EndoSequence BC Sealer Research Articles

Physico-chemical properties of calcium silicate-based sealers in powder/liquid and ready-to-use forms.

Calcium silicate-based root canal sealers have been developed in powder/liquid or premixed ready-to-use forms. The evaluation of the physico-chemical properties of a prototype powder/liquid MTApex Sealer (Ultradent) in comparison to a ready-to-use material EndoSequence BC Sealer (Brasseler) was performed. The paste/paste epoxy resin-based AH Plus (Dentsply) served as control for comparisons. The sealers were evaluated (n = 6) regarding setting time (in dry and moist environments), flow and radiopacity, following the ISO-6876/2012 standard. Also, the pH was assessed. Material's surface and chemical characterization was evaluated using scanning-electron-microscopy (SEM) and energy-dispersive-spectrometry (EDS). Mixed ANOVA, Shapiro-Wilk, Levene, and post-hoc analysis with Bonferroni correction were performed at a significance level of 5%. MTApex Sealer exhibited the highest flow and EndoSequence BC Sealer had a significantly longer setting time in dry compared to the moist environment; however, for MTApex Sealer and AH Plus no significant changes occurred when additional moisture was provided. All materials exceeded 7 mm Al of radiopacity and showed a decreasing alkalinity over the 21 day-analysis. SEM/EDS evaluation resulted in peaks of calcium, silicon, and the respective radiopacifier. The prototype powder/liquid MTApex Sealer had the highest flow and similar setting time in both dry and moist environments; opposingly, EndoSequence BC Sealer was crucially influenced by external moisture. This suggests that the powder/liquid materials' setting seems to be more predictable.

Cytocompatibility and bioactive potential of AH Plus Bioceramic Sealer: An in vitro study.

AimTo assess the cytocompatibility and bioactive potential of the new calcium silicate cement‐based sealer AH Plus Bioceramic Sealer (AHPbcs) on human periodontal ligament stem cells (hPDLSCs) compared with the epoxy resin‐based sealer AH Plus (AHP) and the calcium silicate cement‐based sealer Endosequence BC Sealer (ESbcs).MethodologyStandardized sample discs and 1:1, 1:2 and 1:4 eluates of the tested materials were prepared. The following assays were performed: surface element distribution via SEM–EDX, cell attachment and morphology via SEM, cell viability via a MTT assay, cell migration/proliferation via a wound‐healing assay, osteo/cemento/odontogenic marker expression via RT‐qPCR and cell mineralized nodule formation via Alizarin Red S staining. HPDLSCs were isolated from extracted third molars. Comparisons were made with hPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media. Statistical significance was established at p < .05.ResultsA higher peak of Ca2+ was detected from ESbcs compared with AHPbcs and AHP in SEM–EDX. Both AHPbcs and ESbcs showed significantly positive results in the cytocompatibility assays (cell viability, migration/proliferation, attachment and morphology) compared with a negative control group, whilst AHP showed significant negative results. Both AHPbcs and ESbcs exhibited an upregulation of at least one osteo/odonto/cementogenic marker compared with the negative and positive control groups. Both ESbcs and AHPbcs showed a significantly higher calcified nodule formation than the negative and positive control groups, indicative of their biomineralization potential and were also significantly higher than AHP group.ConclusionAH Plus Bioceramic Sealer exhibited a significantly higher cytocompatibility and bioactive potential than AH Plus and a similar cytocompatibility to that of Endosequence BC Sealer. Endosequence BC Sealer exhibited a significantly higher mineralization potential than the other tested sealers. The results from this in vitro study act as supporting evidence for the use of AH Plus Bioceramic Sealer in root canal treatment.

The Impact of Laser-Activated and Conventional Irrigation Techniques on Sealer Penetration into Dentinal Tubules.

