Bioceramic Research Articles

Bioceramics for Guided Bone Regeneration: A Multicenter Randomized Controlled Trial.

To compare the clinical effectiveness of a novel bioceramic (BC) with a control xenograft (BO) for guided bone regeneration (GBR) performed simultaneously with implant placement. This clinical study enrolled patients with insufficient bone volume who required GBR during implant placement to increase bone width using either BC or BO. Outcome measures included a dimensional reduction in buccal bone thickness measured by cone beam computed tomography performed immediately post-surgery and at 6 months postoperatively (ΔHBBT), soft tissue healing at 14 days, 1 month, and 6 months postoperatively, and complications rates. The primary outcome was the change in buccal bone thickness around the implant. Of the total 152 patients included, 76 from each group received BC and BO treatments. The ΔHBBT in BC and BO groups were -0.276 mm (-0.432, -0.121) and -0.614 mm (-0.769, -0.459) mm, respectively, rejecting the null hypothesis. No significant difference in soft tissue healing was observed between the two groups, with no inflammatory changes in 96.05% and 90.79% of the BC and BO groups, respectively, at 2 weeks postoperatively. However, the BC group exhibited a lower overall complication rate (3.95%), including mild inflammation, poor soft tissue healing, and bone graft extrusion in 3 out of 76 patients. Both BC and BO demonstrated favorable outcomes in bone regeneration and soft tissue healing when used for simultaneous implant placement and bone augmentation.

Obturation quality of bioceramic sealers with different obturation techniques: a micro-CT evaluation

This micro-computed tomography (micro-CT) analysis in vitro study was designed to compare void volume in root canal fillings performed using the single-cone (SC) technique and the continuous wave condensation (CWC) technique with bioceramic (BC) sealer. Forty human-extracted, single-rooted mandibular premolars were cleaned, shaped, and divided into two groups (n = 20) based on the obturation technique. In the first group, obturation was performed using the CWC technique with TotalFill HiFlow BC sealer. In the second group, obturation was performed using the SC technique with the conventional TotalFill BC sealer. All roots were scanned with micro-CT, and ©CTAn software version 1.20.8.0 was used to measure the void volume of each root third in all samples. Despite the different obturation techniques, both groups exhibited voids in filled root canals. The overall mean void volume in the SC group (0.253 ± 0.186) was significantly higher (p = 0.000) than that in the CWC group (0.035 ± 0.043). The difference was significant in the coronal (p = 0.000) and middle (p = 0.017) thirds. The CWC technique with TotalFill HiFlow BC sealer achieved superior obturation quality compared to the SC technique with conventional BC sealer in oval-shaped premolars.

Obturation of Simulated Internal Resorption Cavities With Four Different Techniques and a Hydraulic Root Canal Sealer: A Comparative Stereomicroscopic Evaluation.

Aim To compare the quality of obturation using WVC (warm vertical compaction), CLC (cold lateral compaction), injectable (iFill), and Thermafil (GuttaCore) techniques, along with hydraulic condensation of bioceramic (BC) sealer, and evaluating the percentage of gutta-percha (GP), sealer, and voids in simulated internal resorptive lesions, using an advanced stereomicroscope with ImageJ software (National Institutes of Health, Bethesda, MD, USA). Methods and material In this study, 40 freshly extracted maxillary incisors were collected, and endodontic instrumentation was done to working length using hand K-files. Simulated internal resorption cavities were created in the middle-apical third of the roots after horizontal sectioning and were re-cemented. The root canals were obturated using four techniques: WVC, CLC, iFill, and Thermafil, along with BC sealer. After one week, the samples were resectioned, the surfaces were photographed, and the percentage of GP, sealer, and voids in resorptive cavities was calculated using an advanced stereomicroscope and ImageJ software, respectively. The data were statistically analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey tests. Results The iFill approach had the highest total filled area in the simulated resorptive region (96%), followed by WVC (92%), CLC (91%), and GuttaCore (77%). CLC had a notably high percentage of sealers (46%), compared to WVC (40%) and Thermacore (41%). With 23% of voids, the GuttaCore technique was considered the least successful. Conclusions Warm GP condensation techniques, combined with hydraulic sealer in filling artificial resorption cavities, outperformed the other obturationprocedures.

