Biocompatibility Of Root Canal Sealers Research Articles

Cytotoxicity and biocompatibility of root canal sealers: A review on recent studies

Many types of endodontic root canal sealers have been employed for the purpose of filling voids and irregularities in root canals, as well as reducing/removing bacterial remnants/remains. Sealers are available in various formulations, and research work to find the most appropriate ones is still ongoing. Recently, many kinds of novel root canal sealers have been introduced under various commercial names. However, most sealers are known to exhibit different levels of cytotoxicity on tissues which would result in prolonged wound healing, inflammation, and bone resorption. Preferably, sealers need to have tolerable biological and physico-chemical properties along with biocompatibility. Additives promoting the biocompatibility and bioactivity of sealers are of major concern in clinical applications. The aim of this review was to compare, evaluate, and analyze comparatively the cytotoxic effects, biocompatibility, and antimicrobial properties of recently used root canal sealers. A comprehensive literature search was made to identify their properties involving biocompatibility and cytotoxicity. In general, the sealers reported in recent literature exhibited favorable biological features in comparison to conventional ones. They promoted better cell viability and biocompatibility. The incorporation of additives influences favorably the potential negative effects. However, it has been highlighted that there is a lack of well-designed long-term clinical applications, and more in vitro and in vivo research work would be helpful to confirm the sustainability of the sealers for further clinical practice.

Antimicrobial activity and biocompatibility of the mixture of mineral trioxide aggregate and nitric oxide-releasing compound

Background/purposeAntimicrobial activity and biocompatibility of root canal sealer are related to the success of endodontic treatments. This study investigated the efficacy of mixture of mineral trioxide aggregate (MTA) and a NO-releasing compound for the antimicrobial activity, biocompatibility, and physical properties. Materials and methodsMTA was mixed with diethylenetriamine-NO (MTA-NO), and the extracts from MTA and the MTA-NO mixture before and after setting was obtained were investigated the antimicrobial activity against Enterococcus faecalis and Porphyromonas endodontalis. After setting MTA and MTA-NO, pulp cell was incubated in the presence of MTA and MTA-NO disk using Transwell® cell culture insert, and the proliferation assay and mineralization-stimulated factors of the cells were analyzed by MTT assay and real-time RT-PCR, respectively. The physical properties of MTA and the MTA-NO mixture, such as surface hardness and flowability was also analyzed. ResultsThe MTA-NO mixture showed stronger antimicrobial activity against E. faecalis and P. endodontalis than that by MTA. Both MTA and MTA-NO mixture increase the ratio of cell proliferation and induced the expression of alkaline phosphatase, collagen type I, osteocalcin, and osteopontin. Moreover, the induction of gene expression by MTA-NO mixture was higher than that by MTA alone. No significant difference was observed for surface hardness and flowability between MTA and MTA-NO mixture. ConclusionThe addition of a NO-releasing compound to the endodontic treatment using MTA root canal sealer might reduce the risk of bacterial infection and help to regenerate the dental pulp tissue.

Biocompatibility of Root Canal Sealers: A Systematic Review of In Vitro and In Vivo Studies.

(1) Aim: To perform a systematic review of the literature on the biocompatibility of root canal sealers that encompasses the various types of sealers that are commercially available as well as both in vitro and in vivo evidence. (2) Methods: This systematic review has been registered in PROSPERO (ID 140445) and was carried out according to PRISMA guidelines using the following databases: PubMed, Cochrane Library, ClinicalTrials.gov, Science Direct, and Web of Science Core Collection. Studies published between 2000 and 11 June 2019 that evaluated cytotoxicity (cell viability/proliferation) and biocompatibility (tissue response) of root canal sealers were included. (3) Results: From a total of 1249 studies, 73 in vitro and 21 in vivo studies were included. In general, studies suggest that root canal sealers elicit mild to severe toxic effects and that several factors may influence biocompatibility, e.g., material setting condition and time, material concentration, and type of exposure. Bioactive endodontic sealers seem to exhibit a lower toxic potential in vitro. (4) Conclusions: The available evidence shows that root canal sealers exhibit variable toxic potential at the cellular and tissue level. However, the methodological heterogeneity among studies included in this systematic review and the somewhat conflicting results do not allow a conclusion on which type of sealer presents higher biocompatibility. Further research is crucial to achieve a better understanding of the biological effects of root canal sealers.

