Epoxy Resin-based Root Canal Sealer Research Articles

The effect of bioactive glass-based, bioceramic based and epoxy amine resin based root canal sealers on post-obturation pain: A double blinded randomized controlled trial.

The aim of this study was to compare the effect of two calcium silicate-based and an epoxy resin-based root canal sealers on postoperative pain and analgesic intake following single-visit root canal treatment. Ninety patients with at least one first or second molar tooth diagnosed as symptomatic irreversible pulpitis and symptomatic apical periodontitis were selected and allocated into three groups (n=30) according to the sealer used. Root canals were prepared using Protaper Gold instruments (Dentsply Sirona) in a crown down technique and irrigated with 2.5% NaOCl (Calyx, India) and saline solution. Root canal filling was then accomplished with a single cone obturation technique and treated in a single visit by the same endodontist. Patients were told to use a Visual Analog Scale (VAS) to rate their postoperative pain severity as none, minimal, moderate, or severe after 6 h, 24 h, 48 h, 5 days and 7 days following obturation using the appropriate sealers. The need for analgesic intake was also recorded. The data were statistically analyzed. Results showed a significant difference among the studied groups. Bio-C Sealer Ion+ reported the least pain score followed by Nishika Canal Sealer BG and AH plus sealer at all the time intervals recorded. The intergroup analysis, revealed was a significant difference in postoperative pain at 6 h (p=0.000) and 24 h (p = 0.028), but not at 48 h, 5 day or 7 days (P > 0.05). VAS ratings for all the three groups decreased over time. Also, there were significant differences between the means of analgesic intake among 3 groups (p=0.022). Analgesic intake in group BIO-C Sealer Ion+ is significantly lesser than AH Plus and Nishika Canal Sealer BG group. Calcium silicate-based sealer (Nishika Canal Sealer BG and Bio-C Sealer Ion+) resulted in significantly lower levels of pain as compared to epoxy resin-based sealer (AH Plus) at 6h and 24-h interval, there was no significant difference in postoperative pain occurrence at 48-h, 5 day and 7-day period. The analgesic intake in Bio-C Sealer Ion+ group is significantly lesser than Nishika Canal Sealer BG and AH Plus group.

Epoxy resin-based root canal sealers: An integrative literature review.

The correct obturation of the root canal system achieved by means of a core and a cement is essential for the success of endodontic treatment. There are several root canal cements (RCCs) on the market; however, because of their excellent characteristics, epoxy resin-based sealers (ERBSs) have been widely used. The main aim of this review was to analyze and integrate the available information on different ERBSs. An electronic search was performed in the PubMed and Scopus databases, using "epoxy resin" AND "root canal treatment", and "epoxy resin" AND "endodontics" as search terms. In general, ERBSs have good flow properties, film thickness, solubility, dimensional stability, sealing capacity, and radiopacity. They are also able to adhere to dentin while exhibiting low toxicity and some antibacterial effects. However, their main disadvantage is the lack of bioactivity and biomineralization capability. A large number of ERBSs are available on the market, and AH Plus keeps being the gold standard RCC. Yet, information on many of them is limited or non-existent, which could be due to the fact that some of them are relatively new. The latter emphasizes the need for relevant research on the physicochemical and biological properties of some ERBSs, with the aim of supporting their clinical use with sufficient evidence via prospective and long-term studies.

Evaluation of push-out bond strength, dentinal tubule penetration and adhesive pattern of bio-ceramic and epoxy resin-based root canal sealers.

