Resin-based Root Canal Sealer Research Articles

Comparison of biocompatibility of epoxy resin and bioceramic-based root canal sealers.

The purpose of this study is to compare the cytotoxicity of 2 bioceramic-based (Bioserra and AH Plus Bioceramic (Bio)) and 2 epoxy resin-based (Sealart and AH Plus) root canal sealers on the Saos-2 cell line. The cytotoxicity of the root canal sealers was determined using the MTT metabolic activity assay. The mRNA expression levels of Bcl-2, Beclin1, Cas-3, IL-6, LC3, MMP-9 and TNF-α genes were assessed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and the expression of Beclin1 and LC3 proteins were assessed using western blot (WB) method. The canal sealers' total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were measured using photometric kits. AH Plus Bio significantly increased metabolic activity compared to the 2 resin-containing sealers, but there was no difference with Bioserra. Sealart was clearly the most cytotoxic group. QRT-PCR analysis revealed that the mRNA expressions of Bcl-2, Beclin1, Cas-3, IL-6, LC3, and MMP-9 in the Bioserra group, Bcl-2, Cas-3, and IL-6 in the Sealart group, Beclin1, Cas-3, IL-6, and MMP-9 in the AH Plus group, and Bcl2 in the AH Plus Bio group were stimulated. The OSI results showed no significant difference between the root canal sealer groups. In the study, the best biocompatibility results in MTT, qRT-PCR, WB and OSI were in the AH Plus Bio group. Although Bioserra, the study's other bioceramic paste, was found to be biocompatible according to MTT and OSI measurements, it increased the expression of all genes in qRT-PCR except for TNF-α, and also increased LC3 protein levels in WB. Since periradicular tissues can be directly affected by the materials used in root canal treatment, the sealers with high biocompatibility are being developed. In vitro studies examining the biocompatibility of newly produced root canal sealers are guiding for clinical success.

Outcomes and prognostic factors of endodontically treated teeth filled with calcium silicate- or epoxy resin-based root canal sealers: A retrospective cohort study.

The objectives of this study were to compare the clinical outcomes of root canal treatment between calcium silicate-based sealer using the cold hydraulic condensation technique and epoxy resin-based sealer using warm vertical compaction and to identify the prognostic factors affecting the outcomes of both obturation techniques. Dental records and radiographs of the teeth that received root canal treatment with calcium silicate-based sealer using the cold hydraulic condensation technique or epoxy resin-based sealer using warm vertical compaction during 2015-2021 were selected using inclusion and exclusion criteria. The cases were matched between the two groups based on four factors: primary root canal treatment or retreatment, tooth type, periapical lesion and its size and extension of root canal filling. The success rates of root canal treatment between two sealers/obturation techniques were analysed. The incidence and resorption of extruded sealer were evaluated using the McNemar's test. Generalized estimated equations were used to evaluate any prognostic factors. The median recall period of this study was 15 months. A total of 234 teeth, comprising 117 cases in each sealer/obturation group, were included. No significant difference was found in the success rates between the calcium silicate-based sealer using the cold hydraulic condensation technique group (91.5%) and the epoxy resin-based sealer using the warm vertical compaction group (94.9%). The incidence of sealer extrusion for the calcium silicate-based sealer (27.6%) did not significantly differ from that of the epoxy resin-based sealer (36.2%), with both sealers typically demonstrating no resorption at recalls. No prognostic factors related to the success rate of either technique were detected. The study findings suggest no difference in the success rate between calcium silicate-based sealer and epoxy resin-based sealer. The study did not identify any prognostic factors that significantly influenced the outcomes of the endodontic treatments.

Root canal cleanliness and debris extrusion following retreatment of thermoplastic injection technique and bioceramic-based root canal sealer.