Objective: The present study was aimed at comparing the efficacy of 1-hydroxyethylidene-1, 1-diphosphonic acid (HEDP) and ethylenediaminetetraacetic acid (EDTA) by using various final irrigation techniques on penetration of sealer. Background: Traditional irrigation of root canals with a syringe limits the ability of sealer penetration. Various irrigants and activation techniques, including sonic and ultrasonic devices and various kinds of lasers, have been introduced to improve penetration of sealers into dentinal tubules. Methods: One hundred mandibular premolars were selected. Final irrigation was performed with HEDP or EDTA by conventional syringe irrigation (CI), EndoActivator (EA), passive ultrasonic irrigation (PUI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS) methods (n = 10). After obturation of root canals with the EndoSequence BC Sealer, samples were evaluated using a confocal laser scanning microscope (CLSM), which enabled measurement of the maximum depth, percentage, and penetration area. Tests performed for analysis included the Kruskal-Wallis H and Mann-Whitney U tests. Results: In the EA method, the penetration percentage achieved using HEDP was significantly higher than EDTA at both sections (p < 0.05). Irrespective of the final irrigation solution employed, the PUI, PIPS, and SWEEPS techniques exhibited greater tubule penetration values compared with the CI and EA techniques (p < 0.05). Conclusions: HEDP and EDTA showed similar effects on the amount of penetrated sealer into the dentinal tubules, and the PUI, PIPS and SWEEPS methods provided enhanced EndoSequence BC Sealer penetration compared with the CI and EA methods. This study was approved by the Near East University institutional review board (#2020/86-1225).

Evaluation of Bond Strength of Four Different Root Canal Sealers.

The purposes of the study were to evaluate the influence of the sealer’s chemical composition on the interfacial strength between root canal dentin and root filling material, for two different classes of endodontic sealers, and to assess their failure modes. Methods: Forty extracted single-rooted teeth were randomly divided into four groups using the following endodontic sealers: RealSeal SE and Resilon (RSSE); EndoSequence BC sealer and BC Point (EBCS); Endoseal MTA and gutta-percha (EDS); Bioroot RCS and gutta-percha (BRS). Teeth were embedded in acrylic resin, and the roots were sectioned horizontally into 1 mm slices. For each slice, the perimeter was measured. A push-out test was performed using an Instron universal testing machine. For each sample, bond strength was calculated. Specimens were examined by SEM investigation in order to analyze the dentin–sealer–core interface. Results were assessed using analysis of variance (ANOVA) and Tukey and Bonferroni test. Results: Statistical analysis revealed that EDS and gutta-percha had significantly higher resistance to dislodgement compared to the other three groups (p < 0.05). EBCS and BC Point showed significantly greater push-out bond strength values compared to RSSE and Resilon (p < 0.05). Conclusions: Bioceramic endodontic sealers showed a higher bond strength to root dentin than methacrylate resin-based endodontic sealer.

Comparison of bioceramic and epoxy resin sealers in terms of marginal adaptation and tubular penetration depth with different obturation techniques in premolar teeth: A scanning electron microscope and confocal laser scanning microscopy study.

ABSTRACTIntroduction and ObjectiveThe proper performance of a sealer in root canal treatment depends on its physical properties. The aim of this study was to investigate the effect of two bioceramic and epoxy resin sealers in terms of marginal adaptation and tubular penetration depth in different obturation methods of human premolar teeth.Materials and MethodsA total of 82 premolar teeth extracted due to caries and gum disease were used in the present in vitro experimental study. Two types of sealers, epoxy resin (AH-Plus, Dentsply, Germany) and bioceramic (Endosequence BC sealer, Brasseler, Savannah, GA, USA), were used in this research. Lateral compaction and single-cone techniques were used for filling the teeth. Marginal adaptation and tubular penetration depth were measured by scanning electron microscopy (SEM) and confocal laser scanning microscope (CLSM), respectively. Statistical analysis of data was performed by repeated-measures ANOVA. The significance level was considered as P < 0.05.ResultsThe marginal adaptation and tubular penetration depth in all three coronal, middle, and apical regions were better in bioceramic sealer (P < 0.001). The marginal adaptation and tubular penetration depth in all regions were not affected by the filling method and the interaction between the sealer type and the obturation technique.ConclusionBased on the results of this study, the use of bioceramic sealer caused better depth of tubular penetration and marginal adaptation compared to epoxy resin. Further studies and the use of different filling techniques are necessary to achieve a three-dimensional sealing in curved root canals.

Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals.

To assess the interfacial adaptation (gap-containing areas) of two root canal sealers (EndoSequence BC Sealer and AH Plus) to a conventional gutta-percha (GP) cone (GP-sealer interface) in oval-shaped canals filled using the single cone technique. Sixteen teeth with oval-shaped canals were selected, scanned in a micro-computed tomographic device, and pair-matched according to the volume, aspect ratio and configuration of root canals. Root canals were then sequentially prepared with WaveOne Gold Primary and Large instruments, followed by filling with WaveOne Large GP points associated with either the premixed calcium-silicate EndoSequence BC Sealer or the epoxy resin-based AH Plus sealer (n=8 per group) using the single cone technique. After 7days stored in phosphate-buffered saline solution at 37°C, the specimens were rescanned and the reconstructed images segmented in order to differentiate the filling materials (sealer and GP cone) to the dentine. A total of 453 cross-sectional slices were assessed and categorized according to the presence or absence of gaps at the GP-sealer interface. Mann-Whitney U-test verified the differences between groups and were considered significant at alpha=5%. Gaps were non-homogenously distributed in two-dimensional axial cross-section images and none of the specimens showed completely gap-free areas along the entire GP-sealer interface. Root canals filled with EndoSequence BC Sealer and AH Plus displayed 171 (37.75%) and 136 (30.02%) slices with gaps in the GP-sealer interface and these frequencies were statistically significant (p=.000). Although none of the specimens had a gap-free area along the entire GP-sealer interface, oval canals filled with AH Plus showed less gaps than the ones filled with EndoSequence BC Sealer.

A Comparative Evaluation of Fracture Resistance of Teeth Obturated with a Novel Sealer: Chitra CPC with Endosequence BC Sealer, MTA Fillapex and AH Plus

Background: Bonding of sealer to root canal walls is likely to increase the integrity of the sealer-dentin interface during mechanical stresses, thus increasing resistance to fracture. Chitra-CPC sealer is an indigenously manufactured bioceramic material and has been used as bone graft and perforation repair material. When used as a sealer, it has good potential to reinforce the root strength in addition to excellent biocompatibility.&#x0D; Aim: To compare the fracture resistance of teeth obturated with novel Calcium phosphate cement-based sealer viz. Chitra CPC with Endosequence BC sealer, MTA Fillapex and AH Plus&#x0D; Methods and Material: The study was carried out in 100 single rooted extracted, decoronated mandibular premolars of length 11 mm. The teeth were randomly divided into 4 groups (n = 20 for each group). Other than Group 1A and group1B, all other groups were restored with various endodontic sealers and obturated with Gutta Percha. In group1A, the teeth were left unprepared and unfilled (negative control), in group 1B, the teeth were left unobturated (positive control) In group 2, Epoxy resin based sealer (AHPlus ) ;In group 3, mineral trioxide aggregate–based sealer (MTAFill apex); In group 4, Calcium phosphate cement based sealer (Chitra-CPC);in group 5,Bioceramic based sealer(Endosequence BC ) were used. After 2 weeks all specimens were tested for fracture resistance using Universal testing machine at a crosshead speed of 1.0 mm/min until the root fractured. The force required to fracture each specimen was recorded, and the data was analysed statistically.&#x0D; Results: The fracture resistance values of Chitra –CPC and Endosequence BC sealer were significantly higher than that of positive control and comparable to negative control.&#x0D; Conclusions: In contrast to MTA Fill apex and AH Plus, Chitra –CPC and Endosequence BC sealer increased the fracture resistance of teeth.

