EndoSequence Root Repair Material Research Articles

Comparative Evaluation of the Push-Out Bond Strength of Glass Ionomer Cement, Mineral Trioxide Aggregate, Biodentine, and Endosequence Root Repair Material in Repair of Furcation Perforations: An In Vitro Study

ABSTRACT Introduction: An in vitro comparative analysis was performed to calculate the push-out bond strength of commercially existing root repairing cements like glass ionomer cement (GIC), biodentine, mineral trioxide aggregate (MTA), and endosequence root repair material (RRM) employed in furcation perforation, with or without blood contamination present. Materials and Methods: Eighty molars were selected and subjected to furcal perforations. They were categorized based on the cement used for repair (GIC, MTA, biodentine, and endosequence RRM); furthermore, they were sub-divided into two sub-groups, that is, blood contaminated and non-contaminated. For 24 hours, all the samples were kept in an incubator till the materials were fully set. Then these samples were examined for push-out bond strength measurement. Results: The 24-hour push-out bond strength of was the highest in biodentine and the lowest in glass ionomer cement. The push-out bond strength of endosequence RRM, MTA, and GIC was influenced by blood contamination. Conclusion: The push-out bond strength of biodentine was the highest as compared to endosequence RRM, MTA angelus, and GIC. The push-out bond strength of endosequence RRM and MTA angelus after 24 hours with or without blood contamination showed insignificant differences. Group 1A (GIC contaminated with blood) displayed the least push-out bond strength among other groups.

Porosity analysis of four bioceramic materials used for the repair of furcation perforations via micro-computed tomography.

Porosity is a crucial parameter that affects the solubility, sealing and mechanical strength of a material. It plays a significant role in determining the success of treatment. The present study aimed to evaluate and compare the porosity of different bioceramic-based materials, using micro-computed tomography (micro-CT). In the study, 76 permanent lower first or second molars that had been extracted for periodontal reasons and were free of calcification, resorption, root cavities, fractures, or cracks, with discrete roots and complete root apex development were selected. In each of the 4 experimental groups, perforations were made in the furcation areas of 19 molars. Mineral trioxide aggregate (MTA) Angelus®, EndoSequence® Root Repair Material (ERRM), Biodentine™, and BioAggregate were placed on the perforated areas of the samples and scanned with a micro-CT to evaluate porosity. The pore volume and the pore percentage with regard to the closed, open and total porosity of these repair materials were calculated individually in each sample. While no statistically significant differences were found between group I (MTA), group III (Biodentine) and group IV (BioAggregate) when evaluating the total pore percentage (p > 0.05), the parameter in group II (ERRM) was found to be significantly lower as compared to other groups (p > 0.05). In comparison with the other materials used in this study, the use of ERRM may be more suitable for perforation repair.

Dentin Bond Strength of Calcium Silicate-Based Materials: A Systematic Review of In Vitro Studies

Background: Dentin adhesion is a basic aspect to consider in a root canal sealer. Calcium silicate-based cements are materials that have excellent biocompatibility and bioactivity. Bioactivity is closely related to dentin bond strength. One of the tests that is most used to evaluate the adhesive property of a sealing cement is the “push-out bond strength” test, which consists of applying tensile forces to the root to measure the resistance of the bonding of a material to root dentin. Aim: The aim of this systematic review is to perform a qualitative synthesis of available evidence on the adhesion of calcium silicate-based sealers to dentin. Methods: An advanced search of the literature was performed in five databases, limited to in vitro studies on human teeth published in the last 5 years. Results: 42 studies were eligible for the review, and data were collected according to the number of teeth studied, the canal preparation, the irrigant used, the mechanical test used, the root thirds and the type of sealer studied. A qualitative synthesis of the evidence is presented. Conclusions: TotalFill BC sealer and EndoSequence Root Repair Material appear as the calcium silicate-based materials with the highest bond strength to dentin. In addition, using 17% EDTA as a final irrigant increases the bond strength of calcium silicate-based sealers.

