Endosequence Root Repair Material Putty Research Articles

Efficacy of Mineral Trioxide Aggregate Repair High Plasticity, Biodentine, and EndoSequence Root Repair Material Putty as Apical Barriers in Immature Permanent Teeth: An In Vitro Bacterial Leakage Study.

To assess the microleakage of mineral trioxide aggregate (MTA) repair high plasticity (HP), EndoSequence root repair material (ESRRM) putty, and Biodentine, when used as an apical plug in immature permanent teeth. In an in vitro model, 55 extracted maxillary incisors were decoronated and resected 3 mm apically to obtain standardized 15-mm root blocks, which were then cleaned and shaped. All samples had a 1.1-mm standardized, prepared artificial open apex. The teeth were arbitrarily designated into three experimental groups (n = 15) and two control (positive/negative) groups (n = 5). In the experimental groups, orthograde 4-mm thick apical plugs of Biodentine (group I), ESRRM putty (group II), and MTA repair HP (group III) were placed. Positive control samples were left vacant while negative control samples were filled with Biodentine. The bacterial leakage method was used to appraise the sealing efficiency of the cements. Statistical package for the social sciences (SPSS) software, version 21.0, was used for data analysis. Post hoc Tukey's test, one-way analysis of variance (ANOVA), and repeated measures of ANOVA were used for intergroup and intragroup comparisons. On day 1, there was a significant difference between the groups, with group II showing the least and group 1 showing the maximum microleakage. No significant difference among the groups was seen at other observational periods. There was a tendency for leakage to increase significantly from day 1 to 7, then decrease till the end of the experimental period. It was concluded that the three materials evaluated, with time, exhibited comparable apical microleakage when treating teeth with open apices. MTA repair HP can be used as an apical plug material in open apices with similar success as ESRRM putty and marginally better outcome than Biodentine.

Sealing ability of mineral trioxide aggregate, Biodentine, and EndoSequence RRM putty used as retrograde restorative material: An in vitro bacterial leakage model study

Sealing ability of mineral trioxide aggregate, Biodentine, and EndoSequence RRM putty used as retrograde restorative material: An in vitro bacterial leakage model study

Bioactivity and Physicochemical Properties of Three Calcium Silicate-Based Cements: An In Vitro Study.

Objective This study evaluated the bioactivity and physicochemical properties of three commercial calcium silicate-based endodontic materials (MTA, EndoSequence Root Repair Material putty, and Biodentine™). Material and Methods. Horizontal sections of 3 mm thickness from 18 root canals of human teeth were subjected to biomechanical preparation with WaveOne Gold large rotary instruments. The twelve specimens were filled with three tested materials (MM-MTA, EndoSequence Root Repair Material putty, and Biodentine™) and immersed in phosphate-buffered saline for 7 and 30 days. After this period of time, each specimen of each material was processed for morphological observation, surface precipitates, and interfacial dentin using SEM. In addition, the surface morphology of the set materials, without soaking in phosphate-buffered solution after one day and after 28 days stored in phosphate-buffered saline, was evaluated using SEM; also, the pH of the soaking water and the amount of calcium ions released from the test materials were measured by using an inductively coupled plasma-optical emission spectroscopy test. Data obtained were analyzed using one-way analysis of variance and Tukey's honest significant difference test with a significance level of 5%. Result The formation of precipitates was observed on the surfaces of all materials at 1 week and increased substantially over time. Interfacial layers in some areas of the dentin-cement interface were found from one week of immersion. All the analyzed materials showed alkaline pH and capacity to release calcium ions; however, the concentrations of released calcium ions were significantly more in Biodentine and ESRRM putty than MM-MTA (P < 0.05). ESRRM putty maintained a pH of around 11 after 28 days. Conclusion Compared with MM-MTA, Biodentine and ESRRM putty showed significantly more calcium ion release. However, exposure of three tested cements to phosphate-buffered solution resulted in precipitation of apatite crystalline structures over both cement and dentin that increased over time. This suggests that the tested materials are bioactive.