Biocompatibility of a New Calcium Silicate-Based Root Canal Sealer Mediated via the Modulation of Macrophage Polarization in a Rat Model

(1) Background: The EndoSequence BC Sealer HiFlow (Brasseler, Savannah, GA, USA) has recently been introduced in clinical applications. Thus, the aims of the present study are to determine its biocompatibility in vivo and to examine its ability to drive macrophage polarization in vitro and in vivo. (2) Methods: HiFlow was implanted into rat connective tissue for 7, 30 and 150 days. The microstructures and elemental compositions were determined by scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). Hematoxylin–eosin, immunofluorescence, RT–qPCR and flow cytometry were used to elucidate the effects on inflammatory responses and macrophage polarization. (3) Results: SEM-EDX revealed the formation of surface hydroxyapatite crystal layers. Histological evaluation showed that HiFlow exhibited long-term biocompatibility because it decreased inflammatory responses and reduced the number of macrophages over time; however, tissue necrosis was observed in all the groups. RT–qPCR verified that HiFlow regulated the expression of inflammatory factors to inhibit the inflammatory response. Immunofluorescence analysis performed on in vivo samples revealed that HiFlow promoted M2-like macrophage polarization, and these results were confirmed by flow cytometry in vitro. (4) Conclusion: After 150 days of investigation, HiFlow was considered biologically acceptable, and the formation of apatite crystal layers and the promotion of M2-like macrophage polarization may contribute to its favorable biocompatibility.

The efficacy of different sealer removal protocols on the microtensile bond strength of adhesives to a bioceramic sealer-contaminated dentin.

The optimal bonding of adhesives to dentin requires the sealer to be completely removed from the dentinal walls. This study compared the efficacy of different sealer removal protocols on the microtensile bond strengths (MTBS) of single-step adhesives to a calcium silicate-based bioceramic root canal sealer-contaminated dentin. Standardized box-shaped Class I cavities were prepared in human lower third molars (N = 50). All cavities were contaminated with a bioceramic root canal sealer (Endosequence BC Sealer, Brasseler, Savannah, USA), except the control group (G1) cavities. For the experimental groups, contaminated dentin surfaces were wiped with a dry cotton pellet (G2), wiped with a cotton pellet saturated with water (G3), rinsed with the air/water spray (G4), and passively applied aqueous ultrasonic energy with an ultrasonic scaler (G5) before the restoration procedure. All the cavity surface was restored with a one-bottle universal adhesive and composite resin. All the specimens were subjected to both thermocycling (2,500 thermal cycles from 5 to 55°C, with a 30-s dwelling time and a 10-s transfer time) and mechanical loading (50 N load for 100,000 cycles). The restored specimens were sectioned into resin-dentin beams for MTBS evaluation. Additional specimens were prepared for the scanning electron microscopy (SEM) to examine the dentin-adhesive interface (n = 10). No significant difference was found between the mean bond strengths of the groups. In SEM examination, no residual sealer was found in any group. Calcium silicate-based bioceramic sealer was removed from the dentin surface with all removal protocols when evaluated with MTBS after the thermal and mechanical cycle tests.

Retrievability of Calcium Silicate–based Root Canal Sealers During Retreatment: An Ex Vivo Study

