Bioceramic-based Sealers Research Articles

Effect of PHMB on the Push-out of Bioceramic-Based Sealer

Effect of PHMB on the Push-out of Bioceramic-Based Sealer

Comparative evaluation of continuous and sequential chelation on the dentinal tubule penetration of bioceramic-based sealer - A confocal laser scanning microscopic study.

Effective endodontic treatment relies heavily on proper instrumentation, thorough disinfection, and precise three-dimensional obturation of the root canal system. This study aims to evaluate and compare continuous chelation (etidronic acid and sodium hypochlorite [NaOCl]) and sequential chelation (citric acid and NaOCl) on the dentinal tubule penetration of bioceramic-based sealer (Bio-C)-A confocal laser scanning microscopic study. In vitro experimental study. Sixty extracted permanent single-rooted teeth were selected and decoronated below cementoenamel junction to get a standardized length of 12 mm across all samples followed by enlargement of root canals till rotary ProTaper F3. The samples were randomly divided into three groups: Group I (control): Canals were irrigated with 3 mL 17% ethylenediaminetetraacetic acid/3 mL 3% NaOCl; Group II: Canals were irrigated with 10 mL etidronic acid + NaOCl solution; and Group III: Canals were irrigated with 3 mL 10% citric acid followed by 3 mL 3% NaOCl. 0.1% rhodamine B dye was mixed with Bio-C sealer followed by obturation. All the samples were subjected to confocal laser scanning microscopy evaluation. One-way analysis of variance with the Bonferroni post hoc test was used for the statistical analysis. The level of significance was set at P < 0.05. The pairwise comparison of depth of penetration showed statistically significant results in all the coronal, middle, and apical thirds. Group II showed better depth of penetration than Groups I and III. Continuous chelation protocol using etidronic acid and NaOCl showed greater and statistically significant sealer penetration depth when compared to the sequential chelation protocol, i.e., citric acid at all three levels.

Quality of different obturation techniques to fill perforating internal root resorption: a micro-computed tomographic study

BackgroundThis study aimed to assess the quality of various obturation techniques to fill perforation caused by internal root resorption using Micro-computed Tomography.MethodsCone-beam computed tomography images of a maxillary central incisor tooth with perforating internal resorptive defect were used to create a 3D printed model of the affected tooth. The replicas were divided into four groups based on the obturation technique used. The techniques included Group 1: a polydimethylsiloxane-based sealer (GuttaFlow-2) with gutta-percha. Group 2: same as Group 1 except for using a pre-mixed Bioceramic-based sealer (NeoSEALER Flo). Group 3: the defect was filled entirely using the NeoSealer Flo Bioceramic-based sealer. Group 4: the samples were obturated using the warm vertical compaction technique with a resin-based sealer (ADSeal). The resin models were then scanned a micro-computed scanner to evaluate the percentage of voids in each group.ResultsThe results showed that NeoSEALER Flo groups had significantly the highest volume of voids while GuttaFlow-2 and warm vertical compaction groups had the lowest void volume.ConclusionsGuttaFlow-2 and warm vertical compaction techniques performed best in filling the internal resorptive defect.

Effects of ethylenediaminetetraacetic acid, citric acid, and etidronic acid on root dentin mineral content and bond strength of a bioceramic-based sealer: A scanning electron microscopy-energy dispersive spectroscopy study.

This study assessed the impact of chelating agents, 17% ethylenediaminetetraacetic acid (EDTA), 10% citric acid (CA), and 18% etidronic acid (HEDP), on root dentin mineral content. Scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) was applied to analyze changes, and the push-out bond strength test was used to measure dentin adhesion of Well-Root ST, a bioceramic root canal sealer. A total of 80 extracted single-rooted lower premolar teeth were included in this study and randomly divided into four groups (n=20): group 1 (17% EDTA), group 2 (10% CA), group 3 (18% HEDP), and group 4 (distilled water, control). After irrigation and drying, SEM-EDS was applied to analyze eight samples from each group at coronal, middle, and apical root regions for mineral content and SEM images. The remaining 12 samples underwent a push-out bond strength test using Well-Root ST sealer and gutta-percha. Kruskal-Wallis and Dunn's tests were used for statistical analyses. Statistically significant differences were found between groups (P<0.05). SEM-EDS showed significant differences in C, O, Ca, P, and Ca/P content, with no significant differences in Na and Mg. Push-out bond strength was significantly higher in the 17% EDTA, 10% CA, and 18% HEDP groups compared to the control group, with no significant differences between chelating agents. Chelating agents altered root dentin mineral content and improved the adhesive properties of the bioceramic sealer. These findings highlight the importance of considering the selection and use of chelating agents in the clinical practice for root canal treatment.