The Response of the Pulp-Dentine Complex, PDL, and Bone to Three Calcium Silicate-Based Cements: A Histological Study in an Animal Rat Model

Objective The aim of this study was to histologically examine the tissue reaction of three different calcium silicate cements in the closure of perforations in rat incisor teeth. Material and Methods. An experimental lateral root perforation with pulp exposure was performed in 32 lower incisors of 16 male Wistar albino rats. They were randomly assigned into three test groups (each including eight teeth) that were filled either by Biodentine (BD) or MicroMega mineral trioxide aggregate (MM-MTA) or EndoSequence root repair material putty (ESRRM putty), besides eight unperforated incisors from the other four rats (control group). The inflammatory response and healing process were evaluated histologically and scored after one and four weeks. Differences among groups were tested by Kruskal–Wallis tests at P ≤ 0.05. Results In the first week, BD produced more inflammatory response in the pulpal (score 3) than other materials (score 2). Only ESRRM putty showed odontoblast-like cells in 50%, 25% dentine-like deposit, 25% evidence of bone deposition in the drilling site (score 2), and minimum periodontal ligament (PDL) necrosis and disorganization (25%, score 2). After one month, all groups had healthy pulpal tissue, but 25% of ESRRM putty retained score 1 inflammatory response, and 50% of the BD case had an incomplete palisading odontoblast layer (score 3). A thick and regular dentine bridge deposition was seen in the ESRRM putty group in comparison with MM-MTA and BD cases. The cortical plate healing in all ESRRM putty samples was complete (score 3), while an incomplete closure was seen in MM-MTA and BD groups (score 2). Both the MM-MTA and ESRRM putty groups had fully organized PDL (score 2), while in 50% of BD cases, a necrotizing area and disorganized PDL with inflammatory cells infiltration were still present. Statistically significant differences in the scores of any histologic parameters among the three tested materials were observed neither in the 1st nor in the 4th weeks of the experimental period. Conclusion Better tissue compatibility and repair of pulpal and periodontal tissue have been detected after lateral perforation in the root of rat incisors when treated with ESRRM putty than MM-MTA and BD. However, the difference was not significant.

Biocompatibility of three calcium silicate based materials implanted in rat subcutaneous tissue.

Objective: The purpose of the present study was to evaluate the inflammatory response caused by three calcium silicate based cements in rat’s subcutaneous tissue. Materials and methods: Fifteen Wistar rats were divided into three groups of 1, 4, and 8 experimental weeks. Sterile silicone tubes were filled with Micro-Mega Mineral Trioxide Aggregate (MM-MTA), Biodentine (BD) and EndoSequence Root Repair Material (ESRRM) putty and implanted subcutaneously. Empty tubes were implanted as negative control. After the experimental periods, all animals were sacrificed and the specimens stained histologically with hematoxylin-eosin (HE BD produced less biological reaction than MM-MTA and more than ESRRM and control during the initial periods. While both MM-MTA and BD had reduced inflammatory reaction with time. ESRRM showed tissue-tolerance features almost comparable to control during all experimental periods. Conclusion: ESRRM putty was significantly more biocompatible than MM MTA and BD in the 1st week of the experiment. However, there was no significant difference between the materials at the end of the 8th weeks. ESRRM putty, BD, and MM MTA can be considered suitable calcium silicate materials.

Effect of acidic pH on microhardness and microstructure of theraCal LC, endosequence, mineral trioxide aggregate, and biodentine when used as root repair material.

