Bioceramic Sealer Research Articles

Effect of the filling technique on the filling removal from oval-shaped canals.

This ex vivo study aimed to evaluate the influence of different filling techniques on the filling removal from oval root canals filled with bioceramic sealer. Thirty-six mandibular incisors with single oval canals were filled with bioceramic sealer following the techniques (n = 12): single-cone, modified McSpadden, or continuous wave of condensation, and scanned by micro-computed tomography (micro-CT). The filling was removed using the Clearsonic ultrasound tip and Reciproc system up to the R40 instrument, and the working time was recorded. The teeth were scanned again by micro-CT. Percentage of remnant volume (mm³) of the filling material, dentin thickness, and root canal transportation were measured. The data was analyzed using parametric and non-parametric tests with a significance level of 5%. It took more time to remove the filling material using the continuous wave of condensation technique (p < 0.05), followed by the modified McSpadden and single-cone techniques. There was no difference (p > 0.05) when comparing the percentage of remaining filling material among the three groups, nor did it among the segments of each tooth. There was also no difference in the analysis of dentin thickness and transportation when comparing the groups (p > 0.05). The filling technique did not influence the amount of remaining filling material, dentin thickness, and transportation. The working time was longer with thermoplastic filling techniques. Endodontic retreatment in teeth filled with bioceramic sealers increases with their use. Several techniques are used to fill the root canals, thus, it is important to know whether the filling technique influences the non-surgical endodontic retreatment.

Influence of bioceramic sealer residues on the adhesion interface with a universal adhesive in the etch-and-rinse strategy, based on the application protocol and evaluation time.

The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.

Retreatability of Bioceramic-Filled Teeth: Comparative Analysis of Single-Cone and Carrier-Based Obturation Using a Reciprocating Technique

Objectives: To evaluate the retreatment efficacy of premixed bioceramic sealer using a reciprocating system, comparing single-cone and carrier-based obturation techniques. Materials and Methods: Twenty-three monoradicular teeth with oval canals were divided into two groups: NeoSealer Flo with single cone (SC) and NeoSealer Flo with Guttafusion (GF). Retreatment was performed using Reciproc Blue (RB) with a crown-down technique. X-ray and CBCT images were taken to measure the remnant areas and volumes. Results: Apical patency was achieved in all the samples. The remnants were mostly distributed in the middle third in the GF group, while an equal distribution in both the middle and apical thirds was observed in the SC group. The GF group had a lower remnant area and volume after RB 50.05, respectively (0.18 ± 0.33 mm2 vs. 0.39 ± 0.80 mm2 and 0.36 ± 0.59 mm3 vs. 0.51 ± 1.16 mm3). The use of RB 50.05 led to an additional reduction in the remnant areas in the SC (14.89%) and GF (69.49%) groups, while in terms of the volume, the reductions were 20.63% and 36.36%. Conclusions: Reciprocating instruments are effective in removing remnants from root canals filled with both single-cone and carrier-based techniques. The blooming effect in CBCT imaging suggests further in vivo studies for validation.

Effectiveness of Sectioning Method and Filling Materials on Roughness and Cell Attachments in Root Resection Procedure.

The purpose of the present study was to investigate the created roughness and cell attachment of intact teeth (C), obturated teeth with bioceramic (BR), or epoxy resin (AH) after root resection using piezoelectric ultrasonic and carbide bur. Three groups of first mandibular premolars were used in the present study: control group (without any preparation or obturation) (C); second group was obturated with an epoxy resin sealer (AH, AH Plus Jet); and finally, the third one was obturated with a bioceramic sealer (BR, BioRoot RCS). All teeth were incubated for 4 months at 37°C. After that, the samples were sectioned using tungsten carbide bur or piezoelectric ultrasonic. Roughness and then cell attachment of periodontal ligament cells on the sectioned surfaces were investigated by profilometer and confocal microscope, respectively. Data were statistically analyzed using one-way analysis of variance. After root resection, no significant difference was found between the roughness among the three groups sectioned using the piezoelectric technique (p > 0.05). In contrast, concerning the sectioned samples by burs, C demonstrated a rougher surface compared with BR (p < 0.05). There was a significant higher cell attachment in BR compared with AH in the piezoelectric groups (p = 0.047), while no statistically significant difference was found between the groups sectioned with bur (p > 0.05). Dentists are now focused on the use of calcium silicate-based sealers due to their bioactivity. The present study advises dentists to use bioceramic sealer which could improve the dentin characteristics which ameliorate the cell attachment.