Bioceramic versus traditional biomaterials for endodontic sealers according to the ideal properties.

Odontology, as a scientific discipline, continuously collaborates with biomaterials engineering to enhance treatment characteristics and patients' satisfaction. Endodontics, a specialized field of dentistry, focuses on the study, diagnosis, prevention, and treatment of dental disorders affecting the dental pulp, root, and surrounding tissues. A critical aspect of endodontic treatment involves the careful selection of an appropriate endodontic sealer for clinical use, as it significantly influences treatment outcomes. Traditional sealers, such as zinc oxide-eugenol, fatty acid, salicylate, epoxy resin, silicone, and methacrylate resin systems, have been extensively used for decades. However, advancements in endodontics have given rise to bioceramic-based sealers, offering improved properties and addressing new challenges in endodontic therapy. In this review, a classification of these materials and their ideal properties are presented to provide evidence-based guidance to clinicians. Physicochemical properties, including sealing ability, stability over time and space, as well as biological properties such as biocompatibility and antibacterial characteristics, along with cost-effectiveness, are essential factors influencing clinicians' decisions based on individual patient evaluations.

Effect of a 10-Methacryloyloxydecyl Dihydrogen Phosphate- treated Bioceramic Sealer on the Bond Strength of an Endodontic Fiber Post: Multilayer Composite Disk Models and Ultra-highspeed Imaging Analysis

Multiple materials are found in the root canal after fiber-post cementation. The layer of a bioceramic-based (BC) sealer may affect the bond strength (σBS) of the fiber post in the root canal. The purpose of this study was to employ multilayer compos-ite-disk models in diametral compression to investigate whether the bond strength between a fiber post and root dentin can be in-creased by the application of a primer on the BC sealer. The multilayers of materials in the root canal required 3D finite-element (FE) stress analyses (FEA) to pro-vide precise σBS values. First, BC sealer was characterized using x-ray powder diffraction (XRD) to determine when the sealer com-pletely set and the types of crystals formed to select which primer to apply to the sealer. We selected a 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-based primer to treat the BC sealer before post cementation. Ultra-highspeed (UHS) imaging was utilized to analyze the crack initiation interface. The obtained failure force was used in FE analysis to calculate σBS. UHS imaging validated the fracture interface at the post-dentin junction as FEA simulations predicted. σBS values of the fiber posts placed with various material combinations in the root canal were 21.1 ± 3.4 (only cement/ post), 22.2 ± 3.4 (BC sealer/cement/post) and 28.6 ± 4.3 MPa (10-MDP primer treated BC sealer/cement/post). The 10-MDP-treated BC sealer exhibited the highest σBS (p < 0.05). The multilayer composite disk model proved reliable with diametral compression testing. The presence of BC sealer in the root canal does not reduce σBS of the fiber post. Conditioning the BC sealer layer with 10-MDP primer before fiber-post cemen-tation increases σBS.