Root canal sealing materials play a crucial role in an endodontic procedure by forming a bond between the dentinal walls and the gutta-percha. The current study aims to analyse the dentinal tubule penetration and adhesive pattern, including the push-out bond strength of six commercially available root canal sealers. Eighty-four mandibular first premolars were split into seven groups (and n = 12), Group 1: Dia-Root, Group 2: One-Fil, Group 3: BioRoot RCS, Group 4: AH Plus, Group 5: CeraSeal, Group 6: iRoot SP, Group 7: GP without sealer (control). Two groups were made, one for dentinal tubule penetration and the other for push-out bond strength; the total sample size was one hundred sixty-eight. Root canal treatment was performed using a method called the crown down technique, and for obturation, the single cone technique was used. A confocal laser scanning microscope (Leica, Microsystem Heidel GmbH, Version 2.00 build 0585, Germany) was used to evaluate dentinal tubule penetration, and Universal Testing Machine was utilised to measure the push-out bond strength (Shimadzu, Japan) using a plunger size of 0.4 mm and speed of 1mm/min. Finally, the adhesive pattern of the sealers was analysed by HIROX digital microscope (KH-7700). Statistical analysis was carried out by a one-way Anova test, Dunnet's T3 test, and Chi-square test. Highest dentinal tubule penetration was noticed with One-Fil (p<0.05), followed by iRoot SP, CeraSeal, AH Plus, Dia-Root also, the most negligible value was recorded for BioRoot RCS. Meanwhile, BioRoot RCS (p<0.05) demonstrated the greater value of mean push-out bond strength, followed by One-fil, iRoot SP, CeraSeal, AH Plus and Dia-Root. Regarding adhesive pattern, most of the samples were classified as type 3 and type 4 which implies greater sealing ability and better adherence to the dentinal wall. However, BioRoot RCS revealed the most type 4 (p<0.05), followed by AH Plus, One-Fil, CeraSeal and Dia-Root. The highest dentinal tubule penetration was shown by One-Fil compared to other groups. Meanwhile, BioRoot RCS had greater push-out bond strength and more adhesive pattern than other tested materials.

Comparative evaluation of the effect of calcium silicate and epoxy resinbased root canal sealers on postoperative pain in patients with primary endodontic lesion: A randomized clinical study.

This study's objective was to assess and compare postoperative pain response between bioceramic sealer (Nishika BG) and epoxy resin based (AH Plus) in patients with primary endodontic lesion at time interval of 24 h, 48 h, and 7 days using the Visual Analog Scale (VAS). The study included 40 individuals with necrotic pulp and apical periodontitis. Calcium hydroxide was administered as the intracanal medication during the two-visit endodontic therapy. They were subsequently allocated randomly to either the AH Plus root canal sealer or the Nishika Canal Sealer BG, with a total of 20 participants in each group. Patients were told to use a VAS to rate their postoperative pain severity as none, minimal, moderate, or severe after 24 h, 48 h, and 7 days following obturation using the appropriate sealers. Nishika Canal Sealer BG (CS-BG) has a lower pain score as compared to the AH Plus group at 24-h time point. VAS ratings for both the groups decreased over time. According to the intergroup analysis, there was a significant difference in postoperative pain at the 24 h (P = 0.022), but not at the 48 h or 7 days (P > 0.05). Although bioceramic sealer (Nishika Canal Sealer BG) resulted in significantly lower levels of pain as compared to epoxy resin-based sealer (AH Plus) at 24-h interval, there was no significant difference of postoperative pain at 48-h interval and 7-day period.

A confocal laser scanning microscopic evaluation of nonthermal atmospheric plasma on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers.

Using confocal laser scanning microscopy (CLSM), the current study assessed the impact of nonthermal atmospheric plasma (NTAP) on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers (CLSM). Forty human mandibular premolar teeth with a single root that had just undergone extraction were chosen and biomechanical preparation of root canals was done with ProTaper Gold rotary Nickel-titanium instruments. Samples were divided into four groups (n = 10). Group 1: Bioceramic sealer (BioRoot RCS); Group 2: Epoxy resin-based sealer (AH Plus) without application of NTAP; Group 3: Bioceramic sealer (BioRoot RCS); and Group 4: Epoxy resin-based sealer (AH Plus) with the application of NTAP for 30 s. In Groups 3 and 4, all of the samples underwent obturation with the appropriate sealers following NTAP application. For determination of the sealer's dentinal tubule penetration values, slices with a thickness of 2 mm were taken from the middle third of sample's root and examined using CLSM. The acquired data were statistically analyzed with one-way analysis of variance and the Post hoc Tukey's test. The cutoff for statistical significance was P < 0.05. In comparison to other groups, the maximum sealer penetration values into dentinal tubules were significantly higher in Group 3 for Bioceramic sealer with NTAP application and Group 4 for Epoxy resin-based sealer with NTAP application. NTAP application increased the dentinal tubule penetration of bioceramic and epoxy resin-based sealers in comparison to groups without NTAP application.