Comparative Micro-CT Evaluation of Dentinal Tubule Penetration of BIO-C and AH Plus Jet Root Canal Sealer Using Three Intra-Canal Activation Techniques

ABSTRACT Objectives: This study aimed to compare the effectiveness of three intra-canal sealer activation techniques: ultrasonic, Lentulospiral activation, and GP cone-mediated ultrasonic activation on dentinal tubule penetration of a bioceramic (BIO-C) root canal sealer and AH Plus jet sealer with single cone obturation. Materials and Methods: Eighty single-rooted straight canal teeth were randomly divided into two main groups – BIO-C sealer and AH Plus jet sealer (n = 40). Each group was further divided into four subgroups, based on the three activation techniques: ultrasonics, Lentulospiral, gutta-percha cone-mediated ultrasonic, and a control. The canals were obturated using the single cone obturation technique. Dentinal penetration of sealers was measured using Micro-CT at the coronal, middle, and apical portions of root canals. Results: Greater sealer penetration was observed with ultrasonic and Lentulospiral agitation compared to GP-mediated ultrasonic agitation for both sealers. Conclusion: BIO-C yielded better results with ultrasonic and Lentulospiral agitation, while AH Plus performed better with ultrasonic agitation.

Comparative Evaluation of Sealing Ability, Bond Strength, and Antimicrobial Properties of Endodontic Sealers: An In Vitro Study

ABSTRACT Objective: To compare the sealing ability, bond strength, and antimicrobial properties of BioRoot root canal sealer (RCS), TotalFill Bioceramic (BC), EndoSeal Mineral Trioxide Aggregate (MTA), and AH Plus in endodontic therapy. Methods: Eighty single-rooted human teeth were divided into four groups (n = 20). Sealing ability was assessed via dye penetration, bond strength with push-out tests, and antimicrobial properties using agar diffusion tests against Enterococcus faecalis. Statistical analysis involved one-way ANOVA and Tukey’s Honestly Significant Difference (HSD) tests (P < 0.05). Results: BioRoot RCS showed the best sealing ability, highest bond strength, and largest antimicrobial zone. AH Plus had the poorest performance. Conclusion: BioRoot RCS is a superior endodontic sealer.

Comparison of Retreatability of AH Plus Sealer and Bioceramic Sealer with Solvent, Retreatment Files and Diode Laser: A CBCT and SEM Analysis

ABSTRACT Aim: The present study evaluated the retreatability of canals obturated using AH Plus sealer and Bioceramic (BC) sealers, employing Cone beam computed tomography (CBCT) and Scanning Electron Microscope (SEM). Methodology: A group of 90 extracted premolars was classified into two main categories based on whether they were sealed with AH Plus or BC Sealer. Each of these categories was then divided into two subcategories according to the retreatment technique applied. CBCT and SEM were used to assess the residual filling material within the canals. Results: The findings showed that there was no marked statistical variation in the retreatment success of canals sealed with BC and AH Plus sealers. Conclusion: The diode laser was the most effective modality for eliminating root canal filling materials in the least amount of time. None of the retreatment modalities used removed the obturating material completely.

