Pulp Canal Sealer Research Articles

Retreatment of Root Canals Filled with BioRoot RCS: An In Vitro Experimental Study

IntroductionThe purpose of this study was to compare the speed of removal of root canal filling material and re-establishment of apical patency in root canals filled with a tricalcium silicate–based sealer (BioRoot RCS [BRCS]; Septodont, Saint-Maur-des-Fossés, France) versus a zinc oxide–eugenol sealer (Pulp Canal Sealer [PCS]; Sybron Endo Kerr, Orange, CA) and to analyze the effect of the operator’s experience. MethodsOne hundred twenty root canals of 40 Dentalike dental simulators (Dentsply Sirona, York, PA) were shaped with a WaveOne (Dentsply Sirona) reciprocating file using short 3-mm strokes. Root canals were obturated using a single gutta-percha cone and either BRCS or PCS. Samples treated either with BRCS or PCS were equally dispatched between experienced practitioners and junior practitioners. The time required to remove root filling material and establish apical patency was recorded for each root canal. Samples were compared according to the sealer used and the practitioner’s experience (Mann-Whitney test). ResultsOne hundred fifteen root canals were successfully retreated. No differences in the time required to remove the filling material were observed between the 2 materials for mesiobuccal or distobuccal canals (P > .05). In contrast, the procedure was longer for palatal canals filled with BRCS compared with PCS (79.10 vs 182.45 seconds, P < .01). Experienced practitioners took significantly less time than junior practitioners (P < .05). ConclusionsBRCS can be successfully removed from root canals as quickly as a zinc oxide–eugenol sealer in both mesiobuccal and distobuccal canals but not in palatal ones. The duration of the procedure was affected by the operator’s experience independent of the filling material used or the canal type.

Physico-chemical investigation of endodontic sealers exposed to simulated intracanal heat application: epoxy resins and zinc oxide-eugenols.

To gain information in a laboratory setting about the effect of thermal treatment of epoxy resin-based and zinc oxide-eugenol-based sealers. AH Plus and Pulp Canal Sealer (PCS) were exposed to thermal treatment at 37, 47, 57, 67, 77, 87 and 97°C for 30s. According to clinically relevant considerations, intracanal sealer temperature is likely not to exceed 60°C during warm vertical root canal filling. Heat application is recommended for less than 30s during continuous wave technique, but might exceed this threshold in complex cases. Furthermore, heat treatment at 97°C was performed for 60 and 180s to simulate inappropriate implementation of warm vertical filling techniques. Specimens were heated inside 2-mL plastic tubes in a thermo-controlled water bath until the temperatures were reached and kept at this temperature for the determined period of time. Afterwards, specimens were cooled to body temperature and physical properties (setting time, flow, film thickness according to ISO 6876) were assessed. Chemical properties (Fourier transformed infrared spectroscopy) were assessed after complete setting of the specimens in an incubator at 37°C and 100% humidity. Statistical analysis of physical properties was performed using Kruskal-Wallis test (P=0.05). The setting time of AH Plus and PCS decreased when temperature and duration of heat application increased. Whilst the setting time of AH Plus decreased from 622min at 20°C (for 30s) to 381min at 97°C (for 180s; P<0.05), heat treatment of PCS at 97°C for 180s led to an immediate setting of the material. From 20°C (for 30s) to 97°C (for 30s), the setting time of PCS decreased from 80.1 to 41.0h (P<0.05). Film thickness and flow were not relevantly influenced by thermal treatment except for PCS at 97°C for 180s. FT-IR spectroscopy did not reveal any chemical changes of either sealer after thermal treatment. Thermal treatment simulating clinically relevant temperature levels and heating times did not lead to any substantial physical or chemical changes at all temperature levels when heating did not exceed 60s. AH Plus and Pulp Canal Sealer can be considered suitable for warm root filling techniques.

Evaluation of single visit endodontic treatment and non-surgical retreatment with foraminal enlargment of teeth with apical periodontitis ?