Influence of bioceramic intracanal medication on the bond strength of bioceramic root canal sealer.

To investigate the influence of the remaining volume of a new intracanal medication based on bioceramic compounds on the bond strength (BS) and formation of an adhesive interface between calcium silicate-based and epoxy resin-based root canal sealers. For this purpose, the specimens were distributed according to the intracanal medication (n = 26): Bio-C Temp (BCT) and Ultracal XS (UXS). The roots were scanned in microCT, and after 7 days, the medication was removed. Then a new scan was performed to evaluate the volume of medication remaining. Subsequently, 40 specimens were redistributed into 2 subgroups (n = 10) and filled according to the sealer used: AH Plus (AHP) and Bio-C Sealer (BCS), to assess the bond strength by using the push-out test, and the adhesive interface by confocal laser fluorescence microscopy (CLSM) and scanning electron microscopy (SEM). The t test showed a smaller remainder of BCT (1.77 ± 0.86) compared with UXS (10.47 ± 5.78), irrespective of the root third evaluated. The BS showed that teeth with BCT + BCS had higher bond strength values (3.70 ± 1.22) when compared to the other groups: BCT + AHP (2.15 ± 1.07), UXS + BCS (3.18 ± 1.09) and UXS + AHP (2.11 ± 1.02) (p<0.001). The cervical third had higher BS when compared with the middle and apical thirds (p < 0.001), and higher number of adhesive failures. The adhesive interface in SEM and CLSM images showed better adaptation for the association between BCT + BCS. Intracanal medication and silicate-based endodontic sealer appeared to interact chemically by forming a biomineralizing layer, allowing for an increase in the bond strength and forming an adhesive interface between the materials, with no or less gap formation.

PH influences the volumetric change of calcium silicate- and epoxy resin-based root canal sealers: An ex vivo micro-CT study.

This study assessed the influence of pH variation on the volumetric change of EndoSequence BC Sealer compared to AH Plus Jet. Eighteen single-rooted teeth were uniformly prepared and filled with one of the sealers. After 24-h storing, samples were scanned in a micro-CT device. Then, roots were immersed in 20 ml phosphate-buffered saline (PBS) with pH of 5, 7 or 12 at 37°C for 7 and 30 days and rescanned. Statistical analysis was performed using Shapiro-Wilk's test, one-way ANOVA and Tukey's or Student's t-tests (p < 0.05). Differences between sealers were observed only at neutral pH and after 30 days of acidic pH exposure, with a higher loss of EndoSequence (p < 0.05). After 7 days, alkaline pH reduced and increased the volumetric loss of EndoSequence and AH Plus, respectively, compared to neutral pH (p < 0.05). It can be concluded that the pH directly influenced the volumetric change of both tested root canal sealers in different ways.

Evaluation of the Bond Strength of Epoxy Resin-based Sealer Following Different Calcium Hydroxide Paste Removal Methods in Oval-shaped Root Canal

The study aimed to investigate the bond strength of epoxy resin-based sealer following five different calcium hydroxide paste removal methods in oval-shaped root canals. Sixty single-rooted human mandibular premolars having an oval-shaped root canal as evidenced by radiographs were decoronated and instrumented to size 40/0.04, medicated with calcium hydroxide paste for 7 days, before being randomly assigned to the conventional needle irrigation (CNI), manual dynamic agitation (MDA), sonic irrigation (SI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XP) groups to be irrigated using different irrigation systems. All specimens were then obturated using an epoxy resin-based root canal sealer and warm vertical compaction obturation technique. After 7 days, each specimen was sectioned into 1 mm root slices at the coronal, middle, and apical third of the root canal and tested for the push-out bond strength using a universal testing machine. The XP group was the only group that had comparable bond strength to the control group at every level of the root canal following removal of calcium hydroxide medicament (p >0.05). The control group had higher bond strength than the CNI group at every level of the root canal (p < 0.05). Calcium hydroxide interfered with the bonding of epoxy resin-based sealer to root canal walls. Irrigation with the XP increased the bonding sealer at every level of the root canal. The XP was efficacious as a final rinse agitation technique to promote the bonding of the epoxy resin-based sealer at every level of the root canal following calcium hydroxide medication.

