Calcium Silicate-based Root Canal Sealers Research Articles

Comparison of the antibacterial activity of calcium silicate- and epoxy resin-based endodontic sealers against Enterococcus faecalis biofilms: a confocal laser-scanning microscopy analysis.

This study assessed the antibacterial activity of BioRoot RCS in comparison with that of the Totalfill BC and AH Plus sealers against Enterococcus faecalis biofilms in dentinal tubules using confocal laser-scanning microscopy. Sixty-six root dentin halves were prepared and sterilized. Three sections were used to ensure sterilization. The remaining were inoculated with E. faecalis. Three specimens were examined to verify the viability of biofilms. The sixty specimens were randomly divided into four groups: AH Plus, BioRoot RCS, Totalfill BC sealer, and no sealer. The specimens were incubated for 1, 7, and 30days. The specimens were stained and four corners of each disc were scanned. Statistical analysis was performed using two-way ANOVA and Tukey's post hoc test. Almost half of the bacteria were dead in BioRoot RCS group on day 1 and in Totalfill BC group on day 7. All sealers killed significantly more bacteria than the control after 30 days (P < .05). On day 7, Totalfill BC showed a significantly higher percentage of dead bacteria than BioRoot RCS (P < .05). On day 30, the BioRoot RCS group registered the highest percentage of dead cells (61.75%), which was significantly higher than the percentages of the AH Plus and Totalfill BC groups (P < .05). Calcium silicate-based root canal sealers exerted antimicrobial effects against E. faecalis biofilms. The antibacterial activity of BioRoot RCS was significantly higher than that of the Totalfill BC and AH Plus sealers after 30 days of exposure.

Comparative pH and calcium ion release in newer calcium silicate-based root canal sealers

Aims: The aim of this study is to compare and evaluate pH and calcium ion release in newer calcium silicate-based root canal sealers. Methodology: Polyethylene tubes were cut into 35 tubes of equal sizes; with each tube measuring 10 mm length × 1 mm diameter. The tubes were pre-weighted using digital weighing balance machine to allow a similar weight of each tube. The polyethylene tubes were divided into four groups according to the materials with which they were filled. Group 1 (n = 5) control group, Group 2 (n = 10) sealapex, Group 3 (n = 10) mineral trioxide aggregate (MTA) fillapex, and Group 4 (n = 10) White MTA. The tubes after being packed with the respective sealers were placed inside polypropylene flasks containing 10 ml of deionized water. The flask was closed and stored at a constant temperature of 37°C during all the evaluation period. At 24 h, 7 days and 1 month, pH and calcium ion released was measured using pH meter and atomic absorption spectrophotometer, respectively. Results: At 24 h, White MTA showed the highest pH (8.52) and highest calcium (Ca++) release (14.7). At 7 days and 28 days, MTA fillapex showed significantly higher pH (8.64; 8.7) and Ca++ release (10.30; 18.60) than the other two groups. Conclusion: Although at 24 h, the new calcium silicate-based root canal sealer, MTA fillapex showed the least Ca++ release but over longer time intervals, i.e., at 7 days and 28 days, MTA fillapex showed significantly higher pH and Ca++ release than both White MTA and sealapex.

Anti-inflammatory and Osteogenic Effects of Calcium Silicate–based Root Canal Sealers

IntroductionAn ideal root canal sealer creates a bacteria-resistant seal and exhibits antimicrobial activity, biocompatibility, and osteoconductivity. The aim of this study was to assess the effects of 3 root canal sealers on cell viability, inflammatory response, and osteogenic potential in MC3T3-E1 cells. MethodsAH Plus (Dentsply Caulk, Milford, DE), MTA Fillapex (Angelus Solucxoes Odontologicas, Londrina, Brazil), and EndoSequence BC (Brasseler, Savannah, GA) were mixed according to the manufacturer's instructions, and samples were prepared as extraction media (final dilution: 1/10). Lipopolysaccharide (LPS) (100 ng/mL) treatment was used to induce an inflammatory response in this study. Cell viability was evaluated using the Water soluble tetrazolium-1 (WST-1) assay. The levels of inflammatory mediators (interleukin 6 and tumor necrosis factor alpha) and osteogenic marker genes (ALP and OCN) were measured by reverse-transcription polymerase chain reaction and real-time polymerase chain reaction. Osteogenic potential was evaluated by alkaline phosphatase staining and alizarin red staining. ResultsCalcium silicate–based sealers such as MTA Fillapex and EndoSequence BC showed strong cell viability compared with AH Plus. AH Plus, MTA Fillapex, and EndoSequence BC decreased the levels of LPS-induced inflammatory mediators (P < .05). The expression of osteogenic marker genes, alkaline phosphatase activity, and mineralized nodule formation decreased with LPS treatment. However, AH Plus and calcium silicate–based sealers increased the osteogenic potential reduced by LPS treatment (P < .05). ConclusionsCalcium silicate–based sealers exhibit anti-inflammatory effects and induce osteogenic differentiation in MC3T3-E1 cells.

