Assessment of sealing efficacy, radiopacity, and surface topography of a bioinspired polymer for perforation repair

Background

Root perforation repair presents a significant challenge in dentistry due to inherent limitations of existing materials. This study explored the potential of a novel polydopamine-based composite as a root repair material by evaluating its sealing efficacy, radiopacity, and surface topography.

Methods

Confocal microscopy assessed sealing ability, comparing the polydopamine-based composite to the gold standard, mineral trioxide aggregate (MTA). Radiopacity was evaluated using the aluminium step wedge technique conforming to ISO standards. Surface roughness analysis utilized atomic force microscopy (AFM), while field emission scanning electron microscopy (FESEM) visualized morphology.

Results

The polydopamine-based composite exhibited significantly superior sealing efficacy compared to MTA (P < 0.001). Radiopacity reached 3 mm aluminium equivalent, exceeding minimum clinical requirements. AFM analysis revealed a smooth surface topography, and FESEM confirmed successful composite synthesis.

Conclusion

This study demonstrates promising properties of the polydopamine-based composite for root perforation repair, including superior sealing efficacy, clinically relevant radiopacity, and smooth surface topography. Further investigation is warranted to assess its clinical viability and potential translation to endodontic practice.

Sealing ability of various endodontic sealers with or without ethylenediaminetetraacetic acid (EDTA) treatment on bovine root canal

This study investigated the wettability and consistency of various endodontic sealers, both inorganic and organic, and evaluated their sealing ability of root canals using the single-cone obturation technique, with and without ethylenediaminetetraacetic acid (EDTA) treatment. Bovine root canals were endodontically prepared and filled in preparation for the dye penetration test with toluidine blue solution. All sealers exhibited contact angles similar to or lower than dentin and displayed superior consistency. Among the sealers, organic sealers used without EDTA treatment showed reduced dye penetration compared to inorganic sealers. However, some inorganic and organic sealers showed dye penetration in the sealer and dentin of root canals subjected to EDTA treatment. In conclusion, the single-cone obturation technique, combined with these endodontic sealers, achieved close contact with root canal dentin due to their wettability and consistency. However, the sealing ability of certain sealers was influenced by EDTA treatment.

The effect of 2% chlorhexidine iontophoresis on dentin sealing ability of etch-and-rinse adhesive: An in vitro study

Background/purpose

Iontophoresis could enhance the delivery of chlorhexidine into oral tissue. This study aimed to determine the effect of 2% chlorhexidine iontophoresis (CHI) on the sealing ability of etch-and-rinse adhesive in human dentin using hydraulic conductance (HD) measurement, scanning electron microscopy and energy dispersive x-ray spectroscopy (SEM-EDS).

Materials and methods

Thirty-nine sound dentin specimens were prepared from 39 extracted intact third molars. Thirty specimens were used for HD measurement and randomly divided into 3 equal-sized groups; (1) No chlorhexidine treatment (control), (2) passive chlorhexidine treatment (CHT) and (3) CHI on acid-etched dentin. Each dentin surface was treated with etch-and-rinse adhesive. HD of each specimen was measured before treatment, after immediate bonding and after 14 days. The other 9 specimens were subjected to SEM-EDS analysis of the acid-etched dentin and the dentin treated with CHT and CHI. ANOVA test and Student-Newman-Keuls method were used for statistical analysis.

Results

After bonding, there was no significant difference in percentage decrease of HD among the treatment groups (P > 0.05). After 14 days, CHI and CHT groups had greater percentage decrease of HD than the control (P < 0.001 and P = 0.009, respectively). Under SEM-EDS analysis, acid-etched dentin with CHI presented opened dentinal tubule orifices and more chlorhexidine precipitates on dentin than the dentin with CHT, which strongly related to a higher percentage of chloride ions on the CHI dentin surface (P < 0.001).

Conclusion

The use of CHI on acid-etched dentin had a positive effect on dentin sealing ability of etch-and-rinse adhesive.