Effect of Blood and Synthetic Tissue Fluid on Marginal Adaptation and Surface Microstructure of Different Root-end Filling Materials: A Scanning Electron Microscope Study

Aim: This study aimed to evaluate the effect of blood and synthetic tissue fluid on marginal adaptation and surface microstructure of Mineral trioxide aggregate (MTA) and Endosequence root repair material (ERRM Putty).
 Materials and Methods: Sixty human single-rooted teeth were endodontically treated, and root-end cavities were prepared to 3 mm depth. The teeth were divided randomly into three groups (n = 20) based on the contamination, and each group was again divided into two subgroups (n=10) based on the root-end filling material used.
 Group I (Blood Exposed): The root-end cavities were filled with fresh blood then gently aspirated. The retro cavities were then filled with MTA and ERRM putty and placed in molds containing heparinized blood.
 Group II (STF-Exposed): STF was mixed accordingly and the retro cavities were then filled with STF and then gently aspirated. The cavities were now filled with MTA and ERRM putty and placed in molds containing STF.
 Group III (Control): The root end cavities were not contaminated with any fluid and were filled with MTA and ERRM putty in this group. All samples were viewed Under SEM at 2000x magnification and statistically analyzed with Tukey post hoc test.
 Results: Mean gap width in microns (SEM) was blood with MTA(22.12), followed by blood with ERRM putty (18.89), Control with ERRM putty (14.53), STF with MTA (6.86), Control with MTA (6.85) and STF with ERRM putty (3.78). A significant difference was observed among the three groups (Blood, STF and Control) with gap width in microns (SEM) at 5% level of significance. 
 Conclusions: The samples contaminated with blood showed more gap width, and ERRM putty exhibited better marginal adaptation.

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.

Outcomes of endodontic microsurgery using different calcium silicate–based retrograde filling materials: a cohort retrospective cone-beam computed tomographic analysis

PurposeTo evaluate the outcomes of endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA; Dentsply Sirona, Charlotte, NC, USA), EndoSequence root repair material (RRM putty; Brasseler, Savannah, GA), and injectable Bioceramic (BC) sealer (Brasseler USA) followed by the application of RRM putty (lid technique) as root-end filling materials. MethodsOne hundred and ten patients who underwent EMS between 2016 and 2020 at King Abdulaziz University Dental Hospital were recruited for clinical and radiographic follow-up after a minimum of 1 year. Radiographic assessment was performed using periapical radiographs (PAs) and cone-beam computed tomography (CBCT). Volumetric analysis of periapical radiolucencies (PARLs) was performed using Amira software. ResultsSeventy-nine patients (103 teeth: MTA group, n = 28; RRM putty, n = 41; lid technique, n = 34), attended the follow-up visit, with an average follow-up period of 24 months (recall rate = 74.5%). Of the 103 teeth, 40 were anteriors, 24 were premolars, and 39 were molars. All three groups of retrograde filling materials (MTA, RRM putty, and lid technique) showed high success rates on both PA (85.7, 85.4, 94.1%, respectively) and CBCT imaging (67.9, 75.6, 88.2%, respectively), without any significant difference among the success rates of different materials. Overall, a slight agreement was noted between the PA and CBCT outcomes, with a statistically significant difference (P = 0.029). None of the patient-, tooth-, or treatment-related factors significantly influenced the outcomes of EMS. Adequate density of root canal filling material was significantly associated with a high percentage of completely healed cases on CBCT (P = 0.044). PARL volumes were reduced significantly over 1–4 years follow-up after EMS (P < 0.001)ConclusionsEMS showed high success rates on both PA and CBCT when MTA, RRM putty or lid technique were used as retrograde filling materials. CBCT imaging is more precise than PA in detecting the healing outcomes of EMS.

Effect of Acidic Ph on Push-Out Bond Strength of Various Root Repair Materials – An In vitro Study

ABSTRACT Background: Root repair material ideal characteristics are its ability to adapt to the walls of root canal and avoid leakage of microorganisms and their by-products into the peri-radicular tissue. They should be biocompatible, able to produce osteogenesis and cementogenesis, bacteriostatic, radiopaque, and remain unaffected by blood and moisture. Tissue inflammation and metabolic acidosis following bacterial colonization in pathological condition such as necrotic pulp or periapical abscess lead to change in neutral pH. The pH near periapical tissue lowers to around 5.5. The purpose of this research is to determine the effect of acidic media such as butyric acid on bond strength on mineral trioxide aggregate (MTA), Biodentine (BD), and EndoSequence root repair materials (ERRM) with root dentin wall. Methodology: The research was conducted in Vasantdada Patil Dental College. About 60 extracted teeth without any curve canal were selected. They were further divided into three groups of 20 each. Using diamond saw disc, mid root dentin were sectioned horizontally to thickness of 2.0–2.1 mm, further root repair materials were mixed according to instruction given by manufacturer. Result: The result concluded that push-out bond strength in both phosphate-buffered saline and acidic environment was higher with ERRM. Conclusion: Thickening agent and fillers added in ERRM result in higher push bond strength than MTA and BD.