Improved sealing ability promoted by calcium silicate-based root canal sealers

Aim: This study investigated the sealing ability produced by AH Plus (Dentsply DeTrey, Konstaz, Germany), EndoSequence BC sealer (Brasseler USA, Savannah, GA, USA), GuttaFlow (Coltène/Whaledent, Altstätten, France) and MTA Fillapex (Angelus, Londrina, Brazil). Methdos: A total of forty-six single-root human canines were prepared and randomly divided into four experimental groups (n=10): MTA Fillapex, EndoSequence BC Sealer, AH Plus or GuttaFlow. Teeth with intact crowns served as negative controls (n=3) and teeth filled with only gutta-percha served as positive controls (n=3). Teeth were mounted in a two-chamber apparatus and exposed to Enterococcus faecalis. The number of days over a 60-days period was recorded for the appearance of turbidity in the lower chamber. Kaplan-Meier method was used to estimate the survival curves. The nonparametric log-rank test was used to compare the survival curves using a significance level of 0.05. Results: The results at the end of the observation time were further analyzed by chi-square testing. All positive controls leaked within 24 h, whereas none of the negative controls leaked after 60 days. EndoSequence BC Sealer and MTA Fillapex had significant less bacterial leakage (P&lt;0.05) than the other tested sealers. No significant difference between AH Plus and GuttaFlow was observed (P&gt;0.05). Conclusion: In conclusion, calcium-silicate based root canal sealers promoted improved sealing ability when compared to other endodontic sealers.

Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal

Background/purposeBacterial infection is closely associated with the failure of endodontic treatment, and use of endodontic sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. The purpose of this study was to investigate and to compare the antibacterial effect of two calcium silicate-based root canal sealers (Endoseal and EndoSequence BC sealer) as recent development sealers and with three conventional root canal sealers (AH Plus, Sealapex, and Tubli-Seal), before or after setting, on Porphyromonas endodontalis, Porphyromonas gingivalis, and Enterococcus faecalis. Materials and methodsThe sealers were soaked in phosphate buffered saline to elute its compositions after and before setting, and the elutes were performed the antimicrobial assay. Also, X-ray fluorescence analysis was carried out to compare compositions of two calcium silicate-based sealers. ResultsThe conventional root canal sealers have strong antibacterial activity against the Gram-negative bacteria, P. endodontalis and P. gingivalis. Endoseal sealer showed antibacterial activity against not only the Gram-negative bacteria, but also against the Gram-positive bacteria, E. faecalis. However, Endosequence BC sealer exhibited a weak antibacterial effect on all bacteria in this study. X-ray fluorescence analysis exhibited that Endoseal contained more types and more amount of the oxide compound known to have strong antimicrobial activity such as Al2O3, Fe2O3, MgO, Na2O, NiO, and SO2 than Endoseqeunce BC. ConclusionEndoseal, which contains various types of oxide compounds, seems to be a suitable sealer for preventing bacterial infection in both treated and untreated root canals.

Dentinal Tubule Penetration of a Calcium Silicate–based Root Canal Sealer with Different Obturation Methods

IntroductionThe purpose of this study was to investigate the depths of penetration of a calcium silicate–based sealer in dentinal tubules by using 3 different obturation methods. MethodsOne hundred extracted human permanent anterior teeth were endodontically prepared and divided equally into 3 experimental groups and 1 control group as follows: CPoint single cone (CPSC), gutta-percha single cone (GPSC), gutta-percha vertical condensation (GPVC), all with a calcium silicate–based sealer and calcium indicator Fluo-3, and CPoint single cone with a calcium indicator Fluo-3 (CPF3) without sealer as the control. The roots of the teeth in each group were axially cross-sectioned, and the surfaces were examined under confocal laser scanning microscopy at ×10 and ×20 magnifications. The sealer penetration depths were measured at their maximum depths and at 4 circumferential depths (12, 3, 6, and 9 o'clock) by using fluorescence. ResultsStatistical analyses by using one-way analysis of variance and repeated measures analysis with linear mixed models showed no statistically significant difference among the mean maximum depth measurements (CPSC, 283.83 μm; GPSC, 318.66 μm; and GPVC, 313.03 μm; P = .7553) and among the average depths across all points (CPSC, 111.24 μm; GPSC, 135.38 μm; and GPVC, 126.62 μm; P = .5304) for the 3 experimental groups. ConclusionsThe pressure derived from hygroscopic expansion of CPoint or warm vertical condensation did not enhance penetration depths of the calcium silicate–based sealer. Sealer penetration into the dentinal tubules occurred independent of the obturation technique.

