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Mansour MM, Moussa SM, Meheissen MA, Aboelseoud MR. Bacterial sealing ability of calcium silicate-based sealer for endodontic surgery: an in-vitro study. BMC Oral Health 2024; 24:584. [PMID: 38773504 PMCID: PMC11107006 DOI: 10.1186/s12903-024-04309-3] [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: 01/13/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Apical surgery with standard retrograde maneuvers may be challenging in certain cases. Simplifying apical surgery to reduce operating time and streamline retrograde manipulation is an emerging need in clinical endodontics. AIM OF THE STUDY The aim of the study was to compare the bacterial sealing ability of a calcium silicate-based sealer with the single cone technique combined with root end resection only, and calcium silicate-based sealer as a retrograde filling versus MTA retrofilling, and to analyze bacterial viability using confocal laser scanning microscope (CLSM). MATERIALS AND METHODS In this in vitro experimental study, 50 extracted human maxillary incisor teeth were instrumented and randomly divided into five groups: three experimental groups, a positive control group, and a negative control group (n = 10/group). In the experimental groups, the roots were obturated using the single cone technique (SCT) and a calcium silicate-based sealer. In group 1, the roots were resected 3 mm from the apex with no further retrograde preparation or filling. In groups 2 and 3, the roots were resected, retroprepared, and retrofilled with either a calcium silicate-based sealer or MTA, respectively. Group 4 (positive control) was filled with a single gutta-percha cone without any sealer. In group 5 (negative control), the canals were left empty, and the roots were sealed with wax and nail varnish. A bacterial leakage model using Enterococcus faecalis was employed to assess the sealing ability over a 30-day period, checking for turbidity and analyzing colony forming units (CFUs) per milliliter. Five specimens from each group were examined using CLSM for bacterial viability. Data for the bacterial sealing ability were statistically analyzed using chi-squared and Kruskal-Wallis tests. RESULTS The three experimental groups did not show significant differences in terms of bacterial leakage, or bacterial counts (CFUs) (P > 0.05). However, significant differences were observed when comparing the experimental groups to the positive control group. Notably, the calcium silicate-based sealer, when used as a retrofilling, yielded the best sealing ability. CLSM imaging revealed viable bacterial penetration in all the positive control group specimens while for the experimental groups, dead bacteria was the prominent feature seen. CONCLUSION Within the limitations of this study, it could be concluded that the bacterial sealing ability of calcium silicate-based sealer with the single cone technique combined with root end resection only and calcium silicate-based sealer as a retrograde filling were comparable with MTA retrofilling during endodontic surgical procedures.
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Affiliation(s)
- Mai M Mansour
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt.
| | - Sybel M Moussa
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
| | - Marwa A Meheissen
- DMedical Microbiology & Immunology, Faculty of Medicine, Alexandria University, Alexandria, 21527, Egypt
| | - Mahmoud R Aboelseoud
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
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Agrawal TS, Singh S, Podar RS, Kulkarni G, Gadkari A, Agarwal N. In vitro comparative evaluation of apical leakage using a bioceramic sealer with three different obturating techniques: A glucose leakage model. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:76-81. [PMID: 38389733 PMCID: PMC10880467 DOI: 10.4103/jcd.jcd_303_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/05/2023] [Accepted: 11/03/2023] [Indexed: 02/24/2024]
Abstract
Context Bioceramic sealers have improved sealing ability by forming an interfacial apatite layer that chemically bonds the sealer and radicular dentin thus decrease apical leakage. Aim This study aims to evaluate and compare the apical leakage of Cerafill RCS bioceramic sealer and gutta percha when used with three different obturating techniques. Materials and Methods Thirty-four extracted single-rooted premolars were decoronated and prepared up to size F3. Then, the specimens were randomly divided into 3 experimental groups (n = 10) cold lateral obturation technique, warm vertical obturation technique, single-cone obturation technique, positive and negative control groups (n = 2), according to the obturation technique used along with a bioceramic sealer. To evaluate apical leakage, all specimens were mounted in a glucose leakage model and assessed at 7 and 14 days using an ultraviolet-visible spectrophotometer. Statistical Analysis The results were subjected to ANOVA/Kruskal-Wallis ANOVA; followed by post hoc analysis using Bonferroni correction. Results Significant differences were found in the cumulative leakage of all the three experimental groups. Significantly higher leakage was found in groups obturated using single-cone obturation technique as compared to warm vertical compaction technique at both 7 and 14 days. Conclusions Warm vertical compaction showed a better sealing result than single-cone obturation techniques at all observation periods.