Effects of the application protocol and bonding strategy of the universal adhesive on dentin previously impregnated with bioceramic sealer

PurposeTo evaluate the effects of the application of universal adhesive with manual brush (MB) or rotary brush (RB), in the etch-and-rinse (ER) or self-etching (SE) strategy, on the bond strength, adhesive layer thickness, and adhesive failure pattern to dentin impregnated with bioceramic sealer, at 24 h and 1 year. Materials and methodsEighty-eight bovine incisor crowns were impregnated with bioceramic sealer was kept for 15 min and cleaned with cotton soaked in distilled water. They were then divided into four groups (n = 22): ER-MB, ER-RB, SE-MB, SE-RB. Subsequently, the specimens were restored with Filtek Z-250 resin. The adhesive layer thickness was individually analyzed using laser confocal microscope. Bond strength was assessed through microtensile testing, and the failure pattern was examined using a stereomicroscope. Data were analyzed by one-way ANOVA/Tukey's tests (α = 0.05). ResultsThe adhesive layer thickness provided by ER-MB and SE-MB was greater than that provided by ER-RB and SE-RB (P < 0.05). ER-MB showed the lowest bond strength at 24 h (P < 0.05). At 1 year, SE-MB and SE-RB exhibited the highest bond strength values (P < 0.05). ER-MB demonstrated a higher incidence of adhesive failure at 24 h. At 1 year, SE-RB and SE-MB showed a higher incidence of mixed failure. ConclusionThe use of Scotchbond Universal® adhesive in the etch-and-rinse strategy applied with a MB negatively affects bond strength at 24 h, worsening after 1 year of control, regardless of the application protocol.

Effects of heating on bioceramic sealers: a scoping review of chemo-physical properties and clinical implications.

This scoping review aims to summarize current research to assess the impact of heating on the chemo-physical properties of bioceramic sealers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines, a comprehensive literature search was conducted in April 2024 across PubMed and Scopus databases. Inclusion criteria referred to all study types evaluating the effect of heating temperature on bioceramic sealers' properties, with no language or time restrictions applied. Studies were independently screened by two reviewers, and relevant data were extracted and synthesized qualitatively. Out of 91 initially identified studies, 19 met the eligibility criteria for inclusion in the qualitative synthesis. The selected studies ranged from 2014 to 2024 and comprised laboratory-based investigations. Various bioceramic sealers, including EndoSequence BC Sealer, BioRoot RCS, and TotalFill BC, were analyzed across different heating techniques. The findings revealed divergent responses of bioceramic sealers to heat, with some demonstrating stability while others exhibited alterations in properties such as flow, setting time, and chemical composition. The impact of heat on bioceramic sealers depends on the sealer's composition and laboratory setting. While some sealers are affected significantly, others remain stable. Clinicians should carefully consider these factors when bioceramic sealers are used with warm obturation techniques, but caution is needed as real-world conditions may vary. Integrating laboratory results with clinical evidence is essential for improving treatment efficacy and patient care.