Utility of biphasic calcium phosphate cement as a seal for root-end filling

The recently developed biphasic calcium phosphate cement (BCPC) consists of α-tricalcium phosphate-tetracalcium phosphate as the solid phase and calcium phosphate solution as the liquid phase. BCPC powder is composed of a single solid solution with a monomodal size distribution. Here, we used a bacterial leakage model to examine the utility of BCPC as a seal for root-end filling. We prepared large (median particle size=9.96 µm; BCPC-L) and small (median particle size=4.84 µm; BCPC-S) BCPC powders. In total, 45 single-rooted teeth were instrumented, resected at the root-end, and retrofilled with experimental materials. Mineral trioxide aggregate (MTA) was used as the control. After visual confirmation of BCPC powder size and retrofilling quality by microscopy, bacterial leakage tests were conducted using Enterococcus faecalis. The bacterial leakage tests did not reveal any significant differences between BCPC-S and MTA. Our findings suggest that BCPC-S is useful for root-end filling.

A novel bioactive glass-based root canal sealer in endodontics

Background/purpose

Bioactive glass (BG), one type of bioceramics, shows similar or better characteristics to calcium silicate which has been regarded as a promising root filling material in endodontics. This study aimed to develop a novel BG-based root canal sealer for endodontics.

Materials and methods

The novel BG-based root canal sealer was composed of phytic acid derived bioactive calcium phosphosilicate glass named PSC mixed with zirconium oxide (ZrO₂) as powder, and phosphate solution (PS) dissolved with sodium alginate (SA) named PS-SA as liquid. Moreover, the physicochemical properties, mineralization, sealing ability and biocompatibility of the novel BG-based root canal sealer were evaluated.

Results

This study developed a novel BG-based sealer named BGS-SA-Zr which contained the powder of PSC and ZrO₂ and the liquid of PS-SA. Results indicated that the flow, film thickness and radiopacity of BGS-SA-Zr conformed to ISO 6876:2012. The setting time and solubility of BGS-SA-Zr were 53.7 ± 1.5 min and 21.46 ± 0.54%, respectively. The pH value of the simulated body fluid (SBF) immersed with BGS-SA-Zr raised slightly up to 7.70. The CCK-8 assay indicated that BGS-SA-Zr had no cytotoxic effects on MG-63 cells. After immersion in SBF for 4 weeks, dense hydroxyapatite crystals were observed on the surface of BGS-SA-Zr. Furthermore, there was no difference in the sealing ability between BGS-SA-Zr and the bioceramic sealer iRoot SP whether setting at 1 day or immersed in SBF for 4 weeks (P > 0.05).

Conclusion

Our results suggest that the novel BG-based sealer may be a promising sealer for endodontic treatment.

Void characteristics and tortuosity of calcium silicate-based cements for regenerative endodontics: a micro-computed tomography analysis

Background

Internal voids of materials can serve a hub for microorganism and affect the sealing ability. This study aimed to evaluate the sealing performance of calcium silicate-based cements in immature teeth treated with regenerative endodontics.

Methods

Twenty single root canals from immature permanent premolars were prepared using regenerative endodontic protocols. The root canals were randomly divided into two groups and sealed with mineral trioxide aggregate (MTA) and Biodentine (BD). The teeth were kept in humid environment for 7 days and scanned using micro-computed tomography. The voids within the cements were segmented and visualized using image processing, incorporating the modified Otsu algorithm. The porosity of each sample was also calculated as the ratio between the number of voxels of voids and the volume of the cements. Tortuosity was also calculated using the A-star algorithm.

Results

Voids larger than 70 μm were predominantly observed in the top and interfacial surface of cements. The others were evenly distributed. MTA and BD showed the same level of porosity and tortuosity at interfacial surfaces. In inner surfaces, MTA showed more less porosity and tortuosity compared to BD (p < 0.05).

Conclusions

There were no differences in sealing performance between MTA and BD.

Sealing ability and microbial leakage of root-end filling materials: MTA versus epoxy resin: A systematic review and meta-analysis

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.