Comparison between AH plus sealer and total fill bioceramic sealer performance in previously untreated and retreatment cases of maxillary incisors with large-sized periapical lesion: a randomized controlled trial

ObjectiveThis study aims to assess the efficacy of bioceramic (BC) sealer when applied using the single cone technique (SCT), in comparison to AH Plus sealer applied with the cold lateral condensation technique (LCT), concerning their impact on the healing of large-sized periapical lesions in both untreated and retreatment cases.Materials and methodsA randomized controlled trial was conducted on 41 patients who had 60 permanent teeth in the maxillary incisors that were accompanied by large-sized periapical lesions. The included teeth were radiographed with cone beam computed tomography (CBCT) images and divided equally into two groups according to the endodontic treatment statute (30 untreated previous cases and 30 retreated cases). Subsequently, teeth received uniform preparation, irrigation, and dressing procedures. Then each group was divided equally according to the used sealer (15 teeth obturated using AH plus sealer with LCT and 15 teeth obturated using BC sealer with SCT). All cases were followed up after 6 and 12 months with CBCT images. Subsequently, the change in periapical lesion diameter (PLD) was observed as an indicator to determine the treatment outcome score. One-way ANOVA and Mann–Whitney U test were used to analyze the PLD changing and scoring the treatment outcome during the follow-up periods. The significance level was set at α = 0.05.ResultsThere were no statistically significant differences between untreated and retreatment cases neither using AH plus sealer with LCT nor BC sealer with SCT regarding changes in PLD in the follow-up periods. Moreover, there were no significant differences between groups regarding treatment outcome scores in the follow-up periods. All groups showed a high success rate.ConclusionsSuccessful treatment was achieved for untreated or retreatment maxillary incisor cases accompanied by large-sized periapical lesions using either BC sealer with the SCT or AH Plus sealer with LCT with a similar high success rate up to 12 months follow-up period.

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.

Quality of Root Canal Filling in Curved Canals Utilizing Warm Vertical Compaction and Two Different Single Cone Techniques: A Three-Dimensional Micro-Computed Tomography Study.

Successful endodontic treatment depends on three-dimensional (3D) root canal filling to prevent the leakage of residual bacteria. Different obturation techniques with different sealers should be compared by employing advanced assessment tools. This study compared the obturation quality of warm vertical compaction (WVC) and two different single-cone (SC) techniques using micro-computed tomography (micro-CT). Thirty-three extracted maxillary molars with mesial root canal curvature of 20‒40º were prepared in vitro with One-Curve files and randomly assigned to three groups (n=11) for root canal obturation with WVC, SC technique with AH Plus sealer (SC-AH), or SC technique with SureSeal bioceramic (BC) sealer (SC-Su). The root canals underwent micro-CT examinations before and after obturation to determine the volume percentages (VPs) of voids and gaps at different distances from the apex (coronal, middle, and apical thirds). Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. The highest VP of voids and gaps was recorded in the SC-Su group, with no significant difference from other groups (p> 0.05). There were significant differences in VP of gaps at different distances from the apex (p<0.05). The VPs of gaps in the apical third of all the samples were significantly higher than in the coronal and middle thirds. However, the difference in VP of voids was not significant at different distances from the apex (p>0.05). None of the tested techniques could provide a void-free and gap-free filling. The apical third of the canals showed the highest VP of gaps in all obturation techniques.

Evaluation of Mean Apical Sealing Ability of Bio Ceramic and AH Plus (Dentsply Sirona) Sealer in Single Rooted Teeth: An In Vitro Study

A good seal is essential to prevent bacteria from re-entering the canal. Sealers can significantly impact the success of the treatment. Understanding which sealant works better can help dentists improve the outcome of root canal treatments. Objective: To compare mean apical sealing ability of bioceramic sealer and AH plus sealer in single rooted tooth. Methods: Extracted single-rooted teeth were divided into two groups and sealed with either bioceramic or AH plus sealer. After soaking in dye solution, the depth of dye penetration was measured to assess leakage. Results: Bioceramic sealer showed significantly better apical sealing ability (mean 5.43 mm) compared to AH plus (mean 8.55 mm), suggesting it may be a more effective choice for preventing future problems after root canal treatment. Conclusions: The study concluded that bioceramic sealer is superior to AH plus in sealing the tips of single-rooted teeth. This finding can help dentists choose the most effective sealant for their patients, potentially reducing the chance of treatment failure.