IntroductionThe retrievability of calcium silicate–based sealers (CSSs) during nonsurgical retreatment has been equivocal. This study compared the retrievability of 3 different CSSs using 1 of 3 different solutions or no solution. MethodsA total of 130 extracted teeth with a straight canal were decoronated to a standardized root length. The canals were instrumented to 35/.04 and divided into 3 groups (BC: EndoSequence BC sealer; EBC: EdgeBioceramic; NEO: NeoSEALERFlo), and each group was further divided into 4 subgroups (6% sodium hypochlorite; 5% acetic acid; carbonated water; no solution). After sealer placement, each master gutta-percha cone was placed intentionally 2 mm short of the working length (WL) to ensure the apical 2 mm was filled only with sealer. After storage for 21 days at 37°C and 100% humidity, retreatment was performed until apical patency was obtained. The operator was blinded to the CSS and solution used. Data were analyzed using analysis of variance to compare apical patency rates and the mock chair-times. ResultsOverall success rates for apical patency in BC, EBC, and NEO were 63.64%, 69.77%, and 100%, respectively. There was significantly higher apical patency rate in NEO than BC and EBC. The chair-time for NEO was significantly shorter than BC (P < .05) and EBC sealer (P < .001). There was no significant difference in the chair-time between BC and EBC sealer groups. ConclusionBC, EBC, and NEO sealers in a straight canal were consistently retrievable when no solution was used. Compared with no solution, the retrievability of BC, EBC, and NEO decreased when solutions were used.

Apical Sealing Ability of Experimental Apatite Calcium Phosphate based Coated Gutta-percha Points

Aims: This study aimed to assess the apical sealing ability of experimental apatite-coated gutta-percha points compared to various coated gutta-percha root filling materials.&#x0D; Study Design: Experimental in-vitro study.&#x0D; Place and Duration of Study: Department of Restorative Dentistry, University of Malaya, June 2014 and November 2014.&#x0D; Methodology: Ninety-six extracted permanent maxillary central incisors were standardized and prepared by ProTaper universal rotary files. The specimens were allocated into six groups (n=15) and filled using matching single cone technique as follows; EndoREZ points with EndoREZ sealer, Bioceramic coated points (BCGP), Active GP (ActiV GP), Conventional gutta-percha (GP), apatite coated GP (HAGP) all in combination with Endosequence BC sealer. The sixth group was filled using cold lateral compaction of Conventional GP and Endosequence BC sealer. The specimens were subjected to a dye leakage test. The remaining six teeth were divided equally to be used as a negative and positive control. One-way analysis of variance (ANOVA) followed by the post hoc Dunnett T3 test was performed for data analysis, and the significance value was set at P =.05.&#x0D; Results: ActiV GP had the least leakage followed by BCGP, HAGP, cold lateral compaction, conventional GP, and EndoRez.&#x0D; Conclusion: HAGP as root canal filling showed favourable sealing ability comparable to ActiV GP, BCGP, and conventional GP and it was superior to EndoREZ.

In vitro evaluation of the antibacterial effect of four root canal sealers on dental biofilms.

To dynamically evaluate the effect of four root canal sealers on the killing of biofilms within dentinal tubules. Dentin blocks were prepared for infection of the dentinal tubules. Enterococcus faecalis VP3-181 and multi-species bacteria from two donors were cultured. After 3days of incubation, the infected dentin specimens were rinsed with sterile water for 1min and subjected to treatment. Additionally, multi-species bacteria from donor 1 were incubated for 3weeks to allow biofilm maturation and then the specimens were subjected to treatment. Gutta-percha-treated dentin specimens comprised the control group. A root canal sealer (bioceramic sealers: EndoSequence BC Sealer, ProRoot Endo Sealer, or GuttaFlow Bioseal; and a traditional silicone-based sealer: Guttaflow 2) was spread onto the canal walls of the dentin. The specimens were examined with confocal laser scanning microscopy at 7, 30, or 60days. In the 3-day-old biofilm group, the proportion of killed bacteria decreased significantly from the first 7days of treatment to 60days of treatment for all sealers (p < 0.05). In the 3-week-old biofilm group, 60days of exposure to bioceramic sealers resulted in more significant dead bacteria than 7-day exposures of the biofilms (p < 0.05). Bioceramic sealers were more effective in killing bacteria than the GuttaFlow 2 sealer (p < 0.05). Calcium silicate-based sealers showed good antimicrobial effects against biofilms within dentinal tubules, especially in the first week in young biofilms. There is no substantive antibacterial activity observed for the examined root canal sealers against young dentinal tubule biofilms. The bioceramic root canal sealers examined demonstrate minimal additional antibacterial effects after long-term exposure to young biofilms.

