EndoSequence BC Sealer Research Articles

Influence of sonic activation of epoxy-resin and calcium silicate sealer on postoperative pain: a patient-blinded, parallel group, randomized clinical trial

BackgroundThis clinical study aims to compare postoperative pain after single-visit root canal treatment of teeth with asymptomatic apical periodontitis using epoxy-resin-based AH Plus and calcium silicate-based Endosequence BC sealers with or without sonic activation.MethodsThis study included 72 individuals with one first or second mandibular premolar tooth with asymptomatic apical periodontitis. They were randomly divided into four groups according to the root canal sealer (AH Plus or Endosequence BC) and activation protocol (sonic activation or non-activation) (n = 18). The participants were ask to rate their postoperative pain intensity on a NRS scale as none, minimal, moderate, or severe after 24 h, 48 h, 72 h, and 7 days following treatment. Patients were also asked to record the number of prescribed analgesic medication tablets (400 mg of ibuprofen) taken. Statistical analysis were performed using the Mann-Whitney U test, the Friedman test, the Spearman’s correlation test, the Chi-square test. Significance level was established at 0.05.ResultsThere was no statistically significant difference in postoperative pain scores or analgesic intake between AH Plus and Endosequence BC sealers regardless of the activation protocol (p > 0.05). There was no statistically significant difference in postoperative pain scores between the sonic activation and non-activation groups (p > 0.05). A weak positive correlation was detected between Endoactivator sonic activation and sealer extrusion (r = 0.36).ConclusionsAH Plus and EndoSequence BC root canal sealers showed similar results in terms of prevalance and intensity of postoperative pain. Sonic activation and non-activation groups had similar postoperative pain scores.Clinical trial registrationThe study was retrospectively registered with ClinicalTrials.gov (NCT06403293). Date of Registration: 07/05/24.

Clinical outcomes of nonsurgical root canal treatment using NeoSealer Flo and Endosequence BC Sealer: A retrospective analysis with short-term follow-up.

Sealers are an important component in root canal obturation to provide the seal of the root canal system. In recent years, there has been an increase in the use of hydraulic silicate sealers, commonly referred to as bioceramic sealers, due to their many advantageous properties. NeoSealer Flo (NS; Avalon Biomed USA, Houston TX) is a recently introduced premixed bioceramic sealer. There is limited evidence on its properties and clinical performance. Therefore, the purpose of this study was to evaluate the outcome of root canal treatment using NS in a sealer-based obturation technique. The records of patients in a private practice between 2017 and 2022 were analyzed to identify both initial and retreatment cases obturated with either EndoSequence BC sealer or NS using sealer-based obturation with a minimum of one-year follow-up. Treatment outcome between NS and BC was compared with chi-square test. Logistic regression was used to identify additional prognostic factors. Six hundred and eighty-seven teeth met the inclusion criteria for the study. The success rate of cases obturated with BC was 94.9% and 96.5% for the cases obturated with NS.No statistically significant differences were found between the two sealer types. Presence of a periapical radiolucency or periapical radiolucency > 5.00mm were statistically significant prognostic factors. Endodontic treatment using BC or NS with sealer-based obturation method is a viable treatment option. Root canal obturation with bioceramic sealers, such as NeoSealer Flo and Endosequence BC sealer, provide favorable clinical outcomes.

The Push-Out Bond Strength, Surface Roughness, and Antimicrobial Properties of Endodontic Bioceramic Sealers Supplemented with Silver Nanoparticles.

This study evaluated push-out bond test (POBT), surface roughness, and antimicrobial properties against Enterococcus faecalis of bioceramic sealers supplemented with silver nanoparticles (AgNPs). The sealers tested were CeraSeal®, EndoSequence® BC SealerTM, and Bio-C® Sealer. The POBT was measured with a Universal Testing Machine, and the type of failure was evaluated with a stereomicroscope. The roughness average (Sa) and peak-valley height (Sy) values were evaluated by atomic force microscopy. The bacterial growth inhibition was evaluated using a disk diffusion test, and antimicrobial activity was determined with the plate microdilution method. The POBT showed no significant difference between sealers with and those without NPs in cervical and apical thirds (p > 0.05). In the middle third, the adhesion force was significant for Endosequence BC Sealer® (p < 0.05). The results showed that the Sa and Sy parameters, when AgNPs were added, did not show a statistically significant difference compared to the groups without nanoparticles (p > 0.05). All tested sealers showed bacterial growth inhibition, but no significant difference was found. Their efficacy, in descending order of antibacterial activity when AgNPs were added, is as follows: EndoSequence® BC SealerTM > Bio-C® Sealer > CeraSeal®. The incorporation of AgNPs into bioceramics improves antimicrobial activity without affecting mechanical properties.

