca(OH)2 demonstrated significantly higher bond strength compared with the typical clinical concentration and the control groups. For Biodentine applied coronally in the roots, 1 mg/mL of DAP resulted in significantly higher bond strength than all other groups. For Endosequence putty cement applied coronally in the roots, 1 mg/mL of DAP offered significantly higher bond strength than all groups except for Ca(OH)2. CONCLUSION The use of 1 mg/mL DAP resulted in significantly higher push-out bond strength compared with the typical clinical concentration of TAP and DAP regardless of the type of the root cement used.
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Affiliation(s)
- Rayan B Yaghmoor
- Department of Restorative Dentistry, College of Dental Medicine, Umm Al-Qura university, Makkah, Saudi Arabia.,Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, United States
| | - Jeffrey A Platt
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, United States
| | - Kenneth J Spolnik
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, Indiana, United States
| | - Tien Min Gabriel Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, United States
| | - Ghaeth H Yassen
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, United States.,Department of Endodontics, Case School of Dental Medicine, Cleveland, Ohio, United States
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