Objetivo: avaliar o tratamento endodôntico (TE) e o retratamento não cirúrgico do canal radicular (RNCCR), associado a ampliação foraminal, realizado em sessão única. Material e Métodos: foram incluídos 125 dentes com periodontite apical e proservação de 6 a 12 meses. O sucesso foi considerado pela ausência de sinais e sintomas e reparo periapical completo ou incompleto. Análises de regressão logística foram utilizadas para identificar fatores associados ao reparo (p&lt;0,05). Resultados: o TE mostrou 71,58% de cicatrização completa e 23,16% de cicatrização aceitável. O RNCCR mostrou 80% e 20% cicatrização completa e aceitável, respectivamente. Idade, sexo, tipo de tratamento e dor pré-operatória não foram estatisticamente significantes para o processo de cicatrização (p&gt;0,05). Os pré-molares apresentaram a maior chance de reparo periapical. O cimento Pulp Canal Sealer mostrou maior chance de reparo periapical quando comparado ao Sealapex (p&lt;0,05). Conclusão: o TE e RNCCR utilizando um protocolo de alargamento foraminal, proporcionaram um prognóstico favorável da cicatrização periapical

Antimicrobial and ultrastructural properties of root canal filling materials exposed to bacterial challenge

IntroductionChemo-mechanical preparation of the root canal leaves behind viable bacteria which can lead to treatment failure. Materials used inside the root canal should possess antimicrobial properties and also resist disintegration in the presence of biofilm. MethodsGutta-percha, three root canal sealers (Pulp Canal Sealer, AH Plus and BioRoot RCS) and materials used to make posts (a metal and a resin) were evaluated. Their antimicrobial activity against Enterococcus faecalis in direct contact was assessed by scanning electron microscopy and live-dead staining using confocal microscopy over a period of eight weeks. The materials’ structural integrity was assessed by scanning electron microscopy. ResultsThe antimicrobial activity of the materials varied. The metal alloy posts as well as BioRoot RCS sealer did not allow any biofilm accumulation; but gutta-percha, Pulp Canal Sealer and resin from fibre-reinforced posts encouraged thick biofilm accumulation. Microstructural changes were observed in AH Plus (washout) and BioRoot (crystal deposition) in contact with biofilm. The Pulp Canal and BioRoot RCS sealers exhibited a modified ion leaching pattern in contact with microbially loaded media. ConclusionsThe microbial challenge affected the material microstructure in some of the materials tested and allowed biofilm accumulation. Although clinical success depends on a number of factors, materials that are structurally sound and exhibit antimicrobial properties are preferable for endodontic therapy and tooth restoration involving entry in the root canal.

BioRoot RCS Extracts Modulate the Early Mechanisms of Periodontal Inflammation and Regeneration

IntroductionThe balance between periapical tissue inflammation and regeneration after the removal of necrotic/infected tissues is pivotal in determining the success of endodontic treatment. This study was designed to investigate the effect of silicate-based root canal sealer BioRoot RCS (BRCS; Septodont, Saint-Maur-des-Fossés, France) on modulating the inflammatory mechanisms and early steps of regeneration initiated by human periodontal ligament (PDL) fibroblasts. MethodsSamples of BRCS and Pulp Canal Sealer (PCS; SybronEndo, Orange, CA) were incubated in culture medium to obtain material extracts. To simulate bacterial infection and endodontic sealer use, PDL fibroblasts were stimulated with lipopolysaccharides and cultured with material extracts. The secretion of proinflammatory cytokine (interleukin 6) and growth factor (transforming growth factor beta 1) were quantified by enzyme-linked immunosorbent assay. Inflammatory cell recruitment sequence was investigated using a human inflammatory monocytic cell line (THP-1) that can be activated into macrophage-like cells. The adhesion of THP-1 to endothelial cells (human umbilical vein endothelial cells) was studied using fluorescent THP-1, their migration using Boyden chambers, and their activation into macrophage-like cells using a cell adhesion assay. The proliferation of PDL fibroblasts was quantified by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, whereas the migration of PDL stem cells was investigated using Boyden chambers after immunofluorescence and reverse transcription polymerase chain reaction characterization. ResultsInterleukin 6 secretion decreased with BRCS, whereas it increased with PCS. Transforming growth factor beta 1 secretion significantly increased only with BRCS. The material extracts did not affect THP-1 adhesion to human umbilical vein endothelial cells, but only BRCS inhibited their migration. Moreover, activation of THP-1 decreased with BRCS and to a lesser extent with PCS. Finally, BRCS increased PDL fibroblast proliferation without affecting PDL stem cell migration. By contrast, PCS decreased PDL fibroblast proliferation and PDL stem cell migration. ConclusionsThis work shows that the endodontic sealers modulate the PDL inflammatory and regeneration potentials in vitro. It demonstrates that BRCS has anti-inflammatory effects and the potential to promote tissue regeneration.

