EndoSequence Root Repair Material Research Articles

Analysis of Stability in Time of Marginal Adaptation of Endosequence Root Repair Material on Biological Samples

Introduction: The introduction of mineral trioxide aggregate (MTA) and bioceramic sealers increased the success rate of endodontic surgery and perforation repair. The aim of this study was to evaluate the marginal adaptation at different times of endosequence root repair material (ERMM) in order to evaluate its dimensional stability using variable pressure-scanning electron microscope (VP-SEM). Material And Methods: Fourty-eight teeth were selected shaped up to a master apical size of 25. Then a 3 mm cut perpendicular to the long axis and a retrograde cavity preparation were performed. In order to obtain 2 mm thick sample a second cut was done and, in this disk, ERMM was inserted. The samples were stored at 37°. The samples were divided into four time-depending groups observed with VP-SEM at time 0 (Group 1) and after 2 (Group 2), 7 (Group 3) and 30 days (Group 4) after ERRM setting. Statistical analysis with one way-ANOVA test was performed (95%). Results: None of the four groups analyzed showed a complete marginal adaptation between dentin and ERRM. Instead, in all groups ERRM exhibited a completely preserved marginal adaptation to the dentin wall in all time-dependent groups. The mean (±SD) gap value was for time 0, 3.91 (±2.55) µm after 2 days, 4.32 (±2.69), after 7 days 4.49 (±2.53), and after 30 days 4.81 (±2.85) µm. No statistically significant difference was found between the four groups. Conclusions: The results of the present study demonstrate the dimensional stability over time of ERMM.

COMPARISON OF MINERAL TRIOXIDE AGGREGATE, ENDOSEQUENCE ROOT REPAIR MATERIAL, AND BIODENTINE USED FOR REPAIRING ROOT PERFORATIONS: A SYSTEMATIC REVIEW

The root perforation, in spite of being taken as a challenging accident in root canal treatment, has to offer favorable results when exposed to appropriate therapeutic conduct and the usage of materials that have convenient properties. The aim of the current review is to collect all updated and available studies including imperative information concerning the use of Mineral trioxide aggregate, EndoSequence root repair material and Biodentine in the treatment of root perforation approaching some of the key properties for treatment success. A search was performed in the two automated databases (Google Scholar and PubMed use English-language literature) for this systematic review, using specific inclusion and exclusion criteria and keywords. The electronic search was done in December 2018 and update in June 2019. Our inquiry uncovered Twenty-two studies that met the exclusion and inclusion criteria. These studies investigated the use of MTA, EndoSequence ERRM and Biodentine in the root perforation that happened during the endodontic treatment. It was confirmed that there is no unanimity in this review concerning the material that shows the best characteristics, once none of the materials discussed had all the major properties higher than the others, this way it is required the enforcement of further studies aimed at selecting the best characteristics of the material suggested in the root perforation treatment.

Morphological and Spectroscopic Study of an Apatite Layer Induced by Fast-Set Versus Regular-Set EndoSequence Root Repair Materials.

This study aimed to evaluate the morphology and chemistry of an apatite layer induced by fast-set versus regular-set EndoSequence root repair materials using spectroscopic analysis. Holes of a 4 mm diameter were created in the root canal dentin, which were filled with the test material. Fetal calf serum was used as the incubation medium, and the samples incubated in deionized water were used as controls. The material-surface and material-dentin interfaces were analyzed after 28 days using Raman and infrared spectroscopy, scanning electron microscopy/energy dispersive X-ray, and X-ray diffraction. After incubation in fetal calf serum, both materials formed a uniform layer of calcium phosphate precipitate on their surfaces, with the dentinal interface. This precipitated layer was a combination of hydroxyapatite and calcite or aragonite, and had a high mineral maturity with the regular-set paste. However, its crystallinity index was high with the fast-set putty. Typically, both consistencies (putty and paste) of root repair material have an apatite formation ability when they are incubated in fetal calf serum. This property could be beneficial in improving their sealing ability for root canal dentin.