Cytotoxicity and Genotoxicity of Epoxy Resin-Based Root Canal Sealers before and after Setting Procedures.

Epoxy resin-based sealers are commonly used for successful endodontic treatment. This study aimed to evaluate the cytotoxicity and genotoxicity of epoxy resin-based sealers under unset and set conditions. Three epoxy resin-based sealers were used: Adseal, AH Plus, and Dia-Proseal. To test cytotoxicity, an agar overlay test and a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay were performed using unset and set sealers on L929 mouse fibroblasts. The genotoxicity test of the comet assay was performed using the same cell line. Extract dilutions in the culture media were used as test materials for the MTT and comet assays. The comet tail produced by the damaged DNA was calculated by image analyses. Statistical analyses were performed using one-way analysis of variance and Tukey’s post hoc test. Unset sealers did not show defined decolorized areas. Hardened specimens of resin-based sealers showed circular discolored zones in the agar overlay test. Dia-Proseal was the least cytotoxic after hardening. These results were confirmed in the MTT assay. Cell viability was significantly higher in cells treated with hardened sealers in both groups than that in cells treated with freshly mixed sealers in the MTT assay. Unset AH Plus® and Dia-Proseal™ significantly increased cell viability with decreasing dilution. Adseal™ was the least cytotoxic. Freshly mixed Adseal™ was more genotoxic when freshly mixed than when set. Unset epoxy resin-based sealers were generally more cytotoxic and genotoxic than set materials. Cytotoxicity does not always match the genotoxicity results; therefore, various test tools are required to test toxicity. It is necessary to properly evaluate the toxic effects to establish a biocompatibility test that mimics clinical conditions.

Dissolving efficacy of xylene on epoxy resin-based and bioceramic-based root canal sealers

Background: Epoxy resin-based and bioceramic-based root canal sealers are used in endodontic treatment as root canal obturation materials because they are considered to have many advantages. The complete removal of these materials during root canal retreatment is crucial in order to ensure adequate disinfection. Due to the difficulty in accessing root canal ramifications, removal of these filling materials without damaging the teeth can be successfully achieved using endodontic solvents. Objective: The aim of this study was to evaluate the solubility of two types of root canal sealers in xylene used in endodontics. Methods: A total of 34 epoxy resin and bioceramic samples were stored for 72 h in an incubator to set. The samples were then immersed for 2 min in 1 mL of xylene. The excess xylene on the samples was drained with an absorbent paper and stored in an incubator for 24 h to dry. The pre- and post-immersion weight of the samples was measured using a digital analytical scale, then the weight difference between the groups was analyzed using the independent t test at a 5% significance level. Results: No significant difference was observed between the epoxy resin-based root canal sealer group and the bioceramic-based root canal sealer group (P ≥ 0.05). Conclusion: Xylene endodontic solvent has a similar efficacy for removing epoxy resin-based and bioceramic-based root canal sealers in in vitro study.

Influence of the use of chelating agents as final irrigant on the push-out bond strength of epoxy resin-based root canal sealers: A systematic review.

This systematic review (PROSPERO - CRD42020150722) was performed to answer the following question: Does the use of chelating agents affect the dislodgment resistance of epoxy resin-based root canal sealers? A search was conducted in PubMed, EMBASE, Scopus, LILACS and Web of Science, hand searching of two endodontic journals and grey literature until September 2020. Extracted data included: teeth used, sample size, root canal preparation, irrigant, chelating solution, neutralisation solution, type of resin-based sealer and obturation approach, storage method and duration, root third and slice thickness, plunger dimension and loading direction and the push-out testing parameters and values. The search retrieved a total of 2.389 studies. After analysis, 12 studies fulfilled the eligibility criteria and were included. Most of the final irrigation protocols with chelating agents had a positive impact and promoted an improvement in the dislodgment resistance of epoxy resin-based sealers to the root dentin.