Comparative evaluation of postoperative pain after root canal obturation using resin-based sealer (AH plus) and bioceramic sealer (IROOT SP) in adult mandibular molars: A double blinded randomized controlled trial

ABSTRACT Aim: The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain following root canal obturation using a bioceramic (IROOT SP, Innovative BioCeramix, Inc.,) and a resin-based endodontic sealer (AH plus) using visual analog scale (VAS). Methods: A total of 40 subjects with chronic irreversible pulpitis needing root canal treatment were included in this double blinded randomized clinical trial. Randomization was done using manually generated sealed envelopes. According to the sealers used, the patients were divided into 2 groups where in Group 1 (n = 20): AH plus sealer and Group 2 (n = 20): Bioceramic sealer. Postoperative pain was assessed using VAS scale. Mann–Whitney U test was used for statistical analysis. Results: The occurrence of postoperative pain was similar in both groups. Postoperative pain intensity decreased in both the groups after 48 h. No statistically significant difference was found in the occurrence of postoperative in either group (P &gt; 0.05). Conclusion: AH Plus and bioceramic sealer perform similarly in terms of the occurrence and intensity of postoperative pain with no significant difference. The average pain levels and number of rescue medication taken were similar in both the groups.

Effect of root canal obturation using resin and bio-ceramic sealers on reinforcement of endodontically treated teeth.

Effect of root canal obturation using resin and bio-ceramic sealers on reinforcement of endodontically treated teeth.

Premixed calcium silicate-based ceramic sealers promote osteogenic/cementogenic differentiation of human periodontal ligament stem cells: A microscopy study.

To evaluate the effects of premixed calcium silicate based ceramic sealers on the viability and osteogenic/cementogenic differentiation of human periodontal ligament stem cells (hPDLSCs). The materials evaluated were TotalFill BC Sealer (TFbc), AH Plus Bioceramic Sealer (AHPbc), and Neosealer Flo (Neo). Standardized discs and 1:1, 1:2, and 1:4 eluates of the tested materials were prepared. The following in vitro experiments were carried out: ion release, cell metabolic activity 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell migration, immunofluorescence experiment, cell attachment, gene expression, and mineralization assay. Statistical analyses were performed using one-way ANOVA followed by Tukey's post hoc test (p < .05). Increased Ca2+ release was detected in TFbc compared to AHPbc and Neo (*p < .05). Biological assays showed a discrete cell metabolic activity and cell migration in Neo-treated cell, whereas scanning electronic microscopy assay exhibited that TFbc group had a better cell adhesion process of substrate attachment, spreading, and cytoskeleton development on the niche-like structures of the cement than AHPbc and Neo. The sealers tested were able to induce overexpression of the CEMP-1, ALP, and COL1A1 genes in the first days of exposure, particularly in the case of TFbc (***p < .001). All materials tested significantly increased the mineralization of hPDLSCs when compared to the negative control, although more pronounced calcium deposition was observed in the TFbc-treated cells (***p < .001). Our results suggested that TFbc promotes cell differentiation, both by increasing the expression of key osteo/odontogenic genes and by promoting mineralization of the extracellular matrix, whereas this phenomenon was less evident in Neo and AHPbc. RESEARCH HIGHLIGHTS: TFbc group had a better cell adhesion process of substrate attachment, spreading, and cytoskeleton development on the niche-like structures of the cement than AHPbc and Neo. The sealers tested were able to induce overexpression of the CEMP-1, ALP, and COL1A1 genes in the first days of exposure, particularly in the case of TFbc. All materials tested significantly increased the mineralization of hPDLSCs when compared to the negative control, although more pronounced calcium deposition was observed in the TFbc-treated cells.

Antimicrobial efficacy of calcium silicate-based bioceramic sealers against Enterococcus faecalis and Staphylococcus aureus - An in vitro study.