A Comparison of Solubility of Endosequence Root Repair Material Fast Set Putty and Mineral Trioxide Aggregate: An in Vitro Study

A Comparison of Solubility of Endosequence Root Repair Material Fast Set Putty and Mineral Trioxide Aggregate: An in Vitro Study

Shear Bond Comparison between 4 Bioceramic Materials and Dual-cure Composite Resin

IntroductionBioceramic materials have shown biologic and physical properties favorable for regenerative treatment. A key to treatment success is an adequate restoration to prevent microleakage; however, research is limited regarding the bond strength between restorative and bioceramic materials used in regenerative procedures. This study compared the bond strength between 4 bioceramic materials and a dual-cure composite resin. MethodsEighty wells in Teflon (ePlastics, San Diego, CA) blocks were filled with bioceramic materials representing 4 groups: White ProRoot mineral trioxide aggregate (MTA) (Dentsply Tulsa Dental, Tulsa, OK), Biodentine (Septodont, Saint Maur des Fosses, France), EndoSequence Root Repair Material Fast Set Putty (Brasseler USA, Savannah, GA), and NeoMTA (Avalon Biomed Inc, Houston, TX). After allowing samples to set according to the manufacturers’ instructions, exposed surfaces of the bioceramic materials were prepared using ClearFil SE Bond (Kuraray America, Inc., New York, NY) followed by restoration with ClearFil DC Core Plus (Kuraray America, Inc.). To test shear bond strength, each block was secured in a universal testing machine, and the crosshead was advanced at 0.5 mm/min until fracture. Newton peak force was recorded and megapascals calculated followed by data comparison. ResultsThe mean shear bond strengths between ClearFil DC Core Plus and the bioceramic materials were as follows: White ProRoot MTA, 7.96 MPa; Biodentine, 9.18 MPa; EndoSequence Root Repair Material Fast Set Putty, 4.47 MPa; and NeoMTA, 5.72 MPa. White ProRoot MTA and Biodentine were statistically similar, with a higher stress bond strength than NeoMTA, which had a statistically greater bond strength than EndoSequence Root Repair Material. All these values were lower than typical bond strengths shown for dentin–composite resin bonding. ConclusionsThe choice of which bioceramic material to use in regenerative procedures should be based on factors other than the bond between that material and the overlying coronal resin restoration.

Effects of newly-developed retrograde filling material on osteoblastic differentiation in vitro.

The aim of this study was to compare chemical properties and bioactivities of with mineral trioxide aggregate (MTA) and EndoSequence Root Repair Material (ERRM). After setting, surfaces of test materials were observed by scanning electron microscope (SEM). The pH and cell viability of materials were tested. Osteoblastic differentiation and alkaline phosphatase (ALP) activity were measured by quantitative real-time PCR and ALP staining. MTA showed spindle-shaped crystals while ERRM showed round-shaped crystals of various sizes. ERRM presented lower pH than MTA. Both materials showed good cell viabilities compared to the control. Expression levels of osteoblastic genes and ALP staining were increased significantly (p<0.05) in ERRM and MTA groups compared to those in the control group. In conclusion, ERRM and MTA both had effects on osteoblastic differentiation. Therefore, ERRM can be used as a desirable alternative to MTA for root-end filling material.

Induction of Osteogenic Differentiation of Mesenchymal Stem Cells by Bioceramic Root Repair Material.

This study aimed to evaluate the osteogenic activity of Endosequence Root Repair Material (ERRM) putty using rat mesenchymal stem cells (MSCs). The extract of set ERRM and ProRoot-mineral trioxide aggregate (MTA) (control) was cocultured with rat MSCs and incubated for one, three, and seven days. The cell viability and proliferation were assessed. A quantitative real-time polymerase chain reaction for bone morphogenetic protein-2 (BMP-2), alkaline phosphatase, bone sialoprotein, and osteocalcin gene expression was performed. Both materials enhanced cell viability and proliferation, which increased over time. On day seven, the cells treated with either material exhibited significantly greater cell viability compared with control untreated cells. MSCs treated with either material showed deeper alkaline phosphatase staining after three days compared to control untreated cells. Treated MSCs also exhibited upregulation of the gene expression of bone morphogenetic protein-2, alkaline phosphatase, bone sialoprotein, and osteocalcin. Both ERRM and ProRoot-MTA enhance the osteogenic differentiation of MSCs.

CYTOTOXICITY OF REGULAR AND FAST SET BIOCRAMIC MATERIALS

Aim: To compare the cytotoxic effect of regular and fast set Root Repair Materials using oral epithelial cells (OEC).Materials and methods: The cytotoxicity of the two forms was tested against OEC cells using Sulfo-rhodamine B (SRB) assay. The cells were exposed to the test compound for 72 hrs. Results: Both fast and regular set root repair materials showed a considerable cytotoxicity against OEC cells with IC50 of 3.0 and 3.4 μg/ml, respectively. Despite their moderate cytotoxic effect, the resistant fraction was relatively high for Fast and regular root repair composites (R-values equal 35.6% and 32.2%, respectively). Conclusions: Both fast and regular set of EndoSequence Root Repair Materials have a considerable cytotoxicity against OEC cells. Despite their moderate cytotoxic effect against the cells the resistant fraction was relatively high for both.