The effect of two rotary and two reciprocating NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth: A randomized controlled trial.

This randomized clinical trial aimed to assess the effect of two rotary (ProTaper Retreatment + ProTaper Gold and Hyflex EDM) and two reciprocating (Reciproc Blue and WaveOne Gold) NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth. One hundred and eighty patients scheduled for root canal retreatment were randomly assigned to one of the four groups according to the NiTi system (ProTaper Retreatment + ProTaper Gold, Hyflex EDM, Reciproc Blue or WaveOne Gold) used for the removal of root canal fillings and further canal preparation. The working length was determined to be 1mm shorter than the '0.0' mark of the apex locator. Root canals were filled with gutta-percha and an epoxy resin-based root canal sealer using a lateral compaction technique. The teeth were restored using a resin composite material. A single operator performed the retreatments in a single visit. The incidence and intensity of postoperative pain were rated on a numeric rating scale by patients 24, 48 and 72h after retreatment. The number of analgesic tablets (400mg Ibuprofen) taken by patients was also recorded. Data were analysed using the Mann-Whitney U, Wilcoxon and chi-square tests. For the intensity of postoperative pain, the difference between the four groups was not significantly different (p>.05). No significant difference was found between the groups in terms of analgesic medication intake (p>.05). The rotary and reciprocating NiTi systems tested in this study were associated with similar intensity of postoperative pain and intake of analgesics following root canal retreatment on single-rooted incisor teeth completed in one visit.

Solubility of bioceramic- and epoxy resin-based root canal sealers: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluated whether epoxy resin-based root canal sealers present an increased solubility than calcium silicate-based root canal sealers. A systematic search was performed in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey. The inclusion criteria consisted of invitro studies that compared the solubility of epoxy resin-based and calcium silicate-based sealers. The quality assessment and data extraction of the selected articles were performed. The meta-analysis of the pooled data and the subgroups according to the root thirds were carried out using the RevMan software (P < 0.05). After the duplicate removal and eligibility criteria assessment, a total of 22 studies were included all of them were considered as having a low risk of bias. The meta-analysis demonstrated overall lower solubility of AH Plus. AH Plus presented lower solubility than Bio-C Sealer, BioRoot RCS, MTA Fillapex, Sealer Plus and Total Fill BC Sealer.

Comparative evaluation of retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals-An In-Vitro micro-CT analysis.

To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning. Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment. The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal-Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05. Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS.

Effect of Sodium Thiosulfate on Interfacial Adaptation and Penetration of an Epoxy Resin-Based Root Canal Sealer.

Our study evaluated the impact of sodium thiosulfate (ST) irrigation, subsequent to sodium hypochlorite (NaOCl) and just before root canal filling, on the filling quality (interfacial adaptation and penetration segment) of an epoxy resin-based root canal sealer. Twenty single-rooted human teeth were prepared with the ProTaper system. The specimens were then divided into the following groups: 5.25% NaOCl irrigation (NaOCl group) and 5.25% NaOCl irrigation+0.5% sodium thiosulfate (NaOCl+ST group). The root canals were filled using single-cone technique with ProTaper F3 cones and AH-Plus sealer, labeled with rhodamine B dye to allow analysis under a confocal laser scanning microscopy (CLSM). All samples were sectioned at 2, 4, and 6 mm from the apex and prepared for CLSM analysis. The percentage of voids, gaps and dentinal sealer penetration segment of the canal were calculated at the apical, middle and coronal thirds. The non-parametric Mann-Whitney statistical test was used at 5% significance level. Higher percentage of gaps and voids were observed at all root thirds of the NaOCl group when compared to the NaOCl+ST group (P<0.05). There was a significant increase in the penetration segment of NaOCl+ST group at the coronal and middle root third when compared to the NaOCl group (P<0.05). Our in vitro results showed that the use of ST as an antioxidant agent after NaOCl irrigation promoted a better interfacial adaptation and penetration of epoxy resin-based root canal fillings.

The effect of two calcium silicate-based and one epoxy resin-based root canal sealer on postoperative pain: a randomized controlled trial.