The main objective of endodontic therapy is to achieve a sterile environment and three-dimensional filling of the root canals. Endodontic sealers play an important role in the obturation of the root canal system as they may provide a seal, which prevents the penetration of bacteria. Sealers are meant to entomb residual bacteria, prevent leakage of nutrients, and ideally possess antibacterial properties. The aim of the study was to evaluate and compare the antimicrobial effectiveness of calcium silicate-based bioceramic root canal sealers against Enterococcus faecalis and Staphylococcus aureus using the agar diffusion method. The materials were divided into four groups of nine samples each for both E. faecalis and S. aureus. Group I (control group) - MTA-Fillapex (Angelus), Group II - BioRoot RCS (Septodont), Group III - Bio-C Sealer (Angelus), and Group IV - Dia-Root Bio Sealer (Diadent). To evaluate the antibacterial activity of the samples, the agar diffusion method was utilized. To begin, a bacterial suspension was evenly spread onto sterile Petri dishes using sterile swabs. Four wells of 4 mm diameter were then punched, and the sealers were mixed following the manufacturer's instructions and placed onto the prepared wells. The Petri dishes were then incubated at 37°C for 72 h. After incubation, the zones of inhibition around each well were measured at 24 h, 48 h, and 72 h, and the resulting values were statistically analyzed. The data were analyzed using the ANOVA and post hoc Tukey's test. Calcium silicate-based root canal sealers showed significantly better efficacy than the control group. BioRoot RCS (3.44 ± 1.13 mm) showed maximum antibacterial effect against E. faecalis at 24 h, 48 h, and 72 h time intervals. Bio-C Sealer (16.44 ± 1.42 mm) showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h time intervals. The effectiveness of root canal sealants eventually decreased over a period. Based on analysis using the ANOVA test, a statistically significant difference (P ≤ 0.05) was observed between the mean values of antimicrobial efficacy of sealers against both E. faeca lis and S. aureus. The study's findings lead to the conclusion that BioRoot RCS showed a maximum antibacterial effect against E . faecal is and Bio-C Sealer showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h.

Comparative evaluation of Postoperative Pain following Ultrasonic activation and Root Canal Obturation with Bioceramic Sealers versus Epoxy-Resin in Partially Edentulous Patients Rehabilitated with Tooth-Supported Overdentures : RCT

Comparative evaluation of Postoperative Pain following Ultrasonic activation and Root Canal Obturation with Bioceramic Sealers versus Epoxy-Resin in Partially Edentulous Patients Rehabilitated with Tooth-Supported Overdentures : RCT

Fracture resistance of endodontically treated root obturated with different root canal sealers( A comparative in vitro study)

Aim: The aim of this study is to evaluate and compare the fracture resistance of endodontically treated root obturated with four different root canal sealers.. Methods: Sixty extracted palatal root of upper molars were collected and sectioned to get a 11mm root length. All root canals were instrumented using edge endo X7 system rotary files and 35# size was the final size used to finish all the canals. After instrumentation the samples were divided into four groups of 15 samples in each according to the type of sealer used, a single cone obturation technique was used: Group 1: obturated with AH Plus sealer and gutta-percha. Group 2: obturated with Neosealer BC sealer and gutta-percha. Group 3: Obturated with MTA-Fillapex sealer and gutta-percha. Group 4: Obturated with OneFill BC sealer and gutta-percha. After incubation period of 7 days at 37°C and 100% humidity the samples covered with thin layer polyvinylsiloxane impression material to simulate a periodontal membrane and then molded in acrylic blocks so as to set the samples ready for fracture resistance test using universal testing machine at a cross head speed of 0.5mm/min., One-way ANOVA and Posthoc tests assessed the data statistically. Results: The results showed that fracture resistance was significantly higher in those canals that were filled with Neosealer BC sealer (69.90N) in comparison to the other different sealers used in the study (p≤0.05). Conclusion: Under the condition of this study, the following conclusions can be derived: The application of any root canal sealers resulted in an enhancement of the resistance to fractures in teeth that have undergone endodontic treatment. Neosealer Bioceramic sealer group showed the highest fracture resistance than other groups. Followed by Onefill bioceramic, MTA Fillapex and Ah plus.