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Affiliation(s)
- Tanvi S Agrawal
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Rajesh S Podar
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Gaurav Kulkarni
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Anuprita Gadkari
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Navin Agarwal
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
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Kim S, Lee JW, Kim JH, Truong VM, Park YS. The impact of Morse taper implant design on microleakage at implant-healing abutment interface. Dent Mater J 2022; 41:767-773. [PMID: 35858791 DOI: 10.4012/dmj.2022-022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The microbial leakage at the implant-abutment interface (IAI) is one cause of peri-implant infection that puts long-term implant stability at risk. The present study compared two types of Morse taper implants in terms of sealing performance at the implanthealing abutment interface. Three implant systems, one of which exhibited a partial face-contact design (TSO) and the other two a line-contact design (TSM and BLT), were analyzed in vitro using two quantitative implant leakage measuring techniques: air-injection pressure measurement test and microbial examination. An in-house-developed device was used to determine implant leakage by recording the initial drop in pressure while injecting air through the implant. The microbial examination measured the absorbances of culture mediums in which the inoculated implants were contained. Significant difference was found between the partial face- and line-contact groups (p<0.001). Both tests revealed that partial face-contact implants are more prone to leakage than line-contact implants.
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Affiliation(s)
- Soyeon Kim
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Joo Won Lee
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Jae-Heon Kim
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Van Mai Truong
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Young-Seok Park
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University.,Center for Future Dentistry, School of Dentistry, Seoul National University
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De-Deus G, Santos GO, Monteiro IZ, Cavalcante DM, Simões-Carvalho M, Belladonna FG, Silva EJNL, Souza EM, Licha R, Zogheib C, Versiani MA. Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals. Int Endod J 2022; 55:795-807. [PMID: 35383977 DOI: 10.1111/iej.13744] [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: 05/05/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To assess the interfacial adaptation (gap-containing areas) of two root canal sealers (EndoSequence BC Sealer and AH Plus) to a conventional gutta-percha (GP) cone (GP-sealer interface) in oval-shaped canals filled using the single cone technique. METHODOLOGY Sixteen teeth with oval-shaped canals were selected, scanned in a micro-computed tomographic device, and pair-matched according to the volume, aspect ratio and configuration of root canals. Root canals were then sequentially prepared with WaveOne Gold Primary and Large instruments, followed by filling with WaveOne Large GP points associated with either the premixed calcium-silicate EndoSequence BC Sealer or the epoxy resin-based AH Plus sealer (n = 8 per group) using the single cone technique. After 7 days stored in phosphate-buffered saline solution at 37°C, the specimens were rescanned and the reconstructed images segmented in order to differentiate the filling materials (sealer and GP cone) to the dentine. A total of 453 cross-sectional slices were assessed and categorized according to the presence or absence of gaps at the GP-sealer interface. Mann-Whitney U-test verified the differences between groups and were considered significant at alpha = 5%. RESULTS Gaps were non-homogenously distributed in two-dimensional axial cross-section images and none of the specimens showed completely gap-free areas along the entire GP-sealer interface. Root canals filled with EndoSequence BC Sealer and AH Plus displayed 171 (37.75%) and 136 (30.02%) slices with gaps in the GP-sealer interface and these frequencies were statistically significant (p = .000). CONCLUSIONS Although none of the specimens had a gap-free area along the entire GP-sealer interface, oval canals filled with AH Plus showed less gaps than the ones filled with EndoSequence BC Sealer.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - Gustavo O Santos