Experimental investigations of temperature-sensitive shape memory polymer composites for 4D printing

Shape memory polymers (SMPs) and their composites (SMPCs) have emerged as popular materials in a variety of industries due to their unique properties of shape-changing behavior in response to external stimuli. The inclusion of reinforcement may modify the SMPs to enhance their thermal and shape memory properties. Different types of bio ceramics have already been used to alter the thermal and shape memory behavior of SMPs. However, using bioactive glass (BG) as filler to modify these properties has not yet been explored. Despite the significant advantages that shape-memory polymers (SMPs) offer when combined with 3D/4D printing technology, their potential in 3D printing has been explored only to a limited extent. This work created a solvent-based 4D-printed temperature-sensitive shape memory polymer composites (SMPCs) system using polylactic acid (PLA) and bioactive glass (BG). The influence of BG on the thermal as well as shape-memory capabilities of composites was further examined. An increase in the degree of crystallinity and viscoelastic characteristics of PLA/BG composites led to improved shape memory properties, like shape fixity and shape recovery. These findings suggest the potential for using the developed SMPC printed through 4D printing technology, to develop complex shapes for self-foldable structures and smart biomedical devices in the future.

Influence of root canal moisture on the penetration of TotalFill bioceramic sealer into the dentinal tubules: A confocal laser scanning microscopy study

Abstract Introduction: Bioceramic (BC) sealers exhibit multiple desirable biologic and physical properties. The aim of this study was to evaluate the effect of root canal moisture on the depth of TotalFill BC sealer penetration into dentinal tubules at different levels using a confocal laser scanning microscope (CLSM). Materials and Methods: The manuscript of this laboratory study has been written according to preferred reporting items for laboratory studies in endodontology 2021 guidelines. Forty single-rooted extracted human premolars were decoronated using a low-speed diamond disc, followed by root canal preparation using nickel–titanium files under copious irrigation. The samples were randomly allocated for obturation into four groups n = 10 based on the sealer and root canal moisture status. Group A: TotalFill BC sealer in wet canal, Group B: TotalFill BC sealer in dry canal, Group C: AH Plus sealer in wet canal, and Group D: AH Plus sealer in dry canal. The roots were sectioned at three different distances from the apex. The root segments were examined using CLSM to measure the extent of sealer penetration into the dentinal tubules. The data underwent analysis through a three-way mixed ANOVA test, followed by post hoc assessments (P &lt; 0.05). Results: In wet canals, the tubular penetration of TotalFill BC sealer was notably greater than that of AH plus, with a statistically significant difference. However, AH Plus sealer had a statistically significant tubular penetration in the dry canals compared to the wet. Greater sealer penetration was observed at 5 mm from the apex, followed by 3 mm, and the least penetration depth was found at 1 mm from the apex. Conclusions: The presence of root canal moisture and distance from the apex had a significant impact on the penetration of TotalFill BC sealer into the dentinal tubules.

The ability of different compositions of calcium silicate and epoxy sealers to withstand gutta percha removal via in vitro pull-out testing

Objectiveexamination of the influence of chemical composition changes on the ability of sealers to withstand a pull-out test.Materials and methodsFifty distal or palatal canals of extracted teeth were prepared by Dc Taper files. The teeth were divided into five groups: AH Plus, BJM RCS, Total Fill BC,AH Plus Bioceramic and a group with Gutta Percha with no sealer added. Ten days after obturation, each cone was subjected to the “pull-out test” with the Shimadzo Universal Testing Machine until it was torn or removed from the canal. A force to Stroke graph was generated and the maximum vertex of this graph was recorded. The number of times the cone was torn or removed was recorded.ResultsThe amount of force needed to remove or rupture the cone was significantly higher in all sealer groups compared to the AH Plus Bioceramic group. The force needed for the AH Plus group was double that needed for the AH Plus Bioceramic group 4 (1.87 ± 0.53 N vs 0.93 ± 0.48 N, respectively, P < 0.001). All of the cones (n = 10) in the AH Plus Bio Ceramic Sealer group were removed in their entirety (P = 0.01 compared to each of the other groups).ConclusionsThe addition of macromolecules to epoxy sealer does not change the material’s ability to withstand the pull-out test. Decreasing the amount of tri- and di-calcium silicate compounds combined with increasing amounts of zirconium oxide in a Bioceramic sealer significantly decreased the material’s ability to withstand the pull-out test.