Nanostructured ZnO thin film to enhance gutta-percha’s adhesion to endodontic sealers

BackgroundGutta-percha (GP) combined with an endodontic sealer is still the core material most widely used for tridimensional obturation. The sealer acts as a bonding agent between the GP and the root dentinal walls. However, one of the main drawbacks of GP core material is the lack of adhesiveness to the sealer. ZnO thin films have many remarkable features due to their considerable bond strength, good optical quality, and excellent piezoelectric, antibacterial, and antifungal properties, offering many potential applications in various fields. This study aimed to explore the influence of GP surface’s functionalization with a nanostructured ZnO thin film on its adhesiveness to endodontic sealers.MethodsConventional GP samples were divided randomly into three groups: (a) Untreated GP (control); (b) GP treated with argon plasma (PT); (c) Functionalized GP (PT followed by ZnO thin film deposition). GP’s surface functionalization encompassed a multi-step process. First, a low-pressure argon PT was applied to modify the GP surface, followed by a ZnO thin film deposition via magnetron sputtering. The surface morphology was assessed using SEM and water contact angle analysis. Further comprehensive testing included tensile bond strength assessment evaluating Endoresin and AH Plus Bioceramic sealers’ adhesion to GP. ANOVA procedures were used for data statistical analysis.ResultsThe ZnO thin film reproduced the underlying surface topography produced by PT. ZnO thin film deposition decreased the water contact angle compared to the control (p < 0.001). Endoresin showed a statistically higher mean bond strength value than AH Plus Bioceramic (p < 0.001). There was a statistically significant difference between the control and the ZnO-functionalized GP (p = 0.006), with the latter presenting the highest mean bond strength value.ConclusionsThe deposition of a nanostructured ZnO thin film on GP surface induced a shift towards hydrophilicity and an increased GP’s adhesion to Endoresin and AH Bioceramic sealers.

Osteoinductive and regenerative potential of premixed calcium-silicate bioceramic sealers on vascular wall mesenchymal stem cells.

The osteogenic potential of new premixed calcium-silicate-containing bioceramic sealers (Ca-Si sealers) was tested with porcine vascular wall-mesenchymal stem cells (pVW-MSCs). Two Ca-Si-containing sealers: Ceraseal (MetaBiomed, Cheong-si, South Korea) and AH Plus Bioceramic (Maruchi, Wonju-si, South Korea), and an epoxy resin sealer (AH Plus; Dentsply, Konstanz, Germany) as a control, were prepared according to the manufacturers' indications. All samples were allowed to set for 100% of their setting time in a sterile humid cabinet at 37°C and 95% relative humidity. pVW-MSC seeding efficiency and osteogenic differentiation were analysed as marker of gene/protein expression for up to 12 days. Mineralization assay and immunofluorescence staining were performed and evaluated over a period of 21 days. Statistical analyses were conducted using one-way analysis of variance (p < .05). Additional samples were prepared and stored under the same conditions and inspected using an environmental scanning electron microscope equipped with an energy dispersive X-ray spectroscopy system. Significantly higher cell seeding efficiency (p < .05) was observed for both Ca-Si sealers from day 8. pVW-MSCs showed a significant shift towards the osteogenic lineage only when seeded in contact with Ca-Si sealers. Gene expression of osteopontin was upregulated significantly. Collagen I and osteocalcin were clearly expressed by cells in contact with Ca-Si sealers. Mineralization granules were observed in Alizarin red assays and confocal laser scanning microscopy analysis of both Ca-Si sealers. No gene expression or granule mineralization were observed on the epoxy resin sealer. Premixed Ca-Si sealers displayed a higher potential for osteogenic activity on pVW-MSCs. Epoxy resin sealer was unable to induce any osteogenic activity. The properties of both Ca-Si sealers suggest their potential as osteoinductive platforms for vascular MSCs in periapical bone.