To evaluate the amount of apically extruded debris and to determine the remaining filling material on the root canal walls by microcomputed tomography (micro-CT), following the root canal retreatment of root canals filled with different obturation techniques (single cone technique, thermoplasticised injection technique) and the different root canal sealers [bioceramic-based, epoxy resin-based root canal sealer]. 60 single rooted human premolar teeth were prepared with the ProTaper Gold system (Dentsply Maillefer) up to the F4 file and the samples were divided into 4 groups according to obturation procedures: Single cone technique + AH Plus sealer(epoxy resin-based root canal sealer, Dentsply International Inc., York, PA, USA); Single cone technique + Sure-Seal Root(bioceramic-based root canal sealer, Sure Dent Corporation, Gyeonggi-do, South Korea); thermoplastic injection technique[Calamus Dual Obturation System(Dentsply-Tulsa Dental, Tulsa, OK, USA)] + AH Plus(Dentsply International Inc.); Sure-Seal Root(Sure Dent Corporation) + Calamus Dual Obturation System (Dentsply-Tulsa Dental). The teeth were inserted into preweighed Eppendorf tubes and retreatment was performed. The tubes were kept in an incubator at 37°C for 14days to obtain the dry debris weight. Following the removal of the root canal fillings, the samples were scanned with a micro-CT device to analyse the volume of filling residues. Retreatment of samples obturated with epoxy-resin or bioceramic based root sealers combined with Calamus system resulted in higher amount of apical extrusion compared to their combination with single cone technique (p = 0.026 for Single cone technique + AH Plus sealer vs Calamus + AH Plus sealer and p = 0.005 for Single cone technique + Sure-Seal root sealer vs Calamus + Sure-Seal root sealer). The most debris was observed in the Calamus + Sure-Seal root sealer group, the least debris was observed in the Single cone technique + AH Plus sealer group. The percentage of residues was the highest in the Single cone technique + Sure-Seal root sealer and the lowest in the Calamus + AH Plus sealer group, but there were no significant differences between groups (p = 0.463). No correlation was observed among the groups in terms of extruded debris and remnants inside the root canal. When combined with bioceramic based sealer, thermoplasticised injection technique did not affect the cleanliness of root canal walls; however, it increased its apical extrusion potential during retreatment. The obturation method does not play a role in the removability of bioceramic based root canal sealer, however the use of bioceramic-based root canal sealers with cold obturation techniques may be beneficial in preventing apical extrusion.

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.

A Laboratory Comparative Study of the Cytotoxic Effect of Bioceramic and Resin Based Root Canal Sealers

A Laboratory Comparative Study of the Cytotoxic Effect of Bioceramic and Resin Based Root Canal Sealers

Canal disinfection using photo-chemically activated micro-bubble emulsion, Emblica officinalis, and Nd: YAP laser on smear layer and push-out bond strength of resin-based root canal sealer to the radicular dentin

AimsEvaluation of the effects of the latest root canal disinfectants i.e., Micro-bubble emulsion (MBE), Neodymium-doped yttrium aluminum perovskite (Nd: YAP), Emblica officinalis (E. officinalis) on the removal of smear layer (SL) and push out bond strength (PBS) of resin-based root canal sealer to the radicular dentin. MethodsThe coronal portion of sixty single-rooted human mandibular premolar teeth was precisely sectioned at the cementoenamel junction. The canals were prepared to utilize ProTaper universal rotary files till F3. All the study specimens were divided into four groups based on the disinfection regime (n = 15) Group 1: 5.25% NaOCl, Group 2: MBE, Group 3: Nd: YAP laser and Group 4: E. officinalis extract. All the canals were then finally irrigated using 17% EDTA solution as a final disinfecting agent. SL removal assessment was performed on five samples from each group using a scanning electron microscope (SEM). Ten samples from each group were then filled with root canal filling material and the roots were sectioned. Push-out test and failure mode analysis were performed using the universal testing machine (UTM) and stereomicroscope respectively. The mean scores of PBS and SL removal were compared using a one-way analysis of variance (ANOVA) and Post Hoc Tukey's HSD test p = 0.05. ResultsGroup-2 (MBE + EDTA) coronal section (1.50 ± 0.23) exhibited the most effective eradication of SL from the canal space. The apical third of Group-1 (NaOCl+EDTA) (2.68 ± 0.82) samples demonstrated the least effective removal of SL from the radicular canal. The maximum score of PBS of AH plus sealer to the canal dentin was exhibited by the coronal section of Group-2 (MBE + EDTA) (9.55 ± 0.45 MPa) samples. However, the apical third of Group-1 (NaOCl+ EDTA) specimens (5.16 ± 0.32 MPa) demonstrated the minimum EBS. ConclusionMBE+ EDTA displayed better smear layer removal and bond integrity of AH plus sealer to the root canal dentin. Nd: YAP+ EDTA laser and E.officinalis displayed comparable outcomes to that of control NaOCl+ EDTA