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | | | | | | | | | | | - Erick M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Raphael Licha
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marco A Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Torres FFE, Jacobs R, EzEldeen M, de Faria-Vasconcelos K, Guerreiro-Tanomaru JM, Dos Santos BC, Tanomaru-Filho M. How do imaging protocols affect the assessment of root-end fillings? Restor Dent Endod 2022; 47:e2. [PMID: 35284328 PMCID: PMC8891473 DOI: 10.5395/rde.2022.47.e2] [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: 08/17/2020] [Revised: 09/29/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives This study investigated the impact of micro-computed tomography (micro-CT)-based voxel size on the analysis of material/dentin interface voids and thickness of different endodontic cements. Materials and Methods Following root-end resection and apical preparation, maxillary premolars were filled with mineral trioxide aggregate (MTA), Biodentine, and intermediate restorative material (IRM) (n = 24). The samples were scanned using micro-CT (SkyScan 1272; Bruker) and the cement/dentin interface and thickness of materials were evaluated at voxel sizes of 5, 10, and 20 µm. Analysis of variance and the Tukey test were conducted, and the degree of agreement between different voxel sizes was evaluated using the Bland and Altman method (p < 0.05). Results All materials showed an increase in thickness from 5 to 10 and 20 µm (p < 0.05). When evaluating the interface voids, materials were similar at 5 µm (p > 0.05), while at 10 and 20 µm Biodentine showed the lowest percentage of voids (p < 0.05). A decrease in the interface voids was observed for MTA and IRM at 20 µm, while Biodentine showed differences among all voxel sizes (p < 0.05). The Bland-Altman plots for comparisons among voxel sizes showed the largest deviations when comparing images between 5 and 20 µm. Conclusions Voxel size had an impact on the micro-CT evaluation of thickness and interface voids of endodontic materials. All cements exhibited an increase in thickness and a decrease in the void percentage as the voxel size increased, especially when evaluating images at 20 µm.
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Affiliation(s)
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mostafa EzEldeen
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria-Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Chopra V, Davis G, Baysan A. Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers-A Systematic Review and Meta-Analysis of Laboratory-Based Studies. MATERIALS 2021; 15:ma15010229. [PMID: 35009375 PMCID: PMC8745986 DOI: 10.3390/ma15010229] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The aim of this systematic review is to analyse the effect of physico-chemical properties of calcium silicate-based sealers in comparison to epoxy resin sealers in permanent teeth using a single-cone obturation technique. METHODS The study was conducted according to the guidelines of Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Literature search was performed using the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ, Open Gray with no language restrictions until October 2020. Two reviewers assessed the studies for eligibility. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was performed using the RevMan software (p < 0.05). RESULTS Results from the 28 included studies showed that the mean difference in adaptation to root canal walls (marginal adaptation, interfacial gaps and void volume) for both sealers were non-significant. However, void volume values showed a significant mean difference (p < 0.00001) favouring the calcium silicate-based sealers. The pooled meta-analysis reported statistically significant differences for apical microleakage (p = 0.0007) whilst there were non-significant mean differences for fracture resistance (p = 0.09) and push-out bond strength (p = 0.63). The heterogeneity among the included studies was 97% (I2). CONCLUSIONS Within the limitations of this review, calcium silicate-based sealers demonstrated a similar or superior performance in comparison to resin-based sealers in terms of the physico-chemical properties.