An in vitro assessment of cytotoxicity and genotoxicity of root repair materials.

The success of the root-end procedure depends on the regeneration of the functional periodontal attachment system, including the cementum on the resected root-end surface, periodontal ligament (PDL), and alveolar bone. As root end filling materials remain in close contact with live periapical tissues, they may influence the endodontic treatment outcome. To assess and compare the cytotoxicity and genotoxicity of three root repair materials, mineral trioxide aggregate (MTA), endosequence, and geristore in human-cultured periodontal ligament fibroblasts. Cultured human periodontal ligament fibroblasts of the third passage were used in the study. They were placed in contact with the root repair materials. The cytotoxic effect on PDL fibroblasts was determined by (3-(4,5-dimethylthiazol-2-yl)-2,5-tetrazolium bromide) assay after 24 hours and 48 hours intervals. Cell viability was determined using an inverted phase contrast microscope. The genotoxic effect on the periodontal fibroblast cells was determined by comet assay using imaging software. Data were analyzed using Tukey's multiple comparison test and Dunnett's multiple test. All the test materials showed higher cytotoxicity and genotoxicity at the 48th hour interval with a statistically significant difference from the control group (P < 0.05). MTA was shown to be least cytotoxic and genotoxic to PDL fibroblasts, followed by endosequence root repair material and geristore at 24 hour and 48 hour intervals. The cytotoxicity and genotoxicity of MTA were the least compared to endosequence and geristore on human-cultured PDL fibroblasts.

Successful Surgical Management of Periapical Cyst with Accidentally Extruded MTA through Open Apex - A Case Report with One Year Follow up

ABSTRACT An immature tooth with a blunderbuss canal presents a challenge in achieving a hermetic seal. Closure of the wide-open apex with materials such as mineral trioxide aggregate (MTA), biodentine, and endosequence root repair material is required to achieve success. Despite following proper methods, the extrusion of filling material into the periapical region is unavoidable. In this case report, due to a lack of apical stop, MTA was extruded unintentionally. Endodontic surgery was performed to remove the extruded MTA and curettage of the apical lesion was done to remove the cystic lining. Follow-up after regular intervals of 1, 3, 6 months, and 1 year showed resolution of periapical radiolucency with radiopaque corticated borders surrounding the radiolucency. This case report describes the successful surgical management of accidentally extruded MTA through large wide-open apex. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Surgical planning involved flap design in collaboration with periodontist for preservation of the interdental papilla.

Comparison of Post-Operative Pain in Mandibular and Maxillary 1st and 2nd Molars after Pulp Capping with Biodentine and Endosequence Root Repair Material as Pulp Capping Agent

Objective: To analyze and compare the response of human pulpal pain with Bio-dentine and Endo-sequence root repair material as pulp capping agents.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Operative Dentistry Department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan,from Feb 2019 to Aug 2020.&#x0D; Methodology: This study was performed on 100 maxillary and mandibular vital permanent molars with symptoms of reversible pulpitis. Patients were divided into two groups, with 50 patients in each group. In Group-A, Bio-dentine was used as a pulp capping agent whereas Endo-sequence root repair material was used for pulp capping in Group-B. Patients of both groups were then recalled after one week, one month and three months. A visual analogue scale was used to record the intensity of pain.&#x0D; Results: In a sample size of 100 patients, 16% were maxillary first molars, 4% were maxillary second molars, 26% were mandibular second molars, and 54% were mandibular first molars. Between Groups A and B, four patients from Group-A (8%) and three patients from Group-B (6%) complained of pain of mild category (1-3), according to VAS. The rest of the patients remained asymptomatic at 1 and 3-months follow-up (p-value=0.695). Hence no significant difference was found in the post-operative pain following pulp capping with Bio-dentine and Endo-sequence root repair material.&#x0D; Conclusion: Bio-dentine and Endo-sequence root repair material has comparable effectiveness. Hence, they can be used as suitable pulp capping agents.

Dislodgement pushout resistance of five bioceramic root-end filling materials.