Effect of Irrigants on the Push-Out Bond Strength of Two Bioceramic Root Repair Materials

The purpose of this study was to compare different irrigants’ effect on two EndoSequence root repair materials’ push-out bond strength. Sixty root slices were filled either with EndoSequence premixed fast-set putty or regular-set paste, and then immersed either in sodium hypochlorite, chlorhexidine gluconate, or saline (as control) for 30 min, after which the slices were subjected to the push-out test. The surface structures were evaluated with Scanning Electron Microscopy and Fourier Transform Infrared. Fast-set putty exhibited greater displacement resistance when immersed in saline and subjected to adhesive failure mode, while regular-set paste showed greater resistance when immersed in chlorhexidine and subjected to cohesive failure mode. Infrared analysis showed changes in organic filler, and carbonate and phosphate bands after using irrigants. The lowest carbonate/phosphate ratio was found for chlorhexidine in both materials. Therefore, sodium hypochlorite reduced EndoSequence root repair materials’ displacement resistance markedly.

Outcome of Endodontic Microsurgery Using Mineral Trioxide Aggregate or Root Repair Material as Root-end Filling Material: A Randomized Controlled Trial with Cone-beam Computed Tomographic Evaluation

IntroductionThe purpose of this randomized clinical trial was to evaluate healing after endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA) versus EndoSequence root repair material (RRM; Brasseler, Savannah, GA) as root-end filling materials. MethodsTwo hundred forty-three teeth with persistent or recurrent apical periodontitis were randomly assigned to either the MTA or RRM group. EMS was performed, and follow-up visits with clinical and radiographic investigation were scheduled at 6, 12, and 24 months with follow-up cone-beam computed tomographic (CBCT) imaging after 12 months. ResultsOne hundred twenty teeth with an average follow-up of 15 months were evaluated. The overall success rate was 93.3% for periapical (PA) evaluation and 85% for CBCT evaluation. The RRM group exhibited 92% and 84% success rates as assessed on PA and CBCT imaging, respectively. The MTA group exhibited 94.7% and 86% success rates as assessed on PA and CBCT imaging, respectively. No significant difference was observed between the 2 groups. Microsurgical classification, root canal filling quality, root-end filling material depth, and root fracture were found to be significant outcome predictors. ConclusionsEMS is a predictable procedure with successful outcome both 2-dimensional and 3-dimensional radiographic evaluation when RRM or MTA was used as the root-end filling material.

The effect of different chelating agents on the push-out bond strength of proroot mta and endosequence root repair material.

This study aimed to evaluate the effects of 17% ethylenediaminetetraacetic acid (EDTA), 7% maleic acid (MA), and 10% citric acid (CA) on the push-out bond strength of ProRooT MTA and Endosequence Root Repair Material (ERRM) putty. Eighty single-rooted extracted human teeth were instrumented to obtain a standardized immature teeth model. Based on the chelating agents tested, the specimens were randomly divided into three experimental groups: Group 1 (17% EDTA), Group 2 (7% MA), Group 3 (10% CA), and Group 4 (Positive Control) (n=20 for each group). Each group was further classified into two subgroups: Group A (ProRoot MTA) and Group B (Endosequence Root Repair Material (ERRM) putty) (n=10 for each subgroup). After irrigation and placement of cements, teeth were stored at 37°C and in 100% humidity for a week. A total of 240 dentine discs (three discs per teeth) were obtained and subjected to push-out assay. Data was analyzed using two-way analysis of variance and Tukey's post hoc t-test. Both types of chelating agent and calcium silicate-based cement were significantly associated with the push-out bond strength values. The push-out bond strength was significantly less for CA as compared to EDTA or MA. ERRM had higher bond strength values than ProRoot MTA (p<0.05). The use of chelating agents increased the push-out bond strength of CSC. Regardless of tested chelating agents, ERRM had higher bond strength values than ProRoot MTA.