Comparative Evaluation of Fracture Resistance of Bioceramics as Obturating Material with and without Guttapercha

Background and Aim Bioceramic sealers have revolutionized endodontic practice. However their use as obturating materials has not yet been evaluated. Therefore the present study aimed to evaluate the fracture resistance of root filled teeth obturated with bioceramic-based sealer BioRoot RCS epoxy resin AH plus and Zinc oxide eugenol ZOE based sealers with and without guttapercha using various obturation techniques.Methods Ninety human single-rooted mandibular premolar teeth were extracted decoronated and standardized to a root length of 13 mm. The teeth were instrumented using the Neoendo flex rotary system up to an apical size of 25. Subsequently the specimens were divided into three groups n30 based on the obturation materials and techniques employed. Group 1 Lateral condensation with 0.02 guttapercha LC Group 2 Single cone obturation with 0.06 gutta-percha SC Group 3 Complete sealer obturation without gutta-percha CS. Each experimental group was divided into three sub-groups n10 using following sealersA ZOE B AH plus C BioRoot RCS. The specimens were coronally sealed with Cavit mounted in an acrylic mould and fracture resistance was determined using Universal testing machine and the obtained values were tabulated. Statistical analysis was done using One-way ANOVA and post hoc Tukey tests P le0.05.Results Among the experimental groups subgroup 1C Lateral condensation with bioceramic sealer showed the highest fracture resistance and no significant difference was found between 1C and 2C Single cone GP while subgroup A ZOE showed least resistance among all groups.Conclusion The absence of gutta-percha with bioceramic sealer resulted in reduced fracture resistance. Conversely the use of gutta-percha in conjunction with bioceramic sealer through lateral condensation and single cone techniques enhanced the resistance to fracture in endodontically treated teeth.

The solubility, pH value, chemical structure, radiopacity, and cytotoxicity of four different root canal sealers: an in vitro study.

The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet sealers. Cytotoxicity analysis with direct and extraction tests at 3 different concentrations (1:1, 1:2, 1:4 v/v%) and time (24 h, 48 h, and 72 h) on Saos-2, PdLF, and THP-1 cell lines, chemical structure with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis, solubility, pH, and radiopacity values of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet were evaluated. For statistical analyses of the groups, repeated measures, factorial, and one-way ANOVA tests were used. The statistical significance level was set at p < .05. Resin-based sealers showed higher cytotoxicity values than the bioceramic-based sealers (p < 0.05). Time and concentrations were effective on the cell viabilities for celllines. Higher peaks of calcium were detected bioceramic-based sealers and higher amount of zirconium was detected in AH Plus BC (p < 0.05). AH Plus BC showed similar radiopacity value with AH Plus, AH Plus Jet, whereas TotalFill BC showed the lowest radiopacity (p < 0.05). Bioceramic-based sealers had higher pH values in all experiment periods, and the difference between resin- and bioceramic-based sealer groups was significant (p < 0.05). However, the solubility values of the tested root canal sealers revealed no differences (p > 0.05). The newly produced AH Plus BC Sealer showed similar properties with TotalFill BC, and their biological properties were better than AH Plus and AH Plus Jet. AH Plus BC could be a possible alternative to other bioceramic- or resin-based sealers.

Different Dentin Conditioning Protocols on Bond Strength of a Bioceramic Root Canal Filling.

Bioceramic-based sealers, in combination with bioceramic-coated gutta-perchas, have become more commonly used in root canal obturation. The present study aimed to assess the influence of laser-assisted dentin conditioning compared with conventional conditioning protocols on the push-out bond strength (PBS) of a bioceramic-based root canal filling. Sixty extracted mandibular premolars with one root canal were instrumented with EndoSequence rotary files up to size 40/0.04. Four types of dentin conditioning protocols were used: 1) 5.25% NaOCl (control), 2) 17% EDTA+5.25% NaOCl, 3) Diode laser-agitated 17% EDTA+5.25% NaOCl, 4) Er,Cr:YSGG laser irradiation+5.25% NaOCl. Teeth were obturated using the single-cone technique with EndoSequence BC sealer+BC points (EBCF). After having obtained 1-mm-thick horizontal slices from the apical, middle and coronal root thirds, push-out test was carried out, and failure modes were determined. The data were analyzed by two-way analysis of variance and Tukey's test with a significance level of p<0.05. The apical segments showed the highest PBS in all groups (p<0.05). In the apical segments, EDTA+NaOCl and diode laser agitated EDTA increased the PBS compared to the control (p=0.0001) and Er, Cr: YSGG laser (p=0.011 and p=0.027, respectively) groups. Both laser-used groups revealed significantly higher PBS values in the middle and coronal segments than EDTA+NaOCl (p<0.05). The bond failure was predominantly cohesive without any significant difference among the groups (p>0.05). Laser-assisted dentin conditioning had distinct effects on the PBS of the EBCF at different root segments. Although Er, Cr: YSGG was ineffective in the apical segments, generally, laser-assisted dentin conditioning affected PBS more favorably than conventional irrigation groups, with a more pronounced effect in the diode laser-agitated EDTA group.