Physicochemical properties of AH plus bioceramic sealer, Bio-C Sealer, and ADseal root canal sealer

BackgroundThe aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer).MethodsSolubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer.ResultsThe least film thickness, highest alkalinity, and highest calcium ion release were all displayed by AH Plus Bioceramic Sealer. High solubility, high alkalinity, intermediate calcium ion release, and intermediate film thickness were all displayed by Bio-C Sealer. While ADseal root canal sealer displayed the greatest film thickness, least solubility, alkalinity, and calcium ion release.ConclusionsBoth AH Plus Bioceramic Sealer and Bio-C Sealer represented adequate properties to be considered a good sealer that could be used as a potential alternative to resin-based root canal sealers.

Influence of minimally invasive cavities on color stability of dental crowns with different filling sealers.

The minimally invasive endodontic access is not directly associated with tooth discoloration in the presence of bioceramic or epoxy resin-based root canal sealers. This study aimed to evaluate the influence of minimally invasive access and endodontic sealer composition on the color stability of endodontically-treated teeth, the restorative material adaptation, and the presence of remaining filling material in the pulp chamber. Endodontic access surgery was performed in maxillary central incisors, either through conservative or minimally invasive approaches, and the root was filled with AH Plus or Bio-C Sealer. The crown color was measured with a spectrophotometer at baseline and after root obturation, restoration, and specimen storage for one year in an oven. The occurrence of voids in the restoration and the remaining filling material was analyzed using micro-CT scans. The Yellowness Index (YI) and color changes (∆E00) were calculated after each color measurement. Data of micro-CT were submitted to 2-way ANOVA, and YI and ∆E00 were analyzed with repeated-measures ANOVA. Pair-wise comparisons were performed with Tukey's test (α = 0.05). The experimental conditions had no effect on the presence of the remaining material. The minimally invasive access associated with Bio-C Sealer resulted in more voids between the restoration and the remaining filling material. Only the evaluation time affected YI and ∆E00 values. Specimens became more yellow after filling and storage in the oven (the highest ∆E00 values). The present study showed that sealer and minimally invasive cavities are not associated with crown color stability following endodontic treatment.

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.

Comparison of the Physical Properties of Three Resin-Based Root Canal Sealers: An In-Vitro Study.

Objectives: This in-vitro study aimed to evaluate the physical properties of three resin-based root canal sealers, including BETA-RCS, AH26, and Adseal. Materials and Methods: Flowability, film-thickness, solubility, and radiopacity of BETA-RCS, AH26, and Adseal sealers were evaluated according to ISO 6876/2012 specifications. Three samples of each sealer were used to test each of the properties. Results: The results revealed that the flow rate (mm) of BETA-RCS, Adseal, and AH26 were 23.06±1.58, 22.5±4.23, and 21.85±1.71, respectively. Film-thickness values (µm) for BETA-RCS, Adseal, and AH26 sealers were 52.33±2.51, 18.66±0.57, and 52±2, respectively. No significant difference was observed regarding film-thickness between AH26 and BETA-RCS (P>0.05), while Adseal showed significantly lower film-thickness (P˂0.05). The highest and lowest solubility were related to BETA-RCS and Adseal, respectively. However, all sealers had acceptable solubility and radiopacity. Conclusion: The findings of the current study suggested that all three root canal sealers including BETA-RCS, AH26, and Adseal had similar properties based on ISO 6876 standard criteria. As such, they could be viable choices for facilitating effective root canal procedures. Further long-term clinical studies are warranted to assess their performance and success rates in actual endodontic cases.