Polymeric nanoparticles for endodontic therapy

The effectiveness of novel polymeric nanoparticles (NPs) application in reducing dentin permeability and facilitating dentin remineralization after endodontic treatment was evaluated. The effect of undoped NPs, zinc, calcium and doxycycline-doped NPs (Zn-NPs, Ca-NPs and D-NPs, respectively) was tested in radicular dentin. A control group without NPs was included. Radicular dentin was assessed for fluid filtration. Dentin remineralization was analyzed by scanning and transmission electron microscopy, energy-dispersive analysis, AFM, Young's modulus (Ei), Nano DMA, Raman, and X-Ray Diffraction analysis. Ca-NPs and Zn-NPs treated dentin exhibited the lowest microleakage with hermetically sealed dentinal tubules and a zinc-based salt generation onto dentin. Zn-NPs favored crystallinity and promoted the highest Ei and functional remineralization at the apical dentin, generating differences between the values of complex modulus among groups. Ca-NPs produced closure of tubules and porosities at the expense of a relative mineral amorphization, without creating zones of stress concentration. The highest sealing efficacy was obtained in Zn-NPs-treated samples, along with the highest values of Young's modulus and dentin mineralization. These high values of Ei were obtained by closing voids, cracks, pores and tubules, and by strengthening the root dentin. When using undoped NPs or Ca-NPs, deposition of minerals occurred, but radicular dentin was not mechanically reinforced. Therefore, application of Zn-NPs in endodontically treated teeth previous to the canal filling is encouraged.

Comparative evaluation of sealing ability of gutta percha and resilon as root canal filling materials- a systematic review

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.

Novel bioactive root canal sealer with antibiofilm and remineralization properties

OBJECTIVES

(1) To develop a novel bioactive root canal sealer with antibiofilm and remineralization properties using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP); (2) investigate the effects on E. faecalis biofilm inhibition, sealer flow and sealing ability, compared with an epoxy-resin-based sealer AH Plus; and (3) investigate the calcium (Ca) and phosphate (P) ion release from the sealers.

METHODS

A series of dual-cure endodontic sealers were formulated with DMAHDM and NACP at 5% and 20% by mass, respectively. Flow properties and sealing ability of the sealers were measured. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms on sealers were determined. Ca and P ion releases from the sealers were measured.

RESULTS

The new sealer containing 20% NACP and 5% DMAHDM yielded a paste flow of (28.99 ± 0.69) mm, within the range of ISO recommendations. The sealing properties of the sealer with 5% DMAHDM and 20% NACP were similar to a commercial control (p > 0.05). The sealer with DMAHDM decreased E. faecalis biofilm CFU by more than 4 orders of magnitude, compared to AH plus and experimental controls. The sealer with 20% NACP and 5% DMAHDM had relatively high levels of Ca and P ion release necessary for remineralization.

CONCLUSIONS

A new bioactive endodontic sealer was developed with strong antibiofilm activity against E. faecalis biofilms and high levels of Ca and P ion release for remineralization, without compromising the paste flow and sealing properties.

CLINICAL SIGNIFICANCE

The bioactive antibacterial and remineralizing root canal sealer is promising to inhibit E. faecalis biofilms to prevent endodontic treatment failure and secondary endodontic infections, while releasing high levels of Ca and P ions that could remineralize and strengthen the tooth structures and potentially prevent future root fractures and teeth extractions.

Comparative Evaluation of Sealing Ability, Water Absorption, and Solubility of Three Temporary Restorative Materials: An in vitro Study

Background

The quality of the coronal seal of root canal filling material is important for periapical health. Absorption of water or saliva by the temporary restorative materials leads to dimensional changes, loss of retention, staining and breaking in margin contours. Hence this study was carried out to evaluate and compare the sealing properties, water absorption and solubility of IRM (intermediate restorative material), Cavit G and GC Caviton.

Study design

Experimental, in vitro intergroup randomized control trial.