Investigating unset endodontic sealers’ eugenol and hydrocortisone roles in modulating the initial steps of inflammation

Endodontic treatment success is achieved not only when the cement provides a hermetic seal but also when the injured periapical tissue is regenerated. However, an exaggerated inflammatory reaction hinders tissue regeneration and it has been shown that dental materials affect the inflammatory response through modulation of cytokine secretion. This work was set to investigate the effects of the presence of hydrocortisone in zinc oxide eugenol sealers (Endomethasone N) on modulating the initial steps of inflammation in vitro. Hydrocortisone and eugenol leaching from Endomethasone N and Pulp Canal Sealer (PCS) were quantified by ELISA and spectrofluorometry, respectively. The effects of Endomethasone N and Pulp Canal Sealer were studied on lipopolysaccharides (LPS)-stimulated human periodontal ligament (hPDL) cells. Cytokine (IL-6, TNF-α) secretion from cells was quantified by ELISA. Inflammatory cell (THP-1) adhesion to activated endothelial cells, their migration and activation were studied in vitro. Endomethasone N decreased secretion of IL-6 and TNF-α from hPDL cells. THP-1 adhesion to activated endothelial cells (HUVECs) and migration significantly decreased with Endomethasone N while no effect was observed with PCS. Activation of THP-1 decreased with both materials' extracts but was significantly lower with Endomethasone N than with PCS. These results performed in vitro show that Endomethasone N anti-inflammatory effects are due to the presence of hydrocortisone. Endomethasone N has potential local anti-inflammatory effects which appear to be due to its hydrocortisone rather than eugenol content. Decreasing the inflammatory response is a pre-requisite to initiate the periapical healing.

In vitro study of the periapical sealing ability of three root canal sealing cement

Objective: The objective of this study was to determine the sealing ability of different root canal cement: resin AH Plus®, calcium hydroxide Sealapex®, and eugenol zinc oxide Pulp Canal Sealer® by measuring the apical penetration of a dye. Methods: One hundred straight single-canal teeth were biomechanically prepared to 0.5 mm of the apical foramen. The teeth were divided into four groups, three experimental groups, with thirty teeth in each group, and a control group, with ten teeth. The following sealants were selected: AH Plus®, Sealapex®, and Pulp Canal Sealer®. The root canal was not sealed in the control group. Lateral condensation was performed on the experimental groups using gutta-percha. The teeth were immersed in Indian ink to determine leakage. Results: In the experimental groups, ink penetration was observed in about 50% of the teeth. The lowest mean penetration was observed in the AH Plus® group (30.9 (±42.9)), and the highest was observed in Pulp Canal Sealer® (94.35 [±79.9]), (P

Evaluation of the biocompatibility of root canal sealers on human periodontal ligament cells ex vivo

The aim of this study was to evaluate the biocompatibility of two comparatively new calcium silicate containing sealers (MTA-Fillapex and BioRoot-RCS) with that of two established sealers (AH-Plus, epoxy resin-based; Pulp-Canal-Sealer, zinc oxide eugenol containing). Human periodontal ligament cells (PDL-cells) were brought in contact with eluates from freshly mixed and set sealer. The sealers were mixed strictly according to the manufacturers' instructions and identically samples were produced. 1:1, 1:2, and 1:10 dilutions of sealers extract were used. Extracts from freshly mixed sealer were added to the PDL-cells on day one to simulate a clinical scenario. Subsequently, at 24h, 7, 14, and 21days extracts form set sealers were used for PDL-cell culturing. PDL-cell viability was analyzed by living-cell-count, MTT-assay, and living/dead-staining, cytotoxicity by LDH-assay, and changes by Richardson-staining. All data were statistically evaluated by one way ANOVA and a posthoc analysis with Bonferroni-Holm testing (p < 0.05). In contact with BioRoot-RCS a regeneration of the PDL-cells were observed over time. This sealer showed the lowest toxicity in a freshly mixed and set state (p < 0.05). MTA-Fillapex and Pulp-Canal-Sealer were cytotoxic in a fresh as well as in a set state, whereas AH-Plus was cytotoxic in a freshly mixed state, but not when the sealer was set. BioRoot-RCS is biocompatible and bioactive because it seems to have a positive influence on the PDL-cell metabolism. Pulp Canal Sealer and MTA-Fillapex showed no biocompatibility in contact with PDL-cells at all. Freshly mixed AH Plus is less biocompatible on PDL than in a set state.