Tuning low frequency dielectric properties of flexible ternary polymer blend film reinforced with bio- ionic liquid for the application in green electronics

Biofriendly conducting polymeric blends and composites exhibiting high dielectric constant and dielectric loss are promising for applications as sensors, actuators, microwave absorbing materials, fuel cells and biomedical applications. A great deal of work is reported on using fillers such as conductive nanomaterials, bio ceramics, carbon nanotubes, graphene etc in blends of Polyvinylchloride, Polyvinylpyrrolidone, Polymethylmethacrylate, Polyvinyl alcohol with conducting polymer Polypyrrole, Polyaniline for enhancing their conductivities, tailoring dielectric and electrical, thermal and surface properties of such polymeric materials. However, appropriate dispersion of such fillers in polymeric matrices remains technically challenging. In this regard, bio-ionic liquids have emerged as a novel class of materials and their combination with specific polymer blends opens the possibility to develop smart novel materials with different morphologies. Present work aims to explore the low frequency dielectric properties exhibited by free standing, flexible, biofriendly/biodegradable ternary polymer blend film of Polyvinylchloride-Polyvinylpyrrolidone-Polypyrrole reinforced with choline acetate. The detailed analysis of low frequency dielectric properties authenticates that addition of choline acetate result in modifying the dielectric properties of ternary polymer blend film.. The harmlessness of these films was confirmed from disk diffusion test indicating their benign nature towards (Escherichia coli) (CFT073) and (Bacillus subtilis). Therefore, the developed films can potentially be used for various scale multifunctional dielectric and electrical applications working in close contact with living matter, green electronics and various health monitoring systems.

Assessment of the impact of XP-Endo Finisher file on push-out bond strength of various endodontic sealers.

An endodontic treatment is considered a success after thorough chemomechanical debridement coupled with obturating root canals in a concrete way thereby providing hermetic seal. Gutta-percha being nonadherent necessitates use of a sealer to achieve hermetic seal. Adequate adhesion of root canal sealer with gutta-percha core and radicular dentin ensures lack of apical leakage. Sixty extracted mandibular premolars with single root canal decoronated at cementoenamel junction were selected and randomly allocated to two groups (n = 30). Samples in Group 1 were prepared with BT Race file, while Group 2 samples were prepared with BT Race alongwith XP Endo file. Absorbent paper points were used for canal drying and samples were randomly divided into six subgroups. In Subgroup I, obturation was done with bio-ceramic (BC) sealer (Endosequence BC) and BC gutta-percha. In Subgroup II, resin-based (AH plus) sealer and gutta-percha were used. In Subgroup III, calcium hydroxide-based (Sealapex) sealer and gutta-percha were used. Sectioning of root samples was done perpendicularly into coronal, middle, and apical segments of 3 mm each. A universal testing machine was used for sample testing, in which push-out bond strength corresponded to the highest value obtained. Stereomicroscopic (×20) study of the samples determined the failure mode at dentin/sealer/main cone interface. Analysis of variance and post hoc Tukey's tests were used for data analysis. Endosequence BC with XP-Endo files showed the highest mean push-out bond strength (16.31 MPa), whereas Sealapex without XP-Endo file had the lowest values (12.76 MPa). Mixed failure of adhesive and cohesive mode was observed for most samples. Adjunctive irrigation agitation technique utilizing XP-Endo Finisher facilitates biofilm eradication from difficult niches in root canals, thereby improving adhesion of sealer and subsequently the sealer bond strength.