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Affiliation(s)
- Viresh Chopra
- Department of Adult Restorative Dentistry, Oman Dental College, Department of Oral Bioengineering, Queen Mary University, Mile End Rd. Bethnal Green, London E1 4NS, UK;
| | - Graham Davis
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Mile End Rd. Bethnal Green, London E1 4NS, UK;
| | - Aylin Baysan
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Mile End Rd. Bethnal Green, London E1 4NS, UK;
- Correspondence: ; Tel.: +44-96896632942
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Kaul S, Kumar A, Badiyani BK, Sukhtankar L, Madhumitha M, Kumar A. Comparison of Sealing Ability of Bioceramic Sealer, AH Plus, and GuttaFlow in Conservatively Prepared Curved Root Canals Obturated with Single-Cone Technique: An In vitro Study. J Pharm Bioallied Sci 2021; 13:S857-S860. [PMID: 34447215 PMCID: PMC8375899 DOI: 10.4103/jpbs.jpbs_52_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Inadequate obturation techniques of the root canal system have been found to be the most frequent reason of failure post root canal treatment. An ideal endodontic sealer should fulfill all ideal requisites. The present study aimed to compare apical sealing ability between bioceramic (BC) sealer, GuttaFlow, and AH Plus. Methodology: One hundred and twenty-five curved roots of maxillary and mandibular third molar teeth with fully formed apex were collected for this study. The root canals were cleaned and shaped using a standard single-cone preparation to file at the established working length and divided into five groups of 25 each. Dye leakage was carried out. Group A: with GP, using EndoSequence BC sealer with conventional with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group B: with ceramic coated with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group C: with GP, using AH Plus sealer (Dentsply, De-Trey Konstanz, Germany) with 4% gutta-percha; Group D: with GuttaFlow bioseal (Roeko-Coltène/Whaledent, Langenau, Germany) with 4% Gutta-percha; and Group E is a negative control group. Statistical analysis was done using the Statistical Package for the Social Sciences software and Student's unpaired t-test. Results: The group AH Plus showed more leakage values than the GuttaFlow group and of two groups of BC sealer and negative control. Student's unpaired t-test disclosed no significant difference (P < 0.05) between the groups. Conclusion: None of the sealers used in the study could completely seal the apical foramen to have a fluid-tight seal.
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Affiliation(s)
- Shalan Kaul
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu, India
| | - Ajay Kumar
- Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Bhumika Kamal Badiyani
- Department of Public Health Dentistry, Clinical Practitioner, Mumbai, Maharashtra, India
| | | | - M Madhumitha
- Department of Pedodontics and Preventive Dentistry, RVS Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Amit Kumar
- Department of Public Health Dentistry, Clinical Practitioner, Mumbai, Maharashtra, India
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Dioguardi M, Alovisi M, Sovereto D, Troiano G, Malagnino G, Di Cosola M, Cazzolla AP, Laino L, Lo Muzio L. Sealing ability and microbial leakage of root-end filling materials: MTA versus epoxy resin: A systematic review and meta-analysis. Heliyon 2021; 7:e07494. [PMID: 34401555 PMCID: PMC8353296 DOI: 10.1016/j.heliyon.2021.e07494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/27/2021] [Accepted: 07/02/2021] [Indexed: 01/30/2023] Open
Abstract
Objectives The purpose of this systematic review of the literature is to investigate which of the epoxy-based cements and those based on Tricalciumsilicate (MTA, Bioceramic) have the best sealing capacity through the analysis of studies that have provided a survey model in vitro of bacteria leakage. Source The articles were identified using electronic databases such as PubMed, Scopus, the search was conducted between 8.12.2020 and 31.12.2020 and a last search was conducted on 2.12.2021. Study selection 678 records were identified and after removing the duplicates we obtain 481 records, with the first phase of screening and selection of records we reached 204 and with the application of the inclusion and exclusion criteria we selected 31 articles, only 9 studies made a direct comparison between the two endodontic cement categories and presented data that could be included in the metaanalysis. Data The meta-analysis of first outcome shows an odds ratio of 2.70 C.I.(Confidence Interval) [1.54, 4.73], the test for overall effect has a p value = 0.0005 with a heterogeneity index of I 2 of 9%; The second outcome meta-analysis shows an Odds Ratio of 1.50 C.I. (Confidence Interval) [0.92, 2.46] with a p value of 0.10 with an I 2 of 79%. Conclusion the sealing ability is higher for epoxy resins than for tricalcium silicate-based cements, for observation periods longer than 90 days. Clinical relevance The knowledge of the cement that determines the best sealing ability and resistance to microbial leakage, can be of help for the dentist who has to face clinical situations such as endodontic retreatments whose failure is determined by the persistence of bacteria in the endodontic canals.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Giancarlo Malagnino
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
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Sfeir G, Zogheib C, Patel S, Giraud T, Nagendrababu V, Bukiet F. Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives. MATERIALS 2021; 14:ma14143965. [PMID: 34300886 PMCID: PMC8306764 DOI: 10.3390/ma14143965] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide-eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners' clinical habits rather than manufacturers' recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (C.Z.)