The Influence of Bioceramic Cements on the Activity of Macrophages of Different Lineages: A Laboratory Study

IntroductionThe repair process of periradicular tissues depends, among other factors, on the properties of endodontic cements. Macrophages are among the main cells involved in this process. Materials and MethodsMurine peritoneal macrophages obtained from C57BL/6 (MBL6) and BALB/c (MBalb) mice, respectively, were cultured with capillaries containing or not Endosequence BC Sealer (BC), Sealer Plus BC (MK), Bio-C Sealer (Ang), and mineral trioxide aggregate (MTA). Cell viability was measured by Trypan blue and MTT methods at 24, 48, and 72 hours. Cell adhesion, phagocytosis of Saccharomyces boulardii, production of reactive oxygen species (ROS), nitric oxide (NO), and the cytokines tumor necrosis factor-α and transforming growth factor (TGF)-β were also evaluated. The data were analyzed using the analysis of variance test (P < .05). ResultsCell viability was similar between bioceramic sealers and MTA (P > .05). There was no statistical difference between both macrophages when adherence and phagocytose were assayed. The presence of inflammation stimulus significantly altered the production of ROS by MBL6 macrophages in contact with the cements. The production of TGF-β was similar for both lineages of macrophages. ConclusionsThis study shows that the evaluated bioceramic cements do not interfere with MBL6 and MBalb macrophage adhesion, phagocytic capacity, or TGF-β production. The cements stimulated the production of ROS by MBL6 macrophages in response to induced inflammation, potentially favoring the elimination of residual pathogens.

Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial.

The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.

Three-dimensional assessment of obturation volume in lateral canals after three obturation techniques with bioceramic sealer: an in vitro comparative study

ObjectiveThis study aimed to evaluate the obturation ability of simulated lateral canal in mandibular premolars at three levels (3, 5, and 7 mm) from the apex using gutta-percha and BC Sealer HiFlow (BCHiF) with different obturation techniques, including continuous wave compaction (CWC), cold lateral condensation (CLC), and single cone (SC) techniques, by a 3D assessment method of the obturation volume with cone beam computed tomography (CBCT) and MIMICS software analysis.MethodsThirty intact human mandibular premolars were decoronated, instrumented up to #30 taper 4%, and uniformly irrigated with 5.25% NaOCl and 17% EDTA. Six simulated lateral canals (3 pairs) were prepared at 3, 5, and 7 mm from the apex in each root, using #10 modified C-file. CBCT images were obtained, and lateral canal volumes were calculated using MIMICS software. The samples were divided into three groups: CWC (n = 10), CLC (n = 10), and SC (n = 10). All groups were obturated with BCHiF and gutta-percha. Another CBCT image was taken post-obturation, and 3D lateral canal obturation volume percentages were calculated using MIMICS software. Data were analyzed using SPSS software with One-way ANOVA and Sidak tests (α = 0.05).ResultsSignificant differences were observed in the 3D lateral canal obturation volume percentage at all three levels (P < 0.05). Both CWC and CLC techniques demonstrated higher 3D lateral canal obturation volume percentages (x¯\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\bar{x}$$\\end{document} = 89.64% and x¯\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\bar{x}$$\\end{document} = 73.28%; respectively) compared to the SC group) x¯\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\bar{x}$$\\end{document} = 43.10%).ConclusionBCHiF combined with the CWC technique has a higher ability to achieve preferable 3D obturation volume in the simulated lateral canal at 3, 5, and 7 mm.Clinical relevanceIn cases requiring endodontic treatment with lateral canals, the CWC obturation technique using BCHiF with gutta-percha may offer better outcomes compared to other obturation techniques.

Regenerative Potential of Dental Pulp Stem Cells in Response to a Bioceramic Dental Sealer and Photobiomodulation: An In Vitro Study.