The efficacy of XP endo retreatment system in removing bioceramic sealer from dentinal walls: An in vitro micro computed tomography study

Objectives: This study compared the efficacy of the XP endo retreatment (XPER) system in removing Total Fill Hi Flow BC (Bio ceramic) and Total Fill BC sealers from dentinal walls to that of the Pro Taper Universal retreatment (PTUR) system using micro-computed tomography (micro CT) analysis.

Developments in Biomedical Materials: From Conventional Implantation to State-of-the-Art Pharmaceutical Uses

In order to improve and restore the functions of biological tissues and organs as well as for the identification and treatment of diseases, biomedical materials a developing subject of materials science are indispensable. Materials like these are frequently employed in many different medical equipment employed in clinical settings, such as scaffolding, sutures, substitute teeth, artificial bones, and even heart replacements. Innovative methods for identifying, treating, and regaining physiological functions have been made possible by biomedical materials, which have completely changed the healthcare industry. The development, categorization, and therapeutic uses of biomedical materials are examined in this study, with a focus on metallic biomaterials, synthetic polymers, and bio ceramics in addition to their biologically derived counterparts, such as collagen, silk, chitosan, and alginate. The functionality of medical devices has been significantly advanced by bioengineering improvements, that have produced healing implants and progressive diagnostic imaging that improve patient effects. This evaluation explores the capacity of nanomaterials in biomedicine, current wound dressings, and antimicrobial methods, highlighting the limitations and destiny opportunities inside the creation of extra powerful therapy and minimally harmful diagnostic tools.

Fabrication of hydroxyapatite reinforced polymeric hydrogel membrane for regeneration

BackgroundThe regeneration of lost/damaged support tissue in the periodontium, including the alveolar bone, periodontal ligament, and cementum, is an ambitious purpose of periodontal regenerative therapy and might effectively reduce periodontitis-caused tooth loss. Guided tissue regeneration (GTR) is a technique currently used in dentistry for periodontal surgery, which allows osseous regeneration prior to soft tissue migration into the area of interest. Calcium phosphate-based bone grafts (mostly Tricalcium Phosphate or Hydroxyapatite) are bio ceramics that show the greatest similarity to the mineral found in the bone. Thereby, giving calcium-phosphate excellent biocompatibility, biodegradability and osteoconductivity. The aim of the study is to fabricate hydroxyapatite reinforced polymeric hydrogel membrane for regeneration. Materials and MethodPure alginate fabrication was done by cross linking sodium alginate with calcium chloride. Hydroxyapatite (HAP) alginate (Alg) was formulated by adding nanoparticles to the alginate mixture, which was then cross-linked with calcium chloride to formulate a HAP alginate polymeric membrane. The Fourier-transform infrared spectroscopy (FT-IR), Scanning Electron Microscope (SEM), and biocompatibility tests were performed to analyse the membrane characteristics. ResultsFabricated Hydroxyapatite- alginate (Hap- Alg) membrane has longer durability, because of strong crystal structure which in turn might take a longer time to regenerate. The membrane was found to be biocompatible and HAp induces faster mineralisation which in turn will increase the tissue regeneration rate of the membrane. ConclusionThe findings of our study suggests that the HAP-Alg hydro gel membrane is highly durable and hemocompatible and it has faster mineralisation capability thus making it superior from the clinically available membranes for GTR. Further analyses needs to be conducted to evaluate the potential of this membrane to be used for regeneration.

Adjunctive use of Er, Cr: YSGG laser, Potassium titanyl Phosphate laser, and photosensitizer on extrusion bond strength of radicular dentin to bioceramic sealers.