Introduction:The aim of this study was to investigate the microhardness and microstructural features of newer tricalcium silicate materials: TheraCal LC, mineral trioxide aggregate (MTA), biodentine (BD), and Endosequence Root Repair Material (ERRM) putty, after exposure to acidic environments in comparison with distilled water.Materials and Methods:A total of 80 extracted single-rooted premolars were collected. All the selected specimens were sectioned vertically, and cavities were prepared on the root surface. Specimens were divided into four groups of 20 each, i.e., Group 1: (n = 15) MTA (ProRoot, Dentsply Tulsa Dental, Tulsa, OK, USA), Group 2: (n = 15) BD (Septodont, France), Group 3: (n = 15) ERRM putty (Brasseler, USA), and Group 4: (n = 15) TheraCal LC (Bisco Inc Schaumburg). Materials were placed into prepared cavities. About 10 specimens per each group were exposed to butyric acid buffered at a pH level of 5.5 for 7 days at 37c, and 10 specimens from each group were exposed to distilled water serving as a control group. The surface microhardness was measured after exposure to either acid or distilled water. Scanning electron microscope was used to observe the internal microstructure morphology. Two-way analysis of variance was applied to evaluate the Knoop microhardness value (KHN).Results:Results showed that the microhardness values of the materials were significantly higher in the neutral environment of butyric acid at pH 7.4 when compared to those in the acidic condition of pH 5.4 for all groups (P < 0.001). TheraCal LC had higher microhardness values than BD, MTA, ERRM putty at 5.5 pH levels (P < 0.001).Conclusion:The microhardness values of TheraCal LC, BD, ERRM Putty, and MTA were reduced in an acidic environment, which resulted in these materials having more porous and less crystalline microstructures. TheraCal LC seems the most suitable material for application to an area of inflammation where a low pH value may exist.

Effect of Blood Exposure on Push-Out Bond Strength of Four Calcium Silicate Based Cements.

Introduction:The purpose of this study was to compare the push-out bond strength of white ProRoot Mineral Trioxide Aggregate (MTA), Biodentine, calcium-enriched mixture (CEM) cement and Endosequence Root Repair Material (ERRM) putty after exposure to blood. Methods and Materials:A total of 96 root dentin slices with a standardized thickness of 1.00±0.05 mm and standardized canal spaces were randomly divided into 4 main experimental groups (n=24) according to the calcium silicate based cement (CSC) used: white ProRoot MTA, CEM Cement, ERRM Putty and Biodentine. Specimens were exposed to whole fresh human blood and then subdivided into two subgroups depending on the exposure time (24 or 72 h). Push-out bond strength was measured using a universal testing machine. Failure modes were examined under a light microscope under ×10 magnification. Data were analyzed using the two-way ANOVA test. Results:Biodentine exhibited the highest values regardless of the exposure time. The lowest push-out strength values were seen in white ProRoot MTA and CEM cement in both post exposure times. After exposure to blood, the push-out bond strength of all materials increased over time. This increase was only statistically significant in white ProRoot MTA and ERRM specimens. The dominant failure mode in all CSCs was the adhesive mode. Conclusion:Biodentine showed the highest values of push-out bond strength and may be better options for situations encountering higher dislocation forces in a short time after cement application.

In Vitro Cytotoxicity Evaluation of Three Root-End Filling Materials in Human Periodontal Ligament Fibroblasts.

The aim of this study was to evaluate in vitro the cytotoxicity on human periodontal ligament fibroblasts of three root-end filling materials: MTA Angelus®, EndoSequence Root Repair Material Putty® and Super EBA®. A primary culture of human periodontal ligament fibroblasts was previously obtained in order to evaluate the cytotoxicity of the three extracts from the root-end filling materials after 2 and 7 days of setting. Serial dilutions of these extracts (1:1, 1:2, 1:4 and 1:8) were evaluated at 1, 3 and 7 days using the methyl-thiazol-tetrazolium (MTT) colorimetric assay. Cell viability was evaluated as percentage of the negative control group, which represented 100% cell viability. Statistical analyses were done with t-test, ANOVA and Kruskal-Wallis test at a significance level of 5%. It was found that the main difference among root-end filling materials was in the higher dilutions (p<0.05), but there was a similar behavior in lower dilutions (p>0.05). Cell viability of MTA Angelus® was superior for 2-day setting (p<0.05), compared with the other two root-end fillings. There were no statistically significant differences between 7-day set MTA Angelus® and EndoSequence Root Repair Material Putty®. Super EBA® showed the lowest percentage of cell viability at higher dilutions (p<0.05). Therefore, MTA Angelus® and EndoSequence Root Repair Material Putty® were less cytotoxic in the highest dilution (1:1) compared with Super EBA®.