This study aims to assess the synergistic effect of utilizing a bioceramic sealer, NeoPutty, with photobiomodulation (PBM) on dental pulp stem cells (DPSCs) for odontogenesis. Dental pulp stem cells were collected from 10 premolars extracted from healthy individuals. Dental pulp stem cells were characterized using an inverted-phase microscope to detect cell shape and flow cytometry to detect stem cell-specific surface antigens. Three experimental groups were examined: the NP group, the PBM group, and the combined NP and PBM group. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) experiment was conducted to assess the viability of DPSCs. The odontogenic differentiation potential was analyzed using Alizarin red staining, RT-qPCR analysis of odontogenic genes DMP-1, DSPP, and alkaline phosphatase (ALP), and western blot analysis for detecting BMP-2 and RUNX-2 protein expression. An analysis of variance (ANOVA) followed by a post hoc t-test was employed to examine and compare the mean values of the results. The study showed a notable rise in cell viability when NP and PBM were used together. Odontogenic gene expression and the protein expression of BMP-2 and RUNX-2 were notably increased in the combined group. The combined effect of NeoPutty and PBM was significant in enhancing the odontogenic differentiation capability of DPSCs. The synergistic effect of NeoPutty and PBM produced the most positive effect on the cytocompatibility and odontogenic differentiation potential of DPSCs. Creating innovative regenerative treatments to efficiently and durably repair injured dental tissues. How to cite this article: Alshawkani HA, Mansy M, Al Ankily M, et al. Regenerative Potential of Dental Pulp Stem Cells in Response to a Bioceramic Dental Sealer and Photobiomodulation: An In Vitro Study. J Contemp Dent Pract 2024;25(4):313-319.

Efficacy of root-end filling techniques using premixed putty type bioceramic cements: an ex vivo study.

Currently, premixed putty-type bioceramic cements (PPBCs) have become popular materials for root-end fillings. This study investigated three root-end filling techniques using PPBCs and calcium silicate-based sealers including EDTA pretreatment. Ninety root segments were prepared and standardized with an artificial fin and lateral canal, and assigned to three groups (n = 30). Root-end fillings were placed using BC-RRM Putty alone (Group PA), injection of BC sealer followed by BC-RRM Putty (Lid Technique: Group LT) or BC-RRM Putty with BC sealer coating (Deep putty packing technique: Group DP). Half of each group was pretreated with 17% EDTA. The radiographic images of the specimens were assessed by five graders and push-out bond strength tests were conducted. The data were analyzed with a general linear model including two-way ANOVA and chi-square test at a significance level of 5%. DP approach demonstrated significantly higher bond strength than LT (P < 0.05). However, there was no statistically significant difference in bond strength between PA and either DP or LT. EDTA pretreatment had no significant effect on push-out bond strength. Radiographically, for the main canal, PA and DP scored significantly higher than LT. In the fin, PA scored significantly higher than others (P < 0.05). Our study highlights variations in root-end filling techniques. Injecting a bulk of bioceramic sealer before the placement of PPBCs may reduce bond strength and radiopacity. The application of PPBCs alone or in the deep putty technique demonstrates potential for favorable outcomes. EDTA pretreatment did not enhance bond-strength. Careful selection and application of bioceramic materials and techniques in root-end fillings may influence the outcome of endodontic root-end surgery. When PPBCs and calcium silicate-based sealers are used together for root-end fillings, sealer followed by deep putty application may offer improved bond strength and radiographic fill compared to the lid technique.

Micro-Computed Tomography Analysis of Resin and Calcium Silicate Based Sealers Removal in Mandibular Molars Curved Canals.

The removal of the root canal sealer is an important factor in nonsurgical retreatment. The aim of this study was to compare the removal of AH Plus, Well Root ST, and AH Plus Bioceramic Sealer using Protaper Universal retreatment files. The curved mesio-buccal canals of extracted mandibular molars were prepared with the Protaper Gold file system (up to F2). Specimens were randomly divided into 3 groups and filled with the single cone technique using AH Plus, Well-Root ST, and AH Plus Bioceramic Sealer, respectively. After two weeks, the root canal filling of all specimens was removed using Protaper Universal retreatment files. All specimens were scanned using micro-CT. The remaining volume of the root canal filling was recorded in total and the coronal, middle, and apical third of each specimen. Well-Root ST and AH Plus Bioceramic Sealer groups had a higher percentage of total remaining filling material than the AH Plus group (P<0.05). This study has shown that the volume of remaining root canal filling was significantly higher in the samples filled with calcium silicate-based sealers.