Toxicity of bioceramic and resinous endodontic sealers using an alternative animal model: Artemia salina.

Aims:The present study assessed the toxicity of a novel calcium silicate-based root canal sealer (Bio-C Sealer) in comparison to Endosequence BC Sealer and AH Plus through a lethality assay involving brine shrimp (Artemia salina).Methods:Brine shrimp cysts were incubated for 24 h for the hatching of the larvae, which were then exposed to different concentrations (2.5, 5, 10, 20, 40, 80, and 100 μg/mL) of the test endodontic sealers for 24 h, followed by the determination of the survival rate.Statistical Analysis Used:One-way repeated-measures ANOVA and the Newman–Keuls post hoc test were used to compare the different materials as well as different concentrations of the same material. Dunnett's test was used to compare the different concentrations and different sealers to the control. The lethal concentration of each endodontic sealer necessary to kill 50% of the brine shrimp larvae (LC50) was also determined.Results:The toxicity of Bio-C (10, 20, 40, 80, and 100 μg/mL) and Endosequence BC Sealer (20, 80, and 100 μg/mL) was lower than that of AH Plus. No significant difference was found between Bio-C and Endosequence BC Sealer or among the different intragroup concentrations of these sealers. In the AH Plus group, concentrations ≥5.0 μg/mL exhibited greater toxicity compared to the concentration of 2.5 μg/mL and the control. AH Plus had the lowest LC50 (59.95 μg/mL), whereas Bio-C and Endosequence BC Sealer had LC50 values >200 μg/mL.Conclusions:Bio-C Sealer proved to be less toxic than AH Plus and exhibited similar toxicity to that of Endosequence BC Sealer.

Effect of therapeutic fractionated radiotherapy on bond strength and interfacial marginal adaptation of Adseal, MTA Fillapex, and EndoSequence BC sealer: An in vitro study

Introduction: The study aimed to assess the impact of fractionated radiation on push-out bond strength of sealer to dentin interface and on marginal adaptation of the sealer (Adseal, MTA Fillapex, and EndoSequence BC sealer) to irradiated dentin.Materials and Methods: Ninety maxillary central incisors were randomly divided into two groups: with irradiation (n = 45) and without (n = 45). All the samples to be radiated were exposed to fractionated dosage (60 Gy) through Co-60 gamma (1.17 and 1.33 Mev) photons. Specimens were prepared and subdivided into three subgroups (n = 15 each) according to assigned sealer Adseal, MTA Fillapex, and EndoSequence BC sealer. Later, the samples were sectioned into a 1 mm thick segment at each root third for bond strength and scanning electron microscope (SEM) analysis. SEM micrographs were analyzed with an ORION version 6 image analyzer. The percentage of failure mode after debonding was evaluated with a stereomicroscope. Bond strength data were analyzed using two-way analysis of variance and the Tukey's post hoc test.Results: Bond strength was significantly (P < 0.0001) decreased after radiotherapy (0.76 ± 0.12 Mpa) versus without radiation (0.93 ± 0.18 Mpa). Furthermore, when the pooled average of sealers was compared, significantly highest bond strength was perceived in Adseal (0.98 ± 0.18 Mpa) followed by EndoSequence BC (0.84 ± 0.13 Mpa). Coronal sections showed significantly (P < 0.0001) higher bond strength (0.99 ± 0.16 Mpa) compared to the middle (0.81 ± 0.14 MPa) and apical third (0.74 ± 0.12 Mpa). Qualitative SEM revealed a higher interfacial gap between sealer and irradiated radicular dentin. The percentage of mean change was recorded significantly high in MTA Fillapex (52%), then in EndoSequence BC (31%), and least was in Adseal (17%).Conclusions: Irradiated teeth resulted in consequential decreased adhesiveness and bond strength of dentin to root canal filling material. In addition, the highest bond strength was noticed in Adseal.