Material and methods

36 non carious premolars were randomly selected assigned to three groups, 12 teeth in each. Standard endodontic access cavities of approximately 4x4mm wide were prepared followed by the root canal obturation with Gutta-percha and restoration with experimental materials. For microleakage testing dye penetration method was used with 2% methylene blue dye. Followed by evaluation and scoring under stereomicroscope at 40x magnification.

Disc shaped 12 specimens for each group were prepared for each material, stored in desiccator at 37° C, weighed daily to verify mass stabilization (dry mass,m1). Thereafter, the specimens were stored in distilled water at 37°C for 7days to obtain the mass after saturation with water (m2). The specimens were placed in the desiccators again, at 37° C, and reweighed until a constant dry mass is obtained (m3). Water absorption (WS) and solubility (SL) was determined by using the formulas, WS = m3 - m2/V and SL= ml - m3/ V.

Results

GC Caviton showed least microleakage and least water absorption followed by IRM and Cavit G, the differences were statistically highly significant ( p < 0.001) and there was no statistical difference found in all the groups with respect to solubility.

Conclusions

GC Caviton is best and suitable temporary restorative material in endodontic interappointments followed by IRM and Cavit G

How to cite this article

Prabhakar AR, Rani NS, Naik SV. Comparative Evaluation of Sealing Ability, Water Absorption, and Solubility of Three Temporary Restorative Materials: An in vitro Study. Int J Clin Pediatr Dent 2017;10(2):136-141.

Sealing Ability of MTA Used in Perforation Repair of Permanent Teeth; Literature Review

There were several materials used to seal different types of perforation defects. MTA is one of these restorative materials that is considered the most effective, biocompatible, non-toxic, and non-irritant; promote bone healing and cementum regeneration. The objective of this article was to review and summarize the sealing ability of MTA compared with the other materials used for sealing different types of root perforations of permanent teeth. A literature search was conducted using Medline, accessed via the National Library of Medicine Pub Med from 2005 to 2015 searching for articles related to sealing ability of MTA. This study found that factors affecting prognosis are the size, site of the perforation and time elapsed as well as the repair material. MTA is an important filling material to be used for sealing different types of perforations when perforated sites sealed immediately with MTA.

Comparative evaluation of sealing ability and microstructure of MTA and Biodentine after exposure to different environments

OBJECTIVES

The aim of this study was to evaluate the sealing ability and morphological microstructure of Biodentine in comparison to ProRoot mineral trioxide aggregate (MTA) after storage in an acidic environment.

MATERIALS AND METHODS

Biodentine and ProRoot MTA were prepared and packed into the canal lumen of dentin disks. Twenty specimens of each material were further randomly divided into two groups according to the storage media: group A: materials with saline as storage medium; group B: materials with citric acid buffered at pH 5.4 as storage medium. The sealing ability was evaluated at 1, 3, 6, and 24 h and 1 or 3 months, using a fluid transport model for quantitative analysis of endodontic microleakage. The morphological microstructures of the materials were also evaluated using scanning electron microscopy.

RESULTS

During the first 24 h, MTA showed greater fluid transport values than Biodentine in both environments. At the 3-month measurement, when the materials were stored in saline, MTA showed greater ability to prevent fluid movement than Biodentine (p < 0.0001). However, when the materials were stored in an acidic environment, no statistical significant difference was found after 3 months. After storage in saline, both materials showed an uneven crystalline surface with similar hexagonal crystals. The microstructure of Biodentine changed after exposure to citric acid, showing a relatively smooth surface with more spheroidal crystals.

CONCLUSIONS

The exposure to an acidic environment, within the limits of this study, seems to result in morphological changes of Biodentine in a different manner than MTA. MTA shows good ability to prevent fluid movement over time, in both environments. The ability of Biodentine to prevent fluid movement over time was enhanced in the acidic environment.

CLINICAL RELEVANCE

The findings of the present study could imply that both materials are indicated for use in an acidic environment.