To compare the effect of two calcium silicate-based (Endoseal MTA and EndoSequence BC Sealer) and an epoxy resin-based (AH Plus) root canal sealer on postoperative pain following single-visit root canal treatment on molar teeth. Patients (n=90) having one first or second molar tooth diagnosed with asymptomatic irreversible pulpitis were randomly divided into three groups according to the sealer used (n=30) and were treated by two endodontists having at least 10years of experience. All patients received a single-visit root canal treatment. After the treatments, postoperative pain scores and analgesic intake were recorded at 6, 12, 24 and 48h, and 3, 4, 5, 6 and 7days. The data were analysed statistically using non-parametric Kruskal-Wallis tests (for the comparisons of the age and VAS scores), Friedman tests (for the assessments of the changes in pain scores over time), chi-squared tests (for the comparisons of categorical variables) and Spearman's correlation test (for the correlation assessments of the age and gender factors with postoperative pain; α=0.05). There were no significant differences amongst the groups in terms of postoperative pain at any time-points assessed (P>0.05) nor for analgesic intake of patients amongst the groups (P>0.05). Analgesic intake decreased significantly after 12h in all groups (P<0.05). The sealers tested in this study were associated with similar levels of postoperative pain and were associated with a similar intake of analgesics.

Effect of heat application on the physical properties and chemical structure of calcium silicate-based sealers.

To determine the effect of heat application on the setting and chemical properties of HiFlow BC Sealer and compare to other calcium silicate (CSBS) and epoxy resin-based root canal sealers. AH Plus, BioRoot RCS (BioRoot), Endosequence BC (Endosequence), and HiFlow BC (HiFlow) sealers were placed at 37 °C or subjected to heat at 200 °C for 10 or 30 s, followed by incubation at 37 °C in a humidified incubator during experiments. Setting time, viscosity, and flow were assessed, and changes in chemical structure were evaluated using the Fourier-transform infrared spectroscopy (FTIR). Thermogravimetric analysis was also used to evaluate the weight change (%) of the sealers upon heating from room temperature to 37 °C or 200 °C at a rate of 20 °C/min. Data were analyzed using a two-way ANOVA with a Bonferroni post-hoc test (p = 0.05). Application of heat extended the setting time for Endosequence and HiFlow but resulted in a faster setting of AH Plus and BioRoot. The highest flow and lower viscosity were observed in HiFlow at high temperature (p < 0.05), whereas the lowest flow with the highest viscosity and greatest weight loss were observed in BioRoot after heat application (p < 0.05). FTIR spectra demonstrated no changes to functional groups after heat application, except for the strong H-O-H absorption peak corresponding to water in BioRoot. Endosequence and HiFlow showed similar chemical properties with a higher flow and lower viscosity in HiFlow after heat application. Heat application resulted in reduced flow, increased viscosity, and weight loss for BioRoot. The setting of AH Plus was fastened with heat, while its weight loss, viscosity, and flow characteristics were stable. HiFlow, Endosequence, and AH Plus can be all used with WVC obturation techniques. Heat application resulted in minor changes in their physical properties including setting time, flow, weight loss, and chemical properties, while BioRoot showed a significant amount of weight loss, increase in viscosity, and reduced flowability after heat application.

Apical Sealing Ability of Calcite-Synthesized Hydroxyapatite as a Filler of Epoxy Resin-Based Root Canal Sealer.

Background:The success of root canal treatment is influenced by hermetic root canal obturation. This study was conducted to analyze the apical sealing ability after the addition of calcite-synthesized hydroxyapatite (HA) as an epoxy resin sealer filler.Methods:Calcite-synthesized HA powder was prepared using the microwave hydrothermal process. HA resin sealer powder and epoxy resin paste (3:1) were mixed, and concentrations of 10%, 20%, 30%, 40%, and 50% were prepared. A sample of thirty maxillary incisors were prepared in the root canal and then, the crown was cut to leave 13 mm of the root and a working length of 12 mm. The root canal was prepared using the crown-down technique and irrigated using 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid alternately. The samples were divided into six groups, with each group consisting of five roots. Group I was obturated with gutta percha using an epoxy resin sealer without HA (HA-0%) as a control group. In each of the Groups II, III, IV, V, and VI, 10% HA resin sealer, 20% HA, 30% HA, 40% HA, and 50% HA were used. All the samples were incubated in a 10-ml simulated body fluid solution at 37°C for 4 weeks. Apical closure density measurement was done using a scanning electron microscope, and the results were analyzed using the Kruskal–Wallis and Mann–Whitney U-tests.Results:A significant increase in the apical sealing ability was observed in the HA-20% sealer group and the HA-30% and HA-40% groups compared to that in the control group. However, the HA-50% sealer group showed a decrease in the apical sealing ability, whereas the HA-10% sealer group showed no difference. The HA-30% had the highest sealing ability than other concentrations.Conclusion:The addition of calcite-synthesized HA as a filler at concentrations of 20%, 30%, and 40% increased the apical sealing ability of the epoxy resin sealer.

Physicochemical Properties and Bioactive Potential of a New Epoxy Resin-based Root Canal Sealer.

The aim of this study was to evaluate physicochemical properties and bioactive potential of Sealer Plus, in comparison with MTA Fillapex, Sealapex and AH Plus. Setting time, flow, and radiopacity were evaluated based on ISO 6876 Standard. Flow was also assessed in area (mm²). The solubility and volumetric change of the sealers were evaluated after 7 and 30 days of immersion in distilled water. Solubility was evaluated by the difference in mass of materials before and after immersion. Volumetric change was evaluated by using microcomputed tomography (micro-CT). The bioactive potential was observed by Scanning Electron Microscopy (SEM) after immersion in PBS. Data were compared using ANOVA and Tukey tests (α=0.05). Sealer Plus presented the shortest setting time (196 min.) and Sealapex the longest (912 min.) (p<0.05). AH Plus showed the highest radiopacity (9.5 mm Al) and MTA Fillapex the lowest (2.7 mm Al) (p<0.05). All the sealers presented flow in accordance with ISO 6876/2012 (>17 mm). Sealer Plus showed low solubility and volumetric change (<1%), and MTA Fillapex showed the highest solubility (>25%), and volumetric change (>4%) after all time intervals (p<0.05). MTA Fillapex was the only sealer that showed bioactive potential. In conclusion, Sealer Plus presented proper physicochemical properties. However, this sealer did not present a bioactive potential.

Comparative Cytocompatibility and Mineralization Potential of Bio-C Sealer and TotalFill BC Sealer

The aim of this study was to investigate the cytocompatibility and mineralization potential of two premixed hydraulic endodontic sealers compared with an epoxy resin-based root canal sealer. The cellular responses and mineralization capacity were studied in human periodontal ligament stem cells (hPDLSCs) that were exposed to premixed hydraulic sealers, Bio-C Sealer (Angelus, Londrína, PR, Brazil), TotalFill BC Sealer (FKG Dentaire SA, La-Chaux-de-fonds, Switzerland) and an epoxy resin-based material, AH Plus (Dentsply De Trey, Konstanz, Germany). Non-exposed cultures served as the control. The endodontic sealers were assessed using scanning electron microscopy (SEM) and energy dispersive X-ray microanalysis (EDX). Statistical analyses were done using Analisis of Variance (ANOVA), with Bonferroni adjusted pairwise comparison (p = 0.05). AH Plus reduced cell viability and cell migration, whereas increased cell viability and cell migration were observed in the Bio-C Sealer and the TotalFill BC Sealer (p < 0.05). The lowest cell attachment and spreading were observed for all concentrations of AH Plus, whereas the highest were observed for TotalFill BC Sealer. At the end of 21 days, only the Bio-C Sealer and the TotalFill BC Sealer supported matrix mineralization (p < 0.05). Additionally, SEM-EDX revealed high content of calcium, oxygen, and silicon in the Bio-C Sealer and the TotalFill BC Sealer. Based on the results from this study, Bio-C Sealer and TotalFill BC Sealer demonstrated better cytocompatibility in terms of cell viability, migration, cell morphology, cell attachment, and mineralization capacity than AH Plus.