Effect of double antibiotic and calcium hydroxide pastes on dislodgement resistance of an epoxy resin-based and two calcium silicate-based root canal sealers.

The purpose of the present study was to determine the dislodgement resistance of AH Plus, MTA Fillapex, and Total Fill BC sealer to root canal dentin walls following placement of calcium hydroxide (CH) or double antibiotic paste (DAP) medicaments. Root canals of 90 single-rooted human mandibular premolar teeth were instrumented with Reciproc rotary instruments to a size R50. The teeth were randomly divided into two experimental groups: those receiving an intracanal medicament with either CH or DAP and a control group (n=30). After 3weeks, the medicaments were removed by irrigation with 5mL of 2.5% NaOCl, 5mL 17% EDTA, and 5mL distilled water under sonic agitation. Each group was then subdivided into three subgroups (n=10), and the canals were filled with either AH Plus, MTA Fillapex, or Total Fill BC sealer. After 1week, a push-out test was applied to the specimens and the results were analyzed using one-way analysis of variance (ANOVA) and post hoc Tamhane's tests. Regardless of the type of intracanal medicament used, Total Fill BC Sealer and MTA Fillapex showed the highest and lowest bond strength, respectively (P<0.05). The use or absence of medicaments did not significantly affect the dislodgment resistance of root canal fillings (P>0.05). Prior CH placement improved dislodgement resistance of all sealers without statistical difference (P>0.05). Adhesive failure between core and sealer was the most frequent failure mode. Prior application of CH or DAP did not significantly affect the adhesion of the AH Plus, MTA Fillapex, and Total Fill BC Sealers. There is a little information about the influence of antibiotic medicaments on the bond strength of root canal sealer. These findings suggest that the use of DAP does not affect the adhesion strength of AH Plus, MTA Fillapex, and Total Fill BC Sealers.

Bond Strength of Calcium Silicate-Based Sealers to Dentine Dried with Different Techniques

Objective: To assess the influence of various canal-drying techniques on the push-out bond strength between radicular dentine and both MTA Fillapex and iRoot SP sealers. Materials and Methods: Eighty extracted single-root teeth were instrumented with ProTaper Universal rotary instruments to a size F4. The teeth were randomly assigned to 1 of 4 groups as follows: group 1, excess fluid in the canals was removed using a Luer vacuum adapter; group 2, the canals were dried with a single paper point; group 3, the canals were dried with 3-5 paper points, and group 4, the canals were rinsed with 95% ethanol and then dried with 3-5 paper points. In each group, the specimens were subgrouped according to root canal sealer into either subgroup A (MTA Fillapex) or subgroup B (iRoot SP sealer). Horizontal sections (thickness 1 ± 0.1 mm) were obtained from each specimen and a push-out test was performed using a universal testing machine at a crosshead speed of 1 mm/min on root slices. Statistical analysis was done using the Kruskal-Wallis test and Dunn's test for pair-wise comparisons. p < 0.05 was considered statistically significant. Results: Canals dried with only 1 paper point and obturated with the iRoot SP sealer (subgroup 2B) showed significantly higher bond strengths to the root canal wall compared to all other subgroups (p < 0.05), except for subgroup 1B (p > 0.05). Conclusions: The canal-drying technique influenced the adhesive bond strength between calcium silicate-based root canal sealers and the root canal wall.

Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-, methacrylate resin- and epoxy resin-based sealers

Aim. To assess and compare the water sorption, solubility and apical sealing ability of iRoot SP and three other widely used root canal sealers. Materials and methods. Solubility was assessed by immersing standardized samples of calcium silicate- (iRoot SP), calcium hydroxide- (Sealapex), methacrylate resin- (EndoREZ) and epoxy resin- (AH Plus) based sealers in distilled water and measuring weight gain and weight loss at 6 h, 24 h and daily for 14 days. Roots of extracted mandibular premolars (n = 80) were prepared with 0.04-taper nickel-titanium rotary files to a final size 40. Roots were then randomly divided into four experimental groups (n = 18) and two control groups (n = 4), root canal sealers were applied and apical leakage was assessed using the fluid filtration method. Data was analyzed using Kruskal Wallis analysis of variance and Mann-Whitney U-tests, with the level of significance set at p ≤ 0.05. Results. EndoREZ exhibited the highest water sorption, followed by iRoot SP, Sealapex and AH Plus. Sealapex exhibited significantly higher solubility than the other sealers, whereas no significant differences in solubility levels were observed between the other three sealers tested. AH Plus exhibited significantly lower microleakage than Sealapex and EndoREZ, whereas no difference in microleakage was found between AH Plus and iRoot SP. Conclusions. In view of the study findings, all tested sealers except Sealapex met the ANSI/ADA's requirements for solubility and no difference was found between AH Plus and iRoot SP in terms of apical sealing ability.