| | - Shanon Patel
- King’s College London Dental Institute, Guy’s Tower, Guy’s Hospital, St. Thomas’ Street, London SE1 9RT, UK;
| | - Thomas Giraud
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
- Correspondence: ; Tel.: +33-(0)6-4395-2183
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11
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Kalantar Motamedi MR, Mortaheb A, Zare Jahromi M, Gilbert BE. Micro-CT Evaluation of Four Root Canal Obturation Techniques. SCANNING 2021; 2021:6632822. [PMID: 33717394 PMCID: PMC7932785 DOI: 10.1155/2021/6632822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE The aim of this in vitro study was to evaluate the quality of four root canal obturation techniques using microcomputed tomography (micro-CT). MATERIALS AND METHODS A total of 36 mandibular first premolars with mostly round canals were decoronated, then instrumented up to a size F3 rotary file, and dressed with an epoxy resin-based sealer. Subsequently, they were divided into 4 different groups (n = 9) based on the method of obturation: lateral condensation using 0.02 tapered master cone (LC2), lateral condensation using 0.04 tapered master cone (LC4), matched single-cone technique (MS), and matched single cone-mediated ultrasonic activation (MSUA). All the teeth were scanned using micro-CT (resolution of 19 μm), and the percentage volume of voids was calculated. One-way analysis of variance and Tukey test were used to analyze the data (α = 0.05). RESULTS The total percentage volume of voids was significantly lower in the MSUA group compared to all other groups (P < 0.05). The total percentage volume of voids was significantly lower in the MS group compared to the LC4 (P < 0.001) and LC2 (P < 0.001) groups. However, there was no significant difference between the LC2 and LC4 groups (P < 0.65). CONCLUSIONS MSUA, significantly, showed the least root canal filling voids amongst all the obturation techniques studied. MSUA can be considered an effective method for the filling of the round root canals. In general, lateral condensation using either 0.02 or 0.04 tapered master cones had significantly the highest volume percentage of voids amongst the experimental groups.
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Affiliation(s)
| | - Amin Mortaheb
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Brett E. Gilbert
- Department of Endodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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Miura H, Yoshii S, Fujimoto M, Washio A, Morotomi T, Ikeda H, Kitamura C. Effects of Both Fiber Post/Core Resin Construction System and Root Canal Sealer on the Material Interface in Deep Areas of Root Canal. MATERIALS (BASEL, SWITZERLAND) 2021; 14:982. [PMID: 33669868 PMCID: PMC7923224 DOI: 10.3390/ma14040982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to examine the resin polymerization of a fiber post/core resin construction system and the interface between resin and root canal sealers, which are important for root canal sealing. We used the i-TFC Luminus fiber post and i-TFC Luminus LC flow (i-TFC-L), the GC fiber post and Unifil Core EM (GCF), and the FiberKor post and Build-It FR (FKP) as core construction systems, and Nishika Canal Sealer BG (CS-BG), Metaseal Soft (META), and Nishika Canal Sealer EN (CS-EN) as sealers. The light transmission of fiber posts (n = 5), the polymerization of core resin (n = 5), and the adhesion between the sealer and core resin (n = 10) were evaluated. The i-TFC Luminus fiber post light transmission was significantly higher than that of other posts. Without shielding, i-TFC-L showed a significantly greater amount of polymerized resin than the other systems. With shielding, although i-TFC-L showed a significantly greater amount of polymerized resin immediately after light irradiation, polymerized resin was significantly greater in GCF and FKP after 10 min. All systems adhered to CS-BG and META but not to CS-EN. These results indicate that resin polymerization in the cavity differs among fiber post/core resin construction systems and that the adhesion of the resin and sealer depends on the property of the sealer.