Physical properties and hydration behavior of a fast-setting bioceramic endodontic material

BackgroundTo investigate the physical properties and the hydration behaviour of the fast-setting bioceramic iRoot FS Fast Set Root Repair Material (iRoot FS) and three other endodontic cements.MethodsiRoot FS, Endosequence Root Repair Material Putty (ERRM Putty), gray and white mineral trioxide aggregate (G-MTA & W-MTA), and intermediate restorative material (IRM) were evaluated. The setting time was measured using ANSI/ADA standards. Microhardness was evaluated using the Vickers indentation test. Compressive strength and porosity were investigated at 7 and 28 days. Differential scanning calorimetry (DSC) was employed for the hydration test.ResultsiRoot FS had the shortest setting time of the four bioceramic cements (p < .001). The microhardness values of iRoot FS, ERRM Putty and MTA increased at different rates over the 28 days period. At day one, ERRM Putty had the lowest microhardness of the bioceramic cements (p < .001), but reached the same level as MTA at 4, 7 and 28 days. The microhardness of iRoot FS was lower than that of W-MTA at 7 and 28 days (p < .05). The porosity of the materials did not change after 7 days (p < .05). The compressive strength values at 28 days were significantly greater for all bioceramic groups compared to those at 7 days (p < .01). ERRM Putty had the highest compressive strength and the lowest porosity of the evaluated bioceramic cements (p < .05), followed by iRoot FS, W-MTA, and G-MTA, respectively. DSC showed that iRoot FS hydrated fastest, inducing an intense exothermic reaction. The ERRM Putty did not demonstrate a clear exothermic peak during the isothermal calorimetry test.ConclusionsiRoot FS had a faster setting time and hydrating process than the other bioceramic cements tested. The mechanical properties of iRoot FS, G-MTA and W-MTA were relatively similar.

Surface microhardness of different thicknesses of a premixed bioceramic material with or without the application of a moist cotton pellet.

Background:This study was conducted to assess the effect of thickness and hydration condition on the surface microhardness of Endosequence Root Repair Material putty (ERRM; Brasseler USA, Savannah, GA), a premixed bioceramic material.Materials and Methods:Polymethyl methacrylate cylindrical molds with an internal diameter of 4 mm and three heights of 2, 4, and 6 mm were fabricated. In Group 1 (dry condition), the molds with heights of 2, 4, and 6 mm (10 molds of each) were filled with ERRM. In Groups 2 and 3 (wet condition), a distilled water- or phosphate-buffered saline (PBS)-moistened cotton pellet was placed directly on the upper surface of ERRM, respectively. The lower surface of ERRM was in contact with floral foams soaked with human blood. After 4 days, Vickers microhardness of the upper surface of ERRM was tested. The data were analyzed using two-way analysis of variance. Significance level was set at P < 0.05.Results:No significant difference was found between the microhardness of three thicknesses of ERRM (2, 4, and 6 mm) with or without placing a distilled water- or PBS-moistened cotton pellet over the material (P > 0.05).Conclusion:Based on the results of this study, it could be concluded that placing a moistened cotton pellet on ERRM putty up to 6 mm thick might be unnecessary to improve its surface microhardness and hydration characteristics.

Acidic pH weakens the microhardness and microstructure of three tricalcium silicate materials.

To investigate the microhardness and microstructural features of three tricalcium silicate materials: mineral trioxide aggregate (MTA), Endosequence Root Repair Material Putty (ERRM Putty) and Endosequence Root Repair Material Paste (ERRM Paste), after exposure to a range of acidic environments in comparison with intermediate restorative material (IRM). Endosequence Root Repair Material Putty (Brasseler, Savannah, GA, USA), ERRM Paste (Brasseler, Savannah, GA, USA), MTA (ProRoot; Dentsply Tulsa Dental, Johnson City, TN, USA) and IRM (Dentsply Caulk, Milford, DE, USA) were set in cylindrical rubber moulds as four groups containing twenty specimens each. Fifteen specimens per each material were randomly distributed into three groups (n=5) to be exposed to butyric acid buffered at three different pH levels (5.4, 6.4 and 7.4) for 7days. The remaining five specimens were exposed to distilled water as a control group. The surface microhardness after exposure either to acid or to water was measured after 7-days at 37°C. The morphology of the internal microstructure was observed using a scanning electron microscope (SEM). Two-way univariate analysis of variance (anova) was applied to evaluate the Vickers microhardness value (VHN). The microhardness values of the materials were significantly higher in the neutral environment of butyric acid at pH 7.4 compared to those in the acidic condition of pH 5.4 for all groups (P<0.001). MTA, ERRM Putty and ERRM Paste had higher microhardness values than IRM at all pH levels (P<0.001). Specimens exposed to distilled water displayed significantly higher microhardness values than those values obtained in the presence of butyric acid buffered to all pH levels (P<0.001). A more porous microstructure was observed following exposure to butyric acid at pH 5.4 than at pH 7.4. Several types of crystalline structures were formed by recrystallization, especially at pH 7.4 in all groups except for IRM. The microhardness values of ERRM Putty, ERRM Paste and MTA were reduced in an acidic environment, which resulted in these materials having more porous and less crystalline microstructures. MTA seems the most suitable material for application to an area of inflammation where a low pH value may exist.