Cytotoxic effects of four different root canal sealers on human osteoblasts.

The aim of this study was to evaluate the effect of an epoxy resin-based (AH-Plus), a zinc oxide eugenol containing (Pulp-Canal-Sealer) and two calcium silicate containing (MTA-Fillapex and BioRoot-RCS) sealers on primary human osteoblasts (hOB) in freshly mixed and set state. All sealers were mixed strictly according to the manufacturers´ instructions and identically samples were produced. In a pretest cytotoxic sealer concentrations were determined. Thus, for the main cell culture study, dilutions of sealer extract 1:1, 1:2, and 1:10 were used. To simulate a clinical scenario, extracts from freshly mixed sealer were added to the cells on day one. Extracts form set sealers were used for subsequent culturing for 24h, 7d, 14d, and 21d. Cell viability was analyzed by living-cell-count, MTT-assay, and living/dead-staining, cytotoxicity by LDH-assay, and changes by Richardson-staining. All data were statistically evaluated by one way ANOVA and a posthoc analysis with Bonferroni-Holm testing (p<0.05). AH-Plus was cytotoxic in a freshly mixed state, but not when the sealer was set. MTA-Fillapex and Pulp-Canal-Sealer were cytotoxic in a fresh as well as in a set state. BioRoot-RCS showed the lowest toxicity in both states; where as a regeneration of the cells could be observed over time (p<0.05). Contact of freshly mixed AH-Plus to osteoblasts should be avoided. Pulp Canal Sealer and MTA-Fillapex showed no biocompatibility in contact with osteoblasts at all. BioRoot-RCS had a positive influence on the cell metabolism (bioactivity) and is biocompatible.

Wettability of endodontic sealers on the root surface using different irrigants

Objetivo: o presente estudo teve como objetivo avaliar a molhabilidade de diferentes cimentos em contato com a dentina tratada com irrigantes utilizados na remoção da smear layer, após o uso da clorexidina como substância auxiliar química. Material e Métodos: trinta dentes unirradiculares foram utilizados. As coroas foram removidas e as raízes seccionadas verticalmente, resultando em dois segmentos, que foram então achatados. Assim, foram obtidas 120 amostras medindo 5 mm. Eles foram imersos em gel de clorexidina 2% (CHX) por 10 minutos e lavados com água destilada (AD) antes de serem submetidos ao irrigante final para remoção da smear layer. Os seguintes protocolos de irrigação foram avaliados: grupo controle - CHX + AD + AD + AD; grupo E-CHX + AD + 17% EDTA + AD; grupo Q-CHX + AD + QMix + AD; grupo Et-CHX + DA + 18% HEBP + DA. As amostras foram secas e o ângulo de contato foi analisado por meio de um goniômetro. Os selantes avaliados foram: AH Plus (AH), Pulp Canal Sealer EWT (PCS) e MTA Fillapex (MTAF). Em cada gota de cimento, 60 medidas foram feitas e o fluxo foi observado por 1 minuto. A molhabilidade dinâmica dos selantes foi calculada. Os dados foram analisados ??estatisticamente. Resultados: em todos os cimentos, a presença de smear layer desfavoreceu a molhabilidade. EDTA e QMix favoreceram a molhabilidade de AH e PCS. Para o MTAF, o QMix apresentou o melhor desempenho, seguido pelo EDTA. A HEBP apresentou resultados estatisticamente inferiores, semelhantes ao controle. Conclusão: As soluções utilizadas para remoção da smear layer, após o uso de clorexidina durante o preparo, influenciaram a umectabilidade dos selantes AH Plus, Pulp Canal Sealer EWT e MTA Fillapex.

Sealer penetration and adaptation in root canals with the butterfly effect.

The butterfly effect is a phenomenon seen in some roots and is related to density of dentinal tubules. The aim was to investigate penetration depth and adaptation quality of root canal sealers and ProRoot MTA into bucco-lingual and mesio-distal aspects of roots with and without the effect. One hundred and twenty teeth were decoronated at the cemento-enamel junction. Canals were prepared and assigned to obturation groups: gutta-percha with a sealer (AH Plus, EndoREZ, Kerr Pulp Canal Sealer, MTA Fillapex) or ProRoot MTA alone (each containing 10 butterfly and 10 non-butterfly roots). Root sectioning yielded coronal and middle samples. Confocal laser scanning and scanning electron microscopy were used to assess penetration and adaptation. Teeth with the effect had greater mean penetration bucco-lingually (766μm) than mesio-distally (184μm, P=0.003). Coronal sections had greater penetration (430μm) compared with middle (247μm, P=0.006). In conclusion, greater penetration in roots with the effect may improve treatment outcomes.