This study evaluated the dislodgement push-out resistance of five bioceramic materials. One hundred single-rooted teeth with one canal had the apical 3 mm and crown resected to create a 14 mm standardized length. The canals were instrumented to an apical size 80 with a 3 mm root-end preparation made with ultrasonic diamonds. The prepared roots were randomly divided into 5 root-end restorative groups (n=20). ProRoot MTA, Biodentine, EndoSequence Root Repair Material, EndoSequence Fast Set Putty, and EndoSequence BC Sealer with each material placed following manufacturer's instructions and stored at 100% humidity for 2 weeks. An apical-to-coronal static testing load with the identified dislodgement force converted into MPa with mean results analyzed with Kruskal-Wallis and Dunn's post hoc tests (α=0.05). ProRoot MTA and Biodentine displayed similar push-out stress resistance and exhibited significantly greater stress resistance than the similar Endosequence materials. However, all materials failed cohesively and were not dislodged from the root canal surface.

The Influence of New Bioactive Materials on Pulp–Dentin Complex Regeneration in the Assessment of Cone Bone Computed Tomography (CBCT) and Computed Micro-Tomography (Micro-CT) from a Present and Future Perspective—A Systematic Review

The present paper is the first article providing a systematic literature review on the visualization of tertiary dentin influenced by modern bioactive materials in CBCT and micro-CT. Six database searches of studies on tertiary dentin visualization using CBCT produced 622 records in total, and the search of the studies on tertiary dentin using micro-CT produced 502 records in total. The results were thoroughly selected considering the inclusion criteria, and five research papers using CBCT and nine research papers using micro-CT for visualization of tertiary dentin were eventually qualified for the analysis. All the non-randomized and randomized studies presented good and high levels of quality evidence, respectively. Among the bioactive materials used, the most frequently analysed were: MTA, Biodentine dentin matrix hydrogel, Pro Root MTA, and EndoSequence root repair material. The highest thickness of the tertiary dentin was achieved after the use of MTA material in both imaging techniques. The remaining parameters had different results, taking into account the CBCT and micro-CT analysis. The possibilities of the qualitative and quantitative assessment of the particular parameters of tertiary dentin using CBCT and micro-CT techniques were presented and analysed. CBCT and micro-CT analyses can be useful in the assessment of tertiary dentin formed beneath the bioactive material applied during vital pulp treatment. The research argues that the presented results differ depending on the material applied to the pulp, the study duration (4–6 weeks), difference in teeth, species (rats, human), as well as the applied technique and differences in computer software used for the analysis.

Morphological and Chemical Analysis of Different Types of Calcium Silicate-Based Cements.

Objectives Particle size and shape can influence the properties of materials. However, to improve the physicochemical and biological properties of mineral trioxide aggregate (MTA), silicate-based hydraulic cements were introduced. This study aimed to evaluate and compare the major constituents and crystalline structures along with the surface morphology of different types of calcium silicate-based cement (CSC). Materials and Methods Six different types of CSC (white Portland cement, white ProRoot MTA, white MTA Angelus, Biodentine, and Endosequence, both putty and paste) were used in this study. Five samples of each material were analyzed in both uncured and cured cement using scanning electron microscopy/energy-dispersive X-ray (SEM/EDX), X-ray diffraction (XRD), and Fourier transform-infrared spectroscopy (FTIR). Results SEM analysis showed that the surfaces of all materials consisted of particle sizes ranging from 0.194 μm to approximately 51.82 μm. The basic elements found in both uncured and cured cement of all tested materials using EDX were carbon, calcium, silicon, and oxygen. A difference was observed in the presence or absence of magnesium, aluminum, bismuth, zirconium, and tantalum. XRD showed that all tested materials were composed mainly of tricalcium silicate and dicalcium silicate, which are the main components of Portland cement. FTIR analysis showed aromatic rings, phosphine PH, alkyl halides, and alcohol O-H groups in all tested materials but at different wavenumbers. Conclusions The different types of CSCs tested in this study were primarily modified types of Portland cement with the addition of radiopacifiers. ProRoot MTA and MTA Angelus contained bismuth oxide, Biodentine contains zirconium oxide, whereas Endosequence root repair materials (both putty and paste) contained zirconium oxide and tantalum oxide. Endosequence root repair materials showed smaller particle sizes than the other groups. White PC had the most irregular and large particle sizes. CSC had a smaller particle size, except for MTA Angelus. Clinical Relevance. The composition of CSC has a direct influence on the properties of these cements, which may affect the clinical outcome of the treatment.