Evaluation of interfacial adaptation and penetration of bioceramic-based sealers in oval root canals: A confocal laser scanning microscope study.

To assess the interfacial adaptation and penetration depth of three different bioceramic-based sealers (CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG) compared to an epoxy resin-based sealer (AH Plus) in oval root canals. Fourty extracted single-rooted mandibular premolar with oval canal were prepared and randomly allocated according to the obturation into; CeraSeal, EndoSeal MTA, Nishika Canal Sealer BG and AH Plus. The roots were sectioned at 3, 6 and 9 mm from the apex. The sealer adaptation and the penetration depth were evaluated under confocal laser scanning microscope. One-way ANOVA and Repeated measure ANOVA were used to statistically analyze the data. Nishika Canal Sealer BG showed significantly higher sealer adaptation than EndoSeal MTA (P < .001) at apical and middle thirds. Meanwhile, AH Plus showed significantly higher sealer adaptation than EndoSeal MTA (P = 0.011) at middle third. For sealer penetration, Nishika Canal Sealer BG showed the longest sealer penetration that was significant compared to AH Plus (P < .001) and EndoSeal MTA (P < .001) whereas CeraSeal was significantly higher than EndoSeal MTA (P = 0.029) at coronal third. For AH Plus, there was a significant less sealer penetration at coronal third compared to apical and middle thirds (P < .05). Whereas for EndoSeal MTA, the coronal third has significant less penetration compared to the middle third (P = 0.032). Endoseal has the lowest adaptation and penetration depth. Nishika Canal Sealer BG has better adaptation and penetration depth using single cone obturation technique in oval canal. RESEARCH HIGHLIGHTS: All the tested root canal sealers have some percentage of gaps and vary in their penetration capability into dentinal tubules. Nishika Canal Sealer BG has significantly better sealer adaptation to root dentinal walls than that of EndoSeal MTA at the apical and middle third but not significantly different from other type of sealers used. Nishika Canal Sealer BG has significantly better penetration depth than AH Plus and EndoSeal MTA at the coronal third of radicular dentin.

Role of Root Canal Sealer on the Post Operative Pain: a Randomized Control Trial

Background: Recent innovations in pulp treatment and root canal sealers include bioceramic. It is proven how bioceramics affect root restoration, radiculer perforation, and vital pulp therapy. Therefore, it is anticipated that using bioceramics as a root canal sealer in traditional root canal therapy for non-vital teeth will have positive results. Methods: In this investigation, 60 nonvital teeth with periapical lesions were included. These teeth were separated into two groups of 30 teeth each and treated as follows: Group A: Bioceramics (Endocequence BCTM) sealer was used to obturate these teeth. Group B was obturated using a sealer based on Zinc Oxide Eugenol (Tubli-sealTM). Participants were contacted after 3, 6, and 12 months. The clinical outcome was assessed by assessing pain by VAS, tenderness on percussion, and using the Chi-square test and unpaired student t-test for testing differences between the two groups, with a p value of 0.05 regarded as statistically significant. Results: It was discovered that at 6 and 12 months of observation, 100% of teeth treated with Bioceramics' root canal sealer and 93.3% of teeth treated with Zinc Oxide Eugenol did not exhibit any discomfort or soreness to percussion. The differences between the groups treated with Zinc Oxide Eugenol and Bioceramics root canal sealer were not statistically significant (p &gt; 0.05). Conclusion:It may be determined that both bioceramic-based sealers (Endosequence BC) and zinc oxide-eugenol-based sealers (Tubli-seal TM) are efficient in reducing post-operative discomfort after endodontic therapy. As a result, sealer has no effect on post-operative pain relief. Update Dent. Coll. j: 2023; 13(1): 31-34

Dislodgment Resistance, Adhesive Pattern, and Dentinal Tubule Penetration of a Novel Experimental Algin Biopolymer-Incorporated Bioceramic-Based Root Canal Sealer.