The Effect of Time of Post Space Preparation on the Seal and Adaptation of Resilon-Epiphany Se & Gutta-percha-AH Plus Sealer- An Sem Study

BACKGROUND

The field of endodontics is dynamic & ever expanding. With the availability of a wide array of products in the dental market it's an absolute necessity to evaluate their efficiency before including them into routine clinical practice.Hence, the purpose of this study is to evaluate the effect of immediate & delayed post space preparation & sealing ability of new root canal filling material & sealers.

AIM

The effect of time of post space preparation on the seal and adaptation of Resilon-Epiphany Se & Gutta-percha-AH Plus Sealer - An SEM study.

SETTINGS AND DESIGN

Eighty extracted permanent maxillary central and lateral incisors selected for the study were decoronated. Roots canals were prepared and obturated.

MATERIALS AND METHODS

Samples were divided into four groups depending on the time of post, space, preparation and obturated material.GROUP I & II: Immediate and Delayed post space preparation respectively with Gutta-percha / AH Plus as obturating material. GROUP III & IV Immediate and Delayed post space preparation with Resilon / Epiphany as the obturating material. The samples were sectioned, then measured and studied by Scanning Electron Microscope.

RESULTS

There was a significant difference found between immediate and delayed post space preparation in resilon -epiphany group (p<0.001). Similarly significant difference was seen between immediate and delayed post space preparation in AH Plus-GP group (p<0.001). Difference in the adaptation of the two materials was seen in the delayed group (p = 0.030) but the immediate group showed no signifcant difference (p =0.971).

CONCLUSION

Within the limitations of this study, immediate post space preparation shows less leakage in both the groups. Resilon-Epiphany shows better results when post space is delayed amongst the two whereas in immediate post space preparation there is no significant difference.

Evaluation and comparison of sealing ability of three different obturation techniques - Lateral condensation, Obtura II, and GuttaFlow: An in vitro study

AIM

To evaluate and compare the sealing ability between the conventional cold lateral condensation technique and two different obturating techniques - Obtura II and GuttaFlow under a stereomicroscope at 40× magnification.

MATERIALS AND METHODS

Sixty single-rooted teeth were selected and the canals were shaped with ProTaper rotary files. Irrigation was performed with 5% sodium hypochlorite and 17% EDTA. The teeth were then separated into three groups depending on the type of obturation technique. Group A (n = 20) - obturated using the Lateral condensation technique and AHplus sealer, Group B (n = 20) - obturated with Obtura II injection-molded thermoplasticized technique and AHplus sealer, and Group C (n = 20) obturated using GuttaFlow. After storing the teeth in 100% humidity for seven days at 37°C, the roots of the teeth were sectioned at five levels. The sections were then observed under a stereomicroscope at 40 × magnification and the images were analyzed for area of voids (AV) and frequency of voids.

STATISTICAL ANALYSIS USED

The data was statistically analyzed using the SPSS version 17 software. The 95% confidence intervals (CI) were calculated. One-way analysis of variance with post-hoc test and non-parametric Mann-Whitney U test was carried out, to compare the means.

RESULTS

The lowest mean of AV was recorded in the Obtura II group, 1.0% (95% CI = 0.5 - 1.5). This was statistically and significantly different from the GuttaFlow group, 3.0% (95% CI = 2.1 - 3.9). There was no significant difference between the Obtura II group and the lateral condensation group, 1.6% (95% CI= 1.0 - 2.2) with regard to the area of voids, but there was a statistically significant difference between the Lateral condensation and GuttaFlow groups. The GuttaFlow group showed the maximum number of voids, 56% (95% CI = 48 - 64), which was significantly higher than those in the lateral condensation, 26% (95% CI= 19 - 34), and Obtura II, 15% (95% CI= 10 - 21) groups.

CONCLUSION

The Obtura II technique utilizing the injection-molded thermoplasticized gutta-percha had better adaptability to the canal walls when compared to the GuttaFlow obturation and lateral condensation techniques.