Pulpal and periapical tissue response after direct pulp capping with endosequence root repair material and low-level laser application

BackgroundThe study aims to investigate the pulp and periapical reaction and healing after capping with EndoSequence Root Repair Material (ERRM) combined with low-level laser application.MethodsIn 6 rabbits, pulps were exposed via class V, half of the samples received a low-level diode laser at 980 nm. Thereafter, cavities were capped with regular-set ERRM. The specimens were processed for histomorphological examination after 2 weeks and two months.ResultsAfter 2 weeks, images show mild inflammation and organized odontoblasts in lased group. The non-lased group shows more severe inflammation. The predentin thickness was thicker in the lased group with statistical significance (p < 0.05). After 2 months, inflammatory cells were sparse in both lased and non-lased groups. In the periapical area, group one showed dilated blood vessels and thick fibrous connective tissues. In group two, there were more numerous maturations of PDL fibers with scattered inflammatory cells and congested blood vessel.ConclusionsUsing low-level laser therapy in combination with ERRM for pulp capping shortens the inflammatory phase and enhances healing.

The effect of low-level laser on the quality of dentin barrier after capping with bioceramic material: Ahistomorphometric analysis.

The study aims to investigate the quality of dentin barriers and pulp reaction to EndoSequence Root Repair Material (ERRM) combined with low-level laser application. In eight dogs, pulps were exposed via class V, half of the samples received low-level diode laser at 870nm. Thereafter, cavities were capped with fast-set or regular-set ERRM. The specimens were processed for histomorphological and immunohistochemical examination after 2weeks and 2months. Dentin bridges were observed in all samples, and 87.5% were complete. The low-level laser group had significantly more reparative dentin area than the non-lased group (p<0.05). The dentin bridges were found to have an unprecedented tubularity of 43%-89%. Tiny dentin island formation was observed within the material particles. Initial mild-to-moderate inflammatory reactions were observed, which subsided after 2months. RUNX2 and osteocalcin staining were evident for all samples at both time intervals. Low-level laser combined with bioactive ERRM is effective in inducing reparative dentin formation.

Comparative Evaluation Of Push Out Bond Strength Of Endosequence Bc Sealer As Against Mta Plus Sealers When Used With Different Obturation Techniques

New technologies have led to the concept of recent bioactive dental materials, which makes the majority of today’s dentists to produce substantial endodontic results. The introduction of advanced material science made tremendous changes in the dental practice. Aim and Objectives : Aim of this study was to assess and compare the push-out bond strength of Endosequence Root Repair Material (ERRM putty), White Mineral trioxide aggregate (WMTA) and Biodentine after incubation in phosphate buffered saline (PBS) for 7 days, 30 days and 45 days. Materials and methods : 90 extracted single rooted human premolar teeth were used in this study. To avoid the desiccation of teeth after extraction, the teeth were kept in hydrogen peroxide solution and washed under tap water. Then the teeth were cleaned with pumice and stored in normal saline at 37˚C until use. The middle 1/3rd portion of each root was sectioned at right angle to the long axis to produce discs of 2.00 ± 0.05 mm thickness using a diamond disc with continuous water irrigation. Finally, 90 root slices were produced. The specimens were dipped in 17% EDTA for 3 min followed by 3 % NaOCl for the same period of time and then rinsed with distilled water and dried. The specimens were divided randomly into 3 groups: Group I- ERRM, Group II - White MTA, Group III- Biodentine. PBS solution was changed every 5 days to replenish the buffering capacity of the PBS. All specimens were incubated at 37ºC. After the completion of experiments, the specimens were sent to the push-out test. Analysis of data was analyzed using descriptive and inferential statistics both. The software SPSS 17.0, EPI_INFO 6.0 version and Graph Pad Prism 5.0 version was used and p&lt;0.05 is considered as level of significance. Result and conclusion : Highest push out bond strength was seen with ERRM at all incubation times followed by mineral trioxide aggregate and Biodentine .It has been observed that increase in the incubation time had increased push-out bond strength of the material significantly.

Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements.