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Affiliation(s)
- Hiroki Miura
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
| | - Shinji Yoshii
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
| | - Masataka Fujimoto
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
| | - Ayako Washio
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
| | - Takahiko Morotomi
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
| | - Hiroshi Ikeda
- Division of Biomaterials, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan;
| | - Chiaki Kitamura
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; (H.M.); (S.Y.); (M.F.); (A.W.); (T.M.)
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Comparison of apical sealing ability of bioceramic sealer and epoxy resin-based sealer using the fluid filtration technique and scanning electron microscopy. J Dent Sci 2020; 15:186-192. [PMID: 32595900 PMCID: PMC7305452 DOI: 10.1016/j.jds.2019.09.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/25/2019] [Indexed: 11/20/2022] Open
Abstract
Background/purpose A perfect sealing of root canal system is essential for preventing ingress of bacteria from the oral environment. The purpose of this study was to evaluate the apical sealing ability of bioceramic (EndoSequence BC Sealer®) and epoxy resin-based (AH Plus®) sealers at 24 h, 7 days and 4 weeks. Materials and methods Forty two extracted human upper anterior teeth were sectioned to leave the root 15-mm long, then all the roots were instrumented using a set of ProTaper® rotary instruments. Four roots were selected randomly as controls, and the remaining 38 roots were randomly divided into 2 groups of 19 roots each: group 1: EndoSequence BC Sealer® and gutta-percha, and group 2: AH Plus® and gutta-percha using a multiple wave condensation technique. The apical sealing ability of the filled root canal was measured using the fluid filtration method with 200 mmHg (26.67 KPa) above atmospheric pressure at 24 h, 7 days and 4 weeks. Scanning electron microscopy (SEM) was used to assess the adaptation and penetration of the sealers. The apical microleakage between 2 groups was compared using Student's t-test. P < 0.05 was considered statistically significant. Results EndoSequence BC Sealer® had significantly better sealing ability than AH Plus® at all test periods (P < 0.001). SEM showed EndoSequence BC Sealer® had better penetration into dentinal tubules. Conclusion Bioceramic sealer could promote proper sealing of root canals obturated with multiple wave condensation.
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Tanomaru-Filho M, Torres FFE, Pinto JC, Santos-Junior AO, Tavares KIMC, Guerreiro-Tanomaru JM. Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers. Restor Dent Endod 2020; 45:e34. [PMID: 32839715 PMCID: PMC7431941 DOI: 10.5395/rde.2020.45.e34] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 12/20/2022] Open
Abstract
Objectives This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.
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Affiliation(s)
- Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | - Jader Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Kim JC, Moe MMK, Kim SK. A micro-computed tomographic evaluation of root canal filling with a single gutta-percha cone and calcium silicate sealer. Restor Dent Endod 2020; 45:e18. [PMID: 32483535 PMCID: PMC7239679 DOI: 10.5395/rde.2020.45.e18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/15/2019] [Accepted: 12/19/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to evaluate the void of root canal filling over time when a calcium silicate sealer was used in the single gutta-percha cone technique. Materials and Methods Twenty-four J-shaped simulated root canals and twenty-four palatal root canals from extracted human maxillary molars were instrumented with ProFile Ni-Ti rotary instruments up to size 35/0.06 or size 40/0.06, respectively. Half of the canals were filled with Endoseal MTA and the other half were with AH Plus Jet using the single gutta-percha cone technique. Immediately after and 4 weeks after the root canal filling, the samples were scanned using micro-computed tomography at a resolution of 12.8 μm. The scanned images were reconstructed using the NRecon software and the void percentages were calculated using the CTan software, and statistically analyzed by 1-way analysis of variance, paired t-test and Tukey post hoc test. Results After 4 weeks, there were no significant changes in the void percentages at all levels in both material groups (p > 0.05), except at the apical level of the AH Plus Jet group (p < 0.05) in the simulated root canal showing more void percentage compared to other groups. Immediately after filling the extracted human root canals, the Endoseal MTA group showed significantly less void percentage compared to the AH Plus Jet group (p < 0.05). Conclusions Under the limitations of this study, the Endoseal MTA does not seem to reduce the voids over time.