Endodontic retreatment of mandibular molars with the presence of missed middle mesial root canals: An important clinical lesion

Aim: Untreated root canals may have a direct impact on root canal treatment (RCT) outcome. The aim of this case report is to describe the nonsurgical root canal retreatment of two mandibular first molars in a patient's mesial roots that had previously missed middle mesial root canals (MMC). Methodology: A 14-year-old female was referred to the our clinic with the complaint of pain in the posterior areas of the right and left mandibula. During the examination, previous RCTs [teeth 36 (mandibular left first molar) and 46 (mandibular right first molar)] were observed. Besides, these teeth have periradicular lesions in the mesial roots probably due to unsuccessful previous treatment. Nonsurgical retreatment was suggested and accepted. Access cavities were prepared and the unnoticed MMCs were detected at the isthmus connecting both mesiobuccal and mesiolingual canals. All the root canals were shaped with NiTi rotary endodontic files. During the shaping, the root canals were irrigated copiously with NaOCl, EDTA, clorhexidine, and saline solutions under a certain protocol. Calcium hydroxide was used for intracanal dressing. Gutta-percha and a resin-based root canal sealer were used for filling. Coronal restorations of the teeth were completed with a composite resin. Conclusion: At follow-up examinations after 3-, 6-, and 12-months, the teeth were asymptomatic and radiographically showed repair of the lesion. Healing was achieved without any need for further endodontic surgical intervention. How to cite this article: Başoğlu A, Harorlı H, Er K. Endodontic retreatment of mandibular molars with the presence of missed middle mesial root canals: an important clinical lesion. Int Dent Res 2023;13(2):99-103. https://doi.org/10.5577/idr.2023.vol13.no2.8 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Evaluation of The Accuracy of Two Apex Locators For Determining The Working Length of Endodontically Retreated Curved Mesial Roots of Maxillary Molar Teeth : An Ex Vivo Study

Objective: To evaluate the accuracy of PROPEX PİXİ (Dentsply Sirona, Ballaigues, Switzerland) and Apex ID (Sybron Endo, Orange, CA, USA) in determining the working lengths of curved mesial roots of upper molars during the retreatment procedure. Method: Twenty curved mesial roots of upper molar teeth were selected. Canals were shaped with ProTaper Next instruments (Dentsply Sirona) up to X3. The canal lengths were determined with a microscope (Carl Zeiss GmbH, Oberkochen, Germany) at 2,5X magnification (DM) and then also detected electronically (EM1P and EM1A) with PROPEX PİXİ (Dentsply Sirona) and Apex ID (Sybron Endo) in an alginate model. Specimens were then obturated using a size X3 master gutta-percha cone and an epoxy resin-based root canal sealer. Seven days later, the coronal part of the filling was removed with a Gates Glidden drill size 3 and for the middle part Protaper Universal Retreatment File D2 used. Working lengths electronically were detected again by two different apex locaters (EM2P and EM2A). Data were analysed by using the Wilcoxon Signed Rank and Mann Whitney u test. The analyses were carried out with MedCalc Statistical Software. Results: No significant difference was found between direct measurements (DM) and electronic measurements before and during retreatment for PROPEX PİXİ (P=0.135) and Apex ID (P=0.232). Also there was no significant difference between two apex locaters before (P=0.108) and during retreatment (P=0.242) Conclusion: PROPEX PİXİ and Apex ID were considered accurate for the root canal length determination during retreatment procedure. Keywords: Apex locator, curved molar, retreatment, working lenght

Effect of Carbodiimide (EDC) on the Bond Strength Longevity of Epoxy Resin-based Endodontic Sealer to Root Dentin: An In-Vitro Study.

EDC (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride) can increase dentin bonding longevity. This study aimed to evaluate the effect of final irrigation of the root canal with EDC on the bond strength (BS) longevity of an epoxy resin-based root-canal sealer. Twenty maxillary canines were sectioned and standardized for root length at 17 mm. Roots were instrumented and distributed into 2 groups according to the final irrigation protocol: EDTA 17%+NaOCl 2.5% (C) and EDTA 17%+NaOCl 2.5%+EDC 0.5M (EDC). The canals were dried and filled with AH Plus (Dentsply Sirona). Three slices were obtained per third, and the first slice from each third was used for the immediate push-out test (i) followed by analysis of the failure pattern (n = 10); the second slice from each third was used for the push-out test after 6-month aging (A) followed by analysis of the failure pattern (n = 10); the third slice from each third was used to examine the adhesive interface under confocal laser scanning microscopy (CLSM) (n = 10). Data were analyzed with ANOVA, Fisher's exact and Kruskal-Wallis tests. Higher BSs were found for EDC-A (5.6 ± 1.9) than for EDC-I (3.3 ± 0.7), C-i (2.5 ± 1.0) and C-i (2.6 ± 1.0) (p = 0.0001), while C-A values were in some cases similar to C-i and in others similar to EDC-i. No statistically significant difference was observed between the thirds (p > 0.05), except for EDC-i, which showed lower BS for the cervical (2.79 ± 0.46) compared to the apical third (3.8 ± 0.5), while the middle third in some cases had values similar to those of the apical and in others to the cervical third (3.2 ± 0.7) (p = 0.032). More mixed adhesive failures were found in the cervical third, and more adhesive failures to the sealer occurred in the middle and apical thirds (p = 0.014). A significant difference was observed between treatments in terms of adaptation of the adhesive interface, with a higher percentage of good adaptation using EDC (66.7%) than using C (40%), and a lower percentage of poor adaptation with EDC (10%) compared to C (20%) (p < 0.05). Root canal irrigation with EDC increased the longevity of the adhesive interface of an epoxy resin-based root-canal sealer.