ObjectivesThis study aimed to investigate the color stability, solubility, and surface characteristics of 3 calcium silicate-based cements (CSCs) after immersion in different solutions.Materials and MethodsProRoot white mineral trioxide aggregate (MTA), Biodentine, and Endosequence Root Repair Material (ERRM) were placed in cylindrical molds and stored at 37°C for 24 hours. Each specimen was immersed in distilled water, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine, or 0.1% octenidine hydrochloride (OCT) for 24 hours. Color changes were measured with a spectrophotometer. Solubility was determined using an analytical balance with 10−5 g accuracy. The surface characteristics were analyzed using scanning electron microscopy and energy-dispersive spectroscopy. Data were analyzed using 2-way analysis of variance, the Tukey test, and the paired t-test.ResultsMTA exhibited significant discoloration in contact with NaOCl (p < 0.05). White precipitation occurred on the surfaces of Biodentine and ERRM after contact with the solutions, and none of the materials presented dark brown discoloration. All materials showed significant solubility after immersion in the solutions (p < 0.05), irrespective of the solution type (p > 0.05). The surface topography and elemental composition of the samples showed different patterns of crystal formation and precipitation depending on the solution type.ConclusionsAll materials presented some amount of solubility and showed crystal precipitation after contact with the solutions. Biodentine and ERRM are suitable alternatives to ProRoot MTA as they do not exhibit discoloration. The use of OCT can be considered safe for CSCs.

Comparative evaluation of the apical leakage of different bioceramic retrofilling materials with and without smear layer: A stereomicroscopic study.

Present in-vitro study aimed to evaluate the apical leakage of different bioceramic retrofilling materials with and without smear layer. : Sixty human single-rooted teeth were decoronated at a standardized root length of 13 mm, chemo-mechanically prepared and obturated. After obturation, root-end resection was done and root-end cavities were prepared using ultrasonic tips. The specimens with prepared retro cavities were randomly assigned into 2 groups (n = 30) based on the smear layer removal protocol used. Each group was further subdivided into 3 subgroups (n = 10) based on the bioceramic retrofilling material MTA (Mineral Trioxide Aggregate; Proroot Dentsply/Tulsa), CEM (Calcium-Enriched Mixture; Bionique Dent, Tehran) and ERRM (EndoSequence® Root Repair Material; Brasseler USA, Savannah, GA). The extension of dye (2% Rhodamine B) penetration was measured in millimetre using a stereomicroscope at 10× zoom. Results were statistically analysed using one-way ANOVA (analysis of variance) test and unpaired Student's t test. In the presence of smear layer, MTA demonstrated maximum mean apical leakage value (1.70 ± 0.30), followed by CEM (1.40 ± 0.37) and ERRM (1.40 ± 0.23), which was statistically not significant. Without the smear layer, ERRM demonstrated the least mean apical leakage value, which was statistically significant as compared with CEM (P <.05) and MTA (P <.01). : All bioceramic retrofilling materials demonstrated apical leakage irrespective of the presence or absence of the smear layer. The presence of a smear layer is beneficial for the sealing ability of MTA and CEM, whereas, the absence of the smear layer is advocated while using ERRM.

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

In vivo comparison of bioceramic putty and mineral trioxide aggregate as pulpotomy medicament in primary molars. A 12-month follow-up randomized clinical trial

Pulpotomy is one of the common vital pulp therapy procedures for primary molars. The present trend in pulpotomy materials is to use regenerative materials that promote dentinogenesis. Mineral trioxide aggregate (MTA) is a very popular pulpotomy material. However, it has some limitations including difficult handling characteristics and long setting time. Tricalcium silicate cements evolved, in which bioceramic cements came into existence, have better properties than MTA. The aims and objectives of the study are to evaluate the efficacy of bioceramic putty with MTA as a pulp medicament in primary molars. In this randomized in vivo study, sixty primary molars in children aged 4-9 years indicated for pulpotomy were selected. They were assigned using nonprobability convenient sampling technique into two groups: test group - bioceramic putty (EndoSequence Root Repair Material) and control group - MTA (Angelus). After pulp therapy, teeth were restored with stainless steel crowns. Recall clinical and radiographic evaluation was done at 3-, 6-, and 12-month interval to assess success rate. The data were statistically analyzed using Chi-square test, and P ≤ 0.05 was set for statistical significance. At 3-month interval, the success rates were 96.7% and 93.1% with bioceramic and MTA groups, respectively. At 6- and 12-month interval, the success rates were 93.3% and 93.1% with bioceramic and MTA groups, respectively. However, the difference in success rate between the groups was statistically not significant at all the time intervals (P = 0.533 at 3 months, P = 0.972 at 6 and 12 months). Bioceramic putty exhibited comparable results to MTA. Hence, it can be considered alternative pulpotomy agent.