Bioactivity of EndoSequence Root Repair Material and Bioaggregate

To evaluate the bioactivity of Bioaggregate (BA), EndoSequence Root Repair Material (ERRM), and white ProRoot Mineral trioxide aggregate (MTA). Sixty horizontal root sections with standardized canal spaces were divided randomly into 3 groups (n=20) and filled with white ProRoot MTA (groups 1 and 2), BA (groups 3 and 4) or ERRM putty (groups 5 and 6). The specimens of groups 1, 3 and 5 (each of 10) were immersed in phosphate-buffered saline (PBS) for 1week and those of groups 2, 4 and 6 (each of 10) for 2months. After the experimental periods, the specimens were processed for scanning electron microscopy (SEM) observations. Precipitation of apatite crystals on the surfaces of the cements and/or at the dentine-cement interface was evaluated and analysed elementally by energy dispersive X-ray (EDX) instrument. Analysis of specimens revealed various surface morphologies that were dependent on the material and immersion time in PBS. The formation of precipitates was observed on the surfaces of all materials at 1week, which increased substantially over time. After 2months, the surface of the cements was changed dramatically and consisted of a substantially greater amount of apatite aggregates. Interfacial layers in some areas of the dentine-cement interface were found only following 2months of immersion. Precipitates on MTA revealed high peaks of Ca, Si and O after 1week of immersion; after 2months, high peaks of Ca, P and O were present. Precipitates on BA and ERRM displayed high Ca, P O peaks after both 1week and 2months. Exposure of MTA, BA and ERRM to PBS resulted in precipitation of apatite crystalline structures that increased over time. This suggests that the tested materials are bioactive.

Biocompatibility of Two Novel Root Repair Materials

Introduction The purpose of the present study was to evaluate the biocompatibility of 2 root-end filling materials, Endosequence Root Repair Material Putty (ERRM Putty) and Paste (ERRM Paste) and compare them with gray mineral trioxide aggregate (MTA). Methods ERRM Putty, ERRM Paste, MTA, intermediate restorative material (IRM), and Cavit G were tested. For cytotoxicity assay, human gingival fibroblasts were incubated for 1, 3, and 7 days with extracts of varying concentrations from materials set for 2 days or 7 days. Cell viability was evaluated by methyl-thiazol-tetrazolium (MTT) assay. For cell adhesion assay, materials set for 7 days were examined under scanning electron microscope directly after setting, after incubation in cell culture medium for 7 days, and after incubation in gingival fibroblast suspension at a density of 5 × 10 4 cells/well for 2 and 7 days. The constituents of crystals formed on surface of materials were determined by energy dispersive analysis by x-ray. Results Cell viability was significantly correlated with the type of material, setting time, and incubation time ( P < .001 for all parameters). ERRM Putty and ERRM Paste displayed similar cell viabilities to MTA at all experimental conditions, except that fresh samples of ERRM Paste showed slightly lower cell viabilities than MTA. Cell viabilities with IRM and Cavit G were significantly lower than with the other 3 materials ( P < .001). Similar surface crystallographic features and cell adhesion were observed on ERRM Paste, ERRM Putty, and MTA. Conclusions ERRM Putty and ERRM Paste displayed similar in vitro biocompatibility to MTA.