The currently available bioceramic-based sealers still demonstrate low bond strength with a poor seal in root canal despite desirable biological properties. Hence, the present study aimed to determine the dislodgment resistance, adhesive pattern, and dentinal tubule penetration of a novel experimental algin-incorporated bioactive glass 58S calcium silicate-based (Bio-G) sealer and compared it with commercialised bioceramic-based sealers. A total of 112 lower premolars were instrumented to size 30. Four groups (n = 16) were assigned for the dislodgment resistance test: control, gutta-percha + Bio-G, gutta-percha + BioRoot RCS, and gutta-percha + iRoot SP, with exclusion of the control group in adhesive pattern and dentinal tubule penetration tests. Obturation was done, and teeth were placed in an incubator to allow sealer setting. For the dentinal tubule penetration test, sealers were mixed with 0.1% of rhodamine B dye. Subsequently, teeth were cut into a 1 mm-thick cross section at 5 mm and 10 mm levels from the root apex, respectively. Push-out bond strength, adhesive pattern, and dentinal tubule penetration tests were performed. Bio-G showed the highest mean push-out bond strength (p < 0.05), while iRoot SP showed the greatest sealer penetration (p < 0.05). Bio-G demonstrated more favourable adhesive patterns. No significant association was noted between dislodgment resistance and dentinal tubule penetration (p > 0.05).

The effect of different acidic irrigation solutions on the pushout bond strength of root canal filling.

This study investigated the effects of different acidic solutions used as the final irrigation on the push-out bond strength (PBS) of resin-based and bioceramic-based root canal sealers. 100 single root and canal human incisors were selected and decorated. Root canal shaping was done with ProTaper Next rotary files up to X4 and rinsed with 5 mL of 5.25% NaOCl between each file. Then, teeth were divided into five main groups according to the final irrigation (n=20). Group 1: glycolic acid; Group 2: phosphoric acid; Group 3: citric acid; Group 4: EDTA and group 5: saline. Then, each group was divided into two subgroups according to the canal sealer used (n=10). The groups filled with bioceramic-based sealer (bioserra) were named A, and the groups filled with resin-based sealer (AH Plus) were called B. PBS test was applied to one of the two samples obtained from the coronal third of each root. The data were statistically analyzed using a two-way analysis of variance and Tukey's HSD test (α=0.05). Statistically, the highest PBS value was obtained in group 2A (4.81±0.03 MPa), which was irrigated with phosphoric acid and filled with bioserra, and the lowest PBS value was obtained in group 5B (1.10±0,03), which was irrigated with saline and filled with AH Plus (P<0.05). There was a statistical difference between all groups except group 1A and group 3A (P<0.05). The bioceramic-based root canal sealer (bioserra) bond strength is superior to resin-based (AH Plus). Phosphoric acid, glycolic acid, and citric acid can be an alternative to EDTA.

Comparison of apical sealing ability between bioceramic and zinc oxide eugenol-based sealer during root canal treatment, in vitro