Properties of BioRoot RCS, a tricalcium silicate endodontic sealer modified with povidone and polycarboxylate.

To evaluate the chemical and physical properties of a tricalcium silicate root canal sealer containing povidone and polycarboxylate (BioRoot RCS), a calcium silicate MTA-based sealer containing a salicylate resin (MTA Fillapex), a traditional eugenol-containing sealer (Pulp Canal Sealer) and an epoxy resin-based root canal sealer (AH Plus). Calcium release, pH, setting time, water sorption, volume of open pores, volume of impervious portion, apparent porosity and weight loss were measured. The ability to nucleate calcium phosphates (CaP) after ageing 28days in a simulated body fluid was evaluated using ESEM-EDX and micro-Raman spectroscopy. Data were statistically analysed (P=0.05) using one-way anova (setting time, radiopacity, solubility, water sorption, porosity) or two-way anova (ion release tests). BioRoot RCS had a final setting time of 300min and adequate radiopacity (5.2mm Al). It demonstrated the highest (P<0.05) and more prolonged ability to release calcium ions (721ppm at 3h) and to increase the pH (11-12) (P<0.05); B-type carbonated apatite deposits were found on aged BioRoot RCS (biointeractivity-related CaP-forming ability). A final setting time of 270min and good calcium release (17.4ppm at 3h) were measured for MTA Fillapex; apatite deposits were present on aged samples. No calcium release and no alkalizing activity were measured for Pulp Canal Sealer and AH Plus; no CaP nucleation was detected on aged Pulp Canal Sealer, and some apatite deposits were found on aged AH Plus (chemi/physisorption-related CaP-deposition). Higher and significantly different (P<0.05) porosity, water sorption and solubility were measured for the two calcium silicate sealers, especially for BioRoot RCS. BioRoot RCS had bioactivity with calcium release, strong alkalizing activity and apatite-forming ability, and adequate radiopacity.

Comparative cytotoxicity evaluation of eight root canal sealers.

BackgroundThe aim of the present study is to evaluate and compare the cytotoxic effects of eight root canal sealers (BioRoot RCS, TotalFill BC Sealer, MTA Fillapex, Sealapex, AH Plus, EasySeal, Pulp Canal Sealer, N2) on immortalized human gingival fibroblasts over a period of 24, 48 and 72 hours.Material and MethodsImmortalized human gingival fibroblast-1 HGF-1 (ATCC CRL-2014) were incubated. Root canal sealers were then placed into sterile, cylindrical Teflon moulds. The extraction was made eluting the sealers in cell culture medium. Cells (1 × 104) were seeded in each well of a 96-well plate and incubated for 24 h at 37°C. Cultures were then exposed to 100 μL of the extracts medium. The percentage of viable cells in each well was calculated relative to control cells set to 100%.ResultsBioRoot RCS and TotalFill BC Sealer extracted for 24h showed no cytotoxic effect, while it was mild by using 48 and 72 h extracts. No cytotoxic effect was measured by using AH Plus medium eluted for 24 h, while it was moderate after 48 h and severe after 72 h. Pulp Canal Sealer, Sealapex and N2 showed moderately cytotoxic activity for all the extraction times. EasySeal and MTA Fillapex remained severely or borderline mildly cytotoxic for all the extraction times.ConclusionsIn the present study only BioRoot RCS, TotalFill BC Sealer and AH Plus showed no cytotoxic effects at least in the first 24h. All the other sealers revealed moderately or severely cytotoxic activity during all the extraction times. Key words:Cytotoxicity, gingival fibroblast, MTT test, root canal sealer.

Subcutaneous Connective Tissue Reaction to a New Nano Zinc-Oxide Eugenol Sealer in Rat Model.