Micro‐XRD and nanoindentation investigation of bioceramics for dental pulp therapy

AbstractTherapeutic bioceramics for dental pulp treatment are an area of active research. This study investigated the phases in two commonly used bioceramics and depth of dentin remineralization after application of these bioceramics. Cavities in non‐carious third molars were filled with ProRoot White mineral trioxide aggregate (MTA) (Dentsply Tulsa Dental), EndoSequence Root Repair Material (Brasseler USA) and with calcium hydroxide (Dycal, Dentsply Caulk) serving as a control. Specimens were immersed in simulated body fluid (SBF) for 3 months, and Micro‐X‐ray diffraction (Micro‐XRD) analyses were performed on the bioceramics two minutes after placement and at seven subsequent intervals. After three months in SBF, specimens were subjected to nanoindentation testing. Micro‐XRD revealed the presence of dicalcium silicate, tricalcium silicate, tricalcium aluminate and calcium sulphate in both bioceramics. Opacifying agents bismuth oxide and zirconia were also detected in ProRoot White MTA and EndoSequence Root Repair Material, respectively. There was no evidence for the silicate gel matrix that forms during setting of these bioceramics. Nanoindentation testing revealed that at &lt;17 µm from the interface, the nanohardness of dentin in specimens filled with Dycal was lower than for EndoSequence and ProRoot White MTA, whereas at 21–97 µm from the interface, there was no significant difference in nanohardness of dentin filled with any material.

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.

Comparison between iRoot BP Plus (EndoSequence Root Repair Material) and Mineral Trioxide Aggregate as Pulp-capping Agents: A Systematic Review.

Introduction:iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent.Materials and Methods:A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected.Results:A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate.Conclusion:iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation.

Comparative evaluation of the effect of various endodontic irrigants on the push-out bond strength of endosequence, Biodentine™, and MTA Plus™ root repair materials: An in vitro study

Aim: This study aimed to evaluate and compare the effects of 2% chlorhexidine and 3% sodium hypochlorite (NaOCl) irrigating solutions on the push-out bond strength of EndoSequence, Biodentine™, and MTA Plus™ root repair materials. Materials and Methods: Teeth were decoronated, and the midroot was sectioned horizontally into slices with the thickness of 2.0 mm with the help of diamond discs. The canal space was enlarged to diameter of 1.4 mm with the help of Gates-Glidden Drill. The samples were divided into three groups (n = 12). EndoSequence, Biodentine™, and MTA Plus™ root repair materials were condensed in the canal space and allowed to set for 10 min. The three groups were further subdivided into two subgroups each. Each material was immersed in NaOCl and chlorhexidine gluconate (CHX), respectively, for 30 min, rinsed with distilled water, and allowed to set for 48 h at 37°C with 100% humidity in an incubator. The push-out bond strength value was then measured using a universal testing machine. Data obtained were statistically analyzed. Results: EndoSequence root repair material (ERRM) proved to have the highest push-out bond strength followed by Biodentine™ and MTA Plus™ root repair materials. In subgroups, CHX in contact with ERRM showed the highest push-out bond strength followed by NaOCl, whereas Biodentine™ when in contact with NaOCl showed more push-out bond strength than when in contact with CHX. MTA Plus™ in contact with CHX showed the least push-out bond strength. Conclusion: The push-out bond strength of ERRM significantly increased after exposure to NaOCl and has the highest push-out bond strength followed by Biodentine™, and MTA Plus™ has the least push-out bond strength.

Evaluation of Biocompatibility and Osteogenic Potential of Tricalcium Silicate–based Cements Using Human Bone Marrow–derived Mesenchymal Stem Cells

IntroductionThe success of endodontic regeneration lies in the appropriate combination of stem cells and bioactive materials. Several novel dental materials are available on the market in this regard. Hence, the current study aimed to evaluate the proliferation, differentiation, and osteogenic potential of human bone marrow–derived mesenchymal stem cells (hBMSCs) onto biomaterials like ProRoot MTA (MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (BD; Septodont, Saint Maur de Fosses, France), and EndoSequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA). MethodsDental cements were formulated into discs and assessed for their biocompatibility. hBMSCs were used to study biocompatitibility and the proliferative and osteogenic potential of these dental cements. A live dead assay was performed using confocal microscopy to study the biocompatibility, proliferation, and cell attachment property of the cements. An 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was also performed on days 1, 3, 5, and 7 to study growth kinetics. The osteogenic potential of these cements was studied by inducing hBMSCs over them using osteogenic differentiation medium (assessed by alkaline phosphatase assay). ResultsERRM and MTA have shown the best biocompatibility among the tricalcium silicate materials used with no significant difference between them. Both have shown significantly higher osteogenic bioactivity than BD. All 3 tricalcium silicate cements support good adherence of hBMSCs. ConclusionsAll of the dental cements used in this study are biocompatible with the potential to induce proliferation and osteogenic differentiation of hBMSCs. Therefore, the newly introduced ERRM can be the material of choice in various endodontic applications.

Effect of intracanal medicaments used in endodontic regeneration on the push-out bond strength of a calcium-phosphate-silicate-based cement to dentin.