Obturation with a sealer material that provides an adequate apical sealing ability is required to prevent endodontic treatment failure due to microleakage. However, there are no sealers that meet all the physical and chemical properties to be able to hermetically seal the root canal system to date. Various sealer materials have been developed in recent years including the use of bioceramic materials which are claimed to have excellent biocompatibility to tissues. This study aimed to compare the apical sealing ability of bioceramic-based and zinc oxide eugenol (ZOE)-based sealer in root canal treatment. A total of 27 extracted mandibular premolars were decoronated to the standard root length of 14 mm. The root canals were prepared with a crown-down technique using manual instrument to file F3 (30/.09). The samples were then divided into three groups: obturation with bioceramic-based sealer (n=9); ZOE-based sealer (n=9); and control group (n=9). Microleakage was measured using a dye penetration method with 1% methylene blue and observed under stereomicroscope at x20 magnification. The mean of the maximum penetration length from the lowest to the highest was found in the bioceramic-based sealer group (0.825 mm), the ZOE-based sealer group (3.850 mm), and the control group (4.444 mm). One-way ANOVA test showed a significant difference in the maximum penetration length between the three groups (p&lt;0.05). The post hoc LSD test showed a significant difference in the maximum penetration length between the bioceramic-based and ZOE-based sealer groups (p&lt;0.001). Obturation with bioceramic-based sealer provides a better apical sealing ability than that with ZOE-based sealer.

Do different irrigating solutions affect the dislodgement resistance of bioceramic-based root canal sealers? A systematic review and meta-analysis

This review aimed to appraise and evaluate the effect of different irrigating solutions on the dislodgement resistance of bioceramic-based sealers to root dentine walls using a push-out bond strength test. Ten electronic databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, EBSCO, Open Gray, Library Genesis, LILACS) and five textbooks were searched for English-language articles published between January 1970 to March 2021. Only in-vitro, in-vivo or ex-vivo articles were included and assessed using the modified OHAT Risk of Bias assessment tool. Data were analyzed using the DerSimonian-Laird random-effect model. Eleven articles were included. All studies were in-vitro experiments, and they were classified as Tier 1 based on their risk of bias assessments. Single-arm meta-analysis revealed that the highest mean pooled bond strength was noted in samples irrigated with 2.5–3% NaOCl, followed by 17% EDTA, 2% CHX, MTAD, and lastly saline. Two-arm meta-analysis showed that 17% EDTA and 2% CHX increase the bond strength of bioceramic sealers by more than 2.5–3% NaOCl, but no significant differences were noted (p > 0.05). Moreover, no significant differences (p > 0.05) were also found when comparing 17% EDTA with 2% CHX and saline, respectively. Substantial heterogeneity was observed with the overall I 2 ranging from 0% to 99.49%. Although using 2.5–3% NaOCl as irrigating solution yielded higher dislodgement resistance of bioceramic-based root canal sealers, other factors such as the type of bioceramic sealer used, presence of gutta-percha, sample thickness, and various methodological approaches significantly affected the push-out bond strength results.

Physicochemical properties of a novel bioceramic silicone-based root canal sealer

Background/purposeWith introduction into endodontics, bioceramic-based sealers have gained considerable popularity for excellent properties. The aim of this study was to investigate the physicochemical properties of a novel bioceramic silicone-based sealer, GuttaFlow Bioseal, and measure heat flow of setting reactions.Materials and methodsFilm thickness, flow, working and setting time of Bioseal were compared with other 4 kinds of sealers: iRoot SP, AH Plus, RoekoSeal and GuttaFlow2. Differential scanning calorimetry test was performed to measure heat flow.ResultsBioseal demonstrated the highest film thickness of 44 μm, double to triple that of the other 4 sealers (P < 0.05). The highest flow was detected in iRoot SP and RoekoSeal, with values of 27.35 and 27.20 mm, while GuttaFlow2 and Bioseal had the lowest of 22.31 and 21.43 mm (P < 0.05). For each sealer, working time at 37 °C was shorter than that at 23 °C (P < 0.05). At 37 °C, Bioseal had the shortest working and setting time of 4.5 and 16.3 min, while iRoot SP showed the longest of 105.0 and 571.7 min (P < 0.05). Differential scanning calorimetry test revealed that setting process of all the tested sealers was exothermic. Bioseal reached an exothermic peak at 14 min, with almost 1.5 times peak intensity of GuttaFlow2 and RoekoSeal. Whereas iRoot SP and AH Plus reached an exothermic peak 5 h after mixing, with intensity 1/2 to 2/3 that of Bioseal.ConclusionThe novel bioceramic silicone-based sealer Bioseal showed intense and fast exothermic reactions with characteristic physicochemical properties.

Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

Introduction Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.

Evaluation of the Effect of the Intensity and Occurrence of Postoperative Pain of Resin-Based and Bioceramic Root Canal Sealers: A Systematic Review and Meta-Analysis of Randomized Controlled Trial Studies

Objective: To evaluate resin- and bioceramic root canal sealers affect postoperative intensity and pain occurrence . Material and Methods: From the electronic databases, PubMed, Cochrane Library, Embase, ISI have been used to perform systematic literature until September 2020. Electronic titles were managed using the Endnote X8 software. They performed searches with mesh terms. Two reviewers blindly and independently extracted data from studies that included data for data extraction. Results: A total of 186 potentially relevant titles and abstracts were found. Finally, four studies were included. Pain score was (RR = -0.20; 95% CI -1.09–0.68; p= 0.65). This result showed no statistically significant difference for the resin-based and bioceramic root canal sealers after 24 hours between the VAS scores . Conclusion: Postoperative pain was low in Patients requiring root canal retreatment and obturated with resin-based or bioceramic-based sealers without extrusion beyond the apex. No differences were observed between postoperative pain in resin-based and bioceramic root canal sealers 24 and 48 hours postoperatively.

Retrievability of bioceramic-based sealers in comparison with epoxy resin-based sealer assessed using microcomputed tomography: A systematic review of laboratory-based studies.

Aim:The objective was to evaluate the retrievability of bioceramic sealers in comparison with epoxy resin-based sealers assessed using microcomputed tomography.Materials and Methods:Four reviewers independently conducted a systematic literature search in four electronic databases. The risk of bias was assessed using modified Joanna Briggs Institute Critical Appraisal tools for Quasi-Experimental Studies.Results:Ten articles were included in this review and all had a moderate risk of bias. The results across the included articles were inconsistent with some indicating easier/difficult removal of bioceramic sealers, while others indicate no difference. The studies varied in terms of the type of bioceramic sealer used, root canal anatomy, and retreatment techniques followed. Due to heterogeneity, only a qualitative analysis was performed and no meta-analysis was conducted.Conclusion:The quality of evidence is low and no definitive conclusion could be derived regarding the retrievability of bioceramic sealer/AH plus sealer from the root canals during retreatment procedures.

Biocompatibility and bioactive potential of the NeoMTA Plus endodontic bioceramic-based sealer.

ObjectivesThis study evaluated the biocompatibility and bioactive potential of NeoMTA Plus mixed as a root canal sealer in comparison with MTA Fillapex.Materials and MethodsPolyethylene tubes filled with NeoMTA Plus (n = 20), MTA Fillapex (n = 20), or nothing (control group, CG; n = 20) were inserted into the connective tissue in the dorsal subcutaneous layer of rats. After 7, 15, 30 and 60 days, the specimens were processed for paraffin embedding. The capsule thickness, collagen content, and number of inflammatory cells (ICs) and interleukin-6 (IL-6) immunolabeled cells were measured. von Kossa-positive structures were evaluated and unstained sections were analyzed under polarized light. Two-way analysis of variance was performed, followed by the post hoc Tukey test (p ≤ 0.05).ResultsAt 7 days, the capsules around NeoMTA Plus and MTA Fillapex had more ICs and IL-6-immunostained cells than the CG. However, at 60 days, there was no significant difference in the IC number between NeoMTA Plus and the CG (p = 0.1137) or the MTA Fillapex group (p = 0.4062), although a greater number of IL-6-immunostained cells was observed in the MTA Fillapex group (p = 0.0353). From 7 to 60 days, the capsule thickness of the NeoMTA Plus and MTA Fillapex specimens significantly decreased, concomitantly with an increase in the collagen content. The capsules around root canal sealers showed positivity to the von Kossa stain and birefringent structures.ConclusionsThe NeoMTA Plus root canal sealer is biocompatible and exhibits bioactive potential.