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.

Evaluation of dislocation resistance of three different resin-based root canal sealers from radicular dentin -An ‘in vitro’ study.

&#x0D; Aim: The aim of this study is to evaluate the dislocation resistance of three different resin-based root canal sealers from radicular dentin -An ‘in vitro’ study.&#x0D; Methodology: Sixty extracted human maxillary canines were sectioned transversally below the cement-enamel junction to obtain 2-mm-thick dentin disks that were randomly divided into three groups (n = 20) for treatment with one of three different root-canal sealers (AH Plus [Dentsply DeTroy, Germany], Bioseal (Equinox Holland), EndoREZ [Ultra dent]). Standardized cavities were prepared to simulate root canals, cavities were filled with sealer material, and push-out bond-strength testing was performed using a universal testing machine.&#x0D; Result: In the present study amongst all the three sealers tested viz AH Plus, EndoREZ &amp; Bioseal. EndoREZ (Group III) goes most superior (14.97 ± 3.17 MPa), followed by AH Plus (Group II) (13.29 ± 2.27 MPa) &amp; the least bond strength was seen with Bioseal (Group I) (4.83 ± 1.62 MPa).&#x0D; There was a gradual decrease in bond strength from a coronal third of radicular dentin to the middle third followed by an apical third in all three groups.&#x0D; Conclusion: Amongst all the three-sealer tested EndoREZ® gave the maximum bond strength, followed by AH Plus® &amp; then Bioseal. Bioseal gave the least bond strength irrespective of the area in radicular dentin. There was a gradual decrease in bond strength from the coronal third of radicular dentin to the middle third followed by an apical third in all three groups.

Efficacy of Reciprocating Instruments in Retreatment of Bioactive and Resin-Based Root Canal Sealers.

To compare the effectiveness of reciprocating instruments in removing gutta-percha and bioactive-based (BioRoot RCS and MTA Fillapex) and epoxy resin-based (AH Plus) sealers from root canals based on filling residues and the time required for root canal revision. Root canals of 90 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and with one of the selected sealers. Samples with oval, straight canals were used and randomly divided into three groups: (i) filled with AH Plus sealer and gutta-percha (n=30); (ii) filled with MTA Fillapex and gutta-percha (n=30); (iii) filled with BioRoot RCS and gutta-percha (n=30). Each group was divided into two subgroups (n=15) according to the retreatment instrument used (Reciproc M-Wire R25/R40 or Reciproc blue RB25/RB40). Root canals were longitudinally split and analyzed with a stereomicroscope at 15 × magnifications in the coronal, middle, and apical third. Computational analyses were performed with the Image J software. Data were compared using the Kruskal-Wallis test and Mann-Whitney U test. While no statistically significant differences in the residual material surface were found for Reciproc Blue, Reciproc M-Wire showed significantly higher residual material surface for AH Plus and MTA Fillapex compared to BioRoot RCS. For AH plus. Residual material surface was significantly lower for Reciproc Blue than for Reciproc M-Wire. In contrast, BioRoot RCS showed a significantly higher residual material surface for Reciproc Blue. Calcium silicate-containing sealers were more retrievable compared to AH Plus, with fewer sealer remnants and shorter retreatment time. Retreatment with Reciproc M-Wire instruments was superior to Reciproc blue instruments in retreatment of BioRoot RCS. However, none of the sealers were removed completely.

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.