Evaluation of in vitro experimental model for analysis of bioceramic sealers

This study aimed to evaluate physicochemical properties of three ready-to-use calcium silicate-based endodontic sealers: Endosequence BC Sealer, Bio C Sealer, and Sealer Plus BC. Radiopacity was evaluated using specimens of 10 mm in diameter and 1 mm in height, along with an aluminum step wedge. For the flow test, 0.5 mL of each sealer was deposited between glass plates and the mean of the measurement of two diameters was considered the cement flow value. For pH and calcium release, root canals of 30 prototypes of upper incisor acrylic resin teeth were filled with sealer and gutta percha point and then immersed in containers with 13 mL of ultrapure water. Both pH and release of calcium ions (atomic absorption spectrophotometer) were measured at 3, 24, 72, and 168 h. Acrylic resin teeth were scanned by Micro-CT 1174 at the time of pH and calcium ion readings for volumetric change analysis. The data were analyzed by ANOVA, Tukey’s, Kruskal-Wallis, and Dunn’s tests. Endosequence BC Sealer presented the lowest, and Bio C Sealer the highest volumetric change after 72 h and 168 h (p < 0.05). Endosequence BC Sealer presented higher radiopacity (p < 0.05). All materials showed alkalinization capacity. All of them presented calcium ion release, with a higher value for Sealer Plus BC. All materials presented alkalinization, calcium release capacity, radiopacity, and flow above the minimum values required by the ISO standard. The highest volumetric loss was experienced by Bio C Sealer and the lowest one by Endosequence BC Sealer.

Radiopacity of premixed and two-component Calcium silicate-based Root Canal sealers

Background/Aim: Radiopacity enables radiographic visualization, which is significant in diagnostic procedures and assessment of the quality of endodontic filling. It is important to compare newly developed endodontic sealers with materials that are already in clinical use in order to promote evidence-based dentistry. The aim of our study was to evaluate radiopacity of different calcium silicate-based sealers in comparison with control, epoxy resin-based sealer. The null hypothesis was that there were no statistically significant differences in radiopacity of the tested sealers. Material and Methods: Premixed (TotalFill BC Sealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer), two-component (BioRoot RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal) calcium silicate-based sealers and AH Plus, as a control, were used. Specimens were radiographed using a Radiovisiography (RVG-4) CCD (charge-coupled devices)-based digital sensor. Results: Ceraseal had the highest, while Bioceramic Root Canal Sealer had the lowest radiopacity. Bioceramic Root Canal Sealer and MTA Fillapex had radiopacity significantly lower than all other sealers. Radiopacity level of AH Plus, was similar to premixed and significantly higher than radiopacities of all two-component endodontic sealers. Conclusions: Calcium silicate-based sealers radiopacity ranged from slightly above minimal required value (3mm), to a value higher than control sealer. Premixed endodontic sealers showed similar radiopacity as AH Plus which suggests that their clinical performance, in terms of visibility on dental radiograms, should be similar

Successful regenerative endodontic treatment in a tooth with incomplete root apex and posttreatment apical periodontitis: A case report

This case report describes the procedure and outcome of regenerative endodontic treatment (RET) in a tooth with incomplete root apex and posttreatment apical periodontitis. A 44-year-old patient was referred to the endodontist because of a periapical lesion on tooth #21 and a recent episode of acute periapical abscess. On clinical and radiographic examination, this tooth presented with tenderness to percussion and palpation, periapical radiolucent lesion, external apical resorption, and incomplete apex formation. After coronal access, the filling material was removed, and the canal was gently prepared with hand files, using 1% NaOCl as the main irrigant followed by final irrigation with 17% EDTA, activated with XP-endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The root canal was filled with a double antibiotic paste with ciprofloxacin and metronidazole (1:1). After three weeks, RET was performed by stimulating bleeding into the canal, and when a clot was formed, a bioceramic (EndoSequence BC Sealer, Brasseler USA, Savannah, GA) plug was placed on it, followed by coronal restoration. The tooth remained asymptomatic since RET was concluded. Clinical and radiographic follow-ups showed complete repair of the apical periodontitis lesion and the absence of symptoms after eight months. This satisfactory outcome was confirmed after 34 months. Key words:Bioceramic material; ciprofloxacin; metronidazole; persistent apical periodontitis; regenerative endodontic treatment.