Objective:To evaluate the effects of various endodontic regeneration agents on the push-out bond strength of Endosequence Root Repair Material (ERRM) to root-canal dentin.Methods:Fifty single-rooted human teeth were selected and instrumented to obtain a standard internal diameter of 1.5 mm. Specimens were randomly divided into four experimental groups and treated with an intracanal medicament [calcium hydroxide (CH), double antibiotic paste (DAP), triple antibiotic paste (TAP), TAP with amoxicillin (mTAP)] and a non-treated control group. Medicaments were removed after three weeks, and ERRM was applied to all specimens. The coronal portion of each root was then sliced into 2-mm-thick parallel transverse sections (2 slices per tooth, n=20 slices per group), and a push-out test was used to measure the bond strength of ERRM to dentin. Data were analyzed using Bonferroni-corrected Mann-Whitney tests, with the level of significance set at p<0.05.Results:The push-out bond strength of the CH group was significantly higher than that of the TAP, DAP and mTAP groups (p< 0.005). Furthermore, the bond strength of the control group was higher than the bond strength of both the DAP and mTAP groups.Conclusion:The use of CH in clinical practice may help improve the adhesion of ERRM to dentin.

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 Root Repair Materials and Bioactive Glasses on Microhardness of Dentin.

Introduction:The use of bioactive glasses to re-establish or increase mechanical properties of the root dentin may be an interesting alternative. The aim of this study was to evaluate the effect of root repair materials and bioactive glasses on the microhardness of human root dentin. Methods and Materials:Sixty-four sectioned palatal roots of human molars were prepared and two slices were obtained of the middle third of each root (one corresponding to the control group, without treatment, and the other to the experimental group). The pairs of slices were randomly divided into four groups (n=16). The root canal of experimental slices were filled with one of the following materials: mineral trioxide aggregate (Angelus MTA, Angelus, Londrina, Paraná, Brazil), EndoSequence Root Repair Material (ERRM, Brassler, Savannah, GA, USA), Bioglass (45S5) and an experimental niobophosphate glass (NbG). The specimens were stored in an oven at 37ºC, in an environment with 100% humidity for 60 days. The specimens were subjected to a microhardness test. Four indentations were made at a distance of 20 µm from the root canal lumen. For microhardness analysis, comparing the experimental groups and their respective controls, the Student’s-t test was applied. For comparison of the percentage increase in microhardness between the groups, the data were statistically analyzed by using One-way ANOVA and Tukey’s test. The level of significance was set at 0.05. Results:All the materials significantly increased the dentin microhardness values (P<0.05). MTA showed a higher increase in microhardness (94.8±42.7%), similar to that of EndoSequence (62.3±39.9%). The 45S5 (46.5±30.0%) and NbG (53.8±31.3%) showed the lowest percentages of increase in microhardness, but were statistically similar to those of EndoSequence. Conclusion:All the materials tested were capable of increasing root dentin microhardness.

The effect of intracanal placement of various medicaments on the bond strength of three calcium silicate-based cements to root canal dentin

This study aimed to evaluate the effect of intracanal placement of various medicaments on the bond strength of ProRooT MTA, Biodentine, and Endosequence root repair material (ERRM) putty. Ninety extracted human mandibular premolar teeth were decoronated and instrumented using Protaper Next rotary system and #1 to #6 Peeso reamers. The prepared teeth were randomly divided into six groups according to the intracanal medicaments: Group 1: double antibiotic paste (DAP) consisting of metronidazole and ciprofloxacin; Group 2: Triple antibiotic paste (TAP) with cefaclor; Group 3: TAPwith clindamycin; Group 4: amoxicillin and clavulanic acid (Augmentin®); Group 5: calcium hydroxide (CH); Group 6: control (no medicament) (n = 15). Parallel transverse sections were obtained in the coronal to the apical direction (4 slices/ tooth) and were divided into three subgroups according to the cements: Group A: ProRoot MTA; Group B: Biodentine; Group C: ERRM (n = 20 slices/subgroup). A push-out test was used to measure bond strength. Data were analyzed using two-way analysis of variance and Tukey’s post hoc test. The bond strength was significantly lower for DAP and TAPs than for Augmentin®, CH, or the control (p < 0.05). Biodentine and ERRM had significantly higher bond strength values than ProRooT MTA (p < 0.05) regardless of the intracanal medicaments tested, while no significant difference existed between Biodentine and ERRM (p > 0.05). While the application of DAP or TAPs decreased the bond strength, application of CH or Augmentin® did not. ERRM and Biodentine had higher bond strength values than ProRoot MTA.