An animal study - underutilized vista of research in dentistry with special reference to biocompatibility of root canal sealer

Background: Endodontic sealers are designed to be used only within the root canal but are frequently extruded through the apical constriction and often placed in intimate contact with periapical tissues for extended periods of time. Hence, assessment of biocompatibility of endodontic sealers is critical to the clinical success of endodontic therapy. Materials and Methods: Eighteen Wistar rats were divided into three groups of 6 each for observation after completion of 14, 30 and 90 days following implantation, respectively. Polyethylene tubes filled with new sealer, and tube without sealer [control] were implanted subcutaneously. The sample subcutaneous tissues from sacrificed rats were analyzed histologically for inflammatory response and were graded with FDI criteria as minimal, moderate and severe. Results were analyzed statistically with Student's t-test and ANOVA tests. Results : Inflammatory reaction to the polyethylene tube was minimal at 14 and 90 days period and to the new sealer it was severe at 14 days and moderate at 30 and 90 days period. Conclusions: 1. Cytotoxicity of the individual ingredient of the new sealer should be investigated to find out its chemical reaction occurring at tissue interface resulting in persistence of inflammation. 2. This subcutaneous implantation method is a practical method for qualitative evaluation of endodontic material and can yield exact detailed information about tissue reaction of material on a cellular level. 3. Hence, animal study is positive, efficient and valuable method to carry out research successfully in dentistry.

Assessment of the biocompatibility of Epiphany root canal sealer in rat subcutaneous tissues

The aim of this study was to evaluate the biocompatibility of the root canal sealer Epiphany in rat subcutaneous tissues. Polyethylene tubes were filled with the sealer (I: Epiphany; II: photoactivated Epiphany; III: Epiphany associated with self-etch primer; IV: photoactivated Epiphany associated with primer; and V: control group) and later implanted into 4 different regions of the dorsum of 15 adult male rats (Rattus novergicus, Albinus Wistar). After 7, 21, and 42 days, 5 animals were killed, obtaining 4 samples per group, in addition to the control group, at each analyzed time. In all periods, Epiphany induced a mild inflammatory reaction. However, in group II, in which the primer was not used, extensive necrosis and a moderate to intense inflammatory reaction were observed, mainly after 7 and 21 days. Epiphany sealer appears biocompatible when tested on rat subcutaneous tissues.

Cytotoxicity of resin-based root canal sealer, adseal

The properties of ideal root canal sealers include the ability of sealing the total root canal system and no toxic effects to periradicular tissues. Cytotoxicity test using cell culture is a common screening method for evaluation of the biocompatibility of root canal sealers. The purpose of this study was to investigate the cytotoxic effect of newly developed resin-based sealer (Adseal 1, 2, and 3) comparing with those commercial resin-based sealers (AH26 and AH Plus), ZOE-based sealers (Tubliseal EWT, Pulp Canal Sealer EWT) and calcium hydroxide based sealer (Sealapex). An indirect contact test of cytotoxicity by agar diffusion was performed according to the international standard ISO 10993-5. L929 fibroblast cells were incubated at 37℃ in humidified 5% CO 2-containing air atmosphere. The freshly mixed test materials were inserted into glass rings of internal diameter 5 ㎜ and height 5 ㎜ placed on the agar. After the 24 hrs incubation period, the decolorization zones around the test materials were assessed using an inverted microscope with a calibrated screen. A Decolorization Index was determined for each specimen. Adseal 1, 2, and 3 did not exert any cytotoxic effects, whereas AH26, AH Plus, Tubliseal EWT, Pulp Canal Sealer EWT, and Sealapex