To assess the impact of adjunctive final root canal disinfection regime curcumin photosensitizer (CP) activated by Photodynamic therapy (PDT), Er, Cr: YSGG laser (ECL), and Potassium titanyl Phosphate (KTP) laser on the bond integrity of two endodontic Bioceramic (BC) sealers. Decoration of eighty human single-rooted teeth was performed up to a cementoenamel junction. After instrumentation, all samples were irrigated with 2.25% NaOCl solution followed by 17% EDTA. The specimens were divided arbitrarily into 8 groups (n=10) based on the adjunctive final irrigation method used. Group 1 and 5 (Control): No adjunctive regime, cleaned using 2.25% NaOCl+17% EDTA, group 2 and group 6: CP activated by PDT, Group 3 and Group 7 using ECL, Group 4 and Group 8: KTP laser. Following disinfection samples in groups 1, 2, 3, and 4 were obturated using Sankin apatite root canal sealer (SARS). Specimens in groups 5, 6, 7, and 8 were obturated using Pro-root endo sealer (PRES). Sectioning of samples was performed. The sectioned specimens were subjected to a compressive loading exerted via a steel plunger moving at a 0.5mm/min crosshead speed till debonding. Means and standard deviations (SD) of EBS of BC sealer with the root canal dentin were assessed using one-way analysis of variance (ANOVA) and Post Hoc Tukey multiple comparison tests. The level of significance was measured at p=0.05. The coronal section of samples in group 5 (Na-E-PRES) exhibited the highest bond value. The lowest PBS was displayed by the middle third of specimens in group 6. Group 1 (Na-E-SARS), group 3 (Na-E-ECL-SARS), group 5 (Na-E-PRES), and group 7 (Na-E-ECL-PRES) exhibited comparable bond values (p>0.05). Whereas, group 2 (Na-E-PDT-SARS) and group 4 (Na-E-PTPL-SARS), group 6 (Na-E-PDT-PRES), and group 8 (Na-E-PTPL-PRES) were found to be comparable (p>0.05). Adjunctive use of Er, Cr: YSGG laser displayed better extrusion bond strength with BC root canal sealer compared to CP activated by PDT and KTP laser. Bond strength is influenced by the type of irrigation.

Outcomes of endodontic microsurgery using different calcium silicate–based retrograde filling materials: a cohort retrospective cone-beam computed tomographic analysis

PurposeTo evaluate the outcomes of endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA; Dentsply Sirona, Charlotte, NC, USA), EndoSequence root repair material (RRM putty; Brasseler, Savannah, GA), and injectable Bioceramic (BC) sealer (Brasseler USA) followed by the application of RRM putty (lid technique) as root-end filling materials. MethodsOne hundred and ten patients who underwent EMS between 2016 and 2020 at King Abdulaziz University Dental Hospital were recruited for clinical and radiographic follow-up after a minimum of 1 year. Radiographic assessment was performed using periapical radiographs (PAs) and cone-beam computed tomography (CBCT). Volumetric analysis of periapical radiolucencies (PARLs) was performed using Amira software. ResultsSeventy-nine patients (103 teeth: MTA group, n = 28; RRM putty, n = 41; lid technique, n = 34), attended the follow-up visit, with an average follow-up period of 24 months (recall rate = 74.5%). Of the 103 teeth, 40 were anteriors, 24 were premolars, and 39 were molars. All three groups of retrograde filling materials (MTA, RRM putty, and lid technique) showed high success rates on both PA (85.7, 85.4, 94.1%, respectively) and CBCT imaging (67.9, 75.6, 88.2%, respectively), without any significant difference among the success rates of different materials. Overall, a slight agreement was noted between the PA and CBCT outcomes, with a statistically significant difference (P = 0.029). None of the patient-, tooth-, or treatment-related factors significantly influenced the outcomes of EMS. Adequate density of root canal filling material was significantly associated with a high percentage of completely healed cases on CBCT (P = 0.044). PARL volumes were reduced significantly over 1–4 years follow-up after EMS (P < 0.001)ConclusionsEMS showed high success rates on both PA and CBCT when MTA, RRM putty or lid technique were used as retrograde filling materials. CBCT imaging is more precise than PA in detecting the healing outcomes of EMS.