Physicochemical properties and osteoclastogenesis for three premixed calcium silicate-based sealers post set.

Solubility, pH, ion release, cytotoxicity, and osteoclastogenesis inhibition in bone marrow-derived monocyte macrophages (BMMs) were evaluated in EndoSequence BC Sealer (END), Bio-C Sealer (BC), and Sealer Plus BC (SPBC). pH was determined after immersion of the sealers in deionized water (DW) and Minimum Essential Medium Alpha (α-MEM). Solubility was obtained by mass loss. Ion release was measured by using X-ray fluorescence spectroscopy (XRF). Cytotoxicity was evaluated by MTT assay. Inhibition of osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP). Data were analyzed using the t-test, ANOVA and Tukey/Dunnett's post-hoc tests (α = 0.05). END had the highest pH in DW (p < 0.05), and BC, in α-MEM (p < 0.05). Solubility in DW was the lowest for SPBC (p < 0.005). The highest calcium release was observed for BC in DW at 12 h (p < 0.05), and in α-MEM at 12 and 24 h (p < 0.05). The lowest toxicity was detected for END (p < 0.05). BC had the highest inhibitory effect on osteoclasts (p < 0.05). Overall, the highest solubility and pH values were found in DW. However, the calcium silicate-based sealer showed higher solubility than the ISO standards. Calcium release was the highest for BC. END showed the highest cell viability, and BC, the highest osteoclast inhibition.

Coronal and apical leakage among five endodontic sealers.

The aim of this study was to use dye penetration to measure apical and coronal leakage simultaneously in single-canal teeth that had been treated endodontically using a single-cone obturation technique. One hundred single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size-X5 (50/.06), then randomly assigned to five sealer groups for single-cone gutta-percha obturation. The teeth were soaked in 0.6% rhodamine B at 37°C for seven days, then the roots were ground mesiodistally and the maximum apical and coronal dye penetration was measured. Differences in leakage among the sealer groups were examined using the Kruskal-Wallis test. Pairwise comparisons were made using the Mann-Whitney test with Bonferroni correction. The mean values (mm) of dye penetration for AH Plus, Pulp Canal Sealer, NeoSEALER Flo, EndoSequence BC, and Super-Bond RC Sealer were 0.200, 0.300, 0.675, 0.850, and 0.900 apically, whereas 1.675, 2.075, 4.800, 6.500, and 4.125 coronally. Pairwise comparisons showed significant apical differences between AH Plus/Super-Bond RC Sealer (P = 0.047) and significant coronal differences between AH Plus/NeoSEALER Flo (P = 0.001), AH Plus/EndoSequence BC (P < 0.01), AH Plus/Super-Bond RC Sealer (P < 0.01), Pulp Canal Sealer/NeoSEALER Flo (P = 0.010), Pulp Canal Sealer/EndoSequence BC (P < 0.01), and Pulp Canal Sealer/Super-Bond RC Sealer (P < 0.01). Coronal leakage was worse than apical leakage for all sealers. AH Plus exhibited the least leakage apically and coronally; Super-Bond RC Sealer showed the most leakage apically, and EndoSequence BC showed the most leakage coronally.

Single Visit Root Canal Treatment: Intensity of Postoperative Pain Using AH Plus Sealer Versus Endosequence BC Sealer in Patients with Asymptomatic Apical Periodontitis (A Randomized Clinical Trial)

Single Visit Root Canal Treatment: Intensity of Postoperative Pain Using AH Plus Sealer Versus Endosequence BC Sealer in Patients with Asymptomatic Apical Periodontitis (A Randomized Clinical Trial)