Introduction:The aim of this animal study was to evaluate the histological response of the new nano zinc-oxide eugenol (NZOE) sealer in comparison with Pulp Canal Sealer (ZOE based) and AH-26 (epoxy resin sealer). Methods and Materials:A total of 27 Wistar rats were used. Four polyethylene tubes were implanted in the back of each rat (three tubes containing the test materials and an empty tube as a control). Then, 9 animals were sacrificed at each interval of 15, 30 and 60 days, and the implants were removed with the surrounding tissues.Samples were evaluated for the presence of inflammatory cell (mononuclear cell), vascular changes, fibrous tissue formation and present of giant cell. Comparisons between groups and time-periods were performed using the Kruskal-Wallis and Mann-Whitney U non-parametric tests. The level of significance was set at 0.05. Results:No significant difference was observed in tissue reactions and biocompatibility pattern of three sealers during 3 experimental periods (P<0.05). In all groups the tissue behavior showed tendency to decrease the irritation effect over time. Conclusion: The new nano zinc-oxide eugenol sealer has histocompatibility properties comparable to conventional commercial sealers.

Cytotoxicity Profile of Endodontic Sealers Provided by 3D Cell Culture Experimental Model.

The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of p<0.05. All tested sealers exhibited cytotoxic effects; however, cytotoxic effect was culture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (p<0.05). In both conditions, EndoSequence BC showed the lowest cytotoxicity (p<0.05). MTA Fillapex was much more cytotoxic than the other tested endodontic sealers (p<0.05), with the exception of AH Plus in the 2D cell culture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p<0.05); however no statistical differences was observed among these sealers in 3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.

Efeito do plasma de oxigênio na dentina previamente exposta ao NaOCl

Resumo Introdução O tratamento de plasma é uma tecnologia eficaz que pode manter as propriedades internas dos materiais inalteradas após o tratamento, modificando apenas a superfície. Objetivo Avaliar o efeito do plasma de oxigênio na dentina previamente exposta ao NaOCl 6%. Material e método Foram utilizados 60 incisivos bovinos. A coroa foi removida, a raiz foi dividida e as faces planificadas, totalizando 120 segmentos referentes ao terço cervical. As amostras foram divididas em dois grupos: controle (imersa em NaOCl 6%, lavada com água destilada, seca, imersa em EDTA 17%, lavada e seca) e plasma de oxigênio (após tratamento descrito no grupo controle, plasma de oxigênio foi aplicado por 30 s). As amostras foram avaliadas qualitativamente em relação à topografia por microscopia eletrônica de varredura, utilizando-se microfotografias com ampliação de 1.000×. O goniômetro Ramé-hart foi utilizado para a mensuração do ângulo de contato entre as superfícies e as seguintes soluções foram utilizadas: água, etilenoglicol e di-iodometano. Em seguida, a energia de superfície, representada pelas componentes polar e dispersiva, foi calculada. Avaliou-se também o escoamento dos cimentos Pulp Canal Sealer EWT (PCS) e Real Sal SE (RS) na superfície dentinária. Os dados foram analisados estatisticamente utilizando os testes Kruskal-Wallis e Mann-Whitney U (p&lt;0,05). Resultado O tratamento com plasma levou à formação de uma camada semelhante à smear layer na superfície dentinária. Este tratamento levou a um aumento da energia de superfície e da componente polar, favorecendo a hidrofilicidade da superfície. Entretanto, desfavoreceu o escoamento do cimento PCS e não influenciou no escoamento do cimento RS. Conclusão O plasma de oxigênio ocasionou mudanças topográficas na superfície dentinária, favorecendo a hidrofilicidade desta. Contudo, não favoreceu o escoamento dos cimentos endodônticos na dentina.

Surface modification of gutta-percha cones by non-thermal plasma

This study was designed to evaluate the effects of Oxygen and Argon plasma on gutta-percha surfaces. A total of 185 flat smooth gutta-percha surfaces were used. Samples were divided into groups: control: no plasma treatment; Oxygen: treatment with Oxygen plasma for 1min; Argon: treatment with Argon plasma for 1min. Samples were evaluated topographically by scanning electron microscopy and atomic force microscopy; and chemically by Fourier Transform-infrared Spectroscopy. A goniometer was used to determine the surface free energy and the wettability of the endodontic sealers. Additionally 60 bovine teeth were filled using pellets of gutta-percha (control, oxygen and argon plasma) and the sealers. Teeth were evaluated by push-out and microleakage tests. Data were statistically analyzed using specific tests. Argon plasma did not change the surface topography, while Oxygen plasma led to changes. Both treatments chemically modified the gutta-percha surface. Argon and Oxygen plasma increased the surface free energy and favored the wettability of AH Plus and Pulp Canal Sealer EWT. Regarding bond strength analysis, for AH Plus sealer, both plasma treatments on gutta-percha favored the bond strength to dentin. However, for Pulp Canal Sealer, there is no statistically significant influence. For leakage test, dye penetration occurred between sealer and dentin in all groups. In conclusion, Oxygen plasma led to both topographic and chemical changes in the gutta-percha surface, while Argon plasma caused only chemical changes. Both treatments increased the surface free energy, favoring the wettability of AH Plus and Pulp Canal Sealer EWT sealers and influenced positively in the adhesion and leakage.