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Affiliation(s)
- Jong Cheon Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Maung Maung Kyaw Moe
- Department of Conservative Dentistry, University of Dental Medicine, Mandalay, Myanmar
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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Torres FFE, Guerreiro-Tanomaru JM, Chavez-Andrade GM, Pinto JC, Berbert FLCV, Tanomaru-Filho M. Micro-computed tomographic evaluation of the flow and filling ability of endodontic materials using different test models. Restor Dent Endod 2020; 45:e11. [PMID: 32483530 PMCID: PMC7239685 DOI: 10.5395/rde.2020.45.e11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/16/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives This study compared the flow and filling of several retrograde filling materials using new different test models. Materials and Methods Glass plates were manufactured with a central cavity and 4 grooves in the horizontal and vertical directions. Grooves with the dimensions used in the previous study (1 × 1 × 2 mm; length, width, and height respectively) were compared with grooves measuring 1 × 1 × 1 and 1 × 2 × 1 mm. Biodentine, intermediate restorative material (IRM), and mineral trioxide aggregate (MTA) were evaluated. Each material was placed in the central cavity, and then another glass plate and a metal weight were placed over the cement. The glass plate/material set was scanned using micro-computed tomography. Flow was calculated by linear measurements in the grooves. Central filling was calculated in the central cavity (mm3) and lateral filling was measured up to 2 mm from the central cavity. Results Biodentine presented the least flow and better filling than IRM when evaluated in the 1 × 1 × 2 model. In a comparison of the test models, MTA had the most flow in the 1 × 1 × 2 model. All materials had lower lateral filling when the 1 × 1 × 2 model was used. Conclusions Flow and filling were affected by the size of the test models. Higher grooves and materials with greater flow resulted in lower filling capacity. The test model measuring 1 × 1 × 2 mm showed a better ability to differentiate among the materials.
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Affiliation(s)
| | | | | | - Jader Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Root fillings with a matched-taper single cone and two calcium silicate–based sealers: an analysis of voids using micro-computed tomography. Clin Oral Investig 2020; 24:4487-4492. [DOI: 10.1007/s00784-020-03313-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 04/24/2020] [Indexed: 12/13/2022]
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Pandey P, Aggarwal H, Tikku AP, Singh A, Bains R, Mishra S. Comparative evaluation of sealing ability of gutta percha and resilon as root canal filling materials- a systematic review. J Oral Biol Craniofac Res 2019; 10:220-226. [PMID: 32489825 DOI: 10.1016/j.jobcr.2019.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 12/01/2022] Open
Abstract
This systematic review aims to comparatively evaluate the sealing ability gutta-percha and resilon as root canal filling materials. A Medline search was conducted to identify in-vitro studies published between October 01, 2004 and October 01, 2019, conducted on human extracted teeth, published in English and testing the sealing ability of gutta-percha and resilon as root canal filling materials using fluid filtration method. The search identified fifty-five published articles. After a thorough screening, five articles meeting the selection, and validity assessment criteria were critically appraised. The results indicated that during the initial time-period, resilon/epiphany sealer has better sealing ability than gutta-percha. However, over a period of time the resilon system demonstrated increased fluid flow. Gutta-percha with AH plus sealer showed the best long term sealing ability.
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Affiliation(s)
- Pragya Pandey
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King Georges Medical University, Lucknow, India
| | - Himanshi Aggarwal
- Department of Prosthodontics, Saraswati Dental College, Lucknow, India
| | - A P Tikku
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King Georges Medical University, Lucknow, India
| | - Arpit Singh
- Department of Public Health and Community Medicine Central University of Kerala, Kerala, India
| | - Rhythm Bains
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King Georges Medical University, Lucknow, India
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Endodontic sealers based on calcium silicates: a systematic review. Odontology 2018; 107:421-436. [DOI: 10.1007/s10266-018-0400-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 11/19/2018] [Indexed: 01/21/2023]
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