The Efficiency of Different Supplementary Irrigation Techniques After Nickel-Titanium Rotary System in Endodontic Retreatment

Objective: To assess the efficiency of XP-Endo Finisher file (XPFF), EDDY, and diode laser as supplementary irrigation activation techniques following nickel-titanium rotary files in the endodontic retreatment. Methods: 48 mandibular premolars were collected. Each root canal was shaped and filled with EndoSequence BC sealer and gutta percha. After 14 days, endodontic retreatment was performed using D-Race instruments. Then, 48 samples were assigned into 4 groups (n=12) as control, diode laser, EDDY, and XPFF according to the supplementary irrigation methods. After the irrigation procedure, all samples were visualized under a stereomicroscope. The remaining root filling material was scored and compared statistically using Kruskal-Wallis and Post-hoc pairwise comparison tests. Results: In all thirds, there was a significant difference between the diode laser and control groups. The amount of remaining filling material in the diode laser group was significantly lower than in the control group. When the other groups were compared, a significant difference was observed only between the diode laser and XPFF groups in the coronal third. Conclusion: No supplemental method could eliminate the root obturation material. The diode laser can be used in addition to nickel-titanium rotary retreatment systems to improve the removal of gutta percha and bioceramic sealer.

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.

Micro-CT Evaluation of the Remaining Endosequence BC Filling Materials and Dentinal Microcracks after Retreatment with D-Race and R-Endo Systems

Objective: To analyze the remaining EndoSequence BC filling materials and microcrack using micro-computed tomography after retreatment with D-Race and R-Endo systems. Methods: The canals of thirty mandibular single-rooted and single-canal premolar teeth were shaped and obturated with EndoSequence BC point and EndoSequence BC sealer. The samples were assigned into two groups and scanned with micro-computed tomography. Then, the canal filling materials were removed with D-Race and R-Endo systems. After all roots were re-scanned, all images were evaluated for the remaining EndoSequence BC filling materials and microcrack. Also, retreatment time was recorded. Results: The remaining filling material in the R-Endo group was greater than the D-Race group. Both systems caused new cracks formation. However, no significant difference was noticed among them. The D-Race group needed significantly less time in comparison to the R-Endo group. Conclusion: D-Race system was faster and more efficient compared with R-Endo system. D-Race and R-Endo files caused new cracks on the canal walls.

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.

Evaluation of canal patency and cleanliness following retreatment of bioceramic sealer-obturated root canals using three different irrigant activation protocols.

This study evaluated the effectiveness of three different irrigant activation techniques in cleaning and establishing patency during retreatment of root canals obturated with gutta-percha and bioceramic sealer. 60 extracted premolars with oval-shaped canals were instrumented and obturated with gutta-percha and EndosequenceBC sealer using the 'warm hydraulic condensation' technique. The teeth were retreated using Protaper Universal Retreatment and XP-Endo Shaper system and divided into four groups according to the irrigant activation protocol used: control, passive ultrasonic irrigation (PUI), Endovac irrigation (EVI) and XP-Endo Finisher R (XPFR). Apical patency was achieved in all the samples of the XPFR group (100%), which showed a significantly higher success rate compared with the control (73.3%) and EVI groups (73.3%) (p < 0.05). The scanning electron microscopic evaluation revealed significantly cleaner middle and apical third root canals in the PUI and XPFR groups compared with the control group (p < 0.05). These findings suggest that XPFR effectively cleans and establishes patency in root canals filled with bioceramic sealers.

Heat-Induced Changes in the Physical Properties of a New Premixed Calcium Silicate-Containing Root Canal Sealer: An In Vitro Study.

This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, and film thickness were tested with or without heating at 100 °C for 30 or 60 s, in accordance with ISO6876:2012 standards. Ultrastructural and elemental analyses were performed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Data were analyzed using one-way analysis of variance (ANOVA) with a Tukey post hoc test (α = 0.05). All sealers exhibited significantly shorter setting time and flow after heating at 100 °C for 30 and 60 s (p < 0.05). After heating, AHB showed a significantly higher film thickness compared to that of the other materials (p < 0.05). None of the tested properties of heat-applied AHB and ES met ISO standards, except the setting time in ES. The SEM/EDS results for AHB and ES were not affected by heating. The detected changes in physical properties can negatively impact the performance of premixed calcium silicate-containing sealers, particularly AHB, when warm vertical compaction is employed.

Oxidative damage analysis and cell viability of Drosophila melanogaster exposed to three different endodontic sealers: an in vivo and ex vivo study.

The aim of this work was to evaluate the toxicological action of AH Plus (AHP), Bio-C Sealer (BCS), and EndoSequence BC Sealer (ESB), using Drosophila melanogaster as the model organism performing in vivo and ex vivo analysis. D. melanogaster were exposed for 10days to three concentrations (5mg/ml, 10mg/ml, and 20mg/ml) of AHP, BCS, and ESB sealers mixed with 10ml of standard diet. During this period, the mortality of flies was evaluated. On the 11th day, the locomotor activity test was performed and the flies were euthanized for oxidative damage analysis (reactive species and lipid peroxidation) and cell viability (resazurin reduction). For the mortality curves evaluation, the log-rank test (Mantel-Cox) was used. For the analysis of other data, a one-way analysis of variance (ANOVA) was applied, followed by Tukey's post hoc test (α = 0.05). Regarding mortality, there were no significant differences. The locomotor activity was reduced, mainly in the two highest concentrations of AHP and BCS. Besides, reactive species generation was bigger in the AHP 20mg/ml group. AHP induced a lipid peroxidation increase in all three concentrations tested, when compared to other sealers. Considering cell viability, the two highest concentrations of AHP reduced this parameter; while in other sealers, viability was reduced only in the highest concentration. AHP showed changes in oxidative markers that led to greater damage to the flies.

Evaluation of the dentinal wall adaptation ability of Mineral Trioxide Aggregate Fillapex, EndoSequence BC, and AH Plus sealers using Scanning Electron Microscope: An in vitro study

ABSTRACT Introduction: The present study was conducted to evaluate the dentinal wall adaptation ability of different root canal sealers (mineral trioxide aggregate Fillapex [MTA], EndoSequence BC [ESBC] Sealer, and AH Plus) using a scanning electron microscope (SEM). Materials and Methods: Forty-five extracted single-rooted human maxillary incisor teeth were selected and divided into three equal groups (n = 15). Working length was established using a #15 K-type file. Canals were prepared with rotary Ni–Ti system to size 30/0.06 or 40/0.06 file using endomotor at 250 rpm, irrigated with 17% ethylenediaminetetraacetic acid, 3% NaOCl, and normal saline solution, and dried with paper points. Prepared canals were obturated with gutta-percha cones using the single-cone technique and appropriate sealers. Specimens were stored in saline solution at 37°C for 48 h and evaluated using a SEM. Statistical Analysis: Unpaired t-test, one-way analysis of variance, and post-hoc tests verified the differences between groups and were considered significant at alpha = 5%. Results: None of the specimens showed a gap-free interface. Gaps compared between MTAF and ESBC did not show any statistically significant differences (coronal [P = 0.9757], middle [P = 0.5464], and apical [P = 0.2136] thirds). However, gaps found at the interface of sealer and dentinal wall in root canals filled with AH Plus showed extremely statistically significant differences when compared with MTAF and ESBC (P &lt; 0.0001). Conclusion: Specimens obturated with MTAF and ESBC Sealer showed smaller gaps on SEM analysis than specimens filled with AH Plus.

In Vivo Evaluation of Tissue Biocompatibility of Calcium Silicate-based and Epoxy Resin-based Sealers.

Calcium silicate-based sealers are an alternative to be used into root canal, mainly to their biological properties. However, some biological parameters need to be determined in an in vivo animal research model. So, the aim of the present study was to evaluate in vivo the tissue biocompatibility of a calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus). Polyethylene tubes were filled with freshly mixed sealers and implanted in connective subcutaneous tissue of 25 rats (5/euthanasia day) (Rattus norvegicus albinus). Empty tubes were used as controls and no tubes as sham. Histopathological (hematoxylin eosin) and histochemical (Picrosirius red) examinations were conducted at 3, 7, 15, 30 and 60 days (five rats/day) after the implantation procedure (n=5/group). The type/intensity of inflammation and collagenesis was analyzed statistically with Friedman or Kruskal-Wallis/Dunn tests (P<0.05). The profile of inflammation induced by AH-Plus (Median=2, Range=2-3) was significantly greater than that by Endosequence BC Sealer (Median=1, Range=1-1) during the 15-day experimentation period (P=0.018). After 30 days, both materials produced similar tissue reaction (P>0.05). AH-Plus and Endosequence BC Sealer (Median=2, Range=1-2) induced a high level of fibrosis after 60-day than control (Median=1, Range=1-1) and sham (Median=0, Range=0-0) groups (P<0.001) of fibrosis based in type I collagen increase (P=0.025 and P=0.021, respectively). Tissue necrosis was not observed and the bioceramic sealer showed significant signs of endocytosed (Median=1, Range=1-1) material after 7 days than other groups (Median=0, Range=0-0) (P<0.05). The calcium silicate-based sealer induced tissue repair faster than the epoxy resin-based sealer tested. However, both materials showed adequate biocompatibility and tolerance by subcutaneous tissues, with few differences in inflammatory profiles, formation of granulation tissue, and collagenesis. It may be concluded that calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus) presented suitable biocompatibility.

Effect of ultrasonic activation on setting time, pH and calcium ion release, solubility, and chemical structure of calcium silicate sealers.

This study evaluated the setting time, pH, calcium ion release, solubility, and chemical structure of four calcium silicate sealers after ultrasonic activation (UA). Five sealers were evaluated: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC), and BioRoot RCS (BR). Ten groups were created based on the use or not of ultrasonic activation: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; and BR/UA. Setting time was performed based on ISO 6876:2012 and ASTM C266-07 specifications. Solubility at 24hs, based on ISO 6876:2012. pH and calcium release were evaluated at 1, 24, 72, and 168hs. Raman spectroscopy was used to evaluate structural changes. Quantitative data were analyzed using One-Way ANOVA and Tukey post-hoc test (α=5%). Raman spectroscopy results were qualitatively analyzed. Setting times and solubility of all sealers were not affected by UA (p>0.05). The highest solubility was found for BCS, BCS/UA; and BR, BR/UA (p<0.05). After 24hs, calcium silicate sealers had higher pH than SP and SP/UA (p<0.05). BR and BR/UA had the highest pH at all time points. SP and SP/UA had stable pH at all time points. SP and SP/UA had the lowest calcium release values at all time points (p<0.05). EBC and EBC/UA calcium release significantly differ at 24,72 and 168hs (p<0.05). No chemical changes were observed during Raman spectroscopy. In conclusion, ultrasonic activation affected calcium ion release only for EndoSequence BC Sealer. Ultrasonic activation did not influence the initial and final setting time, solubility, pH, and chemical structure of any investigated sealers.

Evaluation of the root dentin bond strength and intratubular biomineralization of a premixed calcium aluminate-based hydraulic bioceramic endodontic sealer.

This study evaluated the dentin bonding strength and biomineralization effect of a recently developed premixed calcium aluminate-based endodontic sealer (Dia-Root Bio Sealer) in comparison with existing calcium silicate-based sealers. The root canals of 80 mandibular premolars were filled with Dia-Root Bio Sealer, Endoseal MTA, EndoSequence BC Sealer, and AH Plus Bioceramic Sealer. Medial and apical specimens were then obtained by sectioning. The push-out bond strength was measured using the medial specimens, and the failure mode was recorded. Intratubular biomineralization in the apical specimens was analyzed using scanning electron microscopy and energy-dispersive X-ray spectroscopy (EDS). The data were analyzed using one-way analysis of variance followed by the Tukey test (P < 0.05). The push-out bond strength of Dia-Root Bio Sealer was significantly higher than that of the other tested materials, and a cohesive failure pattern was observed in all groups. Dia-Root Bio Sealer also exhibited a significantly higher degree of biomineralization than the other groups, and EDS analysis indicated that the biomineralized precipitates were amorphous calcium phosphate. The results of this study indicate that Dia-Root Bio Sealer has the potential to be used as an adequate root canal sealer due to its favorable bonding performance.

Filling Material Bond Strength to Dentin Is Positively Influenced by the Agitation of Endodontic Final Irrigating Solutions.

The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third.

Micro-CT determination of the porosity of two tricalcium silicate sealers applied using three obturation techniques.

Using X-ray micro-computed tomography (micro-CT), the aim of this study was to measure the porosity of two tricalcium silicate sealers (EndoSequence BC and NeoSealer Flo) applied using three obturation techniques (single-cone, warm-vertical, and cold-lateral) to six single-rooted human teeth. Six extracted, single-rooted human teeth were shaped with ProTaper Next rotary files and obturated with EndoSequence BC or NeoSealer Flo sealers and gutta-percha (GP) using one of the three techniques above. Micro-CT was used to map the full length of the canals. Deep learning cross-sectional segmentation was used to analyze image slices of the apical (0-2 mm) and coronal (14-16 mm from the apex) regions (n = 230-261 per tooth) for the areas of GP and sealer, as well as porosity. Median (%) with interquartile range of porosity were calculated , and the results were statistically analyzed with the Kruskal-Wallis test. In the apical region, EndoSequence BC had significantly fewer pores than NeoSealer Flo with the single-cone obturation (% median-interquartile range, IQR: 0.00-1.62) and warm-vertical condensation (5.57-10.32) techniques, whereas in the coronal region, NeoSealer Flo had significantly fewer pores than EndoSequence BC with these two techniques (0.39-5.02) and (0.10-0.19), respectively. There was no significant difference in porosity between the two sealers for the cold-lateral condensation technique in both the apical and coronal regions. For optimal obturation, the choice of technique and sealer is critical.

Evaluation of Push-out Bond Strength of Bioceramic Root Canal Sealers with Different Final Irrigation Protocols

This study aims to evaluate the bond strength of bioceramic root canal sealers, with different final irrigation protocols. A total of 104 human upper incisor teeth were selected for applying four different irrigation solutions (Ethylene diamine tetraacetic acid (EDTA), Chlorine Hexidine Gluconate (CHX), Sodium Hypochlorite (NaOCl), and Distilled Water (D.W)) and two root canal sealer protocols (Endosequence BC (BC), Well-Root ST (ST)), in this in vitro study. After root canal treatment specimens were sectioned to three parts (coronal, middle, and apical). Push-out bond strength test was performed in a universal testing machine (Zwick-Roel, Germany) at a crosshead speed of 1 mm/min. Regardless of the irrigation protocol and sealer used, the highest bond strength values were obtained from the apical section ($$p&lt;0.05$$). 5.25% NaOCl + 17% EDTA + 5.25% NaOCl and 2% CHX + 17% EDTA + D.W statistically showed the highest bond strength value and 2% CHX + 17% EDTA + 2% CHX group showed the lowest value in this study ($$p&lt;0.05$$). The bond strength values of Endosequence BC Sealer were statistically higher than the bond strength values of Well Root ST ($$p&lt;0.05$$). According to the final irrigation, Endosequence BC Sealer and Well Root ST root canal sealers showed the highest bonding strength in CHX + EDTA + D.W and NaOCl + EDTA + NaOCl groups.

Tissue Response to a Heat Resistant Silicate-Based and an Epoxy Resin-Based Endodontic Sealer Implanted in Rat Tibias

Introduction: The effect of high temperatures on the properties of endodontic sealers during warm compaction of gutta-percha may be a matter of concern. This study aimed to evaluate the effect of heat on the biocompatibility and bioactivity of EndoSequence BC Sealer HiFlow (ESHF; Brasseler, Savannah, GA, USA) and AH Plus (AHPS; Dentsply, De Trey, Konstanz, Germany) when implanted into the bone tissue of rat tibias. Methods: Medical-grade silicone tubes containing freshly prepared ESHF or AHPS were heated to 100 °C and then cooled down to 65 °C before being implanted in the tibias of 24 Wistar rats. The outer walls of the tubes served as controls. After 10, 30 and 90 days, the animals were euthanized and the implants and their surrounding tissues were dissected, fixed in formalin, and processed for microscopic evaluation. Results: After 10 days postoperatively, a severe inflammatory reaction without reactionary bone formation was observed in contact with ESHF and AHPS. The severity of the reaction had decreased at the 30-day observation period for both sealers but only ESHF samples showed new bone formation adjacent to the sealer. After 90 days, no inflammatory cells were found in contact with ESHF, while a thin fibrous tissue capsule and complete bone reparation of the surrounding areas were observed in contact with the material. For AH Plus, a fibrous connective tissue containing scarce remaining inflammatory cells could be observed in most of the samples, however, in the absence of new bone formation. No significant differences (p &gt; 0.05) between ESHF and AHPS were found at the 10-day observation period. At the 30 and 90-day, significant differences (p &lt; 0.05) between both materials were observed. The reaction to the controls showed significant differences with ESHF and AHPS for all experimental periods. Significant differences (p &lt; 0.05) for the total effect of time were also found between both sealers (p &lt; 0.05). Conclusions: At the end of the experiment, heated ESHF reacted as a biocompatible/bioactive material and stimulated continued development of new healthy bone. Although AHPS was tolerated well by the surrounding tissues, the sealer did not promote new reparative bone formation.

The effects of heating on the physicochemical properties of tricalcium silicate root canal sealers.

This study evaluated the effect of heating on the physicochemical properties and surface changes of tricalcium silicate sealers. Three tricalcium silicate root canal sealers (Bio-C Sealer, BioRoot-RCS, EndoSequence BC Sealer), and one epoxy resin-based sealer (AH Plus; control) were tested. The effect of heating on setting time (ST) and flowability were assessed according to ANSI/ADA 57 and ISO 6876 standards. Solubility and dimensional change (DC) of the set sealers were evaluated at 24 hours and after 30 days; the pH of the water used in the DC testing was also measured. Tests were repeated with heated sealers in an oven at 100 °C for 1 min. SEM and EDS analysis were performed. Data were analyzed using One-Way ANOVA and Tukey post-hoc tests (α=5%). Heating decreased the ST for AH Plus and EndoSequence (p<0.05). Heating reduced flowability (p<0.05) and increased pH for AH Plus (p<0.05). The solubility of Bio-C (dried specimens) was not in accordance with the ANSI/ADA standard. The solubility of EndoSequence was significantly higher (p<0.05) when it was heated and dried after 30 days. DC of Bio-C (24 h and 30 days), BioRoot-RCS (30 days) and AH Plus (24 h and 30 days) were not in accordance with the standards. SEM and EDS analysis showed significant changes in sealer microstructure after heating. In conclusion, heating decreased the ST and increased the solubility of EndoSequence BC sealer. No significant changes in flowability, DC, and pH were identified for all three tricalcium silicate sealers after heat application. However, all sealers had significant surface changes.

Analysis of porosity, sealer dissolution and apical extrusion of endodontic sealers: A micro computed tomography study.

The aim of the study was to determine the porosity, dissolution and apical extrusion of AH Plus, MTA Fillapex and EndoSequence BC sealer after immersion in phosphate buffered saline (PBS) using microcomputed tomography (micro-CT). Forty-eight single-rooted teeth were selected. Gutta percha and one of the aforementioned root canal sealers was used for obturation using continuous wave technique. The specimens were scanned after obturation and after seven days of immersion in PBS, by using micro-computed tomography. Porosity, sealer dissolution and apical extrusion were calculated. Statistical analysis was done by using paired t-test, post hoc tukey test and Fischer exact test. Significantly higher percentage of porosity and dissolution of sealer in the apical 4mm was found for MTA Fillapex and EndoSequence BC sealer than for AH Plus. The incidence of apical extrusion was significantly more in MTA Fillapex (56.25%), followed by EndoSequence BC (31.25%) and AH Plus (0%). None of the three root canal sealers exhibited perfect three-dimensional obturation. The sealers manifested porosity, dissolution and apical extrusion to varying degrees both after obturation and after storage in PBS for 7 days.