Ability of Three Endodontic Sealers to Fill the Root Canal System in Association with Gutta-Percha.

Introduction:The present study compared the ability of the endodontic sealers AH Plus, Pulp Canal Sealer and EndoREZ to fill the root canal system in association with gutta-percha.Methods:Ninety mandibular premolars were accessed, prepared and divided into three groups of 30 teeth each, according to the sealer used to fill the canals: AH Plus, Pulp Canal Sealer and EndoREZ. All the teeth were filled using the continuous wave of condensation technique. The specimens were then decalcified, dehydrated, rendered transparent, and analyzed by three independent evaluators with 8x magnification. Chi-squared test (χ2, p < 0.05) was used to compare the groups in relation to the totally filled, the partially filled and the non filled ramifications. The same test was used to compare the directions of filled ramifications and the number of ramifications among the three thirds of the roots.Results:EndoREZ filled a significantly higher number of ramifications than AH Plus and Pulp Canal Sealer (χ2, p < 0.05). All the groups showed higher number of totally filled ramifications than partially filled and unfilled ramifications. The ramifications were more frequently detected in the apical third, followed by medium and coronal thirds, respectively (χ2, p < 0.05). The ramifications were more frequently detected towards lingual direction (χ2, p < 0.05).Conclusion:EndoREZ presented higher ability to fill the root canal system in association with gutta-percha when compared to AH Plus and Pulp Canal Sealer. The ramifications were more frequently detected in the apical third, running in a lingual direction.

Evaluation of Inflammatory Response to Endodontic Sealers in a Bone Defect Animal Model

The aim of this study was to evaluate the inflammatory response to MTA Fillapex, AH Plus, and Pulp Canal Sealer Extensive Work Time (EWT), in a murine bone defect grafting model. Bilateral mandibular critical defects were produced in 45 Wistar rats with a trephine bur#2 and filled with the endodontic sealers. After 7, 14, and 28 days, the rats were euthanized and their jaws were histologically prepared. For the 7-day group, no statistical significance was observed among all studied groups (p > 0.05), and high levels of inflammatory infiltrate were detected. After 14 and 28 days, Pulp Canal Sealer EWT showed statistically lower inflammatory response in comparison to other sealers (p < 0.05) except for the control group (no sealers). Pulp Canal Sealer EWT presented the lowest levels of inflammatory response. The critical defect grafting model was an effective method to detect differences among differences on the biological response to endodontic sealers. Knowing the biocompatibility of endodontics sealers that will be used in filling the root canal.

Apically Extruded Sealers: Fate and Influence on Treatment Outcome

IntroductionThis retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome. MethodsOne hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment. Sealers included Pulp Canal Sealer (Sybron Dental, Orange, CA), PCS Extended Working Time-EWT (Sybron Dental), Tubli-Seal (Sybron Endo), Endomethasone (Septodont, Saint-Maur-des-Fossés, France), AH Plus (DeTrey GmbH, Konstanz, Germany), and Apexit (Ivoclar Vivadent, Schaan, Lichtenstein). Recall radiographs were compared with immediate postobturation films for removal of the extruded material and status of the periradicular tissues. Data were grouped as 1-, 2- and >4-year recall and statistically analyzed using the chi-square and Fisher exact tests. ResultsAs for the sealers' fate, the only statistically significant differences at the 1-year recall were observed when comparing Tubli-Seal with AH Plus, Apexit, and Endomethasone (P < .05). At both the 2- and 4-year recalls, frequency of complete removal of AH Plus and Apexit was significantly lower when compared with all the other sealers (P < .05). No other significant differences were observed between groups. As for the influence on treatment outcome, there were no statistically significant differences between sealers at all follow-up periods (P > .05). Data from the >4-year recall revealed that 79% of the teeth with apical periodontitis lesions at the time of treatment had healed in comparison with 100% of the teeth with no apical periodontitis (P < .01). ConclusionsNot all extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis.