Endodontic Sealers Research Articles

Biocompatibility and Bioactive Potential of New Calcium Silicate–based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC

IntroductionBio-C Sealer (BC; Angelus, Londrina, PR, Brazil) and Sealer Plus BC (SPBC; MK Life, Porto Alegre, Brazil) are new ready-to-use bioceramic endodontic sealers. The aim of this study was to evaluate the biocompatibility and bioactive potential of BC and SPBC sealers in comparison with AH Plus (AHP; Dentsply DeTrey Gmbh, Konstanz, Germany) in subcutaneous tissue of rats. MethodsPolyethylene tubes filled with materials and empty tubes, serving as the control group, were implanted in the subcutaneous tissues of rats. After 7, 15, 30, and 60 days, the tubes with connective tissue were removed, and inflammatory cells (ICs)/mm2 and immunolabeled cells for interleukin (IL)-6 were evaluated. Osteocalcin and von Kossa analysis were also performed. Data were submitted to analysis of variance and Tukey tests, with a significance level of 5%. ResultsAt 7 days, SPBC showed lower ICs than BC (P < .05). AHP exhibited greater immunolabeled cells for IL-6 (P < .05). After 15 days, BC showed lower ICs and IL-6 compared with other materials. At 30 days, SPBC and AHP showed higher values for ICs (P < .05). After 60 days, calcium silicate sealers did not show statistical difference (P > .05) for ICs and IL-6, with values lower than AHP (P < .05). The materials showed positive structures to von Kossa staining. BC exhibited osteocalcin labeling in all periods. SPBC showed osteocalcin labeling from 15–60 days. AHP and the control group did not exhibit osteocalcin labeling. ConclusionsBC and SPBC sealers are biocompatible and present bioactive potential.

COMPARISON OF THREE BIOCERAMIC SEALERS IN TERMS OF DENTINAL SEALING ABILITY IN THE ROOT CANAL

Objective: The main objective of endodontic treatment is to prevent further infection or reinfection by eliminating microorganisms within theroot canal system. Proper endodontic treatment could prevent apical and coronal penetration of fluids and microorganisms. Endodontic sealer isvital components of root canal obturation to establish a fluid-tight seal. Bioceramic-based root canal sealers are considered to be an advantageoustechnology in endodontics and have been found to be both biocompatible and comparable to other commercial sealers. The aim of this study was tocompare the adhesion of three bioceramic sealers within the root canal system.Methods: Endodontically treated teeth were obturated using three types of bioceramic sealers and then divided into three groups. Specimens werethen observed using a scanning electron microscope, and the attachment distance was measured using ImageJ.Results: The three groups exhibited were statistically significant differences (p&lt;0.05) in dentinal sealing ability. Calcium phosphate silicate-basedsealer showed the highest sealing ability, followed by pure tricalcium silicate-based bioceramic sealers and then tricalcium silicate and resin-basedbioceramic sealers.Conclusion: The sealing ability of calcium phosphate silicate-based sealer is superior to that of both pure tricalcium silicate-based and tricalciumsilicate- and resin-based sealer.

Microstructural composition, ion release, and bioactive potential of new premixed calcium silicate-based endodontic sealers indicated for warm vertical compaction technique.

The aim of this study was to evaluate the microstructural composition, ion release, cytocompatibility, and mineralization potential of Bio-C Sealer ION+ (BCI) and EndoSequence BC Sealer HiFlow (BCHiF), compared with AH Plus (AHP), in contact with human periodontal ligament cells (hPDLCs). The sealers' ionic composition and release were assessed using energy-dispersive spectroscopy (EDS) and inductively coupled plasma mass spectrometry (ICP-MS), respectively. For the biological assays, hPDLCs were isolated from third molars, and sealer extracts were prepared (undiluted, 1:2, and 1:4 ratios). An MTT assay, wound-healing assay, and cell morphology and adhesion analysis were performed. Activity-related gene expression was determined using RT-qPCR, and mineralization potential was assessed using Alizarin Red staining (ARS). Statistical analyses were performed using one-way ANOVA and Tukey's post hoc test (α < 0.05). The three sealers exhibited variable levels of silicon, calcium, zirconium, and tungsten release and in their composition. Both BCI and BCHiF groups showed positive results in cytocompatibility assays, unlike AHP. The BCHiF group showed an upregulation of CAP (p < 0.01), CEMP1, ALP, and RUNX2 (p < 0.001) compared with the negative control, while the BCI group showed an upregulation of CEMP1 (p < 0.01), CAP, and RUNX2 (p < 0.001). Both groups also exhibited a greater mineralization potential than the negative and positive controls (p < 0.001). The calcium silicate-based sealers considered in the present in vitro study exhibited a high calcium ion release, adequate cytocompatibility, upregulated osteo/cementogenic gene expression, and increased mineralized nodule formation in contact with hPDLCs. From a biological perspective, BCI and BCHiF could be clinically suitable for root canal filling.

Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: an in-vitro study.

To compare the dislodgement resistance and the adhesive pattern of four different endodontic sealers to root dentine walls. Ninety lower premolars were assigned to five groups (n = 18), Group 1: no sealer (control); Group 2: EndoRez (ERZ); Group 3: Sealapex (SPX); Group 4: EndoSeal MTA (ESA) and Group 5: BioRoot RCS (BRS). They were instrumented up to size 30 taper 0.06 and obturated using single cone technique with matched-taper gutta-percha cones and one of the mentioned sealers. Six teeth from each group were then randomly subjected to 100, 1000 and 10,000 thermocycles, respectively. 1mm slice of mid root region, measuring 6mm from the apical foramen was prepared and subjected to push-out test under a Universal Testing Machine. Adhesive patterns of sealers were assessed using a stereomicroscope at 20 × magnification and classified using a new system. Statistical analyses were performed using two-way ANOVA, complemented by Tukey HSD and Chi-square tests. ESA and BRS showed significantly higher (p < 0.05) push-out bond strength, followed by SPX, ERZ and lastly the control, but no significant difference was noted between ESA and BRS (p > 0.05) at 100, 1000 and 10,000 thermocycles, respectively. Both ESA and BRS exhibited a significant higher rate (p < 0.05) of Type 3 and Type 4 adhesive patterns as the thermocycles increased. ESA and BRS demonstrated higher bond strength and better adhesive pattern to root dentine wall than SPX and ERZ, especially after artificial ageing.

Matrix levels of metalloproteinase-2 (MMP-2) and toxicity evaluation of carbonate apatite-based endodontic sealer in rat subcutaneous implantation

ObjectiveThe aims of this study is to investigate the matrix metalloproteinase-2 (MMP-2) levels and the toxicity evaluation to determine the safety of carbonate apatite material that will be used as an endodontic sealer. MethodsCarbonate apatite as endodontic sealer material is fabricated with a size of 2 × 2 × 1 mm, sterilized, and then implanted in the subcutaneous area on the murine back. Total of 28 rats was divided into 2 groups: the implantation group and the control group (positive and negative). We observed behavior, macroscopic and microscopic images (through hematoxylin-eosin/HE staining) and MMP-2 levels in the serum (through ELISA examination) to determine the reaction of implant material in experimental animals. ResultsBehavioral test shows impaired motor function within 2–24 h in all rats, autonomic behavioral test does not show any disturbance, macroscopic images show appearance of tumor and rubor within 2–72 h in all rats, microscopic images shows an increase in the mean neutrophils number with the highest point located in the 24 h (3.92×103/μL) and lymphocytes with the highest point in the 14 days (15.31×103/μL). The average value of MMP-2 levels of the negative control group was 1.33 ng/ml, 1.29 ng/ml of the positive control group, and 7.32 ng/ml of the implantation group. Level of MMP-2 in rats with visible implants increased on day 3 (0.75 ng/ml), day 10 (1.49 ng/ml) and day 14 (17.67 ng/ml). ConclusionThe implantation of carbonate apatite material did not cause behavioral disorders or abnormalities in the tissues surrounding of the implant site and did not show signs of toxicity or death.

Bioceramics in Endodontics - A Review

Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxy apatite, resorbable calcium phosphate. They have been used in dentistry as root repair materials, apicall filling materials, perforation sealing, for filling up bony defects, as endodontic sealers and as aids in regeneration. They have similarity to hydroxyapatite, an intrinsic Osteo conductive activity and have an ability to induce regenerative responses in the human body. This review focuses on overview of bio ceramics, classification and their advantages. It also gives a detailed insight into individual bio ceramic materials currently used in the field of endodontics along with their properties and applications.

Physical properties of an endodontic sealer containing calcium silicate

Summary Background: The main objective of endodontic therapy is to adequately clean and seal the root canal system. According to Grossman et al, idealistically root canal sealers must be dimensionally stable, produce a tight seal after setting and exhibit an adequate setting time. They should also be insoluble and provide adequate adhesion with the root canal walls. Therefore, the present study was conducted to evaluate some physio-chemical characteristics of novel poly-dimethyl-siloxane gutta-percha calcium-silicate containing sealer (GuttaFlow bioseal) in contrast with a commercially available zinc oxide and eugenol sealer (ZnO/E). Materials and Methods: Flow, setting time, working time, film thickness and dimensional changes were evaluated for Guttaflow bioseal and contrasted to a commercially available zinc oxide and eugenol sealer (ZnO/E) following the ADA specification number 57. Results: In Flow, setting time and working time tests; ZnO/E sealer showed higher mean values than that of GuttaFlow bioseal with an extremely significant difference, while film thickness of GuttaFlow bioseal was significantly higher than that of ZnO/E sealer. Results of dimensional changes test showed a significant difference between both sealers, where GuttaFlow bioseal exhibited a positive mean value, while ZnO/E exhibited a negative mean value. Conclusions: It can be concluded that; GuttaFlow bioseal might be an acceptable substitute to zinc oxide and eugenol sealer. New researches in-vivo and in-vitro should be postulated for better interpretation of the physical properties of endodontic sealers.

Apical Sealing Ability of Different Endodontic Sealers Using Glucose Penetration Test: A Standardized Methodological Approach

Objectives: To compare the apical sealing ability of four endodontic sealers based on glucose penetration method and validate the uses of contralateral teeth to provide a well-balanced experimental group. Materials and methods: One-hundred-and-twenty (sixty pair) extracted contralateral lower premolars were selected and undergone strict radiographic protocol. Root canal anatomy of each pair contralateral teeth was matched buccolingually and mesiodistally according to inclusion criteria (single canal, mature apical foramen, canal type, canal width, length, and curvature). Matched-pair contralateral teeth were then reevaluated using CBCT and divided into right and left sides (n=60, each side). Next, all canals were instrumented up to size 30, taper 0.06. Subsequently, teeth were subdivided into five groups for each side and obturated with single cone gutta-percha (GP) and various sealers: Group 1 - GP only (control); Group 2 - EndoRez; Group 3 - Sealapex; Group 4 - EndoSeal MTA and Group 5 - BioRoot RCS. All samples were placed in an incubator at 37°C, 100% humidity for 72 hours. Four matched-pair teeth from each group were then subjected to thermocycling for 100 cycles, 1000 cycles and 10000 cycles, respectively. After that, they were decoronated, coated with three layers of nail varnish, and used for glucose penetration test. The concentrations of glucose (mmol/L) were measured after 24 hours. Data analyzed using One-way ANOVA complemented by post hoc Dunnett T3 Test and Paired sample T-Test. Results: EndoSeal MTA demonstrated statistically significant (p&amp;lt;0.05) lowest glucose penetration followed by BioRoot RCS, Sealapex, EndoRez, and lastly control group. Apical sealing ability decreased as the number of thermocycles increased. No significant difference (p&amp;gt;0.05) was found between matched-pair contralateral teeth. Conclusions: Bioceramic sealers demonstrated better sealing ability than resin and calcium hydroxide sealers. Using matched-pair contralateral teeth provided a well-balanced experimental group.

Retreatability of Bioceramic Endodontic Sealers: a Review.

In 2009 a new type of endodontic sealers was introduced to the market. The so called "bioceramic" sealers are a promising alternative to the present golden standard of root canal fillings. Now a decade later, still very little is known about the ability to remove these sealers in cases of non-surgical endodontic retreatment (NSER). There are only a limited number of articles that provide such information. The commonly used hand files are not efficient in removing thoroughly the sealer from the main canal walls. Machine driven files are much easier and faster alternative to the hand ones, but are still not able to ensure complete removal. Although ultrasonics can be applied only in the straight portion of the main canal, they raise the efficacy of sealer removal. Photon-initiated photoacoustic streaming (PIPS) is another way to enhance the removal of bioceramics. Solvents like chloroform and orange oil are effective in softening gutta-percha, but not the bioceramics. This article reviews the available scientific data concerning removal of bioceramic materials in the context of a NSER.

Influence of root canal filling techniques on sealer penetration and gutta percha/sealer ratio: a confocal laser scanning microscopy analysis

Objective: The influence of four root canal filling techniques on the penetration of an endodontic sealer into dentinal tubules and the gutta percha/ sealer ratio (GP/SR) in root canals was evaluated using confocal laser scanning microscopy (CLSM). Material and Methods: Roots of the maxillary central incisors (n=40) were prepared with ProTaper Universal files up to file F5 and assigned to five groups: continuous wave condensation, lateral condensation, single cone, Thermafill®, and negative control group. After root canal filling with gutta-percha and AH26, along with the addition of 0.01% fluorescein, the roots were cut into 2-mm slices. Using CLSM, the specimens were transversely sectioned at 3, 6, and 10 mm from the apex. Results: Sealer penetration was deeper and more frequent at 10 mm than at the 6mm and 3mm for all obturation technique. Penetration was not significantly affected by obturation techniques except single master cone tecnique. Single cone technique demonstrated the lowest sealer penetration at all levels. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone. Conclusion: In conclusion, the single cone technique resulted in lower sealer penetration than the other techniques, which did not differ significantly from each other. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone.KeywordsObturation techniques; Dentinal tubule penetration; Gutta percha, sealer ratio; Confocal laser scanning microscopy.

Effect of Ultrasonic Activation of Endodontic Sealers on Intratubular Penetration and Bond Strength to Root Dentin

IntroductionThis study aimed to evaluate the effect of ultrasonic activation (UA) of endodontic sealers on dentin tubule penetration and the bond strength to root dentin. MethodOne hundred single-rooted teeth were prepared with 40.06 nickel-titanium instruments and divided into 2 groups: with or without UA. Three resin-based sealers (MTA Fillapex [Angelus Dental Solutions, Londrina, PR, Brazil], Sealer Plus [MK Life Medical and Dental Products, Porto Alegre, RS, Brazil], and AH Plus [Dentsply, DeTrey GmbH, Konstanz, Germany]; n = 20) and 2 calcium silicate–based sealers (Sealer Plus BC [MK Life Medical and Dental Products] and EndoSequence BC [Brasseler, Savannah, GA], n = 20) were used and subdivided (n = 10) according to the protocols. Fluo-3 (Thermo Fisher Scientific, Waltham, MA) and rhodamine B dyes were added to the calcium silicate- and resin-based sealers, respectively. In the UA groups, the activation was performed for 40 seconds followed by lateral compaction. Samples were transversely sectioned to evaluate the dentin tubule penetration and the bond strength to root dentin. The penetration data were analyzed with the Student t test, 1-factor analysis of variance, and Bonferroni tests. Bond strength was evaluated using the Student t test, Kruskal-Wallis, and Dunn post hoc test. ResultsResin-based sealers showed the highest tubule penetration without UA (P < .05). UA significantly enhanced MTA Fillapex and Endosequence BC dentin tubule penetration (P < .05). AH Plus and Sealer Plus BC improved their bond strength to root dentin after UA (P < .05). AH Plus/UA, Sealer Plus/UA, and Sealer Plus BC/UA presented the highest bond strength values (P < .05). Adhesive failures were predominant in all groups regardless of the use of ultrasound. ConclusionsUA interferes with tubule penetration and the bond strength to root dentin of resin- and calcium silicate–based sealers.

Bond Strength of Endodontic Sealers to Gutta Percha and Dentin

Aims: The aims of present study were to compare shear bond strength (SBS) and push-out bond strength (PBS) of three types of sealers to gutta percha (G) and dentin (D) and to assess failure modes at debonded interfaces. Materials and Methods: Sealers tested were AH Plus, Sealer 26, and Endofill. In PBS, 30 mandibular premolar decoronated and instrumented with rotary ProTaper to F3 then teeth were divided into 3 groups (10 teeth in each) and obturated with F3 proTaper G and one of tested sealer, 1mm mid root slices were prepared for PBS test. In SBS/D, 30 root cylinders 7 mm length were embedded horizontally in resin then root surfaces were flattened and smooth. In SBS/G, 30 G cylinders were embedded in a resin. In both SBS tests, specimens were divided into three groups, 10 samples each then polyethylene tubes positioned on polished specimens (prepared for SBS/D and SBS/G) filled with one of the tested sealer. All BS tests were performed on digital universal testing machine. Collected data analyzed statistically using one way ANOVA and Tukey test. Results: PBS, SBS/D, and SBS/G for AH Plus significantly higher than Sealer 26 and Endofill. Also Sealer 26 exhibited significantly higher bond strength than Endofill. Predominance mode of failures were adhesive and mixed. Conclusions: According to the finding of present study, it can be concluded that the AH Plus for root canal therapy produce better results in endodontic. PBS and SBS were sufficient tests to measure bond strength of root canal sealers to G and D.

Assessment of Antibacterial Activity of Five Endodontic Sealing Materials Against Enterococcus Faecalis

Objective: Residual and recurrence infection can be prevented by a root canal sealer that possesses good antibacterial activity, which contributes to the success of endodontic therapy. This in-vitro study conducted to evaluate the antibacterial activity of five endodontic sealers (MTA fillapex, HS Mxima MTA, Endosequence BC sealer, BioRoot RCS, and AH plus) against Enterococcus faecalis using agar diffusion test. &#x0D; Methods: Freshly mixed sealers were placed into prepared wells on agar plates. The diameter of the inhibition zone was measured after incubation for 24 hours. The data were analyzed statistically by ANOVA and LSD at a 0.05 significance.&#x0D; Results: All tested samples had an antimicrobial effect against Enterococcus faecalis after 24 hours. MTA fillapex had the greatest antimicrobial effect with an inhibition diameter of 12.77mm, followed by Endosequence BC. Finally, the weakest antimicrobial effect was related to the BioRoot RCS sealer with a mean zone of inhibition of 10.26mm.&#x0D; Conclusions: The root canal sealers showed different antimicrobial activity. However, MTA fillapex was the most effective sealer against the organism tested.

Transforaminal and systemic diffusion of an active agent from a zinc oxide eugenol-based endodontic sealer containing hydrocortisone-in an in vivo model.

This study aimed to quantify in vivo the release of hydrocortisone acetate (HCA) contained in a zinc oxide eugenol-based endodontic sealer, in various tissues. Roots of human teeth, shaped with One Shape single file and sealed with Endomethasone N, previously radiolabelled with tritium (3H-HCA), were implanted in the back of 24 mice. Mice were sacrificed at 2, 8, 24, and 48h to evaluate and quantify the amount of radioactivity in subcutaneous tissues surrounding the apex (periapical-like) of the implanted teeth, blood, spleen, kidneys, liver, and urine. Radioactivity was released from the apex of the tooth into the periapical-like tissues with a peak measured at 2h post-implantation (2.25% of the initial radioactivity/g). This quantity decreased significantly over time between 2h and each time points. Radioactivity was still measured up to 48h in the periapical-like tissues (0.42% of the initial radioactivity). The same pattern of kinetic was observed for all organs. The total quantity of radioactivity significantly decreased over time from 4.36% measured 2h post-implantation to 0.74% at 48h. Finally, about 10% of the initial radioactivity from Endomethasone N used to fill the root canal was retrieved after 48h in the urine. This study demonstrated that radioactive-HCA from Endomethasone N can diffuse through the apex of the root canal and follow a classical pharmacokinetics. This mouse model shows that radioactive-HCA can diffuse through the apex and do not accumulate in periapical-like tissues and organs.

Cytokine Production and Cytotoxicity of Calcium Silicate–based Sealers in 2- and 3-dimensional Cell Culture Models

IntroductionThe aim of the present study was to assess the effects of different silicate-based sealers (ie, BioRoot RCS [Septodont, Saint Maur des Fosses, France], ProRoot ES [Dentsply Sirona, York, PA], and MTA Fillapex [Angelus, Londrina, PR, Brazil]) on cytokine production and viability of human periodontal ligament stem cells (PDLSCs). AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) was used as a reference material. MethodsPDLSCs were cultured either in 2-dimensional or 3-dimensional conditions (in 0.15%–0.5% PuraMatrix [BD Biosciences, Bedford, MA]) for 24 hours with eluates from set endodontic sealers. Additionally, the toxicity of eluates from endodontic sealers was evaluated using an in vitro root model experimental procedure. PDLSC viability was determined using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. PDLSC culture medium was used for cytokine quantification (interleukin [IL]-6, IL-8, growth-regulated oncogene, IL,-4 and IL-10) using the HCYTMAG-60K-PX41 Milliplex kit (EMD Millipore, Burlington, MA). ResultsIn 2-dimensional culture conditions, BioRoot RCS revealed a good PDLSC viability rate. ProRoot ES had no effect on PDLSC viability regardless of the dilution. MTA Fillapex was strongly cytotoxic even at the lowest extract dilutions (1:1, 1:2, and 1:4). Encapsulation of PDLSCs in PuraMatrix tended to decrease the cytotoxic effect of the sealers. In the 3-dimensional in vitro root model experimental procedure, BioRoot RCS, ProRoot ES, and MTA Fillapex revealed a cytocompatibility pattern. Different calcium silicate–based sealers exhibited different proinflammatory cytokine production. BioRoot RCS greatly stimulated the release of IL-10 and, to a lesser degree, IL-4 by PDLSCs (P < .05). ConclusionsBioRoot RCS and ProRoot ES did not induce proinflammatory cytokines and promoted anti-inflammatory cytokine secretion by PDLSCs that may have a positive local impact by attenuating an initial inflammatory response.

Physico-chemical and antimicrobial properties and the shelf life of experimental endodontic sealers containing metal methacrylates

The objective of this study was to evaluate the physico-chemical and antimicrobial properties of a dual polymerization experimental endodontic sealer (E) and experimental sealers containing dibutyltin methacrylate (Sn2+) (ETs) or calcium methacrylate (Ca2+) (ECs). The pH and ion release levels of the sealers were measured. The dimensional stability was evaluated in accordance with ISO 6876. Biofilm growth inhibition was evaluated using confocal laser scanning microscopy (CLSM). Biofilm viability analysis was performed using the SYTO 9 technique. The shelf life was evaluated through the degree of conversion and film thickness tests after the sealers had been stored for different periods of time. For statistical analysis, ANOVA and Tukey’s post hoc test were used, with a significance level of 5%. ETs revealed better anti-biofilm potential after 15 days than that of the controls. The degree of conversion was reduced after the shelf-life period. The addition of calcium and dibutyltin methacrylate improved the anti-biofilm properties of the experimental endodontic sealer without impairing their physico-chemical properties.

Effect of calcium silicate-based endodontic sealer on the retention of fiber posts cemented at different time intervals

ObjectiveTo evaluate the effect of BC HiFlow, a new calcium silicate-based endodontic sealer, compared with a resin epoxy-based sealer after 2 different times of cementation on the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement (RelyX Unicem). MethodologySixty human maxillary central incisors were decoronated, prepared and obturated with gutta-percha and sealer. Roots were distributed into 5 groups according to the sealer and time of post cementation: (1) AH Plus sealer with immediate post fixation, (2) BC HiFlow with immediate post fixation, (3) AH Plus and post fixation after 7 days, (4) BC HiFlow and post fixation after 7 days, and (5) fiber post fixation in canals obturated with gutta-percha only (no sealer). After 1 week of post cementation, the pull-out test was performed and the failure mode was examined under a digital microscope. Data were analyzed using ANOVA followed by Tukey's post hoc and t tests (p < .05). ResultsWith immediate post cementation, AH Plus group showed significantly higher pull-out retentive strength than the BC HiFlow and control groups (p = .009 and p < .001, respectively). There was no significant difference between the groups when the posts were cemented 7 days after obturation (p = .726). The time of post cementation had a significant influence on the canals obturated with AH Plus (p = .003). The time did not significantly affect the canals obturated with BC HiFlow (p = .289). The prominent type of failure was mixed mode in all groups. ConclusionBC HiFlow sealer did not affect the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement immediately after or 7 days after obturation. For immediate post cementation, AH Plus increased the pull-out bond in comparison to BC HiFlow.

Comparative biological assessments of endodontic root canal sealer containing surface pre-reacted glass-ionomer (S-PRG) filler or silica filler.

Surface pre-reacted glass-ionomer (S-PRG) filler releases several ions, such as fluoride, borate and strontium ions, to exert bioactive effects. We fabricated an endodontic root canal sealer containing S-PRG fillers (S-PRG sealer) and then evaluated the antibacterial and anti-inflammatory properties of S-PRG sealer compared with sealer containing conventional silica fillers (silica sealer). Antibacterial tests showed that S-PRG sealer significantly reduced the turbidity of Enterococcus faecalis compared with silica sealer. Implantation of S-PRG or silica sealer blocks in rat subcutaneous tissue showed that S-PRG sealer decreased the proinflammatory response compared with silica sealer at 10 days post-implantation. In addition, immunostaining revealed that infiltration of CD68- and peroxidase-positive cells around the S-PRG sealer was significantly lower than that in silica sealer. Therefore, it was suggested that S-PRG sealer exhibits antibacterial and anti-inflammatory effects.

The effect of smear layer on bacterial penetration through roots obturated using zinc oxide eugenol-based sealer

BackgroundSmear layer removal has been shown to reduce bacterial penetration through root canal obturations when resin-based endodontic sealer is used. The purpose of this in vitro study was to test this effect when a non-resin-based sealer is used.Material and methodsThirty root segments were assigned to the following groups: Smear layer removed (n = 8); smear layer retained (n = 8); negative controls (n = 10; 5 with smear layer, 5 without); and positive controls (n = 4; 2 with smear layer, 2 without). After rotary instrumentation, smear layers were removed in the treatment group and half of controls using 17% ethylenediamenetetraacetic acid (EDTA) prior to obturation. Each obturated root was affixed into a dual-chamber leakage model employing Streptococcus mutans. Roots were incubated at 37 °C for 120 d. Days until lower chamber turbidity occurred was recorded for each sample, and data were analyzed using Kaplan-Meier survival curve analysis (p = 0.05).ResultsNo negative controls leaked, while all positive controls were turbid within 1 day. Mean days to leakage for roots with smear layer intact was 82.75 (+/− 33.29, 95% CI), although three never leaked. Mean days to leakage through roots with smear layer removed was 46.25 (+/− 26.67, 95% CI), and all leaked. Treatment survival curves were significantly different (p = 0.048).ConclusionsUnder the conditions and limitations of this study, retaining the smear layer reduced the rate of bacterial penetration through canals which had been obturated using zinc oxide eugenol (ZOE) -based sealer.

Cytotoxicity and release ions of endodontic sealers incorporated with a silver and vanadium base nanomaterial.

The modification of endodontic sealers with nanoparticles to confer antimicrobial activity allow greater effect, with interaction at a molecular level. The nanostructured silver vanadate decorated with silver nanoparticles (AgVO3) is a nanomaterial unprecedented in dentistry for this application. This study incorporated the AgVO3 into three endodontic sealers of different compositions and evaluate the cytotoxicity and release of compounds. The groups of commercially available AH Plus, Sealer 26, and Endomethasone N and groups of the same sealers with incorporated AgVO3 (at concentrations 2.5, 5, 10%) were prepared, and extracts of the specimens were obtained for 24h. The cell viability (cytotoxicity) of human gingival fibroblasts (HGF) was assessed after 24h, 7 and 14days. Silver (Ag+) and vanadium (V4+/V5+) ion release was quantified after 24h by ICP-MS. Data were analyzed by Kruskal-Wallis and Dunn's post-hoc (α = 0.05). The cell viability was inversely proportional to treatment time. The Sealer 26 and Endomethasone N groups were cytotoxic for HGF cells, regardless of the incorporation of the AgVO3 (p > 0.05), and the incorporation reduced cell viability of AH Plus (p < 0.05). The release of ions was proportional to the concentration of AgVO3. AH Plus released more Ag+ ions, and Sealer 26 and Endomethasone N releases more V4+/V5+ ions. In conclusion, it was not possible to confirm the influence of AgVO3 on HGF cell viability to Sealer 26 and Endomethasone N, however, nanomaterial influenced cell-viability to AH Plus, so the commercial sealers can be cytotoxic in synergy with the nanomaterial. The release of Ag+ and V4+/V5+ was proportional to the AgVO3 incorporated.